My Joints, My Fat, and Me

Ragen Chastain 5’4, 284lbs. Trained by Kate Wodash. Fun fact – that thing that my right foot is on slides. I’m not only having to balance but also having to keep it from sliding too far in either direction.

One of the things that I often see stated as irrefutably “caused” by obesity is joint problems.  This sometimes goes with the oft-repeated claim that the human body “wasn’t meant to carry [insert completely arbitrary number of] pounds”.  It also goes hand in hand with the VFHT (Vague Future Health Threat) in this case taking advantage of the fact that bodies break down over time to say that if my joints do that, it will be because of my fat and not for the reason that thin people’s joints break down.

There have been a few times in my life, at various weights, when I’ve had knee pain.  When I was thinner doctors looked at things like muscle imbalances and tightness, gait, and sure enough that was the (solvable) problem.

When I had knee problems a few years ago the only explanation offered to me by doctors was that I needed to lose weight.  Because I had the luxury of knowing how they treat these issues with smaller people, I asked the doctor if people who weren’t fat had knee problems.  After some pushing he admitted that they do.  So I said that I wanted to be treated like they treat thin people.  I was told that there was no point in treating any muscle issues until I lost weight.  What with the who now?  So I left the doctor’s office and I started working with a massage therapist and when we cleared up the tightness in my quads the knee pain disappeared.  Losing weight would have done NOTHING to help the actual issue – I would have had knee pain in a smaller body.  Later I started working with Kate Wodash at The Mindful Body Center in Austin and I learned to correct my movement patterns to avoid the muscle issues that caused the knee pain.  Yesterday I did 75 full squat jumps (where you do a full squat, hand flat on the floor and jump up explosively, then repeat). Knees feel great.  Still 5’4, almost 300 pounds.  Still have more fat and also more lean body mass than most people.

In general I think that a diagnosis of “fat” is just lazy medicine.  Anytime someone tells you that weight loss is the “solution” to your problem, I would suggest that you ask if thin people have the problem that you do.  If they do, then ask how they are treated.  Every weight loss method ever tested scientifically has a success rate of 5% or less, so prescribing weight loss as if it’s a solution that works isn’t just lazy, it’s also medically unethical without a disclaimer explaining that it’s unsuccessful 95% of the time and also that they have no idea whether or not it will solve the issue, because they have no idea if it caused the issue. So if you are dealing with joint pain, and even if you are choosing to attempt weight loss as a solution, I highly suggest looking into other options that might make you feel better on the way.  It may be that you need to strengthen the supporting muscles, or that your movement patterns have lead to imbalance and so you need to stretch the supporting muscles.  Maybe a bit of both.  Regardless, when joint pain is the problem, weight loss is not the only solution.

Related to this is a video that I’ve been meaning to share here for a while.  Revtristy does Olympic Style Weight Lifting and put together a video called “Strong Fat Lady” that is amazing:

Published in: on July 18, 2011 at 7:15 am  Comments (59)  

59 CommentsLeave a comment

  1. I was repeatedly told to lose weight to fix my gastric reflux disease, which ruined my singing voice by sending acid spraying over the vocal folds. I lost a huge amount of weight. I still have gastric reflux disease.

    On the other hand, I do have to admit that my joints are in bad shape, and did get a lot better after I lost weight.

  2. 75 squat jumps?! Daaang, yo! I’m getting exhausted just thinking about it.

    I was also told to lose weight to treat a knee problem. I did eventually lose a ton of weight (which I gained back–another story), and not surprisingly, the knee still bothered me. It turns out that I have a genetic abnormality in my knees and it’s compounded by my feet overpronating, and what helped me was physical therapy. My brother, who is in the Army and in fantastic shape, now has the same problem.

    Needless to say, I don’t see that doctor anymore.

  3. I am reading an edited book on management of my disability, and it seems that every third contributor recommends weight loss. Only one so far has acknowledged that weight loss might be “difficult”. My heart breaks for the people who consult these specialists in their offices and leave without real solutions because they are fat.

  4. Ugh… I had this issue with foot pain a few years ago. My doctor insisted it was only because of my weight and if I lost weight, it would go away. It seems so dismissive… and like you said, it’s lazy medicine. It’s “let’s not bother to find the true cause of the pain simply because this person is fat and therefore that is the reason for her *insert problem here.*”

  5. I agree with Cindy. My aunt, who is “normal” weight, developed neuromas in her foot after a nasty fracture, which caused her to have a great deal of trouble with walking for about a year and a half. She was able to work intensely with a physical therapist to learn some techniques to minimize the pain when she walked. Imagine if she’d been fat. Her insurance may not have agreed to pay for the treatment because if she’d “just lost weight,” they might have reasoned it would go away.

  6. I am so thankful for massage therapy!!!!
    I Broke my collar bone in college years ago and was told that because I was fat there was nothing that could be done to help it heal properly.
    Later I discovered that they have little to no treatment for a broken collar bone regardless of size.
    The collar bone was giving me much pain in both warm and cold weather making it difficult to use my shoulder. Until I saw a massage therapist. He found the issue right away and dug right in! It was amazing! The pain disapeared completely and hasn’t come back!

  7. Wow, that was awesome!!!

    I love that she is just going for it with the heavy weights and blasting through that “women can’t lift heavy weights or they’ll be bulky” ceiling. The fact that it’s about getting stronger and going for personal best rather than focusing on other results is good too :)

  8. I can’t believe how much doctors get paid to tell people to lose weight. I actually had a doctor write me a script for Weight Watchers. She said weight loss would cure my acne. I was there to get help with PCOS, which I suspected I had, but nah, I’m just fat. *sigh*

  9. I’m so glad to read this. When I started running, one of the things that people always said dismissively was “You’re going to destroy your knees, you’re too fat.” So far my knees are fine! I’ve experienced some pain (feet, calves) but the great part is that it subsided as my muscles got stronger. And, like you, I’ve learned that oftentimes pain means I need to stretch or something’s out of whack.

    It’s amazing what our bodies can do!

  10. Thank you! This inspires me to get my bad knee looked at. To be fair, I know that the knee pain started after I injured my ankle and I guessed that the way I modified my walking was causing the knee problem (also tightness and soreness in the top of the foot with the ankle injury) but I’ve always been sure that a doctor would just tell me it was my weight (5’7″ and 270lbs -ish). I’ll definitely use your argument and demand to have my knee looked at the same way they would if I was thin.

  11. I’ve had excruciatingly painful periods since I was 14. However, I was only diagnosed a couple of years ago at age 28. There were multiple reasons for the delay, but into my adulthood, one of them was definitely body size. I’d need an extra set of hands to count the number of providers who told me that it was probably weight-related and that I needed to lose [insert varying number] pounds before they’d consider further treatment.

    Um, weight-related? When I’ve been experiencing the same symptoms since I was 95 pounds? Does not compute for me.

  12. Weight and doctors is a sore point for me. I put on forty pounds over the course of four years, and the only comment my doctors had for me in that time was that I should watch what I ate and exercise more – basically flatly disbelieving my reported statements of my diet and exercise. There’s nothing like getting an automated message telling you to exercise more when you’re training for a triathlon and putting in 15+ hours a week already!

    Fortunately for me, my Dad is a neurologist, and when my hand size started going up, he stuffed me in an MRI. I had a pituitary tumor playing fun and games with my endocrine system. Interestingly I get much better treatment from doctors now, because I have the medical records to prove I’m a “good” fatty. Suddenly I’m believed when I report my diet and exercise levels, and get treated based on actual symptoms and test results.

    • That reminds me of the episode from season 1 of House, where Dr. Chase didn’t want to treat a fat girl. SPOILER ALERT turned out she had a tumor on her pituitary. The ending was warm and fuzzy with the girl showing up for a check-up months later nice and skinny. Great episode until the FAIL of an ending (hey kids, you’ll only be happy and the cute Austrailian doctor will only like you if you’re thin!)

      • That show has done a few things that ticked me off BUT, I do recall reading of another episode where a woman was having a bunch of issues and they finally attributed it to her WLS. Her diet prior to the surgery was keeping her condition at bay but because she had to change her diet due to the surgery, it caused all of these issues and House told her to get the surgery reversed or she would have to be on medication for life. She wouldn’t do it. She’d rather have the medication because she was finally thin. I can’t remember if it was Junkfood Science that talked about this episode or someone else. But anyway, some of the other House episodes ticked me off to where I couldn’t watch it anymore. I hate when shows are used to make judgements about the medical decisions parents make. I’ve stopped watching a number of shows because of it.

      • That sounds like an interesting episode. I’m surprised I still like the show, frankly. I do hate how they address anti-depressants. They’re not going to work in 3-6 hours. Try 3-6 MONTHS.

        Also, I think the website you’re thinking of is Polite Dissent. It’s a doctor reviewing the episodes for medical accuracy, as well as drama.

      • Yeah, that episode with the woman who had WLS was discussed on junkfoodscience. It sounds like an interesting episode. Here is the link: junkfoodscience.blogspot.com/2008/12/chocolate-cake-and-important-message.html

      • Oh, how I loathed that episode of House. It really ruined my enthusiasm for the show and I loathed Chase (beforehand, I was indifferent.) And then on other storyline on that episode was a caricatured version I’,m sure the writers thought a fat lady with high self esteem would be like—obnoxious, and foolish with choices revolved around her body. THAT had me especially froth at the mouth.

  13. I’m just a pathology undergrad, but I know quite a bit about physiology and degenerative skeletal damage. Being fat in and of itself will not break down joints at some alarming rate, at least no more than a laborer who carries bricks, or a person who wears a very heavy backpack constantly.

    Being extremely heavy does cause extra stress on the joints, and so if one is at risk for joint problems extra would would be a bad idea. Also, the wear that comes with aging will be obviously accelerated, as there’s just more wear happening in general. Bone density scans are a good way to see how one’s own skeleton is doing. A healthy, 280 lb football player with 15% body fat is putting a lot of weight on his bones, but see the trick here is to be healthy as well as heavy. As you know, fat people can be extremely healthy.

    Joint pain from obesity is really only something that becomes a problem in the extremely obese (to the point where general mobility is heavily impaired) or in an aging individual. Being 300 pounds with dense, healthy bones is fine, but as one approaches 50, 60, 70+ it can become a real health issue as osteoporosis speeds up, depending on genetics/environment.

    A good case study:
    My boyfriend’s mother is extremely obese and because of it she’s had terrible joint/foot problems. Though the real root cause was breaking her foot/ankle in Mexico years ago. She didn’t rest it adequately and so it healed in a slightly unstable position, so her heavy frame is stressing her feet/ankles to the point where she’s needed multiple surgeries. This is something that wouldn’t have happened if she were so fat, but then again, it also wouldn’t have happened if she’d just gone to the doctor and gotten a cast like a normal person.

  14. A friend of my Mom’s tried to get treatment for back pain. She went back to her doctor again and again, and was told she would be fine if she lost weight. She lost weight and the pain kept getting worse. By the time they diagnosed the bone cancer in her spine, it was too late to do anything but keep her comfortable until she died.

    • Sadly, the cancer probably helped with the weight loss. Things like that should be seen as gross neglect. Someone should come up with a paper that doctors sign saying that you can sue them if they fail to diagnose something that’s life threatening because they focused so much on the weight.

    • That is deplorable. These so called medical professionals should be stripped of their licenses.

  15. I’ve been living with back pain for close to 5 years now. I refuse to see a doctor because I’m unwilling to fight with them that it’s not weight related. I’ve worked with my massage therapist and my personal trainer to strengthen the muscles in my core to support my back and to learn stretches to ease the pain.

    I don’t know. I should probably be an adult and get it checked.

    • What part of your back? I’ve had lots of back pain due to my sport of choice (hammer throwing). However, believe it or not, no one’s ever judged me for my weight when it came to back pain (I’ve had lower back strains and herniated discs in my cervical spine). I think that because they know the intensity of the sport I did, that it makes sense I’d have such a screwed up back. That doesn’t mean I don’t shake with nervousness every time I see a doctor for back pain, worried they’ll weigh me. I’ve NEVER been weighed prior to getting treated for back pain.

      Good luck! I hope you do get it checked, if it’s a disc issue, it can lead to permanent nerve damage if left untreated. I hope if you get it checked that you have the same quality of care that I had!

      • Kind of unrelated, but a friend of mine on FB just posted that she was told by her doctor that her FOUR YEAR OLD daughter’s BMI was too high.

        I can’t even.

        MissMeaghan, thanks for the info! What’s weird is that I can’t even think of what caused it. It’s not like I was in a car accident or a fall or anything. It’s almost like I just woke up with pain one day. It’s in the middle of my back, it helps to stretch and eases with exercise. However, I can’t walk around stores too long and I can’t sleep lying down anymore.

  16. Here Here on the massage therapy! My husband is a CMT and is fantastic at finding the source of and working with people in pain. Myself included. I wish more people would think of massage as therapeutic and not all of that other junk. I have seen my range of motion improve within 20 minutes! I also wish there wasn’t such a gender bias in the massage world. Ladies: Give the guys a shot! My husband actually trained with larger bodies and is comfortable working with them (and I bought his table so I know it can take as much weight as anyone can dish out). I don’t often comment, but always read and enjoy your blog. Thank you for being you! <3

  17. When I was little (think 10-12), I had a “therapist” prescribe some adult strength anti-depressant because I was too fat and the pills suppressed appetite. At the time, I was on the swim team and weight lifting team, and I had a mother who despised junk food. He didn’t seem to believe my food diary, and so he put me on those pills. He also prescribed that my mom get me a bike (because evidently swimming and weights just aren’t enough). He basically taught me that it didn’t matter what my habits were. It only mattered what the scale said. He did a lot of damage especially in my teen years. I’m writing him an angry letter because looking back he was incredibly irresponsible. I really hate how doctors view “fat.” Though they’re not all bad, I had a wonderful doctor who seemed worried when I was losing too much weight. When I gained it all back she never said a word beyond commenting on my good stats and asking how my swimming was going. We should publicly shame the bad, and laud the good so that we can send people to the doctors who do not look at fat as a diagnosis.

  18. Yes to this! A thousand, million, trillion, gagillion times yes! Not only is it lazy, it’s dangerous. I remember on my last weight loss attempt almost 6 years ago I actually started to gain weight. It wasn’t until I kept a VERY neurotically kept food and exercise diary and had my husband in the office for confirmation that I wasn’t “cheating” on what I wrote down, that it was realized that something could be seriously wrong. I have a wacky body that generally does not work the way most bodies should and my thyroid, which had been underactive, then normally functioning without medication, then underactive again, and now possibly overactive, was playing strange tricks on me…AGAIN. Thankfully the endocrinologist that I went to see was willing to admit that she didn’t have a clue as to what was going on, but that the weight issues were most likely a result of what was going on with me, and not the cause. If I remember correctly I actually broke down crying that she would say that instead of simply blaming my weight. What amazed me was she was a very naturally thin woman. She admitted to being naturally thin and that she couldn’t imagine what it would be like to not be treated properly simply because of something like weight.

  19. A few months ago, I twisted my knee and something inside tore. Went to an orthopeadic surgeon who was so focused on fat-hate that he “forgot” to give me some basic treatment to prevent the development of a blood clot / thrombosis (actually standard medication once you are being given crutches). He even refused to operate me because “that knee of yours if too fat. Somebody younger and more ambitious will need to do this.” A few days later, I was at a hospital with great pain in my leg and was supposed to be operated on my knee. Some lab results were bad and when I pointed out the pain in my leg they shrugged their shoulders and said something about “muscular pain” caused by walking on crutches. As if I had never experienced muscular pain before and they needed to explain the kind of pain to me. Anyway, as lab results were bad they sent me home as surgery was too risky at that time. The next day, I couldn’t stop crying anymore because of the pain and went to see another doc. Surprise! I had developed a thrombosis (two by that time as those ?=”$ hadn’t been able to spot the first one) and the lab works were so bad because of this. The blood clots might as well have killed me had it not been for that last doctor who focused on symptoms rather than giving lectures about weight loss etc.
    It makes me so bitter that chances are I would have gotten proper care had I not been fat.

    • I am so sorry that this happened to you. I hope that you feel better, and if not, that you feel better soon.

      ~Ragen

      • Thanks Ragen, I’m much better now. And you know what? Apart from the occasional bitter feeling, I can now also see the good side of this experience: I learned to no longer take any weight-related BS from doctors (or anyone else) and – more importantly – I don’t blame myself anymore for my weight. And I don’t blame my weight for anything, either.

  20. Kind of unrelated, but a friend of mine on FB just posted that she was told by her doctor that her FOUR YEAR OLD daughter’s BMI was too high.

    I can’t even.

  21. I once had a gyne tell me I had a yeast infection because I was fat. Seriously, dude? Really? This was back in the day before you could get Monistat OTC. He refused to give me any medication, saying once I lost weight it would go away. I wish I were joking. I eventually saw another doc, a nurse-midwife who gave me something straight away, asking why I hadn’t come to see a doctor earlier.

    When I was a younger, the Paed every year would look at my chart and sadly shake his head, saying, “She really needs to lose some weight. Look into signing her up for sports” to which my mother replied, “Really? She rides her bike for two hours after school, roller skates up and down the hill in front of our house, has soccer practice two nights a week, games on the weekends…t-ball in the summer and ice skating in the winter. Which sports would those be??” I never stopped moving as a kid, but all the pictures show I was a chubby girl. There is a definite disconnect there, but I’m sure it will be a looooong time before anyone in the medical field comes out with an official statement about it.

    My mom tells the story of going to see her OB/GYN two months after having me, and instead of saying to her, “Congratulations, Mrs P, on having a healthy, wonderful daughter”, the doc walked in, holding the chart open on his arm, and said scornfully, “Now when are you going to do something about all this extra weight, Mrs P?? It’s about time you lost it, don’t you think??”

    And all I can think of in every one of these instances is the common thread, that it was a male doctor speaking to a female patient. It may not be true in everyone else’s case, but each time a doc has berated me for my size, it has always been a male shaking his finger at me in admonishment, and never a woman. Not wishing to paint everyone with the same brush because that way lies dragons, but…make of it what you will.

    • Well, my last gyn appointment included a female gynecologist trying to give me a lecture on weight with her hand in. my. vagina. I pretty quickly set a boundary but I’ve definitely had my share of women doctors berating me.

      ~Ragen

      • Ugh. Right up there with the male OB at my six month appointment asking me if my breasts have always been large and that I should look into breast reduction WHILE he was doing the breast exam. Never mind that it was my six week post partum check up and that I was breastfeeding.

      • Ditto, Ragen –
        A few years after my hysterectomy, my (female) OB/GYN lectured me on my recent weight gain while giving me my exam. Nekkid as a jaybird & lying on yer back with someone Not.Your.Lover poking about in your vagina …can you get more vulnerable than that? Never asked ME if there was anything going on that I could think of that might explain my weight gain – which was 14 lbs. over the last year — (something like, oh, I don’t know… my partner committing suicide & me being into comfort eating?) No, Dr. just said “You need to eat less, exercise more.” (In her size 2 doctor’s frock.) I, too, set some boundaries — I fired her. But I will say her advice did serve to affect my weight — the comments was hurtful, and I did indulge in some more comfort eating and added another 7 lbs. Still do more walking, cycling, swimming, yard work, dancing and generally living life to the fullest than my two 5’8″ 125 lb. sisters. Oh, that living life to the fullest thing? It includes eating really scrumptious things!

    • It’s been female doctors that have treated me the worst. One told me to go on the South Beach Diet and work out three hours a day and flat out argued with me when I said that I eat a healthy diet and exercise regularly and vigorously. Another told me never to exercise again or I might “run the risk of eating”.

      The male doctor at the urgent care clinic, where I went when my back pain was so bad that I had to leave work and make my brother drive me to the clinic, never made me step on the scale. He x-rayed for fractures and was impressed that I used to throw hammer and acknowledged that it likely contributed to whatever was causing my pain (then he gave me valium, and I went home, got in bed, and sang Christmas carols to myself… it was March). The male orthopedist who treated my most recent back injury, on the other hand, was very nice and weight never came up, and he recognized a) that my past athletic training contributed to my body shape and size and b) my bone structure. When I had tingling and loss of sensation in my arm because of a herniated disc pressing on a nerve in my neck, he said, “I don’t care if you weigh 600 pounds and eat nothing but cheeseburgers. It’s not your heart.” I actually laughed out loud at that, because I think my GP would have told me I’m fatty fat fat and having a heart attack.(obviously with tingling in my left arm he first had to address a heart issue) Then he looked at how wide my shoulders are and said, “I’m putting you in an open MRI, because you have broad shoulders and I think you’d be uncomfortable in a closed MRI.” Not, “you’re too fat we can’t test you.” Maybe it’s because I have a heavy/broad bone structure that he recognized, as a man, why I’m wider in certain areas than most women.

      My female physical therapists were actually wonderful. They don’t care about my weight. They just want me to move and move properly to heal my injury.

    • Now there’s an asinine correlation. Fat = yeast infection. If that were true, half the female population would constantly be walking around scratching our privates! ;-)

  22. [TW for internalized fat hatred]
    Watching the video at the end, I truly realized the extrent to which I’ve been taught to read and encode fat bodies as neither beautiful nor graceful. Watching her work out, I found myself thinking that she didn’t look graceful – then I took a minute to examine that – what would a graceful body look like? And the image that popped up was like a fitness commercial body, and I realized it had nothing to do with actual grace of movement, but just with body size. Sick and sad. More rooting out to do. Thanks for this post.

    • If you want to see a graceful fat woman, go to bigfatblog.com and check out the video “Alexandra Beller dances”, posted in April. The first half of the video is kind of weird, but the last half is a beautiful display of grace, strength, and control. She’s an amazing dancer.

  23. Just to throw my hat in the ring with a bad doctor story: when I was about 29 i went to a dr for an unrelated issue but while there mentioned pain in my feet. He, a young-ish, handsome, slim and well-dressed man, said to me, “My feet would hurt too if I were carrying around a hundred pound backpack.” Bad enough to be told you need to lose 100 lbs., but to hear it this way… bedside manner = Zero.

    • Different problem, same story.
      While at university, I developed an excruciating pain in my lower back. It go so bad that, at one point, I had to stop dead in the middle of the pavement whilst walking with some friends. It took about ten minutes to screw up the willpower to hobble home. After that, I couldn’t get out of bed, sit or stand for more than five minutes without pain (which made the lectures … interesting, to say the least).
      .
      I went to my doctor, who said “You’re fat. Consider that you’re carrying the weight of a bag of cement around with you all day every day.” Those EXACT words. Lose weight and the crippling back pain will go away.
      How exactly? I can’t walk without pain – I’m certainly not going to take up running, I’m living on £10 a week (about $15), and can’t afford to go swimming; but none of this was his problem. You’re fat, now get out of my office and make room for people who are actually sick.
      .
      When term ended, I went to my regular doctor. She sent me to physiotherapy, where they figured out my back muscles were doing the all work of my core muscle group.
      I did eight weeks of pilates at the hospital, bought one of those huge balls instead of a desk chair and went to a private physio for four more weeks (she said I was amazingly flexible for someone of my age, and that probably contributed to the problem).
      I’ve been pain-free for about three years, but my weight is exactly the same as it was when I first went to the doctor.

  24. Thanks for posting this. I’d been wanting to ask you what if anything you did for your knees, but I couldn’t think of a polite way to put it.

    emi11n, thanks for the Junkfood Science link. I had no idea the man who’d invented WLS thinks now that it isn’t such a great idea. Two little known side effects: need for higher doses of antibiotics because less is absorbed (not a problem, I think, if the doctor gets it right, but they may not think of it) and alcoholism– more rapid absorption makes alcohol a much more interesting drug.

  25. I’m 51, and on the far side of 350 lbs, and have been here for years, and my knees DO NOT HURT. Never have, probably never will. (Yes, I call my dad at least once a week and thank him for the Good Genes). My hips are also fine, except for the occassional bout of bursitis. I have had foot pain, even plantar fasciitis once, and several podiatrists have assured me that it has nothing to do with my weight. Same with the back pain. After pulling a muscle back there, at least FOUR physical therapists told me that ‘no matter what your weight, your back Should Not Hurt’. And it doesn’t, as long as I keep up my exercises. So I can only come to the conclusion that most doctors are idiots.

  26. Thanks for another great post! Loved the video and am passing it on. The doctor issues make me think that when my fat friends who have knee problems say it’s because they’re fat, I might introduce the idea that it probably has zero to do with being fat and everything to do with something that can be effectively treated.

  27. I ruined my knees at about age 33 by taking a high-impact aerobics class. This was the mid-80s so the damage done to joints by jumping up and down on them wasn’t well known back then.

    All I know is that I had absolutely no problems with my knees before the class and that a few weeks into the class they started making noise when I crouched, then they started to become painful when I went down stairs, then up stairs, then when I wasn’t doing stairs at all. It didn’t help that I took the class barefoot (I had been used to exercising by doing modern dance). The teacher and the staff (at a gym) didn’t even notice that I wore no footgear – they were young head-in-the-clouds women.

    I went for 20 years having increasing knee pain. I tried injections of rooster-comb to increase the viscosity of the fluid in my knees, doing squats, physical therapy, etc. Then it became clear that I couldn’t going on without surgery. And my search for a surgeon that would work on a 400+ pound woman became heartbreaking.

    I contacted several local knee surgeons and told their staff what I weighed in advance. Only one doctor would even let me make an appointment. I had Xrays in his office, but when he entered the exam room, he didn’t even look at them. He said, and I quote exactly, “I wouldn’t touch you with a ten-foot pole”. He was afraid I’d die of a blood clot on the operating room table and he didn’t want to be associated with that.

    Through the help of a woman who was my virtual twin, I talked to her Mayo Clinic surgeon in Florida who said he believed anyone, 80 or 800 pounds, should have knee replacement surgery if they wanted it. I wished I could go through the phone and kiss him. Since Florida is over 3000 miles away and there was another Mayo Clinic in Phoenix (much closer to me) I asked him for the name of a surgeon in Phoenix who would do my surgery.

    The Phoenix surgeon was a jerk. My husband and I flew down to Phoenix (a mere thousand miles from our home in Portland Oregon) for a consultation. The surgeon tried to talk me into weight loss surgery five times, even though I kept saying I would NEVER consider having it. Eventually he agreed to do my knee replacement and said I should plan on staying six weeks to do my rehab there, where he could watch over me. OK, that made sense.

    He did my surgery (very painful) and I worked hard to get stronger while in the hospital. I did so well in the surgery (no blood clots, no problems) and so well with my physical therapists that I was allowed to go home in two and a half weeks, not the six he expected. Six months later he repaired my other knee and it took him less time in the OR than the first knee. I think he learned more about working on my fat body than he had known before.

    When I asked him if I could refer other fat people to him (since it’s virtually impossible to find a surgeon willing to do knee replacements on fat people), he said, “That wasn’t our agreement”. Asshole. But he did great work.

  28. I developed an osteo-arthritis condition in my feet when I was at my (unnatural, food-obsessed) thinnest. I’ve had achey feet since I was a child and losing weight in my early 20s didn’t help that one bit. Getting my second foot surgery (on the second foot; the doc fixed up my first foot pretty well) on Thursday. Most likely my condition is due to bad foot mechanics or hereditary (bad knees on one side of the family) but sometimes I wonder ruefully if I hadn’t been under-eating for the three years before the diagnosis if perhaps I wouldn’t have had such dramatic deterioration in my toe joints. Of course correlation (of my under-eating) doesn’t mean causation (of my foot problem) so we’ll never know.

    I’ve also been experiencing a rash of friends telling me how their weight is causing their hip/back/knee/whatever problems. I just don’t believe it. I have the same back pain (now manageable through exercise, luckily for me) I’ve had since childhood (and again, it was the worst when I was at my thinnest, most stressed out self…hmmmm) and I know that weight just never made a difference. I encourage them to seek out different treatments, exercise, anything but please don’t accept the old adage that weight causes joint pain. Usually met with the chirping of crickets.

  29. OMG, thank you. Both for smacking me in my face with logic and truth about what is going on in my life (and my knees) and for posting a link to the Mindful Body Center.

  30. I received the worst advice of my life from an orthopedic surgeon “treating” my knee pain. He told me that it was due to my weight and it was soo bad that I should try “not to do too much walking” for fear of making it worse. So lose wieght, but don’t move aorund too much? Several years of my life wasted trying “not to do too much walking” and my knee pain increasing. Recently I figured my knees will hurt anyway, might as well be from exercising and moving around. I’ve also been working with a great naturopathic doctor. Since then, I’ve been able to cut down on my pain medication and have been enjoying myself more than ever and being more active than I have been in years… Bad advice is bad advice, even if it comes from a “professional” who just sees you as a number on a scale.

  31. I hear that one all the time “Your joints must be crumbling with all that weight! You must be in constant pain carrying all that fat!” and variants thereof. I have no joint pain (well, except for a wrist/hand injury from work). My 81 year old Grandma (who is fat) has arthritis, but that’s from being OLD and coming from a long line of arthritis sufferers, not fat.

    I think many people have absolutely no concept of what it’s like to have a fat body. They have convinced themselves that it can only be a life of misery and pain, so when we say otherwise, they insist that we must be “in denial”.

  32. thanks to all “not-main-stream/conventional” body size women and men for loving yourselves sooo much that you are spreading the love to us!!! Thank you for doing this work, being who you are and MOST OF ALL FOR SHARING WITH THE WORLD! I feel so much love AND so empowered.

  33. All my doctor do to me is telling me to have a gastric something (sorry, I dont know the exact english name for that operation but is the operation of getting our stomach smaller…) …Sorry, but three peoples around me had it; two women and a man…The first lady almost die during the operation (all operation are dangerous…so why putting one in that situation just to lose weight?), the other regain a lots a weight and is about to have a third operations just due to the initial operation…cause there are problems with the “ring” or something…The guy got real sick at first…He’s mood were change…From a funny fat guy, He went to a frustrated really thin guy…Now that the weight is comming back, he find back is smile! When you lose weight “mechanicaly” like that…Your body may get thin, but the things that made you fat (emotions…) are not cured! So The real key is to try to cure our heart, our head and then we can try to lose weight…But try to explain that to a sencesseless doctor who only see you as a big fat thing…I hate my doctor!!!

  34. Hrmpf. Why, if someone say “the human body was not meant to carry whatever”, I have to think of that photograph of a soldier who has a servant carry his gear? Or of women carrying water for a family every single day, for lifetimes and generations until the stones where they rest on their way up from the valley have groves worn in them by the water jugs? What does that someone plan to do about it?

  35. I have to laugh (so I don’t cry) when I hear some of the flawed logic that people operate under. If ‘carrying extra weight is bad for your joints’, why do people go to the gym and lift free weights and use weighted machines? Think how strong people with extra weight actually have to *be* to *move* it…
    But I’m not on firm ground with that issue so I’ll move on to the real point I wanted to post about: Joint problems are an issue of either pathology (age/genetics/degenerative disease etc.), possibly nutritional deficiency, or misalignment. As a massage therapist I have the most experience with the last one.
    If our bodies are structurally out of alignment we experience pain and discomfort no matter what our size. Our weight does not necessarily cause joints to go out of alignment, though extra weight pressing on misaligned joints may be painful. Structural issues develop for any number of reasons including injury, muscle tension, and/or fascial tightness (fascia is the fibrous tissue that surrounds every muscle in your body).
    The interesting thing they taught us in massage school is how everything is connected, in this case (specifically structural bodywork) from the ground up – foot issues can lead to knee issues which can lead to hip issues which lead to back, to shoulders, to neck…

    I have been having some knee discomfort for a few weeks while I have been dancing. It doesn’t hold that my weight is causing it, especially considering I’ve lost weight. I can feel that my feet are “off,” and so everything else is getting thrown off. I’m going to see another LMP and get my feet and knees worked on.

    In massage school we were not taught that overweight people are bad, and most weight/health issues are beyond our scope of practice/require a referral regardless. We *were* taught that everyone is different and has different needs that need to be respected and accomidated. Being aware and nonjudgmental of our clients is what allows us to accurately assess their problems and provide the best care possible. The only things we were ever specifically told about people in terms of their size were logistical/safety/comfort issues – that larger people may need more support when in certain treatment positions on the table (pillow props etc.), that the face down position may need adjusting if a person has a larger chest, and that adipose tissue may bruise more easily.

    IMHO, everyone in the medical community could benefit from judging less and treating more.

  36. I have my fair share of horror stories of doctors doing this very same thing to me, attributing my every ailment to my weight. The doctors have been male and female, fat and thin, attractive and not so attractive. It seems this rotten attitude can be found in many different containers. Oddly enough the nicest and most pleasant doctors I have had were all attractive and on the smaller side of the spectrum though? Go figure? I once had an emergency room doctor send me home with a prescription for Zantac (which was useless anyway since the pharmacist simply directed me to the shelf) and tell me I should lose weight, later to find out from a walk in clinic that I had e-coli (which I’m fairly certain I got from eating spinach btw since I wasn’t eating beef at the time.) I would also just like to say, in support of the truth that weight has NOTHING to do with knee pain, that the only time in my life I have ever had knee injury/pain was during my “starving” years (as I like to call them) and that I have never had any knee pain when I am the fat and happy me. I am 34 years old, five foot six, 250 lbs, I walk 2 miles every day, and none of my joints hurt me in the slightest. I absolutely love your response of whether thin people have the same problem and how the doctor would treat a thin person. Thank you for that! I will remember it and use it the next time the opportunity presents itself… and we all know it will, unfortunately.

  37. What a great post and have been loving all the replies. Too many to mention, but I love what Jane said about doctors as that’s been some of my experience. I started having major health problems about 10 years ago, aged 40 and I strongly believe it’s nothing to do with my weight, then and now. In 2004 I was diagnosed with Fibromyalgia, then an under active thyroid, high blood pressure and in more recently Osteoarthritis. The arthritis wasn’t picked up by doctors, possibly due to the Fibromyalgia and pain I had from that and it was only a coincidence when I went for a gynaelogical procedure at a hospital, that a nurse noticed I had very restricted movement in opening my legs! She advised me to get my doctor to refer me to a Rheumatologist, who found out my hips were crumbling and one need to be replaced really soon and had that done at age 48. He and the surgeon didn’t mention my weight but I have had it from other parts of the medical profession. I have moved a lot in recent years and when I change doctors, you have to have to have an initial “check up” with the nurse/healthcare assistant and they always lecture me about my weight. I don’t know if this is the same in the U.S. I think like many who post here, the medical profession are lazy in their thinking, quite often wrong or take ages to find what’s actually wrong with you, and it just seems to be an easy get out to blame weight. Surely if it was your weight that was causing your arthritis or whatever, all other fat people were having the same problems, but they aren’t from what I can see?

  38. My yoga teacher, who is also a massage therapist, told us that he started to have knee pain when he did a lot of dancing. He finally figured out that when the muscles surrounding your hips and the outside of your upper thighs are tight, they have a tendency to pull your knee inwards. He started getting massage and doing self-massage on those areas and says now he has no problem with knee pain, even years later.

  39. Last January I had my third knee surgery for a knee problem that I was born with that degenerated due to a job that involved frequent squatting. I used to be athletic, and now I can barely walk from my car to my house and spend every night awake from joint pain. The surgical recovery included two weeks of bedrest and six months on crutches. After that two weeks, I noticed that the bottoms of my forefeet had gone numb. At this moment, I am on the sixth doctor (3 neurologists, 1 general, 1 podiatrist, 1 chiropractor) to try and figure out where this numbness is coming from. Each one of them has insisted on a diabetes screening before they will further examine me. Every screening came back negative. My blood pressure is a dream, my cholesterol is normal, and the rather shameful activity of providing my doctor with a weekly food diary via email only has them saying that I must be fabricating information, because there’s no way those numbers add up to someone my weight. I’ve tried asking to be treated the same way as a thin person, but I’ve been outright laughed at and have just had to keep looking for new doctors (and paying new copays). It’s so frustrating.

    • This is awful! I’m so sorry that you are having to deal with this. Our ideas about weight and health are so completely screwed up and it’s fat people who end up getting hurt them most because it’s so incredibly difficult for us to get actual evidence-based treatment. If there is anything that I can do to support you, please let me know. Big Fat Hugs! ~Ragen

      ________________________________

      • At the risk of sounding cheesy, Ragen, you have no idea how much you’ve already done to support me. Before I started reading your blog I wouldn’t have had the nerve to stand up for myself and keep looking for a doctor that sees me as a person instead of just a blob of fat. I am so inspired by pics you post on the same pilates machines I use for therapy, and will often tell my PT that I want to “keep doing it till I am as strong as Ragen”. Thank you so much for being here.


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