Fat shaming, also known as weight discrimination, occurs in the doctor’s office when a patient is undertreated or blamed for their health because of their height. It is an ongoing problem in medical settings that can distress patients or even cause them to avoid treatment altogether.
In a reversal of what some vendors see as a hard love method to motivate people to lose weight, the bias towards fat people results. It includes everything from a provider who is less likely to commit to their patient if they see them as overweight, to mis-dosing of medications, and more.
“No one should have to choose between seeking preventative treatment, cancer screening or active symptom management out of fear that not only will they be blatantly fat-shamed, but that they won’t receive the care they do actually has sucht,” says ani janzen (who forms his name with lowercase letters), operations and project manager at the Association for Size Diversity and Health, a nonprofit organization.
You may have already had an experience where you feel like your health has been ignored or mistreated instead of focusing on your size, especially if your body mass index on the BMI chart is in the “overweight” range or higher lies. What can you do about it?
First of all, it is important to be clear about what you as a patient are entitled to: quality care. If you don’t get it, it’s not your fault as a healthcare user. Second, it’s important to realize that if a healthcare provider doesn’t seem to know what they’re talking about in terms of larger body advice, it’s probably because they don’t know.
How doctors end up flying blind when caring for larger bodies
dr Fatima Stanford is an obesity physician and research fellow at Massachusetts General Hospital and Harvard Medical School. She says she learned more about nutrition and weight management from browsing wellness magazines than she did in medical school. (That was before her special training.)
“The answer to your question is that we’re not trained,” Stanford said when asked about the training doctors receive to talk to patients about weight. “It’s not nice to say, but it’s the reality.”
This lack of training in caring for larger physiques manifests itself in many ways, including offering dietary advice (sometimes asked, often not) that only works for a small fraction of patients as diets usually stand alone. It can also make a patient feel down when the reason they went to the doctor is not addressed or generally not respected, as a societal bias towards larger bodies is just as prevalent in the medical community.
How to get better care when coping with fat phobia
Feeling comfortable with your doctor begins in the waiting room. If you decide to set up this office as your place of care, make sure there is seating that is accessible to you and that you are comfortable with the front desk staff. In the examination room, you can also decide on other details, such as: B. whether the blood pressure cuff is accommodating and, above all, how well you feel understood by the provider.
For some of the layout stuff, if possible, you can call or message ahead of your appointment. janzen also recommends communicating your goals for the appointment or concerns in advance with a letter to the front desk person who can then share it with your care team in advance.
“It’s not going to change anyone’s mind between entering the waiting room and the time you head back to the clinic, but it gives providers a second to engage with what’s being asked of them,” she said.
Within the next few weeks, Janzen says, ASDAH will finalize a list of providers that follow the organization’s Health at Any Size care framework, which could make it easier to find weight-neutral care in your area. But finding a provider that subscribes to that particular label may not be the most important thing, says Janzen. As a provider, being able to “center” the patient and “meet the person in the room they are in today without judgment” is a fundamental standard of care that could improve the healthcare system as a whole.
All to say don’t commit yourself. If you are not comfortable with the care you are receiving from your doctor, consider your rights as a patient and find a new provider.
Reach out to the community
Joining a local group of like-minded people like the Twin Cities Fat Community is a great way to get recommendations for providers in your area or even personal care tips, says Janzen. Another benefit of reaching out online or finding a similar group is that you may also find a support person or someone to come to a doctor’s appointment with you.
A friend or family member accompanying you could also act as a patient advocate—someone to help you coordinate your care, ask your doctor questions, and more. Sometimes hospital systems or clinics have their own patient advocates.
You can also refine your search based on the type of care you receive. For example, we found a fat-friendly Facebook group for people who are pregnant or trying to conceive.
Lead the conversation away from your weight
Weight loss is often a routine part of a doctor’s visit. However, you have a choice about how – or if – you step on a scale. Do Not Weigh Cards, which you can order from More-Love.org, are a way to let your provider know that you do not wish to be weighed unless deemed medically necessary. Alternatively, you can ask the person taking your vital signs at the beginning of the appointment not to read the number on the scale out loud, or tell them to face away from the scale.
If you feel like your weight or height is the focus of your health visit and there is an urgent matter (because it usually is when you seek health services), don’t be afraid to say so.
Stanford provides a direct example of changing direction. Something like, “I hear you’re increasing my weight, I’ve got an ax in the middle of my head,” they said. “I prefer to focus on getting the ax out of my head. It hurts – I’d really rather be able to keep my sight.” You can then suggest a follow-up appointment or actionable resource if you want to discuss something weight-related.
If your doctor keeps pushing the topic of losing weight against your will, take a page from this post by author Virgie Tovar on tips for medical self-defense: “Doctors have a specialized area of knowledge that you put at their disposal – like the So would you hire an electrician to take care of anything electrical.” They should treat you for what you pay for.
In a 2019 post, the blog ComfyFat recommends asking your doctor to write down any treatment requests, such as: B. Peculiarities for urine specimens. In this way, another nurse or doctor in the practice has the note in your file and can save you the repetition.
Remember your rights
“As a patient, you have rights,” Janzen said, adding that there is a strong power dynamic in healthcare when doctors are expected to have all the answers and also control access to medicines.
“They are the ones who hold the key to your treatment, your care and your prescriptions,” she says. Because of this, it can be really frustrating – even demoralizing – to find yourself in an environment that is hostile to you and your needs. But that doesn’t make it right, or something you have to tolerate. You have the right to respectful care and the right to choose your provider.
“As a patient, you have the right to make your health and your healthcare the way you want,” Janzen said. “The idea of body autonomy is incredibly important in the delivery of health services.”
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified healthcare provider with any questions about a medical condition or health goals.