‘It’s Because You’re Fat’ — And Other Lies My Doctors Told Me
Martina Donkers

I appreciate the difficulties that you went through in getting your knee pain resolved. I know it took sometime to get a doctor to correctly diagnose my mom’s cancer as something other than complications due to a lifetime of smoking. So I can understand your issues with getting the right diagnosis and treatment due to the bias your history triggers.

I’m a little concerned, however, with the implication your article makes that ALL health care providers are going to be biased against patients because of their weight and refuse to take a holistic look at patient history. The standard of care for any Doctor/PA/NP is to do a complete history, regardless of what is already in the chart, and take all risk factors into account. The idea of a provider who decides the diagnosis as soon as your walk into the room is the exception, not the rule.

I understand that being overweight, by itself, is not a detrimental disease. Our bodies are more than likely built to accommodate a wider range of weight beyond the “normal” range. But obesity IS an issue. It IS linked to higher morbidity. You do a dis-service to your readership when you link to a meta-study, saying that “overweight people actually have lower rates of all-cause mortality than normal weight people”, but fail to mention that the results of the study indication that grade 2 and 3 obesity is linked to SIGNIFICANTLY higher all-cause mortality rates. That’s a caveat that’s important to mention if you’re not making it clear that you only mean BMI of 25–30 when you use the descriptor “overweight”.

You also downplay the relationship between obesity and disease. For example, we know that being obese doesn’t cause diabetes, there is a clear causal link between poor diet/lack of exercise and Type 2 diabetes. That tends to lead to a very high correlation between obesity and diabetes. Treating the obesity can often negate the diabetes. These correlations also exist for heart disease and other similar issues.

I understand the point you were making. Some providers place too high a premium on patient weight when developing their diagnoses and treatment plans. And I agree that one should seek additional medical opinions when wight alone (especially for people in the 25–30 BMI range) doesn’t seem like a reasonable cause. But your article goes a long way toward making the case that weight is a total red herring. And I think that is a bit irresponsible.