Do you judge your overweight classmates?

[CidHighwind]

We all know how unhealthy it is to be overweight, and how it can even affect how residencies select you. Regardless of how you feel about the latter, I was wondering if people here personally judge their bigger classmates. I feel like it’s difficult to tell patients to exercise and eat healthy if you don’t as well.

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[Matthew9Thirtyfive]

I don’t have any overweight classmates. Maybe a couple on the slightly fluffy side, but we all have to meet height and weight standards. I try not to, but I do sometimes judge classmates who smoke though.

 

[odyssey2]

Overweight people get enough judgment, I wouldn't add to it by pretending it's bad for the profession.

 

[CidHighwind]

This question made me crack up a bit. I have a class mate who is very overweight. Routinely when we do case studies, one of the topics discussed is the role of diet and exercise and whenever the classmate speaks up I smirk a bit, not gonna lie. I certainly wouldn't say I hard judge my overweight classmates though.

I mean I do as well. I’m not talking about the ones that are just slightly bigger, I’m talking about the ones that just look fat. Some guy that played lineman in college but you can tell has some muscle is different than someone that just looks like they eat Cheetos and play Dota all day.

 

[Matthew9Thirtyfive]

I mean I do as well. I’m not talking about the ones that are just slightly bigger, I’m talking about the ones that just look fat. Some guy that played lineman in college but you can tell has some muscle is different than someone that just looks like they eat Cheetos and play Dota all day.

I mean they certainly don’t need you judging them. Same reason I try not to judge the smokers. Never know what they are going through or trying to get healthy.

 

[wholeheartedly]

actually, sometimes heavier patients have an easier time listening to advice from an overweight doctor because they feel like the doctor gets it.


after working in healthcare for years and years, I can honestly say, everyone has their vices. Some people eat too much, some people smoke, some people drink too much, some drive waaay to fast

 

[IsleyOfTheNorth]

I think the answer is that everyone does and some people admit it.

 

[CidHighwind]

I mean they certainly don’t need you judging them. Same reason I try not to judge the smokers. Never know what they are going through or trying to get healthy.

Agree. It’s just hard not to shoot them a judgemental look when we’re talking about healthy diets on rounds. IMO while it doesn’t necessarily make it better, I can understand a non-triad with the dad bod. I’m just smh at guys in their mid 20s looking twice their age because they don’t take care of themselves. Like you’re already studying all day wasting your youth, now you want to waste your prime being obese?

 

[Sephirakra]

We all know how unhealthy it is to be overweight, and how it can even affect how residencies select you. Regardless of how you feel about the latter, I was wondering if people here personally judge their bigger classmates. I feel like it’s difficult to tell patients to exercise and eat healthy if you don’t as well.

A problem with that attitude is that you don't actually know if that's the circumstance. I put on a good 20-25 pounds after college and it took a few years for me to take it back off because of a leg injury (I'd been a runner previously). I knew I had put on weight, I wanted to take it off. I didn't need someone else giving me crap about it, even silently. I get that it might be a natural assumption on your part, but you should endeavor to keep it in check.

 

[CherryRedDracul]

I think the answer is that everyone does and some people admit it.

I definitely judge but I don't say everything that's on my mind.

Right now, I'm a little overweight, and I am judging that.

 

[deleted962973]

Agree. It’s just hard not to shoot them a judgemental look when we’re talking about healthy diets on rounds. IMO while it doesn’t necessarily make it better, I can understand a non-triad with the dad bod. I’m just smh at guys in their mid 20s looking twice their age because they don’t take care of themselves. Like you’re already studying all day wasting your youth, now you want to waste your prime being obese?

But what good does your judgment do? It’s not going to make it any easier for your classmates to get in shape. Honestly as long as people aren’t pushing harmful ideologies like “healthy at all sizes”, I’m not going to get worked up over someone else’s body. Like others on here have said, you don’t know what your overweight classmates might be going through that caused them to put on that weight.

 

[Matthew9Thirtyfive]

I think the answer is that everyone does and some people admit it.

Or not.

 

[odyssey2]

I think the answer is that everyone does and some people admit it.

Finding someone personally unappealing due to their weight and appearance is different than judging them for it. You may not like how someone looks but that's different from saying they shouldn't be doctors or counsel patients on diet or exercise.

 

[delamj]

I don't judge them, as I don't really know all the things that are going on with their life. I've struggled with getting a handle on my own weight; I was well in the normal weight range the first year of med school then gained a bunch of weight studying for step. Finally starting to shave it off now that I have the bandwidth for it. I'm sure they themselves understand how weight impacts their health and performance, but I don't have enough energy to devote to judging them about it when I have my concerns to contend with.

 

[goldchallenge]

But what good does your judgment do? It’s not going to make it any easier for your classmates to get in shape. Honestly as long as people aren’t pushing harmful ideologies like “healthy at all sizes”, I’m not going to get worked up over someone else’s body. Like others on here have said, you don’t know what your overweight classmates might be going through that caused them to put on that weight.

My understanding is that HAES is a nonjudgmental and compassionate approach to finding ways for people to improve their health regardless of what their weight is... not sure how that's harmful. What's your take on HAES that makes you say that it's harmful?

 

[deleted962973]

My understanding is that HAES is a nonjudgmental and compassionate approach to finding ways for people to improve their health regardless of what their weight is... not sure how that's harmful. What's your take on HAES that makes you say that it's harmful?

That was the initial goal of the HAES movement, which I support. Unfortunately, at least some parts of it have turned into a pseudoscientific cult that rejects any claim that obesity might have a detrimental impact on health, and suggests that any doctor who encourages a patient to lose weight for health reasons is bigoted and unhelpful. The movement has derailed to the point that its activists shame people if they lose weight (I am so truly sorry for linking a Daily Mail article; it’s the first one I found).

Given that obesity is linked to cancer, heart disease, metabolic syndrome, etc etc, I find this to be pretty dangerous. It’s a backlash against the way overweight people have been treated for years, which is why I completely disagree with people like the OP who think fat people deserve even more judgement. But it’s now gotten to the point that people actively believe you aren’t causing harm to your body by being at a BMI of 45, and will get upset at you if you recommend lifestyle modifications.

 

[brocephalic]

A problem with that attitude is that you don't actually know if that's the circumstance. I put on a good 20-25 pounds after college and it took a few years for me to take it back off because of a leg injury (I'd been a runner previously). I knew I had put on weight, I wanted to take it off. I didn't need someone else giving me crap about it, even silently. I get that it might be a natural assumption on your part, but you should endeavor to keep it in check.

Are you saying we shouldn’t bring up the weight issues with our patients?

 

[goldchallenge]

That was the initial goal of the HAES movement, which I support. Unfortunately, at least some parts of it have turned into a pseudoscientific cult that rejects any claim that obesity might have a detrimental impact on health, and suggests that any doctor who encourages a patient to lose weight for health reasons is bigoted and unhelpful. The movement has derailed to the point that its activists shame people if they lose weight (I am so truly sorry for linking a Daily Mail article; it’s the first one I found).

Given that obesity is linked to cancer, heart disease, metabolic syndrome, etc etc, I find this to be pretty dangerous. It’s a backlash against the way overweight people have been treated for years, which is why I completely disagree with people like the OP who think fat people deserve even more judgement. But it’s now gotten to the point that people actively believe you aren’t causing harm to your body by being at a BMI of 45, and will get upset at you if you recommend lifestyle modifications.

Thanks for clarifying. I agree that shaming people for losing weight is an extreme that is actually contradictory to the underlying message of HAES. Although, there are some data out there that intentional weight loss can increase mortality... The idea that a high BMI on its own is harmful and having a lower BMI is always better is where things aren't as clear cut. Statistically speaking, yes, higher BMIs are correlated with increased risk of cancer, heart disease, etc. There are well established links there. But when I am looking at an individual patient, their BMI doesn't really tell me how healthy they are. Their cholesterol, BP, glucose, etc. could look amazing (maybe not likely at a BMI of 45, but not improbable), and unless there are other weight related issues going on (joint pain, sleep apnea, intertrigo, etc.), I don't know if I have enough evidence to say that the high BMI itself is harmful, and that weight loss is going to be beneficial.

 

[Epilepsy365]

TSH check asap

 

[deleted915325]

Oh man. No, I do not judge them and to be frank, you shouldn’t. There is a difference between caring about somebody’s health and judging them for it

 

[Sephirakra]

Are you saying we shouldn’t bring up the weight issues with our patients?

Not at all. It's important to discuss weight issues with those patients who need it, but it's not appropriate to judge them harshly about it. OP stated, "I feel like it’s difficult to tell patients to exercise and eat healthy if you don’t as well." What this neglects is any context. Let's say someone is 50 pounds overweight but they start exercising/eating better/etc. and they lose 10 pound. It may not show outwardly and they'll still be 40 pounds overweight. But to that patient, they're probably proud that they lost those 10. Looking down on them for being overweight in this situation would accomplish nothing. And as for OP's original post, judging your colleagues in a similar vein is just bad form.

 

[CidHighwind]

Thanks for clarifying. I agree that shaming people for losing weight is an extreme that is actually contradictory to the underlying message of HAES. Although, there are some data out there that intentional weight loss can increase mortality... The idea that a high BMI on its own is harmful and having a lower BMI is always better is where things aren't as clear cut. Statistically speaking, yes, higher BMIs are correlated with increased risk of cancer, heart disease, etc. There are well established links there. But when I am looking at an individual patient, their BMI doesn't really tell me how healthy they are. Their cholesterol, BP, glucose, etc. could look amazing (maybe not likely at a BMI of 45, but not improbable), and unless there are other weight related issues going on (joint pain, sleep apnea, intertrigo, etc.), I don't know if I have enough evidence to say that the high BMI itself is harmful, and that weight loss is going to be beneficial.

Unless they’re a bodybuilder or athlete it’s pretty legit. Although there are some skinny people that are unhealthy. There needs to be an easy and accurate way to measure bf% and we should just use that instead

 

[deleted480308]

I judge the bastards that reach over the chipotle partition to point at the toppings they want. Keep your gross hands on this side of the glass and I don’t care how fat you are.

That and close talkers, freakin’ step back. We don’t need to snuggle to talk

 

[CidHighwind]

I judge the bastards that reach over the chipotle partition to point at the toppings they want. Keep your gross hands on this side of the glass and I don’t care how fat you are.

That and close talkers, freakin’ step back. We don’t need to snuggle to talk

What about those people that are basically dry humping you in line. I’m like STEP BACK

 

[Angus Avagadro]

I have empathy for those medicating themselves with food. Often they have histories of abusive childhoods or traumatic episodes. Before weight loss can occur, we must understand their personal relationship with food and why they over eat. This is not a time for Physician Heal Thyself. Once the identifiers are found, then serious efforts at weightloss can be successful. Judgemental views offer little to help the situatuon

 

[ciestar]

You can be heavy and exercise. You can be skinny and sedentary.

I lost over 100lbs 13 years ago. Since Step dedicated two years ago, I stopped having time to go to the gym and I gained almost 40lbs. Even 10 years after losing weight, I have to really restrict my calories (plus exercise every day) to maintain. It's been a real struggle to obsess over my weight for the past 13 years. I was obese from around 9-15 years old, before I even had a concept of health and those 6 short years of obesity will impact my metabolism, self-image, and body for the rest of my life. Judge all you want, but I know you don't have the strength to push a 300lb body through the pain of running for miles and likely don't have the mental stamina. Med school is a cake walk compared to my weight journey. My recent gain pushed me to a bmi of around 29, but my body can do great things. I have several other classmates with similar journeys.

Importantly, eating disorders are rampant in med school. I have overweight classmates who struggled with long term bulimia. I have many many classmates who over exercise, purposely undereat, or binge and purge for fear of becoming overweight. Part of that fear is the societal beauty standards and part is trying to demonstrate the self-control and healthy image that physicians are supposed to have.

In the end, judge away, but keep your opinions to yourself. You don't know anyone's story.

Ive historically used food as reward/punishment. First year, i was living off like 500 calories a day and i lost 25 lbs (i was under 100 lbs at one point)

and now, my BMI is right about 25. And i HATE it.

 

[Alkaidius]

I judge them in only two situations: 1) I witness them actively trying to convince others to pursue their lifestyle, 2) On planes....

 

[ciestar]

I judge them in only two situations: 1) I witness them actively trying to convince others to pursue their lifestyle, 2) On planes....

2.Kids

 

[Dantrolene FC]

Unless they’re a bodybuilder or athlete it’s pretty legit. Although there are some skinny people that are unhealthy. There needs to be an easy and accurate way to measure bf% and we should just use that instead

There are scales you can step on barefoot that measure body fat. It’s ash easy as stepping on a regular scale, minus having to take your socks off.

 

[OnePunchBiopsy]

Coincidence this thread was started at the peak of bulking season.

We're accumulating mass OP

 

[Osminog]

I don’t mean to brag, but I’m a perfect person. I’ve never struggled with personal demons or made poor decisions that negatively impacted my life. That’s why I make sure to spend as much time as possible judging my classmates for their personal failings. When I think negative thoughts about my peers with nicotine addictions, alcohol problems, and unhealthy diet and exercise regimens, it makes me feel really good about myself.

 

[nimbus]

I judge the bastards that reach over the chipotle partition to point at the toppings they want. Keep your gross hands on this side of the glass and I don’t care how fat you are.

That and close talkers, freakin’ step back. We don’t need to snuggle to talk

The E. coli was already there.

 

[nimbus]

“Overweight” is relative and also depends on race. If you are Asian, you need to be a lower bmi to be considered a healthy weight. If you are black, you can be a slightly higher BMI and still be considered a healthy weight.

Ethnic Differences in BMI and Disease Risk

The chance of developing diabetes, heart disease, and other weight-related health risks increases with increasing body mass index (BMI). But theres strong evidence that at any given BMI, these heal…

www.hsph.harvard.edu

 

[Mass Effect]

A problem with that attitude is that you don't actually know if that's the circumstance. I put on a good 20-25 pounds after college and it took a few years for me to take it back off because of a leg injury (I'd been a runner previously). I knew I had put on weight, I wanted to take it off. I didn't need someone else giving me crap about it, even silently. I get that it might be a natural assumption on your part, but you should endeavor to keep it in check.

I have a family member who hasn't been to a doctor in 3 years, even when she was so sick with the flu that I begged her to go to the ED. The reason? Doctors make her feel like crap because of her weight (she is just over the obese mark). Even the ones who don't say anything, she knows are judging her. She's one of those people who says she's tried everything. While I know that isn't true, I'm giving this example to show that even when you don't voice your judgment, it comes across to others, including classmates.

 

[Matthew9Thirtyfive]

I have a family member who hasn't been to a doctor in 3 years, even when she was so sick with the flu that I begged her to go to the ED. The reason? Doctors make her feel like crap because of her weight (she is just over the obese mark). Even the ones who don't say anything, she knows are judging her. She's one of those people who says she's tried everything. While I know that isn't true, I'm giving this example to show that even when you don't voice your judgment, it comes across to others, including classmates.

Totally agree with you, but I also have personally witnessed patients freak out and say they are being judged or shamed simply because their doctor had the audacity to want to talk about their weight. I’m not saying this is your family member, but I’m willing to bet a non-trivial number of overweight people who say they feel judged by physicians for their weight are simply reacting emotionally to an appropriately voiced concern.

That said, all we can do is not judge them and try to encourage weight loss in a non-judgmental way that puts us on the same team. If a patient doesn’t want to hear it or loses their ****, at least we’ll know it’s their own personal ****.

 

[Mass Effect]

Totally agree with you, but I also have personally witnessed patients freak out and say they are being judged or shamed simply because their doctor had the audacity to want to talk about their weight. I’m not saying this is your family member, but I’m willing to bet a non-trivial number of overweight people who say they feel judged by physicians for their weight are simply reacting emotionally to an appropriately voiced concern.

That said, all we can do is not judge them and try to encourage weight loss in a non-judgmental way that puts us on the same team. If a patient doesn’t want to hear it or loses their ****, at least we’ll know it’s their own personal ****.

This is true and addressing weight -- whether overweight or underweight -- we should discuss it with our patients. But in this case, we're talking about classmates and my point was just that going by my relative's experience, even if you don't talk about it, people still know judgment when they see it.

 

[stickgirl390]

Medical students have time to worry about what other classmates look like??

 

[AMEHigh]

No I didn’t.
I’m fat, pretty much always have been.
Yet I played a D1 sport in college, still play sports, run marathons, etc.
I mean even if I didn’t do that, you don’t know people’s lives so I don’t judge.
There’s already enough judgement and disrcimination that fat people face.
At 5’3 I’m never going to be 135 pounds unless I literally starve myself (have tried that and yes it was like I had an eating disorder). My weight doesn’t affect me being a compassionate and intelligent doctor.

 

[IsleyOfTheNorth]

Honest question for those who said they wouldn't judge a colleague for being overweight: Would you judge a colleague that had a heroin addiction?

 

[IsleyOfTheNorth]

I’m fat, pretty much always have been.
At 5’3 I’m never going to be 135 pounds unless I literally starve myself (have tried that and yes it was like I had an eating disorder).

No disrespect intended, but that sounds like an excuse. If you ate nothing but steamed, low starch vegetables and egg whites you would be under 135 pounds and not starving (unless you count any weight loss as "starving").

 

[Matthew9Thirtyfive]

This is true and addressing weight -- whether overweight or underweight -- we should discuss it with our patients. But in this case, we're talking about classmates and my point was just that going by my relative's experience, even if you don't talk about it, people still know judgment when they see it.

Yeah I totally agree.

 

[odyssey2]

No disrespect intended, but that sounds like an excuse. If you ate nothing but steamed, low starch vegetables and egg whites you would be under 135 pounds and not starving (unless you count any weight loss as "starving").

If I ate nothing but steamed vegetables and egg whites I would be severely underweight since I would die from boredom.

 

[IsleyOfTheNorth]

I’m fat, pretty much always have been.
At 5’3 I’m never going to be 135 pounds unless I literally starve myself ...
My weight doesn’t affect me being a compassionate and intelligent doctor.

What if you had a patient who was going to die if they didn't lose weight? What would you tell them when they said they've tried everything? That some people just can't lose weight?

 

[IsleyOfTheNorth]

If I ate nothing but steamed vegetables and egg whites I would be severely underweight since I would die from boredom.

Er.... food isn't meant as entertainment.

 

[Matthew9Thirtyfive]

Honest question for those who said they wouldn't judge a colleague for being overweight: Would you judge a colleague that had a heroin addiction?

I had shipmate who was addicted to heroin and also a family member. While it may have been a stupid decision to start using it, it is a terrible, terrible drug. It really changes people and even if they want to get clean, the drug really just keeps pulling them back in.

 

[Matthew9Thirtyfive]

Er.... food isn't meant as entertainment.

I’m not a foodie, but there are definitely people who get a lot of satisfaction out of cooking and exploring fun things to do with food. And shockingly, you can still really enjoy food without being overweight.

 

[odyssey2]

Er.... food isn't meant as entertainment.

Eating healthy is great but food is one of the central pleasures in life. You can eat well and not have turn every meal into an ordeal.

 

[Osminog]

Medical students have time to worry about what other classmates look like??

Step 1 is pass/fail now. Judging random classmates’ eating habits is the new Zanki.

 

[IsleyOfTheNorth]

Eating healthy is great but food is one of the central pleasures in life. You can eat well and not have turn every meal into an ordeal.

Food can be healthy and tasty too; I don't disagree. However, it's dangerous to put food as a central pleasure.

 

[IsleyOfTheNorth]

I had shipmate who was addicted to heroin and also a family member. While it may have been a stupid decision to start using it, it is a terrible, terrible drug. It really changes people and even if they want to get clean, the drug really just keeps pulling them back in.

Did that affect your opinion of him/her? By calling it a stupid decision, it sounds like it did, at least a little.