Mass. Doctor Won’t Accept New Patients Who Are Obese

(Tobyotter/flickr)

I couldn’t really believe the headline in Everyday Health when I read it this morning:

Doctor Turns Away Obese Patients
A Massachusetts doctor says she won’t treat patients over 200 pounds because they put her staff at high risk for personal injury.

So I called Dr. Helen Carter to ask whether it was true.

Yes, she said, her office has instituted a new policy: no new obese patients who weigh over 200 pounds. “I had no other choice,” she said. “It’s self-preservation.”

The Worcester-based internist, who has been practicing medicine for 20 years, says she’s not discriminating against fat people, rather the policy is more related to safety. In the spring, Carter said, a physician in the practice got a serious neck injury while pulling out the exam-table foot rest for a 284-pound patient. The injury remains painful, she said, and now prevents the doctor from performing pap smears because she can’t bend fully. A new electric exam table costs between $4,000 and $7,000, Carter said, which is at the moment prohibitively expensive.

Carter says she hasn’t dismissed current patients in her practice who are obese. Indeed, she says, the new policy has been a motivating force for them to lose weight. “It gives them a goal,” she says, adding: “The problem with obesity is it has become socially acceptable,” with nearly one-third of Americans now categorized as obese and those numbers rising. (Not to mention the cost of overweight and obesity which was recently reported to be nearly $300 million annually).

As far as the new policy, Carter offered this comparison:

She doesn’t treat people with addiction, she said, because she’s not an addiction medicine specialist. Similarly, she’s decided that obese patients in the region would be better served at a facility like the weight loss center at UMass Memorial with a full range of tailored interventions, including psychotherapy, nutrition and exercise counseling and surgical options.

Carter says she has focused on the long-term implications of obesity for several years. She says she gives her patients “a whole long list” of the health risks related to carrying around so much extra weight — from heart disease to diabetes and stroke. But even though they’re at higher risk, Carter says they are not necessarily experiencing all of the downside of obesity yet and may not feel any urgency to lose weight. “It’s an insidious condition,” Carter says. “But in the end, the individual has to decide, “OK, I have to lose weight.”

Or deal with the consequences.

Carter cites, for example, an obese friend who buys two seats when she flies in order to have enough room on the plane.

“But I can’t charge double for an obese patient,” Carter said.

In the end, she says, it comes down to a personal decision.

If they don’t lose the weight, Carter said, “I’m paying the cost of other people’s choices.”

Readers, what do you think? This policy may sound harsh but is it simply a self-protective and rational response to the growing epidemic? Let us know.

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  • Jak Stone

    The thing is 200 isn’t that obese depending on the person. Short little lady at 200 ok that’s obese, but my very tall football player brother? He’s 220 but the majority of that is pure muscle (which weighs more than fat) with a bit of fat padding it, which you’ll want when you’re taking hits half the day, plus like I said he’s tall so it’s spread out more. But they wouldn’t have to struggle lifting my brother because he has more than enough muscle to lift himself or whatever necessary limb for them.

    And I get the point their making but that injury, really, that’s what they’re whining about? I’m betting they’re exaggerating it too. Was there some reason they couldn’t have pulled out the foot rest thing before the patient got up there? Or how about simply having the brains to know your own limits, why did she push herself to the point of causing this injury? I tried lifting something that was too heavy for me the other day, I could have strained until I hurt myself, but I stopped because I knew I could hurt my back if I pushed it any further, gave up, and got a second body to help me move it. If I had strained until I threw out my back I certainly wouldn’t blame anything or anyone but myself. Some reason she couldn’t call in extra assistance? They sound like a bunch of huge whiny babies.

  • Nig Mcfridge

    Good fuck fat people all of them.

  • Heather127

    That’s nice that she wants to refer patients to obesity specialists.

    The question is, how many insurance plans will cover that?

    Answer? None.

    I have yet to find a plan that covers any kind of obesity treatment except bariatric surgery — and the plans that cover that are becoming fewer.

  • silvermaran

    Idiot doctors don’t even know why American’s are Obese. The same reason 1 in 29 of our kids are being born severely multiply infected from the real cause of AIDS they gave us all in vaccines. The same reason Millions suffer hundreds of syndromes the multiple infections in immune suppression infectious vaccines has caused.
    And NOW they don’t want to TREAT any of them….LOL The Stupid Americun Way@@
    http://www.youtube.com/watch?v=yOno_2m_8LY
    Sick cells cannot get rid of toxins and heavy metals or cholesterol spirochetes secrete in your arteries, veins, and tissues. Good Luck America, the war for USA is almost over.

  • CircusMcGurkus

    Right. Because doctors should discriminate against the people who most need them to be compassionate.

    We all pay the cost of people’s choices – whether it be the teenager who gets paralyzed from a gunshot or the person who becomes obese or the diabetic who simply does not want to prick her finger a few times a day or the addict who cannot break free of heroin or the sickly child whose life is prolonged through advances in medicine. That is the cost of being in a first world nation. In impoverished lands, babies die of curable diseases, young women die in childbirth and men die in war…that’s if they can survive the famine, natural disasters and indescribable but ever present poverty while the rest of the world looks the other way. This is the price of living in society – we take the good with the bad and we deal. It’s basic civics. For shame!

    And, by the way – much to our disgust – we are paying for your choice, Dr. Carter, of becoming a physician when you really should have chosen another field. We pay higher hospital bills so you could get trained at a teaching hospital; we pay higher home prices due to your inflated salary; we pay on a mandated basis into the grossly inflated medical costs of this state without having any say in reducing those costs; and we pay to have self-important nimrods take a slot in medical school – funded no doubt by student loans that by the way we pay for – which took a place away from a promising student who actually wanted to help people.

    Doctors are SERVICE providers – you are not gods, you are not perfect, you are not dictators who can tell people how to live their lives and then treat them poorly for not following your orders. And you certainly do not have the authority to diminish another human being or banish him or her from receiving health care due to an inability – or lack of desire – to lose weight to achieve some arbitrary goal to make your job easier. Part of your job description is to care for those in need and to do no harm – none of it is to judge those asking for your help or to decide that some are “worthy” of care while others are not. By refusing to care for those in need and harming their psyche immeasurably with your judgment, you are the antithesis of a healer. I am sure you do not even see the irony in using your title to get a good table at a restaurant.

  • trench

    They SHOULD feel like that. Obesity is a completely reversible condition (in most but not all cases of course). The real problem is that these disgusting masses of humanity think it is US who need to accommodate THEM.

    • Blondesareeasy Fullname

      THAT is exactly correct. Fat patients have fat family members and they want it all. It’s their personality and their life style…more, more, take, take.

    • Jak Stone

      I think the real problem is calling people like this “disgusting masses of humanity”. There are plenty of obese people right in the middle of working hard and losing weight right now, it takes time though, they can’t lose that 100 over night. There are plenty who don’t think they should get special accommodations. But hearing themselves referred to as disgusting masses and being lumped together with self entitled meatheads certainly can be psychologically damaging and make it all that much harder not to slip into depression and lose all that progress. I think if the attitude in general were less hostile, if people didn’t feel as such deep shame and disgust with themselves, that maybe they would be quicker to pull out of the negativity and less people would fail on their diets, they could stick to it far longer with encouragement than ridicule. I mean you could have said the same thing you said, gotten your same point across, and not called them disgusting masses, why did you feel it was a necessary thing to say?

      • Blondesareeasy Fullname

        You’re correct there. They need to lose “that 100″ over years.
        And if any of them screwed up a fellow airplane passengers flight by sitting next to them, they need to reimburse them for the inconvenience.

  • Rob

    haha If she got a serious neck injury pulling out the little footstool on the exam table it sounds like she is in pretty poor physical shape herself!

    • Jarek Draven

      Exactly what I was thinking.

      Hypocrite!

  • clem238

    The table hurt the doctor, not the patient

  • MsHolmes45

    My doctor couldn’t get past my weight, ignoring all other health risks. After a year, she dropped me. I thought this was an isolated case, thanks for posting this.

  • Jane Queue Citizen

    On insulin, my weight went slightly over the big THREE OH OH. I must have gained 60 lbs. on it. Now I am on Victoza, after ten years on insulin, and have lost about 30 lbs. So am I not lazy anymore?
    But Dr. Carter is acting ridiculous. Regardless of how fat I am, I am flexible. My arms are double-jointed, crooked bend at the elbows. Not straight arms when I press the hands down. I can do yoga easily, and am perfectly capable of stretching and bending and helping on an exam table.
    My deceased mother was not capable of helping anyone bend herself around due to a vascular problem in her stomach. She once hit 300 lbs also. Lung cancer caused her to lose to under 200 lbs. She was given kudos when she started losing weight, when she should have been checked for lung cancer, since she was a former heavy smoker.
    I cannot imagine her at any weight being able to help anyone get her on and off an exam table.
    Helen Carter is crazy. This is also part of the preventive medicine myth, that doctors need to fix what they call major stuff instead of treating routine stuff like flu and headaches. An obesity center is not family practice!

  • shadow

    So the doctors put me on meds that cause me to gain water weight and then won’t treat me when I get fat. I think this doctor needs to not be one. She did take an oath.

  • LizH

    Exam table foot rest accident? Seriously? That’s a freak occurrence. It sounds like the doctor is grasping at straws to avoid dealing with patients who disgust her for other reasons. Obese people already have a hard enough time getting medical care. And 200 lbs is not even overweight for many tall people and athletes. I highly doubt she’s kicked all the tall men out of her practice.

    Claiming that simply by being obese, you must see an obesity specialist for treatment is absurd. Those specialists focus on weight, but your regular doctor is supposed to keep an eye on many other health issues. Besides which, there is no evidence of any diet or exercise plan that keeps weight off for 5 or more years for more than 1% of people. I guess fat people can just stay second class citizens forever. Might as well let them die off without medical care, eh doctor?

  • http://twitter.com/ieatatonofrice LL

    She’s completely in the right, I would do the same thing. Although, what she could have done is charge obese patients more. If they have to have special equipment to handle their condition, they need to pay for it.

  • Gabby

    LOL Here’s my take.

    This doctor probably got stuck with a large work comp case so she has to take it out on someone. Most patients, whether fat or thin, do not put their feet on the foot rest until it is fully pulled out, thus the leg weight of the patient rest soley on the foot rest NOT the doctors upper body. The youtube video clearly shows this as well. Dah.

    Someone is lying.. My guess its the injured doctor. Humm, preexisting neck problem would be my hunch.

    • Jarek Draven

      Oh, pre-existing? I hope her insurance doesn’t cover it.. lol
      Maybe that’s what this is– an insurance scam. lol

  • B

    As harsh as this sounds my experience in the medical field prevents me from being unbiased. My time as an EMT on an ambulance was a shocking revelation of the overwhelming obese patients that are filling the ER and whom we also took on routine dr visits. Yes, that’s right insurance pays for these people who can’t fit in regular vehicles or most of the time who simply are to lazy to stand up on their own to see their family doctor. Time and time again health care providers from doctors, nurses, cnas emts and paramedics are all jeopardizing our own health for the others who clearly do not care enough about themselves to prevent this weight gain. I do understand many would find this judgmental but it’s the facts people and I would be hard pressed to ask those who don’t agree with this how much they weigh? I understand the challenges of weight gain and trying to lose the weight but we aren’t talking about 30 pounds we are talking about weight that takes years to put on and there should be no excuse. This is all coming from a wife,a working (in a hospital) mother of a 3 year old and is a student 4x week and I myself am a healthy 135 pounds. It’s all about priority and I wholly support this doctor and the message she means to spread.

    • Jarek Draven

      Typical. Just enough medical knowledge to think you know everything, just little enough so you really don’t know shit.

      Obesity and weight loss can become complicated issues because there are psychological and emotional components– an area that is not easy to deal with– on top of the obvious physical ones.

      Since you rather rudely (and incorrectly) assume that anyone who disagrees with you or this horrid doctor must be fat, allow me to offer a counter-assumption. May I assume that most of the people in your family are not seriously obese (no major obesity running through your close relatives) and/or no major mental illness? If either or both of these are true, you have a massive genetic advantage right out of the box (some pun) and are quite disgusting for looking down on others who weren’t blessed as you are.

      Very (and I mean VERY) few people actually WANT to be fat. In our culture that mocks, ridicules, laughs at, antagonizes, and yes, even “legally” DISCRIMINATES against fat people, what within you allows you to imagine that anyone in that unfortunate position would allow this to go on, were it even remotely easy for them to change it? (As you make it sound)

  • Carla Marx

    Typical woman doctor. Kicking a patient when they are down. They go on about who they won’t treat, with no concern about the other person’t feelings. If someone is going to the doctor for a cough lets say, it doesn’t matter if he or she is an addict or over 200 pounds. And sometimes people are labeled way too harshly by an adversary such as an ex. I think 300 pounds would be a more reasonable limit. If she doesn’t want to work with people who are sick, then why be a doctor. Rejection often makes people not care what they eat.

    • Samuel Georgian

      Why does it matter that she’s a woman?

  • http://www.facebook.com/profile.php?id=637510269 Amanda Collins

    I think this is fantastic. The doctor is correct that obesity HAS become socially acceptable. We have shunned smoking and made smokers inconvenienced by disallowing it in public venues. Why not make life a little more challenging for obese folks who, much like smokers, are putting their health at risk?

    • Jarek Draven

      You’re an idiot. Almost in more ways than I have the patience to describe right now. Being fat is about as socially acceptable as saying “Women should remain barefoot, pregnant, and in the goddamned kitchen– if they know what’s good for them.” (In other words, not really at all.)

      • Cassie

        That’s the stupidest goddamn fatlogic I’ve ever heard. Congratulations.

  • Concerned

    In general, Dr. Carter’s argument on this seems very weak. What about job requirements? Read any job posting and you’ll see things such as “must be able to sit for long periods” or “must be able to lift X amount of lbs.” The job fo any doctor is to treat conditions and illness. Her practice should simply hire the right people for the job.

    • Jarek Draven

      Well, we can’t tell doctors they have to STAY IN SHAPE That would be illegal, discriminatory, and just plain wrong.

      Er.. hang on….

  • danm

    Dr. Carter did in fact provide a service to Ms. Davidson – a wake up call. Good health requires people to adopt the appropriate lifestyle habits. Ms. Davidson should regard this incident as an opportunity to be healthier and happier. She will enjoy a higher quality of life by decreasing the amount of calories she consumes and increasing the amount of calories she burns.

    Complain all you want about the “insensitivity” of a doctor.
    There is no emotion attached to the laws of thermodynamics.

    • Jak Stone

      You can’t force a wake up call, people are ready when they are ready. Everyone likes to completely ignore why these people are overweight to begin with, there is usually an emotional component. If it’s ignored and never resolved this woman is going to keep trying and keep failing to keep the weight off. If we really want her to succeed we would find the root cause. This doctor should instead be talking her patients into taking therapy or something if she really wants them to make changes that are permanent and going to stick.

  • Miss Effie

    Sad news for those who think it’s discrimination: preventable conditions like obesity and cancer from smoking can be denied by health insurance coverage. Tanning bed related cancers are next.
    This physician is not heartless or soulless, she is simply no longer willing to take on personal responsibility and its high risk for injury from individuals who can not/will not care for themselves.

    • Jarek Draven

      Right. And next we should round up the retards and execute them because they refuse to not be stupid. And the crazy people, because they refuse to be normal.

      Hopefully, eventually, the list will go on to include those incapable of compassion or understanding. You will not be missed.

      • Blondesareeasy Fullname

        They choose to be fat. Retards, and you, have no choice in the matter. Completely different. But you don’t get it.

        • Jak Stone

          No, not everybody does choose to be fat. My family is lucky to be so tall because when we do put on a bit of weight it doesn’t tend to show nearly as much. One of my shorter friends actually weights less than my brother but looks quite a bit larger.

          My sister also struggled years with weight, she’s thin and healthy now, oh look surprise an obese person who wasn’t lazy and actually worked hard! It was never laziness that was the problem in he first place however, it was extreme clinical depression, something far far too many people brush off. Thing is when you are struggling to even find a reason to get out of bed in the morning, to find a reason to even live, it’s pretty hard to care enough or summon the motivation and energy needed to start working out and actively trying to lose weight. Or you might be all gung-ho about it for a few months, then another depression settles in, and you lose all the progress you made. There is also a craving for stimuli which causes people to seek it in food.

          Matter of fact is it’s got rarely anything to do with laziness, if you get that person into a healthy emotional place you’ll see how much faster and easier they lose the weight, it’s not just a coincidence. Compassion and dealing with underlying causes does far far far more to help them than saying, “just get up and exercise fatty, stop being lazy” will ever do.

  • soupy

    I say she is right in principle, but the 200# limit should rather be a BMI score. I weigh 220, but my BMI is 25…

    • gg13s

      according to the CDC’s BMI calculator, to be 220 and have a BMI of 25, you must be a little over 6’6”. If true, than you are waaaaay over the average height of most americans, and it would make sense that equipment made to fit 99% of people wouldn’t fit you. In that case, she would be referring you to someone who had the proper equipment to examine you. However, I doubt you’re actually 6’6”.

      • soupy

        Actually I am two metres tall, 6′-7″, and weigh 100kg, so it’s easy to calculate by BMI.

    • Jarek Draven

      Oh, so you think it’s only fatties who should suffer, and not you, because you don’t think you’re a fatty for your size?

      LMFAO. I hope one day you realize how ridiculous you sound..

      And the supposed justification for this has to do with WEIGHT, not FAT. So your heavy ass is banned. Maybe lose some weight and come back later. Thanks for playing. Better luck next time, Big “Bones.”

      • Blondesareeasy Fullname

        Well “Jarek,” that response really teared it. Soupy is trying to shed some light on the subject…he’s not taking sides, as you are.

  • John of Indiana

    Well, I see the popular myth that took the nation by storm when Psychologists snatched obesity research away from the Endocrinologists in the 60′s is still alive and well. “people get fat because they won’t quit stuffing their faces!”. Hogwash! Oh, and the Corn Refiner’s Council thanks you for providing cover and directing scrutiny away from their showcase product: High Fructose Corn Sweetener.
    The Human body was never intended to try and metabolize that garbage.
    You skinny people, go ahead and laugh while you can, your day of “Why am I sick?” is coming, Food Scientists are working on YOUR future problem right now.

    • Chris

      Unfortunately people with too much excess weight ask the “why am I sick” question much more than fit people, and it won’t change. Discriminating against people based on weight is wrong (you do need to know the difference between real discrimination and a simple dent in your ego); calling all skinny people sick, in the same vein, is equally wrong. You may not like to hear it but being overweight has more health risks and usually can’t be blamed on some “complex network of metabolism and other endocrine variables.” Go to the parts of Africa hit by famine and live for five years and trust me, whatever “medical” problems you have, you WILL lose weight.

      • Blondesareeasy Fullname

        That would be cool if we could ship all the fat-asses to Africa. But they’d capsize the ship. Wait…that’s an idea…

  • Iris

    My mom is an amazing nurse. However, she kept hurting and straining her back trying to assist obese patients in the hospital (lifting, turning, helping to stand, changing diapers, etc.) There is not enough support staff in order to attend to these patients safely. She is fully aware of proper body mechanics and is in good shape. She had to leave bedside nursing and become a clinic nurse. I’m not saying that what this doctor is doing is right, I’m just offering a perspective on what health care workers go through everyday. And with obesity on the rise, it’s just going to get worse and worse.

    • Jarek Draven

      And thanks for offering your perspective in a reasonable way. However, IMO this still shouldn’t be entirely on the patients. If they are under-staffed, that is the fault of who ever is in charge of the hospital / practice. Sounds like they’re cutting corners to try to save a few bucks. Typical.

      • Cassie

        So the patients that are so big that they have to use the MRI machines from Seaworld, is it the hospital’s fault that they do not provide patients with equipment big enough for whales?

        • Blondesareeasy Fullname

          “Jarek” didn’t have a response for that one.

      • Blondesareeasy Fullname

        Cutting corners to try to save a few bucks.
        VS permanently injuring your own staff members for LIFE.
        If they are properly staffed for a “normal” patient clientele, they obviously haven’t had any issues.
        If you HAVE to staff for MORBIDLY OBESE clientele, you have to shell out more MONEY.
        The “fault” lies in those who are FAT.
        Got it?

  • http://www.facebook.com/profile.php?id=668282813 Holly Goodhead

    Yes by all means lets all pick who we want to treat now. Oh you’re a red head so Im not going to treat you or oh I see you are Native American and Ive chosen not to treat anyone from 1st Nations. Better yet, lets just load up all fat peope and those over 60 because obviously they are useless to society and have nothing to contribute to society and ship them all to camps where they can be lazy & useless because we all know that no one who is fat can possibly make a positive contribution to society and lets face it once peope hit 60, they are pretty much done with anything they could contribute & will now become a drain on our resources so by all means, Dr Hitler, let’s send them to te ovens. Really, where does it end? Today she does want to treat people over 200lbs tomorrow it could be redheads. Either way, over 60, fat & redhead, Im screwed.

    • mdylanbell

      You list arbitrary reasons, the doctor cited concrete and legitimate ones. Not the same.

  • cab02149

    She needs us more than we need her. She can move to some other country. It really is quite straight forward. I will even buy the tickets for her and her family. Poor kid. So confused. Be confused somewhere else.

    • mdylanbell

      You sound mad. The truth is your weight has substantial negative implications not just for you, but others. It’s a hard truth, and nobody is trying to be insensitive or gloating about it. Take a real hard, honest look.

  • Guest

    More of this needs to be done and maybe FAT people will lose weight. It’s their bad eating habits, such as, not know foods that are digested by acid vs alkaline. Add, keeping one’s carbs below 40 grams for older people who get little exercise is mandatory. There are no valid excuses for FAT people, at least, the majority of them. Fat people are lazy, uneducated and like to eat gross amounts of potatoes and other bad carbs. Limit your carbs and you will lose weight. It’s that easy.

    • Jarek Draven

      I have college level nutrition courses, as well as over 20 years studying diet and sports nutrition, and based on your comment, I feel pretty comfortable calling you a moron, and informing you that no, it’s not “that easy.”

      • Blondesareeasy Fullname

        “College level nutrition courses” means you didn’t get a real degree.
        You are correct. It’s not “that easy” for a buffalo to push itself away from the table when it’s hogging down the hay.

    • Jak Stone

      What about clinical depression? Seems to run pretty heavily in my family, I have experienced periods of depression and slight weight gain myself, though nothing like what my sister was going though. Depression runs so heavily on my mother’s side however I have no doubt there’s a genetic component. It’s certainly something we seem to have limited control over.

      You think that plays no part? Tell me how much energy you have to work out when you don’t even have the energy to get out of bed. Tell me when you are desperate for even the slightest thing to make you feel better for even a moment’s relief how easy it is to avoid the pleasing stimuli that food offers. Tell me then that when everyone around you is calling you lazy and uneducated and plenty of other things that it is so easy to drag yourself out of that depression and negative thinking. Tell me than when you have no friends and no hope it isn’t easy to slip back into not caring about anything anymore and thinking that if you aren’t going to enjoy anything else about life you might as well enjoy the food. Tell me how much it doesn’t suck to have to work back through all that weight once you start managing to care again. That easy my ass.

  • the lid

    I totally agree with the doctor. I also think that one should be charged for his/her health plan by weight. If they are overweight, they pay more accordingly! What I have noticed is that overweight people often don’t see themselves as overweight. It seems normal to them because it is so common!

    • Jak Stone

      Are they suppose to act as if they are constantly ashamed? Have you asked them personally? Just because people don’t walk around in a constant cloud of shame doesn’t mean they don’t see themselves as overweight or not normal.

      • Blondesareeasy Fullname

        Well, they SHOULD. Easier to blame someone else than to stop eating so much.

  • rockhauler

    does this mean she wouldn’t treat any condition if the patient is obese or over 200 lbs? since when would a weight loss center treat appendicitis or tonsillitis? there has to be another way to deal with this. what is the quid pro quo?

  • http://www.facebook.com/wendy.beth1 Wendy Golenbock

    If I was her patient I would start a boycott against her practice- it is arbitrary and unethical to discriminate like that.

    • mdylanbell

      It is NOT arbitrary. Her reasons are valid and concrete. There are additional costs and even physical risks to those people who aren’t negligent about their health and weight. It’s not fair to the doctors to put themselves at such risk because some people are unwilling to deal with the very real problems of their own obesity.

  • Kara

    So she won’t treat Shaquille O’Neal, then. I agree that the 200-lb. limit is really arbitrary.

  • marge sullivan

    I believe she is insensitive and should look for another profession

    • Eric

      She may be insensitive in your eyes, but you are more insensitive and IGNORANT than she will ever be. What if she ways 100 pounds and is only 5’0 tall? You expect her to potentially injure herself? Are you going to pay for her bills if she can no longer work because she got hurt treating someone that is twice her weight? I didn’t think so Miss SENSITIVE.

      • Jarek Draven

        Or, she could…. I don’t know… get someone to help her. Hire someone capable of doing the job. Many jobs have physical ability requirements.

        Also, the word is “weighs” not “ways,” you fucking moron.

  • thoughtful

    i hope an obese person falls on this Doctor…..by mistake of course.

  • siamesedream83

    I don’t understand the outcry here. Obese people are clearly
    better served with specialist medical firms that have expertise in
    obesity-related health issues in addition to more accommodating medical gear. I
    recognize that being obese is not always a “matter of choice”. But you can cry “medical
    ethics” all you want. The doctor in this case is trying to run a business, and
    in business it’s up to your discretion as to who you want to take on as a
    client, especially from an ROI perspective. Why should she put herself at
    additional safety risk and incur extra costs to upgrade her medical equipment?
    Because it’s the “right thing to do”? Being obese has with it a host of
    interrelated problems that are again, best served by a specialist who is in
    every way better equipped to deal with them.

    • eyoungrn

      As I mentioned before, doctors who specialize in obesity are specialists who treat patients for obesity. They don’t treat strep throats, they don’t do routine Pap smears or prostate exams or many of the other things we go to our PCPs for.

      • Blondesareeasy Fullname

        And bariatrics costs a hell of a lot more money than other disciplines. You’ve got to buy all of the special lifting equipment or you’ll put your staff at risk.

  • Ginacali

    All of you who agree with this doctor
    show your true colors as people the rest of us wouldn’t want within 100 feet of
    any positions of leadership (and if you are, then the rest of us are duly
    forewarned). It also belies your ignorance of the spirit of the Hippocratic Oath (I realize that the classic version
    has been challenged). However, where is
    the clause that supports as a medical doctor you have the right to turn away
    someone in need of medical care? All
    this nonsense over bringing up specialties in the health care field for certain
    issues is just that. You’re comparing apples to oranges. Of course, if one has addiction issues, you go to a specialist. Of course, if one has AIDS, you go to a
    specialist. What one shouldn’t expect from anyone in the medical profession is,
    to be turned away outright.

    What does this doctor do, have
    someone guarding the entrance to her office to fight off anyone from entering
    who appears to be obese? Does she screen them over the phone when they call for
    the first time: “Oh, you have a fever of 101 and need to come in? Well,
    let’s get this out of the way first; how much you weigh.”). Any health
    professional who thinks it’s all right to discriminate with patient care needs
    to get their backsides out of the medical profession and become lawyers.

    Now that’s a profession in which we
    recognize you can choose who you wish to represent and who you don’t.

  • Nikki

    As an obese person (working my way down), I would like to challenge doctors (like this one) to treat their obese patients with a perscription of vegetables, excercize, fruits, nuts and beans instead of treating the diseases that were caused by obesity (i.e. diabetes, heart disease etc…).

    • Samuel Georgian

      Most doctors I know recommend that, patients just don’t listen.

  • Queen Kitty

    If this is her policy, then she should be up front about it: post signs on the clinic door, tell new patients when they make appts, list it on her website (if she has one). To wait until the patient’s 2nd appt to sandbag her with this is, IMHO, inconsiderate and disingenuous.

    Re charging double for the cost of caring for obese patients: Really? Why not start charging more for patients with complex medical conditions because they need more resources? Why not charge more for patients who ask a lot of questions because they force the doctor to talk more? Why not charge more for patients who aren’t health literate because you have to do more patient education? Really, Dr. Carter?

  • http://www.facebook.com/profile.php?id=549411952 Stephanie Montpetit

    Dan! “Most people are fat because they make fat choices.” – Really! I bet you come from a whole family of high metabolism fit people. The fact remains that some people are born with a susceptibility to being overweight. I weigh 220lb. Before you pass judgment, I am 5’10”. I have been active my entire life and currently spend over 10 hours a week playing a physically demanding sport. I am fit and can outlast my smaller friends in endurance challenges. I have an underactive thyroid but I control it with diet. Contrary to popular belief I am not the exception to the rule. My best friend and I had sons at the same time. My son from birth has always been more than twice the size of her son. You’re telling me this is because he’s been exposed to “fat choices”. It has nothing to do with genetics at all?? All I have to say to people like you is – Ignorance is the most destructive force available – Educate yourself before you express yourself!

    • gg13s

      5’10 and 220 is considered obese if you calculate your BMI. Genetics is MUCH more complicated than you seem to realize, and really there isn’t sufficient evidence (peer reviewed papers) out there linking genetics to obesity–trust me, I am a geneticist. If you don’t believe me go look on pubmed yourself. It’s quite simple–if you burn more calories than you take in, you will lose weight. That’s simple physics. You probably aren’t well educated about nutrition, and don’t realize some poor choices you might be making that would also be effecting your son. There are actually quite a few studies that demonstrate overweight and obese people significantly underestimate how many calories they consume in a day.

      • Jarek Draven

        Absence of (DISCOVERED) evidence of something does not equate to that thing not being true, or not existing. It simply means the connection has not been proven.

        You’re absolutely correct that expending more calories than you take in should result in some weight loss.

        However, like many things, that sounds far simpler than it is in reality.

  • http://mitchlabuda.com/ Mitch Labuda

    If the goal is for the patients to slim down, the people will simply find a doctor who will treat them, and the goal will not be met. It’s a market place as doctors are in the business of being in business.

  • TJtruthandjustice

    I won’t see a doctor who is too weak and fragile to pull out an exam table foot rest.

    • Jarek Draven

      Seriously. And that sounds like the pot calling the kettle black, to me.

      Try some stretching before you move heavy things, lazy doctor. LMAO

  • Jeanna

    I fully support her decision, although I don’t necessarily follow the airline seat comparison. I have read past news stories about EMT’s having to invest in larger ambulances, stretchers, etc. to accommodate for heavier patients. These EMT’s are putting their bodies at risk for having to lift and push heavier people. It’s not a personal thing against obese people, it’s a matter of physics. A lot of medical equipment is not designed for people who are obese. It is completely possible that her exam table is only rated for a certain weight and does not function properly under excess weight.

    I also think she’s right about obese people needing to go to specialists.. it’s much the same as having children go to pediatricians, cancer patients going to oncologists, and females going to OB/GYN’s . Obese people have more specific health concerns and need specialized care and equipment that suits their needs. Regardless of whether obesity is a choice in an individual, it’s better that they are directed to a place where they can receive more specialized treatment that meet the conditions of their body.
    And she is COMPLETELY correct about how it’s wrong that obesity has become more socially acceptable. I’m not saying people shouldn’t feel confident, pretty, or attractive at any weight, but the fact is that it’s a serious and expensive health condition and should be seen as such.

    • Lynda

      I agree with this. The details are arguable- 200lb cutoff, etc, but I feel more physicians should address this issue, and how it affects the health care industry in ways we may not have considered. I see what people are buying for “food” and it is clear that people are not in a lot of cases being realistic about how they should take care of themselves. Let’s treat it like a crisis, make people seek out special care, let them know this is something that is just not normal, and will not be treated as such.

    • eyoungrn

      The issue goes so much deeper into our society than a number on a scale. There needs to be a grassroots effort to make truly healthful foods affordable and available. The cost of all groceries has skyrocketed in the last four years while people’s incomes have stagnated for many of those who have managed to stay employed or been reduced for those who have been out of work. I go to farmstands at this time of year to take advantage of all the wonderful fresh produce available and it has gotten really expensive. Three large tomatoes, four nectarines, two cucumbers, a red pepper, a couple of onions and three squashes cost nearly $20 (and this isn’t expensive, organic stuff either). I know the weather has an impact on prices, too. But someone who is at the grocery store could get a heck of a lot of white rice/pasta, processed “cheez”, chips, etc. for that same $20 that would make more people feel full for longer than my veggie purchase. There is something so wrong with this that it makes me crazy!

      • Samuel Georgian

        It costs an estimated $1.50/day more to eat healthy.

        • Jarek Draven

          That number, like your statement, is sheer bullshit on multiple levels.

          Estimated? By whom?

          Eat Healthy? How healthy? Healthier than what?

          1.50 more? More than what? For what products? At what stores? You sure all or even most people have access to said products and stores?

          eyoungrn got it 100% right.. It is MUCH (not a little) cheaper to buy unhealthy, garbage food that is filling, and sometimes even tasty, than it is to buy highly nutritious food. And that is one of the things we need to change in order to truly combat our seeming obesity epidemic.

          • Samuel Georgian

            A peer reviewed study: http://bmjopen.bmj.com/content/3/12/e004277.short?g=w_open_current_tab

            I’ll take a quantitative approach by someone with a PhD from Harvard over your intuitive guess any day.

          • Samuel Georgian

            Google it. There’s a 2013 meta-analysis of food costs. I’ll take the word of someone with a PhD from Harvard over your intuitive guess any day.

      • Jarek Draven

        This is one of the most intelligent comments in this entire thread. Thank you.

      • Blondesareeasy Fullname

        Healthy foods ARE available and affordable.

        But they have to make the EFFORT. And that effort is lacking.
        This is proven by the fact that there are people of NORMAL size walking around that don’t CHOOSE to wolf it all in one sitting.

  • Mom16

    The Body Mass Index (BMI) would better identify obese patients rather than an arbitrary number, like 200 lbs. For example, she could deny morbidly obese patients with BMI of greater than 40.

    Perhaps the physician’s decision is, like she said, based on self preservation- she feels unsafe trying to examine or care for patients over 200 lbs. I work in a clinical setting as well and often feel pain and frustration by the physical demands of lifting and positioning patients. That’s when it is time to get more help to avoid injury–not necessarily turn patients away.

    • ARGH

      Yeah, but everyone who is saying “I’m 200 pounds and 6’6″ so I’m normal and shouldn’t be turned away…or suggesting we use BMI…that supports the idea that she is only turning away these people because they’re overweight/obese. She claims that it’s because of her equipment — so, an extremely fit, tall, basketball player over 200 pounds weighs the same amount as an obese person over 200 pounds, thus the same strain on her equipment, thus should follow the same rules. If it’s truly an equipment issue and not a “I don’t want to treat obese people” issue, then it doesn’t matter.

      I do suspect, though, that the doctor is mingling some of the former and some of the latter. Specifically, she states that this policy is a motivator for some of her current obese patients, and that she’s not turning them away. If the equipment is unsafe for her to use, they all should go too, and she should feel fine about that. Similarly, if she feels that the fear of being shamed and “fired” from a doctor’s practice will help motivate her patients, then she is clearly more focused on her own projected disgust of fat than she is of potential equipment problems.

      • Jarek Draven

        You’re right. And the fact that people keep saying “yeah, but BMI would be a better measurement,” and “But I’m 200+ pounds and ATHLETIC, don’t ban ME!”

        …. just proves not only how sickeningly biased many people are, but also just how bad at reading, and completely incapable of employing SIMPLE LOGIC (e.g., fucking stupid) , some of these very biased, compassionless, arrogant creatures actually are.

  • FishFingersAndCustardGirl

    Why doesn’t she motivate herself to do something simple like I don’t know say pull out the footrests before the patient sits down or better yet, just ask them to stand up? Come on, this is common sense. How could somebody who has gone to school for so long sound like such an idiot?

    • Jarek Draven

      Common sense? We can’t have that!

      Why look for a simple solution, when you have a perfectly good excuse to finally fuck with fatty?

    • Blondesareeasy Fullname

      Fish, you’ve never seen them or had to “help” them, have you? They’re huffing and puffing, can’t lift their legs by themselves, need a helping left to rise out of their medicare purchased/taxpayer financed hover carts.

      But that’s what I do. I tell the fatso’s, “Hop up on the table. Can’t do it. You stay in the chair. I’m not helping you. You need your hemmorhoids examined? Ya’ gotta’ get up and spread your fat ass cheeks yourself. Can’t do it? Go to the hospital and wait in line..”

  • DA

    Clearly this woman should not be allowed to practice medicine. Someone should take her licence and patients should sue her for discrimination. I would call and ask to come as a new obese patient and record the conversation.
    And I agree with the comment about the foot rest. What’s that got to do with the patient’s weight?

    • Blondesareeasy Fullname

      She had to physically lift that fat, 150 pound leg to get it on the support, And the fat person PROBABLY insisted that she do it without help.

  • Eileen

    Obesity is a complex health issue whose treatment requires a physician not only with medical skills and knowledge, but also the needed emotional skills –skills like caring, kindness, and compassion. These seem to be skills that Dr. Carter does not possess. She has done potential patients as well as any current patients now under her care (over or under her 200 pound limit) a huge favor by making her insensitivity public. All of them would be better served by seeking medical care somewhere other than Dr. Carter’s office.

    • Keep It Balanced

      Dr Carter is a medical GP right? She even states directly that she is NOT trained to deal with the complex issues of obese care. “she’s decided that obese patients in the region would be better served at a facility like the weight loss center at UMass Memorial with a full range of tailored interventions, including psychotherapy…” Dr Carter has to prioritize what she can offer (like we all do not matter what our jobs are, to stay viable) She has stated practical reasons why obese patient care is damaging her practice to the point it my force her close it down. How would that help ANY of her patients then? If she is forced to choose between being “insensitive” and her livelihood, then I say Dr Carter is obviously making the most unpopular, yet best choice. Bravo Helen Carter.

  • Doctor Teeth

    Not dissimilar to the recent trend of OBs refusing to see patients who are also employing the services of a midwife.I am 230 and 6’1. I need to lose some weight, but there is nothing that I cannot do because of a few extra pounds and I am very active (including cutting my own firewood). I certainly would not consider myself obese (or unable to lift my leg out of the way of someone trying to move a leg rest. The Dr.s staff need ergonomics training, a chiropractor, and perhaps a different benchmark, like BMI.

    • gg13s

      even if you don’t consider yourself obese, you likely are. Check the CDC’s BMI page, you are in the obese category.

  • RNfromMA

    What’s next for this practice? In the interest of “self preservation,” will this physician also begin turning away patients with communicable diseases? Perhaps her focus should be on educating her staff on the use of proper body mechanics as opposed to banning an entire group of individuals from her practice.

    • Keep It Balanced

      It would depend on the costs that treating these particular maladies would incur. Then it would be Dr Carter’s choice to make and patients can also decide with their feet…really this victimization stuff it getting old. Also I am not a doctor but I can make a diagnosis for everyone reading this…fat or not…None of you will be alive in 100 years so enjoy what you have now responsibily and be willing to accept your own consequences. Yes I am 20+ lbs too heavy and yes I struggle with it, but it is my life and my choices that got me here and I readily accept them

      • Jarek Draven

        Being 10 or even 20 pounds over weight is NOT just a “scaled-down” version of severe obesity.

        A few extra pounds almost seems to imply just a tiny bit of gluttony and/or laziness. That is not necessarily the same as severe weight issues, or genuine food addiction.

        Kudos on the acceptance, though.

    • Jarek Draven

      ” In the interest of ‘self preservation,’ will this physician also begin turning away patients with communicable diseases?”

      LOL Brilliant. Wish I’d thought of that one.

  • http://www.facebook.com/shivasteve.ordog Shiva Steve Ordog

    Choices? A complete understanding of weight problems and addictions leads to understanding of the karmic conditioning that creates our minute by minute behavior. Such understanding leads one to use the word “choice” less and less. If we don’t fix the food supply then this doctor will go out of business eventually as the percentage of obese people rises.

  • Susan

    1) I have never been sitting in any position on an exam table where the foot rests have been under me so I can’t see how pulling out the foot rest would cause such a severe injury. Also, there is no mention of any other “staff” that have been injured in the care of obese people. I think she is blaming her injury on the patient and not herself.
    2) By continuing to treat her existing obese patients she is still bringing potential harm to her staff which leads me to believe her logic is not sound. If she wanted to stop a potentially harmful situation from occurring she should follow through and “fire” all her patients over 200 lbs. Oh wait, that would be discrimination.
    3) Just because you are over 200 lbs doesn’t mean you can’t be active and in fact require no help to move or position yourself at the doctors office. Most people at a doctors office get around by themselves and require no help so I don’t see the potential danger to the staff.

  • Peter

    When your bad habits are causing misfortune for someone else, you can’t blame them for taking action. If the person is so obese that opening a footrest would cause long term neck injury, you would be at fault if you didn’t do something to avoid causing injury to yourself like that; not your patient. I can’t blame the doctor for making this decision.

    • RNfromMA

      As a medical professional, that physician should know about using proper body mechanics to prevent on the job inury. If the physician injured himself the way it is described here in this article, it is most certainly not solely the fault of the patient.

  • amelia

    I think that this is fantastic! Hold people accountable for their actions and build the experience you care to have. There are certainly many other doctors that they can see.

    • LR

      So you’re saying that you don’t have any behaviorally related health problems or risks yourself? You don’t, say, avoid exercise, eat too few vegetables, work long hours or accept a desk job instead of one that involves lots of movement, get angry, etc. etc. etc.??? You could probably dismiss half of all patients if health problems that are caused by their behavior excluded them from treatment for anything else.

      I’ve seen a somewhat obese patient at a rehab facility who had to be hoisted with a mobile lift, so I know handling heavy patients is a problem, but this may be going a bit too far.

      BMI is kind of a crock too, for anyone whose build isn’t average or who has extra muscle mass. Back when I was 30, I was in good shape. I could even do 6 chin ups or so. But my BMI was 25.5 or so, which is in the overweight range. I understand that when Lance Armstrong was bike racing, before he got cancer, his BMI would have been in the overweight range. OTOH, ectomorphs who don’t get any exercise could certainly be overweight and have a reasonable BMI.

    • Jarek Draven

      I can see the “experience you care to have” is extreme ignorance.

      Hope that works out for you.

  • http://www.facebook.com/profile.php?id=1787714095 Amy Witzel Jordan

    All I will say is that obesity is anything BUT socially acceptable. I don’t care how much of the population has become obese, the public, media and now apparently doctors make obese people feel like lesser, lower-class citizens.

    • nikki

      …because WE are.

      • Honeymaid0

        Because you made the actions and choices that resulted in your condition. Obesity is not THRUST upon someone, they shovel it down their gullets one day at at a time.

        • Jarek Draven

          You mean just like your massive level of ignorance and stupidity probably took you years to achieve?

        • Joey D.

          With children it is…

        • Christina Staab

          how does my obesity effect you? you can’t catch fat. you don’t like what i eat? don’t eat it. we all have our vices. food is mine. i’m not going to put food in your mouth any more than you could get me to gulp down alcohol or chain smoke.

    • Nathan Browett

      are you fucking kidding me?

      • Jarek Draven

        Excellent point. Really well-said. (<—- Note: EXTREME sarcasm)

        • Nathan Browett

          do I really need to elaborate on a comment suggesting being fat in America isn’t socially acceptable? are you really that fucking stupid?

    • Jarek Draven

      Excellent point. Really well-said. ( <—- Note: NOT sarcasm)

    • Christina Staab

      this is absolutely true. food is a vice,and everyone has vices. the only thing is that obesity is a VISIBLE vice. smoking, gambling, sex, drugs those things a person can hide. its like my obesity is a get out of jail free card for people to make fun of me. i wasn’t always obese, so i can see things from both sides.

  • http://www.facebook.com/victoria.rios.501 Victoria Rios

    This is horrifying. As a person who has lost 180 lbs and understands deeply what it is to be obese I am saddened and shocked by this article. and also – Hippocratic Oath ?? what about that….I am so offened by the fact that she thinks its a bad thing that being obese has become “socially acceptable” – Socially everyone should be accepted regardless of their MEDICAL problems. There is nothing NOTHING shameful about obesity. it is an illness with many causes, and no one is Obese just cus theyre lazy and gluttonous. being obese is physically and emotionally excruciating at times and everyone wants out who is trapped in there…..if it were that easy and simply an issue of procrastination, we wouldn’t have a multi-billion dollar industry trying to help people figure this out. This should be illegal. I am incensed.

    • Eric

      You know what Victoria, quit making excuses. Being fat IS socially unacceptable. I know a ton of people who say “It’s easy for you to lose the weight”. Hell no it isn’t!!! I lost my 80 pounds by getting my fat ass in the gym. I had to sacrifice my time to go to the gym. I made an EFFORT to do something about it. The people who complain it is EASIER for me to lose the weight than them is because they eat out every day for lunch, and dinner at fast food places like McDonalds, and Applebees. The illness you mentioned is called LAZINESS!!!! Too lazy to make a healthy lunch or dinner and not wanting to work out because they would rather watch Family guy. If you are so incensed, then why aren’t you complaining about the Doctors who refuse to do an abortion based on religious grounds? Why not be incensed by the Pharmacist who doesn’t want to sell the day after pill? When was the last time you stopped to help someone on the side of the road because there car was down? Exactly, you just drove on by. Quit justifying people being fat and lazy. Procrastination is just another word for “I am too lazy to get off my FAT ASS!!!!” You dropped 180 pounds, so obviously you got off your fat ass.

      • Gerald

        Chill out Eric. You obviously know nothing about leptin and metabolic set point. It is almost impossible for a morbidly obese person to lose weight without a clinical treatment plan and/or bariatric surgery. Your inability to view obesity as anything other than a personal choice is obnoxious. I bet you see poverty the same way too.

      • Jarek Draven

        No. YOUR illness was laziness. Don’t assume that everyone else is like you.

    • Chris

      I wonder why this “illness” is not so prevalent in the parts of our planet where food is scarce and/or often requires intensive physical work, such as hunting, climbing, or agricultural labor.

      • Jarek Draven

        Congratulations– this is possibly the dumbest fucking comment in this entire thread. And THAT is actually an impressive feat.

  • Joe Sacerdos

    Hey, I’m all for personal choice too … as long as your choices do not infringe on my space. People who “choose” or not choose to be obese drive my health insurance rates up. People who choose to smoke (I know it’s an addiction and a disease … however) do the same. Cigar smokers in particular pollute the air with their stench for hundreds of feet around them. All of the above do infringe on my “space.”

    What if the physician said, “I’m no longer taking new patients who smoke because as a physician I’m committed to your health, but if you are not committed to working with me, then, sorry.” Although I disagree with her on the 200lb thing. I’m a middle age man in excellent shape, 6’3″ and I weigh 210. I think maybe the doctor should base the criteria on body mass index. A person 4’10 who weighs 195 would be obese, but would pass the 200 lb test.

    • Jarek Draven

      No, it’s the greedy health insurance companies that are driving your rates up, you fucking moron.

      They just realize that a little “divide and conquer” will get you looking at the fatties and the smokers rather than THEM. Unfortunately, most people are like you (e.g. really fucking stupid) so the sham works.

      Why don’t you make the personal choice to stop being a moron, and learn who’s REALLY got their dick in your uptight little ass….?

  • TallGirl

    @facebook-100004105530044:disqus – exactly. What a random number. I am 205 lbs and 6’2″, so my BMI is above the healthy range (but not in the obese). All other indicators, including my height/waist ratio, put me well within the healthy range. At the same time, I have friends who are nurses on a heart ward, and they have slings to move heavier patients. So maybe the concern is moving large patients.

  • emb

    I don’t know that she could pull out the footrest first. Any time I’ve been to a doctor’s office; I’ve been seated (and sometimes disrobed) before they entered. And the footrest is under my legs. I could see it being difficult to pull out under those circumstances.

    I think, ultimately, she is right about the fact that she isn’t as equipped to deal with the specific issues related to obesity (as she cites in her addiction example). And she isn’t turning away her current patients. She’s simply saying that she may not be able to help them as well as a doctor who is prepared to actually meet a larger number of their needs. That makes sense to me. In essence, it seems that she is referring those patients to a specialist. Doctors do that all the time.

    • eyoungrn

      A bariatric specialist isn’t going to see patients for sore throats, sprained ankles, Pap smears and the like. A bariatric specialist is just that, a SPECIALIST and if the patient’s complaint isn’t directly related to being obese, the patient will be referred elsewhere. As a home care nurse I can tell you that most of the specialists my patients have refuse to even touch a diagnosis not directly related to their specialty. For example I might call a surgeon about a post-op patient on narcotic pain relievers who is not helped by the laxatives prescribed by that surgeon and be told to call the patient’s primary care doctor. (And most internists refer me to specialists for anything they think is related to a specific body system.) From where I sit, this is a GIGANTIC part of the wasteful spending in medicine today.

  • http://www.facebook.com/people/Tracy-Moscato/100000062732497 Tracy Moscato

    This is so absurd. I mean 200 is not a high threshold. not like there should be any at all anyway. overweight people are the most discriminated against group in the country. This is such a MA elitist thing.

    • http://www.facebook.com/robyn.martyroix Robyn Marty-Roix

      I think this physician is going by CDC (and other stats-based) standards and not arbitrarily picking 200 lbs. According to the CDC a person who is 5’9″ and weighs 203 lbs is considered to be obese. The average height of women in the U.S. is around 5’4″ and men is 5’8″. I think most Americans have a factually incorrect notion of what ‘healthy weight’ means.

      • http://www.wbur.org/people/rzimmerman Rachel Zimmerman

        I just spoke with Dr. Carter to clarify this issue. She said in general, she won’t accept new patients who are obese or over 200 pounds. However, if the patient weighs over 200 because he or she is quite tall, or if the patient has a BMI under 30, she won’t exclude them from her practice. I hope this makes things clearer for readers. Thanks. RZ

    • Eric

      I take it you are fat then?

  • http://www.facebook.com/mcarrollreeves Meghan Reeves

    I’m ok with this. There are Dr’s that only treat women, my daughters pediatrician only treats patients that are vaccinated…it makes sense to me. I think more Dr’s should specialize care. People would gain from their specific expertise.

  • MEJ

    I am someone who weighs over 200 pounds. I gained 75 pounds in a year because of a medicine that was prescribed to save my life. Since this time, I have been unable to lose the weight as I must stay on similar meds–again to save my life. This sudden and severe weight gain has been very difficult for me. I started with a new primary care physician last week since I recently moved. She said something so reassuring: I’d rather that you be overweight and alive versus dead and skinny. THIS is the correct attitude. The doctor also clearly has no sense of the emotional and mental aspects of weight gain. These can be addressed by a psychiatrist and/or psychologist, but we still need the care of ob/gyns and primary care physicians. This is blatant discrimination–being overweight isn’t necessarily a choice.

    • Dan

      You are an exception. How do you know that she would not take your situation into consideration? Most people are fat because they make fat choices. The message society sends out needs to be “don’t get fat; if you are fat, figure out why and fight to not be fat.”

      • Susan of Brookline

        MEJ is not an exception. Though other obese people may not have gained weight due to medication, obese people, in general, have difficulty losing and maintaining weight loss for a host of complex emotional and physically based reasons. I have lost really large amounts of weight, and then gain it back and then some, multiple times over. My nutritionist tells me that is a pretty common phenomena. Though of course weight loss requires work, she advocates following guidelines rather than a weight loss plan, which she states is usually a set up for failure in the long run. Weight loss is a slow process. I am so glad I have a PCP and a nutritionist (and other specialists) that are educated and empathic. They encourage me to lose weight, but they would never reject me because of my current condition.

        • BD

          People who are overweight and complain about their mental and physically based reasons are suffering from victimization. For the vast majority of people who are obese, all they need to do is eat better food, eat less, and exercise more. If they are unable to do that, they simply lack discipline (in the vast majority of cases). Stop blaming, start doing.

      • eyoungrn

        Many people get fat by making poor dietary/lifestyle choices AND many people stay fat because in order to lose the weight they have gained they have to take such drastic measures that they can’t sustain them. (As in severely restricting calories to less than 1000 per day in order to lose any weight at all. How long do you think someone who has a lot of weight to lose would stay on that program with the headaches, dizziness, nausea and generally poor feeling that accompanies inadequate nutrient intake?) We as a society are so quick to blame individuals for anything that befalls them: what about improving access to healthy, life-sustaining foods for those who don’t have enough money? The majority of the cheap foods in the grocery store are overly-processed, nutrient deficient JUNK made with ingredients that set up cravings for fat, salt and sugar.

  • http://www.facebook.com/taylor.rouleau Taylor Rouleau

    Uh, what doesn’t make sense here is that if you’re 5’9″ or taller and weigh 200lbs you are NOT obese– and if you’re 6’3″ you’re not even overweight!

    • http://www.facebook.com/profile.php?id=612833125 Alex Hindley

      exactly!

    • eyoungrn

      It’s that stupid, useless BMI again — no allowance for body composition.

      • soupy

        At least it’s a tool to open discussion. What’s your BMI?

    • Jordan Knoll

      im 6’3 and 120 pounds wot.

  • http://www.facebook.com/people/Tracy-Moscato/100000062732497 Tracy Moscato

    This is the most insensitive, hateful thing I’ve ever read. “other people’s choices”. Their brains are wired differently and also, some are obese due to treatment for health problems. steroid treatment, etc.

    • Ian Gustafson

      “This is the most insensitive, hateful thing I’ve ever read.”

      You must not read much.

    • Eric

      Quit making excuses. Everyone’s brain is wired differently. DUH??? So if I decide to defecate on your front lawn, it’s not my FAULT I did that, it’s because my brain is wired differently right?? We control our own actions, quit making excuses.

      • Voice of Reason

        Unless, of course, your brain really IS wired differently so as to make you do that. (Say you had a hallucination that you were in the bathroom, or you were sleepwalking.) “We control our own actions,” you say. What evidence, if any, do you have of this?

  • http://www.facebook.com/people/Tony-Anzalone/1203292141 Tony Anzalone

    This is causing harm by omission. What’s next will the doctor only treat patients that are healthy?

  • Stacey

    This is ridiculous and discriminatory. The physician could have pulled out the foot rest BEFORE the patient got onto the table, for God’s sake. So now they will be denying care to people because of a physician’s mistake? Again, ridiculous. The worst part is that this is a doctor charged with helping people to heal and denying help to people who are especially in need of healing.

  • decyferite

    Ok, so let me get this straight… Im 6’4″ and weigh 220, so Im obese?

    • Eric

      You just might be..

    • dr2chase

      No, your BMI says you are not obese (I know this because I am 6′, 220lbs, and BMI says I am overweight, but not obese. And though I am in good shape from loads of exercise, my doctor would like me to also lose some weight.)

  • Josh

    I think she is totally right. A physician is not required to treat a patient. It is their choice to treat patients. If she chooses to not serve obese patients that is her right. Being obese may not be a choice, but choosing to live a healthy lifestyle and exerciseto lose weight is.

  • Heather Katsoulis

    She’s got a good point about other institutions being better prepared to deal with the complexities of obesity…

    • http://www.facebook.com/profile.php?id=612833125 Alex Hindley

      No she doesn’t … because tall people who weigh 200 pounds are not even “obese”.

  • Rebecca

    Her choice, maybe they should lose some weight.

    • RNfromMA

      Maybe you should get a clue.

  • Amy

    First of all, I don’t see how pulling out a footrest can be blamed on the obese patient. A footrest is a footrest, whether the patient is obese or not. Did I miss something? Secondly she is indeed being discriminatory. People have a right to make their own choices. I agree the choices people make are sometimes unfortunate, be it overeating or driving too fast. Also please note that obesity is not always a choice.

    • Jeanna

      A lot of medical equipment (same with chairs, elevators, anything made to support a human) is only rated for a certain weight. If the load exceeds that weight, then no, it does not function properly. The excess weight probably made the exam table sag slightly, which made it so that she had to pull hard to get the footrest out.

      Keep in mind that driving too fast is a ticket-able offense and is punished in our society. There are down sides and consequences to making risky decisions, whether it be tickets or not being able to see certain doctors.

      • http://www.facebook.com/people/Kathy-Wnuk/100000450245663 Kathy Wnuk

        I worked for a med device company – most equipment is designed for a certain weight limit. There are bariatric devices for heavier patients, however a GP wouldn’t purchase this unless that were a specialty.
        At first I was annoyed that she refused to help a sick person – and if one is obese, sickness will follow. If she offers a referral to a doctor who is more able to treat obesity, fine. But many obese people enjoy eating and don’t like to exercise…I know several.

        • Keep It Balanced

          “she’s decided that obese patients in the region would be better served at a facility like the weight loss center at UMass Memorial” so she is offering another option

    • Dan

      She has a choice not to serve obese people then, no?

    • Luau

      “people are free to make choices” – then the doctor should be free to make her own choices too.

    • soupy

      Obesity is not a choice? Really? In what % of the population? What’s your BMI?

  • Nancy

    I am hard pressed to think of another medical condition that a doctor would feel comfortable saying publicly he or she won’t treat. Lung cancer from smoking? Cirrhosis caused by alcohol abuse? A head injury from riding without a bicycle or motorcycle helmet? Injuries from a bungee jump? I am reminded of the early days of the AIDS pandemic, when some
    clinicians did not want to treat people with HIV, sometimes saying, at least for gay men, that
    it was the patient’s “irresponsible and reckless behavior” that led the
    patient becoming infected. I find this deeply troubling and unethical. Love to see the Board of Registration in Medicine look into this to determine if it is legal. (And I had the same question as Roger below about the exam table and how the injury was related to the patient’s weight.)

    • Kristin Russell

      doctors frequently don’t treat patients with such-and-such (including HIV)…it’s not what their speicialty is or what they as a general practitioner feel comfortable (or even want) to spend their time doing. Would you want a GP to treat a head injury? I think not. I think your particular argument holds no water.

      • Susan

        Actually, I would expect my GP to treat my cold or flu without having to go to a specialist.

        • Keep It Balanced

          Right so the real problem is discerning the severity of obesity (in regards to $ for long term treatment and bodily damage) vs a cold or flu. Who is the best to make that call? Probably the ones with the medical training, practical experience and actually running the practice (ie Dr Carter). It all comes down to this…obesity causes hardship who is the one to absorb it?

    • http://www.facebook.com/profile.php?id=1205739571 David Wagle

      Actually I would think most internists would not treat a whole host of conditions: heart disease, cancer, immune deficiencies, endocrinological disorders and on and on. In all those cases they’d refer the patient to a specialist who would oversee their care in light of their particular specific conditions.

    • Ian Gustafson

      “As far as the new policy, Carter offered this comparison:

      She doesn’t treat people with addiction, she said, because she’s not an addiction medicine specialist. Similarly, she’s decided that obese patients in the region would be better served at a facility like the weight loss center at UMass Memorial with a full range of tailored interventions, including psychotherapy, nutrition and exercise counseling and surgical options.”

    • Ed

      The thing is, food is essential to living. It isn’t something that one can make a choice to do with or do without. If you choose to fulfill that essential need with garbage, your body outputs garbage.
      I agree that the doctor’s reasoning for this ban is weak, but I guess she couldn’t just outright say no?

      • B

        Everyone here would agree that no one can go without food but again its about priority food is the problem in america and the laziness of going to mcdonalds rather than take an extra 30 min to make a meal with actual food that comes from the ground or meat that isn’t full of chemicals and hormones the human body was never meant to ingest in the first place.

        • Hyperthyroidism

          It is mostly cost, it cost more to feed me by myself cooking 10-15 a meal vs premade meals. I do not have room to freeze things. Medicine is my priority.

    • Mike_Card

      So. She restricts herself to patients between the ages of 18 & 30, and weigh between 120 & 160 lbs, and have no identifiable illnesses or maladies. What does she do, exactly? Dispense flu shots?

      • eyoungrn

        Probably not even many of those — how many 18-30 year olds do you know who bother with flu shots?

  • Bob

    So this physician’s stand against obesity – which I would even support if it was not so self-serving – ends up causing everybody else to pay for her choice.

    • Eric

      How do you figure Bobby-Boy?? So if she decided not to see you because she might get hurt because let’s say she only ways 100 pounds and is 5’2 how is everybody else paying for her choice?? You really are a dumb-ass.

  • Roger Kent

    Wouldn’t you have to pull the same exam-table foot rest for a patient who weighs less than 200lbs? Does a heavier patient make the foot rest heavier or more difficult to pull?

    However I do agree w/the doctor (and I’m over 200 lbs). The rest of the world shouldn’t have to cater to my choices.

  • http://www.facebook.com/david.pickett.3720 David Pickett

    What about treating non obese patients who weigh over 200lbs?, bodybuilders for example?

    • Sam

      This is the part that makes no sense to me. 200lb so arbitrary. What if a guy is 6’5″? If he’s under 200lb I’d be worried he was underweight, most likely.

    • http://www.facebook.com/people/Kathy-Wnuk/100000450245663 Kathy Wnuk

      She needds to get equipment that can handle heavier patients.

      • Eric

        You are right that she needs equipment to handle heavier patients. So are you going to pay for it then Kathy? Why should she have to pay for it when it will only be used maybe 2% of the time?

        • Heather127

          Except that > 50% of the citizens of the US are overweight or obese, so it would be used, um, half the time. Right?

          And as far as tables and such, nothing prevents them from being used for smaller patients.

          Pointless argument.

      • Peter Herndon

        I say send the fatties to the zoo for treatment with the other elephants.

        • Joey D.

          Because when you’re 200 pounds that makes yo immediately a fatty…