ニューヨーク・タイムズのインスタグラム(nytimes) - 7月3日 03時03分

When you’re told you’re too fat to get pregnant: Does it make sense — medically or ethically — when fertility clinics refuse to treat prospective mothers they consider too large? Chelsea Ritchie, now the mother of twins, got a call from a nurse the day before her initial appointment with a fertility doctor in 2011. “She said, ‘The doctor only sees patients with a BMI under 30, so you’ll need to lose 22 pounds,’” Chelsea recalled. A BMI of 30 or above is classified as “obese,” the word still used by doctors, researchers and the media, although surveys of larger patients show that most consider it derogatory; many now reclaim the once offensive “fat.” The belief that a high body weight causes infertility — and that weight loss is necessary to resolve infertility — are a part of almost every interaction a heavy woman will have with the reproductive health care industry. Yet, there are no established guidelines on whether treatment should be declined on the basis of weight. @elinorcarucci shot this photo. Click the link in our bio to read more from @nytmag.

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asallysnaps Ok. Let s step back. In medicine, we needs medical parlance to describe what we see aka realities. Whether derogatory or not, these descriptions are necessary and part of our jobs..documenting the human (patient) condition. Is emaciated derogatory? It is the extreme opposite of obese. If you are you are. If I am short, I am short—derogatory or not. We need to get over ourselves. Patients need to get over their egos. It is your doctor’s job to help you and direct you to make better health decisions for yourself. Being obese is a risk factor for many different conditions in and of itself. Obese women have much higher risk pregnancies. Customer (patient) does not know all. This is the problem when healthcare is treated like hospitality. Doctors do not exist to tell you what you want to hear. We have a job to do and it is quite difficult without having to stroke your egos or pay homage to customer service scores.

dblank80 There’s research to support the reasoning behind why Doctors express severe concerns with patients that are obese. This post is nothing more than a woman who has a problem being told the truth about herself. Obese, your BMI is to high, you are fat, you are large. There’s not a perfect way to say it to appease every person on the planet. As someone who has worked in healthcare for 15 years there’s time when you have to be honest wether it hurts the patients feelings or not. Next we’ll be told someone is offended when a Doctor tell a patient they have cancer. The word Cancer will become offensive. Oncology wards around the country will have to stop calling it cancer.

meganmurrow Beyond fertility and pregnancy, there's the life of the child to consider. As a daughter of an overweight mother, I grew up watching her struggle with diabetes, congestive heart failure, blocked arteries, and ultimately a liver disease that ended her life when I was just 16. All of her health issues stemmed from her weight, and I wonder how many children are impacted by the weight of their parents. Of course I loved my mom, and I am so grateful that she and my dad adopted me (she couldn't have kids due to a tubal pregnancy). It's a complex topic that I'm still unsure as to whether there's a clear answer.

fabsheeba Look beyond the words and into the science. Adipose cells are a source of hormones which can lead to a host of maladies and impede fertility overall. Focusing on a more healthy lifestyle is crucial to avoiding ailments like diabetes and cardiovascular disease which can make a pregnancy high risk . Why not prevent that and aim for longevity in your life expectancy in the long run. I realize as a provider how the words are not helpful so instead I seek to counsel patients on the need for the lifestyle change. It is necessary. Avoid and prevent the avoidable while meeting her where she IS.

footydoc If you think the obesity is the cause for the infertility why spend money on trying to get pregnant? IMO, the doctor could be shadey, not counsel her on low success rate, and charge her a lot of money for an intervention (that’s not benign - lookup ovarian hyper stimulation syndrome) that is more likely to fail. Lose weight first, try again if you are still having trouble they are there to help. OTOH, Let’s say for argument sake they help her get pregnant. Here are the risks of obesity in pregnancy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621047/#idm140337069770816title

mommyiloveyousobig For the folks taking the time to educate themselves on these topics, the big issue is the use of BMI. It is in no way diagnostic of an individual’s actual health. We’re also learning that a lot of the conclusions being made about obesity and its effects on our health and disease are due to correlation, not causation. Please follow people like @evelyntribole, @rebeccascritchfield, @themilitantbaker, @bodyposipanda, @thebirdspapaya, to learn more about the ways in which diet culture is hurting all of us.

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