So don’t try to tell me that it’s just as easy and mildly unpleasant for me to lose weight as it is for the skinny chick in the waiting room. It’s a known medical fact that that’s not true.

My doctor is truthful with me about my health risks from my weight. She is helpful in recommending what kinds and level of exercise are medically appropriate, and what food choices will help if I can manage to make them.

I need to know that, so I know what exercise I should do now, and what I should eat now, instead of what weight loss efforts would be actively dangerous.

The line between professional and unprofessional conduct is when truth becomes divorced from compassion, and when practical advice is replaced with blame and rancor.

The relationship between doctor and patient is economic. *You* may think you have some sort of metaphysical guardianship of my health. *I* think I’m paying an alleged professional to provide the service of telling me things I may not already know about my health—like a tumor or something, and to provide the service of treating the illnesses I complain of in the most effective way possible *regardless of the behavior I choose in my personal life*.

Why should Doctor X treat my high blood pressure if I’m just going to be dead in ten years because of my weight? Because that’s what I’m paying him for!

Priesthood is a sacred trust. Medicine is a profession.

If you aren’t going to alleviate my symptoms or treat my problem with the best technology available regardless of my behavior in my personal life, then show me the door and don’t charge me for the visit where you tell me so.

I’ll go find a business where the professional I hire will do his job instead of whining at the customer.

I know being fat is unhealthy. And when the pharmaceutical companies come up with a medical treatment that lets me stay slim with the same level of effort and personal discomfort slim people go through, I’ll lose weight. Fat people may lose weight eating the same amounts as skinny people, but restricting our intake to those amounts is much more unpleasant, every hour of every single day, week, and year we do it. It’s living in hell.

I know I’m fat. My husband knows he’s fat. You know what? I’m not going to live a living hell, and neither is he, just for the sake of not being fat—and don’t tell me that’s not what it takes because it *is*.

If you can’t do your job for a particular customer because our behavior offends you, then don’t take us as customers.

If you do choose to take me as a customer, don’t lie to me, just don’t waste my time nagging me about behavior I know damn well is unhealthy—just treat my ills as best you can working *around* my behavior in my personal life.

Professional: You need to lose sixty pounds in a responsible way. Your extra weight is causing or worsening [list of problems]. I want you exercising like so, I have a brochure on how to eat right. Please read it and, if you have any questions, ask. Now, about your cholesterol levels, here’s what we can do medically with the situation as it stands…. Your weight problem is at the level that bariatric surgery may help you. If you don’t follow this diet I can’t keep your blood sugar down and you could lose your eyesight or your limbs. If working together we can’t get fifty pounds off of you, you could have a heart attack at any time and fall over dead. If we can’t get fifty pounds off you, it could kill you within ten years no matter what else I can do for you. If you don’t think you can handle hearing about it today, I’d like you to schedule time with (me, specialist, whatever) for a weight loss consultation.

Unprofessional: You’re fat. If you don’t lose weight you’re going to die. If I was as fat as you I’d my knees would hurt, too. Why should I treat your cholesterol with pills when you won’t take off the weight? What you need isn’t this ingrown toenail fixed, you need bariatric surgery.

If I wanted to pay money to be insulted and punished, I’d hire a dominatrix, not a doctor.

I don’t think I would have done/said what this physician did/said. I am NOT making judgments about the propriety of what was said because I obviously don’t know the complete story, but SHEESH!!! — tell the woman to get a life and just change doctors. Referring this matter to local law enforcement — from of all places the state medical board — is shocking beyond belief.

In the scales of life, I wonder which is worse: hurting someone’s feelings OR desperately trying to reduce their morbidity — which is VERY high. While the two are not necessarily mutually exclusive, … I mean, God forbid I insult someone in an effort to help them.

I don’t know if it is true as reported, but if so I don’t think this would be the most appropriate argument to make for weight loss. I do know that I don’t think it is actionable!

While I believe that involving Attorney General is way out of proportion, one cannot blame the woman for complaining, if this was what the doctor said.

So, sure, tell her smoking will kill her and she should stop. Offer to help her find a way to quit smoking. However don’t be the jerk who said “Why should I bother treating your high blood pressure/degenerative disk disease/hypothyroidism when you are just going to be dead in ten years?” It really happened.

(1) I have several attendings I should have been ratting out to law enforcement long ago; and,

(2) THIS PROFESSION HAS FAR BIGGER ISSUES THAN MALPRACTICE REFORM.

I know there are ways to discuss sensitive matters with patients, obesity being one of them, and unless the doctor insulted this patient in any derogatory manner, I see no need for him to apologize. Just hoping she won’t be consulting a trial lawyer soon.