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. Lizzo has become a punch line as much as an icon 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.