healthy dialogue

April 4, 2007 10:56 AM

Often there are questions posted to Ask Metafilter that have a similar format. The poster will have a general health problem, and will also be fat. In 95% of the cases, losing weight is the first step to solving the problem. Yet, this answer is often immedietly removed. Is it really so terrible to point out the elephant in the room? And, more pointedly, are we doing others a diservice by not being frank?
posted by four panels to Etiquette/Policy at 10:56 AM (178 comments total)

I do not understand why you are asking this question, four panels. What do you hope to accomplish here? Do you want moderators to leave "lose weight" answers more generally? Did you leave a "lose weight" answer that was deleted, which you felt should have been left in a thread?
posted by cgc373 at 11:04 AM on April 4, 2007

four panels, you are obese! We love you and we don't want you to die! You'd be better for it too, you fat arse.
posted by parmanparman at 11:04 AM on April 4, 2007

Is it really so terrible to point out the elephant in the room?

Hehe.
posted by The Straightener at 11:05 AM on April 4, 2007 [8 favorites]

If the asker mentions his or her weight problem, it seems like fair game for an armchair diagnosis, to me. Obesity is linked to many health problems (heart disease, diabetes, etc.).
posted by Blazecock Pileon at 11:06 AM on April 4, 2007 [1 favorite]

The question you posted that on was about how to address patronizing doctors. If the poster wanted advice on how to lose weight, she would have asked. Seems she faces enough criticism from her doctors, who are actually qualified to tell her to lose weight.
posted by sian at 11:07 AM on April 4, 2007

four panels, you kind of gloss over the tone and the ways in which people say "losing weight would be the first step in solving your health issue".

Often, it's something like "drop some pounds, fatass" which maybe sorta conveys the information in the previous statement but does it in an "attack the questioner" lameness that gets deleted.
posted by mathowie (staff) at 11:08 AM on April 4, 2007

Often there are questions posted
How often?

In 95% of the cases
What's 95% of often?

answer is often immedietly removed.
Often looses all meaning when you look at it too often.

Oh, god.
posted by Alvy Ampersand at 11:10 AM on April 4, 2007 [1 favorite]

I'm going to guess four panels that you've never had much trouble maintaining a target mass? For those who are eat watch challenged a simple "lose weight" comment is essentially useless (and undoubtedly something the asker already knows and therefor wouldn't need to ask Metafilter about). The elephant doesn't need pointing to.

Do you really think an answer of "lose weight" is going to induce a forehead slapping epiphany and exclamation of "Why didn't I think of that?"?
posted by Mitheral at 11:11 AM on April 4, 2007 [2 favorites]

four panels, your response was not answering the question.

The thread in question: "How can I get my doctor to take me seriously about my libido problems?"

In which the poster notes asks some fairly specific things about communicating with her doctor, and acknowledges having been overweight for much longer than the issue she's addressing has been in play.

This is your comment, for posterity:

The very first thing you must do is lose weight.

Many things thereafter will fall into place, including your once unstoppable sex drive.

The South Beach program works like magic if you stick with it for at least a month.

Also consider an elliptical machine.

Good luck.
posted by cortex (staff) at 11:13 AM on April 4, 2007

I don't remove "Maybe you should lose some weight, it might help with your knee problems" types of answers from these threads. I do remove "Lose the lard tubbo" answers from these threads. There is a wide high desert plain between those two types of answers most of which are dealt with a on a case by case basis.

Sometimes -- and I have no idea what thread you nmight be referring to here, so this isn't about that OP -- the OP (and/or their friends) in health questions flags answers they don't like and this might lead someone to think that there is more of an issue with "lose some weight" responses than there actually is.

So, the phenomena you are referring -- this immediate deletion happening "often" -- does not actually exist. So, the next question is: is there a speciic situation you are referring to? None of the admins on this site are particularly touchy about fat issues except that it can be an admin headache that other people are particularly touchy about them. My bsic advice is that if you really think the OP should lose some weight to help them manage their problem -- and they know they are overweight, they said it already -- you need to find a better or more useful way of explaining that opinion so that it becomes a truly helpful comment and not just echo chambery "losing weight solves everything" nattering.
posted by jessamyn (staff) at 11:16 AM on April 4, 2007

Fat people know about the health problems associated with being fat, and generally either are trying to lose weight or know from experience that it's not going to happen. So it's usually pointless and redundant to tell them yet again.

On the other hand, if you are fat, people tend to jump on that as the first explanation of any health problem you may have, even if it's totally unrelated. This gets pretty annoying, and also makes it harder to find out about anything else that could be related to your problem. So people that jump into the thread just remind you that (surprise!) you're fat, and (surprise!) being fat is unhealthy, tend to come off as annoying assholes.
posted by moss at 11:16 AM on April 4, 2007

Q: My VCR keeps flashing 12:00, how do I fix this?
A: Lose some weight tubby.
posted by blue_beetle at 11:20 AM on April 4, 2007 [13 favorites]

If people would just stop being fat, then we wouldn't have this problem in askme.
posted by pieoverdone at 11:25 AM on April 4, 2007 [1 favorite]

Well, losing weight might make doctors take libido problems more seriously, I would imagine. It's still a pretty bad answer, and since the questioner is not asking for actual medical advice, but rather interpersonal advice, the answer is even worse.
posted by delmoi at 11:30 AM on April 4, 2007

It's still a pretty bad answer, and since the questioner is not asking for actual medical advice, but rather interpersonal advice, the answer is even worse.

Many of the answers in that thread have to do with dropping birth control pills, which also are medical advice and not interpersonal advice. They haven't been deleted yet.
posted by found missing at 11:42 AM on April 4, 2007 [1 favorite]

And why do I keep getting deleted when I tell people they're ugly?

Yeah, I'm talking about you, you hideous beast.
posted by Astro Zombie at 11:46 AM on April 4, 2007

If what you think you know about fat causing all these health problems is coming from mainstream media, you should read The Obesity Myth or other similar books--and double-check for yourself in the medical literature the claims that are made therein--before you post on the subject.
posted by not that girl at 11:48 AM on April 4, 2007 [1 favorite]

Dear AskMetafilter: My feet hurt. [more inside]

I'm over 500 pounds, which I realize is unhealthy but I'm not interested in losing weight. What I'm looking for is softer socks. Any suggestions?
posted by DU at 11:53 AM on April 4, 2007 [5 favorites]

Do I agree with DU for once? ::pulls brain out of head through ears::
posted by ThePinkSuperhero at 11:57 AM on April 4, 2007 [1 favorite]

The huge number of responsive answers that are removed from AskMe makes it much less useful. In general, Jessamyn et. al. tend to permit only those answers which they approve of to remain undeleted, which means that a huge spectrum of valid, accurate responses gets whacked.

Excess weight is not *a* cause of low sexual desire, it's the number 1 cause. Excess weight reduces testosterone, which hits sex drive directly, as well as the numerous ways it affects sex drive indirectly. And currently (16 undeleted comments in that thread right now) there are no comments suggesting that she lose weight, because Jessamyn has deleted them all.

(If you read the question narrowly, to only be "help me with my doctor" rather than "help me with my real problem", "lose weight" is *still* a decent answer. One reason she's having problems with doctors is that her substantial obesity is making her "a joke" to doctors.)

Dear admins: You're not doing a service to the poster or the community by deleting answers that are responsive to the question but Jessamyn doesn't like for whatever reason. Just because "lose weight" is a boring answer to a health question doesn't mean it's not the absolutely correct one.
posted by jellicle at 11:58 AM on April 4, 2007 [2 favorites]

The original poster:

I have always been overweight (yet confident, healthy and body positive!) and I have been using oral contraceptives for three years. I have not made any drastic changes to warrant my problem.

About a year ago, my sex drive just... disappeared. (My emphasis.)

What in that leads one to believe that the really insightful advice "Maybe you should lose some weight!" is even remotely helpful?
posted by Skot at 12:05 PM on April 4, 2007 [2 favorites]

Fat people have sex?
posted by Astro Zombie at 12:07 PM on April 4, 2007

I have been using oral contraceptives for three years

About a year ago

So all the "it's the contraceptives" comments are going to be deleted now?
posted by DU at 12:08 PM on April 4, 2007

The original poster:

About a year ago, my sex drive just... disappeared.

What in that leads one to believe that the really insightful advice, you should drop the birth control pills that you started three years ago, is even remotely helpful?

Or, on preview, what DU said less snarkily.
posted by found missing at 12:09 PM on April 4, 2007

Fat people have sex?

No, because they don't feel like it. Weren't you paying attention?

Also Skot, she's been on the pill for 3 years but is only recently having libido problems. Why is reasonable to blame the pill, but not the weight?

(I have no idea, one way or the other)

(but I suspect it's the contraceptives)
posted by ODiV at 12:10 PM on April 4, 2007

(and beaten... twice... soundly)
posted by ODiV at 12:12 PM on April 4, 2007

Okay, I get the point! You can say it without being snarky.
posted by found missing at 12:13 PM on April 4, 2007

What in that leads one to believe that the really insightful advice "Maybe you should lose some weight!" is even remotely helpful?

On the other hand, the poster is only 21 years old. So the three years on birth control is from 18-21. Bodies change as they get older- in that time period, I gained and lost weight (oh, college), and my stomach became more sensitive, and now I can't eat french fries for dinner every night without feeling gross. It's possible as she gets older that the extra weight will have more an effect on her sex drive then it did when she was younger. So it's not a completely crazy answer to this question, and it kind of sucks that a commenter would have to go to great lengths to justify what is a relevant answer to this question.
posted by ThePinkSuperhero at 12:14 PM on April 4, 2007 [2 favorites]

Fat people have sex?

It's called 'going hogging' or 'whale tagging'.
posted by pieoverdone at 12:16 PM on April 4, 2007 [2 favorites]

Why is reasonable to blame the pill, but not the weight?

Because if I take her at her word (I have little choice), she's "always" been overweight--which I take to mean "since becoming sexually active"--and the pill is a (relatively) recent change? I don't get it. The poster acknowledges that she's overweight, always has been, it's never been a problem libido-wise, and people here are suggesting that magically . . . it's become not just a problem but the problem?

Look, maybe I flew off the handle (that would be the reason that I mostly lurk here any more anyway), but it seems like whenever anybody even whispers "overweight" in a thread, there's a dozen people ready to pounce. I mean, South Beach diet? As advice to a woman who's lost her sex drive? Really?
posted by Skot at 12:17 PM on April 4, 2007

found missing? Hope you don't think I was making fun of you. Just saying that both you and DU beat me in responding to Skot with the same answer.
posted by ODiV at 12:19 PM on April 4, 2007

Birth control pills are known to have delayed side-effects.
posted by moira at 12:19 PM on April 4, 2007

it kind of sucks that a commenter would have to go to great lengths to justify what is a relevant answer to this question.

Not really. Your point is valid, but HURF DURF BUTTER EATER is a much bigger problem on this site (and in society at large) than failure to "point out the elephant in the room" (hurf durf). I think it's perfectly reasonable to make sure people justify such comments rather than seize the opportunity to let fly with another "lose weight, fatty!"

I mean, no one can possibly think that overweight people have never been told that they should lose weight or thought about their weight before, so it's not as though they're being deprived of vital information. The important thing is to try to make sure they can post about health problems without cringing.
posted by languagehat at 12:21 PM on April 4, 2007 [3 favorites]

and the pill is a (relatively) recent change?

Three years? Really?
posted by Blazecock Pileon at 12:21 PM on April 4, 2007

I think it's perfectly reasonable to make sure people justify such comments rather than seize the opportunity to let fly with another "lose weight, fatty!"

No, that's true. And the deleted comment four panels posted above didn't go into as much detail as it should have. jellicle's answer above regarding weight gain as it relates to testosterone levels in the body was pretty interseting, and might(?) be appropriate for the thread, in some form.
posted by ThePinkSuperhero at 12:24 PM on April 4, 2007 [1 favorite]

Bad deletion.
posted by smackfu at 12:25 PM on April 4, 2007

...no one can possibly think that overweight people have never been told that they should lose weight or thought about their weight before, so it's not as though they're being deprived of vital information.

The vital information is obviously not that they are fat. The vital information is that being fat can affect sex drive. Personally, I didn't know that thing about testosterone, obesity and sex drive. Did you? Did the poster?
posted by DU at 12:26 PM on April 4, 2007

OViV: Sorry, my comment was meant to be self-critical, not defensive. I need to practice more at my supposed first language.
posted by found missing at 12:28 PM on April 4, 2007

The huge number of responsive answers that are removed from AskMe makes it much less useful. In general, Jessamyn et. al. tend to permit only those answers which they approve of to remain undeleted, which means that a huge spectrum of valid, accurate responses gets whacked.

Do you have any idea how few comments are deleted compared to those left to stand? It's not some crazed willy-nilly machete fest, nuking any little thing we can find.

I've deleted two whole comments from that thread—the four panels comment cited above, and a link to a porn site. No idea if Jessamyn has nuked any others, but I'd guess not much.

The get-off-the-pill responses may be piling up a bit, but they seem at least to be addressing directly the concern, rather than simply ordering the asker to lose weight wholly irrespective of the question asked.

An answering respectably suggesting in useful terms that the asker discuss weight as a potential factor of discussion with her doctor wouldn't be a problem.
posted by cortex (staff) at 12:28 PM on April 4, 2007

Three years? Really?

Relative to "always" having been overweight? Sure, unless the poster is four.

Gah, I knew piping up was a bad idea. At any rate, since I am skinny, I will never need advice anyway, but now that you know that I'm skinny, maybe someone can help me out with some much-needed advice along the lines of, "Hey, scarecrow! Why don'tcha put some meat on yer bones!"

Hey, I can't get the paint all the way into this corner!
posted by Skot at 12:31 PM on April 4, 2007

Skot: Don't sweat it. Your comments helped lead to further insightful discussion about site etiquette and libido problems. And eat a sandwich, would you?
posted by ODiV at 12:39 PM on April 4, 2007

1. South Beach for at least a month
2. Elliptical machine
3. ???
4. PROFIT!!!

People assuming that just because a weight loss tactic worked for them, it will work for any random fat person, offend me more than jokes ever could.
posted by gnomeloaf at 12:41 PM on April 4, 2007 [6 favorites]

And, more pointedly, are we doing others a diservice by not being frank?

Yes. Because no one else but MeFites dare speak the truth! I bet millions overweight people are walking this earth, completely unaware that mainstream society thinks of them as unhealthy jokes. We must fight the power, and say what others are too timid to say.

I mean, really! Talking about people being fat is such a taboo in this society! No one jokes about it, doctors fear mentioning it to their patients, the television news media refuse to run stories about it. I can't think of the last time I read about a new diet or exercise plan that could help these poor people with their unmentionable problems. It's as if publishers were actually frightened to put these books on the shelves or promote them. And don't even get me started about the campaign of terror that keeps women's magazines from addressing this all-important issue with the proper words and photos to shame those fatties.

It's time the iconoclasts on MetaFilter take up the cause, and say what no one else will say. How else will overweight people get the message?
posted by occhiblu at 12:53 PM on April 4, 2007 [17 favorites]

Perhaps wrapped in some sort of pastry?
posted by ODiV at 12:58 PM on April 4, 2007 [6 favorites]

And currently (16 undeleted comments in that thread right now) there are no comments suggesting that she lose weight, because Jessamyn has deleted them all.

cortex: I've deleted two whole comments from that thread

I don't know if you think I'm doing this hatchet job activity because you think I'm the only person adminning AskMe or if you think I'm doing this because I'm a female and -- maybe? -- uptight about weight issues but in any case as all three admins have said "What you say is happening is not happening." and especially it's not happening at my hand. jellicle, your histrionics obscure the real issues here and if you want to talk policy, let's do that, not just point the finger at some nonexisistent "the bitchy chick did it" conspiracy.

People will often hop into any AskMe thread about anything and say "my hobby horse topic is the answer to your problems" whether it's nasal douching, church/prayer, weight loss or reading Andrew Carnegie. If you can't take ten words to explain what the correlation between your suggestion and the OPs problem is (as you did here, four panels, but you did not do in your comment) the "it helps" to "it's annoying" ratio can get out of kilter.
posted by jessamyn (staff) at 1:01 PM on April 4, 2007 [7 favorites]

Jessamyn et. al. tend to permit only those answers which they approve of to remain undeleted, which means that a huge spectrum of valid, accurate responses gets whacked.

This is a bunch of bullshit.
posted by OmieWise at 1:05 PM on April 4, 2007

nasal douching

My crush deepens.
posted by and hosted from Uranus at 1:07 PM on April 4, 2007 [3 favorites]

Fat people know about the health problems associated with being fat

Not at all universally true. Sure, most people know, but an alarming number of people do not know about all of the health problems associated with being fat.

Many obese people are proud and/or don't care that they're obese, and think it's just an appearance thing and not a health risk / problem. That or they're aware it can cause heart trouble, but they: a) feel invincible ("It won't happen to me"), b) don't realize all of the other problems it causes.

You'd think they'd know given how much media is out there to explain that it's bad for your health, but they don't. Hence the birth and continued use of terms like "BBW" and others. Many large individuals are perfectly content to be so, and many of those are mostly unaware of just how many health problems can be caused by obesity.
posted by twiggy at 1:15 PM on April 4, 2007

Perhaps if her boyfriend were not circumsized she'd be more interested?
posted by Rock Steady at 1:17 PM on April 4, 2007 [3 favorites]

Health problems can be caused by not exercising, even if you're skinny. Health problems can be caused by living in a polluted city. Health problems can be caused by having bad genes. Health problems can be caused by falling down. Health problems can be caused by having pets. Health problems can be caused by gardening. Health problems can be caused by eating salad. Health problems can be caused by exercising. Health problems can be caused by eating too much meat. Health problems can be caused by eating not eating enough protein. Health problems can be caused by listening to really loud music. Health problems can be caused by having sex. Health problems can be caused by spending too much time at the computer.

Health problems can be caused by almost anything at all.

The ridiculous insistence that we must tell fat people, and only fat people, that they are obviously unhealthy because of X cause, is just bias and self-righteousness.
posted by occhiblu at 1:20 PM on April 4, 2007 [8 favorites]

nasal douching

I just found the name for my new punk band.
posted by Gamblor at 1:24 PM on April 4, 2007

Hence the birth and continued use of terms like "BBW" and others. Many large individuals are perfectly content to be so, and many of those are mostly unaware of just how many health problems can be caused by obesity.

One can have self-esteem and still be cognizant of the potential problems. I find your etymological analysis of "BBW" pretty much entirely ignorant of the culture.
posted by and hosted from Uranus at 1:29 PM on April 4, 2007 [1 favorite]

Obligatory. (not very SFW)
posted by Burhanistan at 1:31 PM on April 4, 2007 [1 favorite]

I lost 54 pounds by nasal douching in church while reading Andrew Carnegie, and I've never felt better.
posted by Fuzzy Monster at 1:54 PM on April 4, 2007 [2 favorites]

Many obese people are proud and/or don't care that they're obese, and think it's just an appearance thing and not a health risk / problem. That or they're aware it can cause heart trouble, but they: a) feel invincible ("It won't happen to me"), b) don't realize all of the other problems it causes.

Or, you know, maybe they're just fucking sick and tired of people assuming that they are stupid. Or maybe they have decided that they aren't going to wait until they've lost the weight to develop some self-esteem. Or maybe they don't think it's any of your damned business and would rather not discuss their personal health issues with someone who doesn't even think they have the right to like themselves or thinks that fat people are only allowed to be fat if they're properly miserable and ashamed about it.

Just maybe.

You'd think they'd know given how much media is out there to explain that it's bad for your health, but they don't.

They probably know more than you think. Especially when there are so many helpful people like yourself just itching to point it out. Because you care so much.

Hence the birth and continued use of terms like "BBW" and others.

So the only way that someone could label themselves a "big beautiful woman" is if they are ignorant about the health problems that obesity causes? Meaning what? If they DO know about the health risks then they couldn't possibly consider themselves beautiful anymore? If someone is unhealthy they can't be beautiful?

Many large individuals are perfectly content to be so

Oh noes!! Whatever shall we do! There are people out there who are CONTENT TO BE FAT!!!

and many of those are mostly unaware of just how many health problems can be caused by obesity

Where are all of these mentally deficient fat people I hear so much about? I don't think I have ever met one. No one I know has ever met one. In fact, the only people I know who have had encounters with these ignorant lardasses are people like you who like to complain about them. Interesting. You'd think I would have run into one or two of these woefully uninformed individuals given that I come from a whole family full of fatties and used to be one myself. Perhaps the next time we are sitting around eating lard straight from the can I will take a poll.
posted by LeeJay at 1:56 PM on April 4, 2007 [18 favorites]

People will never stop making fun of fat people.
posted by Burhanistan at 2:04 PM on April 4, 2007 [1 favorite]

When someone posts something, there's only a very limited amount we know about them - just what is in their question. And while its possible that the poster's libido was decreased because a toxic waste plant opened next to her house, all anyone has to work with is what she told us, which is probably why the responses were mostly having to do with birth control and weight. I think telling the OP that her weight could be correlated to her libido, and that the doctor's not just saying that to be a jerk, is resonable, but it has to be made relevant.
posted by fermezporte at 2:05 PM on April 4, 2007

I have to put forth that a large number of people within the community are of the type that attribute internal decisions as the result of external forces, or attribute external forces more, ahem, more weight and validity than they deserve.

The person that is fat and has a related issue ... doesn't want to be told that they're fat because of their own action. And others seem to suggest that the very notion of "fatness" is some kind of social construct, so they jump to the defense of the fat person.

I see the same thing happening for other questions, where the obvious answer is "see a therapist, see a lawyer, see a doctor," and members of the community shoot down those suggestions, because they seem to think that sanity/crime/disease can only be approached within the framework of half-assed, undergrad social theory.

- "Am I crazy/wrong/diseased?"
- "No! You're not crazy/wrong/diseased, you're just misunderstood by this damn conformist society!"
- "No, actually, he really IS crazy/wrong/diseased and needs real help."
- DELETE! This is not JudgeMe!
- Umm ... how is that judging...?
posted by frogan at 2:06 PM on April 4, 2007

The huge number of responsive answers that are removed from AskMe makes it much less useful. In general, Jessamyn et. al. tend to permit only those answers which they approve of to remain undeleted

Horse hockey.

If there's any problem in AskMe it's -insufficient- deletion.
posted by phearlez at 2:15 PM on April 4, 2007

So I went to see the doctor about my sex life. He said, "You're overweight." I said, "I'd like a second opinion." He said, "Okay, You're ugly, too!"
posted by timeistight at 2:26 PM on April 4, 2007

The person that is fat and has a related issue ... doesn't want to be told that they're fat because of their own action. And others seem to suggest that the very notion of "fatness" is some kind of social construct, so they jump to the defense of the fat person.

Talk about "half-assed, undergrad social theory."
posted by delmoi at 2:36 PM on April 4, 2007

I would guess it's all in the framing. I can't think that anyone would object to the issue of weight being brought into things if it is done respectfully, non-judgmentally, and with some basis in fact rather than opinion. Using jellicle's suggestion:

Many people are not aware that excess weight is the #1 cause of low sexual desire. Excess weight reduces testosterone, which hits sex drive directly, as well as the numerous ways it affects sex drive indirectly. This may or may not be related in your case - it apparently wasn't in the past, but that doesn't mean it mightn't be a factor now. Perhaps worth exploring given the link to testosterone?

Astro Zombie: Yeah, I'm talking about you, you hideous beast.

*weeps* - did you have to be so blunt about things? My mom thinks I am pretty.
posted by madamjujujive at 2:39 PM on April 4, 2007

So I went to see the doctor about my sex life. He said, "You're overweight." I said, "I'd like a second opinion." He said, "Okay, You're ugly, too!"

Heh.
posted by cortex (staff) at 2:42 PM on April 4, 2007

occhiblu and LeeJay are exactly right. twiggy's sadly eponysterical comment is utter bull.
posted by Rock Steady at 2:59 PM on April 4, 2007

Just so we're clear here:

if i understand cortex correctly, we're talking about a question where an overweight person asked how to get her doctor to take her seriously, correct?

and the answer that seems to have been deleted was advice on how to lose weight and thereby regain her libido.

Is there some way in which armchair medical advice answers a question asking for social advice?

Q: I have bad gas and sometimes it escapes noisily without me wanting it to. Does anyone know any funny jokes I can make to lighten the mood when this happens that aren't tired old cliches?
A: Try Beano! It's great for combatting bad gas! Having bad gas is a bad thing and you shouldn't have it!
posted by shmegegge at 2:59 PM on April 4, 2007 [1 favorite]

The ridiculous insistence that we must tell fat people, and only fat people, that they are obviously unhealthy because of X cause, is just bias and self-righteousness. (emph. occhiblu's)

No one in this thread has suggested such a thing.
posted by DevilsAdvocate at 3:12 PM on April 4, 2007

noisy farts are a direct result of fat ass cheeks.
posted by quonsar at 3:12 PM on April 4, 2007 [1 favorite]

This is a fascinating discussion, but could someone please point me in the direction of some conclusive evidence that links obesity to female sexual dysfunction? I had never heard of this before, so I PubMed'd it and am only coming up with a couple of small case control studies. PCOS and sexual dysfunction, yes. Obesity and erectile dysfunction, yes.

Just thought it might be relevant in that, "Lose weight, fat ass" might not even be correct advice. I happy to admit it if I'm wrong here.
posted by Slarty Bartfast at 3:24 PM on April 4, 2007

Q: Does anyone know any funny jokes I can make to lighten the mood when this happens that aren't tired old cliches?

A: To lighten the mood, tell them, "noisy farts are a direct result of fat ass cheeks."
posted by found missing at 3:52 PM on April 4, 2007

Is there some way in which armchair medical advice answers a question asking for social advice?

When the questions is asking for social advice on how to get help in solving a medical problem, perhaps?
posted by vorfeed at 3:53 PM on April 4, 2007

Ok, further research. Only one decent study. Nothing in text books. I am going on record to say that the advice to lose weight is clinically flimsy and based more on bias than actual evidence. Hurf durf.
posted by Slarty Bartfast at 3:58 PM on April 4, 2007 [1 favorite]

Personal story. When I was overweight, I developed plantar fasciitis (inflammation of the heel tissues in one's feet, quite painful). Not only did I not know what it was, I didn't know that it was weight-related. I just knew that my feet hurt. When I went to the doctor about it and was told it might help to lose weight, it did add to my (pre-existing) incentive to lose weight, I lost weight, and the condition improved. In this case, I was unaware not that I was fat (most people who struggle with weight have a pretty good sense of where they are), but that my weight might be contributing to the specific problem I was experiencing.

If I had asked about it here at the time, I'd have appreciated the advice "Ask your doctor whether it might be related to your weight." I'd have appreciated it because a) the advice would have been warranted, i.e., there is real evidence that weight is one of the possible contributors to that particular problem, and b) the tone would have been respectful and helpful in intent. '

When a comment meets those two conditions, I imagine the chances of its being deleted are near zero.

Advice of any other kind - unwarranted and disrespectful - isn't really advice, just a cheap dig. Unless you know or can find information that shows the condition or problem could be weight-related, there's no reason to speak up. And whether you know or not, if you speak up in a dismissive, unhelpful, or insulting manner, there's no reason anyone should have to listen to you anyway, and the deleted comment won't be missed.


nasal douching, church/prayer, weight loss or reading Andrew Carnegie

Or high fructose corn syrup. Don't forget high fructose corn syrup.
posted by Miko at 4:05 PM on April 4, 2007 [3 favorites]

Dropping the OCP's, as pointed out ad nauseum, is no more likely to lead to restoration of libido as weight loss. That is to say, either might help. When confronted with a vexing, often insoluble clinical problem, it's important to explore any and all possible solutions. The poster stated they were overweight. The process of losing weight, as well as weighing less in general, may improve libido. What's wrong with stating that? It's irrelevant that the poster is "OK" with her weight, since no one's telling her it's bad to be fat.
posted by docpops at 4:06 PM on April 4, 2007

Wah wah wah you insulted me wah - LeeJay....

I personally have more than one obese friend who didn't realize the health risks associated with being fat, and thought the only downside was primarily cosmetic.

You got your panties in a bunch just because I basically said "there do exist fat people who don't understand the health risks" and went off on some huge rant about how people like myself are self righteous assholes.

Did it ever occur to you that I might just be pointing out that most but not all obese people are aware of the associated health risks, and that health risks BESIDES heart disease (the most known one) exist that many obese people are unaware of?

Oh, it didn't? Because I said exactly that and you flipped out like a ninja and ignored what I was saying to attack me and my supposed "self righteousness" because you were worried I was insulting you.

I'll repeat it again:

There is a [probably small, but very real] subset of obese people who do not understand some or all of the health implications of being obese.

I don't point it out because I "care so much" and want to "fix fat people", I point it out because it's a FACT.
posted by twiggy at 4:07 PM on April 4, 2007 [2 favorites]

another wah wah...

First of all, what does eponysterical even mean? I couldn't find it in the dictionary. It sounded like a big word though so I was initially sure you had to be right and I had to be an idiot. Oh well.

Secondly, what was so bad (I've gotta assume eponysterical means bad in some way - crazy? incorrect? stupid?) about my comment? I said: "an alarming number of people do not know about all of the health problems associated with being fat."

The above is a true statement. A lot of people have no idea just how bad it is for them. A majority? No.

Come join me for a bit in the real world, where not everyone has insurance or money to go to doctors and be told how being fat is bad. Not everyone is as educated as you think.
posted by twiggy at 4:12 PM on April 4, 2007

I avoid the fat person threads, because there's generally just no point in responding.

People have gotten it into their heads that they have the god-given right to weigh as much as a petting zoo, and nothing you or I can say will shake their conviction.
posted by Mr. President Dr. Steve Elvis America at 4:15 PM on April 4, 2007 [1 favorite]

Nevermind, I figured out eponysterical via google instead of the dictionary. I read mefi all the time and sitll didn't realize there's inside made up words within this community. How funny.
posted by twiggy at 4:17 PM on April 4, 2007

What's wrong with stating that? It's irrelevant that the poster is "OK" with her weight, since no one's telling her it's bad to be fat.

Because anonymous said that she's heard this and wants to know what other possibilites exist before she accepts this. I'm not sure weight comments are deletion-worthy, but they are certainly not helpful, in this instance.
posted by Slarty Bartfast at 4:18 PM on April 4, 2007

twiggy - it's a derogatory reference that juxtaposes your mefi handle w/ the content of your post, i.e. eponymous.

This is a no win situation. Smokers do not know all the ways their habit affects them. People who do not exercise - same. Shitty diet, well, reap the results. Persons w/ high blood pressure that refuse treatment are floored when they find out they can't have an erection. If you are overweight the number of health consequences of that state are numerous. Tough shit if that's a bothersome or irritating reality.
posted by docpops at 4:19 PM on April 4, 2007 [1 favorite]

"Birth control pills are known to have delayed side-effects.."

Yeah?

So does sex. About 9 months delayed.

And they last about 18 years or so.
posted by mr_crash_davis at 4:21 PM on April 4, 2007

Come on, docpops. If you were my doctor and I went to you because my feet hurt, would you tell me to stop smoking? Because "smokers do not know all the ways their habit affects them"? Or might we look at the most likely causes first?
posted by Miko at 4:22 PM on April 4, 2007

ImmeDIETly... hahaha. Immediately.

Didn't you all see that epsiode of House where the 700-pound guy was SURE his health problems weren't weight-related, and it turned out he was right, he had cancer.
posted by IndigoRain at 4:28 PM on April 4, 2007

Claire: What's your name?
Bender: What's yours?
Claire: Claire.
Bender: Claire?
Claire: Claire. It's a family name.
Bender: It's a fat girl's name.
Claire: Oh, thank you.
Bender: You're welcome.
Claire: I'm not fat.
Bender: Not at present, but I can see you're pushing maximum density. See, I'm not sure if you know this, but there are two kinds of fat people: There's fat people that were born to be fat, and there's fat people that were once thin but became fat -- so when you look at 'em you can sort of see that thin person inside. See, you're gonna get married, you're gonna squeeze out a few puppies and then ...
posted by mr_crash_davis at 4:32 PM on April 4, 2007

It's also been fairly well established that the best way to be healthy at any weight, and even actually the best indicator of whether someone will lose weight, is high self-esteem. Shaming people, assuming that they're stupid, and treating them as if they're completely ignorant is a great way to work against a goal of helping reduce health problems that co-exist with obesity, and obesity itself.

If you think obesity is a problem, encourage people you think are overweight to feel good about themselves.
posted by occhiblu at 4:33 PM on April 4, 2007

Mr_crash_davis, I gather you've never been pregnant.
posted by moira at 4:35 PM on April 4, 2007

A#1) Twiggy,

Sure, most people know, but an alarming number of people do not know about all of the health problems associated with being fat.

does not equal

There is a [probably small, but very real] subset of obese people who do not understand some or all of the health implications of being obese.

Sorry.

B#2) Are you serious, Steve Elvis? Do you really think people don't have a right to weigh whatever they want/do? I'm not sure about god-given (rights aren't in some way pre-existing), but control over one's body is pretty fundamental (leaving aside the contested issue of narcotics, which isn't the issue at hand). I hope you're joking.

C#3) Eponysterical isn't derogatory.

D#4) The ratio of awesome to not comments in this thread is far greater than usual for fat-related topics. Thanks all who braved the storm to post.
posted by wemayfreeze at 4:35 PM on April 4, 2007

it's a derogatory reference

Well, it's not necessarily derogatory or pejorative. That mostly depends on intent. Someone could playfully describe as eponysterical a comment by twiggy on the subject of, say, bonsai, and that'd hardly be a jab.
posted by cortex (staff) at 4:37 PM on April 4, 2007

occhiblu: high self esteem is actually not "well established" as the best way to be healthy...

It was, however, "positively correlated with racist attitudes, drunken driving and other risky behaviors, Dr. Emler found in his 2001 review."

At best, the subject is debateable, rather than "well established."

Stating a fact doesn't always have to mean "shaming" someone.
posted by twiggy at 4:39 PM on April 4, 2007

wemayfreeze point A: Actually they are pretty equal. I said in my first statement "most people know, but an alarming number do not"...

There are 60 million obese americans. If 59 million of them know all about all of the health risks of obesity, and 1 million do not, 1 million people being completely oblivious to those risks is alarming.

1 million also constitutes a relatively small (1.6%) but real group of people who are unaware of said risks.

I wonder what health risks there are related to hypersensitivity to just about every damn thing anyone's ever said that isn't fluffy pretty and positive. High blood pressure's gotta be one of them.
posted by twiggy at 4:43 PM on April 4, 2007

"Mr_crash_davis, I gather you've never been pregnant."

Not to my knowledge.
posted by mr_crash_davis at 4:46 PM on April 4, 2007

Come on, docpops. If you were my doctor and I went to you because my feet hurt, would you tell me to stop smoking? Because "smokers do not know all the ways their habit affects them"? Or might we look at the most likely causes first?
posted by Miko at 4:22 PM on April 4 [+]

I do not understand.
posted by docpops at 4:47 PM on April 4, 2007

It's more that people think they have a right to weigh as much as they want without consequences.

My point is just that it's pointless to argue with fat people about being fat. The best thing you can really do is ignore their stupid fat-person problems, both on here and in real life.
posted by Mr. President Dr. Steve Elvis America at 4:48 PM on April 4, 2007

I don't point it out because I "care so much" and want to "fix fat people", I point it out because it's a FACT

I notice you completely fail to address my points about self-esteem along with your laughably weak and uninformed and ultimately ignorant attempt to insult people who use the label "bbw".

And I'd still like to know where you are meeting and conversing with all of these ignorant fat people. Seriously. Are you out on the streets taking a poll? Asking every fat person you meet if they are aware of the health risks? Do you think that fat people live in caves an are completely unaware of the mass media saturation surrounding this topic? C'mon. Everyone knows that fatties spend all of their time in front of the TV.
posted by LeeJay at 4:56 PM on April 4, 2007

Eponysterical isn't derogatory.
It was that time.
posted by docpops at 4:57 PM on April 4, 2007

FWIW - don't forget that the mechanisms behind obesity are not as simple as we would like to think. If you are thin, don't pat yourself on the back, and thank your DNA. If you are obese, the whole story is hardly known.
posted by docpops at 4:59 PM on April 4, 2007

Well that's both completely offensive and totally ridiculous.

Why are you arguing with fat people about being fat in the first place? What is your investment in it?
posted by wemayfreeze at 5:02 PM on April 4, 2007

That was at Steve Elvis's last comment. Thanks for listening!
posted by wemayfreeze at 5:03 PM on April 4, 2007

I'm not arguing with fat people about being fat. That's what I just said! I was encouraging the OP not to worry about it either.
posted by Mr. President Dr. Steve Elvis America at 5:08 PM on April 4, 2007

LeeJay: I didn't address your points about self-esteem because frankly they show you didn't really try to read what I said at all, you just looked for a reason to be pissed off.

Your oversensitivity to the issue blinds you to the words I was saying and the point I was trying to get across, so you put words in my mouth.

I never implied the existence of the term "BBW" means anyone who uses it is ignorant to the health problems - YOU INFERRED THAT. You inferred a bunch of stuff I didn't say, so I didn't address it because it just didn't justify addressing.

You want me to address you? Okay, I'll address you. You said:

Where are all of these mentally deficient fat people I hear so much about? I don't think I have ever met one. No one I know has ever met one.

You've probably never met a ninja either, but that doesn't mean they don't exist.

In fact, the only people I know who have had encounters with these ignorant lardasses are people like you who like to complain about them.

It is only your perception that I "complained about" fat people. This assumption on your part is likely a result of your oversensitivity to anything said about fat people.

I didnt' complain about them, I pointed out to someone who said "all fat people know the risks so telling them is dumb" that not all fat people know the risks. That's not complaining about fat people.

Interesting. You'd think I would have run into one or two of these woefully uninformed individuals given that I come from a whole family full of fatties and used to be one myself.

Last I checked, families typically talked to each other, so the fact you come from a family of fatties and they all know the health risks of being fatties is pretty meaningless and proves nothing.

I could say "I come from a family of magicians and we all know how magic tricks are done, so therefore so does the rest of the world" and you'd rightfully think I was not very good at the whole "logic" thing, wouldn't you?

I pointed out that not 100% of fat people understand all of the health problems (from heart disease to erectile dysfunction to knee and back problems) that come with being fat, and you flipped out like a baby about it because you felt that that was somehow calling fat people ignorant.

I didn't call fat people ignorant. I said there exist fat people who do not understand the entire list of health risks associated with their fatness, and some are even proud of their fatness.

I also didn't say "hah, look at those dumb fatties who are proud of their fatness. dumb fatties." I simply said there exist fat people who are proud of their fatness and oblivious to one or more of the associated health risks.

You got all pissy and ranted about it and put a bunch of words in my mouth and a few of your fellow hypersensitive readers even favorited your rant.
posted by twiggy at 5:13 PM on April 4, 2007

It's always a shock to me that bigoted attacks on fat people are allowed to remain here. Not saying that all the objections to the deletion are bigoted (they're not, it was arguably a bad deletion), just that the ones that are should be deleted and result in a week's timeout.

Why does MeFi tolerate bigoted crap like that?
posted by mediareport at 5:21 PM on April 4, 2007

Doesn't anyone watch House, M.D.? If that show has taught us anything, it is:

(1) never lupus
(2) always a non-intuitive solution to a medical problem (liver failing? It is a clot in the heart. No clot visible? Well we need to induce a heart attack to make the clot reappear, obviously it is an incredibly rare genetic condition where clots reappear during specific conditions)

I don't mean to scare anybody but I'd like to posit that our anonymous has lesions on her brain that is causing a reduction in libido. Lab results don't show she should have lesions? Run them again dammit!
posted by geoff. at 5:22 PM on April 4, 2007 [1 favorite]

Metafilter: You've probably never met a ninja either.
posted by occhiblu at 5:29 PM on April 4, 2007

Being overweight is nothing to be proud of. Fat people who claim they have no control of their weight or the consequences look like idiots.

Giving an overweight person unsolicited (and incorrect in this case) advice that X problem that they're dealing with is probably the result of their weight is close to outright bigotry. These people also look like idiots.

There, I've pissed off both sides in this debate.
posted by Slarty Bartfast at 5:29 PM on April 4, 2007

And I agree with Slarty. And his cadre of ninjas.
posted by occhiblu at 5:33 PM on April 4, 2007

Aces! Another fat people thread! Am I too late to get spattered with some flung poo?
posted by stavrosthewonderchicken at 5:33 PM on April 4, 2007

I don't like fat people, and I don't care if that makes me a bigot.
posted by Mr. President Dr. Steve Elvis America at 5:36 PM on April 4, 2007

Stavros, you're just in time. Hold still.
posted by moira at 5:39 PM on April 4, 2007

I never implied the existence of the term "BBW" means anyone who uses it is ignorant to the health problems - YOU INFERRED THAT. You inferred a bunch of stuff I didn't say, so I didn't address it because it just didn't justify addressing.

Oh for Pete's sake. Let me try this one more time and we'll see if you can actually answer a question or if you're just as sensitive and prissy as you claim I am:

You wrote this: "You'd think they'd know given how much media is out there to explain that it's bad for your health, but they don't. Hence the birth and continued use of terms like "BBW" and others."

Now, what is to be INFERRED from this statement? The only logical conclusion given your wording and the order of statements made by you is that if fat people knew about the health consequences of being overweight they wouldn't have come up with and perpetuated the term "BBW." BBW means Big Beautiful Woman. What does that have to do with health? The only thing "BBW" says about a person is that they consider themselves beautiful. It says NOTHING about their mental capacities or their ability to discern whether being fat is harmful or not. Why even bring it up unless you believe that the label cannot be a valid one?

Look, I'll cop to being sensitive about this particular subject. I grew up overweight. I took a LOT of shit for it. I am not overweight anymore. I lost nearly a hundred pounds and am now within the "healthy" range for my height. But I still vividly remember the insults and condescension heaped upon me when I was fat. And frankly, I'm not so sure that being sensitive to such a topic should be considered a BAD thing.

However, I wasn't the only one who got a negative vibe from your post and you might want to consider your tone in the future when establishing the FACTS.
posted by LeeJay at 5:43 PM on April 4, 2007

I looked at all the recent fatty threads on AskMe and I didn't see any deleted comments of the type you describe.
posted by Mister_A at 6:05 PM on April 4, 2007

docpops: I'll explain.

You seemed to be saying that weight loss should always be recommended to obese patients of any kind because it could never be ruled out as irrelevant in questions of illness. Even if weight seemed to be unrelated, you were arguing, it has mysterious effects we don't fully understand, so that no matter what the complaint, if the complainer is obese, their treatment should involve losing weight because we don't fully understand all the effects of obesity.

To support this, you said "Smokers do not know all the ways their habit affects them. People who do not exercise - same. Shitty diet, well, reap the results... Tough shit if that's a bothersome or irritating reality."

You also said: "When confronted with a vexing, often insoluble clinical problem, it's important to explore any and all possible solutions."

Usually, doctors say it's important to explore the most likely causes of the symptoms and only if those fail, to proceed to the more unlikely causes. Causes of low libido are many - Drug side effects. Depression. Poor circulation. Emotional problems. Too much stress. Fatigue. Alcoholism. Anxiety. Sexual orientation questioning. Hormonal fluctuations. Early menopause. One source I found even mentioned very low-fat diets, because lipids are necessary for hormone production.

But following your treatment philosophy, since we don't understand all the effects of behaviors like smoking or conditions like obesity, then every presenting illness should be treated by quitting smoking and losing weight. Because of the unknown effects they may be having. Even if, say, the problem is a yeast infection. Or a broken arm. Or melanoma. Do I have that right, or do you want to clarify?
posted by Miko at 6:20 PM on April 4, 2007

Obligatory. (not very SFW)

I think he's actually winded at the end of it. (I could have done without the nipple licking.)
posted by Dave Faris at 6:35 PM on April 4, 2007

There's no moratorium on bad or wrong AskMe answers, is there? If the answerer is sure the answer is correct, it's not intentionally misleading, and would ostensibly lead to correction and a clearing-up of the issue for all readers, ultimately improving the thread and the answer for everyone.

I know there's a moratorium on inappropriate answers, but what if the answerer doesn't know or think it's inappropriate? Wouldn't the same mechanism that takes care of bad or wrong answers take care of inappropriate ones, too? Doesn't deletion of (borderline or unintentional, like this one) inappropriate answers remove the chance for edification through correction?

The only existing mechanism for questioning deletions is to bring them here, where we can see how things turn out: a ridiculous war, every time, over the idea and intentions behind the answer, encouraged by the free-for-all nature of MetaTalk.

But if an inappropriate answer was allowed to stand in the thread and be responded to by someone who knows why it's inappropriate (in this case it would just take one person saying "this is a social question on how to deal with doctors, not a medical one on the perils of obesity") the issue of inappropriate comments would be dealt with in a more constructive, and dare I say more pleasant, way than it is here.

Of course, I can already think of three problems that would probably plague this solution. First, there's nothing worse than fifty justified folks piling on a transgressor to tell them how inappropriate they've been, and the self-righteous love to sing in harmony. Second, the inappropriate answerer often feels self-righteous themselves, and steps would have to be taken to prevent them from responding and turning the thread into an inferno like this one. Which leads to the third, and biggest, problem, that when these problems came up, moderation time and difficulty would go through the roof.

So I guess this all has been a little voyage into cloud-cuckooland and back; there's no better solution than a quick deletion and the attendant fallout over here, self-control being in as short a supply as it is. Carry on.
posted by breezeway at 6:35 PM on April 4, 2007

Is there some way in which armchair medical advice answers a question asking for social advice?

I can think of many instances where this would be true. And your own example...

Q: I have bad gas and sometimes it escapes noisily without me wanting it to.

... warrants a medically related answer. "Try Beano and you won't need a funny joke in the first place."

How about another one...

Q: I have a thorn in my paw and it makes me angry. How can I be less angry?
A: Have you considered having the thorn removed?
posted by frogan at 7:20 PM on April 4, 2007

You wrote this: "You'd think they'd know given how much media is out there to explain that it's bad for your health, but they don't. Hence the birth and continued use of terms like "BBW" and others."

Now, what is to be INFERRED from this statement? The only logical conclusion given your wording and the order of statements made by you is that if fat people knew about the health consequences of being overweight they wouldn't have come up with and perpetuated the term "BBW."

No, that's not the only logical conclusion that can be drawn. It's the only conclusion you yourself were able to draw, I'll grant you that, but it's not the only logical conclusion.

The fact that there are many people who are "fat and proud", so to speak, is supportive (though not necessarily "proof") of the fact that there are obese people who do not understand that it's very unhealthy. Nobody is proud of being unhealthy.

I'm sorry you took a lot of shit for being a fat girl. Believe it or not (and I'm sure you'll opt for "not"), it's no more a picnic being an underweight male growing up than it is being a fat female. I empathize because of my different but parallel experience, but you can't let all the shit you took force you to think that any time anyone says "fat" or "obese" that they necessarily mean harm or insult.
posted by twiggy at 7:32 PM on April 4, 2007

Good lord. This is all so horribly stupid.
posted by Burhanistan at 7:33 PM on April 4, 2007 [1 favorite]

It is pretty stupid.

Talk about weight if it's relevant and useful, and don't use it as an opportunity to feel superior.

How's that?
posted by Miko at 7:36 PM on April 4, 2007 [1 favorite]

Mr. President Dr. Steve Elvis America: I don't like fat people, and I don't care if that makes me a bigot.

Says the person bearing the name of a man famous for his love of deep-fried peanut butter and banana sandwichs, among other things.
posted by CKmtl at 7:36 PM on April 4, 2007

Metafilter: I could have done without the nipple licking
posted by mr_crash_davis at 7:42 PM on April 4, 2007 [1 favorite]

No, that's not the only logical conclusion that can be drawn. It's the only conclusion you yourself were able to draw, I'll grant you that, but it's not the only logical conclusion.

Well then you should word your statements more clearly as what you wrote is clearly not what you meant.

The fact that there are many people who are "fat and proud", so to speak, is supportive (though not necessarily "proof") of the fact that there are obese people who do not understand that it's very unhealthy. Nobody is proud of being unhealthy.

No, it really isn't. This is akin to saying that the fact that there are people out there who are "skinny and proud" is supportive of the fact that there are skinny people who do not understand that that it is unhealthy to be underweight. The VAST majority of people at both ends of the scale are aware of the health risks.

Additionally, there is a difference between finding yourself beautiful in spite of what society considers a flaw and being "proud" of that flaw. THIS is the origin of the term "bbw" and the point you seem determined to miss.

Believe it or not (and I'm sure you'll opt for "not"), it's no more a picnic being an underweight male growing up than it is being a fat female. I empathize because of my different but parallel experience

Actually, I DON'T opt for "not." One of the curses of being a panty-twisted sensitive type is the ability to empathize. The difference is I don't assume that "many" people who are underweight are underweight because they don't know any better. I give them more credit than that.
posted by LeeJay at 7:43 PM on April 4, 2007

Miko - My original assertion was in support of Twiggy's comments that people, in this case the obese, often are not aware of all the ways that their condition/habit affect them. In the case of low libido, we [medicine] are so in the dark as to it's causes that we necessarily have to look at solutions that often involve multiple approaches to improvement, because there is almost never one simple solution. Back pain is a good example. It's a miserable problem for which there is rarely a quick fix, and improvement often involves quite a few small, cumulative steps (fitness, yoga, stopping tobacco, etc.). There are actually a lot of problems like this in medicine. Low libido is perhaps one of the more exemplary ones, in fact.

Usually, doctors say it's important to explore the most likely causes of the symptoms and only if those fail, to proceed to the more unlikely causes.
You make an excellent point. In many clinical scenarios there is usually a singular, likely diagnosis, and many less likely ones. For reasons of safety, cost, etc. we will usually follow the most likely path prior to embarking on others. But in many cases where patients seek our advice, much more is accomplished if we delve into all the myriad reasons why they may be having certain problems, and all the myriad ways in which they may have a positive impact on their recovery. Frankly, I'd be wasting your time and money if I didn't do that. As well, most people are smart and assertive enough that if I don't cover these things they'll learn it for themselves, but with less accuracy or explanatory context.
posted by docpops at 7:44 PM on April 4, 2007

it's no more a picnic being an underweight male growing up than it is being a fat female. I empathize because of my different but parallel experience, but you can't let all the shit you took force you to think that any time anyone says "fat" or "obese" that they necessarily mean harm or insult.way, wa
posted by twiggy at 7:32 PM on April 4


Dude, I looked like a concentration camp survivor growing up. It sucks way, way worse to be overweight.
posted by docpops at 7:46 PM on April 4, 2007

"Nobody is proud of being unhealthy"

Yeah, those anorexically-thin supermodels and actresses and all the steroid-using pro athletes haven't got an ounce of pride to split between them.
posted by mr_crash_davis at 7:47 PM on April 4, 2007

I can think of many instances where this would be true. And your own example...

... warrants a medically related answer. "Try Beano and you won't need a funny joke in the first place."

this implies that you either don't know the askme guidelines or that you're being willfully disingenous.

just because someone asks a question related to a medical condition doesn't mean they aren't already aware of the treatment options for said condition. If she'd wanted askme's advice for her libido, she'd have asked for it. She wants a doctor's advice for her libido. answer what she asks or don't answer at all. It's actually a rule, here.

Similarly your example doesn't resemble the question at hand. She didn't say her weight was preventing doctors from taking her seriously.
posted by shmegegge at 7:48 PM on April 4, 2007

In a limitary way, the AskMe OP is a god, and the question is his revelation. If you don't respect the OP or the revelation, you are a heretic. Simple.
posted by Burhanistan at 7:51 PM on April 4, 2007

shmegegge: Similarly your example doesn't resemble the question at hand. She didn't say her weight was preventing doctors from taking her seriously.

Exactly. The doctor is laughing off the libido of an unmarried woman, who happens to be overweight. Should someone suggest that she get a sex change?
posted by CKmtl at 7:55 PM on April 4, 2007

Sure, docpops. It's just important to emphasize the fact that low libido has a lot of low-hanging fruit. Obesity is definitely not the first or most likely one.

And the OP did not even rule out the idea that losing weight might improve matters'; her problem, her actual question, was that her doctors were leaping to that assumption, rather exploring the many other more common reasons for low libido. Given that her weight and hormonal birth control method haven't changed in the last few years, it would be strange for either of those to suddenly pose problems they had not before. Wouldn't you look elsewhere?

Certainly it would be reasonable for a doctor to say "We'll rule out the more common causes...look at your drug interactions, check your thyroid, and run a depression screening....but you might find losing weight would improve things too. And since there are other good reasons for doing that, I encourage it." That's just good medicine, as you say. But it sounds as though her doctors are not willing to engage in an exploratory dialogue, any more than are the commenters here who can't resist taking shots at an easy target, even if it wasn't the question topic.
posted by Miko at 8:09 PM on April 4, 2007

Wouldn't you look elsewhere?

If only. Improving the female libido is a multi-million [billion?] dollar industry based on sham treatment and platitudes. There's no question that if the OP is being accurate her MD's acted poorly. But a more honest approach would be to tell the patient how badly we understand this issue and let her know that literally anything might help.

"We'll rule out the more common causes...look at your drug interactions, check your thyroid, and run a depression screening....but you might find losing weight would improve things too. And since there are other good reasons for doing that, I encourage it."

Well stated.
posted by docpops at 8:21 PM on April 4, 2007

So, how many of you people are actually doctors or nurses?
posted by Brandon Blatcher at 8:21 PM on April 4, 2007

Brandon Blatcher, since a lot of the flapping in here seems to relate to the idea that answering the question involves social rather than medical advice, does it matter who is or isn't a medical professional?
posted by cgc373 at 8:27 PM on April 4, 2007

IANAD. IANAN.
posted by Dave Faris at 8:28 PM on April 4, 2007

I am a lawyer of lovin your oven.
posted by and hosted from Uranus at 8:33 PM on April 4, 2007

Persons w/ high blood pressure that refuse treatment are floored when they find out they can't have an erection.

hell, persons who take the damn high blood pressure medication are floored when they find out they can't have an erection.
posted by quonsar at 8:45 PM on April 4, 2007

What's an unmarried woman doing having sex?

Surely her loss of libido is God's way of enforcing the chastity she should be practicing.
posted by sourwookie at 8:50 PM on April 4, 2007

I don't like fat people, and I don't care if that makes me a bigot.

Like I said, a week's timeout. The site doesn't tolerate comments like that if it was "black people," and recently stopped tolerating bigoted anti-gay garbage, so why is it still ok to make comments like that about people who are heavy? Is there some logic there I'm missing?
posted by mediareport at 8:51 PM on April 4, 2007

I don't like fat people, and I don't care if that makes me a bigot.

That's funny, cause I dont like superficial asshats. I guess that makes me a bigot too. [NOT ASSHATIST]
posted by supercrayon at 9:05 PM on April 4, 2007

just because someone asks a question related to a medical condition doesn't mean they aren't already aware of the treatment options for said condition.

Please point me to the evidence where you can make this assumption. Moreover, please re-read your statement, because it contradicts itself. A person asks a medically related question ... but already knows the treatment options ... so why are they asking the question at all? That makes no sense.

But still, if this is your interpretation of the AskMe guidelines ... that answers MUST be limited ONLY to an extremely limited focus, a laser-beam iron rule, that rules out any other related offerings ... then I strongly disagree with your interpretation.

- "My neighbor borrowed my lawnmower and didn't return it. What kind of handgun should I use to shoot him?"
- ".357 Magnum."
- "Uhh, couldn't you try talking to him first?"
- "DELETE! Fails to answer the question!"
- "Wha...?"
posted by frogan at 10:01 PM on April 4, 2007

"Nobody is proud of being unhealthy."
posted by moss at 10:02 PM on April 4, 2007

[NOT PHATIC]
posted by stavrosthewonderchicken at 10:06 PM on April 4, 2007

Like I said, a week's timeout. The site doesn't tolerate comments like that if it was "black people," and recently stopped tolerating bigoted anti-gay garbage, so why is it still ok to make comments like that about people who are heavy? Is there some logic there I'm missing?

Yeah, you're missing the fact that black and gay people are born that way, and have endured violence, denial of civil rights, and pervasive ongoing discrimination.

Fat people, on the other hand, just eat too fucking much and don't exercise. I know you're going to cry at me about the 150 people in this country who actually have a medical reason they can't lose weight, but just shove it, I don't care.

If fat people don't want me to dislike them, they can stop being fat. Black and gay people don't have that choice. Being fat is unhealthy. Being black and gay isn't. Being fat burdens the people around you. Being black and gay doesn't. Being fat is caused by having a shitty, lazy lifestyle. Being black and gay isn't.

There's the logic you're missing. HTFH.
posted by Mr. President Dr. Steve Elvis America at 10:17 PM on April 4, 2007

My goodness, you're very edgy! You must have an extremely large penis.
posted by LeeJay at 10:31 PM on April 4, 2007

Yes.
posted by Mr. President Dr. Steve Elvis America at 10:35 PM on April 4, 2007

I gotta ask, Steve, how are fat people a burden to you? I'm being serious here: please tell me what harm fat people cause or have caused you.
posted by wemayfreeze at 10:51 PM on April 4, 2007

Jeez, wemayfreeze, aren't you familiar with this playbook? INSURANCE PREMIUMS! According to this argument, there's a 98% overlap between fatties and preventably-unhealthies.
posted by booksandlibretti at 10:53 PM on April 4, 2007

If fat people don't want me to dislike them

If incurring your dislike means not having to talk or deal with you in any way, I'm pretty sure the obesity rate is going to spike, at least 'round these parts.

What a thoroughly unpleasant little man.

*Washes down tub of shortening with gallon jug of corn syrup, just to be on the safe side*
posted by Alvy Ampersand at 11:06 PM on April 4, 2007 [1 favorite]

Mr. President Dr. Steve Elvis America may not like fat people. Huh.
posted by cgc373 at 11:54 PM on April 4, 2007

Mr. President Dr. Steve Elvis America:

We don't like you, either. Please choke on a bucket full of cocks.
posted by SteveTheRed at 5:03 AM on April 5, 2007

I also hate Jews, because they could always be Christians, if they wanted.
posted by Astro Zombie at 5:10 AM on April 5, 2007

You're all fat.
posted by fourcheesemac at 5:25 AM on April 5, 2007

Well, OK, maybe a little, but I've started going back to the gym. Anyway, being somewhat fattish and exercising regularly makes you healthier than being skinny and not, by crikey.

If I cut out the beer, I'd be a goddamn Adonis! [but there's no way in hell I'm gonna cut out the beer.]
posted by stavrosthewonderchicken at 5:40 AM on April 5, 2007

Please do not feed the Mr. President.
posted by and hosted from Uranus at 5:47 AM on April 5, 2007

Ironic Punishment Dept.
posted by Blazecock Pileon at 6:20 AM on April 5, 2007

wemayfreeze, fat people spill over into my seat on airplanes, trains, and buses. They block stairways, doorways, hallways, passageways, and sidewalks with their girth. They wheeze obnoxiously during meetings.

Alvy Ampersand, are you trying to give yourself diabetes? Use sugar, at least.

SteveTheRed, see, disliking people is satisfying. Accepting everyone unconditionally is bullshit. I don't like fat people, you don't like people who don't like people, and there's nothing wrong with any of that.
posted by Mr. President Dr. Steve Elvis America at 6:26 AM on April 5, 2007

Let's stop feeding the troll. I can almost hear the masturbation.
posted by Miko at 7:36 AM on April 5, 2007

How was your holiday, fourcheesemac? Did you take pictures?
posted by terrapin at 8:11 AM on April 5, 2007

Please point me to the evidence where you can make this assumption. Moreover, please re-read your statement, because it contradicts itself. A person asks a medically related question ... but already knows the treatment options ... so why are they asking the question at all? That makes no sense.

It's not an assumption, that's the thing. It is, in fact, the lack of an assumption. People ASSUME that the OP hasn't explored her options for treatment, when they have no reason to assume that, especially since she's obviously seeing medical proffessionals about that. Also, just because the word doctor is in the question doesn't mean she's asking for medical advice, as I already said. She asked for advice on talking to her doctor, not on improving her libido. Please reread the entire thread and related threads, you don't seem to be understanding the dicussion.
posted by shmegegge at 10:08 AM on April 5, 2007

Given that her weight and hormonal birth control method haven't changed in the last few years, it would be strange for either of those to suddenly pose problems they had not before. Wouldn't you look elsewhere?

"Dear AskMe, I have a problem and I know the reason can't be X..."

"Actually, the reason could be X because..."

How many times do we see this scenario unfold? Is it disrespectful because it's daring to disagree with an assumption of the OP?

It would be a hell of a lot more respectful of the people asking the questions if they could make up their own minds about what is useful or not rather than returning to the thread not knowing that some material is gone. Clearly offensive, ok, out. But this "useful -- not useful" garbage... who are YOU to decide?
posted by dreamsign at 11:03 AM on April 5, 2007

It's the moderators that decide.

The problem is that the 'actually, the reason could be...' doesn't answer the question, which is, how do I get more thorough/attentive treatment from my doctor?
posted by Miko at 11:10 AM on April 5, 2007

"Dear AskMe, I have a problem and I know the reason can't be X..."

"Actually, the reason could be X because..."

That, done well, isn't necessarily a problem. If that was the situation with the comment and question that inspired this thread, there wouldn't have been a deletion and we wouldn't be having this discussion.

The thing is, if you're going to tell the asker that their premises are wrong, the onus is on you, and not them, to provide the context for your assertion. Doubly so—even, I could argue, unsalvageably so—if you're not only contradicting the asker's premises but answering a question orthogonal to the one they asked.
posted by cortex (staff) at 11:16 AM on April 5, 2007 [1 favorite]

People ASSUME that the OP hasn't explored her options for treatment...

But you're assuming she has ... and that assumption is worse, because it's assuming something exists, and it may not, whereas the opposite tack is the safer and more responsible play.

We're not doctors, but hypothetically -- a middle-aged man walks into an emergency room with chest pains. It could be nothing (indigestion, a muscle strain). It could also be a heart attack. Which is the safer assumption to make? Wouldn't you at least, you know, ask some questions, pull out the stethoscope and listen to a heart beat?

This laser focus interpretation ultimately is less helpful, not more.
posted by frogan at 11:23 AM on April 5, 2007

Except it seems that half the people frustrated by not being able to "explore other options" on questioners' behalf (behaves?) are coming at it from a different cultural perspective (which could be fine) and without empathy or understanding for the questioners' perspectives and understanding of his or her own problem (which is not so fine).

You can double-check that a poster has explored all options for treatment without doing so in a way that implies she's an idiot -- as evidenced by her being fat -- and you need to come in and straighten her out. (I'm speaking of the editorial "you" here.) "Lose weight" is different from "Have you considered whether the weight might be having an effect on X, Y, Z? If not, maybe you could explore trying A and B. If you've already done that, here's some other avenues to explore."

The second response, un-coincidentally, requires that you know what the hell you're talking about.

If the only advice on weight loss you feel qualified to give is "Lose weight! Fat people are unhealthy!" then you don't know enough to be advising people on the matter. If you would actually like to advise people on the matter, then spend some time learning something about it rather than just spewing off anti-fat rhetoric about insurance premiums and laziness. If that doesn't sound like any fun, then, again, just don't answer these questions.
posted by occhiblu at 11:43 AM on April 5, 2007 [1 favorite]

One source I found even mentioned very low-fat diets, because lipids are necessary for hormone production.

Wouldn't it be ironic if she changed her diet to lose weight and that lead to a lower libido instead of the fat being the cause of her low libido.
posted by Deoridhe at 12:28 PM on April 5, 2007

Q: I have bad gas and sometimes it escapes noisily without me wanting it to. Does anyone know any funny jokes I can make to lighten the mood when this happens that aren't tired old cliches?

Declare "Speak up, Brown - you're through!"

It probably won't be long before that becomes a tired old cliche though.
posted by teleskiving at 12:47 PM on April 5, 2007

People ASSUME that the OP hasn't explored her options for treatment...

But you're assuming she has ... and that assumption is worse, because it's assuming something exists, and it may not, whereas the opposite tack is the safer and more responsible play.

this is flatly untrue. I'm saying that we can't assume one way or the other, and so we rely on the mefi guidelines which explicitly state that we must answer the question asked and not the question we think should be asked. She didn't ask for medical advice, and there is insufficient reason to think that her weight is contributing to her doctors not taking her seriously.

remember, counter to your example, that she didn't walk into an emergency room. if there's an applicable metaphor, it's that she walked into a library asking a librarian for books about how to deal with doctors. If the librarian then points her to a book about how to lose weight, it's not only offensive but flatly does not help her with the problem she came in to solve.
posted by shmegegge at 1:08 PM on April 5, 2007

Declare "Speak up, Brown - you're through!"

that's not bad. Although I was using a purely fictional question, one of the funniest things I've ever heard someone say when they fart noticably is to say, in a very high pitched tight voice, "I'm free!"
posted by shmegegge at 1:10 PM on April 5, 2007

The huge number of responsive answers that are removed from AskMe makes it much less useful. In general, Jessamyn et. al. tend to permit only those answers which they approve of to remain undeleted, which means that a huge spectrum of valid, accurate responses gets whacked.

This is the stupidest thing I've read here in some time, and I've been reading me some serious stupid on MeFi lately.
posted by scrump at 3:48 PM on April 5, 2007

I just want more of this occhiblu & ODiV comedy duo goodness.
posted by Ethereal Bligh at 7:02 PM on April 5, 2007

Goddamnit.

I have been coming to this site for a bit over 6 years. For the most part I have been content with lurking and was only motivated to get a membership less than a year ago.

If there is anything I regret about not registering earlier, it is having lost the opportunity to participate in one of the legendary Skinny vs. Fatty monkey shitfights.

Then this thread happens. And where am I? Sleeping on it. By the time I get here it's all over save a few scragglers.

My day will come.
posted by BigSky at 9:20 PM on April 5, 2007

if you're going to tell the asker that their premises are wrong, the onus is on you, and not them, to provide the context for your assertion. Doubly so—even, I could argue, unsalvageably so—if you're not only contradicting the asker's premises but answering a question orthogonal to the one they asked.

Good response. That works.
posted by dreamsign at 9:54 PM on April 5, 2007

also this

I'm overweight. This is not a health issue, as I am pretty happy with my weight, feel really good, and have no desire to lose any. It's a problem when I fly though. My girth sort of spills over onto the seat next to me, and sometimes whoever is sitting next to me gets a little snippy at having part of their seat taken up by me. The last time I flew, the skinny woman sitting next to me got really annoyed after I elbowed her for the 10th time, and she asked me if I could please move over a little in my seat. Can you believe it?! I have just as much right to fly as skinny people, and if I end up crowding them in their seat, I guess that's too bad for them; maybe next time they should try taking a Greyhound. So, smart people of AskMe, what are some clever things I can say to the skinny person sitting next to me that will make them shut up and mind their own business? Thanks in advance!
posted by herfderf to what the fuck is WITH people at 9:16 AM - 278 answers +

(and the rest of that page) is excellent.
posted by dreamsign at 10:12 PM on April 5, 2007

I think what everyone was missing in the post in question is that OP was basically saying, "I know I'm fat and I know that could be a reason, one I'm willing to address if that's really the cause. It's just that I've always been overweight and had a fine libido until recently. Since I can't get my doctors to give me any reason other than being overweight, can someone think of anything else that might be the cause? Also, who can I talk to who will take my loss of sex drive seriously?"

So unless libido and fattitude are 100% correlated, mentioning being overweight is not a useful answer here.

It would be like someone saying, "I want to go somewhere in Europe. Everyone keeps telling me to go to Paris, which I know is beautiful and will go there if no other city exists in all of Europe, I just wanted to check if there was something else worth seeing." and then getting the answer, "Go to Paris. It's really nice." It doesn't matter if it's true. It only matters if it answers the question.
posted by Deathalicious at 5:32 AM on April 6, 2007 [1 favorite]

It doesn't matter if it's true. It only matters if it answers the question.

At the risk of sounding condescending (to question posers), people ask questions but what they really want is solutions. And the solution is not always the answer they thought they were looking for.

Q: I climbed to Annapurna Base Camp and got altitude sickness. I've done it before with no problems, so I know it's not me. Could it have been an atmospheric thing?

A: Actually, it could very easily have been you. Dehydration, tiredness, and other bodily conditions can greatly affect if and when someone gets altitude sickness, regardless of experience, not to mention the key factor: rate of climb. I can't comment on the atmospheric issue but being familiar with climbing and unfamiliar with that theory, it seems unlikely.

BZZT! That's not what was asked! Quick. Erase it so he/she will never have the benefit of that completely off-topic answer.

The issue here should be offensiveness, not on-topicness. It's not a great hardship to skip over tangential material, the OP may change his or her mind about its usefullness after reading it, perhaps much later after reflection or additional information, and it's insulting to presume what may or may not be useful to the person based on what is often a fairly cursory explanation of the problem. For goodness sake it's not a real estate problem. Answers are not scrolling off the bottom of the question poser's screen, preventing the reception of information. I'm not saying give the answerers another chance; I'm saying give the question poser another chance -- to consider alternate information. (but I agree with Cortex -- the link should be established by the answerer so the mods can consider, across a broad range of topics, whether it's simply contextless threadspam)

ps: that climber could have been to ABC a hundred times and still gotten sick. That's what came to mind when I read the "fat/libido problem" explanation. Not everything is so simply reducible as yesterday's event = today's problem.
posted by dreamsign at 10:24 AM on April 6, 2007 [2 favorites]

Yes, it IS so terrible to point out the elephant in the room because, as far as weight goes, it is usually the wrong elephant.

People who are overweight do not have health problems because of the weight, they have health problems because of multiple nutritional deficiencies. An erroneous correlation has been made. It just happens that many people are overweight because they have a poor quality diet that does not include the GTF (glucose tolerance factor) and other necessary nutritional components. It's not the fat making the overweight person have high blood pressure, diabetes, etc. it's the lack of appropriate nutrients in the diet. Supplying appropriate amounts of B6, B12 and Folic acid will lower blood homocysteine levels and normalize blood pressure and blood sugar, but these levels must be appropriate to the person's weight. The more weight you have, the more of these nutrients you need. If you get appropriate amounts of these nutrients, you will cease to have high blood pressure or diabetes, no matter what your weight is, because there is a direct correlation between high homocysteine and low amounts of these nutrients. These nutrients break down homocysteine in the blood, so they can't damage your arteries and cause blockages.

People often look at those who are overweight as if this is their main problem in life when it isn't.
posted by unhindered at 4:47 PM on April 7, 2007

are you quoting science, cause I think I got that same info in a spam email
posted by found missing at 5:03 PM on April 7, 2007

Oh, jesus, it's SCIENCE!
posted by OmieWise at 6:12 PM on April 7, 2007

How did I miss this? This is hilarious!
posted by klangklangston at 8:02 PM on April 7, 2007

People who are overweight do not have health problems because of the weight, they have health problems because of multiple nutritional deficiencies.

On the chance an ignorant reader might run across your post and accept its scientific tone to influence how they live their lives, speaking as a person in a extended family that -- like that of a great many others -- has seen various members of said family and friends suffer and too-often die from complications of diabetes, heart problems, and other health issues directly tied to weight, and further having been involved with the medical decisions thereto, your remarks are utter bullshit. Very dangerous bullshit that, if acted upon, will lead to additional misery, pain, and death.

Normally I ignore poor health and relationship responses and rationalizations on MetaFilter, but this attempt at scientific justification for being significantly overweight is simply beyond my tolerance. Is almost the entire professional medical field in on this grand weight-control conspiracy? Or are you merely attempting to reduce overpopulation by plying the suffering with comforting lies?

Or if a troll, then well-played, ma'am. Now please cast in waters not so likely to kill.
posted by mdevore at 11:15 PM on April 7, 2007

Mr. President Dr. Steve Elvis America writes "They wheeze obnoxiously during meetings. "

Proably unrelated directly to mass, instead health issues would be the cause.

dreamsign writes "The issue here should be offensiveness, not on-topicness."

No, in ask on-topicness is required.

unhindered writes "The more weight you have, the more of these nutrients you need. If you get appropriate amounts of these nutrients, you will cease to have high blood pressure or diabetes, no matter what your weight is, because there is a direct correlation between high homocysteine and low amounts of these nutrients."

Members with Type I Diabetes; Vitamins will not cure your disease. Please continue to take your shots.
posted by Mitheral at 12:51 PM on April 11, 2007

People who are overweight do not have health problems because of the weight, they have health problems because of multiple nutritional deficiencies. An erroneous correlation has been made. It just happens that many people are overweight because they have a poor quality diet that does not include the GTF (glucose tolerance factor) and other necessary nutritional components. It's not the fat making the overweight person have high blood pressure, diabetes, etc. it's the lack of appropriate nutrients in the diet.

Shit, and all this time I thought I was an insulin-dependent diabetic because of poor endogenous insulin production! I'M SAVED!

No, wait, that's not what I meant to say.

What I meant to say is that you're an idiot, and anyone who takes anything you wrote as fact is just asking for a trip to the ER, where the great evil of modern medicine will work to save them from their self-induced biochemical imbalance.
posted by scrump at 3:07 PM on April 11, 2007 [1 favorite]