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Reader Arlie reached out to ask what I think about the field of “ob*sity* medicine” (OM). This, for many, is a life-or-death question, so I’m going to give my thoughts on this as not just someone who is an expert in the field, but also as a fat patient (albeit one with plenty of privilege.)

First of all, some facts about this certification.

The American Board of Ob*sity Medicine, which doles out the certification (it currently costs $1,500 to take the test) is not an official licensing body and is not recognized by the American Board of Medical Specialties (ABMS).

One of the ways they are working to get accreditation is through creating “fellowship programs.” One of the ways they suggest people fund these programs is through support from businesses that “have an interest in…ob*sity treatment” which sounds to me like code for taking money from the weight loss industry.

One of the paths to recertification is to read journal articles. However, the articles must be approved by their “Journal Article Review Advisory Panel” suggesting that this field is an echo chamber, which may be why they are still peddling weight loss methods that have been shown to be ineffective for about a century.

Their board is a veritable who’s who of people who have pinned their careers to the weight loss paradigm. To be clear, I don’t believe that every doctor who is board certified in OM is out to harm patients. I think many if not most may believe that they are helping people. But as an expert, advocate and patient, my focus has to be on keeping the fat patients safe and not on the doctors’ feelings or intentions. So when a doctor tells me that they are “board certified in OM” I have to assume a worst-case scenario, meaning that there are three assumptions I need to make in order to keep myself safe as a fat patient:

Assumption One:From the moment I walk into their office as a higher-weight patient, they are trained (and certified!) to see my body as a problem to be solved, often by any means they deem necessary.

The word “ob*sity” was literally made up to pathologize higher-weight people (and is from a Latin root that means “to eat until fat,” so not so much science as stereotype.) With a doctor who has chosen to buy into the idea of “ob*sity medicine,” it’s very possible that they won’t be able to see past their beliefs about higher-weight people (including their tendency to blame nearly anything on my size) to give me care for any health issue I may actually be having. By extension they may, without notifying me, suggest treatment options, not because they have the greatest efficacy in dealing with my actual health issue, but rather because the doctor hopes that they might result in weight loss, or prevent weight gain. Similarly, they might withhold viable treatment options because they have a possible side effect of weight gain. In my experience, as well as individuals I have worked with, I have found these doctors to be the most egregious offenders when it comes to ethical informed consent conversations.

Assumption Two:They are willing to risk my life and quality of life to make me thin.

They have willingly joined a branch of medicine which centers around the idea that it is completely acceptable (and often recommended) to risk a fat patient’s life and quality of life for the smallest chance that we might get a bit