The War On Fat

Nurses General Nursing

Published

To make a long story short I am a student and I write quite a bit about the experience of becoming a nurse.

So with that being said I have decided due to some recent developments that I am going to write about the cultural war on fat focused on nursing.

I am acquainted with a woman who is a critical care nurse. I have to tolerate her toxic presence in my life due to her association with my dude's friend. Now, I would like to mention I am no small girl and have gained and lost, and gained again 100lbs. I have finally gotten to the point where I am not beating myself up about it and see efforts now as a matter of love for my body rather than hate. Recently she said this (to me of all people), "I hate fat people so much. They smell, they are hard to move around, and I think they should all die in a hole somewhere."

A member of my clinical group said, "You know these doctors will get upset at the COPD patient who is smoking like three cigarettes a day but say nothing to these fatties who don't follow their diets." I stood up, looked very serious for a moment and said, "HEY! I am one of those fatties that don't follow their diet." Then we went a few rounds with her saying she wasn't talking about me because I am "an attractive fatty."

What does my face have to do with my extra 100lbs? Seriously?

In any case I'd like an open dialog about the war on fat in nursing.

Do you see it in your practice? Are you militant anti-fat? If so why?

I've noticed that a good deal of the arguments that I've heard is fat is unhealthy, yet no one seems to see fat as being a symptom and not the disease.

You guys do realize that research shows that weight loss is 1. Extremely difficult to do and 2. Nearly impossible to maintain (almost everyone gains the weight back). And it's not because people become "lazy" or go back to eating crap, when you lose a lot of weight your body changes so that you gain it back very easily. Basically, a former fat person can gain from eating far fewer calories than a person who has never had a weight problem. I think we need to start coming up with weight loss plans that actually work, instead of blaming individuals who try and fail. The research on weight loss is far from compelling and before we start blaming patients, maybe we should question our approach.

I'm truly amazed at the kind of moral assumptions people make about others just based on their weight. Being overweight doesn't make someone a bad person and I really think we should reserve judgement until we as a field have developed interventions and treatments that actually work, instead of blaming people for failing.

I'm of the belief that we need a paradigm shift and that current recommendations do not work because they don't address the real problem (ie: people focus way too much on calories and not enough on insulin and its control over fat tissue).

Here is a great article:

Why the Campaign to Stop America's Obesity Crisis Keeps Failing - The Daily Beast

Specializes in PDN; Burn; Phone triage.

Oh, gawd. Not this again.

Ya'all want to be treated poorly?

Try showing up with a significant, documented mental illness history and copious scars to all extremities. I've had over 300 stitches in an arm without any lidocaine whatsoever because I obviously "didn't need it" as a cutter.

Fat people complain. Crazy people complain.

Specializes in Emergency, Telemetry, Transplant.

These comments are totally inappropriate. A person can become obese for many reasons--both for reasons they can control and those they cannot control.

However, I also believe healthcare professionals need to be frank with their patients. Being obese can cause incredible negative health consequences and people need to know the risks of being overweight...in short, they ultimate consequence of being overweight is and earlier death than if they were at a healthy weight. Now, my body is certainly not perfect, but we cannot continue to sugar coat (no pun intended) the risks of being overweight. I agree that we should not be rude to people who are obese (we cannot refer to them as "fat" or call them "fatty"), but they need to know the ugly consequences of continuing to be dangerously overweight.

There are numerous threads on this topic. You may wish to research them, as the topic gets beaten to the ground around here.

If you pull up an old but interesting thread and comment on it there is always someone to say "why are you on this thread it's old!" But then you start your own thread and someone has to say there are other threads out there...who cares!?

Also, if a hospital doesn't want to hire me then screw them, nurses can go on and get there NP degrees and go into business with fellow docs, PA's, NP's, CRNA's, etc. Amazing thing about being a nurse is all the opportunity!

I am as anti-fat as I am anti-anorexia/bulimia, anti-smoking and anti-riding a donorcycle without a helmut, anti-unprotected sex, anti-failing to wash your hands, etc. I counsel all my patients that smoke, I counsel all my patients that have high BP, high cholesterol, and too high or too low BMI, etc. It is my professional responsibility to discuss the risks associated with unhealthy behaviors. I have probably lost patients over it. I don't care. They don't get tacit approval for ignoring risk factors just because they are embarrassed about it.

People need to separate the emotional component from the facts. As BMI increases over 25, risks go up. As pack years smoking history increases, risk increase. I have a cardiologist friend who will not treat smokers. You either quit, or find a new cardio. He sees them as just wasting his time. I think that's extreme, but I do get frustrated hearing "my knees hurt, gimme medicine" from people with BMIs over 35. "I smoke 2 packs a day and I'm SOB, gimme medicine, FIX IT!" It gets tiresome.

That is a whole world of different than what the OP was talking about. Education is one thing. Sentiments like the one below is another.

"I hate fat people so much. They smell, they are hard to move around, and I think they should all die in a hole somewhere."

Or:

"You know these doctors will get upset at the COPD patient who is smoking like three cigarettes a day but say nothing to these fatties who don't follow their diets."

It's quite easy to get a point across thoroughly, honestly, even bluntly, without name calling or employing and insulting, derogatory terminology.

Specializes in PDN; Burn; Phone triage.

Also, if a hospital doesn't want to hire me then screw them, nurses can go on and get there NP degrees and go into business with fellow docs, PA's, NP's, CRNA's, etc. Amazing thing about being a nurse is all the opportunity!

This is satire, right?

A new grad NP job is harder to find than a new grad BSN RN job.

You guys do realize that research shows that weight loss is 1. Extremely difficult to do and 2. Nearly impossible to maintain (almost everyone gains the weight back). And it's not because people become "lazy" or go back to eating crap, when you lose a lot of weight your body changes so that you gain it back very easily. Basically, a former fat person can gain from eating far fewer calories than a person who has never had a weight problem. I think we need to start coming up with weight loss plans that actually work, instead of blaming individuals who try and fail. The research on weight loss is far from compelling and before we start blaming patients, maybe we should question our approach.

I'm truly amazed at the kind of moral assumptions people make about others just based on their weight. Being overweight doesn't make someone a bad person and I really think we should reserve judgement until we as a field have developed interventions and treatments that actually work, instead of blaming people for failing.

I'm of the belief that we need a paradigm shift and that current recommendations do not work because they don't address the real problem (ie: people focus way too much on calories and not enough on insulin and its control over fat tissue).

Here is a great article:

Why the Campaign to Stop America's Obesity Crisis Keeps Failing - The Daily Beast

What type of overweight are people talking about though? Is the girl who is 5'7 and weighs 165-170lbs or the one who weighs 220? I do feel that being a little overweight has become acceptable in our society however being 'fat' or 'obese' is not.

I also don't think everyone is meant to be thin, and the older you get, the less appealing it looks. Sometimes it makes older people's face look more gaunt. I think some extra weight can make a person's face look more youthful and healthy

You asked for open dialogue, and I believe that you just received it. If you choose to argue about someone's belief, then you may stifle the open dialogue. It is never right to call people names like fatty, etc.

Just because something isn't right doesn't mean that it doesn't happen. I am of the opinion that by confronting things that aren't right rather than shying away from them we as a people might actually be able to make a change. I wasn't being combative at all and rather was stating that health (as we are taught) is multifaceted.

As a fat woman I have two options concerning the word fat - I can either feel shame and self loathing, or I can accept it as a part of who I am, neither positive or negative and go from there.

Let's be honest here - shame doesn't work. Shame has never, ever, worked.

When we correct pts on their smoking, their drinking, lack of exercise, caffeine intake, even tactfully, it all is going to hurt their feelings. Being told that one is doing wrong hurts their feelings. But to not address it hurts their body.

Being on the other side of the spectrum I can tell you from experience that a patient can see disgust on the face of their nurse. That attitude cannot be stifled so again I ask - who does it serve?

Often as nurses we must hurt pts to help them. And quite bluntly, it is quite wastful to keep paying for knee replacements, bypasses, disability for backpain, on a morbidly obese pt that refuses to adhere to a diet. Why should HCW work ever harder to care for someone who does nothing to help themselves? or who insists on overeating despite the harm that it is causing them.

It is also wasteful for older patients to use resources in general. We prolong the moment of death in many cases, not the actual event. Should we then just toss all people over the age of say 75 into a hole as well? I mean it takes effort to care for them, and it's hard work.

Many of us have have medical issues that make it difficult to lose weight. I frequently use high dose prednisone, for example. We also make excuses as to why we eat the way we do. I'm stressed, my work place hasn't got healthy food, I can't make the time to eat right, yada, yada.

But the fact remains, that human biology (metabolism) has not changed that much from a century ago, or for our fellow humans in nearby nations. We (in the first world) have incredible resources for food, and ease of obtaining much of what we need, yet, have incredible poor health, bad eating habits, and skyrocketing obesity rates.

No but our food has change dramatically. We have farmed things like CLA out of meat.

Recently, I went to NYC. I pretty much doubled or tripled my calorie intake. And yet I lost weight (despite prednisone). Why? I walked up stairs, downstairs, stood on the bus, the subway, ran to catch my ride and did alot of walking tours and was on the go.

That tells me something.

I walk 2.5 miles, 5 days a week with my dog. I eat a low carbohydrate/calorie restricted diet. I keep a strict food journal. I have been tested for just about every endocrine disorder under the sun. I have a physical every year. My total cholesterol is low, my HDLs are high, my LDL's are low.

Twice a month I eat an ice cream cone. It is my twice a month ice cream cone that makes me say I don't follow my diet.

Keep in mind, I am not arguing with you but rather seek to understand why this attitude is so prevalent in a profession built on empathy.

Specializes in Oncology/hematology.

Very hot topic. I am a nursing student who used to be a personal trainer. I tried to focus my business on helping the morbidly obese who were too embarrassed to go to the gym (I had a gym in my house that they would come to). Almost without fail, these clients would not follow my advice. They would come work out with me, then take home my recommendations on exercise and diet and do none of it. They were paying me to help them lose weight, but didn't want to do the work. I did have a few clients whose lives were changed, and I feel so lucky to have been able to help them, but it was frustrating to deal with the rest.

I have heard major complaints from my friends who are nurses because when a patient is morbidly obese, they are HEAVY! Nurses are throwing their backs out trying to help them, but I haven't heard any of this name calling.

I am not anti-fat. I am anti-unhealthy lifestyle. That includes over eating, smoking, not exercising, etc.... Our job as nurses is to work towards our patients health, and you can't be healthy if your weight can lead to diabetes, hypertension, etc....

There is never a place for name calling, but to think that a patients weight shouldn't matter is ridiculous. Yes, being overweight is a health risk. I guess the good news is that with America's weight increasing, we will all have job security.

To the OP, I'm sorry that you have had to hear these comments. Totally uncalled for.

I'm more interested in the moral judgements people make about someone's weight, especially a woman's. I find it pretty disturbing. Also, it's made all the more ridiculous by the fact that research in the field shows that current weight loss advice doesn't really work. But of course, we can just blame people for not losing weight and assume they're all just lazy non-compliars, right? Anyway, I'm of the belief that weight loss advice (eat less/exercise more, eat less fat, eat fewer animal products, eat more "healthy" grains and starches, etc.) doesn't work because it is bad advice. It's probably a conversation for another thread, but if anyone is interested, the Gary Taubes article I linked to in my previous post is a great place to start.

Specializes in Oncology/Haemetology/HIV.
If you pull up an old but interesting thread and comment on it there is always someone to say "why are you on this thread it's old!" But then you start your own thread and someone has to say there are other threads out there...who cares!?

Also, if a hospital doesn't want to hire me then screw them, nurses can go on and get there NP degrees and go into business with fellow docs, PA's, NP's, CRNA's, etc. Amazing thing about being a nurse is all the opportunity!

There is a difference in pulling something up 5 years or older with no more recent posts, and posting again on something that has a new fresh post every few days and strted less than 1 month ago.

This topic gets a new start practically every couple of of weeks with numerous posts on it. Much like the ADN vs BSN argument, it has been beaten up. And the data, and points brought up virtually never change, unlike such topics like changed in immigration rules, or pay rates or job availability.

The facility in Texas that is barring hiring those over a BMI of 35, has the requirement for all employees, I believe, not just nurses. Much like facilities that bar employees of all types from smoking. Getting one's NP does not alter the requirement. And if you review the data, I believe that you will find that smaller groups (clinics, offices) are less likely to hire high BMIers than hospital d/t bias in hiring.

I am definitely overweight, though not obese. I have had acquantances that do hiring for clinics. that stay away from the hire that is significantly overweight, d/t worries about too much sick time, insurance costs, worries about employee disability. they may not verbalize it to the candidate, but it is out there.

It is not right and it hurts my ability to get a job. But that does not mean I do not see the logic of it.

Specializes in Oncology/hematology.

It's not all bad advice. There is a way to eat and exercise that is not only good for weight loss, but also healthy.

You are correct though that there's a lot of fad stupidity out there that is just adding to the problem. Atkins, Southbeach, cleanses, and such. I blame these "quick fixes" more than anything else for what has happened to this country.

Sorry, I was trying to quote myelin, but it didn't work.

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