This morning I had the unfortunate experience of watching a particularly vile video. This was brought to my attention by Dr Yoni Freedhoff and I have to say that I share his outrage. The video is supposed to be a “satirical representation” of a typical encounter between a doctor and an overweight patient. It was published on a popular medical website Kevin MD, the “social media’s leading physician’s voice”.
My first inclination after watching this was to smash my computer screen. My second inclination was to write a post. If you are reading this I chose the second. There are many MANY features of this video which are both disturbing and revealing of our current public health system and societal attitudes to obesity.
Let’s start with the title of the article: THIS IS THE VIDEO WHICH WILL MAKE YOU FEEL SORRY FOR DOCTORS TREATING OBESITY. Before you even click PLAY you are clearly told who the victim here is: the poor frustrated overworked Doctor. The first scene of a slim tired-looking Doctor having a clearly stressful conversation with an insurance company confirms that impression.
What helps us form our first impression of the female overweight patient? She is referred to as Ms Fatty (kinda takes you back to the playground with childish name-calling, huh?) just in case you were going to miss the fact that she is Fat. The first image of the Patient is designed to impress us with her enormous size: the music, the heavy slowness of her gait, the close up on her large calves, the way she rams the skinny nurse out of the way, and the way she crushes the poor doctor’s hand with her powerful grip. In other words, a hippopotamus, not a lady.
Next the poor Doctor is expected to tell her she looks good. What he really wants to do is to tell her how disgustingly ugly and fat she is but in our crazy modern world of political correctness insulting a patient is weirdly frowned upon. So he is forced to give her a mendacious compliment.
It does not take us long to realise where the problem lies. It is laid squarely at the Patient’s door. In spite of the Doctor telling her to lose weight (he even uses the F word. Seriously. Just lose the fucking weight. How much clearer can this be?), she continues to shove sled-sized pieces of pizza, large burgers, and buckets of soft drinks in her gob. She even burps. That’s even more disgusting. The desperate physician tries to point out to her how unattractive she is to the opposite sex because she doesn’t have a boyfriend. Everybody knows that being skinny is the prerequisite to a meaningful romantic relationship. But the stupid woman just doesn’t get it.
The representation of the Patient as a comical grotesque figure does a good job in raising the viewer’s indignation. Several times during the interview the Doctor points out that she CHOOSES to stay fat. It’s like she just can’t see how fat she is. She lives in a “fantasy world”.
One of the most fascinating parts of the interview is the conversation about the Patient’s medications. We learn that she was started on a diabetic pill because she CHOSE not to lose weight 6 months ago. This was followed by multiple other medications, each one of which designed to counter-act the unfortunate side-effects of the previous one. The Doctor even had to prescribe 3 antidepressants because she “didn’t feel happy with one”. These rather questionable prescribing practices do not stop the Doctor blaming the patient for non-compliance with this bizarre regimen.
The video is concluded with the patient demanding the Miracle Pill by Dr Oops and her Doctor patiently explaining that there is no such thing. She just has to get off her fat arse and exercise some willpower. She storms out of the office.
WHERE DOES THIS LEAVE US?
In a place where shaming and humiliating a patient is a legitimate method to promote behaviour change.
In a place where every case of obesity is a result of a moral failure of an individual who voluntarily CHOOSES to be fat.
In a place where BEING FAT is a disease in spite of multiple evidence that the relationship between body weight and health is far from linear.
In a place where Doctors puts themselves in a position of superior moral authority disregarding the fundamental principle of EMPATHY.
In a place where the Food Industry enjoys unlimited Freedom and the population is granted the illusion of Choice.
In a place where we strip people of power by engineering the environment that is designed to make them fail and then we blame them for these failings.
It’s a dark place.
I don’t want to practice medicine there.
Banner image: Sumo! Chris Lewis. flickr.com CC BY-NC 2.0