Diagnosis: Fat

That’s not an original title. There’s a whole hashtag devoted to it on Twitter, although it’s been overtaken and trolled enough by now to have lost its original momentum and intent.

This is not a post promoting obesity. I’m not encouraging people do “just do you” and ignore healthy lifestyles or guidelines. I’m not saying doctors who suggest a heavier weight is detrimental to your overall health are meanies or bullies. My feelings do not spare me from the realities of being overweight.

My weight also does not disqualify me from receiving quality, unbiased care. And THIS is what I’m writing about today.

I remember the first time I ever encountered a doctor who couldn’t see past my weight. I’d made an appointment with a doctor because I’d been experiencing some crippling anxiety and thought it was time to ask for help. I went through the usual routine with the nurse – weight, height, blood pressure, symptoms, allergies. Having never been a patient in this office before, I answered everything with patience. The handle turned, the door opened, and the as-yet-unintroduced doctor walked in, chart in hand, and handed me a pamphlet and a few information sheets. “These will help you lose weight.” Those were the first words he said to me. Barely 3 months postpartum with my second child, and being a WOMAN, I was embarrassed. I hadn’t yet realized that you’re allowed to stand up to doctors and demand they treat your symptoms, demand that they listen to you. I timidly tried to remind him what I was there for. He didn’t listen. Never once made eye contact, and wrote me FOUR prescriptions before he finally took the time to find something suitable for a breastfeeding mother. I never filled that prescription, a sort of symbolic “forget you” to the doctor I swore to never see again. For years I chalked the experience up to him simply being a jerk, a butthole, a tool, whatever. After all, in any profession you’ll find people like him, so I couldn’t assume I’d ever be treated so poorly by another physician.

Until I needed another physician.

Let me just get this out of the way: Fat people know we’re fat. No one is telling us anything new. We shop at different stores, take elevators to separate floors in department stores. We own mirrors and scales. We read the same articles and see how big of a deal it is when Target announces they’ll carry something in our size. We rarely see anyone like us in the media, and most of the time it’s only because someone felt it was their place to point out how much bigger that person is getting. Kirstie Alley has become a punch line for struggling with something the VAST majority of Americans struggle with, and somehow the same majority feels it’s okay to laugh. She knows what number stares back at her from her closet, long before anyone writes a joke about it. She knows. We know. We all know.

if you’ve read my previous posts, you know I’ve battled PCOS for most of my life. A few years ago, it began to get out of control. Not that it was ever a walk in the park, but it was truly affecting my quality of life. I sought help from a highly-specialized doctor, a man with incredible reviews and a very fancy office. I saw him several times, went through some invasive procedures, bloodwork, and tests, then sat in his office and slumped my shoulders when all he said was, “Yep, you have PCOS.” I reminded him of my symptoms, my complaints, my misery, of how I’d gained 50 pounds in a single month. Through tears I asked him if there was nothing else that could be done to help, nothing else to look for. “Well, you’re fat, so you’re not going to feel well.” Ouch. He offered to send my information to a surgeon he knew who performed bariatric surgery, despite my insistence that diet had not caused my appearance.

I worked up the courage a few months later to see another doctor. I knew that my weight was a symptom of something going horribly wrong in my body and was determined to find out what it was. This new doctor interrupted me as I tearfully shared my complaints with her to ask about my diet. My nearly 100% organic, home-cooked, acceptably-portioned diet. She was puzzled, I could tell. The confusion on her face was clear: How does she eat like that but look like this? When I told her I drank a Pepsi every day, she looked relieved and let out a huge sigh. She thought she’d solved the mystery. “Well, are they two-liters?” Out loud. She said that out loud. To me. A woman in tears, begging for her help. She didn’t care what was wrong with me, she couldn’t see past my size.

Months later, I braved the MDs again. This one actually handed me tissues as I cried. She scheduled surgery, bloodwork, tried really hard to figure out a lot of the symptoms I was experiencing. At the end of the months-long process, we were none the wiser and I was no better. Having earned my Google University medical degree at this point, I asked if she could check my thyroid. She, instead, handed me a Weight Watchers flyer. Again, yet again, this prison of fat was being seen as a cause, not a symptom. I lost my cool that time, handed her the flyer back, and gave her quite a speech on how many patients she’s probably missed the mark on because she couldn’t see past the weight.

I read a blog a few months ago that discussed this very topic, how doctors are so blinded or biased by weight that they fail to treat the actual underlying cause of a patient’s complaint. A sore knee is seen as the byproduct of bearing too much, not a possible autoimmune disorder, a legitimate injury, or even a blood clot. Labored breathing or chest pains in a plus-sized patient are met with eye rolls, not concern. There is no sympathy, no dedication. As soon as the weight of a patient is assessed, it becomes a hurdle the patient must overcome in the long path to getting a doctor to LISTEN. Yes, we know we’re fat, but please listen to what else is bothering us. Please stop staring in judgement long enough to listen with care. If doctors attend medical school for so long to help people, then start doing it already. Yes, obesity is an epidemic that causes an incredible amount of health concerns, disabilities, and death. Yes, it’s bad for us. But so are doctors who don’t pay attention to anything more than our waist band. Google “doctor fat bias” and you will find numerous studies indicating that doctors tend to treat thinner patients better and more effectively. I, for one, am less likely to seek medical care because I don’t believe that my concerns will be heard or addressed, and I don’t feel like dealing with the judgement or embarrassment that comes from being ignored.

This is a problem. All patients, no matter their size, deserve equal, empathetic care. I spent hundreds, heck, thousands of dollars trying to find a doctor who would behave like a doctor. My money is the same as that of a thin person’s. I wasn’t looking for a pat on the back, I wasn’t looking for someone to make me feel good about myself, I was looking for a DOCTOR. Yes, I’m fat, now let’s find out WHY, please. Despite treating the PCOS (which causes weight gain, hurray), I still had extreme fatigue. Hair loss. Mental fog. Aching joints. Hives. More weight gain. The overwhelming diagnosis was that I was fat. Fat people are supposed to feel miserable. Fat people only get fat by eating a whole lot. Fat people are unhealthy. Lab result after lab result showed that I was actually in incredible health. (One doctor even said “wow” when she saw my healthy blood work.) My cholesterol is fine. I am not diabetic. My heart and lungs and liver and everything else work great. I just feel terrible and won’t stop gaining weight. They all missed it. Every doctor I saw, every doctor I begged, every doctor I worked up the courage to share my struggles with, every doctor I trusted to help me. They were blinded by my size and their objective abilities to help left the room. They didn’t see the pattern. They didn’t see the fatigue, the weight gain, the hair loss, the joint pain, the mental fog, the hives, the sleeping troubles. They didn’t see a woman in front of them with Hashimoto’s thyroiditis. Because that woman is fat.

When I got the phone call from yet another doctor (who asked in our initial consult if I’d ever eaten a salad), I knew what was coming. A simple Google search had provided me with a diagnosis more than a half-dozen doctors couldn’t reach, months before. I knew what was wrong with me and I knew what to ask for. And while he was quite rude about it, that last doctor ran the tests that needed to be ran all along. I’d cried for years that my body felt like a lemon, like it was attacking itself, and it was finally confirmed to be true. I cried VICTORIOUS tears after that phone call. I wanted to call every doctor I’d seen and tell them the news, tell them they’d failed me. Instead my mind went to all of the other potential patients they’d failed. How many other people were walking around with treatable illnesses because they’d been diagnosed as fat? How many people who become statistics each year by dying from obesity-related issues actually have years left, but were written off as collateral damage caused by cake? I kept this news largely to myself, mostly because I’d complained enough about my health. Hashimoto’s is an autoimmune disorder, so there is no cure, only treatment. It was likely caused by the extreme imbalances from the PCOS, but everyone is different. It takes, on average, 5 years for a patient with an autoimmune disorder to get a diagnosis. And with the way autoimmune disorders work and how connected every hormone and organ and gland in our body is, those with autoimmune disorders often develop other autoimmune disorders. So we are quite literally getting worse as we look for help. We are actually wasting away. Our health deteriorates with every doctor we visit. Doctors, who take oaths, who vow to help, who wear white coats and earn letters after their names, are making their patients WORSE, simply because they don’t have their listening ears on.

I love Humans of New York. If you don’t follow Brandon and his project, you’re really missing out on an incredible glimpse at humanity. Similar to what Post Secret used to be, it shows us, every day, that we can’t judge a book by its cover, that we truly have no idea what’s going on inside someone. Until we listen.

Last night I had to go to the doctor. My throat burned like lava, I had a fever, and my lymph nodes were swollen. I needed a doctor. He walked in, sat down, and asked if I had diabetes. “No, but I have a sore throat.” It turns out I have strep throat. Treatable. Temporary. And in no way related to my weight.

Listen up, doctors. Your patients are dying and don’t care what size their coffins are.

Reasonable Expectation of Dignity

I don’t want to share this.

My hands are shaking. My heartbeat is visible through the skin over my collarbone. I’m so nervous and humiliated that I feel lightheaded. I do not want to share this.

But I have to. For a week I’ve been fighting this, and for a week I’ve tossed and turned and been awakened by my brain that seems to want to write this on its own. So while I don’t want to share this, I need to.

I love fashion. I hang out in sweatpants and Backstreet Boys t-shirts and revel in the no-makeup days, but I love fashion. I also love to laugh. It seemed a given that I would enjoy a marriage of the two, Fashion Police on E!. I DVR’ed the heck out of it, I wanted Joan Rivers’ job (and wardrobe!), I laughed, I looked forward to it. Until a few months ago when I read an interview with a random celebrity that I can’t even remember, but their words stuck with me. She said that she did not watch Fashion Police, because it was hurtful. The women they tore apart on that show left their house feeling beautiful, and those “judges” thought it was their place to say otherwise. Boom. I haven’t watched since.

Many of you know that I struggle with my weight. Yes, I say “struggle”. I’m still battling the irrational anxiety that has popped up in the last year. I went from fat and happy to fat and terrified. Terrified of what people thought, terrified of what people saw. Leaving the house means winning an internal battle some days. As much as I love to encourage others, I cannot seem to rally myself to hold my head up as often. Yes, my husband loves me and tells me how beautiful he thinks I am. Yes, I am HEALTHY. No, I never share this struggle with my children. Because this weight is beyond my control, I feel like I am grasping at nothing, drowning, falling down a well. I want to wear a sign that says “Yes, I know I’m overweight, but NO, I did not do this to myself.” I feel like I need to explain myself to the perceived disgusted public. It’s a truly overwhelming feeling to not have control over your body. Enter the hot tears. I can take captive every thought and make it obedient to Christ (2 Corinthians 10:5). But the outside? The part that people see? All I can do is shave my legs, do my hair, and put on some makeup. Well, it’s winter, so the legs can wait. I have literally had panic attacks in the middle of stores because I was so ashamed of how I looked and what I thought people were thinking. Again, I know it’s irrational. But again, grasping at nothing.

Last week, my worst fear happened: I caught someone taking a cell phone picture of me. This is where my hands shake and my heart races again. This person was trying to go unnoticed, pretending to check emails or Facebook, until the flash accidentally went off. I was sitting alone, just a bare wall next to me. When I climbed far enough out of my shame cloud to tell my best friends and husband what had happened, they all tried their obligatory encouraging alternatives: “Maybe it was your beautiful hair! Maybe they liked something you were wearing! Maybe this, maybe that…” Nope. Momma was having a ROUGH day that day. Ponytail, my black flats with the holes in them, glasses. Also, we had been chatting, so a compliment could have been offered up at any time. I also know that this person is a member of a very trendy gym, one that prides itself so much on fitness that the various branches host competitions for members to prove themselves. I’m not calling this gym out, I’m just saying that given this person’s trained way of thinking with regard to fitness, and my appearance that day, it is not hard to conclude why that person took a sneaky picture of me.

I’m fat.

As a fat person, I’m allowed to say that. It’s not the worst thing someone can be, so I’m okay with saying it. It’s just a descriptor, it’s not my identity. But when that’s all someone bothers to notice about you, especially as a woman, it hurts. You can’t tell by the picture that person took that I love my family and friends, that I’m a beast with a glue gun, that I can quote every episode of Friends, that I’m freaking funny and flippin’ awesome. That picture doesn’t show my dedication, my creativity, my desire to help other people. It doesn’t show the rivers of tears I’ve cried over pants that stop fitting, the number of doctors I’ve met with to find a cure, or at least a STOP. It doesn’t show the fear I have when I approach a folding chair, an amusement park ride, or when I pass someone leaving a restaurant. It doesn’t show the internal battle being waged by my hormones, how my body is turning against me, how I have no control and no end in sight to this horrible, horrible disease. But you know what it does show, that image of my outsides? It shows the insides of the person who took it.   

As a photographer, I can assure you that this person was within their legal rights to take my picture. Once you attend a public event, you lose what is called a reasonable expectation of privacy. As a human, I want to shout that they had NO right. I am a mother, a wife, a friend… not a punchline. I may not meet that person’s standards of beauty, but then again, I’m not trying to. I can call that person rude, judgemental, callous, a butthead… I can say whatever I want, but it doesn’t take away the shame. Again, I wanted to scream, “I didn’t do this to myself!” I don’t owe that person an explanation, but I was so humiliated that I felt the need to justify my measurements. Instead, I just hung my head. My worst fear, that a stranger was internally laughing at my appearance, had just played out in front of me. Me, the strong-willed, opinionated, loud, energetic force of nature, had been reduced to a lump of indignity. My friends and husband also gave me the obligatory accolades, but the facts that I’m caring, sweet, thoughtful, funny, or made of concentrated awesomesauce don’t show up in sneaky, malicious cell phone pictures. It hurt. Bad. It still hurts. Writing this has helped some, given me a sense of control over how I will react to it. Like I said, it says as much about the person who took that photo as it does about the way I look. But beyond a personal victory, I needed to share this so to offer my perspective, the person on the other side, the person who is likely in someone’s newsfeed with a crude caption.

Please consider this side the next time you do the same. People of Walmart can be hilarious and mind-boggling, and you KNOW there are people who dress that way intentionally in the hopes of a POW appearance (or the $50 gift card), but what about the innocent ones? The people who don’t have any fashion sense, the people who say “Screw it, it’s Walmart and I need toilet paper!”, the people who don’t have the money for nice clothes, or even a home to hang them in? What about the people who don’t have the mental capacity to arrange a Milan-worthy look, the people you see wearing holey clothes, too-tight clothes, too-short clothes, too-dirty clothes, too-ugly clothes, too-old clothes… what if those are all the clothes they have? Can you imagine how they would feel to see their photo on a website devoted to judging peoples’ appearance, to read the comments of strangers about how they look, when no one knows their circumstances? I myself am guilty of taking a sneaky photo of a cashier who was dressed exactly like Blanche from Golden Girls. But now I ask myself, “Why?” Why did I need the picture? Why was it my place to secretly tease this woman? And what pain and embarrassment might she have felt, what insecurities might I have unearthed if she’d noticed? When did our desire to judge and tease become greater than someone else’s right to dignity? If I am fearfully and wonderfully made (Psalm 139:14), if I was knit together in my mother’s womb (Psalm 139:13), if I am God’s MASTERPIECE (Ephesians 2:10), then so are you, so is Blanche, so are we all. Taking pictures and laughing isn’t going to change that person’s life for the better. And it certainly won’t make you a better person. So please, stop.