Differenza di peso: odiare le loro viscere

Quanto è comune la stigmatizzazione del peso nell'assistenza sanitaria?

Questo video e il prossimo discute l'importante e preoccupante questione della distorsione e della discriminazione del peso, che potrebbe essere un argomento delicato per alcuni spettatori.

Il prossimo video di questa serie in due parti è The Impacts of Weight Bias in Health Care (
https://nutritionfacts.org/video/the-impacts-of-weight-bias-in-healthcare).

Entrambi i video della serie sono tratti dal mio libro How Not to Diet (https:// Nutritionfacts.org/book/how-not-to-diet/).

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Grazie per la visione. Spero che ti unirai alla rivoluzione nutrizionale basata sull'evidenza!
-Michael Greger, MD FACLM

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68 Risposte a “Differenza di peso: odiare le loro viscere”

  1. Thank you for shedding light on this terrible topic. I have read other research that indicates many severely obese people have a history of trauma that contributed to their situation. I believe that more compassion is called for with people struggling with obesity not more contempt.

  2. The funny thing is (as a morbidly obese middle-aged woman), most of the doctors and other discriminators themselves are overweight. Although not my size in most cases. It's clear that they themselves are struggling with the Standard American Diet as well. The disdain appears as a mix condescending sympathy and a feeling of "Well at least I'm not as bad off as her…". Oh! And there is no group more harsh than an obese people who lost their weight – if they did it – you can too… Until, of course, when they gain their weight back. Anyways, I love your work and try to follow it – but there's a lot more than just buying the food and following a check list. There's a mental component that I'm trying to battle as well. The food most definitely helps but there's something so ingrained that always pulls me back. I am very hopeful for Psilocybin therapy to become "a thing" – although I have my doubts it ever will. Thank you again & looking forward to second part of this series!

  3. This is interesting considering that the majority of Americans are overweight- including many doctors.
    Is it a need to see others as "worse"?? And denial of their own weight/health issues?

  4. We obviously shouldn't belittle obese people, but in no way should we adopt the body acceptance movement. Obesity is unacceptable and a major drag on our healthcare system.

  5. Probably unpopulair opinion but maybe we are disgusted with obesity cause obesity brings a lot of health problems and we naturally don't want those. I do have to say that I do think badly about obese people that don't even try to lose weight of try to stay in shape and are constantly complaining. Losing weight ain't easy especially if you eat a lot of prepared meals or deepfried meals.

  6. There is Zero reason to be overweight it is that simple if you are it is your own fault and if you can not manage yourself properly why would you expect any respect from anyone else?

  7. Important clip for me…..guilty….sometimes I do look at obese people in a negative light. This is something I need to personally work on.
    Keep it up Dr. Gregor.

    Mr. Phillips
    Canada
    Retired & caregiver

  8. This entire video hurt from beginning to end. It was a litany of people’s unkindness and unfairness. It was not about the disease of individuals, but of society towards obese individuals. How do we improve the health of society in this regard? Are there cultures or settings where these biases are not prevalent?

  9. You make some very fair points. On the other hand, we also have a 'healthy at any weight' approach that pushes the idea that 'metabolic health' is not affected by fat. There are 'influencers' advising people to refuse to accept advice from physicians about the need for weight loss, and any idea that obesity might not be reasonable is attacked as 'discrimination' by the body positivity movement. We need healthier approaches.

  10. Obese people are seen as ‘different’, a group we’re not good at treating as humans and worthy. We’re really good at discrimination.

  11. I've been severely bullied during my school years when I was a child and teen just because of my weight. They simply hated me because of it, but didn't care why I became like this. I developed binge eating disorder as a child and later on bulimia as a teen to – unconsciously – cope with traumatic things that had happened to me (I was abused as a child). They also didn't care that their bullying made everything worse… I started cutting myself and even contemplated suicide.

    I then became anorexic and suddenly the bullying stopped; instead, everyone was complimenting me… it felt weird and I was disgusted by the fact that I now somehow was worth to be accepted/respected/liked… I felt betrayed by my peers. My anorexic phase thankfully didn't last long and I got back to binge-eating/bulimic behaviour and people again started talking about me, reminding me all the time that I've gained so much weight back (like I didn't know it myself)… they made me feel worthless again. They – like most people – never cared about my health, but looks.

    I still struggle with my weight (even though I eat WFPB for 7 yrs now)… a few years ago I got diagnosed with PCOS, which partly explaines why I struggled with binge-eating all my life and why I'm having a hard time losing weight. Since my diagnosis, I'm taking meds and it got much better, but losing and maintaining weight is still hard!

    Yet, people think they have a right to judge without knowing the facts and claim to simply care about your health, but they don't! Being overweight my whole life, I can tell you that those people are the biggest hypocrites I've ever met. They are simply vain and mean people who like to pick on overweight people.

  12. Overweight people should be treated with dignity and respect. That said, there is a new trend where media is trying to push the idea that being overweight is healthy and attractive – it's not. We should be kind to all people, but we should also be honest.

  13. This is an important topic. Negative self-image and social pressures are a major obstacle to people having self-esteem, and therefore, committing to their health. The first person to teach someone healthful diet and nutrition should never blame someone for falling victim to a larger system that kept them ignorant and restricted access.

  14. I worked at a hotel that turned away people that were morbidly obese because they always broke the toilet or sink the tub.

  15. I have some friends who work in medicine. I honestly don’t know how they do it. One friend does procedures where he regularly finds “unexpected” objects in patients folds. I will always remember when he told me about the rotten sandwich remnants he found in one patient. I honestly could never do that kind of work. I get sick thinking about it.

  16. but doctors can smoke yet judge their patients about their obesity? 🤔 Yet they are ignorant to nutrition. One short course in Med doesn’t cut it. I was two pounds over that put me into the obesity. This gastroenterologist told me he didn’t believe me I had Ehlers Danlos simply because he said my skin was stretchy skin was due to weight loss. It’s easy to lose upwards to 100 over the course of 20 years when you YO-YO 🪀 🙄 He was dismissive – labeled me a drunk 😤- told my Internist to have a talk with me about my (non) drinking – after my colonoscopy he misdiagnosed me and brought someone’s else’s info to me – I caught him in the lie – in his own words “You remember that?” I remember all things sir even when others don’t … apparently even when on sedatives. Over a year later my diagnosis came through; Ehlers Danlos III … the only doctor who’s cared to encourage me to lose some weight is my Pulmonologist who’s also Vegan. I told her against my best efforts even on a Vegan diet my excess doesn’t shed. I know what I’ve shared isn’t unique but I feel it’s something that is universally experienced and felt more so as women.

  17. Wait, they forced perfectly healthy, lean people to take unnecessary Covid vaccines and waste our hard-earned tax money and hospital resources caring for obese people (who usually have 2-3 comorbidities anyway) who don't make efforts to improve their health, but now we're supposed to sympathize with them for the very predicament that they caused and continue to cause themselves? Guys, grow up. The fact is that everyone is responsible for their own health, and if you don't like being called names, do yourself a favor and take a walk, eat a salad and stop whining.

  18. Obesity is a health issue. No one should be fat shamed.
    Having said that every doctor visit should include nutrition information and discussion of how being over weight contributes to heart disease, high blood pressure and cancer. Being over weigh is now considered "NORMAL" today.

  19. I was fat almost my entire life, sorry but I think a level of stigmatisation serves an important role. It’s not ideal to be fat, you can’t change biological attraction and you shouldn’t feel all warm and cushy about being overweight.

  20. You are what you eat. Your diet impacts your health.
    Lower stress, reduce obesity and more exercise are key to a healthy life.
    Obesity in children and adults is rising across the world.
    Fast food and sugary drinks are contributing to the problem of poor health and obesity.
    Eat a healthy plant based diet and exercise regularly.
    Reduce or ELIMINATE cows milk, eggs, cheese and meat. Eat more salad greens, beans, fruit and vegetables. Eliminate fast food, snacks like cookies, cakes, chips, and sugary drinks and juices.
    Every adult and child should own a bicycle and ride it regularly.
    Regular exercise will help you sleep better. Yoga is a great stress reducer.
    Obesity is all too common today. Get off the couch. Get off the phone, ipad or video game.
    A variety of stretching and other exercises help with increased mobility.
    Ride to work, ride to school, ride for fun.
    Every city should be a bicycle city. Speak up for bicycles in your community

  21. So shocking to hear how biased physicians and nurses are, especially. I wonder, why do most physicians get only a semester or two of nutrition training but are viewed as experts (at least I've in the passed viewed them as experts!)?

  22. It should not be about image, or vanity. It’s about feeling good and being happy in your own skin. When you are healthy you are happier. But you have to put in the work. Whether it’s about healing yourself from an injury or losing weight, taking care of oneself is an essential life skill and benefits those around you. It’s not natural to spend your whole life indoors. Get outside and enjoy some fresh air and the beautiful body in which you live.

    And if you come to have compassion for yourself, maybe you will also learn compassion for other suffering beings.

  23. Talk about cognitive dissonance, I hated giving this video a thumbs-up when the video is helpful, but the behavior is reprehensible. God help us love one another as ourselves.

  24. maybe these patients are ok with their providers because their bar of acceptable behavior for healthcare providers is so low to begin with? What many people, patients, providers, general public forget, or maybe never knew , in an increasingly documented number of cases obesity is a symptom not a disease, but if we are to busy telling people that being 'fat' is a moral failing we will never be able to identify the underlying cause in the first place, and like some other symptoms sometimes it remains even after the other issue is resolved.

  25. @G B (I think he deleted his comment, but wanted to post for posterity) There's no word limit to YouTube comments, to my knowledge. If you don't want to be misinterpreted, deliver your message plainly and at length. If you don't want to be challenged, don't make outrageous claims or try to make yourself out to be an expert on soemthing when it's just your opinion. (Now, if you are some kind of researcher with representatively sampled data, please share by all means). I don't believe I claimed I was privy to any special data or that I was an expert. But when you say "in all cultures" and that "most obese people" are self-indulgent, and you're using that to bolster an argument, you have to provide some data.

    Anyway, I'm not arguing for the sake of arguing, any more than you are. And I don't meant to be antagonistic to you as a person, just the position you seem to be supporting. I'm not even really concerned about your personal behavior, because all I have is your words to go on. But a good deal of people do actually believe and behave the way I was describing, believing obesity is a moral failing, fat people are morally bad, their abuse and criticism is justified and good, and concomitantly, they themselves are good people for not being fat and for shaming fat people. That's very basic human nature and tribalism, so no real outrageous claim there.

    But really quick, on the point of it all being about appearance, my point was that appearance is all you have to go on when you're talking about someone's health, unless you have an in-depth knowledge of them. It just so happens that obesity is salient while other forms of unhealthiness are not. Thus, when someone criticizes someone for being fat (strange to criticize someone for having a disease if there is no moral failing), then they are criticizing them for their appearance and what they assume that appearance means. It's called concern trolling because it is trolling under the guise of concern, because there is no genuine caring relationship there. Which incidentally is why it doesn't work, and may even backfire.

    We may or may not disagree on the fundamentals, but that's rarely where anyone disagrees anyway. It's all about the approach, and the approach you describe (whether or not you personally practice it) is flawed and unhelpful if the goal is actually to get people healthier. That's all I'm saying.

    In any case, I'm not really sure I agree with most people's approach to public health, because most people aren't public health experts, and also I don't consider other people's health to be any of my business. If they want to smoke, drink, eat bacon and bologna, do heroin, that's their choice. Them being healthy is their goal to accomplish, not anyone else's. What I care about is that healthy options are as available or more so than unhealthy ones, people have the education to make informed choices between them, and they aren't stigmatized for their suffering even if some people see it as self-inflicted.

  26. What a lot of commenters overlook is that being overweight is the norm in our society, esp in the US. So in effect they are setup to fail. And it’s not as simple as they’re eating too much or they’re lazy about exercise. We are forced to work long hours at mostly sedentary jobs, and since time is at a premium for so many, we turn to things like fast food and packaged, unhealthy meals. So in order to adopt a healthy lifestyle, you have to go against the grain in a lot of ways. Not that easy.

    On a personal level, we need to have MORE compassion and understanding for overweight individuals. I know I’ve been guilty of passing judgment and not seeing the person first.

  27. Why is it not ok to tell people that they are too fat, but it IS ok to tell people that they are too skinny? The next person who tells me I’m too skinny is going to get a boot in the backside.

  28. No doubt there is a fine line, because too much acceptance prevents us to consider obesity for the major problem it is. And, if we disregard all the nasty side of it, how are we going to keep the junk food industry from preying on the vulnerable with their increasingly ferocious marketing strategies? Compassion is nothing without its partner– analysis and love of truth.

  29. compassion from doctors and nurses can be hard also because of the compensation model and the time crunch. Imagine getting to know your patient in 10 minutes ( it is hARD).it takes sitting down, not feeling rushed to even start the process. And the current model does not afford that…..i see a lot of people saying the doctors are rude and nurses are mean etc…this model was meant to rush you through and teach everything in an algorithm…..it is HARD

  30. I am not even one minute in and I have a problem with this "feels" study.

    With 80% of the people overweight or obese and 40% obese, who is doing the stigmatizing? Other overweight or obese people?

    Also, that very first study @0:40 where they asked 50 women to report when they "felt"…study ends there. What someone might find offensive or taken as a personal attack someone else might laugh at even with they are the target of it. This study was over a week, 50 women and they had 1,077 instances of of these people feeling stigmatized. Well, that is over 50 women which means that some likely reported little to none and a few women really skewed the data to the high side.

    One also has to consider that weight is often an outcome or the result / symptom of other issues such as depression, mental / emotional problems or stress, etc. and for others, they just like to eat the wrong food and enjoy taste pleasure over physical health. So, how biased was the sample group of 50 women? Did they do a full psych eval to see if they were going to get a pool of people biased to be overly sensitive or receive some outside thing as a personal attack even when something was not?

    Then to assume that it happens less to men because it just is a lower daily occurrence when the world knows that most men, less betas, don't care. If I called anyone one of my male friends fat they'd laugh, rub their belly, say, 'Yeeaappp" and then take another swig of beer. Say that to any woman I know, even those that know that they are well over a healthy weight and it is a personal attack.

    perhaps the hring bias impacting the overweight women more is a subconscious response by the people hiring knowing that the men are less likely to care or respond emotionally to some external action, event, etc being perceived as a personal attack.

    I just cannot take any study, no matter how rigerous, is based on personal opinion perception about feelings. Especially when the vast majority of the population is part of the same group that feels slighted. This can only mean that the overweight and obese are prejudiced against themselves.

    If being stigmitized isn't enough to get people to wake up to what they are doing to themselves, how about they realize what there habits do to the total healthcare costs in the US and the drag on the economy that a lazy & poor diet are on the economy.

    FYI – I have been fat and I have, and still am much slimmer and eat a great diet nearly entirely plant based so I get it…and then I shat and then got off the pot and made changes. I also knew I was fat and didn't take it personal either. It was clearly by my own decisions that I got that way.

  31. Please do skinny shaming for vegans please I'm at my healthiest weight but as soon as I say I'm vegan I'm called too skinny too- I'm protein deficient bullies who discriminate vegans as they are discriminated in work family friends – in surveys bosses fired employees who were vegan or chose not to employ a vegan and the perception of vegans is on par with drug addicts can there be a vegan protection act that stops people financially depriving employees based on their being vegan

  32. The discrimination against people, obesity, race, gender etc. is so hurtful and stressful. I believe the number of acts of discrimination a person experiences leads to more health issues in the future and more need to numb with food, alcohol etc.

  33. In my psychology class we learned that this has a lot to do with how the media, corporations, marketing techniques towards women, and how Hollywood perceives thinness. For example, take a look at most of the Disney characters and how they deliver them to their young audience.

  34. I have struggled with my weight my whole adult life. I may be unusual in that I don't make excuses for myself and I am working on adjusting my diet. But this is more about improving my overall health, weight loss has been just a positive side benefit. At 61, I am at risk for many of the usual old fart issues and I don't want to just take drugs if avoidable. I want a doctor who will give me the "eat better, lose weight and exercise more" lecture when I need it. I'm probably the odd one. My daughter is about 350 pounds in her mid-30's and has a few issues that would certainly be helped by not carrying so much weight around. I want to help motivate her, but it all backfires.

  35. From MY perspective, I feel the evidence stated in this video came to false or overstated conclusions for fat discrimination.
    Yes it's true that many people are cruel in their treatment of others with all types of physical challenges, but to make a straw man generalization about employers and the health industry as to their prejudicial treatment of those obese, is unfair.
    How many times do I try to help coworkers beat their addiction to smoking or help their obesity and I can't help, as I've also struggled with obesity.
    I've heard many times over " How dare that fat old doctor tell me to quit smoking or lose weight!".
    Further edit: If readers think I'm being insensitive, I've been a yo-yo dieter for many years, finally found the keys by the info from people such as Dr. Gregor, and weigh a normal BMI since January, but I haven't been victim to that much prejudice in my phases of high obesity.

  36. I experience so much weight stigma foreign underweight.
    In England 2 thirds of people are overweight, there is a lot of social media push and marketing to celebrate curves and "body confidence" for plus sizes. But there is nothing for the underweight apart from judgemental comments in public and diagnostic overshadowing in healthcare

  37. Completely understandable. Personally, I do not want a dentist with rotting teeth to work on mine. It bothers me that my Doc and his nurse…both…need to lose 50lbs, and give me medical advice. The American Diet is simply awful. Big Pharma and Big Agriculture own the medical establishment. Scientists can be bought…just like politicians. YouTube is full of MD/Ph.D. personnel who cite different studies and every one of them has BIAS. Let me say that again: Everyone has Bias. 3 out of 5 Americans are clinically obese, dehydrated, and lacking in sleep. We are looking at a generation that may just outlive their offspring.

  38. Shaming only works if the recipient feels shame for it. If the shamer and the shamed both think its shameful – thats because it is. You cant shame someone for being fit, or for working hard. You can try. But since it isnt shameful, it doesnt work. Gluttony is gross and shameful. The food companies shouldnt prey on the public with addictive foods, but thats the world we are in. Grow up people. Being fat is gross and shameful.

  39. Maybe, the majority of people have an ingrained negative bias toward overweight people, because that's a choice for the vast majority? The other options are not choices, but circumstances. Maybe if you included other options that were choices people make, the outcome might have been different?

    Very, very rarely, is weight a medical condition for what a person eats. Otherwise, it's a choice that we all make, whether to over eat or not. Now, granted, there are definitely areas that are not being catered to properly at all, but for as many in our society this effects, it is not the main reason. It's quite literally comes down to the vast majority of people's choices.

  40. Well just in case anyone obese is looking for a bariatric surgeon who understands nutrition and that obesity is a very complicated matter, rather than the type spoken of in this video, look up Garth Davis, MD in Houston. He has videos as well. The world needs more doctors like Dr. Davis. He is authentic.

  41. Dr. Greger’s lead-ins (and more) while on a treadmill is distracting. He’s said he is making a point. Good. It still takes away from the message.

  42. Maybe the physician doesn’t feel like they can be authentic with them. But it definitely is wrong how they view them and spend less time with them. It’s really sad and too bad.

  43. This is just my observation but morbid obesity as a disease seems to correlate with emotional and mental health problems. These are difficult patients for the staff both physically and emotionally. The tendency to talk about the complaint-du-jour and not address the patient's need for emotional and mental therapy seems to be prevalent. We don't ignore a smoking patient or alcoholic patient but consistently offer help. Are doctors ignoring 'the elephant in the room?' (no joke)

  44. I've been decently in shape, and I've been over weight. And, I've seen/felt a difference in how people perceive me in the contrast of the two. Ok, so what? So, there's a bias. Maybe that's the natural way. When the body gets something unhealthy it rejects it. That's natural. When we are unhealthy in an obese way, society rejects us. Why isn't that also considered natural? It probably should be. I believe most of the rejection/bias one receives from being obese is in lack of consideration, lack of respect… a subtle dismissiveness, and not as commonly the more aggressive forms of rejection. If it's the other way for an individual, I would suspect that person is highly uncalibrated with society. Ultimately, the main thing should be (imo) that an individual who is overweight begins to see that they are in a walking (usually) state of unhealth… aka they are sick, and they need to get well (in a healthy weight range).

  45. Sexism and the patriarchy has really created barriers and let the fems down. We are targeted to suffer…. Thanks for addressing this Doc. 💌

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