The Good Doctor
There’s a new blog in town called First, Do No Harm: Real Stories of Fat Prejudice in Health Care. They’re soliciting your stories, so if you have any fat prejudice stories, now you know where to send them. Here’s a sample:
She gave me a 30 minute lecture about people “your size” and how it was irresponsible of me to use the patch because of my weight and then, out of the corner of her mouth, said “Well, I guess it’s no surprise.” I asked her what that meant, and she said – “It’s obvious you have a problem with being responsible for your body.”
The stories there are pretty powerful and guaranteed to piss you off.
On the other hand, I have an admission to make, in honor of this new blog. I went in for my physical today and I realized I get super defensive about my weight at the doctor’s office, especially if my doctor is thin. (I had a fat gynecologist for many years who was awesome, and yet as I think about it, I realize I still got a little defensive about my body.) I am absolutely not proud of this.
My regular doctor is on maternity leave, and so I met a new doctor today. When she came in I saw that she was (horrors) thin and my heart sank a little because I had no idea how she might respond to me. Then I immediately set out to prove to her I was a “good” fat person. She asked if I had any health issues. “I have acid reflux,” I said, “But I’m trying to lose weight to resolve it. I’ve already lost five pounds!”
I cringe just thinking about this, and I know you’re all very disappointed. Not because I’m losing weight (at least I hope not) but because I put the “blame” on myself for my health issue and bought into the whole “bad fatty” mentality. I mean, I know reflux sometimes correlates with overweight, but according to the doctor’s chart, I weighed almost exactly the same last year (I’m seven pounds lighter than I was last November, and I’ve lost five pounds in the past two weeks, in case you want to follow my logic) and the reflux began, very suddenly, in March. It’s not like I gained a whole bunch of weight this year; it’s been pretty stable. I might have been blaming my fat for something that has nothing to do with fat. Me, not my evil thin doctor.
But the happy ending to this story is that the new doctor turned out to be great, and at one point she said, “You know, with some people, acid reflux just happens. It isn’t necessarily connected to weight all the time.” That’s kind of amazing to me. A thin doctor actually told me not to blame my weight for a health problem. Of course she was supportive when I explained that I’d largely cut sugar out of my diet and that I was losing weight, but she was very fat positive, I felt. She didn’t pressure me to lose more weight; in fact, she said she’s happy with patients who maintain their weight, because it’s so difficult to do.
So there you go: my confession to you. And I’m wondering, can anybody relate to this? Do you get defensive at the doctor’s office? Is your doctor fat positive, fatist, or somewhere in between?
Posted by mo pie
Filed under: Advocacy, Fat Positive, Health, Personal, Question
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The appropriate response to that first doctor is “And it’s obvious you have a problem with being responsible for your mouth.”
Also, I’m not fat by anyone’s standards, and I have acid reflux. Its severity depends on my coffee and alcohol intake, and how stressed I am at work. It has little to do with weight.
This is my first time posting a comment. I love this site, and read it on a daily basis. Thanks for the great reading, and keep up the good work!
My doctor always sort of recommends weight loss, but not in a pushy way. I actually kind of wish she’d be more aggressive with me – I sort of feel like my weight is the elephant in the room, so to speak. It’s there, we might mention it (oh, yeah, the elephant, don’t worry about him!), but then after that we don’t say anything else (so the elephant sort of rampages around knocking stuff over and everybody studiously looks away). Granted, though, this is my gyno, since I don’t have a regular GP right now – had issues with waiting way way way too long before I was seen at the old one and haven’t yet searched out a new one.
If it’s a doctor I don’t know, I’m immediately on the defensive. I practice what I’m going to say if I get the “you need to lose weight” lecture. I’m definitely ready for a fight.
That being said, I rarely see doctors I don’t know. I was very careful in choosing my doctors to make sure I had ones that were, if not fat positive, at least not fat-phobic. My gyn is simply AMAZING (anyone in the Fredericksburg, Virginia area who needs a good ob/gyn give me a shout and I’ll share his info) and has never treated me with anything but complete respect and support. Two years ago when I told him there was something very wrong with me and I needed him to help me find out what it was there was no hesitation on his part to schedule the tests. He trusts that I know my body. And we found cancer. Thanks to him listening to me we caught it very early and I’m okay now.
I tell this story a lot but I want other fat folks to know that there are positive doctors out there who will see beyond your fat and treat you. I’m living proof.
Awesome post! I’ve had NPs, but not doctors rag on me about my weight. I mean, seriously, I can’t remember the last time an actual DOCTOR saw me for a check-up. Would losing weight be good? Sure! How likely is significant weightloss? Not very!
Maybe the medical community is starting to get wise to the fact that the yo-yoing does more harm than the actual overweight in most cases.
I’ve been reading “The Obesity Myth” in small doses, because I’m usually fuming after each chapter. Very illuminating.
This was an amazing post. Thanks for your honesty. I think I’ve only had maybe 2 run ins with fat hating Dr.’s. But those are the ones I remember of course, because I was nearly in tears on the way out of the office. I want someone who is willing to talk to me about ANYTHING I WANT to talk about. Earlier this year it was my knee. After I gained some weight I knew it was part of the reason why my bad knee was hurting more than usual. I talked to my Dr. and he did address my questions about how weight can affect joints, but he also gave me lots of things I could do to feel better that weren’t related to my weight. I want to be able to ask questions about my weight but unless there’s a real reason, I don’t want to have the “lose weight just because I say so” talk when I go to the Dr.
I don’t want to go in for strep throat and be told to lose 30 pounds.
I actually go out of my way to keep my internist as my doctor, even though I’ve moved to a different town and it’s an hour and a half to get to her office now. She’s absolutely tiny, but she is seriously the best GP I’ve ever had. She’s only ever brought up my weight out of very sincere concern (my cholesterol had risen, and even though it’s still very good, there’s a lot of family history for me to deal with and she wanted to talk to me about that), and we had that one conversation, and she said nothing after that. She’s taken very, very good care of me, and she always says she wants to hear from me if anything at all is not right. I am so very lucky with her.
Although, when I was in college and was having serious asthma problems, the nurse in the ER did lay into me about how if I’d lose weight I wouldn’t have so much trouble breathing and wouldn’t be in here causing everyone problems. I was so out of it I couldn’t even say anything, and I was so stoned off the medication they gave me when we left that I never mentioned it to my friend who had taken me to the hospital (he wasn’t in the room when she said that. He’d gone to call my mom. Otherwise, he probably would have laid her out, and then we really would have been causing trouble).
I know I’m a bit defensive at the doctor’s office, too. A lot of the time in my experience the actual practitioner I’m there to see is no problem at all, but the staff (you know, the people who are not required to have any medical or nursing training of any kind) have some little comment or other, which doesn’t help.
At my new doctor’s office, where I actually see the tall, thin, gorgeous NP, everyone is very respectful and positive, she most of all. I didn’t even get the little compliment-but-not-really when it turned out I’d lost 5lb between visits, which I think speaks well to consistency of practice attitude (and I have in the past seen the doctor who was awesome and seemingly size-positive while I was incidentally losing weight on my own, but turned into an ass when I regained).
I do the same thing. I have completely stressed myself out unnecessarily with trying to be prepared for doctor visits in the last few years, and I get really defensive when they question how much exercise I’m actually doing.
I’ve had plenty of run-ins with doctors of all stripes in the last month. I’m pretty sure the first one I saw dismissed my back pain as something not worth treating because I’m fat.
My (very petite) primary care physician has been awesome.
My physical therapist was surprised that I had actually done all the exercises she wanted me to do two or three times a day every day last week, like she wanted me to.
To be perfectly honest here, I don’t know if it was because she’s used to fat people not complying or if nobody does. Either way she’s been great too.
So aside from that first jackass, overall it’s been very positive.
For nearly 20 years, I had a big, fat, wonderful GYN. He never mentioned weight loss (I maintained a near-constant weight for all of those years); he DID at one point, when I’d dropped 65 pounds, remind me of the dangers inherent in yoyo-ing, saying I’d either have to keep the weight off or, if I gained it back, maintain the old level, since I’d had no health problems & had simply lost the weight as a curiosity.
I miss Marvin & his fantastic attitude. When you find a doc this good, keep him! Should you encounter a fat-phobic MD, it’s YOUR job to put him or her in their place, and remind them that being fat had no bearing on the fact that a bus ran you down & broke your leg.
The doc’s job is to repair anything you have that might be broken & put things back the way they were without extraneous comment.
Oh God I totally do. And my doctor never says one thing about it. At all. But I feel like I need to give her a report of how “good” I’ve been.
I had a doctor when I was 18, though, who told me that I needed to weight 100 pounds. I’m 5’2, sure, but 100 pounds? Suck on it. I didn’t even try.
I used to go to an osteopath and he was WONDERFUL and really examined family history and all sorts of things instead of assuming issues were weight-related. Unfort. he retired.
The new doc I got decided my acid reflux, knee problem, migraines and back spasms were all due to my weight.
I went vegetarian and the migraines and acid reflux ended, and realized my walking down the stairs at work in heels was causing the knee problems, and the back spasms were due to a bad desk chair. Fixed all these on my own, came back a year later and told him all was fixed.
“Well you lost weight!”
In a year I had lost 2 lbs. Yep, it was because I lost weight :-(
I found a new doctor.
Oh, BTW I love your blog!
My GP is an osteopath, and I love him. I’ve never ever been told I need to lose weight, and when I went in recently about an asthma attack I’d had while doing a 30 mile bike ride, I sort of complained that even though I was riding about 40 miles a week, I hadn’t lost much weight.
He said, to my shock and delight, “Oh, don’t pay any attention to the number on the scale. If you’re exercising that much, the only way you’d see significant weight loss would be if you stopped suddenly and the muscles atrophied. Just go by how you feel, and your heart rate and lung function.” Seriously. I could have kissed him. (Plus he’s really dishy!)
I guess I’ve been either lucky or oblivious (a definite possibility). Since I reached adulthood, my doctors have treated me well or been fired pretty promptly, but even firings had nothing to do with their attitudes toward my weight.
It was their attitudes toward my gender (Dr. Capelli, I’m looking at you), or a general arrogance toward their stupid, ungodlike patients that got them canned.
I love my GP, my Gastroenterologist, and my OBGYN. They’ve never treated my illnesses or conditions based on my size, and they’ve always been supportive of my health at any size.
Of course, I’ve always let them know up front that I expect to be respected and treated as intelligent or I will find a new physician. Meekness, I’ve found, gives license to a bad doctor to treat you like crap.
Come to think of it, though–I could live without the nurses practically dying of shock when they take my blood pressure–and it isn’t high!
I’ve had a few bad experiences with doctors. And I’ve never weighed more than 165 (I’m short, I should say.) I can’t imagine what people go through when they weight 200 lbs or more.
I had a breast reduction when I was 25, something I wouldn’t do if I had it to do all over again. I steeled myself for the “well, of COURSE you have gi-normous breasts! You’re a COW!” response at the consultation. I expected the doc to tell my mom I needed to drop 60 pounds. He didn’t. He said I was a candidate and did the surgery.
During a follow-up physical, the guy launched into a gentle moral lecture about how I needed to lose weight so I could “enjoy my youth.” Because I would be dead by 30, I guess? Because chubby girls don’t attract the all-important sexual attention of more guys?
I wanted to tell the guy: “Dude, I’d be willing to bet both of my brand new, perky breasts I’m getting laid much more than you — even though you are a cute, Latino plastic surgeon with a f**cking yacht.” I was at my biggest and I was enjoying the hell outta my youth, sexually speaking (I had a broken coffee table to prove it!)
Instead, I went to the parking lot, got in my mom’s Jeep Grand Wagonneer and bawled my eyes out. It ended on a good note, though. I returned to my apartment, the breasts healed and I got folded up in my hide-a-bed while enjoying my youth.
Sigh.
When people WEIGH, not weight.
I haven’t been to the same doctor more than twice since I have been picking my own doctors. Here’s (partly) why:
When I was an overweight 7 year old, my doctor tested my thyroid (it was fine; I was just a cute little chubster, okay).
When I was an anorexic with a “normal” BMI, my doctor congratulated me on my “willpower”. Then my mom had my friends start watching me at college to make me eat.
When I was an overweight dieter about 10 years later, my doctor said, “Your exercise habits are good if what you’re reporting is true. All you probably need to do is push away from the table”.
Last winter when I had a nasty virus munching on my throat, I waited in the waiting room for an hour, coughing and getting annoyed. When I went in, my blood pressure was a little high. My doctor asked, “Why do you think your blood pressure is so high?” as he eyed my belly. I said, “Because I am sick and annoyed and just spent an hour wheezing in your waiting room.”
I am now in the process of looking for a good doctor I’d visit more than once. The First Do No Harm website has some good doctor recommendations.
I’m 5’2″. Let’s just start there. About four years ago my back hurt, like, constantly. I ended up at the neurologist. The MRI confirmed that I have two completely degenerated discs. Doctor: “Well, for starters, don’t gain any weight. That will only make your back problems worse.”
I weighed, I kid you not, 97 pounds on their scale, fully dressed with shoes and everything. I quit my job, gained back the twenty pounds the stress of that job took from me, and oddly enough my back stopped hurting.
Some doctors are just assholes, particularly about women’s weights.
I am easily 200lbs overweight. I understand when my doctor is concerned about it, but I’ve had one gyn who mentioned gastric bypass every single time I saw her. I’ve done my research; I’m not comfortable with the mortality rate. Thanks, but I think I’d rather just be fat… My mom is the same size, and she has fibromyalgia. She has awful horror stories about doctors! I wish doctors would advertise “Won’t give you shit.” I haven’t been to the gyn in three years because I just don’t want to mess with the bullshit. Yeah, yeah, I know… I need to get over it and go, but I’m stubborn. Just gimme my damn birth control pills!
I really like the doctors I’ve seen from the Fat Friendly list. The one I see now didn’t even freak out when I gained 10 pounds in a year; he said it was probably because the birth control pill he’d switched me too was less diuretic than my previous one and I was probably retaining more water. Sure enough, the 10 pounds went away when I switched to yet another brand. I wish I could clone him; although I do wish he’d shut up about statins (I don’t see any evidence that they benefit women), it’s not like he’s refusing to treat me unless I take them.
In college I was told by an otherwise awesome infirmary (male, average weight) doctor that if I didn’t immediately lose at least 75 pounds I WOULD end up diabetic in the next ten years. Note that he didn’t know any of my family history or medical history; he made that kind of diagnosis simply from looking at me. (I have no family history of diabetes, for the record.) At the time I swallowed it hook, line and sinker and spent the next two years dieting.
The other infirmary doc (female) told me, once again without knowing anything about me, that if I’d switch completely over to diet sodas that I’d lose 20 pounds. I did and was extremely disappointed that it didn’t happen. (Of course, when I mentioned that to others later, it was always “well you must be making up the calories somewhere else!”)
The GP I have now is not exactly size friendly, although he refrains from total obnoxiousness. I’ll have to check the recommendation list for any northern VA doctors.
I’ve never had any doctor say anything about my weight. I’m in the UK – wonder if that makes a difference?
I did rather worry recently when I went in with sore feet that the Dr would suggest the problem was caused by my weight, but it didn’t happen. I was all ready to tell him I hadn’t had any problems when I was heavier, but it wasn’t necessary.
You’d think NHS doctors wouldn’t have to worry about annoying a paying customer… and I have had the occasional one who didn’t listen. Such as the one who asked me if I could conceivably have an STD, and then sent me for a test despite my telling him it wasn’t possible. (Without telling me that’s what he was testing me for, either.)
Funny thing that. On my most recent doctor’s visit with a new doctor he asked a bunch of questions about whether I was always overweight and whether my family was, but said it was fine as I was exercising and everything else seemed fine…
But about two years ago, I had to have an occupational physical for work through a local hospital. When I got on the scale, the nurse said to me “That’s a shame. You would be so pretty if you weren’t so (and then she puffed up her cheeks and made a big round gesture with her arms).”
What the hell?
I get pretty defensive about my weight too, when I’m at the doctor’s. I dread meeting a new doc because I worry how they’ll respond.
I’m starting to get over it. I am losing weight- I’m going to lose enough to make my health problems go away and I’m not going to worry about it.
Sony – “To be perfectly honest here, I don’t know if it was because she’s used to fat people not complying or if nobody does.”
Pretty much nobody does all of the exercises they’ve been given, so when someone does it’s truly shocking. Hehe.
Two years ago when I told him there was something very wrong with me and I needed him to help me find out what it was there was no hesitation on his part to schedule the tests. He trusts that I know my body. And we found cancer. Thanks to him listening to me we caught it very early and I’m okay now.
Wow, CJ – you *do* have a good doctor! If only they were all as responsive to their patients. Glad to hear you’re OK.
I admit to defensiveness also. I had lost 80 pounds in the year and a half before moving to a new city. When I found a new GP (which is no small feat-there is a severe shortage in my area) he was fairly diplomatic. During my physical, amongst a bunch of other questions, he said “What would you like your weight to be?” I quickly said my goal weight (about 20 lbs lighter than I was at that point). I quickly then regaled him with the tale of my weight loss, so he wouldn’t think I was a lazy slob who was just picking a weight out of a hat. I think he was a little taken aback with my tone (which in retrospect was quite defensive-as in “get off my back about these 20 pounds, I’ve worked really hard to get where I am okay?”) His response “Do you eat a lot of bread?” When I quizzically said no, he said “Well, keep up with what you’re doing. It will come off eventually” and moved on. I wasn’t sure what to do with that response, as I had maintained my weight for over a year, working out 5 x a week and logging calories daily. Not exactly supportive, but not a horror story like others have had. It was just disappointing that he couldn’t offer any more helpful intervention that eating less bread. I felt like I knew more about nutrition and fitness than he did! Crazy!
I went to the dr yesterday about a bump on my neck. The girl leading me to the exam room automatically took me to the scale and I was quite proud of myself for stating, “I don’t really want to be weighed”. She looked taken aback, but said I didn’t have to be weighed.
I have severe asthma and it is triggered badly by cats. I went to a designer’s house that would make me clothes personally because I have a funky style and I want to sell the pieces online. I didn’t know that she had a cat; until i saw the cat when I was leaving. I get outside with my roommate and I couldn’t breathe really well. I told myself to relax and calm down. But i couldn’t breathe at all. The paramedics came; they said I was having a panic attack; I had shown my middle finger to one ( sadly me nor my roommate didn’t have an inhaler)one off and they took me to the emergency room. When I got there I didn’t even know I was there because I was told that I had fainted on the way.
Here comes a little Filipino woman as a nurse; who tells me that my breathing level is at 50 percent and that I need to rest a bit. I’m still groggy struggling to breathe.
My breathing gotten better and I am awake now. Breathing better and ready to leave. This here comes the little Filipino nurse telling me ” You need to lose weight; so you wont have an asthma attack again”. Mind you I almost fucking died. I truly didn’t want to hear that shit at all.
I explained to her that I am a student-athlete (at the age of 22 and stronger than an ox )and that I throw shot put and discus. Being a big girl in my sport is normal and I work out very strenuous. Actually more than you do and it looks like you need to lose some pounds too.” She was taken aback and I gotten an AWESOME nurse instead of her. I explain to the AWESOME nurse that I do not pay 60 dollars a month for my PPO to be disrespected by anyone. I don’t truly care if she was “concern” and it was not her place to tell me that If I wasn’t a fat ass I wouldn’t be in this predicament. She told me that she understood and that she’s sorry for the lack of class that was shown to me. I thanked her and my roommate came and got me.
I’ve had totally jackasses for doctors and it made me feel like shit. However, I do not need to be disrespected at all. I pay good money for my PPO and I do not need to be belittle because of my size. I’ve always been a big girl and I’ve always been in sports all of my life. So, I tell doctors now to kiss my ass and if they do not like it trust and believe that I would write a lovely letter to the board of medicine or walk my happy fat ass to the head of the hospital and my a complaint about the disrespect from the doctor. Thank god I know that doctors can be wrong ( thanks to my ex Dr. Mo). Ladies you can always walk out the office and get a refund on your partial pay. If you do not get the right treatment and write a complaint letter. The pen is mightier than the sword.
I’m hoping that you won’t see this message as SPAM, I have a totally non-commercial (no ads- no fee) website that tries to answer questions and has articles on the biology of the human body. It’s at drsculerati.com (also drscuerati.org). Anyway, doctors who are in touch with the cutting edge understanding of body fat know that fat regulates itself- it holds on, is able to even change a person’s metabolism and appetite. I’d appreciate if you would take a look at the articles on Obesity and Body Fat, they are far from complete and I’d appreciate a few questions/feedback to try to make the site worthwhile. Thanks, Nancy
When one of my friends was thirteen, she was 5’6″ or 5’7″, 134 lbs, and a size 5. Her doctor told her that she had to lose 13 lbs, which, in addition to her pre-existing body-image issues, was just great. I was ready to kill the guy.