Story from the front lines of the war on obesity from a physical therapist Hi, FPH!  I have been lurking here for a few weeks, and I figured I would make my first post. I work as a physical therapist, and many of my patients are morbidly obese.  In many cases, I have to use a special table for these patients because the integrity of some of my tables cannot handle the weight of these patients. I recently had a patient whose mechanism of injury was literally falling through stairs that she was navigating.  The stairwell literally broke under the pressure of her weight.  She injured her knee in the process.  I asked her if she had pain walking prior to this injury, and she unsurprisingly said she did.  I brought up her weight and how this will only increase pressure on her joints, particularly with her knees.  She was barely receptive to this fact, as is too often the case.  Too often, the level of denial among my overweight and obese patients prevents them from starting to make any change whatsoever.  I find the least "in denial" group are those patients I have treated who are a little older (35+), have been hospitalized, have been diagnosed with Type 2 diabetes, or who have extremely high BMIs and already experience severe difficulties with basic ambulation, transfers from chairs, or interaction with their kids.   I find it endlessly frustrating how often I see 100% avoidable problems caused by obesity.  The level of denial, particularly among the young fats, feeds (pun intended) the inevitable progression toward the older ham planets whose bodies are no longer young enough to resist the self-abuse any longer. I currently have a 385 pound patient who bafflingly told me he has no excess weight to lose.  He is a paramedic and is apparently therefor in charge of working quickly in a physical job to save lives under conditions in which seconds count.  I had him doing some extremely basic exercises to start with, and he was literally panting with his entire face covered in sweat in under a minute.  I asked him if he was okay because he was sweating profusely.  He just said he was warm.  I told him his respiration rate implies he needs a LOT of work to build enough basic aerobic capacity in order to really progress his capacity to work in a field where lives may be saved or lost.  He remains in complete denial right now that his weight is a problem though, saying he can lift heavy patients.  While this may be true, for 1 rep, his core strength and body mechanics are incredibly poor and relate to how he hurt his back in the first place, I have already learned so far in my career though that you can't say any one magical line to break through the denial for obeasts.  Shitlording (a term I have learned just this past month) in my mind is an effective and perhaps even NECESSARY step to take to shock these fats out of their denial. If it doesn't cause someone to change, and the best hope for change are for those people who might only be a tad overweight and at a crossroads for what direction they will go (some of you might relate to that point at one time), then there is no hope for them.  I am all for extending a hand to help someone, but if they aren't receptive then the consequences of their self-abuse can hopefully be increasingly privatized to that individual to the extent that their situation could have been avoided with simple behavioral changes (the VAST majority).  We are on an unsustainable course if we keep forcing people who make responsible decisions to subsidize people who make poor decisions. Keep on shitlording!  It is the perfect response to the extreme denial of fatties, especially among the younger ones on the path to disability and disease costing you and me every day. I may post more brief, amusing/disturbing stories in the future.