Today’s springboard is this article about the fate of fat people in the medical system.

Unsurprisingly (sadly), the news is not good. There are now studies proving that fat people get less encouragement and empathy from doctors, and this may well lead to worse medical outcomes.

Like the article says, it is not (usually) that the doctors treat fat people like myself badly so much as they are just less nice to us.

This makes sense to me. Doctors are trained to deal with every patient no matter what, and their sense of professionalism (as well as fear of losing their license due to malpractice or discrimination) would not allow them to be openly hostile or give inadequate care.

But just like it was easy, as a child, I found it easy to tell which students the teachers liked dealing with and which they did not even though technically they treated us all the same, I can see doctors being cold and distant with fat people in a way they are not with thin people.

And (just to get this out of the way) I can see why an experienced doctor might well learn to shut off their empathy when it comes to dealing with obese people like myself. There are only so many times you can watch a patient placidly ignore your advice and drive themselves slowly but majestically into the brick wall of obesity related illness before a sensitive and empathic person might well decide that they are not going to emotionally invest in people who are so clearly doomed and so (seemingly) unwilling to do anything about their downward trajectory.

Obviously, we now know that obesity is far more complicated than mere unwillingness to change and that it functions a lot more like an addiction than a mere bad habit.

But still, it must be disheartening for a doctor to see a patient dying by degrees right before their eyes and not be able to do a damned thing about it.

That does not excuse treating us poorly or even coldly. I am just saying I understand.

That said, there is, of course, a much simpler explanation for their lack of empathy towards the obese.

We disgust them, and disgust destroy empathy. Nothing short-circuits our sense of empathy faster than disgust. That’s why propagandists (and other bigots) always assign disgusting characteristics to the group they want you to hate.

They are dirty, they stink, they breed rapidly (like rats), they have disgusting cultural habits. Any and all things that make the enemy, whoever it is, disgust people, and hence cause us to dehumanize them.

So the disgust people have for fat people causes them to stop caring about it. To withhold empathy. And part of that, possibly the vast majority of it, is our cultural bias.

Like the article says, people see a fat person and they think they already know a lot about us. What we eat, what we smell like, what our moral character is, how lazy we are, and so on.

But I also think that obesity is inherently ugly. There is no way around that. We are bloated and distorted beings because of our addiction, and this is inherently offensive to the human sense of beauty which judges things like proportion, health, and symmetry.

Again, this does not justify mistreating us. But it behooves us to understand the nature of the problem.

Like the author of the article, I have not experience outright abuse from any doctor, but I have noticed a distinct emotional chill coming from the three GPs I have had.

The worst was my first, Doctor Robinson. After a while as his patient, every visit, he would be more irritable, impatient, and dismissive. He made it clear with his tone and attitude that he wanted to be rid of me as quickly as possible, and as I have serious assertiveness issues, I pretty much just went along with it because I was still in a mode where I felt I deserved whatever I got.

In fact, I felt grateful to anyone who even paid attention to me at all, let alone did things to help me. I was a very sad and much more ill person back then.

Did this, as the article suggests, make me less likely to follow his recommendations? I think so, but not in a broad and easily defined way. I am the kind of person who does what the doctor says to the best of his ability. I am not so clueless as to totally ignore doctor’s advice when it does not suit me.

That does not give me magic abilities to defy my addiction, but it does mean that I always take my pilsl when I am supposed to do so, and I monitor my blood sugar and use insulin when necessary.

But I am very sensitive to emotional warmth, and being treated so dismissively definitely did not help with my depression, and in fact merely reinforced my negative self-image and the feeling that I was a disgusting and horrible thing that nobody wants around.

Someone who could only ever be a burden to others, and hence, should feel guilty for being alive.

Harsh stuff, I know. And that part of me is not dead. It is, at best, lightly frozen.

Luckily, my current GP, Doctor Kelvin Chao, is a much nicer, warmer person. He sometimes seems to be in a hurry, but that has more to do with the BC health system’s insistence on a rapid turnover rather than an in-depth system for GPs.

And I don’t really have a problem with that. Back on PEI, it could be six weeks between making an appointment with my family doctor, Doctor Saunders, and the appointment itself.

Here, sometimes I can even get an appointment the same day sometimes. It has never been more than a week.

And that still seems like a miracle to me.

Oh right, the point. I had one, just let me find it. Put it down here somewhere…

Here it is! Obesity and medicine. I am not surprised that we fat people get short shrift even from the people we should be able to trust the most.

And I have no doubt that this results in worse outcomes for it. It would not be the first time that an oppressed minority received substandard care due to medical bigotry.

Perhaps this will change in time. They keep telling us that obesity is an epidemic.

We will see how things roll when we become an oppressed majority.