So, this guy named Patrick has left a comment and, Patrick, if you’re reading, I haven’t approved your comment. Frankly, I’m not quite sure if you’re a troll or not yet. But there IS something in your comment that I want to address. You said one of your primary contentions with FA was disrespectful remarks directed at doctors.
I’m not sure if you’ve ever been denied care. If you haven’t, if you’ve always had really good experiences with doctors, who have been focused on your health and treatment and who have treated you with respect, I can kind of almost understand why you might feel like defending doctors. Hell, even if you’ve only had one or two mediocre/poor experiences with doctors that just serve to highlight how great doctors can be otherwise, I can kind of sort of understand it.
Thing is, though, that’s not how a typical trip to the doctor for way too many fat people (and we’re talking fat people of sizes all over the spectrum from the just barely fat to the very fat). Chances are good that my experience and your experience are very, very different.
My typical (before I found my super awesome doctor) medical experience was pretty much awful. It was an exercise in being disrespected and called a liar. It got bad enough that I really only went in if something was dreadfully wrong (ask me about walking pnuemonia!) and even then, it was crap shoot as to whether I’d be harrangued about my weight or actually, you know, treated like a sick person who has a legitimate complaint. Being fat didn’t give me allergies. I’ve been allergic to the planet at every weight I’ve ever been, including as a small, very skinny child.
So, instead of an ally in the task of taking care of myself and my body, doctors became adversaries.
This is not uncommon. Fairly recent studies confirmed what fat people have known experientially for years: doctors think fat people are weak-willed and repulsive and nurses think we are non-compliant and gross.
Am I really supposed to offer people who treat me like dirt and don’t address my valid medical complaints my respect? Am I really supposed to shit down, shut up, and take their mistreatment without sticking up for myself in some way just because they’ve been to medical school?
I respect doctors who treat me well. Doctors who genuinely care about the health and well-being of their patients, no matter what their size. I respect doctors who understand that dieting is a destructive behavior and that just telling me to lose weight without offering up an actual, (at this point mythical) healthy and cohesive plan for doing so is useless.
Fat activists and people who accept themselves as they are don’t disrespect doctors – we disrespect doctors who disrespect and actively harm us.
47 Comments
That hit me like a blow to the stomach, yet it is a totally fair and accurate summing-up. And as you said, it is supported by studies showing that medical professionals think exactly that.
I think commenters who think our suspicion of doctors is silly often have the either conscious or subconscious belief “Well, you ARE weak-willed and repulsive and non-compliant and gross, so how can you blame someone for treating you as if you are?” Or at least “YOU may not have those characteristics, but 99% of other fatties do, so it’s not doctors’ fault for believing that!” I’m just not sure we can ever share a frame of reference with them.
It also doesn’t help that it’s so hard to argue with medical professionals. I think a certain amount of what folks do on message boards, if not actual bloggers, is blowing off steam from bad encounters. That’s not positive or negative; it just is. But it might make it seem like we spend a lot of time bitching about doctors.
I tend to bitch about doctors because I can’t really bitch to them. After my last (and worst – I’ve been lucky) doctor visit, I realized that arguing with a doctor about weight is like arguing with a priest about whether you should be a Christian. It just doesn’t get anywhere, and they are so sure they’re right, and they have years of medical school and the kowtowing of years’ worth of patients to reinforce that.
Wow, I’m a little bitter. And I still have that thought in my mind, “Well, maybe I am weak-willed and noncompliant, so they should treat me like I don’t deserve proper care.”
This is a very tricky topic for me because on the one hand it is undeniable that many fat people including me have had unpleasant and traumatizing experiences with health care professionals, and in the worst cases been denied treatment or given wrong treatment, on the other hand I do not want to stereotype a whole profession negatively. However, after the experiences I have made (both, working as a full-time volunteer in a hospital right after high school and as a fat patient) I have come to the conclusion that there is something very wrong in the education of doctors. It’s not only that many doctors I have seen are completely uncritical of their own prejudices and how they influence their actions, I also resent the arrogance that seems to be more common among doctors than among people with other professions. I cannot count the times that a doctor assumed that I was completely ignorant about my own body – and that after I had told him or her that a) I have dealt with most the health issues I have since I was a toddler b) I have degree in biochemistry and cell biology and c) I am pursuing a graduate degree in social psychology. I should not have to give that information in order to be taken seriously. But honestly, if I psychiatrist tries to explain to me that “neurotransmitters are hormones in the brain” two minutes after I have told him about my biochemisty background (something he asked about) than this person has to do a LOT to regain my respect. Similarly, if I doctor tries to educate me about statistics although the statistics training of a research psychologist is far more advanced than that of the average doctor then I get slightly pissed off. Doctors are not the only smart, educated, and logically thinking beings on this earth. Hell, there are many people who don’t have a college degree and who still are really, really smart and knowledgable. Also, I think I have the right to not respect a doctor if he or she clearly showed that he does not respect me.
In addition, I have heard some doctors say so stupid things that I don’t take a medical degree as a sufficient sign of competence anymore. For example, a doctor in the hospital I worked in saud that a patient who developed a rush after a heparin injection probably was “allergic to sodium” (since the injection contained a sodiumheparin compound). It is entirely possible that the patient was allergic to one of the substances in the injection, but it is biologically impossible to be allergic to sodium ions. More recently, I also had a doctor tell me that amenorrhea is a “good thing” when I commented on a medical blog that I still was consistently praised for quick weight loss by doctors even when I my period stopped and my hair started falling out. I don’t question that on average doctors’ knowledge about the human body is still far more extensive than my own knowledge about the same topic – but that does not meant I have to accept everything a doctor says as true. And when it comes to a topic I have a lot of experience with (while many doctors don’t) I will certainly not step back and agree with a doctor’s opinion by default.
I think that part of what allows me to not give doctors UNDUE respect is that I work with college students, many of whom have gone on to medical school. Some of these students are brilliant, caring, ethical people. But some are smarmy, self-serving, and going into medicine for all the wrong reasons, such as money, family pressure, and a lack of the creativity to think of a career that’s a better fit for their skills.
I figure that if there are, among the future doctors I know personally, people not worth my respect, there must be doctors I don’t know personally who aren’t worthy of respect.
There are many doctors who are good people, worthy of respect, but simply being a doctor doesn’t make them so.
Agreed with you 100%, TR.
I’m in good health, so I rarely ever need to see a doctor, but I do have to take my annual gyn checkup. Every year, it’s a bit of a stressful moment to go through because it’s never the same doc, and I never know in advance if the doctor will be fatphobic or not. The worst are the doctors who are nice and sweet and then go on to say nicely “you need to lose some weight”.
I just want the damn pap test done and my prescription for the pill written, thank you very much. I try to stay healthy, so I want them to leave me the fuck alone about my weight.
I realized that arguing with a doctor about weight is like arguing with a priest about whether you should be a Christian. It just doesn’t get anywhere, and they are so sure they’re right, and they have years of medical school and the kowtowing of years’ worth of patients to reinforce that.
Just want to say- much like it depends on the Doc… this comparison would also depend on the priest.
I don’t see the fatosphere as being unduly anti-doctor at all. I think it’s anti-asshole-doctor, anti-idiot-doctor, etc — but good doctors should also be angry at their crappy colleagues.
P.S. “Neurotransmitters are hormones in the brain”!? Ow, that makes my brain hormones hurt.
So I think Patrick (and anybody, EVERYbody) would benefit googobs from an hour or two spent here:
http://learn.med.yale.edu/rudd/weightbias/
That is the Rudd Center’s training program for healthcare providers regarding the problem of weight bias in clinical settings. This is not an anecdotal “oh it’s all in fat people’s heads” problem. This is a well-documented, widespread problem (now with Scientific! Research!), that is arguably one of the single biggest reasons for all those stats corrolating fat with bad health.
Because, hello? If going to the doctor is traumatizing? Fat people are not masochists. We’re not gonna subject ourselves to that shit unless we have to.
If Doctors get to be Anti-Fat then Fat people get to be Anti-Doctor.
Fair is Fair.
I feel very lucky to have a primary care doctor who has almost never brought up my weight. In fact, the only time I can recall us ever discussing it is when I brought it up just offhandedly and he told me that maintaining, not losing weight was important and that losing anything more than half a pound per MONTH was not safe for anybody, let alone fat people. My ob/gyn on the other hand, right after my yearly checkup, told me that I’m overweight like I didn’t know it already or something. It wasn’t the words that got me when she said it, it was the look on her face like she was pitying me because I’m fat. I didn’t understand why that was a concern, she just needs to make sure my baby-making parts are okay and what does that have to do with my fat?
Spot on, TR!
This just happened to me a few days ago:
I went to a new doctor’s office because I had been having symptoms like fatigue, depression, loss of appetite, headaches/migraines and nose bleeds. The doctor drew some blood, sent it in and when the results came back it showed that I could have hypothyroidism. Additionally, my cholesterol level was minimally high.
Well, the doctor looked at the cholesterol level and said “Well, we both know it’s high because you eat the wrong things. That comes from eating a lot of fast food”. Ummm, I didn’t say a fucking word about what I eat or don’t eat. She just looked at the size of my thighs and assumed that I eat a lot of crap.
She then almost congratulated me on probably having a thyroid problem, because “you’ll be able to lose weight faster when you’re on meds!”. Excuse me, what?! I told her that I felt god-awful and that had nothing to do with the size of my waist; weight loss is the last thing on my mind. She just ignored that and referred me to an endocrinologist.
Patrick, I recommend you have a look at http://fathealth.wordpress.com/ and then decide if the (so-called) disrespectful remarks are totally uncalled for.
“Because, hello? If going to the doctor is traumatizing? Fat people are not masochists. We’re not gonna subject ourselves to that shit unless we have to.”
I dunno – I’ve proven again and again that I am a masochist, and I still avoid the doctor’s office at almost any cost. Sometimes all I get is an “oh!” when I show up about 50lbs heavier than expected on the scale – not another word about it. Other times I get a lecture and diagnoses without examination. I can sometimes pass as not obese visually, and yet I still get crap about my body. It is reasonable to be wary early on and I have no problem with being outright hostile when provoked.
As people, I often find doctors quite nice. I know several personally and professionally (I work in a dialysis clinic). But that doesn’t ever stop me from cringing when I am confronted by a person in the same profession who harrangues me for being overweight.
I could launch into a diatribe about how the culture of medicine is inherently alienating to those it is supposed to serve, but that’s just a tangent that’s caught my attention recently.
I love Shinobi’s comment. ^_^
What I don’t get is why we’re supposed to give doctors–or anyone, really–a higher level of respect than we’re given, ourselves. I am willing to treat anyone fairly as long as I’m afforded the same, but anyone who wants more than that basic, everyday politeness is going to have to work for it. Be respectful of me, show me you’re not an asshole, and hey! I’ll be respectful to you too. It staggers me when health care professionals, law enforcement personnels, politicians, etc. seem to think they’re immune to that.
LOL…personnels. I are good English ritur. Sorry.
I’ve been lucky. My doctors have been respectful and good to me, they don’t tell me to diet each time I see them. They listen to me and help me to get well. I don’t doubt that there are crap doctors out there. Doctors are not Gods, they are not saints. They are people and people are flawed. I’ve watched enough of the “Mystery diagnosis” shows on Discovery to know that even thin people are treated poorly when they have a problem and the doctor can’t figure it out. It seems a lot of doctors see women and just throw drugs at them rather than actually LISTEN to the problem and diagnose what is wrong. Anyone who would claim all doctors are fabulous and deserve respect, is fooling himself. All people are flawed, even doctors.
I could launch into a diatribe about how the culture of medicine is inherently alienating to those it is supposed to serve, but that’s just a tangent that’s caught my attention recently.
Spinsterwitch (for some reason I type Spinsterwinch), I think that topic is insanely interesting.
As for the rest, I generally offer a baseline level of respect and general courtesy to people. If they don’t offer that in return, adjustments will be made to my attitude.
My distrust of doctors is practically genetic, and I’m certain I’ve gotten it from my father. That said, even when I was skinny I was more often than not totally dismissed or ignored by doctors, and far more often than not dealt with utter imbeciles.
Some notable examples:
I’m starting to try to conceive and I’m on prenatal vitamins (the doctor knows it). I’m experiencing nausea, dizziness, and an inability to focus; some days I can barely stand up. I go to the doc and he looks at me and says “I have no idea what’s going on. Why not wait for it to go away?” Turns out I have iron poisoning, which I self-diagnosed through google, and self-treated.
Cut to a year later and I’m gaining weight, feeling exhausted, and generally non-functional. Again, another “wait for it to go away” mixed with a “work on your diet and exercise.” Uh, my diet and exercise hasn’t changed since I was 130 pounds and a size 4. Thank you, try again.
A year later, the weight gain and fatigue hasn’t gone away. I give up, go to the doctor and bitch and moan until I actually get tested. 4 months of blood tests and an ultrasound reveal PCOS. Too bad I literally had to break down and cry in the office to get any treatment beyond “why don’t you lose some weight?”
4 months later, I’m 6 weeks pregnant (woo hoo!). I have my first ultrasound to check for a heartbeat, and there’s one that’s 111 bpm. I’m thrilled. The physician’s assistant I see for that appointment a) didn’t read my chart (as evidenced by asking the woman with recurrent pregnancy loss if this was her first pregnancy), and b) said “wow, that heartrate is low. We like to see it higher.” My MD from Google University tells me that 111 is indeed NORMAL for 6 weeks, where the average is 90-110. OF COURSE IT’S LOW!!! At 8 weeks it was at 164, and I’m now 11 weeks and going strong. Said PA also told me to no lift anything, push anything, or have sex until the 2nd trimester, all for no apparent reason.
I’ve had doctors who couldn’t even remember my penicillin allergy for 2 minutes. I come in with a UTI, it’s a) on my chart, b) I mention it to the nurse when she asks, c) I mention it to the doc when he asks…so he writes me a prescription and I say “is it related to penicillin?” His response? “I don’t know, let me check.”
I’ve given myself better care through Google than most doctors with their fancy degrees have given me. And by treating my doctor like a total idiot I”ve managed to avoid a potentially lethal allergic reaction and ER visit. And I’m not even that fat!
Also, if you read medical blogs you will find many doctors that say VERY nasty things about patients in general, and particularly about fat patients. I never said comparable things about doctors. I never will, because I just don’t talk like that about human beings. But expressing my anger or pointing out that not everyone with a medical degree is morally and intellectually superior?! Hell yeah, I am entitled to do that.
I figure doctors are human beings. As with any profession staffed primarily with human beings, a few will be insanely good, a few will be insanely bad (I’m looking at you, doctor who diagnosed my friends whose appendix had burst as a twelve-year-old-GIRL with an hysterical MOTHER), and most will be mediocre. Those mediocre ones will spend their days spouting whatever the popular mythos of the moment for their profession happens to be. Right now the popular mythos is that fat people are lazy, dishonest, stupid, and bad. Oh, and About To Die of Teh Fatz. That means the majority of doctors (the really horrible ones and the mediocre ones) will pretty much be gunning for anyone with a BMI higher than 22.
I see no reason to assume that all doctors have my best interests at heart AND know how to help me be my healthiest until experience shows me this is the case.
I’m with TR. When meeting with a new doctor for the first time, I will treat said doctor with the same basic courtesy and respect I would give any new acquaintence. It is then up to the particular doctor to treat me in a way that allows me to adjust upwards or makes me run screaming for the hills.
I don’t have much to add to the doctor discussion–everyone has already said what I think. But I just had to say: “allergic to the planet”? Totally stealing! People ask me what I’m allergic to at least once a week (I sneeze. A lot.) and that’s just perfect.
I have a heavy bias against the medical community – fostered by the intensive medical supervision I’ve had for the past 25+yrs of being a type-1 diabetic. It wasn’t until the past 10yrs or so that I realized that, hey, I’ve been diabetic way longer than they’ve spent in time in school/doctoring. They take a semester’s worth of education on how to treat diabetics, I’ve spent decades fine-tuning how to treat *this* diabetic. I.know.more.than.they.do.
Unfortunately a lot of dr’s won’t cop to that. Some will, and will actually let me have my say in my own treatment (go figure). Some won’t and I’ve had to make concessions to even get treatment (pregnancy + insurance).
I tend to treat dr’s like children. They tell lovely stories about life sometimes but most of the time it’s just a story.
Does any group of people besides fat people think “I guess I’m not healthy enough to go to the doctor?” I catch myself thinking that all the time and oh man, it is such a screwed up thing to think–first of all, my weight does not automatically mean that I’m unhealthy (and as far as I know, the issues I ought to get help for are unrelated to weight), and second, I shouldn’t feel like I need to make myself thin before I deserve medical care. But I keep thinking that I can’t go in to the doctor until I’ve started an exercise program so that I have something to hold up as a sheild between me and the “all your medical problems are YOUR FAULT because you’re so FAT” meme.
This is one of those posts that (gasp) – make me happy I have an eating disorder. Ya see, I am fat due to an eating disorder and even fully recovered my metabolism may be permanently damaged from all the horrible dieting/starving junk I did back in the day.
I learned some years ago that when the docs start talking to me about my need to lose weight, I can say “I have an eating disorder – I’m in treatment – I’m not going to talk about this with you.”
If I had not had those lines to shut them up… uh oh for the docs, because I do not take that kind of ignorance lightly. This culture is so obsessed with what everyone else weighs as if it is a morality measure. “Don’t litter. Don’t cut in line. Don’t be fat.” Grrr… that just makes me so mad.
j – that’s actually an interesting take. I always felt that my eating disorder made me more vulnerable towards doctor’s anti-fat attitudes because I think that my body is just naturally fat to some degree I cannot deny that I probably would weigh less if I had no eating disorder or at least if I never had had an eating disorder – there is no denying that I am to some degree fat because I overeat/ binge. I also find it extremely triggering if doctors bring up my weight – and it pisses me off that they don’t understand when I tell them that food restriction and weight cycling is part of my problem. Even at times when I had just lost a lot of weight far too fast and my doctor must have been aware of it I got nothing but praise for weight loss. Way to encourage normalizing my eating behavior.
I have nothing but the utmost respect for other people — until they show that they have no respect for me. Doctors are people, just like other people, and are not ever granted a free pass for bad behavior simply because of their degrees. In fact, I think doing so sets a dangerous precedent.
While I endeavor to be patient with the ignorant, I have limited patience with ignorance in those who are in positions of power over me, such as doctors who are able to grant or withhold necessary medical care.
So, Patrick, you should be aware that I am doing nothing more than a) holding doctors to the same standards of respect that I apply to all other people and b) respecting myself by refusing to tolerate ignorance in someone who is ostensibly there to give me medical advice and provide necessary care.
It is sad that fat people have to do these things as often as they do. It is sadder still that society as a whole and the medical profession in particular has bullied so many of us into being unable to do those things. We, as fat people, are taught that we deserve pretty much whatever foul treatment we get, and that to expect better is foolhardy and pointless. We are not taught to stand up for ourselves, speak out, or resist. We have to learn it.
For every fat person who speaks ill of a doctor or of the medical profession in general, with or without reason, there are dozens more who honestly think they deserve the poor treatment they are getting.
That’s far more troubling to me than the possibility that some fat people are a little harsh on the subject of doctors. After all, even totally unreasonable badmouthing of doctors and a total belief in the worst stereotypes of bad doctors is unlikely to cause the death of a doctor. A doctor’s ignorance about body fat and belief in the worst stereotypes about fat people is quite possibly deadly.
Am I really supposed to shit down, shut up
Oh dear.
Great post, though.
I’d also like to concur with Shiniobi’s wonderfully succint comment.
If doctors feel they have nothing to lose and therefore they can liberate their inner bully, they need to wake up. For each and every force, there is an equal and countervailing one.
sannanina,
I guess I was lucky in that my doc’s knew right off that they knew nothing about eating disorders.
Well, actually one time a doc did try this “exercise more, eat less is the cure for my eating disorder” crap on me. I invited him to talk to my eating disorder treatment team and told him this was certainly not their view… and that an eating disorder is a mental illness… not something exercise fixes in and of itself.
Then he stopped bugging me about it.
Eating disorders cause so much guilt. I wonder if that’s why you’d expect that rough treatment from ignorant doctors. Anyway… maybe you’re not that way, but I used to be that way – no doubt.
I didn’t ask for an eating disorder and I’m sure you didn’t either. We get them for complex and varied reasons. You don’t deserve guilt for it… you deserve professional and knowledgeable treatment! Not lectures on fat and how it is worse than cigarettes, nuclear bombs, rabies and shark attacks.
I have a double whammy where doctors are concerned. I’m fat and I have fibromyalgia. So not only am I lazy and gross, but I’m a hypochondriac to boot.
I actually cried with happiness when I was diagnosed with fibromyalgia because at last someone actually believed I was sick.
These days, I don’t take any guff off of doctors. If they give me a hard time, I walk out the door.
*laughs* I had one doctor send me a formal letter refusing to see me again because I told her that the endocrinologist she wanted me to see bordered on malpractice by treating patients by mail. She’d see you once, and everything after that was by mail. She mailed you the paperwork to have blood work done, and then she’d mail you a letter with her recommendations. There wasn’t even so much as a questionnaire to check for symptomology. And she couldn’t believe I wouldn’t see her again *rolls eyes*.
Yes, I’ll bad mouth doctors in a heartbeat when they pull crap like that. I’ve got a good one right at the moment, but they’re hard to find. I sent formal letters to over 50 doctors in my area when I moved here, looking for a doctor who would work with me on my thyroid dose. I got 1 positive response, 1 mayber, and 15 negative responses telling me what I wanted to do was dangerous, including 1 crackpot who went off for two pages about the dangers of chiropractors and naturopaths.
I understand my body and it’s needs better than any doctor out there. I’m intelligent, well read about my health conditions, and a good critical thinker. Doctors that treat me like a not-very-bright child get nothing but the sight of my back leaving their treatment room.
Sannanina and j,
Sadly, telling the doc (who assumed I gorge on fast food all day) that I had an eating disorder and was in treatment didn’t seem to have an effect AT ALL. Usually, it works (even though I hate to bring it up), but some doctors either don’t care or don’t know better.
I believe this “Patrick” has been to other FA blogs, and while his comments yet have not reached the level of “go kill yourself you disgusting fatty,” his remarks are more along the lines of the “nice concern trolls” who think fat people need don’t get enough education about how bad their size is. “For our health,” of course, not realizing we hear it everyday.
I’ve been lucky in that I haven’t had nightmarish experiences with doctors, despite being on the “you’re so fat you’re gonna DIE!” level. My OB GYN wants me to have my thyroid tested, but never mentioned my weight. My former PCP did not believe in diet drugs, and when I brought up the subject of Meridia six years ago, he told me I didn’t need to take it. Instead, he told me to increase my walking and watch my sodium intake. Nothing about actual calorie or food restriction. I’m probably better off health-wise for his non-judgmental attitude, instead of if he tried to shove a bunch of WLS or WW pamphlets in my hand.
I do not like doctors for a variety of reasons (i could write a book), but what the author of this blog said is really close to home. I have had doctors not even try and hide their disgust with my body, it hurts so much. I mean I’d rather not be at the dr’s office but if I make the effort to be there, I’d really like to be treated like a human being you know.
I don’t have a problem with doctors, I have a problem with any human who cannot say that they might be wrong, and sadly, a lot of doctors fall into that category of human.
In fact, I have found one doctor who is not so painfully, egocentrically, self-assured that he is uncomfortable saying, “Oh, I don’t know. That symptom could be several things and there could be several ways to treat it. Let’s start with the one that is least invasive and see how that works.” And the Heavens parted and choirs of angels sang. Now, I drive an hour to a neighboring city for the pleasure of his company any time I am sick and consider myself lucky.
Karin, you said your cholesterol was high, having an underactive thyroid can do that. It’s not unusual for a person with untreated hypothyroidism to have high cholesterol, and your doctor should have known that. Hell, five minutes with Dr Google will tell you that. I hope you can find a better doctor!
Something to remember is this:
Your doctor is YOUR EMPLOYEE.
Sie is there to TAKE CARE OF YOU.
If the “care” part fails to happen — what has sie done to earn a wayward glance, much less respect?
Respect is not something you should be given due to your status. Respect is something you earn from your fellow people by acting like a decent human being.
You are not owed respect. Period. I don’t care WHO you are. Who’s the most important being below God Himself? Whoever it is, even sie doesn’t get a damn drop of respect unless sie treats you well enough that you would like to give it to hir.
Period.
I’ve had awful experiences with doctors, and wonderful ones. I think that many doctors are great people, they do amazing work. And they shouldn’t be smeared. But that’s because of their status as HUMAN BEINGS. As for the doctors who treat you like shit on their shoe — well, I don’t see why you would think they deserve to be shielded from any critical treatment whatsoever. I mean, when people are denied a BASIC HUMAN RIGHT I think they deserve to be a little upset.
j – I’m in a similar situation to you. I had thyroid cancer go undiagnosed for 18 months because I was just “fat and lazy” (I have a post on First Do No Harm with more detail) and thus I have a GREAT BIG HAMMER for doctors who don’t treat me with appropriate care. My girlfriend, though, who has lost a great deal of weight via treating herself well in line with HAES principles, went to the doctor and was told that since she’d lost more than 100 pounds in a year through healthy eating and exercise, maybe she should try gastric banding now?
To hell with that.
I was watching Big Medicine last night, thinking perhaps understanding the doctors’ perspectives on fat might help me understand how to better get them to understand what they’re doing is wrong.
The doctors on the show, were kind to their patients and empathetic. There was alot of focus on bariatric surgery and such, however from listening to the doctors I realized, maybe they do think they are doing the best the can against disease. It’s like, how I feel it’s no fun to beat up on someone who acts stupid, when they’re really just ignorant.
I think there needs to be more communication between the doctors and size positive people. There are doctors who are mean to fat people, and do believe the myths and prejudices about fat people.
What I found interesting from watching Big Medicine, is how doctors who don’t have any malice towards fat people handle the issues regarding how fat is viewed by the medical community. I felt as if these doctors wanted to do all they could to help the patients, but they didn’t as of yet have the proper tools to help them in a way that would be perfect.
So in a sense, right now it seems doctors are in a bind when it comes to understanding how to treat fat patients. There needs to be more open mindedness from them, and from us, as well as more communication to help things become better.
As someone with Asperger’s Syndrome, I feel like it’s how I struggle with figuring out how to interact with NTs (”normal” people) at times. It always is difficult to remove the barriers between people who have different views, so they can discuss the issues and solve things instead of cause more problems.
The last time I went to the doctor, I worked myself up into such a state – he’ll tell me I’m too fat, that I HAVE to lose weight, etc.
Turns out I was tried and cranky and dizzy and achey not because I’m a big fatty, but because I was severely aneamic and had superlow bloodpressure – Doc’s only diet related comment – “you need more red meat, maybe up your sodium intake.”
So, this over 100kg girl got sent home with instructions to eat some steak and use more salt.
Bugger
I went to a doctor about a month ago after my left foot was ‘felt strange’. I noticed it whenever I was doing high impact exercise – especially dancing. It was then in Step aerobics on morning that it started hurting.
The doctor told me I ‘put too much pressure on it’, and told me to exercise and eat less. Losing 20 kilos would do it, and a 15min walk three times a week would do the trick for a beginner. I lost my head with him assuming that I was a ‘beginner’ to exercise – I’m a triathlete, a runner, a swimmer, and love group fitness classes.
I went to another doctor who straight away recognised it was an impact injury – a sprain, which had absolutely nothing to do with my weight.
Guess which one of the above has my respect and which one doesn’t.
And I failed to mention the ‘best bit’. I told the first doctor about all of the exercise I do, and he interrupted me by saying, “Don’t take this the wrong way, but if you really did that much exercise? You would look very different now.”
That medical centre continues to call me and remind me that I have an unpaid consultation fee for that session, seeing as I stormed out without looking back.
Marshmellow, I’d really want to tell that doctor, “Look if I wanted a 3-year old’s perspective on my health, I’d be playing doctor with one. I came to you, a presumed professional, only to have you tell me what a 3 year old would say, “If you exercised that much you’d look different”.
It’s one thing for a bratty kid to say it, it’s an entirely different thing for a doctor, who went through medical school, to talk to me like a bratty 3 year old. Perhaps I should go and find a doctor who’s beside manner matches his age.
Oh also I just read the part about the medical center. I’d say, “Should I pay you in chocolate or gummy bears. Oh cause you no, aside from the fact that per stereotype being fat I must have hoards of candy hidden about the house, I figure the doctor who acts like a 3 year old should be rewarded like a 3 year old.”
Marshmallow, good for you for storming out! That’s wonderful! I wish we all had the guts to do that.
I’ll repeat what I’ve said before in a comment here: I was telling a friend who’s a doctor about my experiences of having doctors not believe what I’m telling them. She said that if your doctor doesn’t listen to you, if your doctor doesn’t believe you, then you’re not receiving medical care. You’re receiving veterinary care.
In 2006, when my right hip started hurting so badly that it wouldn’t support my weight (har!), the first doctor I saw told me I needed to “move the joint more,” and…”lose some weight.”
I wansn’t sure exactly how I was supposed to do that, when I couldn’t walk more than 1/8 of a mile before excruciating pain set in. Turns out I have a developmental disorder- my hip joints are wonky. It’s my bones, not my weight…but I had to go to Dr. Google to find that out, since the hooman doctor couldn’t see past the “fat as a cause” reason…
Hi, delurking.
I am currently in medical school and my dad is a cardiologist, which has given me the opportunity to work with patients very early on in my training (med school is different over here in Europe, we don’t see patients right away).
I have to agree with you guys on some points. The training we receive is just completely off sometimes. Not only are we consistently taught that “OMG – fat KILLS” (which everybody should know is not true), they also teach us to treat patients like immature toddlers (regardless of their weight, btw).
It’s a kind of indoctrination that is hard to ignore if you face it 8 hours a day for several years.
Plus, a lot of patients just don’t get the facts right. They hear about a kind of treatment and they want the exact same thing for themselves, because it has worked for a friend/relative/neighbor. Never mind that it might not be the right treatment for their particular situation. It just makes you impatient with people thinking they know more about medicine than you do, although they usually don’t. This happens a lot, actually and it leads to a kind of arrogance in doctors that I personally dislike and try to avoid. Please understand, though, that it is annoying to have people tell you that they know better than you all day, when they have never worked in the medical field.
And then there are the people who just can’t follow what you’re telling them, but it’s essential that they do, because how else are they going to be compliant? So you kind of start explaining things REALLY slowly, using very simple vocabulary. Again, this is a thing that they teach us at school. And it’s not necessarily a bad thing. All it means is that you want the patients to understand their disease and what they need to do to get better, since they will be the ones taking the pills every day.
They won’t if they don’t know why they’re doing it.
Now, I am aware that our way of explaining things makes many people feel like we think they’re dumb (I’ve experienced it myself, even while already in med school). I can only speak for myself, but I definitely don’t think that. It’s just that I see many patients every day and don’t have the time to evaluate everyone’s intelligence/medical knowledge before we talk about their condition. And frankly, I’d rather risk pissing people off for underestimating them than overestimating them and having a patient’s health suffer because they didn’t understand what I was telling them.
Yes, I know that stress, pressure and frustration with one patient should not influence the way you treat the other patients, but come on, we’re human, too. Cut us some slack.
Of course, downright disrespecting patients is never excusable.
All right, enough defending the medical professionals. I actually just wanted to tell you guys about a little “experiment” my dad and I conducted with his patients.
My dad (after I talked to him about changing his approach to obesity and shifting his focus away from it in treating his patients) has experienced greater compliance since he stopped telling people to lose weight. He now tells them to set small goals for themselves, goals they can accomplish in a day (le.g. eat 3 pieces of fruit every day, walk around the block once a day, etc.). He’s not telling people to quit doing things (well, except smoking, but I think that’s valid), but rather to add things to their lives. Many of those things could potentially lead to weight loss, but weight loss is never mentioned as the goal. DOING those things is set as the goal.
And it seems to be working. Not only are people getting healthier in regards to LDL and HDL cholesterol, blood pressure and inflammation markers, most of them reported being more confident, because they experience success every day. They are proud to come in for their check-up (he’s a cardiologist, so people come in as often as every two months), because they are accomplishing their goals every day. Some of them have indeed lost a little weight, but that’s more of a side effect and it’s not really an issue talking to the patients.
My dad’s amazed by the huge success.
BTW, when I mentioned the “experiment” in a class, people were laughing at me and even going so far as to call my dad a bad doctor for not making his patients lose the weight. *Sigh*
I guess sometimes, you just can’t blame it on the training or your shitty day. Most (future) doctors are just dicks. ;-D
I found this post a bit late but just wanted to add my voice. Great post!
I’ve had a whirlwind of a week. First a female shrink who outweighs me by about 100kgs (I weigh in at around 120kgs) gave me a diagnosis of Personality Disorder because I am fat-accepting. Basically I’m crazy because I don’t hate myself.
Then I saw a young male doc for a virual infection and not only has he not mentioned my weight one single time, but he treated me like a human being. He still hasn’t diagnosed what the virus is but he tests and doesn’t assume. I’m so crushing on him now!
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