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Medical weight bias discussed in Prevention

There's an article on medical weight bias in July's Prevention Magazine. When Your Doctor Makes You Feel Fat, subtitled "Overweight women are often given a biased diagnosis because of appearance. Here's how to make sure you get the health care--and respect--you deserve."

This article features interviews with a number of women who have experienced weight-based discrimination from medical professionals. However, in spite of the title, the advice it offers is pretty sparse. It suggests calmly discussing the discriminatory behavior with the doctor or nurse, and if they react badly, switching to a different provider.

The article acknowledges that as long as society holds fat people in low regard, so will doctors. Of course, the weight based paradigm in that's fashionable in the medical community - and in magazines like Prevention - almost guarantees that doctors will try to link every health concern to weight, often failing to properly diagnose and treat fat people's health problems.

The New York Times scores a knockout | ASDAH's new HAES Blog

vesta44's picture
vesta44
June 13th, 2011 | Link | Like switching providers is

Like switching providers is so easy. First, there's the matter of finding another provider who will accept your insurance (if you have insurance), then there's the problem of finding a provider who isn't fat-phobic. I fired my doctor 6 months ago, and I'm still looking for a new one. In the meantime, I refuse to go back to see her, so when I have a medical problem, I have to call the clinic where all of my medical records are, tell them I need to see a doctor, what the problem is, and that I don't want to see Dr W.
So it's not just as easy as "switching to another provider" - their privilege is showing, big time.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

GenXer's picture
GenXer
June 13th, 2011 | Link | Re: Medical weight bias discussed in Prevention

I also had a doctor (female) several years ago who said that she wasn't able to "properly" feel my organs because of the fat. She would also get this disgusted look on her face when she touched me. It felt very degrading.

I'm very lucky now to have a fantastic physician who never mentions my weight. She only talks about symptoms, test results, whatever. She is caring and compassionate. It makes such a difference.

GenXer

greywolf June 20th, 2011 | Link | Erin, watch it. You're

Erin, your message reads awfully close to being just like those doctors who refuse to see people instead of their fat. WTH do you mean that a "particular complaint [is probably] caused by one of those two factors"? I truly hope you did not mean this message in the way it seems.

DeeLeigh's picture
DeeLeigh
June 21st, 2011 | Link | I was thinking the same

I was thinking the same thing, hoping maybe I was misreading it, because it didn't make any sense.

Erin, do you really think that most health problems can be cured by weight loss or smoking succession? If that were true, then you'd rarely see thin, nonsmokers at the doctor's office, and I haven't noticed them being underrepresented. Additionally, very few people can keep weight off for more than a few years, so trying to cure medical problems with weight loss is would be pretty pointless even if it worked.

richie79's picture
richie79
June 21st, 2011 | Link | Correct me if I'm wrong, but

Correct me if I'm wrong, but I read Erin's comment as sarcastic / ironic commentary on the medical profession's misplaced obsession with lifestyle behaviours and the false assumption on their part (probably picked up in med school) that weight loss and smoking cessation can cure any given condition. I certainly didn't interpret it as *endorsing* that approach.

"What is right is not always popular and what is popular is not always right" - Albert Einstein

strawberry June 21st, 2011 | Link | It looked like sarcasm to

It looked like sarcasm to me, too. On the internet, there's always been the problem of conveying sarcasm to relative strangers without figuratively holding up cue cards.
It's the written equivalent of "Yeah, right" = Hell No. The last couple of sentences should be a giveaway for Erin's sense of disgust with this cavalier attitude.

chondros June 21st, 2011 | Link | I thought the "you see" in

I thought the "you see" in the second sentence was a dead giveaway for sarcasm.

DeeLeigh's picture
DeeLeigh
June 22nd, 2011 | Link | Yeah, you're right.

Yeah, you're right. Sometimes it's hard to gauge sarcasm on the web.

Alyssa June 22nd, 2011 | Link | Excellent Article

This is an excellent article. I have experienced much of this type of discrimination. The author doesn't mention a couple of things however: time and money. Because so many health cservices providers are fat-haters, it has meant that I usually have had to see several before getting a correct diagnosis and correct treatment. A specific example is my experience with sciatica. I had to go to FOUR orthopedic specialists before I got a correct diagnosis. Fortunately, I have insurance that does not require a copay for specialist office visits, but many do not and it becomes a financial burden pay quadruple the amount a non-fat patient pays. In addition, it took a great deal of time to schedule appointments. Usually, it took 6 to 8 weeks to get an appointment, then time to schedule tests, MRI's, etc. Not all mentioned weight as an excuse for their misdiagnosis, but I would venture even unspoken it was the reason. Then once diagnosed, getting appropriate treatment was next to impossible. Physical therapists often carry the same prejudice. When PT was of limited value, doctors refused to prescribe appropriate pain medication, and when I asked for it, they responded as though I were a drug addict--the goal was to shame and silence me and make me go away. I even went to a pain specialist who indicated the pain was all due to my weight and demanded to know when I was going to lose weight. Today I continue to live in pain, and it has a definite impact on my quality of life. Eventually, as the author noted, many fat patients give up and stop seeking health services.

vesta44's picture
vesta44
June 28th, 2011 | Link | I just got a letter from our

I just got a letter from our local clinic, where my ex-doctor practices, wanting patients' stories of their health care at the clinic and how satisfied they were with it. There was a form to fill out and return and if there wasn't enough space, you could attach additional sheets with what you had to say. I told them they didn't want to publish my story, that I wasn't happy at all with the care I received from Dr W and that I wouldn't be back to see her ever again because of her fat-phobia and that they really needed to educate their doctors on how to relate to and treat fat patients. I also told them I had fired Dr W, why I had fired her, that I had sent her a letter in November of 2010 telling her she was fired and why, that I hadn't heard anything from her in return, and attached a copy of the letter I sent her. I sent that satisfaction form back to the clinic a month ago, and I haven't heard jack shit from them about anything I had to say. I wasn't nasty, I didn't swear, I was polite, but they could probably tell I wasn't a happy camper.
This tells me that my concerns as a fat patient don't mean shit to them and neither do I. And they wonder why fat people don't go to see doctors until their conditions are so bad? This is why. I quit seeing Dr W because all she would recommend for my pain was the Nightmare on ELMM Street (been there done that, it doesn't work). She wouldn't give me a referral to a rheumatologist for my fibromyalgia, using the excuse that there's a 6-month wait. So I'll wait for 6 months to see one, at least I'll get to see one and maybe get some help. Without a referral, I'll be in pain forever because Dr W sure as hell isn't going to prescribe anything stronger than relafen and Cymbalta for pain (and neither of them even begin to touch the pain I have on a daily basis). She wouldn't even prescribe Celebrex for my arthritis because I'm fat and it would give me a heart attack (even though my heart is just fine and I don't have high blood pressure unless she pisses me off, which she does every time I see her). I had to see my orthopedic doc for the Celebrex, and he didn't have a problem with it at all, and didn't understand why Dr W did. I asked her for a referral to a pain clinic and she said "What for? Unless you lose some of that weight, you're never going to get rid of the pain." But will she look past my fat for any other reason for the pain I have? No, it's all caused by being fat, even though I was in pain when I was thinner. She thinks it's all calories in/out and that diets work, and even though I've told her I can lose all the weight she wants me to, I just can't keep it off, that doesn't seem to matter to her. She thinks short-term weight loss is fine and that it doesn't have to be permanent, that I can do the diet yo-yo forever and it's not going to fuck my health 7 ways to Sunday (yeah, like it hasn't already...../sarcasm). And that's why she's no longer my doctor and I probably won't be seeing another doctor unless I'm so sick that my husband forces me to see one.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

Alyssa July 9th, 2011 | Link | Fibromyalgia

Vesta,
I can relate to everything you wrote. As a point of fact, no medical research indicates that fibromyalgia is related to fatness ("obesity" in med terms). I have fibromyalgia myself. (I know that it probably disappoints the fat-hating physcians out there that pain and other symptoms associated with fibro can't be blamed on fat.) Because of that, her refusal to give you a referral to a rheumatologist or other specialist in fibro is inappropriate. You might want to consider seeing another primary care physcian and asking for a referral. If he/she refuses, appeal the refusal to your health insurance. The appeal process may take a lot of time and patience, but if it results in your getting appropriate treamtent for your fibro, it will likely improve your quality of life.

vesta44's picture
vesta44
July 9th, 2011 | Link | Alyssa - I've been thinking

Alyssa - I've been thinking about seeing the physician's assistant I saw when I had strep throat last winter, and asking her for a referral to a rheumatologist and a pain clinic. She should be able to do that for me, and she didn't seem to be fat-phobic (but then again, I wasn't asking about anything to do with back or knee pain or my fibromyalgia, I was there to see her about a sore throat so bad I couldn't eat or even drink anything). Hopefully, she will do that for me.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

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