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Doctors/Monsters: Make Fatties Lose Weight Before You Treat Them

Doctors have always had a problem with telling fat patients that all their problems are a result of their fatty-fat-fatness. But now, rather than being a problem of shitty doctors who can't overcome their personal biases even in the face of science and research that completely contradicts their stupid shitty opinion about fat people resulting in lower-quality health care for the people that they're convinced are the least healthy all the time, it's actually being published as the proper method of treating fat patients. Huzzah.

An article written by people unworthy of medical licenses in The Journal of Clinical Endocrinology & Metabolism introduces new guidelines for treating obese patients: don't.


The authors of the study, led by doctor/garbage person Caroline M. Apovian, suggest that as an alternative to treating fat people's conditions with things like evidence-based medicine and treatments that are already working, doctors should instead tell those fatties to put the fork down before they receive treatment, even if their treatment is already working for the condition, with or without evidence that their weight is causing the issue in the first place.

It's no secret that doctors treat fat patients less thoroughly, with less kindness and empathy, and that "weight loss products" are pretty much just a big old fat scam (I see what I did there) to fleece people, mostly women, out of money by making them unhappy about their bodies and offering them lies that cost a lot of money.

However, there's a lot of money to be made in treating things that are very difficult to treat with medicine that is very unlikely to treat that thing, so the human bile ducts that wrote this article are suggesting that instead of using that antidepressant that makes it possible to leave the house, or the insulin, sulfonylureas, or thiazolidinediones that keeps you from falling into a diabetic coma, or the beta blockers that keep your heart from stopping and making you dead, you should be taken off of those medications until you slim down, because fuck you fatty.

Instead, the authors/death merchants suggest that doctors place their patients on weight loss drugs like phentermine (you know, the "phen" in fen-phen, the drug that possibly could help you lose weight but also just might kill you instead) and lorcaserin (which has side effects including headaches and upper respiratory infection, is associated with the development of cancer in rats, and has hallucinogenic and addictive properties). Oh, and these drugs are rarely covered by insurance, which should be no problem, because fat people are usually rich, right?


And if you don't lose 5% of your body weight in the twelve weeks after switching to weight loss drugs, possibly because you're depressed because your doctor took you off your antidepressant and switched you to a weight loss drug because you're too fat to be treated for depression? The answer would seem to be to put you back on the drug that was treating your condition effectively in the first place, but since you're probably just depressed because you're too fat, you get switched to another weight-loss drug! After all, according to lead author/fatphobe Caroline M. Apovian:

"In the end, you're going to give the best guess of which drug the patient should go on….If the patient doesn't lose 5% of their weight in 12 weeks, stop the drug and try another.

"Unless you can really get a clear idea of what you think the patient is going to do best on, you're going to be prescribing by trial and error....This is the question I get asked the most often. Unfortunately, the research isn't there to help us beyond that."


Of course, these esteemed doctors/executioners/monsters are just looking out for our well-being, and are definitely not influenced by anything like money from Zafgen, MYOS Corporation, Eisai, Vivus, Orexigen, Takeda (which Apovian has a financial interest or leadership position with); Jamieson Laboratories, Pfizer, Healthcare Research Consulting Group, Marwood Group, Novo Nordisk A/S, Eisai, Rhythm, Johnson & Johnson, Ethicon Endo-Surgery, GI Dynamics, Zafgen, GLG Pharma, Vivus, MYOS Corporation, BMIQ (Louis J. Aronne, MD, FACP); EnteroMedics (Daniel H. Bessesen, MD); Vivus, Eisai, Jansenn, Novo Nordisk, Takeda, and Scientific Intake (Donna Ryan, MD). I'm sure that's just one of those cosmic coincidences.

The Hippocratic Oath doesn't actually contain the words "first do no harm", but it does contain the words "I will take care that [the sick] suffer no hurt or damage", along with "I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free", which carry some similar sentiments. These quacks are making those words especially laughable, because these new guidelines will do unthinkable harm to people who need medicine to treat their condition, not to be denied care because their doctor has determined, with or without evidence, that their weight and their weight alone is the cause of all their various maladies. It's malpractice, plain and simple, and none of them are fit for the profession.


The Hippocratic oath ends with, "If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!" Unfortunately, it seems the opposite is true.

Further reading:

Ragen Chastain at Dances With Fat has got an amazing takedown of this contemptible policy.


Joshua David can be found on Twitter at @joshuaadavidd.

Image via Shutterstock.

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