542 posts tagged doctors
Thin Privilege is having doctors not assume you over eat.
In the past month I’ve started to try and lose weight. I gained a lot of weight during college and I was wondering why I wasn’t losing weight when I decided to eat less.
The first doctor I talked to just assumed I was eating over 2500 calories a day. When I told her I usually only ate once or twice a day and that would usually add up to around 1100 and that recently I had dropped that down to eat no more than 700 calories a day she did not believe me until after I walked her through everything I would eat in a given day, even though I told her I was counting my calories.
Still lecturing me on how unhealthy I was eating (as if I didn’t make it obvious I realized that) she then asked me questions that led to find out that the reason for my weight gain was more than likely related to my depression (which causes you to have too much of a hormone called Cortisol which causes you to gain weight and makes losing weight very difficult and also causes inadequate amounts of sleep which also affect the metabolism)
Thin Privilege is assuming that Depression only causes weight gain because it makes you “over eat” when you’re stressed. Which is what I, and most other people I know, thought was why people associate depression with weight gain, which led me to believe there was no way my depression was causing me to gain weight.
Eventually I found out that I also have Hypothyroidism which causes weight gain and makes losing weight difficult as well. Hypothyroidism also causes depression in some people as well.
Thin Privilege is not having your family assume that you gained over 30 pounds in college because “you let yourself go” when in fact you gained so much weight because you had a medical disorder which caused you to gain weight along with making your depression significantly worse which also caused you to gain even more weight, all while taking in fewer than 1100 calories a day.
Thin Privilege is not having a doctor ask you about basic hygiene.
If you go to the doctors while clean and freshly showered there would be no reason for them to ask you- “You’re cleaning under your arms right?” Or if a dude “You’re making sure to get in there and clean your foreskin folds, right?”
And yet last time I went to the doctor for a physical for work despite everything coming back healthy and me not having any complaints not only was I reminded they have nutritional counseling (and casually recommended weight watchers) but then was asked if I was making sure I was cleaning under my fat.
I was embarrassed and ashamed that I even had a roll of fat so I quickly told her I did and was…and tried to forget the experience.
Now though, months later, why would she assume I wouldn’t be cleaning myself? And wait a minute if all my results are saying I’m healthy…why do I need nutritional counseling or weight watchers anyway?!
Along the lines of thin privilege/fat discrimination in fiction, there’s the German movie The Hairdresser. Off the top of my head, some examples are:
Kathi gets a job through an employment service with a salon. When she arrives there, though, the manager/owner gives her this look of disgust and flat-out tells her, “We are an aesthetic business, and you are not aesthetic.”
Kathi and her thin friend are at a bar. The bartender takes the thin friend’s drink order, and assumes Kathi will order a Diet Coke. Then, a fat man Kathi met earlier in the movie appears, and when she finds a way to duck out with her thin friend, the thin friend tells Kathi, “What? He’s cute!” Kathi then tells her friend, “You take him, then. I don’t have to date fat men just because I’m fat.”
At the hospital, they’re trying to give Kathi an MRI. When she tries to explain she’s claustrophobic, the doctor and nurse tell her there’s another option, but not to feel discriminated against. She ends up being taken, on a forklift, to a veterinary MRI.
Netflix classifies this as a comedy. After watching it, I couldn’t figure out why (unless German humor is very different from American) as there wasn’t much funny about it.
I am a thin woman so I don’t usually notice fat phobia and discrimination. However, I couldn’t help being outraged at this poster at the doctor’s office.
TW: eating disorders
Thin privilege means when I lose weight during a relapse with my eating disorder, everybody truly believes that I am struggling.
Thin privilege means getting adequate treatment for my disorder because when I lose a little bit of weight from my normal weight, it puts me in the underweight/lower end of normal.
Thin privilege means being encouraged to eat and to stop exercising and purging rather than being encouraged to continue if it helps me lose weight.
Thin privilege means having my pain recognized and having help extended to me when I am killing myself instead of getting laughed at, ignored, or told I can’t possibly be dying because I’m fat.
I’ve struggled with my weight for my whole life. Looking back, everyone treated me like a monster, even my parents.
My mom would take me to tons of nutritionists every week. They gave me this boring tables with the same food to eat. I was tired of it and I was still the fat child. I just liked videogames and I didn’t care about my weight at all. I was not even 10.
At school, the Physical Education teacher would point out my weight all the time and call me lazy.
I got bullied constantly, but that’s not anything new or unexpected, sadly.
A Social Insurance company rejected me for my weight (I was 16). So I sent them a list of laws featured in the Constitution and they had no choice but to accept me… or accept going to a public trial.
My own mother asked a doctor: “Can this be fixed?” When she said the word “this” she pointed at me with sadness and disappointment. I was a “thing”, a terrible monster that had to be hidden or defeated somehow. I felt I made her feel ashamed of me. I was not a person, a child, anymore.
My father would force me to work out every day for at least an hour on some machines he had bought from TV ads. He even left me a “welcome message” on the PC that said: “Instead of being here, you should be working out.” He asked me at lunch the following day if I had heard it and laughed at me. (He was over 200kg/400lbs himself.)
I developed Polycystic ovary syndrome (PCOS) as a teenager but I didn’t get the diagnose until I was 20. Until then, every single doctor would tell me to lose weight, eat healthy and work out. Like that was going to be the solution to everything in my life, right?
An endocrinologyst medicated me for diabetes. I have never had diabetes in my life and he could have triggered a chronic disease.
Another endocrinologyst medicated me for PCOS, but the medication (birth control pills) made me develop a thromboembolism in my right leg a few years after. I was 24 and these things usually happen to people of advanced age. I could have died if it had moved to my lungs, my heart or my brain (it was only a matter of hours).
But, of course, the first thing the doctors thought was that it was caused for my weight. Until they saw my blood tests and told me I can never take birth control pills and/or aspirins again.
I started developing depression, so I went to psychologysts and then also to psychiatrists. They made it all about my weight and not about the abuses and domestic violence I had been through most of my life.
I had several suicide attempts. And, in time, it all got reduced to eating disorders (mostly bulimia and anorexia) and cutting as punishment for eating. I hated myself… As I type this, I can’t believe this actually happened to me and all the things I did to myself…
Psychiatrists wouldn’t ask me about my depression and how I felt… they just asked me to work out and eat healthy so I could lose weight and, I suppose, be happy?
I lost 20kg in a month and then 70kg with more time, but I was terribly sick with my eating disorders. I was in love with them. I thought I was being strong.
Many more suicide attempts later, I left my (then) boyfriend (who didn’t even care about my well-being and touched my bones all the time and laughed). I got away from all the friends I used to have. Not to mention that I had friends for the first time in my life who wouldn’t feel disgusted to touch me, hug me and be seen with me. If something was smelling bad in the room, for the first time I wasn’t an inmediate guilty suspect. I was considered human.
But I didn’t feel like that. I felt like I was just a vessel for their ideas and prejudgements.
I changed my life, generally speaking. I gained some weight back on the way (more like a lot!) but I don’t feel bad at all about myself and I don’t allow anyone to tell me that I’m worth more or less than anything or anyone just because of a number on a scale. I just discard those kinds of people.
About a year ago I went to another endocrynologyst for a check. Before even looking at the tests, she told me that “noone could gain weight if they didn’t eat much” and that I should “stop lying”. When she saw the tests she confirmed what I had already told her: I had been diagnosed with Hashimoto’s many years before.
I went to a new psychiatrist, who was overweight herself, and she told me that there was a lot of medication I didn’t really need (I was taking like 15-20 pills a day by then). So she changed everything and reduced them to about 4 pills a day.
In a few months, I wasn’t medicated at all anymore. And I’ve not been medicated ever since. I haven’t felt depressed or had any desire to die since then. I can’t believe I’m finally saying this, but I’m stable.
For the first time in years, I can honestly say I feel good! I feel healthy!
And yes, I am overweight, but I’m worth so much more than my weight.
If any of these things have also been experienced by you, well, that’s thin privilege. It’s not just about clothes, it’s a whole culture built around weight.
Thank you so much for having this blog! And I also apologize for my English since it’s not my native language.
So, by now most of you have seen the picture of the fat woman with a large piece of wood sticking through her body saying she’s been impaled and the doctor saying she’d feel better if she lost weight, without even looking up from his clipboard. The situation is, of course, absurd, as I don’t know any doctor who would ignore something that obvious and blame it on a person’s weight, but it does draw attention to the fact that a large number of doctors seem to ignore a fat person’s complaints and blame whatever ails them on the fact that they are fat. It’s not just “minor” problems like colds or simple back aches, but it is also more serious health problems, like broken bones, rheumatoid arthritis, and cancer. Fat people can and do die from these mistakes, but there doesn’t seem to be any standardized way of tracking this. Such failure to diagnose constitutes medical malpractice.
Why do people continue to allow this to happen? Part of it is due to the continued belief that “the doctor knows best,” and that people have been raised to not question their doctors recommendations or judgment. Society as a whole has been conditioned to believe that fat is bad and so the idea that a medical condition is due to being fat is entirely believable. Many doctors even believe that they are helping a patient by telling them these things. This is not to say that weight can never be the cause or a contributing factor in a person’s problems. indeed, there are times when a person’s weight has turned out to be the problem even when I have been absolutely certain it was not. But just because something could turn out to be weight-related doesn’t mean that one can ignore all other possibilities.
Perhaps your doctor doesn’t dismiss complaints based on your weight. Perhaps they consider all the factors including a person’s weight and arrive at a correct diagnosis, but they continue to bring up weight in an inappropriate manner. Like when you come in for a cold or influenza. They diagnose you and give you antibiotics and cough medicine, but then they say, “I see your weight is up 5 pounds since your last visit,” or they make jokes about “you’ve been eating everything in sight again, haven’t you?” I can understand commenting on a person’s weight to some extent, since doctors are supposed to practice “preventive medicine,” and the only time they have to see some patients is when they are ill, but there is a proper way to address a person’s dietary/nutritional habits and then there is the “lazy” way, which is to assume they are horrible (and that therefore is why they are fat) and then lecture the patient.
Such behavior only serves to alienate fat patients. In the case of misdiagnosing, it leads to patients not seeking help sooner because they are conditioned to believe that their doctor will just tell them they are fat. Why go to the doctor only to be told what they already know? In the case of comments being made despite proper diagnosis, it causes the patient to feel ashamed and then they avoid going to the doctor in order to avoid the experience of being made to feel ashamed.
So why aren’t more fat people calling their doctors out on this unacceptable behavior? Partly because they are afraid of what their doctors will do or say. Again, this stems from the tendency to assume that all doctors are infallible and “know what’s best.” Or else they are afraid of being labeled a “difficult patient.” In my experience, most of my “difficult patients” are motivated by wanting to get medical care that is in their best interest and have had many experiences where they have been made to feel that their complaints are being ignored. Another reason that fat people don’t call out their doctors is because they’ve been conditioned to believe that their bodies are a burden on others and that they therefore do not have any right to defend them. You do have the right to defend your body, *especially* when its well-being is threatened by an incorrect or missed diagnosis.
It’s time to start calling your doctors out on their fat-shaming and fat-phobic behaviors. When your doctor dismisses a complaint entirely on the basis of your weight, ask them, “what would you do if I wasn’t fat? How would you approach this?” Acknowledge that you realize that your weight *might* be a factor, but that you don’t want to overlook anything else. Give your doctor the chance to do the right thing for you. If your doctor continues to dismiss your complaints then go to another doctor. (I realize that not everyone has that luxury, but if your doctor repeatedly ignores your problems then going to another one might be in your best interest). If you do go to another doctor, *tell your old doctor why you are leaving them.*
If your doctor makes assumptions or makes you feel ashamed or uncomfortable for being fat, or tries to make jokes about your weight, *tell them to stop.* You may need to state why you want them to stop. Explain that you are not doing it to ignore your health but that what they are doing makes you feel uncomfortable and less likely to visit the doctor in the first place. Again, if they continue to do it, then find another doctor.
If more fat people called their doctors out on these shameful practices, then perhaps less doctors would do these things in the first place, and we’ll have less stories about fat people being misdiagnosed to hear about.
Start calling your doctors out on these practices. If your doctor *truly* cares about your health they will listen.
Bringing this back because it’s important.
Thin privilege is not putting off your doctor’s appointment and potentially losing the right to your prescription because you fear it even more if you don’t at least get back to the weight you were the last time you were there due to the inevitable weighing and backlash for your weight.
Don’t know how to put this in the right format, but I think this clip is really relevant. It’s from the movie “Fat Head” by Tom Naughton.
Adam Baldwin makes an anti gay marriage tweet, Nick Searcy white knights in to defend his meal ticket.
Someone who is overweight says something, and immediately Nick flies into a several hour anti fat rant.
Despite this thinly veiled homophobia, blatant fatphobia, and peripheral racism, he constantly (and I mean constantly) plays the black best friend card in the form that he adopted a black teen. He mentions this almost every 4th rapid fire tweet like he has an unlimited use get out of jail free card because he is so pure and noble he didn’t even mind that the child he was adopting wasn’t white.
Hopefully this will be a PR disaster for Firefly, and Justified.
Hi, I know I always write things that others have already said, but it still feels good to get it off my chest. I would appreciate this being anonymous if you do post it.
UGH today on NPR I was listening to “The People’s Pharmacy.” It usually is a pretty good show, but today was definitely the worst I have heard in awhile. They were talking about the fact that the third biggest killer in America is actually medical mistakes. Heart attacks are number one and cancer is number two. Of course, I immediately thought of all of the studies I have seen that show that the medical profession is biased against fat people and of all of the stories I have heard about fat people not getting proper medical treatment because of those biases. Unfortunately, the high number of deaths due to medical mistakes just didn’t even surprise me because I know that some people, specifically fat people, are never treated with the respect they deserve in order to get the care they need. I was also thinking about how many fat people never go to the doctor because they are terrified of being shamed and if that should count in this category of “deaths die to medical mistakes.” On the program they brought on an associate of surgery at Johns Hopkins U. to talk about why “1 in 4 patients” are affected by these mistakes in hospitals. He immediately began rambling about how many deaths in this country are completely preventable and started right in on “obesity related deaths.” He talked about how the medical system we have in America isn’t prepared for the massive number of deaths that are coming in the future due to obesity. (Can we say fear tactic much?!) It was pretty ridiculous how he completely changed the subject from how hospitals are making mistakes to basically fat people are doing this to themselves. He also openly admitted to the fact that he doesn’t always wash his hands when he sees patients and cited that doctors not washing hands is a problem in the field, but he said all of this while chuckling like it wasn’t even an important issue. Maybe if this guy and other asshole doctors like himself would be more willing to actually analyze their own mistakes then they wouldn’t be responsible for such negligence in the first place! They need to try listening to their patients before judging them and GETTING IT WRONG.
Mod note: This post was originally posted non-anonymously by accident. I apologize, I was traveling and didn’t see the mistake until now. Thanks from a loyal follower and fellow activist for pointing it out! -ATL
TW: fat shaming, medical fat shaming, talk of medical procedure
I was reading about doctors and surgeon perspectives of fat people, there’s a common thread aside from the ol’ fat people eat too much and it’s their fault talk, that it’s hard to work on fat patients. Instead of saying “Why don’t we innovate and meet the challenge of operating on fat patients?” it’s “Why won’t they just put down the fork?!”
If surgeons want operating on fat people to be easier, they should and can devote research to that instead of complaining like teenage trolls on the net that their job is hard. Yeah being a surgeon is hard, you knew that when you signed up to become one. There are retractors out there that hold skin deep and open. The technology is available.
I don’t understand where the connection between “I want to help and care for all patients.” and “Fat people are hhhaaarrrddd to do surgery on!” I can appreciate frustration, but blaming patients for not making your job easier for you? Why be a surgeon if you can’t face a challenge without a post-op hissy fit? Is it the money?
I can’t understand how you can call yourself a good caring surgeon, while singling out fat people for not being convenient to you. This isn’t meant to be insulting, I honestly don’t know how it isn’t egregiously immoral to scapegoat fat people for your job being a challenge as a surgeon. I’m not saying never complain ever, but at least you can try to not contribute to fat bias in healthcare. Something has to change, and in case it hasn’t been clear shaming fat people has failed to make them thinner. You can choose to rise to the challenge, make medicine better for everyone.
I wanted to first say how much I appreciate your blog, since I’ve been made to feel ashamed of my body my whole life.
This example is one of the worst parts of my life, and I’ve never told anybody before. I’m 5’7 and a US 18/20 - I could learn to be comfortable with this if it wasn’t for my breasts. I’m severely asymmetrical (one side is an F, the other a C/D), and I finally plucked up the courage to go to my doctor with this problem, which was affecting my self-esteem. Without even examining me, she told me that no surgeon would touch me until my BMI was acceptable. Never mind that a male doctor (in fair shape and not that old) once told me that my blood pressure was lower than his.
I can’t wear what I would like to because I feel so uncomfortable (my doctor made it clear that it was noticeable from the other side of a desk), and I can’t even consider finding a romantic partner. If I was thin, I could claim that breast implants would help my self-esteem and I’d be granted them, whether it looked like I needed them or not. But I’m not thin, I’m fat, and I’ll probably be asymmetrical my entire life because of it - unless I conform to the stereotypical ideal.
Med student here, I noticed earlier someone posted the question regarding an article on webmd with the above headline. Several online media sources seem to have picked up this up too, all with similar headlines. I took a peak at the original article when a friend posted about it on facebook, and wanted to submit my response to him here.
that number was derived from “vigorous activity” data calculated from a reported hours/d, lazily multiplying by 365 gets 1.095 h/y. Overweight women calculates to about 3.65 h/y, and “normal weight” (problematic to include all BMI’s under threshold for overweight as normal) is at 10.95 h/y. Less shocking, and I can’t find anywhere else in the article it could have come from.
The numbers for moderate and light activity per year for obese, overweight, and normal weight women respectively are about 84, 110, and 128; 2139, 2139, 2186. I dno, I think given the stigma and other challenges of exercise while overweight should be considered as well.
Several of the articles online using this headline will include the words “vigorous activity” in the text, but many also make snide remarks along the lines of “hardly break a sweat for an hour a year” and so on.
Shout out to the Mod’s original response too! Turns out there is an article, but really bad media coverage of it. Of course, the many biomedical/physician biases regarding weight and fat people in particular still need to be addressed.
Addendum: thin privilege is not having an academic medical article be sensationally covered by the media to perpetuate stereotypes.
Thanks for submitting. I was talking to someone else about this today. They also only measured activity for 10 hours a day for 4 days. According to the study “normal” weight individuals only worked out vigorously 11 hours per year. So I’m gonna call bullshit on anyone trying to say those 10 hours are the difference between being fat and thin. Also just to note, the amount of sedentary time was no different across the weight categories.
This article is just a really good example of how the media sensationalizes and cherry picks what they want to report about. They should not only be talking about stigma but the fact that fat people are more likely to live in poverty, lack access to places to move their bodies or the time to be active in general.
It is also important to note that the researcher who was quoted in the article clearly knew what kind of attention his statement would get, particularly when he knows damn well that the level of sedentary time was the same.
thin privilege is not fearing that a therapist you visit because of your eating disorder will tell you to lose weight.
thin privilege is not fearing a therapist might think you losing weight is more important or just as important as you achieving good mental health and/or healthy eating habits.
thin privilege is getting your mental health problems taken seriously.
[i know that many people with disordered eating think they are (too) fat even if they are underweight and probably fear this too, but i’m pretty sure that the chance this would really happen to a thin person is very small if not nonexistent.]