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doctor-reacts-to-is-obesity-a-choice-debate

Doctor Reacts To “Is Obesity A Choice” Debate

we've reacted to the topic of vaccines on middle ground before but now it's time to react about the question of whether or not being fat is a choice it's going to be a worthwhile watch let's get started being fat or skinny is a choice this is a very polarizing question I think it's a false dichotomy I don't think you have to say it's one thing or another but their Community seems to say that it's not a choice so that's interesting being skinny or being fat um is about willpower who you choose to associate with what sort of things you choose to listen to who you choose to kind of have as your friends around you and support you all of those things are choices that you can make yeah and you could easily point it in the other direction and talk about the genetic components the importance of those who raised you and how they taught you to think about food the way that the frontal lobe developed when you were a child meaning that if you had higher exposure to fatty foods growing up or unhealthy Foods or Ultra processed foods you may have a pre reference for that it's not as simple as just this Choice even with the genetics that caus you to want to eat more the same solution is calories and calories out the calories and calories out thing is true but then there needs to be a little bit of nuance here and that Nuance is certain calories will lead you to metabolize Foods differently certain calories will lead you to want to consume more or less of a certain food and certain calories can be unhealthy for you for other reasons other than your weight this is why we're always against starvation diets or heavily restrictive diets on this channel because in many instances they actually create more problems like eating disorders disordered eating unhealthy habits Etc I was supposed to get blood tested probably when I was very very young and I never did and they had mentioned that it could have been because of my weight and how that connects with my thyroid and I never had like that leaning parent to be like go and get checked out go and do this like your weight is probably not your fault it was always like your weight is your fault so that's your issue that's an unhealthy mindset if I have a patient that has not been worked up for a thyroid condition for other reasons why someone may be carrying excess weight we absolutely would check those things if you have low thyroid hormone we can give you thyroid hormone to boost those levels up I mean I also struggle with you know thyroid and my own blood issues I'm not quite sure but I do see an endocrinologist and I go see a doctor and that's not available to everyone in the United States especially those who don't have health insurance or are underinsured and some people are insured but don't have adequate Transportation or they don't have uh paid time off from work as a disabled woman I can't do a lot of the things that people say calories in calories out oh you got to go work out and exert it I have to navigate weight differently I have to look at it differently my weight is the way it is because of medication because doctors put me in this position this is why the false dichotomy pops up in my head if you're going to be very stringent and saying being overweight is a choice fullon you're neglecting a significant part of the population who may be having a side effect of a medication CU there's many medications that we could put patients on to protect their health that as a unwanted side effect they put on weight or they aren aable to lose weight as easily and then there's those with disabilities that can't burn calories as easily as some who are able-bodied so I think probably even a better conversation to be had here is is obesity a disease the AMA and all the major organizations have made it a disease process they've labeled it a disease the doctors who are saying that that's not helpful are usually pointing out that when a patient feels obesity disease they feel powerless to make the change the way that I like to think about it is on a population level it's certainly a disease because it affects our bodies negatively it's certainly contributing to a public health epidemic it's actually happing pandemic really across the world obesity on an individual level we need to have providers who have good relationships with their patients to make the call is this something something that I can present to my patient as a choice that will get them motivated or is this something that we can help them navigate through a medical perspective where we can give them medications surgeries maybe lifestyle modifications if they are going to be motivated to it and make that call on an individual level but again all medicine is practiced on populationbased information and the research that we have there and then we as providers have to look at our patients as individuals and apply that knowledge so I still think on a population level it is a disease and then how we attribute it to each patient and how we help each patient navigate their condition that's going to be different and that's okay I would rather be skinny than fat I think there's a lot of different struggles when it comes to being a bit bigger I have a sister she's 400 lb and she struggles a lot she has lymphadema and the to shower is really really hard so I do think for like an overall happy life and like zero struggle I think I'd rather be skinny I think what we're pointing out here is something that I frequently talk about this channel when people in the past have accused me of being fat phobic where I'm aiming to not just prolong my patients life and decrease their risk of disease but also improve their quality of life and that's exactly what she's talking about here being able to be independent being able to wash yourself have less strain on your knees on your hips developing arthritis early which means that you can't exercise or move up and down on stairs in your home and I think saying I would rather be skinny than fat doesn't mean necessarily that you hate yourself if you are in fact plus- siiz if you're seeking to improve because you're constantly unhappy with yourself that might be an unhealthy coping mechanism but if you're seeking to improve cuz you're seeking growth and you see it from a positive aspect rather than a hate aspect then that could be a very healthy mechanism I had the most body insecurities when I was small and rather than trying to control my body to avoid that negative attention I would prefer to address the situation as a society we aren't feeling like I have to be a certain way that's normal in order to be treated like a human being and respected one of the the big takeaways from her sentence there is that she talks about how we need to address this from a societal perspective that's absolutely true with the way our current Society is fed with the food products that are allowed in our system the ultr processed foods being more readily available and cheaper than true whole food healthy products food deserts areas where there's not enough access to good quality foods all of those things matter now the medical perspective has probably gotten more of a highlight with medications like OIC and The glp1 Agonist because that is more of a financial incentivized way of treating our obesity epidemic it's much better to create a medication that you can make billions of dollars on than it is to create a sustainable change in our society that will lead to people losing weight I don't think skinny always equates to being healthy I don't know where I'd want to lean at a appropriate weight level but I think it's important to understand for some skinny people we're not living a great life by any means and sometimes I feel like that's always kind of Lost in Translation when they see someone who's really skinny well I think that goes to show that no matter what a person looks like you can't know what they're going through this is why as a doctor you have to walk into a room with a blank slate and not judge people but at the same time be able to stereotype certain conditions in the sense of okay you're having symptom X Y and Z that frequently stereotypically happens in condition X so I'm going to try and rule out condition X so there is some stereotyping you're doing in order to come to a diagnosis but then you don't want to stereotype the person's Behavior or their appearance and it's very important to distinguish between positive stereotyping in healthcare and negative stereotyping in healthare both truly exist America has an obesity problem I think we have a problem with how to treat obesity I think we have a problem with how to make it so that it is not an epidemic this is a systemic thing that we are in a society and in an environment that breeds this and we are doing it to ourselves we are doing it to our children and our corporations and our Industries are doing it to us and they aren't having to take responsibility this is true the one thing that I have to point out is that this is a worldwide problem as we have more access to food and food is driving our happiness and we are becoming more disconnected and More Lonely we seek food for comfort and while companies certainly bear some share of the responsibility for making sure that they're not contributing to this problem which they absolutely are ultimately it's not as simple as saying hey company don't sell this product it's easier said than done to villainize a corporation and then say at the same time but it should be fair how do we make that fair that villainization and they're encouraging it with media and the mukbangs I was literally going to bring that up you the mukb and like all those videos that just come up to Trends not only the mukbangs but also like lizo and other big like media I don't think I agree with that uh because lizo has been an example of not that we're celebrating that she has excess weight we're celebrating the fact that she's not allowing people who are being negative to her about her weight and still succeeding so we're celebrating her success not the fact that she's potentially carrying excess weight she's dressing extremely scantily clad and then saying if you don't think that it's normal for a morbidly obese person to be wearing a g- string in the middle of public then you're the problem and they're trying to normalize Society to this obese culture which is extremely unhealthy you do need to normalize it to some degree and I'll explain why we're here we're not going back and there's a significant population in the United States that does fall under the umbrella of obesity you can't neglect that population you can't be destructive to them and say that anyone who is overweight should not be showing their bodies should be hiding themselves because they're not a good example Ro model that is ineffective and that is what fat shaming is so instead we need to celebrate people for who they are celebrate people for the actions they take if they serve as good Role Models celebrate those people as humans and respect them as humans and at the same time we can give them access to potentially lose weight to make other changes in their lives that have nothing to do with weight that can make them healthier but at the end of the day like you can't judge someone for choosing to wear a certain thing because you don't Vibe with one part of their health Journey again it's one part of their health Journey what is an obese culture a culture which like normalizes OB I haven't even heard that well obesity is already normal so it's I don't think it should be normalized the problem is when she says it shouldn't be normalized what you're doing is fat shaming you're telling people that they're abnormal no matter if you have good intentions with that statement because you want people to be healthier let's say that's not a valuable thing to say to the general public the way it needs to be done is with them coming to a conclusion of I need to be healthier I choose to be healthier and then Society the medical industry helping them reach their goals but to say that they're not normal you're not going to make positive change by doing that diet culture has positive effects diet culture is about turning the word diet from uh your your overall eating into um an activity that takes place over a period of time uh a diet it should not be something you do from January until May of next year yeah what you eat should be part of your lifestyle as opposed to like the activity you're doing right now I have to point out here the research that we have of carrying excess weight specifically excess fat shows that it it shortens life it increases risk of disease the disease is not just limited to our heart and our brains ffect all our organs our performance our quality of life our chances for Independence as we age even our fertility cancer risk all of those things so we absolutely need to approach this from a societal level a medical level all of the above it's not a one-sized fits-all answer and whether or not obesity is a choice is not as simple as saying yes and no it needs to be individualized to the person sitting in front of you and the strategies to help that person are going to be different than the strategies going to be help another person or the strategies that we discuss on a systemic level and I think all of those things need to be taken into consideration we shouldn't just seek systemic change and forget about the medical perspective we need to do both we shouldn't just focus on the populationbased changes and forget about the individual strategies we need to be able to do both that's why at the end of the day having a good long-term relationship with a primary care doctor will go a long way to improving Health outcomes and I think that's the biggest takeaway and the idea that the medical society is fraught with bias and all that is true and that carrying excess weight is still unhealthy is also true and we need to be able to accept both of those as realities and make change as we see fit let's watch a middle ground on vaccines and hear my thoughts on that click here check it out and as always stay healthy and happy happy and healthy but that both work

Dr.

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