"What is your BMI, like 2?" I have a ham patient right now who acts as though she is very fit and healthy when in reality her body is basically Nickelodeon Gak (Google it).  She was talking today about how strong her arms have become, grabbing at her cottage cheese upper extremities.  I said nothing to validate that statement.  She is completely delusional, talks about her "breasts" every session (nasty udders indistinguishable from her other torso folds).  She talks about how good she looks, how she is working on her "core" (the only thing in its "core" is adipose tissue). I told her at one point today that losing weight will help reduce the compression forces through her knees (she has diabetes and arthritis...shocker).  Rather than even acknowledge her obesity though, she responds "What is your BMI, like 2?" as if I was some kind of freak of nature for not being a land whale like her.  I corrected her, "I'd be dead if it were 2.  My BMI is a bit over 22, which is actually on the higher half of the normal range."  I told her I have a scale if she would like for me to calculate hers.  She declined of course.  She firmly concluded she couldn't lose weight, and an irrational wall was raised at that point despite my explaining how it comes down to calories in, calories out. Gotta love when hams are in denial despite being PRESENTLY receiving medical care for health issues directly related to their obesity.