From Rethinking Thin: The New Science of Weight Loss--and the Myths and Realities of Dieting, by Gina Kolata:
"Baumann, of California Medical Weight Loss Associates, said that doctors there prescribed [phen-fen] for people who were at least 20 percent above their ideal weight. 'A lady who weighs 120 and should weigh 100 pounds is obese,' he said..."
I'm sorry, but NO. First of all, this "should weigh" bullshit is so subjective that it is practically meaningless. A woman who "should weigh" 100 pounds, even according to the b.s. Met life height weight tables, would have to be under 4'10". So, okay, it's a bad example--but, the fact that he uses that particular example tells me that this has absolutely jack and shit to do with health, and everything to do with making women conform to some insane, unattainable, unsustainable ideal. No adult woman of a normal height* is "obese" or even "fat" at 120 pounds, no matter how much self-deprecation individuals of that size heap upon themselves.
This "20%" rule quoted by the doctor is clearly used to justify making money off of people for weight loss treatment who did not need to be losing weight. Putting a 120-lb woman on phen-fen so that she doesn't eat as much makes absolutely NO sense. If someone is not naturally 100 lbs without having to diet, then they should not try to force themselves to be that weight.
I understand doctors freaking out about those of us who are 220 lbs, because they've been brainwashed into thinking that someone of this size is inherently unhealthy. It's based on incorrect information, of course, and we are working to change it, but I understand it. I DO NOT understand a doctor encouraging a slim woman to lose even more weight, though, except that the woman herself is dissatisfied with her size and asks for help. I think the appropriate thing in that situation, though, is to tell the patient that they do not need to engage in weight loss to the point that they are "underweight"--but how often do you think doctors do that?
It's also quite interesting to note that no one is ever satisfied with their size. If a 250-lb person loses 100 lbs, down to 150, they are not likely to be satisfied; they will move their goal to a lower number. The 120-pound woman wants to be 100 pounds, and at 100-pounds will then want to go below three digits. And so on. And, no matter what you do, it won't ever be enough for some of these fat-hating doctors. Sure, you made it down to 120, but you COULD be 100, so here, have some pills. Have some surgery.
My final observation: The example was a woman. I'm dismayed at how women are so often targeted for needing to be thinner, thinner, thinner, especially by male doctors. Call my cynical, but I really believe that Dr. Fathater's personal aesthetics are more important to him than women's health.
* By normal height, I mean above 4'10", as people under that size may qualify as Little People, depending on other medical factors.