Too Woke for Weight Loss.

i am in rotation d which starts off with
anesthesia ophthalmology emergency medicine in the medical profession there is no bias more fundamental and more widespread than the belief doctors have in the medical profession itself racism matters the history of colonialism matters but doctors above all else want to believe that whatever problem they are presented with is a problem that they as a doctor can solve and this leads to absurdities doctors apparently think that they can address and solve poverty racism colonialism mental health problems people's lack of motivation and then on the other hand we also have to deal with the underlying bias that doctors want to take every problem and transform it into something they can address and solve through surgery the most flattering thing i can say about this new peer-reviewed article that puts itself forward as a new set of guidelines for medical professionals to follow and for the government to follow the most flattering thing i can say about this report is that it argues that the canadian medical system is terrible which is a refreshing voice of dissent in a world where everyone including bernie sanders is always saying how wonderful canada's health care system is this contains a very worrying warning that not only is the canadian medical system too slow and too inefficient it's also too expensive apparently it's incredibly expensive in canada for people to get access to weight loss drugs and to weight loss surgery which basically is here referring to bariatric surgery gastric bypass surgery they report that people have waited for eight years to get this surgery in canada so this article points the finger at crucial crucial shortfalls crucial shortages crucial problems in the canadian medical system but that is not at all the message that the mainstream media took from the article instead as always stumbling and fumbling in the darkness they managed to make this into a very different kind of propaganda latching on to the ostentatiously woke and politically correct elements but again here the most fundamental bias of all is the belief in the medical profession itself this isn't racism we're dealing with this isn't colonialism it's medicalism what are the authors of this report fundamentally interested in they're interested in advocating for bariatric surgery they're interested in advocating for pharmacotherapy which means prescribing drugs like uh naltrexone yeah i rarely say that word out loud they want to treat obesity by handing out this kind of prescription medication and by getting more people into have surgery what they don't want to do is talk about weight loss being something that can be achieved through improvements in diet and willpower so the whole report is very much condemning the notion that obesity is just a problem you can solve through diet exercise and effort sign up for surgery sign up for drugs and complain that the government needs to put more money into providing surgery and drugs now i am not going to claim that the surgery and the drugs have zero positive effect i'm not going to claim that i'm going to warn that if you just look up the side effects of uh the drugs that are listed here under pharmacotherapy if you look up what the chemical effects of these drugs really are there's something very important to think about there in terms of weighing the benefit versus the harm new guidelines out today are calling for a dramatic shift in how obesity is viewed in canada and they urge doctors to look at the root causes of obesity not just a focus on weight loss alone sincerely or insincerely the journalists are manufacturing enthusiasm for this notion that obesity is not just about diet it's about your mental health and it's about your social media and that's that's the part of the equation that gets us into racism and anti-racism and left-wing wokeness so on and so forth the very simple very fundamental question i have to ask here is even if you are obese because of emotional problems what can a medical doctor do about it if you are obese because of poverty what can your medical doctor do about it because of your social media perhaps indeed because of racism and systemic racism both of which are referred to repeatedly in this peer-reviewed medical journal report your medical doctor probably cannot even have an intelligent conversation with you about your lifelong experiences of racism poverty having lousy parents i mean even the conversation about racism is not a conversation you would want to have with your medical doctor but if you could have that conversation with your medical doctor what good could it possibly do either one of you if you go to the doctor because you are afraid of having a heart attack or you have high blood pressure do you really want to sit down with that doctor and talk about your so-called social media talk about racism talk about oppression talk about your economic struggles with poverty knowing that your doctor is not going to lift a finger to actually help you they're not going to help you deal with poverty they're not going to help you improve your economic circumstances or your family circumstances they're not even going to advise you to get a divorce if the reason why you're miserable and poor and overweight is because you have a lousy marriage absolutely no good can come of it so i really have to fundamentally ask is it wise to advise doctors and the government and members of the public to drag this part of the medical system into pretending it has the solutions for these political problems what it calls psychosocial problems the advice comes from obesity canada and the canadian association of bariatric physicians and surgeons some of the factors the experts say need to be considered are genetics and biology trauma and mental health issues can also be factors in excess weight the importance of the racism issue isn't just shown by how much space it takes up in this medical report but also by its intentional omission from what many of the journalists have said about this report in the report the question of racism of white people against indigenous people native people american indians whatever you want to say first nations the creed the ojibwe the inuit that's a huge issue in this report and the news broadcast i just quoted from you which is the official government of canada news broadcast the cbc taxpayer supported it just omits to mention this issue of racism entirely and many many of the journalists writing for different newspapers either choose to not mention this at all or summarize it and allude to it in the most vague and woke manner possible like helping native people overcome their barriers it's a big issue it's a huge issue it's explosive and you know what the worst people in the world to deal with it are medical doctors medical doctors are not equipped to even have a casual conversation about these issues i don't think doctors can do this i'm not questioning whether or not they should really think through the first point on this list what would it mean for your doctor to try to engage with your social realities you come into the doctor's office because you're overweight you have hypertension you're worried about a heart attack or you just have difficulty walking up and down stairs because you're too fat and the doctor tries to quote unquote engage with your social reality the doctor tries to validate your experience of systemic racism how is a white medical doctor who grew up in thunder bay ontario and then joined the most privileged wealthy class of the canadian working public by studying biochemistry how is he equipped to deal with this and let's keep in mind a very significant percentage of our medical doctors in canada aren't even white people who grew up in canada they're from pakistan or india or the arab world the middle east we have so many doctors from all around the world who are just unbelievably poorly equipped intellectually emotionally or even in terms of just raw book learning to even attempt to do this and i think if they did attempt it it would at best result in embarrassment for all parties underlined and read here again strive to build relationships that incorporate healing from multi-generational trauma do you even want your doctor to try to do that for you doctors are advised to build their own knowledge regarding the health legacy of colonization it's so hard to get students who are majors in political science to care about this stuff it's so hard to get anyone to care about this stuff conversely if this could be made to happen who would be equipped to do it who would best be able to do it we would never expect medical doctors to do this i think you can pause and reflect that in the united states and canada there's nobody who can do this political science majors can't do this history majors can't do this indigenous study majors can't do this there is actually no profession there is no area of expertise there is nothing you can study at any university that will prepare you to play the role that's being described in this report in terms of healing the wounds of genocidal colonial history maybe there is something really important for us to think about there but it's mind-blowing to think that this has come up in a report giving you guidelines on how to treat obesity in a general practitioner's office in politics we often have to talk about the public perception of a problem as something quite separate from the problem itself the public perception of obesity weight loss and the role of the medical system role of medical doctors this is a very important problem unto itself in the year 2020 headline obesity not defined by one's weight or size new guidelines say according to arya sharma scientific director of obesity canada it's just a very very simple question and that is does this person's body fat or excess body fat affect their health if it does we've got obesity if it doesn't we just have a large person with a lot of body fat ian patton one of the authors at obesity canada has encountered his fair share of weight discrimination despite excelling in sports he was bullied for his size while growing up obesity did not become a health issue for him until he approached his 30s i'm i'm sorry i'm sorry so you mean when he was in his 20s perhaps you mean in his late 20s he he didn't have any health problems until 27 28 oh oh so it was quite wrong for people to advise him to lose weight earlier in life given that he never developed complications he never developed health problems due to obesity until he approached his 30s well strong strong argument when she approached his 30s he struggled with hypertension and severe sleep apnea he lacked energy and had constant pain and was always out of breath well gee it certainly would be misguided for health professionals to intervene and tell him to lose weight when he was a teenager or in his early 20s back when he was excelling in sports certainly certainly there's there's no reason to worry until after your excess body fat is causing health problems that's the thesis of this newspaper article this newspaper allegedly reaches an audience of 6.5 million people in a country that has only 37 or 38 million people in total i'm very skeptical about that number 6.5 million you should be skeptical too but nevertheless we have here the presentation of you know a very dubious narrative dripping with scientism it presents itself cloaked in scientific certainty and it tells people something they may be inclined to believe new clinical guidelines for obesity focus on health rather than just a number on the scale weight management is not about using willpower and just trying to find the best diet so this this quotation is accurately reflecting what the the actual peer-reviewed article says the peer-reviewed article emphasizes that it's totally wrong to view weight loss in terms of willpower and diet that's wrong wrong wrong we should instead regard this as a chronic disease tell me something can you name another chronic disease that can be cured simply by willpower and improved diet can you name another chronic disease that routinely is cured by willpower and an improved diet there are many many diseases there are many many injuries that you are powerless to cure yourself through willpower and improved diet i think it is incredibly important for that peer-reviewed scientific study and for government guidelines and for newspapers to say the exact opposite of what's being said here that yes obesity although it's a very very serious health problem it's one of those rare health problems you can solve yourself with willpower and improve diet not by using say medications that have very very serious side effects and very very dubious health benefits all right but we continue here weight management is a chronic medical condition and as a medical disease we need to use a medical treatment model yes isn't that convenient for people whose lives revolve around surgery and so-called pharmacotherapy wharton said the new canadian guidelines may be among the first in the world to emphasize medical nutrition therapy rather than diet oh that was the problem we're gonna stop recommending diet and we're gonna start recommending medical nutrition therapy right and and you know the word diet the problem with that is that it's a word that comes with potential negative connotations well that'll that'll solve the problem right okay point taken they also call for compassion and empathy and to consider the patient's goals for their health weight loss is a difficult issue to talk about poverty and racism are difficult issues to talk about and it's no doubt true that some people who are struggling to lose weight are also struggling with poverty and the disadvantages of living in a country that is uniquely racist against them i.e our indigenous people in canada the creed the ojibwe the mohawk so on and so forth these are huge huge difficult issues to deal with and i think that probably some of the authors of this report really wanted to talk about those issues honestly but what we end up with is another paralyzing examination of how political correctness and wokeness ends up with people not being able to discuss these issues at all and not being able to really take action at all again the most fundamental bias throughout this report it's not racism it's medicalism it's that by medicalizing this issue we can solve it and you know what the truth is the solution to the problem of poverty the solution to the problem of racism the solution to the problem of so-called mental health and 99 of the solution to the problem of weight loss is outside the bounds of is beyond the limits of what the medical profession can or should do