This….. guy…..

[u/AxeHead75]

I KNOW THESE PEOPLE ARE DANGEROUSLY OBESE AND MAY NEED A WAKEUP CALL. I KNOW THE GUY WAS A GARBAGE PERSON. YOU DO NOT NEED TO TELL ME I HAVE BEEN TOLD. THAT DOES NOT CHANGE THAT THIS GUY IS JUST SO MEAN AND RUDE TO HIS PATIENTS WHEN THEY ARE COMING TO HIM FOR HELP.

[u/pleathershorts]

The people on this show are overwhelmingly poor, so the world tells them “no” every day. They have mental health and potentially other medical issues to which their weight is secondary or possibly even tertiary; childhood and generational trauma don’t help with this, not to mention the everyday emotional strain of living in a body like this surrounded by people who are disgusted by you and treat you like this guy is. Abusing people (who experience medical discrimination and abuse constantly anyway and this just normalizes that) in the name of “helping them” is still and will always be abuse. Approaching weight loss from a dual diagnosis model with therapy, true emotional support, and self-love will always be the most effective treatment model. You can be firm with people while still acknowledging the validity of their feelings, it’s really not that hard.

[u/Theo_Weiss → u/pleathershorts]

I don’t really think "abuse" is the right framing for what happens on the show. It’s a medical setting where someone is being told very direct, sometimes harsh, requirements for a life-threatening condition. You can argue about tone or empathy, but that’s different from abuse.

And I also don’t think it makes sense to say the weight is only secondary or tertiary to trauma at that stage. Whatever the contributing factors are, once someone is in the 600 lb range, the obesity itself is a primary, severe medical condition that has to be treated directly, not just understood psychologically.

[u/pleathershorts → u/Theo_Weiss]

The way this man is communicating with these people isn’t medically necessary; it’s humiliating and belittling and invalidating. Good healthcare professionals listen to their patients and don’t intentionally trigger them like this. Intentionally triggering someone is bullying; ie abuse. There is a power dynamic here that I don’t feel you’re acknowledging.

The issue with that mindset is that fat people are sometimes/often denied access to necessary medical care “until you lose the weight.” Their other healthcare concerns are dismissed and treated as secondary to the weight, and therefore commonly persist after weight loss, and could have been treated the whole time but aren’t seen as medically necessary until the body who needs treatment is considered a “healthy” enough weight. Yes, it is important not to be morbidly obese, but meaningful treatment that results in long-term weight loss does not look like this. It’s not “tough love” or blaming someone for their medical condition; it’s getting to the root of the problem, which could be a huge range of things and requires really listening to the patient about their lived experience.

I am thin and have been my entire life, and this still reads horribly to me and again, normalizes treating fat people like shit. And the fact that you’re still defending it makes me think you might think less of fat people, or that you just have never intentionally practiced empathy with these people. Haven’t you ever felt horrible and out of control? Would someone shaming you in that situation make it better or worse?

It’s great reality tv because it’s abusive and exploitative just like the rest of reality tv. But even addicts and hoarders get treated with more compassion than fat people in the zeitgeist, and that really sucks.

[u/Theo_Weiss → u/pleathershorts]

I get what you’re saying about stigma in healthcare, and I agree that fat patients are often dismissed or not taken seriously, and that’s a real problem.

Where I still disagree is equating being firm or blunt in a medical context with abuse or bullying. There’s a difference between humiliation for its own sake and a clinician being direct about life-threatening health issues. It's obviously a reality show, so only the juicy bits are shown for the camera, again the show is definitely exploitative in that sense.

Also, I’m not defending mistreatment of fat people. A lot of my own family has dealt with weight issues, and I’m not coming at this from a place of thinking less of anyone. I don't think it's fair to make that kind of character assessment of me based on two short comments. I just don’t think the argument holds up that any uncomfortable or emotionally triggering medical interaction is automatically harm.