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  1. #1
    Intriguing.... Quinlan's Avatar
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    Default Is recommending dieting unethical?

    Doctors will often tell their fat patients to eat less but is this ethical? Given recent evidence that dieting cannabilizes your brain cells, has a terrible success rate, is linked to weight GAIN in the long term and will likely cause shame and avoidance of medical help if they don't lose the weight.

    Dieting

    Likely outcomes of a doctor recommending dieting:

    -Weight gain over the long term
    -Obsessive behaviours/possible eating disorders triggered
    -Lower self esteem (due to high failure rate)
    -Shame/guilt
    -Cannabilisation of brain cells
    -Avoidance of doctors leading to undiagnosed serious conditions becoming worse
    -Stress leading to further health problems

    Unlikely outcomes:

    -Long term weight loss

    Would we allow any other medical treatment that fails so often, actually makes the condition it's supposed to cure worse and results in your brain eating itself to be recommended so often and so casually?

    Shouldn't we be telling people specifically NOT to treat their own obesity so that they don't make things worse?

    Maybe instead of telling people to fight their body and their instincts we should tell them to love their bodies as they are.
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  2. #2
    Crazy Diamond Billy's Avatar
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    I think that it would be unethical to advocate a starvation diet, but advocating a balanced diet would cause weight loss as well.
    Ground control to Major Tom

  3. #3
    Honor Thy Inferior Such Irony's Avatar
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    Quote Originally Posted by Quinlan View Post
    Doctors will often tell their fat patients to eat less but is this ethical? Given recent evidence that dieting cannabilizes your brain cells, has a terrible success rate, is linked to weight GAIN in the long term and will likely cause shame and avoidance of medical help if they don't lose the weight.

    Dieting

    Likely outcomes of a doctor recommending dieting:

    -Weight gain over the long term
    -Obsessive behaviours/possible eating disorders triggered
    -Lower self esteem (due to high failure rate)
    -Shame/guilt
    -Cannabilisation of brain cells
    -Avoidance of doctors leading to undiagnosed serious conditions becoming worse
    -Stress leading to further health problems

    Unlikely outcomes:

    -Long term weight loss

    Would we allow any other medical treatment that fails so often, actually makes the condition it's supposed to cure worse and results in your brain eating itself to be recommended so often and so casually?

    Shouldn't we be telling people specifically NOT to treat their own obesity so that they don't make things worse?

    Maybe instead of telling people to fight their body and their instincts we should tell them to love their bodies as they are.
    I think part of the problem so many have with dieting is they become overly strict and obsessive about it. People are impatient, they expect to lose several pounds a week and want to see drastic results right away. They restrict food too much. Cut calories too much. It wreaks havoc with the body's metabolism and sets someone up for failure because its very difficult to sustain over a long term.

    It's best to lose weight gradually- about 1-2 lbs a week. Just eat food in moderation- know how many calories you need a day to maintain your weight and go a little below that to lose. If you choose healthier foods to eat, you'll likely lose some weight simply because they are likely to be lower in calories. No need to eliminate foods entirely, although if you want to succeed dieting, you'll have to eat alot less junk than you used to.

    In general, weight is just a number and how healthy you are and feel should be what's most important. Do you feel healthy? Do you have enough energy to do normal activities? However, if you are seriously overweight and the weight is to the point where it seriously impacts your health and your ability to get around, then its time to lose the weight. In that case, I don't think it's unethical for a doctor to tell someone to lose weight, since it could be the difference between life and death.

    On the other hand, I don't think doctors should be telling slightly overweight but otherwise healthy people to lose weight. You can recommend someone eat healthier or exercise more without having to bring up weight.
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  4. #4
    Intriguing.... Quinlan's Avatar
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    Quote Originally Posted by SuchIrony View Post
    I think part of the problem so many have with dieting is they become overly strict and obsessive about it.
    If it were any other kind of treatment would we encourage people to go it alone if we knew full well that people are likely to obsess over it and do it wrong?

    People are impatient, they expect to lose several pounds a week and want to see drastic results right away. They restrict food too much. Cut calories too much. It wreaks havoc with the body's metabolism and sets someone up for failure because its very difficult to sustain over a long term.

    It's best to lose weight gradually- about 1-2 lbs a week. Just eat food in moderation- know how many calories you need a day to maintain your weight and go a little below that to lose. If you choose healthier foods to eat, you'll likely lose some weight simply because they are likely to be lower in calories. No need to eliminate foods entirely, although if you want to succeed dieting, you'll have to eat alot less junk than you used to.
    1-2lbs a week actually sounds quite rapid to me, I think most dieters would be more than happy with that. In my opinion a modest approach will only ever achieve modest results, look how extreme bariatric surgery is and the results of that are modest in the long term.

    In that case, I don't think it's unethical for a doctor to tell someone to lose weight, since it could be the difference between life and death.
    But we know in that in practice they are more likely to put on weight with their weight loss attempts than lose it. People who try and fail to lose weight usually end up bigger than those that never try at all. Should the doctor just leave them to treat themselves or should they be carefully managed/supported?
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  5. #5
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    You know there's a difference between suggesting people go on starvation or other "diets" and that people change their diet to something healthier. Trying to pit being "fat positive" against tormenting people to eat less calories or nutrients than is healthy is a false dichotomy.

    Such Irony is right.

  6. #6
    a scream in a vortex nanook's Avatar
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    well, doctors recommend more unethical things than dieting. like shitloads of harmful drugs. given that many diseases are caused by nutrition (although doctors have no education about this link), pointing a client to think about changing his 'eating' is at least in the ballpark of ethical healing. what may make the dieting recommendation 'unethical' are more specific suggestions, if those are just plain unhealthy. not only are doctors uneducated about what is healthy, the education of what is healthy (that of nutritionists) is it self uneducated. so if you have to ask about ethics, than this is has to be an ethical dilemma. much or all treatment of ill people has been such a dilemma. we still don't know much about the body or health. therefore doctors can not know, what they are doing. but they have to do something ... that's the common sense.

    it would be nice if doctors would be more up to date on science. it's a difficult job, even without being up to date. there are not enough smart enough men, too much doctors are needed. few can embody the best, that a doctor could be, at the current state of science.

  7. #7
    Intriguing.... Quinlan's Avatar
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    Quote Originally Posted by Marmie Dearest View Post
    You know there's a difference between suggesting people go on starvation or other "diets" and that people change their diet to something healthier.
    ...and what is that difference specifically?

    Diet = short term calorie restriction, "Lifestyle change" = chronic calorie restriction.

    Either way, the results are unimpressive and the side effects bad.
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  8. #8
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    Obesity has a link with getting heart-attacks.
    Obesity also has a link with getting type 2 diabetes.
    Losing some fat has shown to reduce the likelihood of both.
    The thing that truly decides whether you get none of these, one of these, or both is based on your lifestyle choice.

    Besides giving medicine that only temporarily reduces the likelihood of heart-attacks or diabetes, the doctor can only recommend what the patient should do to prevent these scenarios from happening. The medicine will not work unless the patient is willing to do some lifestyle changes.

    The doctor is giving you a choice, lose some weight, or you may end up with one of these scenarios in the near future. It is not unethical, it is stating the truth.

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    lab rat extraordinaire CrystalViolet's Avatar
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    Actually, I have read that it is Yo-Yo dieting that does the damage, and to be honest, I think smoking and drinking have far more impact myself. My reasoning being, unless you are main lining fat, and most people really don't, and avoid soft drinks etc (which in my opinion, are the real culprits), and squeeze in excersise...There isn't much more you can do really.
    My honest evaluation is people don't exercise enough, and yes, I'm guilty of that. I feel much better when I excersise.
    Currently submerged under an avalanche of books and paper work. I may come back up for air from time to time.
    Real life awaits and she is a demanding mistress.

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  10. #10
    Intriguing.... Quinlan's Avatar
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    Quote Originally Posted by Burning Rave View Post
    Obesity has a link with getting heart-attacks.
    Obesity also has a link with getting type 2 diabetes.
    Losing some fat has shown to reduce the likelihood of both.
    The thing that truly decides whether you get none of these, one of these, or both is based on your lifestyle choice.

    Besides giving medicine that only temporarily reduces the likelihood of heart-attacks or diabetes, the doctor can only recommend what the patient should do to prevent these scenarios from happening. The medicine will not work unless the patient is willing to do some lifestyle changes.

    The doctor is giving you a choice, lose some weight, or you may end up with one of these scenarios in the near future. It is not unethical, it is stating the truth.
    The thing is we know, with great predictablity, that most of them will fail. This is a well established fact, regardless of what they should do in an ideal world whatever it is they do in practice fails in most cases.

    So the high failure rate is predictable and the negative side effects of failure (shame/stress, brain cell autophagy, avoidance of medical treatment, weight GAIN) are predictable, yet we tell them to do it anyway?!

    Doctor says eat less>patient fails>patient feels shame and stress> cortisol levels rise> cortisol causes heart disease> patient dies fat

    Doctor says eat less>patient fails>patient feels shame and stress>patient avoids medical treatment> patient is diagnosed with heart disease too late> patient dies fat
    Act your age not your enneagram number.

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