When I was 17, every time I got my period I experienced nausea-inducing, life-stopping cramps. I needed help—treatment, pain management, anything—so I could go through a cycle without missing school or work.
Today I’m a stereotypically “fit” personal trainer. But back then I weighed over 300 pounds.
I was nervous walking into the gynecologist’s office. It was my first visit.
She asked me if I was sexually active—I wasn’t—and then asked me why I was there.
“My cramps are so bad that I cry and get sick to my stomach. I can’t stand up straight. I need help."
My mom had told me how horrible internal exams were. I hated getting blood drawn. I braced for which would come first.
But she just looked me up and down.
“Lose weight,” she said, like she was stating the obvious.
“Lose weight?” I said, confused, suddenly embarrassed.
“Lose weight and it will get better.”
I looked down at my lap. Wasn’t she curious about what was going on inside me? Wasn’t she worried it might be something serious? Nothing that hurts that bad can be nothing, can it?
I looked back at her. She looked bored and vaguely annoyed.
I was young. I didn’t know I deserved better care. Suddenly, my symptoms seemed trivial, and I felt ashamed of myself and my body.
But I’d been dieting since I was a kid. Maybe, I thought, she had a weight loss solution that would work better.
“How?” I asked.
“It doesn’t matter how, but you need to lose 100 pounds and you need to do it fast.”
“It doesn’t matter how I lose weight?” That didn’t sound right.
“Any weight loss method would be healthier than being that big.”
She walked out of the room. She hadn’t even touched me.
For years after that, I rarely went to a doctor.
Twelve years ago, after I lost over 150 pounds, I started to treat my body with care and take my health seriously. A doctor listened to me and discovered I had endometriosis, a condition that had gone undiagnosed for almost 20 years.
A review of studies published in the journal Obesity Reviews in 2015 surveying empirical evidence across multiple disciplines showed that health care professionals’ negative feelings about fat bodies can lead to misdiagnosis and late or “missed” diagnoses, negatively impacting patient outcomes. Meanwhile, patients who face, or anticipate facing, fat phobia and weight bias from doctors may seek medical care less often, and when they do, they may be less likely to comply with doctors’ orders.
With obesity rates at an all-time high, weight bias in health care is poised to cause more damage—to patients, and to doctor-patient relationships—than ever.
“Some doctors are egregiously nasty and inappropriate with their larger patients,” says Scott Kahan, M.D., a physician on faculty at Johns Hopkins University. “A patient of mine once went to urgent care short of breath only to be told that it was because she had ‘too much fat on her chest.’ Later, at the emergency room, they discovered she had a pulmonary embolism and needed anticoagulants. She’s lucky to be alive. Medical professionals’ underlying belief systems, driven by our thin-obsessed, antifat culture, can and does make their interactions with patients with obesity less productive.”
As the problem of weight bias in health care has grown, so have resources to support those impacted by it. Women who’ve experienced weight bias in health care and in other contexts can complete the Weight Bias Reporting Form created by the Obesity Action Coalition. A committee reads and responds to submissions where appropriate, either by calling out bias, starting dialogues, or offering education.
There’s a large and growing searchable database of respectful, compassionate health care professionals who’ve committed to provide quality care to larger people. Linda Bacon, Ph.D., advocate of the Health at Every Size movement and author of a book by the same name, also offers free downloads on her website that include letters folks can bring to health care providers to help them treat large patients with more respect and ultimately provide a higher quality of care.
Because fat women, like all people, deserve respectful treatment, and fat bodies, like all bodies, deserve care, we asked four fierce, outspoken, fat-positive women to share their experiences of fat-phobia and weight bias in health care. Their experiences are telling.
"I was going to a family planning clinic to get birth control and I had one doctor ask me if I EVER exercised in a really condescending way. I wanted to be like ‘No, I just sit on my couch and have bacon fat intravenously dripped into my bloodstream.’”
—Jes Baker, themilitantbaker.com
“I haven’t been in to see a doctor in a long time: five years. Lots of doctors think they should treat weight first, and I’m terrified of walking into a doctor’s office and getting that kind of reaction. I have polycystic ovarian syndrome, and that needs to be checked out. There are remedies I’m not trying and some things happening for me that could be a problem down the road that I’m not getting addressed because I’m not going to the doctor.”
—Jes Baker, themilitantbaker.com
“I threw my back out three and a half years ago and I was in excruciating pain and the physician just looked at my chart and said, ‘Just take a couple of Tylenol.’ Doctors deny fat patients’ pain or minimize their pain or deny them pain management treatment because some doctors believe that some bodies—namely fat bodies—deserve the pain they’re in."
—Sonya Renee Taylor, The Body Is Not an Apology
“It does not matter how much you wish [your fat patients] were not fat. They are in your office, and that body is a body that needs CARE, or they wouldn’t be there. Talking about weight loss when a patient is in your examining room seeking care—especially for an acute condition—is insulting and condescending. It is also medically worthless. It’s especially true because it will make them less likely to come back. If you are a health care provider who believes that a patient's weight is creating or contributing to some health problem—and there are cases where that’s a legit call to make—the way to negotiate that with a patient is not to come out with both barrels blazing saying, ‘You have to lose weight or your leg will fall off,’ because even if that’s true, your patient won’t be able to leave your office and lose the weight they need to lose to prevent that from happening. You might have to just do something to keep the leg from falling off in the meantime.”
—Hanne Blank, hanneblank.com
“My hip hurt so badly I could barely walk from my car into work. I was sent to an orthopedist. I started to describe the pain I was in and he cut me off with ‘Let me cut to the chase—you need to lose weight.’ The funny thing is, I had recently lost 70 pounds, so if the pain was weight related, why would it be happening now? I started to cry and said to him ‘You’re not even listening to me. The only thing you’re seeing is my weight.’ In his report to my primary care physician, the orthopedist’s diagnosis was ‘obesity pain.’ When I finally worked up the nerve to go to another orthopedist, he took X-rays and discovered I had scoliosis—a 60-degree curve in my spine. My pain is much improved since I started physical therapy.”
—Patty Nece, obesityaction.org
“I went to my doctor with severe abdominal pain, nausea, and sometimes vomiting with eating. My symptoms were more or less dismissed as ‘Well, you just moved and you just started a new job and you're under a lot of stress, I'm sure things will settle down’ because I was also losing weight rapidly because I couldn't eat without being in pain. My doctor quite transparently valued the weight loss enough to ignore the acute symptoms and said something along the lines of ‘You look great and your weight is coming down nicely so let's just wait and see how things are once your life settles down a little bit.’ A few months later, I ended up in emergency surgery with gallstones that had blocked my common bile duct. Turns out it wasn't just stress.”
—Hanne Blank, hanneblank.com
Kelly Coffey is a personal trainer, wellness coach, and writer who once weighed over 300 pounds. Click HERE to see the schedule for her free, online workshop, “Why We Sabotage Ourselves with Food and What We Can Do About It” and follow her on Facebook HERE.
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