The Dreaded Medical Appointment

“People who hate fat people see body love as a move toward people taking charge of their lives and choosing what they want to do, no matter what the culture says. This is really scary to a lot of people. The anger they express is actually toward themselves.”

Things No One Will Tell Fat Girls: A Handbook for Unapologetic Living ― Jes Baker

I know exactly what writer and fat activist, Jes Baker, means in the above quote. I had a medical appointment at the Heart Failure Center last week. It went the way of most medical appointments – me arriving home feeling worse about myself because I was not taken seriously. Healthcare for fat people is frequently far removed from a healing experi6ence.

Because I was fat-shamed at my previous appointment, I had sent the Nurse Practitioner (NP) an article I had written entitled, “Fat Shaming in the Medical Profession.” Instead of her/them being open and receptive to this critical problem, I felt full backlash at my appointment last week.

In general, the anti-fat medical profession does not accept fat empowerment. They see excess weight as a health hazard, a killer disease, a moral failure, and self-indulgent. They persevere in the belief that the only path to wellness is through weight loss. They wear hearing aids without batteries when you try to explain your situation.

The NP never acknowledged that she got my article or read it. Instead, she was cold, defensive, and rejected most of what I said. Nothing can be changed that isn’t recognized, but egos frequently run rampant at the doctor’s office. 

As usual, I was treated differently than a thin patient. Let me explain. I’ve gained a considerable amount of weight this past year due to Covid-19 shutdown and severe leg and muscle pain (perhaps Complex Region Pain Syndrome which is called the “suicide disease”).  It’s torture to move so I’ve been physically moving my body much less this past year.

Interestingly, weight gain during the pandemic was not unusual. There is currently a “quarantine 15” meme circulating because many slim people added as much as 15 extra pounds during a topsy-turvy year that triggered undue anxiety, stress, revised eating, increased screen time, and less physical activity for most. Financial hardship and the unavailability of fresh produce and nutrient-rich foods limited most people’s healthy choices. A little more food and a little less movement equaled more poundage.

Of course, the media and weight loss companies are capitalizing on this increased body weight by making people feel guilty after one of the most stressful times in their lives. The diet culture message is loud and clear:  It’s shameful to have anything but a thin body, which translates into feelings of inferiority and unworthiness for many people, especially larger ones who cannot lose weight and keep it off.

My point is this. If thin people gained weight during this traumatic year, then why isn’t that the same reason fat people gained weight? In the medical field, the right diagnosis is the whole it enchilada. She was resistant to almost everything I said; she was not about to allow me to feel like a powerful fat person. Or, heaven forbid, an equal.

However, the NP at the Heart Failure Center gave no indication that she was aware of anyone gaining weight in 2020 and actually rolled her eyes once when I was trying to explain my lifestyle and the possible reason for weight gain.

Due to a plethora of fat-shaming in the medical arena, larger people are never sure if they can trust that a medical opinion is unbiased. I came away from that appointment feeling as confused as rain during sunshine and as angry as a wild boar searching for food. The goal of healthcare should be to help people, not to make them feel degraded and undignified.

For The Record

Fat bias is the mistreatment of persons based on their size and appearance. It is more prevalent than racial discrimination and elicits similar stress. It manifests through bullying (teasing), isolation (exclusion from society), discrimination (harmful or unfair treatment), and disrespect.

Fatphobia is the pathological fear and dislike of higher-weight people. A medical provider who never touches a fat patient is likely fat phobic. The last I checked, fatness was not contagious.

Anti-fat bias is widespread in both society and medicine and well documented, explains Angela Alberga, an assistant professor at Concordia University in Canada. “You actually experience a form of stress,” she explains. “As cortisol spikes, self-control drops, and the risk of binge-eating increases.”

Fat shaming is also linked to despondency, anxiety, deflated self-esteem, eating disorders, and avoiding exercise, points out Alberga. The intensity of harm increases when people internalize weight bias and turn the hatred upon themselves.

The intensity of harm increases when people internalize weight bias and turn the hatred upon themselves.

When I got home from the medical appointment, I wanted to eat everything in sight. Instead, I got on a Facebook page called Living While Fat, vented my frustration, and received emotional support which saved me from vicariously biting off the NP’s head using food.

Down With Diets

Refuse to weigh yourself daily. Throw out your scales. There is no moral value to weight loss or gain.

A plethora of research confirms that 95% – 98% of diets fail and dieters regain the weight − often more − within 2 to 5 years. In fact, cycling or ‘yo-yo’ dieting is linked to an increased risk of heart problems, which is more damaging to health than maintaining a stable, higher weight.

How many times have you gone on a diet and anticipated getting to your goal weight once and for all? Both dieters and healthcare providers hold unrealistic expectations for weight loss. In one study, subjects anticipated losing 20–40% of their body weight – amounts that are achieved only through bariatric surgery.

Likewise, primary care physicians hold an inflated view of patients, expecting them to lose 21% of their initial body weight. In reality, the best outcomes are 5–10% of a dieter’s average weight. So a 300-pound person might only lose 15 to 30 pounds on a diet. And unfortunately, gain it back plus more because calorie reduction and loss of muscle mass lowers the metabolism and changes the setpoint once a dieter returns to a natural eating pattern.

All of which begs to ask this question: If weight loss has a 95% to 98% failure rate, is it ethical to prescribe dieting? Would you take a drug or engage in another type of therapy or treatment that promised such a low success rate?

Weight Stigma From Medical Professionals

Poor treatment may cause undue stress, avoidance of care, and mistrust of doctors among fat patients.

Sadly, studies reveal that at least three in five fat people tolerate weight-related discrimination from healthcare professionals. Women cite doctors as the most widespread source of this stigma, second only to family members. It is not just doctors though. Nurses, medical assistants, dietitians, psychologists, and even obesity specialists embrace these anti-fat sentiments.

The minute you walk into a doctor’s office, you are probably fighting fat prejudice. The research concludes that 97% of physicians and medical students rate fat people as stupid, 90% view them as unsuccessful or weak, and 86% judge them as lazy, followed by weak-willed, awkward, and ugly. Doctors have complained that heavy patients are noncompliant, waste their time, and make their work less enjoyable.

In a study by by size.

In like manner, I saw a neurosurgeon who had lost 35 pounds after gastric band surgery. He told me that I should “run down the street” to get weight-loss surgery, and then return for back treatment. He pointed to my petite sister, asking: “Wouldn’t you like to look like her?” Then he threatened, “Do you want diabetes because you’re going to get it.” That was 2007. I do not have diabetes, but I saw him in 2014, and he had regained his weight.

This is what we’re up against, folks.

What To Do?

During the Renaissance period, fatness was admired, indicating wealth and power. Prosperous families could afford food while the poor could not. Now it’s the reverse. The poor can only afford unhealthy, junk food, causing weight gain while the wealthy are able to buy organic, healthier foods. If we lived in a different time, we would not be battling this stigma.

Long story short, do not give up educating the medical profession about fatphobia even when they might retaliate. Stay on the message that large people should be treated no differently than thin people. The health treatment offered to a thin person should be the same treatment given to you.

Here are some tips for dealing with the ramifications of fat shaming:

Stand up for yourself
  • Be grateful for what your body has done for you and focus on issues of greater substance and compassion. Stop accepting other people’s negative attitudes toward you because you’re fat.
  • Praise yourself for making it through a difficult time, such as the pandemic or medical prejudice. You are enough as you are. And you are so much more than your body image.
  • Unless your current medical problem is related to weight, refuse to be weighed at the doctor’s office. If medical professionals don’t focus on the weight of thin people, neither should they make that the core issue for a fat person. If they accuse you of noncompliance, explain that getting weighed can trigger an eating or mood disorder. If they insist, stand backward on the scale and tell them you do not want to know the weight.
  • Arm yourself with knowledge and confront medical professionals who try to prescribe methods that you know will not work permanently, such as a ridiculously low-calorie diet that is nothing short of starvation. For example, a two-year-old needs 1200 calories a day. You know your body. The medical profession does not have a corner on how your body responds. Hum Frank Sinatra’s song, “I’ll do it my way.” Then do it your way.
  • When others make jokes about weight, either counter the comments or walk away. It says nothing about you. It means the person uttering it suffers from fatphobia. They obviously pair fat with ugly, but if you have lived it, you know better. Do not internalize it. Fat is merely a description. How could it possibly define the worth of a human being? Refusing to engage in “fat talk” is one way to start teaching others, especially healthcare professionals, that it is never acceptable to body shame anyone.
  • No one else is responsible for how long you live. Stop allowing others to pretend they care more about your life than their own. Do the best you can do. As Lindy West writes in her book, Shrill: Notes from a Loud Woman, “I hate the way that complete strangers waste my life out of supposed concern for my death. I hate knowing that if I did die of a condition that correlates with weight, a certain subset of people would feel their prejudices validated, and some would outright celebrate.”
  • Large people know they are fat. They don’t need others pointing it out. Fat stigma can be brutal, but don’t let that stop you from pursuing your aspirations. You have a right to give your gifts to the world. Show the haters exactly what they underestimated. Do something wonderful with the space you take up. In short, unconditionally love yourself as you give fat-shamers the middle finger.

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