Reply to NYT: Is BMI a scam?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I have mixed feelings about this. I think all these things are true:

[b]1) Doctors rely too much on obesity being the be all end all health problem source of a fat person and this results in bad care[/b]

2) For people in the 'normal' BMI category it can mask health problems unrelated to weight because they believe they are healthy

3) For people who are 36 BMI (like I was!) it can be a useful to be a really be a sure sign that you need to do something about it and for me personally I used the 'BMI doesn't matter' to blow past a lot of numbers I should have cared about.

So like it isn't the be all and end all but I think it has its uses. [/quote]

It isn't so much that it results in bad care, but obesity IS just about the worst chronic health problem to have because it negatively affects nearly all of your other systems-over the long term.  It puts strain on your heart, lungs, joints, builds fatty deposits around organs so they don't function as well, disrupts hormones, circulation, and on and on.  Even something like a minor hemorrhoid is a lot harder to treat on an obese person.  But harder to treat I mean the treatments approved for use are just not as effective- or in some cases- not effective at all due to obesity. What may seem like "bad care" is often that people can't get the therapeutic results they want due to the obesity.  [/quote]

You are showing how true #1 up there is. I had a friend sent home from the ER twice with a saddleback pulmonary embolism because the ER thought her being winded was due to her obesity. She survived, and she's lucky AF to have survived, because she kept going back. Your examples are about people who got diagnosis but for whom the obesity hinders treatment, but the truth is that many obese patients don't get diagnoses because their discomforts are blamed entirely on their weight. Fat people are frequently disregarded by doctor's when they try to discuss medical problems and frequently told to just lose weight to fix it.

I am not saying that obesity is not a health problem in and of itself that people should address, it is, but fat people should also get the same rigorous standard of care that other people get. They shouldn't have cancers go undetected and autoimmune diseases untested for because all of their problems are blamed on their weight.

Two things can be true at the same time, obesity is a condition that exacerbates poor health outcomes and should be faced and doctors do not provide the same level of care on the population level to obese patients. 
[/quote]

I see your point, but medical resources are limited.  Obesity is the cause of lot of thing- such as shortness of breath.  So most Drs are going to rule out the most likely causes (obesity) first before doing rigorous testing.  It wouldn’t make sense to give every obese person who complains of shortness of breath a CT scan.  That is over treating and would bog up any system.  Drs always rule out common things and the most likely causes first.  So yes, a thin person with no health issues who shows up to ER with shortness of breath will get a more aggressive quicker.  But if it is a women, they will blame anxiety first.  But often times it is, so there is that.  [/quote]

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