The meme isn’t about that, I’ve read stories of some doctors refusing to perform surguries to overweight people, but other doctors doing the surgery anyway.
The same way a lot of women get told stuff is just from their period by doctors.
I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.
And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.
This is what I came to say but wasn’t smart enough to put into words. There’s a lot more factors than just being overweight of why a surgery can’t be performed. For a while an issue at my hospital was we were one of the few in the area that could do MRIs on larger patients. So bigger hospitals would transfer these patients to us just for an MRI because their MRI machine was too small or couldn’t handle the weight.
There’s a reason you have to get a pre-op physical exam for any non-emergent surgery. Figuring out if you’ll wake up from the anesthesia at all is part of the calculus that determines whether the benefits of the procedure outweigh the risks.
Sometimes. It depends why the first surgeon would be unable to do the procedure. If the problem is that the patient might not wake up from anesthesia because of problems with heart disease, lung problems, or other metabolic issues, then it doesn’t really matter what the surgeon has to say about actually doing the procedure because the anesthesiologist is the one saying “no”. If it’s an issue of too much adipose, sometimes it would mean that the surgery would take longer than it’s safe for the patient to be under anesthesia.
Another possibility is that the first surgeon operates at a facility that doesn’t have access to more advanced technologies or other medical specialists in the event that something goes wrong. And there are some surgeons that are just more willing to accept the risk of a bad outcome, and I would argue that that’s rarely in the patient’s best interest. There are alternative options that the surgeon should discuss with the patient as part of the informed consent process, and sometimes, the alternatives to surgery are just safer than the risk of the surgery itself, even if they aren’t as effective or are a long term treatment (ongoing) as opposed to a definitive treatment (cure). If the patient has a high risk of serious complications, up to and including death, then attempting the curative procedure might be more risk than it’s worth compared to a long term medication that mitigates the disease.
You’ll see this with pregnant patients too. For elective procedures that have safer alternatives or temporizing measures (a holdover treatment until surgery is safe), those are generally preferred to putting a pregnant patient under anesthesia because of all the cardiovascular, immunologic, and other physiologic changes that happen during pregnancy alongside potential risks to the fetus.
The reason for that is that surgeons are rated based on their success percentages meaning they’ll recommend against risky surgeries.
The upside of this is that surgeons aren’t operating willy-nilly on people and will make a proper risk assessment. The downside is that overweight people have an inherently higher risk of complications from surgery, so some surgeons will pass.
It’s not because they think these people don’t need it, it’s because they think it’s too risky. They’re usually not wrong about that, you just need to find a surgeon willing to take the risk or, if possible, reduce the risk by losing weight.
There’s also no point to surgeries if the people aren’t committed and are just going to eat even more and put the weight back on. It’s like consolidating debt to make one payment easier but keeping all the credit cards and building up the debt again. It just makes you worse off
That depends on the surgery. Gastric bypass notoriously has weight requirements, but a gallbladder removal can still kill you if you’re too fat, and there definitely is a point to doing that even if the patient isn’t going to change their diet.
That’s why where I am from you usually need a clearance from a psychiatrist that there are no psychological issues in eating habits that would render that surgery useless, before the surgeon is allowed to do it
Look. Shitty doctors exist, but when 1/3 of the US is overweight, there are underlying issues that need addressing. I only hear horror stories when an addict, alcoholic, or overweight individual in my life is feeling insecure or defensive about a prognosis. Too many people deflect and it’s enabling a much larger issues. Our basic instincts are being exploited.
America’s obesity epidemic is a function of our car culture. This is the only country on God’s green Earth that feels putting in sidewalks is a moral failure.
You can’t really know it. I suspect it’s a combination of the two. If you drive everywhere and sit around the rest of the time, you can’t be healthy no matter your diet.
Unless you’ve magically discovered the source of energy and mass from nothing, and revolutionized our understanding of the natural world … no, it isn’t.
When talking about obese individuals, the fat very easily gets in the way of surgery. Compared to a healthy patient the risk of complications during surgery is much greater and really not worth chancing it (most if the time)
For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patient’s death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they weren’t healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didn’t spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.
I’ve worked in emergency medicine and I’ve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I haven’t even finished medical school.
The meme isn’t about that, I’ve read stories of some doctors refusing to perform surguries to overweight people, but other doctors doing the surgery anyway.
The same way a lot of women get told stuff is just from their period by doctors.
I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.
And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.
This is what I came to say but wasn’t smart enough to put into words. There’s a lot more factors than just being overweight of why a surgery can’t be performed. For a while an issue at my hospital was we were one of the few in the area that could do MRIs on larger patients. So bigger hospitals would transfer these patients to us just for an MRI because their MRI machine was too small or couldn’t handle the weight.
There’s a reason you have to get a pre-op physical exam for any non-emergent surgery. Figuring out if you’ll wake up from the anesthesia at all is part of the calculus that determines whether the benefits of the procedure outweigh the risks.
Would a surgeon unable to do it refer the patient to one who is capable?
Sometimes. It depends why the first surgeon would be unable to do the procedure. If the problem is that the patient might not wake up from anesthesia because of problems with heart disease, lung problems, or other metabolic issues, then it doesn’t really matter what the surgeon has to say about actually doing the procedure because the anesthesiologist is the one saying “no”. If it’s an issue of too much adipose, sometimes it would mean that the surgery would take longer than it’s safe for the patient to be under anesthesia.
Another possibility is that the first surgeon operates at a facility that doesn’t have access to more advanced technologies or other medical specialists in the event that something goes wrong. And there are some surgeons that are just more willing to accept the risk of a bad outcome, and I would argue that that’s rarely in the patient’s best interest. There are alternative options that the surgeon should discuss with the patient as part of the informed consent process, and sometimes, the alternatives to surgery are just safer than the risk of the surgery itself, even if they aren’t as effective or are a long term treatment (ongoing) as opposed to a definitive treatment (cure). If the patient has a high risk of serious complications, up to and including death, then attempting the curative procedure might be more risk than it’s worth compared to a long term medication that mitigates the disease.
You’ll see this with pregnant patients too. For elective procedures that have safer alternatives or temporizing measures (a holdover treatment until surgery is safe), those are generally preferred to putting a pregnant patient under anesthesia because of all the cardiovascular, immunologic, and other physiologic changes that happen during pregnancy alongside potential risks to the fetus.
The reason for that is that surgeons are rated based on their success percentages meaning they’ll recommend against risky surgeries.
The upside of this is that surgeons aren’t operating willy-nilly on people and will make a proper risk assessment. The downside is that overweight people have an inherently higher risk of complications from surgery, so some surgeons will pass.
It’s not because they think these people don’t need it, it’s because they think it’s too risky. They’re usually not wrong about that, you just need to find a surgeon willing to take the risk or, if possible, reduce the risk by losing weight.
There’s also no point to surgeries if the people aren’t committed and are just going to eat even more and put the weight back on. It’s like consolidating debt to make one payment easier but keeping all the credit cards and building up the debt again. It just makes you worse off
That depends on the surgery. Gastric bypass notoriously has weight requirements, but a gallbladder removal can still kill you if you’re too fat, and there definitely is a point to doing that even if the patient isn’t going to change their diet.
That’s why where I am from you usually need a clearance from a psychiatrist that there are no psychological issues in eating habits that would render that surgery useless, before the surgeon is allowed to do it
Similarly - if you are trans and on HRT, every problem is due to your hormones.
Look. Shitty doctors exist, but when 1/3 of the US is overweight, there are underlying issues that need addressing. I only hear horror stories when an addict, alcoholic, or overweight individual in my life is feeling insecure or defensive about a prognosis. Too many people deflect and it’s enabling a much larger issues. Our basic instincts are being exploited.
I have some horror stories about being a normal weight woman seeking medical care. What’s that about then?
Different issues have different causes.
I know, I’m not arguing for obesity, that would be stupid.
Well someone’s gonna have to
Yes. They’re in the meme.
America’s obesity epidemic is a function of our car culture. This is the only country on God’s green Earth that feels putting in sidewalks is a moral failure.
Obesity is a food issue, our reliance on cars and increasingly sedentary lifestyle may exacerbate the issue but it’s not the cause
You can’t really know it. I suspect it’s a combination of the two. If you drive everywhere and sit around the rest of the time, you can’t be healthy no matter your diet.
It’s obvious that this is not the most important underlying cause, as other countries which are less auto oriented are also quite fat.
Obesity is a product of excess caloric intake NOT sedentary lifestyle.
Lack of cardiovascular and kinesthetic health is a product of a sedentary lifestyle.
It is once again, incredibly simplistic view of a very complicated issue, so simplistic it stops being accurate.
Unless you’ve magically discovered the source of energy and mass from nothing, and revolutionized our understanding of the natural world … no, it isn’t.
You would be surprised, but human biology is slightly more complicated than a furnace that you throw coal into.
When talking about obese individuals, the fat very easily gets in the way of surgery. Compared to a healthy patient the risk of complications during surgery is much greater and really not worth chancing it (most if the time)
I’m guessing that’s under the US health system, where doctors are incentivised to only perform surgeries with a low risk of complications
What countries medical system encourages risky surgeries? As far as I’m aware “reducing risk” is most of the game in medicine
For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patient’s death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they weren’t healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didn’t spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.
I’ve worked in emergency medicine and I’ve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I haven’t even finished medical school.