Soon to be MD, we are trained to acknowledge to our patients how being obese can lead to health complications. We are taught to address it so as to not make it a cosmetic/superficial thing, but purely for medical purposes. It is wrong to dismiss anyone's concerns due to their weight; malnutrition can occur in skinny people, "normal" sized people, and obese people, so we have to consider the differential diagnoses that can manifest as a result of lack of proper nutrition or body habitus (habitus = physical characterization of the body) in order to find the root issue. If it is then found after considering these differential diagnoses that my patient's increased body fat percentage is indeed the root cause of, let's say, their high blood pressure, then we could address that and move forward with the treatment plan. I could not imagine being such a lazy physician that I didn't even try to use my brain to come up with at least 3 non-weight related things that could explain a condition.

I’m underweight and my doctor says most of my health concerns are because of my weight and that weight gain will help alleviate a lot of my symptoms. It definitely does go both ways

I lost about 70 pounds last year dipping into the overweight category and not obese, most of my problems went away (including emotional problems). I have gained about half that back, some problems have returned, but not all. It is very clear that my weight is a significant contributing factor to the point that specific weights I feel better or worse. I’m getting back on track in a more sustainable and healthy diet, not just a caloric deficit. My quality of life was far better at my lowest weight, if you are also obese, please don’t let random people on the web convince you some medicine or test is the only thing that will improve what ails you when your weight will always be in the way of living your best life.

I knew there was going to be some fallout from this. I can’t get behind it. I’m a fat vegan and it’s because I don’t exercise. I love myself, but I don’t love that part of myself. I’m not less of a person and I’m not bad, as you point out; I’m unhealthy. I’m fat because I’m unhealthy and should do more to overcome that, not because being fat is bad, but because being fat is unhealthy.

Obnoxious daughter of a doctor here- I would also like to point out that in some cases an obese person’s obesity makes some treatment plans impossible. My dad is an oncologist and surgery is sometimes impossible because of the weight of the patient. He will suggest weight loss so that his patients are capable of receiving the life-saving care they need.

Small critique from a long time fan: I think you're too quick to brush something off as "having no evidence." I agree with you that we can't give anecdotes too much weight, and that meta-analyses, controlled experiments, etc. are extremely valuable tools for informed public policy. But you shouldn't just brush off things like survey data as having no value at all. For example, we mostly only have survey evidence to study workplace sexual harassment, and I doubt you would respond to a survey about women feeling fear in their workplaces with "We don't have any actual evidence for workplace sexual harassment." You often talk about the importance of messaging for effective activism. I'm inclined to think that you'd get to your audience more effectively if instead of "This isn't science!" you said "We should look into why fat people are disinclined to go to the doctor, and figure out the cause of that fear/shame, even though it doesn't affect the proper health care plan."

My husband is obese and I am normal weight, but neither of us has gotten very exceptional care from doctors. I think people expect a lot more from healthcare than is realistic. Or maybe America just has shit healthcare.

Using type 2 diabetes as an example when it's a simple A1C blood test to diagnose doesn't make sense in your argument. To claim that a simple blood test is too much for a doctor to administer is silly. It should be the first test to give to an obese patient to rule out the most common diagnosis than look closer into other causes. Edit: I didn't catch this in my original watch. You said "if someone comes in with high blood glucose". This requires a test to verify. Jasmin's article specifically talks about no testing of anything whatsoever. It comes across like a strawman argument from you.

Bias in treatment nearly killed me. Multiple doctors told me to just increase exercise and reduce calories to alleviate my symptoms. By the time I got needed care, I was severely anemic, not menstruating, over- exercising, undereating, and nearly dead, literally. A CBC could have flagged that there were bigger problems. I did start losing weight, after four necessary surgeries, removal of 9 tumors, iron infusions, and proper diagnosis (not diabetes). Sure, there are good doctors. But, way more blew me off than gave solid treatment, and while that's anecdotal, it's hard not to be passionate when it's literally life or death. You said it's important to ask how often it happens. The answer is, it happens a lot.

Something clicked in my brain after watching your videos lately. Cut back on junk food, started working out again, and closely monitoring my caloric intake. Thanks for your vids.

I had such a hard time getting doctors to take my heart symptoms seriously because I was a 'healthy-underweight" bmi and in my 20's. Even when I told them I've had an eating disorder for 10 years and never exercised and would pass out from low heart rate and cardiologists would tell me everything was fine I just had a heart rate of an "athlete". Even after I was diagnosed with a heart arrhythmia they couldn't be bothered to schedule the heart ablation. It took a doctor from the ER after I was taken in an ambulance from passing out at the the store, to call to get them to finally help me.

People don't see how unethical it is for doctors to dive into invasive treatments before addressing lifestyle influence. If your doctor insists on expensive tests which cost you a lot of your time to take off to come in and money to pay when it could have been avoided by changing lifestyle, how would you feel about this? Probably very upset

Thats like a smoker saying that its offensive to assume that breathing problems are because they smoke

Unnecessary tests also lead to more unnecessary and expensive tests. If you do more tests you'll diagnose more disease earlier. But you'll also find inconclusive results that require more tests or even surgery and turn out to be nothing. Those tests are expensive, time consuming and emotionally taxing. Statistics tells us where the trade off is.

Just an editing suggestion, can you throw in some quote/unquotes in your writing/speaking if you're doing a just-audio piece? I tend to be multitasking while having your content on. Since I"m not reading the quote that's up on the screen line by line, I tend to get lost as to who's making what point. A lot of time I can tell by vocal inflection or, of course, when you cut back to yourself, but in this mainly-audio format, a bit more directness and clarity would helpful, like a quote/unquote or setting up the ideas more with "this commenter said '...' and my response to that would be..."

I think the issue with this topic is that people are very emotionally invested. The reality is that doctors are trained to think of horses when they hear hoofs, and not of zebras. They need to be able to treat the majority with the resources they have. Real life is not dr House. However some doctors could probably improve on compassionate ways to describe the need for weight loss.

I wish MORE doctors would refer obese people to therapist/psychologist as the root of eating disorders are mental imbalance and addiction!

As someone who isnt even overweight but has several health issues absolutely MOST doctors focus on weight when it has nothing to do with what you're coming in for. Almost ALL the doctors I've seen have told me I need to lose weight even tho my BMI is in the "normal" range but because I was wearing winter clothes they would mention im "a few lbs overweight and try losing it". I'm not going to sit here and say that being overweight doesnt cause health issues cause I'm sure it does but I just wanted to put my 2 cents in as a "normal" weight person even I get told by doctors to lose weight even tho I didnt need to lose any and had nothing to do with why I was coming in.

If obesity is purely behavior driven then the critical issue is one of psychology. It is not good psychology (and therefore not good medicine) to tell someone the self evident -that they need to lose weight-handing them a bill, and telling them to get out of your office.

I'm sorry, but that argument that doctors care more about healthy-weight individuals with menstrual problems is absolute BS. I've always been on the lower end of healthy and when I went to my doctor (several, in fact) complaining of vomiting for days on end and being severely anaemic because I was losing so much blood every month, all they told me was to "take a Panadol and eat some beef." The issue of symptoms not being taken seriously by doctors is a different issue entirely. You can't assume that when a doctor doesn't give a sh*t it's because of your weight, they do that to so many patients because they're pressed for time and the healthcare system can't bear the expense of testing for every complaint.

I have chronic pain due to a couple of conditions I live with. Being very restricted in terms of types and amount of physical activities I am able to do due to these conditions I have gained weight in recent years. Despite having diagnoses I find doctors just see my weight and blame that for my pain when the weight gain came long after the pain. My friend is very lean. She also has chronic pain conditions. She experiences similar weight related comments from doctors but she is told that gaining some weight will solve all her medical problems. In both our cases weight is a factor and is affecting discovering and treating the root cause of our conditions. It is very frustrating.

I love how you just don't take any shit. If people gang up on you, you let them have it. You don't let people get away with pressuring you into telling them what they want to hear, that's why this channel is so rare and valuable.

I had a friend who was in a lot of abdominal pain. She was told it was due to being overweight. So she lost 20 lbs in a few months and was still missing work due to pain. Turned out to be kidney stones.

I’m a med student and I worked in a Gastro care unit in the holidays. The doctors would talk to every alcoholic and every smoker about the health implications and maybe quitting. The only thing I never saw was them approaching a fat person. Which is a shame in my opinion because obese people are so much more care intensive. I respect all kinds of bodies but the moment you and two other nurses on a tight schedule have to carry a obese person from their bed onto a toilet chair it makes you think. The labour is backbreaking and obese people are more work for the nurses.

This is kind of unrelated, but I don’t understand why Lizzo takes all the heat for body positivity, she’s been on diets while in the spotlight. She’s cried on live a bunch of times because she’s obviously insecure about it if you get to know her. Fat people in general pick up way more stigma than smokers/ drug users in my own experience. That’s coming from a smoker/ drug user who has almost never had a problem with people commenting on my looks. The only time was when I was overweight/ closer to the highest end of healthy BMI for a couple years

Bullying is 100% wrong, & I'll never condone it. However, people these days always want to be the victim. I swear, every which way people hate being criticized has resulted in the generation of new "phobic" labels (people don't seem to know what that actually means to begin with). The "body-positive" movement has branched out into stuff like "health at every size" & other slogans & platitudes which exist solely to rationalize being overweight & doing nothing about it.

Okay, I mostly agree with you message on this topic. But when you say that shaming fat people would be okay because the net effect for society would be positive... It's just yikes, to be honest. There's no need to shame when talking openly about the subject is enough.

can’t we just acknowledge that the US health care system isn’t ideal without all this bs >:( ?

unnatural vegan's baby's hand is in the video, canceled

Omg you are so condescending in this video! I did watch the diabetes part (now multiple times) and I still think you misrepresented the first line! You clearly state "jasmine criticizes the very idea of doctors suggesting weight loss to patients" when this is NOT what she states in the line that you are referring to. She may do this generally speaking but not in the part that you underlined and showed in the clip. In the part the comments were referring to you significantly omit that the emphasis of that statement was "without further analysis". And yes you kind of touch on that with the diabetes example but it can still appear (as it did to many viewers!!!) that you did not actually get the point of what Jasmine was originally getting at. So, when so many people "misunderstand" what you said, maybe you could think about how that misunderstanding came about instead of arrogantly assuming we did not listen properly or do not actually think about what we are writing or - by the tone of your hyper judgemental voice - are somehow idiots. Maybe YOU could consider your wording and at least acknowledge: "I understand how people could have misunderstood this but what I actually said was xyz". Or "yeah, I see what the reactions were referring to but I feel it is unjustified because xyz". Coming on here, titling the video "off, y'all are so wrong" and then ramble on about how people allegedly did not even bother to watch the first couple minutes, instead of just taking a second to consider your own part in the misunderstanding, is not a good look. This is not the first time that I have felt that you deal with (polite!) criticism exceptionally poorly.

I think a lot of people just don't understand how impactful too much or too little weight can be.

25:15 Bear with me, I’m not trying to strawman, or play gotcha, I’m just trying to reconcile the fact that losing weight is so hard with fat peoples anecdotal claims of feeling unheard or dismissed. Imagine someone with undiagnosed ADHD goes to their GP complaining of fatigue and insomnia due to racing thoughts, along with some other symptoms. Do you think the doctor is going to prescribe sleep and leave it at that? No. They’ll ask questions, and hopefully try to get to the underlying cause of _why_ their patient can’t sleep. At the end of asking questions, hopefully they’ll give the patient a treatment plan, or refer them to a mental health professional who can treat the underlying cause. It’s not abnormal for people to struggle with their weight creeping up every now and again, just like it’s not abnormal for people to struggle with their house getting messy, or their sleep schedule being thrown off. When things get severely out of hand, it’s usually because something is severely wrong. There’s a huge difference between someone’s weight creeping up because they’ve genuinely been slacking on their diet/exercise, and someone being emotionally dependent on food, or having an impulse control disorder, or having a trauma-based relationship with food, etc. I don’t think you mean this, because I didn’t hear you say it, but I think a lot of people hear the argument for “calories in, calories out” and think that you’re saying that there’s nothing doctors can do for fat patients beyond telling them to lose weight. That’s not true. They have an obligation to offer patients the tools to lose the weight, or refer them to someone who can offer them those tools. Of course there’s a degree of personal responsibility, but I hope that doctors are at least telling their obese patients about their options, even if they don’t directly give them a pill to take or a number to call. I think it’s also important to emphasize that a condition can be harmful to the patient without being a moral failing on the patient’s part. Most conditions are that way. I know that sounds like I’m trying to coddle people and manage their feelings for them, but I think it’s the quickest way to get people to realize that we don’t hate fat people- we want them to suffer less.

As an obese person you are spot on. When I lost a lot of weight symptoms I didn’t even know we’re from my obesity resolved from the weight loss.

If you are thin and eat too much or don't exercise, you are at risk for health problems, if you are fat and eat too much or don't exercise, you are at risk for health problems. Period. Doctors are not always the best sources of dietary advice either. It's changed a little bit and it does depend on a specialty, but they aren't typically nutritionists. The ones that have a stronger background in nutrition are probably more likely to say - we need to get you on a diet of less sugar or might suggest the Mediterranean diet or something. Others are probably gonna blindly just say "you need to lose weight". A more knowledgeable approach probably would do the job. But, with fat stigma and fat-shaming in our culture, we have some rightly sensitive people. I think we need some adjustments in our culture, but I think directing this at doctors is misguided. Yeah, we treat fat people, especially fat women pretty terribly. I mean, ever see a love story in a movie where the leading lady is fat and it's not about her being fat? There is an issue here, but I see this more as a people problem rather than a doctor problem.

I thought your first video was pretty balanced. You recognized that there probably is an issue with treating fat people with respect and being dismissive but also acknowledging the system that doctors work in. They have to start with the most probably cause first even if it isn’t the answer in the end. I saw several people bring up fertility in the comment section. There is a huge correlation with weight (both under and over) and fertility. The first thing your doctor should advise you of is to gain/lose weight depending on your circumstances. Why get poked and prodded by and REI if it’s just weight related. I do think it’s sucks that doctors can be dismissive and I do think fat people are dismissed more than average or even under weight people. But even the most compassionate, best listening doctor is probably going to start with weight if any of your symptoms could be related to weight.

Another anecdote from a thin person. It took me 9 years to get a PCOS diagnosis because I'm not overweight. When I first went to a doctor at age 18, believing I had this condition as I had no periods, had acne since age 12 and was then starting to have issues with excess hair on my face, I was told I just need to GAIN weight (I was at the lower end of the BMI scale) as that was probably why I had no periods and the excess hair. I didn't get sent for proper tests until I was 27 and even then I still got comments about my weight because 'people with PCOS are usually overweight' and my GP couldn't give me any advice on how to manage my condition as losing weight is the advice he would normally give people and I didn't qualify for that advice. When I had my transvaginal US the sonographer said to me 'you're the thinnest person I've seen to actually have cystic ovaries'. This is how deeply ingrained a condition such as PCOS is with weight issues. So yeah, if I was overweight I would have been diagnosed almost a decade earlier than I was and the commenter on the last video who thinks someone who is thin would be sent for tests over a person who is overweight (for this condition) clearly isn't speaking from experience or evidence 🤷‍♀️.

I remember back when I was anorexic, being told I shouldn't gain any more weight and even told multiple times that losing weight would be a good thing for me. I was 12, never underweight, at a healthy weight for most of my recovery, and then slightly overweight. My fear of food was increased drastically by those doctors visits, where I was sometimes basically told it was better to stay anorexic and malnourished than be fat again. I do think that a lot of doctors have an internal fat bias that leaves certain people hurt and even certain medical ailments untreated. Also I'm personally now scared of doctors which is definitely not a good thing, huh?

The problem with America is that people would rather have a drug or a treatment that fixes all of their problems and serves as a temporary bandaid for problems down the road than actually implement any kind of lifestyle change. We’re a lazy society. It’s easier to project your own personal feelings about yourself onto a healthcare professional than it is to actually look inwards and realize that you do not take care of yourself. I gained 40 pounds this year during the pandemic. I am considered overweight now and I am noticing so many negative changes in my health. I get sick more easily, I’m inflamed, I have more aches and pains, I have brain fog, my mental health is shit etc. People really need to wake up. Yes love yourself at every size that is so important but being overweight is not healthy. It does not matter how you frame it. Obesity is a risk factor in just about every chronic disease acquired later in life and more often than not, they’re right! Losing weight is going to improve your symptoms because excess adipose tissue=excess inflammation throughout the body. Period.

I'm so glad you addressed these comments. Fat acceptance and especially Health At Every Size are causing so much unnecessary damage and pain by painting weight loss as something either impossible or evil, it's insane.

Losing weight got rid of 99% of my PCOS symptoms, despite only being slightly overweight at the time. The doctor actually didn’t even try to suggest weight loss, just prescribed birth control ... which is a bandaid solution to PCOS anyway. Healthy diet & adequate exercise CAN definitely solve a lot of our problems 🤷🏻‍♀️

I don't like being fat but I am in a very confused place. I have PCOS and I track my food, steps, and exercise with a fit bit. Even accounting for some error, I'm still burning much more than I'm taking in. I have told my Dr this a few times, but he recently recommended weight loss surgery. I was furious. My hormones are out of whack, and surgery is not going to change the root cause of my problems. My weight is a symptom of my disorder. BTW, I was not fat when I first experienced my PCOS symptoms

I think the control people have over their weight is wildly overestimated. Yes, you are the only person who can influence if you gain or lose weight. However it’s proven to be very hard to actually do so. Most people who try to lose weight gain it back and end up yo-yo-ing, which seems to be worse health wise than staying at the same weight. Many people also start showing disordered eating behaviours when repeat dieting or even get full blown eating disorders, no matter your weight, that is very harmful too. So for a doctor to say ‘you have pre-diabetes, lose weight’ is very dismissive. Even though the solution to the problem is actually weight loss, the assumption that the patient hasn’t tried that and failed is very short sighted. Most people are aware of their overweight-ness and do try to lose it at some point. A doctor would be better off taking the time discussing with the patient how they got to that weight, what problems losing weight may solve and guide them into a healthy sustainable weight loss plan. Sending someone home telling them they need to lose weight isn’t helping the patient in most cases.

Hi Swayze, Im a registered dietitian and I have some thoughts. First, I do feel like you're missing a little nuance. This was really exemplified by your recounting of your own personal experience with being told to lose weight. The major problem with telling people to lose weight as treatment is that we know sustained weight loss is very challenging. If you know your patient is extremely unlikely to be successful with an outlined treatment, is it really the best option? Too often in medical care we view people as non-compliant without considering their circumstances and personal ability. Doctors know very little about nutrition and sustained behavior change and have so little time with patients they're not able to work through this. This is one of the reasons dietitians exist. Prescription for weight loss without support and likely referrals is not helpful and does perpetuate the shame cycle. Imagine telling an addict "you need to get clean, have fun figuring that out". I think we all generally accept that would be incredibly difficult. The same is true with weight loss. it is also possible that a focus on weight status for ambulatory patients is not as helpful as targeted behavior change without regard direct reference to weight.

I like how everyone is suddenly a health expert. Is it so hard to sight studies and not rely on only anecdotal evidence?

I seriously just love this channel

Costochondritis is a bitch. I couldn't get it diagnosed properly until after two visits to the ER, and I lived in sheer terror up to that point.

Another thing people don’t think about is how obesity impacts the healthcare system.

This video just reminds me that I don't like our healthcare system. I don't usually put the blame on doctors themselves, but insurance sucks, so I'm sure the rest of it sucks too.

I wholeheartedly agree that losing just 5 pounds makes a difference in how you feel (and I mean physically, not speaking about confidence etc.). I am in the opposite situation now, I gained 8 lbs (in a spam of a year, so nothing too extreme), and wow (despite my BMI being 24.5 - not even overweight) I have never been to the doctor as many times as in the last two months. What were once in a blue moon problems before, became most of the time problems, affecting my life problems... I have had migraines, headaches for weeks at a time, my right side has been hurting whenever I eat pretty much anything that is a meal not a snack... Went to the doc 2 separate times, all of my blood tests were fine, they did an ultrasound of my liver, kidneys, etc. All fine. I was not told to lose weight, but I wish I had. I believe these problems are related to carrying the extra weight, and maybe and having some accountability with my doctor would be the kick in the butt that I need. Also speaking as someone who had 2 eating disorders in the past and finds weight discussions triggering, but come on, it's our health, we need to grow up or grow a thicker skin at least.

I lost over 120lbs a few years ago. I use to go to the doctors every second week but now I haven’t gone for over two years other then the odd checkup. Haven’t needed antibiotics, cholesterol medication or reflux meds. I had no idea that going to the doctors so often was abnormal and that my weight had such a large effect on my health.

What doctors need to do is explain and treat why some people can eat much more calories of total crap all the trine and never exercise and stay thin, while others need to exercise several hours per week, be hungry all the time, eat way below the recommended calories and very healthy just to maintain their weight and need to eat even less than doctors recommended for healthy weight loss to lose weight.

If you come in to see the doctor complaining of left shoulder pain and you have a knife sticking out of your left deltoid, your doctor is probably not going to work you up for a heart attack even though left shoulder pain can be the only symptom of a heart attack for some people. Obesity is a risk factor for many illnesses so it makes sense that doctors use this as a clue to what is going on. OF COURSE other questions/symptoms/signs needs to be assessed, but many times obesity is playing a major role in illness and should be addressed first.

Moral of the story seems to be that US needs a different health system that prioritise health and not money spend... I wish I had your cold rationality to beeing overweight - only seeing it as a health problem and thus considering every possible solution, even shaming, as a valid one. However for me, I've been overweight all my life, navigating relationships, school, love, sex, along with the hospital, has been always a challenge. Mind you I am not morbidly obese or anything drastic like that. But I was always made to think that I'm am guilty somehow. I still cannot imagine being happy if I'm not thin. And this feeling doesn't magically stop with weight loss - for a big part of my 20's I actually managed to normalize my weight - still didn't feel normal, never felt not-fat, because I was not thin like I saw in the media. Now I'm loosing weight again, and I'm actually scared to gain an eating disorder along with it, because it's such a big part of my daily life. That's why I'm sceptical about people criticizing fat positivity and fat people in the media like Lizzo. I always translate those criticisms as: It's not ok for the fat people to feel good about themselves. In my mind we fat people know - we need to loose weight. But it's a straining process with countless setbacks, and is usually not really our choice - I've always been heavy for example, no matter that I ate the same as other kids in school, etc. I know that I have to deal with the problem. I would just like to not hate my body and not be ashamed to be naked in front of another person while doing so. I would like for this problem to not completely take over my life.

Really appreciated the logic in this video. Usually I’m nodding along to things you say that I already know, but this video gave me food for thought. (Sorry I had to)

Wait. Swayze referring to partner as her soulmate 🥺😭💓

Thanks for offering your important perspective. For those that are looking for a unifying perspective to grapple with these issues, consider an equity and trauma informed approach. As long as the Healthcare system is understanding and recommending weight loss in a way that acknowledges the intersectionality of obesity factors and seeks to lessen the trauma that obese individuals face through support and empathy, recommending weight loss can be just like telling someone to wear sunscreen, compost, or do their homework. I'm not saying we live in this world, but couldn't we?

Your soulmate 🥰 i love hearing you call partner that! I’m not sure why but it’s super cute! Hope your back pain resolves soon and I’m glad partner is getting some relief!

uh oh girl cant wait to see the comment section on this one

The real issue with this doctor’s lack of empathy, and complacency when it comes to just saying “you are fat.” Is wholly unhelpful. There are definitely older doctors that hold a lot of judgment for overweight people. Rather than looking into reasons or education about why they are overweight. I have type 1 diabetes, but I’ve had other symptoms of other conditions even before the diabetes. Even I’m worried my doctors will dismiss this stuff as “diabetes” when a lot of the adjacent symptoms fall under other conditions. We shouldn’t have to but the reality is you have to advocate for your own medical health. If you really think something else is wrong, seriously ask your doctors about getting things tested. Maybe you feel like you have a pituitary problem. Ask for the tests. Ask to rule out diagnoses.

omg I think I have that condition your partner has??? I'm so glad I clicked on this video lol, I'm gonna start doing those stretches from bob&brad

I went do the doctor because of my lack of period, she told me it was because I'm overweight. I showed her my eating diary which averaged at 1900 kcal a day but she blew me off. Three years later it turns out I have pcos with severe insulin resistance. So while it might not happen often, it does definitely happen.

Swazis says obese people earn less and are therefore not contributing as much to society. Most obese people are not disabled. The highest paying jobs require the least physical ability. People’s income from work top out in their 50s in every generation Therefore most people would assume that if someone is working full time and after accounting for many other likely cross-correlated factors, the difference in pay wound be down to irrational discrimination. However Swazi has an extremely homo-economicus efficient-markets-assumption approach to economics. People do not necessarily get paid in accordance with their value to society, even in purely economic terms (i.e. by deduction, in terms of business profit). The economic basis for employment contracts is based on subjective valuations made by imperfect biased actors under the constraints of bounded rationality in a complex system of only partially apparent interests. By Swaze’s logic Jim Crow segregation could not have existed, anti-fat discrimination could not exist, discrimination against minorities or women today could not exist. Discrimination against people judged less attractive could not exist. But we know these do exists and it is not because these people bring less economic value (e.g., human capital, natural talent) to the job market.

Can you make a video about the junk food lobby?? Very curious

I honestly hate SJW warriors going against moderate, polite, matter of fact, individuals. Low hanging fruit. Body positivity can be praised, but the disease of obesity isn't something celebrated.

OK have to comment on the anecdotes. Is the bedside manner of doctors really that bad in the US? I feel like this would never fly in Europe :o

The issue isn’t that losing weight is beneficial for overweight people, we know that. It’s that fat people are disregarded for issues unrelated to being fat. Also, your comment in the last video about not having fat people in the media was very harmful. We exist, why shouldn’t we be allowed in the media?

Swayze went in tonight 😂

If I am a smoker who goes to the doctor complaining about lung pain, are they wrong to assume it is because of my smoking? Even if the lung pain did happen to come from something else, are you really going to tell me that my doctor would be incorrect for focusing on the whole smoking thing and trying to get me to quit?

To be over weight literally means = inflammation- to be inflamed. Which is a very bad place to be in for your body. Inflamed means swollen… So maybe instead of using the words fat, obese or overweight we started using what all that really means people would take their health just a little more seriously. When we hear the word swollen we instantly get worried and do whatever it takes to take the swelling down.

I was a kid when a doctor said I should lose weight and I didn't like hearing it. But I eventually did, still as a young person, and I learned a lot about health and food and exercise in the process. And it profoundly improved my quality of life and continues to in my adulthood.

I'm very glad you made this video clarifying your position. Thank you! ☺

Original Article: maybe we should be nice to fat people Swayze in this video: ok but what if being mean made people lose weight? idk the research is out on Shame

From a purely actuarial perspective, she's not wrong about all humans having a price tag. It looks like a lot of people are upset about that particular comment but we have a health care system that assesses the risk of any given individual and within that context, young, healthy people ARE more valuable, simply because they cost less to care for. It doesn't mean other people are not worthy or valuable as humans in their lives, to their loved ones, etc, that's not the point she's making. And while anecdotes are very compelling, you can't make large scale policies based on them. You gotta go with the math, in order to help the largest number of people possible.

I'm jealous of that woodwork behind you.

Jumping to invasive tests is never the right answer. Not right away. I have been a caregiver for both parents, and typically there is a process of elimination. My mom is not overweight but anytime she has an issue the first thing her doctor will look into is her diet/lifestyle. He will make some suggestions and we follow up. If The problem persists we move on to bloodwork/urinalysis. Nothing there? Maybe Imaging would be next or in some cases a different blood panel. That’s normal! One time my mom went to the ER complaining of chest pain. They inexplicably did an angiogram, which her primary care physician did not think was necessary AT ALL, but he wasn’t there. As a result, the artery used for the angiogram didn’t heal properly. She can home and her upper thigh and groin area tripled in size. She needed vascular surgery and has had a slew of problems since this happened. All because of an unnecessary test.

Please make a podcast where you upload your vids in an audio only version! Not that you need too but I'd love to listen at work :)

Video exclusively talking about yo-yo dieting pls!!

There's a world of difference between a doctor telling a patient that being overweight is unhealthy and that doctor telling them that they're "unworthy" or "unlovable". Of course, some doctors are lazy and/or bad diagnosticians, but many genuinely care about their patients' health. Being overweight _is_ intrinsically unhealthy. That's the boring old truth.

Big thanks for the costochondritis tip!!! Think I may have had the same issue.

To be clear, it sucks ass to be told by a doctor that in order to feel better you have to take the hard route of daily and consistent effort and lifestyle changes for an extended period. I was more than happy to treat my ADHD with pills from the day I was diagnosed. But treating my pre-diabetes and PCOS is way less fun. I hate exercise. I hate eating less. It sucks. There’s going to be a little bit of resentment there for thin people who wouldn’t have to do all this in my same medical situation. I get how upsetting it is for fat people on a personal level, and I understand how it might feel like marginalization or discrimination to be told that weight loss is the answer. Does that mean the doctors are wrong? No! If I don’t lose weight and make changes to my diet, I will likely end up with full blown diabetes within the next 10 years. So I’m dieting and working out for the foreseeable future. Yes, I miss pizza.

Doctors have a lot of biases when doing diagnoses and tend to skip the usual steps if they observe something that can explain your problems. This is the problem the article was addressing. Example would be my friend, who was a smoker. He came to a doctor and complained about sudden problems with breathing. Doctor did nothing just told him to stop smoking and was done with him. Few days later we rushed him to ER. He had lung infection and almost half of his lungs was already filled with water... He could have died. His lungs must have taken permanent damage as he complained for years about his breathing not being like before. This is the level of saving resources you are talking about?

Thank you for putting a word to how I view human beings. Consequentialism I can now put a name to the position.

I just went to say I’m not even vegan, but just love your perspective and you. So I watch!❤️

I have chostochondritis, terrifying when the pain occurred in the chest with no idea what was happening. Luckily the doctors paid attention because I have asthma and it's common amongst sufferers. I can't imagine if I didn't have that reassurance though. I'm glad your partner managed to figure it out, shame they couldn't have help through medical care.

hahahahaha omg the smoking part 😂 i was a smoker for years and doctors dismissed literally EVERY complaint i had - from (rightfully so) breathing problems, to stomach/digestion issues, all the way to back pain. so no, smokers do not get treated better than fat people??? in fact, i quit smoking five years ago and STILL get asked about my smoking at the doctors

That’s why as a patient you have to be your own advocate when receiving healthcare. There is onus on the patient.

Okay. Cool. Well... I'm too expensive for society. Sorry for that. Just don't help me and let me die then. 😑

My weight is a significant contributing factor to some of the health issues I experience, sleep apnea, my joint pain, the fact that I get winded climbing a flight of stairs, higher than average heart rate, restricted blood flow to my hands and feet,. That’s pretty much all of the health issues I have atm, and they really suck sometimes. Me losing weight will greatly benefit my health, and by extension, my life

I recently developed flank pain and was sent to get a ultrasound on my kidneys for stones .. they found NOTHING. They did discover one of my kidneys is slightly smaller but this is normal and not dangerous. The pain eventually faded on its own. Indicating I pulled a muscle on my side. I sure as hell got the $500 bill though . Now imagine getting a cat scan, radiation exposure or worse exploratory surgery for no helpful information. This is why we ONLY test as a last resort

I had zero issues with your previous video. Why you had to do this video, is mind-numbing to me. Just keep being you, Swayze.

I love love love that t-shirt (the red one with the crow)....and I love you of course 💜

Due to the internet (and social media) people expect EVERYTHING to be personally catered to them. Thats not how reality works.

Its really weird comparing doctor horror stories with my own - Ive always been overweight/obese growing up, and while the subject of weight loss does always come up with every appointment I've ever had, I was still able to get supportive specialist healthcare that was unrelated to my weight. So a lot of these stories, while i can empathise immensely, I cant really relate to. Hyperawareness of disgust responses to the existence of fat people leads many of us to be borderline paranoid about other's opinions. Unfortunately, this is likely what leads to misunderstandings and general dissatisfaction and even nihilistic views of society.

I think there are definite issues in medical care. It is more because doctors share similar biases to the rest of society and don't always think flexibly or consider how to handle behavior in practice (they aren't trained in that). It is important that the doctor be able to spend enough time to reflect on the health history so that they can consider differential diagnoses, thoughtfully (not expecting or testing for rare, unless there are red flags). In practice for medicine to work better, simple blood work and physical exams are a starting point with little cost and a focus on what needs to be worked on. More people should know their A1C for preventative reasons. Scans aren't necessary unless previous signs/symptoms look unusual. For the doctors, I think that weight related concerns should focus on discussing the patient's challenges to eat healthy/exercise and evaluating blood work. Seeing quality of life and blood work improve can happen more consistently than a patient getting out of the obese range. Weight loss is helpful, but in practice is too often unreliable. Practically, speaking it is a perk but not always needed for improved health.

Social justic "warriors" can be some of the most SELFISH people at times

I got my blood work done last month during a normal preventative physical and it was $1516.

The tone of this video makes me uncomfortable. It feels defensive rather than reflective.

I have PCOS AND hypothyroidism and diet & activity help regulate the symptoms for both of these conditions. I eat a vegan junk food diet but have starting eating a lower calorie & lower glycemic index diet to lose weight in order to manage my symptoms. Obesity can actually make PCOS and thyroid symptoms worse. So the idea that a heavy period being related to PCOS or hypothyroidism wHiCh iS uNrELaTeD tO wEiGhT is actually comical.

OMGosh I watch Bob and Brad all the time. They are the best!

The truth is that most people who are overweight are in that state because of their life choices, not because of a condition. So a doctor telling them to lose weight is a pretty rational thing to say, considering that it would solve the problem for 99% of cases. And "the problem" isn't being fat by itself, it's the decline in health that's going to result from something that most people have complete control over. If you love your body, you should take care of it and staying at a healthy bodyweight is crucial.