know you said where do you draw the line...and I can't answer that. But the perfect is the the enemy of the good. To say that we must shame ALL overweight people because it's hard to draw a line at a weight....so let's just shame them all....I can't get on board with that.
Please point out where I have said overweight people should be shamed. Not wanting to celebrate their beauty just for being overweight is NOT the same thing as shaming them.
The problem with "I don't know where to draw the line, so let's not draw one" is that the end result of that is that we end up treating your 200 lb woman, who is doing and admirable, scary thing and working on herself with the 400 lb person who wants the world to accommodate him or her. I'm sorry, but I reject that the former is justification for the latter. Obesity is a matter of public health that costs the country billions of dollars a year. Same with smoking. Same with car accidents. We have regulations to make smoking difficult, we legally require people to wear seatbelts and to not drive drunk. The idea that we can't encourage people--as gently as possible--toward being a healthy weight is frankly bullshit.
I am in no way, shape, or form saying that your example should be made to feel uncomfortable in the gym. *I* feel uncomfortable at the gym, and I'm in the best shape I ever have been in. But I am saying it's unreasonable for her to present a card asking not to be weighed at the doctors office (have seen them) or to say that any mention of weight by a doctor is somehow hurtful or some kind of personal attack (ibid). There's the old saw about an ounce of prevention being better than a pound of cure, and encouraging people to maintain a healthy weight HAS to be the priority over designing things to accommodate morbidly obese people. This morning on a physician group I belong to on Facebook I saw someone asking for recommendations to refer a patient who's 600 lbs to a different gynecologist because she is too large for the tables at her existing one. I'm sorry, she should absolutely not be denied care, but the costs for that woman's choices are being pushed onto the doctor's office. I think that's wrong.
As much as any man is capable of understanding, I do know how vicious clothes sizing can be. Trust me, I'm a former 3XL guy who's (legitimately) wearing Mikey's Medium Shirts these days, and it took me a long, long time to get rid of my bigger clothes. I drive my husband nuts because I need daily reassurance that I don't look fat, even though, despite my extra skin, I can sort of see my abs now. I'm more comfortable in my own body, but I still don't like it.