5 ms·

I don't think you understand how stupid and googleable most customer support questions are. Doctors will have more time for real questions if they aren't answe

I don't think you understand how stupid and googleable most customer support questions are. Doctors will have more time for real questions if they aren't answering idiotic questions. You are living in a bubble.

SoftTalker 2y ago
Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed.
- rsynnott 2y ago
  … Doctors have, of course, been doing that for about a century. It isn’t particularly effective. Ozempic actually is effective, and will likely lead to significant improvements.
- justrealist 2y ago
  Are you really trying to blame obesity on doctors? Impressive.
  - deleted 2y ago
    [deleted]
  - lupusreal 2y ago
    [flagged]
    - ceejayoz 2y ago
      No, they’re ignoring the medical fact that “tell people to lose weight” has a basically zero percent success rate. The only intervention known to work reliably was bariatric surgery until stuff like Ozempic showed up recently.
      - lupusreal 2y ago
        Cutting losses to spend time with other patients isn't ignoring that little medical fact. It's an acknowledgement of it; all the effort spent treating the symptoms of obesity is basically wasted, squandering the resources (time particularly) of the medical system.
        ceejayoz 2y ago
        Except the post directly criticizes one of the major new ways of reducing that effort. Someone genuinely worried about obesity wasting doctors' time should be all for stuff like Ozempic.
        lupusreal 2y ago
        As far as I see, the only one directly talking about Ozempic is you.
        ceejayoz 2y ago
        I welcome your alternative explanation of what "instead of giving them shots" meant.
        arcticbull 2y ago
        Are you suggesting that the purpose of the medical system is not to treat medical conditions? I suppose if they took that tack, yes, the system would be more efficient.
      - glp1guide 2y ago
        Note that GLP1 receptor agonists are a whole class of drugs, and they were known to be effective in treating diabetes as well, and have been for a while. Recent commercialization and buzz is definitely new and there have been new formulations of course. It is quite remarkable that people might think simply telling people to "lose weight" will work still, in this day and age.
        deleted 2y ago
  - arcticbull 2y ago
    It is in a sense their fault for prescribing something (diet and exercise) we have known is utterly ineffective for over a hundred years. Likely because until now there weren't non-surgical alternatives, and caloric restriction and exercise do have other non-weight-loss benefits.
- ceejayoz 2y ago
  I promise you, doctors have been telling fat people it's their fault for many, many decades. It's one of the most common complaints of fat people in a medical context - that the first response to nearly any medical issue is "well you should lose weight". https://www.nbcnews.com/health/health-news/doctors-move-end-bias-overweight-patients-rcna29680 https://www.nbcnews.com/health/health-news/doctors-move-end-... > When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits. > On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease. The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.
  - Gibbon1 2y ago
    A silver lining of being mentally ill is that you don't suffer from the diseases that normal people do. Doctors know whatever the complaint it's due to the mental illness.
  - ghufran_syed 2y ago
    So the doctor gave the best correct general health advice to the patient, AND did the appropriate test, and appropriately reassured the patient regarding the pre-test probability of a good vs bad outcome of the test AND followed up the rare but possible bad test finding appropriately? Would you prefer the doctor give factually incorrect advice in order to avoid upsetting a patient? It’s interesting that you frame it as “faulting” the patient - if a patient comes in with shortness of breath, should doctors avoid asking patients if they smoke? If they ask a patient about previous surgery, are they blaming the surgeon? If a doctor asks about family or work history, are they criticizing family or work choice respectively?
    - ceejayoz 2y ago
      That’s… certainly a way of reading this.
- arcticbull 2y ago
  > Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed. There is no scientific evidence, whatsoever, that diet and exercise is an effective way of losing a clinically significant (>5%) amount of weight and keeping it off for a long period if time (5y). Go ahead and try and find even one study that shows this is the case. When you diet and exercise, your basal metabolic rate slows down as much as 20-30%, permanently, and your hunger increases. Your BMR is where the vast majority of your energy expenditure goes, no matter how much you work out. In fact there's reason to think that more exercise will actually slow your BMR. Body weight set point is principally genetic and epigenetic, as evidenced from twins studies. Maybe we'd make some progress on this particular topic if we stopped throwing out tired tropes and blaming people. The only scientifically proven methods of achieving significant, long-term sustained weight loss for most people are GLP-1/GIPs or bariatric surgery (but even there, only a gastric sleeve or roux-en-y work, lap bands do not). Here's a 29-study meta-analysis which walks you through what I said in more detail [1] and of course the famous Biggest Loser study where everyone on that show regained all the weight in the six years following. The more they lost on the show the more they gained back. [2] Let's not even get started on the use of insulin to treat type 2. It's pretty wild how backwards our approach to metabolic health is from a clinical perspective. Your response here is a perfect example. Now look at Tirzepatide. 90% success vs. 5% success. [3] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ [3] https://www.nejm.org/doi/suppl/10.1056/NEJMoa2206038/suppl_file/nejmoa2206038_research-summary.pdf https://www.nejm.org/doi/suppl/10.1056/NEJMoa2206038/suppl_f...

SoftTalker 2y ago

Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed.

rsynnott 2y ago
… Doctors have, of course, been doing that for about a century. It isn’t particularly effective. Ozempic actually is effective, and will likely lead to significant improvements.
justrealist 2y ago
Are you really trying to blame obesity on doctors? Impressive.
- deleted 2y ago
  [deleted]
- lupusreal 2y ago
  [flagged]
  - ceejayoz 2y ago
    No, they’re ignoring the medical fact that “tell people to lose weight” has a basically zero percent success rate. The only intervention known to work reliably was bariatric surgery until stuff like Ozempic showed up recently.
    - lupusreal 2y ago
      Cutting losses to spend time with other patients isn't ignoring that little medical fact. It's an acknowledgement of it; all the effort spent treating the symptoms of obesity is basically wasted, squandering the resources (time particularly) of the medical system.
      - ceejayoz 2y ago
        Except the post directly criticizes one of the major new ways of reducing that effort. Someone genuinely worried about obesity wasting doctors' time should be all for stuff like Ozempic.
        lupusreal 2y ago
        As far as I see, the only one directly talking about Ozempic is you.
        ceejayoz 2y ago
        I welcome your alternative explanation of what "instead of giving them shots" meant.
      - arcticbull 2y ago
        Are you suggesting that the purpose of the medical system is not to treat medical conditions? I suppose if they took that tack, yes, the system would be more efficient.
    - glp1guide 2y ago
      Note that GLP1 receptor agonists are a whole class of drugs, and they were known to be effective in treating diabetes as well, and have been for a while. Recent commercialization and buzz is definitely new and there have been new formulations of course. It is quite remarkable that people might think simply telling people to "lose weight" will work still, in this day and age.
      - deleted 2y ago
- arcticbull 2y ago
  It is in a sense their fault for prescribing something (diet and exercise) we have known is utterly ineffective for over a hundred years. Likely because until now there weren't non-surgical alternatives, and caloric restriction and exercise do have other non-weight-loss benefits.
ceejayoz 2y ago
I promise you, doctors have been telling fat people it's their fault for many, many decades. It's one of the most common complaints of fat people in a medical context - that the first response to nearly any medical issue is "well you should lose weight". https://www.nbcnews.com/health/health-news/doctors-move-end-bias-overweight-patients-rcna29680 https://www.nbcnews.com/health/health-news/doctors-move-end-... > When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits. > On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease. The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.
- Gibbon1 2y ago
  A silver lining of being mentally ill is that you don't suffer from the diseases that normal people do. Doctors know whatever the complaint it's due to the mental illness.
- ghufran_syed 2y ago
  So the doctor gave the best correct general health advice to the patient, AND did the appropriate test, and appropriately reassured the patient regarding the pre-test probability of a good vs bad outcome of the test AND followed up the rare but possible bad test finding appropriately? Would you prefer the doctor give factually incorrect advice in order to avoid upsetting a patient? It’s interesting that you frame it as “faulting” the patient - if a patient comes in with shortness of breath, should doctors avoid asking patients if they smoke? If they ask a patient about previous surgery, are they blaming the surgeon? If a doctor asks about family or work history, are they criticizing family or work choice respectively?
  - ceejayoz 2y ago
    That’s… certainly a way of reading this.
arcticbull 2y ago
> Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed. There is no scientific evidence, whatsoever, that diet and exercise is an effective way of losing a clinically significant (>5%) amount of weight and keeping it off for a long period if time (5y). Go ahead and try and find even one study that shows this is the case. When you diet and exercise, your basal metabolic rate slows down as much as 20-30%, permanently, and your hunger increases. Your BMR is where the vast majority of your energy expenditure goes, no matter how much you work out. In fact there's reason to think that more exercise will actually slow your BMR. Body weight set point is principally genetic and epigenetic, as evidenced from twins studies. Maybe we'd make some progress on this particular topic if we stopped throwing out tired tropes and blaming people. The only scientifically proven methods of achieving significant, long-term sustained weight loss for most people are GLP-1/GIPs or bariatric surgery (but even there, only a gastric sleeve or roux-en-y work, lap bands do not). Here's a 29-study meta-analysis which walks you through what I said in more detail [1] and of course the famous Biggest Loser study where everyone on that show regained all the weight in the six years following. The more they lost on the show the more they gained back. [2] Let's not even get started on the use of insulin to treat type 2. It's pretty wild how backwards our approach to metabolic health is from a clinical perspective. Your response here is a perfect example. Now look at Tirzepatide. 90% success vs. 5% success. [3] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ [3] https://www.nejm.org/doi/suppl/10.1056/NEJMoa2206038/suppl_file/nejmoa2206038_research-summary.pdf https://www.nejm.org/doi/suppl/10.1056/NEJMoa2206038/suppl_f...