Treat fat first even if it kills you

Melissa McEwen of Shakesville linked to a column about a frightening proposed medical guideline, telling physcians to "treat the weight first." Never mind that many times the obesity is caused by an underlying condition that won't get treated and would likely become worse.

Ragan Chastain takes up the story. At her blog Dances with Fat she describes herself as a "Speaker, Writer, Dancer, Choreographer, Marathoner, Soon to be IRONMAN, Fat Person, Activist." She links to the article by Dr. Caroline Apovian (which I did not read). According to Apovian treating the weight first includes postponing treatment for such things as diabetes and high blood pressure. In addition, medications that have a side effect of weight gain, including insulin, should be tapered off and alternatives found.

That leaves even me gasping. Tapering off the use of insulin? I'm pretty sure there isn't an alternative to that and life without it could end up rather short. That means Apovian is advocating a path that would lead to death.

And what is Apovian's alternative? Try something. If the patient hasn't lost 5% of their weight in 12 weeks try something else. Yep, let's experiment on the patient rather than trust evidence-based treatment plans.

The big question: why is a doctor advocating the dangerous path of tapering off the use of insulin? Chastain easily found the reason for what Apovian says. She sits on several advisory boards of and received research money from pharmacy corporations. And their products include weight loss drugs. She's a part of the Diet Industry and a frontline player in the war on obesity.

Though Apovian wants this to be official policy there are already many doctors who unofficially follow it. Fat hatred in the Medical Industry is already common.

Chastain has suggestions for dealing with doctors who are a part of this war on obesity. Ask questions: What treatment plan would you offer a thin person? I want to research what you're recommending, where can I find a study? Where can I find a study on the safety issues of the diet plan or diet surgery you recommend?

Also ask to see your chart. The doctor might have tagged you as "non-compliant" – meaning you might be denied future treatment, such as a transplant, because you don't follow his orders on fat reduction.