Healthcare is Killing Fat People

WTF are you doingIn Devon (UK),  people who are classed as “morbidly obese” and higher (a BMI of 35+) will be denied any and all routine surgery until they lose 5% of their weight. An amount which experts explain “is not only remarkably lax but has no medical rationale.”

The issues with this should be obvious.  First, the use of BMI in healthcare settings is deeply problematic. Also, for many people losing 5% of their weight won’t change their BMI category at all so they will be approved for surgery at a weight at which they would be denied if it was their weight when they walked in. Then of course there’s the fact that they have no evidence that this weight loss can be maintained or that it will improve health (in fact, evidence points to the opposite conclusion.)

But you know what’s even less likely to improve your health than weight loss attempts?  Not getting the surgery you need until you manipulate your body size by some arbitrary amount.  And that doesn’t even take into the extreme and unhealthy things that people are likely to do to “make weight” so that they can access basic healthcare.

“Routine surgery” is not the same thing as “elective surgery” so please understand that they consider a medical procedure that fat people’s doctors have deemed necessary, to be a perfectly reasonable “carrot” to dangle in front of us to try to force them to lose weight.

It does not matter how much anyone thinks losing 5% of our body weight will help a fat person, it’s inappropriate to force us to choose between accessing healthcare, and attempting weight loss (for which their is, by the way, no evidence basis.)

Fat is a body size and not a behavior – fat people are as varied in our behaviors, health, and habits as any other group of people who have only a single physical characteristic in common.  But let’s be clear that even if those who would deny healthcare based on body size are so dense as to believe that you can tell someone’s habits, behaviors, and health just by knowing their height and weight, that still doesn’t justify their behavior.

They are suggesting that fat people should be denied routine surgery because our body size is considered our fault, and is changeable.  But they aren’t not forcing people with sports injuries to give up sports.  Or people who need routine surgeries because of injuries sustained while they were drunk to quit drinking.  Or people whose need for routine surgery followed the exclamation “Hey y’all, watch this…!” to sign a contract promising to stop hurling their bodies at solid objects, or people who are injured because they were driving cars to quit driving etc. (nor should they!) That tells us pretty clearly that this is nothing more than appearance based discrimination in healthcare.

In response to a Boston Globe article about medical mistakes, the brilliant Lesley Kinzel started the hashtag #diagnosisfat and people took to Twitter to discuss the ways that their doctors’ antifat bias led to substandard care.  What they talk about will not likely be surprising to any fat person who has ever tried to access medical care:

A doctor prescribed weight loss for my sinusitis.

Told doc I was a dance major. He said, “if you were, you wouldn’t be fat.” I went for a tetanus shot.

GP’s withholding pain-management meds ’til I lose weight.

Went to clinic w/ a deep wound on sole of my foot. NP told me it was caused by my “excess weight.” WHAT? It was a rusty nail!

And it goes on and on (as someone who has been prescribed weight loss for a broken toe, separated shoulder, and strep throat, and who has been sent countless stories from my readers of medical mistreatment because of their size I am saddened but not surprised.)  I encourage people to add their stories to the thread.

When it comes to fat patients, the healthcare system is rife with bias and the kind of misinformation and mistreatment that happens when “everybody knows” is considered as good as evidence-based medicine, and when bias, stereotyping, stigmatizing, subhuman treatment and other oppression based on appearance are encouraged by the healthcare establishment and governments that are proudly using fat people’s tax dollars to wage war on us.

I can’t help looking at the juxtaposition of anti-fat healthcare bias with “public health” messaging suggesting that the goal of our society should be eradicated from the Earth,  and notice how it seems like they are happy to achieve “victory” in the “war on obesity”  by making us thin or killing us, and they don’t much care which.

I think that the solution to this is going to have to be large scale activism – fat people recording their doctors, naming names when it comes to fatphobia, refusing to leave the doctor’s office until we get proper treatment, rating doctors on rating sites, perhaps creating our own rating sites, lists of fat friendly doctors,  filing malpractice lawsuits etc. If what they say is true (and I’m not saying it is, but I’m not above using our oppressors own messaging against them) that the majority of people are fat and we have above average healthcare costs, then we have some real leverage to bring to this particular situation.

All of this type of activism comes with risk and some of it will end up hurting the person doing the activism (I already know people who have been blacklisted by doctors in their small town because of their refusal to accept a diagnosis of fat and a prescription of body size manipulation when they have health issues for which people who aren’t fat get actual proven interventions.)

That’s the thing about creating social change – in order to create change a lot of people have to risk a little, some people have to risk a lot, and a few people will risk everything.  We shouldn’t have to do this, this is not our fault but it becomes our problem,  and we each get to choose how to deal with it – nobody is obligated to be involved in activism, but the option to be involved in activism is there.

Regardless, the current discrimination against fat people, and the treatment of body size as a diagnosis and barrier to healthcare are just plain wrong, and the only appropriate health care for people of all sizes is blame free, shame free, and future oriented care.  Until that is the standard, fat people will suffer and some will lose their lives due to anti-fat bias in healthcare.

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Published in: on December 5, 2014 at 11:25 am  Comments (71)  

71 CommentsLeave a comment

  1. Great post. It reminds me of my friend T, who currently has breast cancer. She is in the middle of 20 weeks of chemo, which will be followed by a mastectomy. T is a large but not enormous person – about six feet tall and maybe 250 pounds. Recently, her doctors told her they would “not consider” doing reconstructive surgery on her breast until she reached her “ideal weight,” a weight set by them (bmi, charts, personal opinion, magic 8 ball, not sure). The rationale they gave her is that a reconstructed breast won’t change as you gain or lose weight, so obviously if you’re fat now, you’ll want to be losing weight, and we should wait until you do that so your boobs don’t look weird once reconstructed. Because walking around with one breast indefinitely isn’t weird? Because subjecting a patient to two separate surgeries and two recoveries, after the body-wracking indignity and pain of cancer and chemo, is a better, healthier choice than simply doing the reconstruction at the same time as the mastectomy, which is what they told her they’d do for a patient of “normal size.” (As you say, sarcasm meter 10 out of 10 here). T asked them who determined her ideal weight – her or them? And they wouldn’t even consider her question as serious. I mean, obviously, them. That she has always been a large person was not considered. That she has healthy habits – T is a marathoner, lifelong athlete, and volleyball/basketball superstar – was not considered. That she has no intention to lose weight was not considered. That she has a knee condition which now prevents many, many forms of exercise was not considered. That she’s a young person, early 40’s, was not considered. That she wants to reconstruct at this size was not considered. And now my friend has to choose to either divert precious strength and energy towards fighting her doctors, in the midst of chemo, or not fight them, and be subjected to their fatist, discriminatory, stupid (ok maybe i’m editorializing) policy. I’m so mad I could spit nails.

    • She should report them to their state medical board. File a formal complaint. Go on social media, Craigslist, Angie”s list and any other venue she can think of to publicly condemn them. She could also speak to the medical director and administrator of the hospital where her mastectomy will be done and register complaints with them and be sure to let them know she is going to pursue this PUBLICLY. I’ve worked in hospitals all my adult life and they do not want this kind of publicity. If there is a local news station that does consumer investigations, call them. Or at the very least, tell the hospital that’s what you’ll be doing. A cancer patient being denied treatment based on no medical evidence? That’s ratings gold.

      Or switch physicians. I realize any and all of this will be/would be extremely difficult while she’s in the middle of treatment, as you say. But this is just beyond the pale. I am outraged for your friend,

      • All good ideas!

        You didn’t indicate if there is health insurance involved here. Might tell them as well, as the cost for one surgery (mastectomy + reconstruction) has got to be more than the two performed separately. They won’t take that lying down.

        I too, am angered over this one.

      • Please keep in mind when suggesting what a person “should” do is that these suggestions all take a great deal of time and energy (physical, emotional, spiritual) that a person may not be able to spare. Having been on the receiving end of such advice, I often feel like now I have to defend myself from my allies (for insufficient militancy) as well as my enemies (for hurting me in the first place).

        I think instead of suggesting that a person “should” do all sorts of hard, tiring, draining things, we should ask if that person would like an activist who is already raring to go to take up their cause.

        • That’s an excellent suggestion! Maybe someone can start a database of people who DO have energy and are willing to help those who need it and don’t have the time/energy. Or are there any advocate organizations already out there that do this?

    • Are there any local cancer charities that can help with patient advocacy?

      Whatever happens I hope your friend recovers well.

  2. Like my daughter who has suffered from CFS and consequent depression, sleep deprivation issues, and mental health issues for the past TWENTY YEARS. New GP astonished her by agreeing that CFS is the root cause, not laziness, not being fat – but she can’t access the support group/clinic for CFS, because her BMI is too high. Seriously, a syndrome/disease that stops people exercising because they’re too exhausted and in too much pain, cannot be treated if the sufferer is FAT. This is the Merton, Sutton and Wandsworth Health Authority. My daughter’s GP is furious at this senseless discrimination and is doing all she can to replicate the treatment offered by the group, direct… but Whiskey Tango Foxtrot? A syndrome/disease that is KNOWN to make people fat, and yet fat sufferers are excluded from any treatment?

    • As a hypermobility syndrome sufferer I have had a similar experience. I explained how I had lost fitness and gained weight due to the symptoms (joint and muscle pain and fatigue) and the physotherapist told me the solution was to “lose weight and exercise” and that i didn’t need any specific exercises, which would help strengthen my joint and enable me to be more active. She didn’t even seem to be able to believe that I was an active person before my symptoms got worse. I recognise that it is a cycle as deconditioning worsens the symptoms, but I have been fighting so hard for so many years (was not diagnosed for many years- was told it was depression and offered meds)- I need some expert help to break the cycle. not just to be told “It’s because you’re sooo unfit and overweight, go home and diet and exercise”- how did she know how fit I was just be looking at me anyway, because despite my illness I have continued to be reasonably active! So I am on my own, just me and my pilates DVD v the world!!

  3. I love the idea of the fat-friendly doctor list, but the only one listed for my area is an astrologer. As in, not a doctor. Um, thanks?

    My latest GP told me I was clearly upset when she was trying to tell me about how she lost so much weight and that proves I’m not happy with my size. No, I’m not happy with you judging me based on my size. STFU. Thankfully, she’s a very nice person, so I think she’ll not push the issue, but it’s just so frustrating sometimes:/

    • I’m concerned with your GP’s reliance on magical thinking. If you’re over the age of 5 logic doesn’t work like, “I lost weight and I’m happy! So my patient who’s fat must be sad.”

    • Hi, I’m the maintainer of the fat friendly health professionals list. It’s not just for doctors; it lists anyone fat friendly who self-refers or who was submitted by a client as dealing with health. Sadly, there are a lot of areas I haven’t received many listings for.

      I don’t verify credentials or make judgements about which modalities count as having to do with health and which don’t.

      So if you (person who is reading this) know any fat friendly health professionals, and you think the list is a good idea, then please, please submit their info so other people can benefit from your knowledge. recommend at fatfriendlydocs.com, subject line “ffp submission”. Thanks!

  4. I’ve been pretty lucky. I can only recall one fat diagnosis.

    I had recurring cysts on my lower abdomen. I went to a new clinic. Before making any examination, the doctor, who I was seeing for the first time, told me they were fungal infections from diabetes.

    I told him I did not have diabetes.

    He asked me if I’d had my sugar tested.

    I told him I had not, because I had never had any symptoms. (It’s been tested since and it’s perfect.)

    His armchair diagnosis foiled, he deigned to actually do his job and examine my abdomen.

    Oh, he said, this definitely is something else.

    No apology.

    TLDR: I was visually misdiagnosed with diabetes while fully clothed, with no symptoms, examination, or testing.

    • I once went to a podiatrist who began the visit by going off on me about how I needed to put my diabetes on the patient intake form because it was important and could determine how I was treated.

      I told him that I didn’t put that on the form because I wasn’t diabetic.

      He told me of course I was, or I wouldn’t be on metformin. I explained that metformin was to treat my insulin resistance, which was part of my PCOS that *was* listed on the form (and that he either had never heard of or didn’t believe was a real diagnosis), and was not the same as a diagnosis of diabetes.

      And that I why I say I went to him ONCE.

      • I wonder if the docs ever give serious thought as to why some patients never return.

        Yeah, once had a doc tell me my hormones were all out of whack. Only test he ran was a hematocrit -which tells him the RBC level. Bet he thought I was impressed. Dumbass didn’t realize I have a biochemistry degree and work at a company that designs & manufactures medical diagnostic testing kits. Got out of there fast.

    • I can actually beat you!

      I was misdiagnosed with gestational diabetes when I wasn’t even in the office, and also the diagnosis was added to my file after I had given birth, and furthermore the diagnosis was written on top of the pages showing all the times I had obediently poked myself using a home testing kit and come in to provide pee because they were so dang sure I was going to explodeanddie from fat–and every single test was not even in the borderline.

      Meanwhile, the very same clinic failed to test my urine for UTIs, even when the samples I provided were cloudy and orange, because UTIs aren’t a fatty disease–and the doctors brushed off my reports of lower back pain, strangury, etc., as “You’re fat and over 30, that’s what you get.” My non-fat-phobic midwife, who’d actually sent me to the clinic for shadow care, caught the UTI just before the point at which premature labor would have become a significant risk. Then the clinic took the credit.

      I also just fired the doctor who used to be my HCP because she tried to get me back on Weight Watchers. Including eating their stupid overpriced meals with the stuff I can’t even pronounce in them.

      • Just made a ham lasagna with all the stuff a person craves in the heart of the bleak winter, including satisfying spinach, a creamy pillowy white sauce (made from the 1 percent milk WIC insisted on in order to keep my son safe from Teh Fat) spiked with mustard and black pepper, stick-to-your-ribs ricotta with egg, and of course some salty-sweet ham.

        Weight Watchers Smart Ones. Feh and ptui.

        Hey, I could put the spinach in the white sauce instead of the ricotta next time, stir in the ham, and spoon the hot mixture over baked potatoes in their jackets. Or put it in a pie dish and bake under a mashed potato cloak. Mmmmm.

  5. “Fat is a body size and not a behavior…” !!!!!❤ So well said.

  6. Not that it would be better if it was required to get under a BMI of 35, actually that would be worse for many people, but it does make it extra ridiculous. Because obviously the reason isn’t that it’s just too dangerous for anyone over a BMI of 35, since they are still operating on folks over a BMI of 35. So instead, how about you just pretend I was 5% more fat originally? (maybe folks should just start wearing some weighted vests to the doctor, then when it’s time to lose weight to get medical care, you’re all set…)

    • I truly like your thinking!

    • Awesome!

    • That was my thought. If it was me, at the point of the weight check I would be eating a big meal just beforehand and carrying some things in my pockets!

      I wonder how it will work- when will the check weight and when will they check for the weightloss. There will still be a waiting list so will weight be checked to be allowed on the list (I assume so as they say it is partly to reduce waiting lists) but then what if the person regains the weight by the time they get to see the consultant?

  7. The most horrifying part of the story Ragen references is that they fully admit it’s nothing but a cost-cutting measure. They say straight out that the surgery wait list was too long, so they’re essentially yanking the “undeserving” (my word, not theirs) right out of line, because why not spend the money on thin, non-smokers who “deserve” it?

    They’re also giving those with hearing loss only one hearing aid instead of two to save money, so I guess the disabled are now in the untouchable category of their health-care caste system, too.

    So much for single-payer healthcare creating fairness and equality. I’m scared to death of it coming to America.

    • Absolutely! I immediately noticed this myself and like you, I was mortified. Whether God exists/listens or not, I will pray that the people involved in this atrocity either come to their senses or get resoundingly thwarted by decent people who believe that rationing health care (ESPECIALLY based on appearance) is Bull to the Shit.

      • It absolutely is — we’ve all heard about threats of older people not getting care based on age, which is bad enough. But now they’re not going to treat people because they literally don’t like the looks of them? It’s a big, steaming pile.

        (I also want to argue that it’s counter-productive and completely ass-backward in terms of logic. But I felt like getting into that would accidentally legitimize this crap.)

    • I was going to say the same thing as Laney. How is a modern society allowing a program even the people who created the program baldly admit is eugenic? *How are they getting away with this?* I’d heard bariatric surgery was already mandatory for anyone whose BMI was 35 or above +one “obesity-related” illness (which they could twist to mean anything they wanted) and that’s messed up enough, but is this the most fatal case ever of “refuge in audacity?” Devon said, “Hey, the fat and the disabled are lesser beings and smokers are immoral, so we’re gonna cut them off and let them die of neglect to save money, which we will then give to decent able-bodied thin people,” and it sounded so ridiculous nobody’s taking them seriously enough to stop them?

    • My grandma had similar issues with the hearing aids. She had almost 0% in one ear, and the other had 8%. They decided to treat the 8% ear (with the hearing aid it bumped up to 80%) since it would have the most results. She always had to turn her head so she could hear you. If you were facing her direct on, she still couldn’t hear though.

    • Only ONE Hearing aid???? I just cannot fathom this. What the hell?????

  8. There actually needs to be a condition created where fat people are terrified to go the doctor to get help with what ails us because we are so terrified of the shame we get.

    I recently went to a new PCM because I was having an issue with my mobility device causing rubbing on a certain area of my backside. What I needed was the lesion cleaned, and some prescription ointment and probably oral antibiotics. What I got was something else entirely.

    He was a nice, young Osteopathic Doctor with excellent ratings and a graduate of the more prestigious school of Osteopathic medicine in the country. We hit it off amazingly well as we went through my medical history and finally he asked if I’d ever had my testosterone levels checked. I said no, so he did a blood draw. When I came back a few weeks later for him to check on how my lesion was healing he had the results. I have T-levels of around 125 (the low end of normal range is about 350) he said in his calm Doctor voice “Simon, we have to get you on testosterone placement, I have a feeling that many of the problems you have will be greatly helped” He started to go through a list “your mood swings, your heart disease, depression, energy levels.” As he was listing these off I was thinking wow! All this would be amazing…tell me more I thought. And then finally he said “and getting your T-levels back to normal range will help greatly with weight loss.” There it was…the knife in the back, the arrow to the heart. It all comes back to that with these quacks.

    Did he know my history with weight loss? Nope. Did he know that I’ve been on 800 calorie restricted diets and almost died (while actually gaining weight)? Nope. Did he know that the weight stigma and shame that I’ve experienced literally since my first memories is far more responsible for my 5 heart attacks and stress levels than any amount of “extra” weight I carry. Nope. All he saw me as was two numbers a big huge 425lbs and a tiny little 125 Testosterone count.

    I politely thanked for his input but refused the Testosterone replacement therapy and left his office. Guess who is back in the search for a new PCM? Think I’ll find one without the enormous chip on their shoulder for fat people?

    • I’m sorry your doctor was so callous and tactless. While I soundly applaud your decision to refuse treatment from a doctor who treated you poorly, I urge you to get a second opinion about taking testosterone supplements, once you’ve found a doctor who understands (and respects) that you’re not seeking “treatment” for your weight. If your T-levels are demonstrably low, supplements might benefit you enormously. I’m no medical professional, so I’m NOT recommending you do anything more than ask a much better doctor what he/she thinks about it.

    • Maybe Fat Discrimination Related PTSD would work as a name.

    • Not sure if it’s real, but on the show House, in one ep. there was testosterone cream. I have no idea how you’d get it, but the patient in the show likely got it OTC.

      • Yes, there’s testosterone cream out there. No, it’s not OTC (in the US, anyway.) And it shouldn’t be. My (almost ex) husband actually ended up damaging his shoulders because one muscle became too strong and pulled things out of whack. He nearly had to undergo surgery until they figured that out, and dropped the T dosage.

        And I do agree that it sounds like the Testosterone would benefit you, @Simon J. Any weight loss would be a side-effect of having your hormones properly in balance. I do understand your concern, but it seems to me that the doctor was making a “standard assumption” that “of course” you’d want to lose weight. So in his view, suggesting that this treatment might aid in that would in fact be a GOOD thing. If he — or another doctor — might be willing to hear that you’re not “seeking treatment for your weight,” then it might be worth the weight loss side effect in order to get all the other benefits, perhaps? Certainly I didn’t hear in your account — which is of course not complete — that he wanted to shame you or stigmatize you around weight. Just that he wanted to treat your hormone imbalance and that weight loss might be one result, along with a whole lot of other results you yourself said might be “amazing.”

        I do wish you all the best in finding appropriate, supportive, and non-shaming care. Not easy, of course… but we ALL deserve it!

  9. My Mum lives in that area and she’s been on a diet. I wonder if it’s because they’ve told her to lose weight before they repair her knees. I do note one positive thing in that news story and that’s the response by the Royal College of Surgeons

    “Losing weight, or giving up smoking is an important consideration for patients undergoing surgery in order to improve their outcomes, but for some patients these steps may not be possible.

    “A blanket ban on scheduled operations for those who cannot follow these measures is unacceptable and too rigid a measure for ensuring patients receive the best care possible.”

  10. As I’ve mentioned here before, I damn near lost Mr. Twistie in 2013 because his doctor kept insisting that his pneumonia was indigestion from eating too quickly. He kept prescribing Prilosec until Mr. Twistie took himself to the emergency room where they treated the pneumonia and severe edema… and still sent him home with a second insanely expensive prescription bottle of Prilosec, even though he’d never opened the first one.

    The real capper? The Prilosec was the same strength you can buy at the drugstore for a third of the price. AND HE NEVER NEEDED IT, ANYWAY.

    Funny, but his cardiologist never said a single peep about his weight or body shamed him in any way. Neither did the ER staff.

    Now the same doctor is telling a woman I know that she needs to lose large amounts of weight before he can sign her up for a pain management clinic. Yes, being unable to exercise for the past year due to serious knee issues has meant that she’s gained weight. She’s also had a couple spinal issues and is taking anti-depressants, many of which can lead to (wait for it) weight gain… but if she’s serious about getting pain-free, apparently she will miraculously become able to do heavy-duty exercise until she loses fifty pounds and is suddenly worthy to have her pain managed.

    I’ve been telling her she needs a new doctor. I wish she would actually get one.

  11. I’ve shared my story here before, and just tweeted the 140-character condensed version.

    I’ve had problems with my gallbladder for years. About seven years ago, I had a bad attack and, after a doctor visit, got an ultrasound. The doctor said signs were pointing towards future gallstones, but there wasn’t a justification yet for removing my gallbladder. I was told to be careful of rich meals, like lots of cream and cheese sauces, to keep an eye out for future symptoms, and if things got worse, come back immediately.

    Nothing serious happened again until this past spring, when an attack sent me to the emergency room. I got blood tests and an ultrasound, and the doctors confirmed it was gallstones. They referred me to one of their surgeons, who made an appointment for me at his private office.

    When I was sent back to the examining room, nothing. No taking of height, weight, blood pressure, pulse, or respiration, not even a request to take off my shirt and put on a paper gown. The doctor comes in, sits down, and says he doesn’t think there’s anything wrong with my gallbladder. Then he starts a hard sell for gastric banding surgery, telling me he could tell just by looking at me that I have a fatty liver and am probably diabetic. I told him “just by looking at me” is inadequate medical care. He actually tried to make it sound like he was sad that I just didn’t want to hear the truth or something. I complained to the hospital but, since it wasn’t done on their property, they didn’t want to hear it.

    I got referred to a competent surgeon through my PCP and my gallbladder was gone a month later.

    • “He actually tried to make it sound like he was sad that I just didn’t want to hear the truth or something.”

      I’ve noticed a lot of fatphobia involves fatphobes projecting their own personal and emotional baggage onto fat bodies, and the old “ur in denial!!1” line is no exception – it is often the desperate last resort of a fatphobe who has failed utterly to convince their targeted fatty to harm themselves trying to not be fat, and rather than wonder if this is because they aren’t very convincing, they decide the only possible problem is that the other guy is too flawed to hear their deep wisdom.

      In other words, they’re in denial.

      • I better say Trigger Warning for exaggerated media language and diet stuff here; I didn’t know I was going on such a rant!

        I keep hearing from the media that SO MANY FATTIES don’t know they’re fat!! Doctors saying smugly that they discuss BMI with their patients because the patients don’t KNOW they’re OBESE! That many women who are OVERWEIGHT think of themselves as SLENDER! …and I think I’m getting television signals from another planet. I know about four women who think of themselves as not overweight, and they are all genetically very slender individuals who have a tendency to lose weight when they don’t want to. Every other female and most males on the planet seem to be worrying about her weight, OMGDEATHFATZ is shoved in your face every fifteen seconds (“even FIVE EXTRA POUNDS can contribute to eternity in hell!!… Are you OVERFAT but UNDERWEIGHT? Are you AFRAID ENOUGH OF ADIPOSITY?!”) the attack of the headless fatty is rife—and X% of fat people don’t…know…they’re…fat? Does not compute!

        If it’s true, I say where ignorance is bliss, ‘this folly to be wise.

        I have a gynecologist whom I like very much, in general, but she recommended weight loss (not, at least, in stentorian tones) for excessive bleeding after an IUD was placed. She actually said “you could probably lose fifty pounds in a year.” (I probably could, and gain back seventy the next year, if my history is anything to go by.)

        In the meantime, I was supposed to go on bleeding like a horse for a year?? I suppose that’s one way to lose weight—in addition to the weight of the blood, I’d lose a lot more after I died… Eventually it turned out that the bleeding was caused by a polyp and when it was removed all was well.

        I terribly miss my old GP, now retired, who actually appeared to read studies. He told me to exercise to feel better, not to lose weight, and, showing me a graph of my escalating weight, that I should NOT try to lose weight, but focus on a healthy diet and exercise. I could have done without the graph, but it was excellent advice.

  12. You wanted stories, so here’s mine:

    Went to see the doctor about a week and a half ago for a routine check-up. I thought that since I was there, I’d bring up the fact that my back has been hurting in the middle of the night (about 3 or 4 hours after I go to bed) and has been keeping me up. Only thing that lets me sleep is to sit up. And so she told me some stuff that made sense (apply heat, try stretching before bed to relax the muscles, core strength might help because it helps you stay upright and keeps some pressure off your back), but she also 1) never even asked what I was sleeping on, which I found very odd, and 2) finished it all with, “But, you know, weight loss really helps with back pain.” Excuse me? Because I’ve been this weight my whole life and my back has been giving me trouble for a couple of months. So what the hell are you talking about?

    In the end, the stretching & working my core seems to be helping a little, so I’ll do that, thanks. *shakes head at doctor*

  13. This blog hit home for me. I live in pain every day. I have a replaced knee that needs fixed. My other knee and my shoulder need replaced. I have a mass on my hip area too. All these need surgery. will they do it?……. sure…… AFTER I LOOSE 130#!!!!! Really???!?! If it was that easy I would have done it already!!! One doc looked at me and told me “you eat 5000 calories a day”. I said “NO WAY! I eat like once a day. He said “no you have to be eating 5000 a day to stay this big”. I just shook my head. When I told this to the endocrinologist I was sent to she said “I can look at you and tell you only eat once. Your body is in starvation mode and keeping every calorie you take in”. This is what my main doc had said too. I am keeping my body in starvation mode and the metabolism is not working. Finally 2 docs that actually believe me. And their solution was for me to eat 6 times a day. Can’t wrap my head around that as I have been told most of my life to “not eat so much”. So here I am feeling like I have food in my mouth all the time. Feels wrong cuz of what others have drilled into my head for most my life. I don’t get why some docs are just so narrow minded and don’t even listen to the patient. and here I am still in major pain every day, can’t hardly walk most days, and the docs….. well they don’t care other than to give me more pain pills!!! Like those are good for me!!! Been on them for about 7 or 8 years daily. But hey, they don’t care what those are doing to me either! My experience with orthopedic doctors is they only want to work on athletes and people who are within their “guidelines” of weight. so much for there oath to take care of people!!!

    • I have had several other orthopedic doctors treat me extremely badly. 2 doctors at one clinic were so rude and so insensitive that I left and never saw them again. and the 3rd doc was going to do my surgery……until she talked to the other 2. then she said she wouldn’t. I have never gone back to that clinic and suggest to others they don’t go to them either.

      • I feel your pain–I have NEVER met an orthopedist I liked. I have been to many, until recently for injuries related to sports, so even though I didn’t fit the “athlete” mold, I was given grudging respect. But now I am old and fat and in pain and to quote the comic “I get no respect.” One very awful one told me my hip had so much arthritis I could just plan on getting it replaced, so lose 80 pounds and save your money for it. Then he verbally abused me for being fat, until I just walked out. A year later my Dr insisted I see another one. This guy had new xrays done, then hopped in and said “Good News! There is no arthritis in that hip!” I was nonplussed, to say the least. So he got defensive and showed me the 2 sets of xrays stating I had “Beautiful hips” (Orthopedically speaking I am sure.) Then he gave me a different diagnoses, or 2. So now I don’t know if one of them is a liar, incompetent or just a jerk. Or all 3? Or both? Or some combination? ERRR!

    • The first ortho I saw confirmed that I needed a new hip…and that he’d be happy to put one in after I lost 150lbs so my care wouldn’t be such a horror for the nurses. He’s lucky I was speechless. Went to another doc who agreed to do surgery on condition I lost 30 lbs to get under 300. He said his experience was lower infection rate under that limit. I was in so much pain I didn’t argue with him about weight based dosing & how valid were his stats really. Lost 35 lbs & got a new hip. Honestly I was just grateful that he wasn’t abusive like the first doc.

      3 years later I have gained the weight back with a bonus. I just had a shoulder replacement with no infection problems and my doc never said a single word about my weight. I need another hip and told him I’m hesitant to go back to my original doc because I don’t think it’s in my best interest to diet again. He gave me a referral to a colleague who does hips (including for the mother of doc #1) and doesn’t set a weight limit.

      My husband is getting a knee replacement this month & once he’s rehabbed I’ll be seeing a surgeon about my 2nd hip. Fingers crossed!

      • You wrote: “he’d be happy to put one in after I lost 150lbs so my care wouldn’t be such a horror for the nurses.”

        My response: “Well then, get better nurses. And schedule me for surgery soonest. Thank you.”

        • My thoughts exactly, if they can’t do the job, maybe they aren’t cut out for doing that kind of work.

        • I would suggest that they don’t need better nurses, they need to support their nurses better – there are tools that can make lifting, moving, and caring for patients of size much easier for nurses (the same tools are often a help to patients with disabilities and elderly patients) The problem here is the medical facilities are built and stocked ignoring the fact that fat people will need to use them. Then when fat people show up we are blamed for their lack of preparation, and nurses are put in situations where they are injuring themselves because they don’t have the proper tools to treat us, and fatphobic doctors uses phrases like “horror for the nurses” when describing fat people who want access to basic healthcare.

          ~Ragen

  14. I may have shared this story here before, but a relative of mine went to the doctor to have a lump in her breast checked and the doctor told her it was just fat tissue and that she needed to lose weight. Unfortunately she trusted the doctor, didn’t seek out a second opinion, and eventually died of breast cancer. Her immediate family just accepted it all for reasons incomprehensible to me, so, that doctor is probably still practicing medicine as I type.

    They are literally killing us with their discriminatory practices, and nobody seems to give two shits.

  15. For the information of people posting here, the “Devon” referred to is in the UK.

  16. For real? Fat people will be denied appendectomies and similar immediate life-saving procedures because of their appearance? Does this BMI restriction include obese athletes who don’t necessarily appear “fat”? What the actual fuck?

    • No, it doesn’t apply to emergency surgeries or ones needed for life-threatening circumstances. It’s bad enough, but it’s not quite THAT bad. This is for “scheduled surgeries” (i.e., things like hip replacements). I completely agree that it’s still unconscionable and infuriating, but they’re not suggesting denying emergency or immediate life-saving treatment to anyone.

      From the BBC news report, http://www.bbc.com/news/uk-england-devon-30318546 :

      ‘Dr Tim Burke, Chair of NEW Devon CCG, said: “All of these temporary measures relate to planned operations and treatments, not those which must be done as an emergency or to save lives.

      “We recognise that each patient is an individual and where their GP or consultant feels that there are exceptional circumstances we will convene a panel of clinicians to consider the case.”‘

  17. This story is milder than most, but here goes –

    I used to be obsessed with my weight and was reasonably successful in staying thin. Until I got pregnant and I decided I had the perfect excuse to stop being so hungry all the damn time. Plus, I figured if incubating new life isn’t an excuse to eat whatever I want (after making sure I got my necessary nutrition for the day), what excuse is there? So I ate whenever I was hungry. And I loved every bite. And I looked like Jessica Simpson during her first pregnancy (minus the long blonde hair).

    EVERY TIME I went to the doctor I got a lecture about my weight. Never mind the fact that my heart rate and blood pressure are fine, the baby’s heart rate is fine, the baby shows no signs of distress, and some of that weight is the extra muscle mass in my legs from hauling my pregnant self everywhere.(*) Nope – I had to endure a sermon about my weight every time.

    After I had the baby I lost a lot (but not all) of the weight just from the fact that I pretty much always had a baby in my arms for the first few months and I rarely had any hands free to EAT anything.

    But my second and third pregnancy – same thing. I ate what I wanted, gained weight, listened to lectures about it, and just inwardly rolled my eyes. I should point out here that I never ate when I wasn’t hungry – my body is just really good at ravenously packing on the pounds. Maybe it was glad that I finally started listening to it and eating when I was hungry. The way I figured, if there’s a time when you should listen to your body, it’s pregnancy. New life is WAY more important than vanity.

    (*)Hey – I said I ate whatever I wanted; I never said I sat on my ass. I was still PLENTY active with lots of brisk walking.

  18. These stories are honestly frightening – the way doctors treat people, it really is obscene.
    And only in everyday practice, but LEGALLY, FORMALLY sprurting nonsense like the 5% weight loss.

    IThis is really hard to believe.

  19. I’ve had shin splints since I was 14 and weighed 110 pounds. A couple of years ago they got pretty bad and I went to my doctor and asked her to give me a referral to physical therapy so I could fix them. I wanted to take higher-impact dance-exercise classes like zumba, because I find them fun.

    She refused. She said she wasn’t going to help me in any way with any problem until I went on a medically-supervised liquid weight loss diet and lost at least 40 pounds. Said weight loss plan costs $5000 out of pocket. In addition, I have jaw problems that have required I go on a liquid diet before and I know I find liquid diets too depressing to remain on for more than 5 days – I’d have to have my jaw wired shut to complete one. She also told me to eat 1100 calories or less per day. So I quit her.

    My current general doctor is very nice, but she reads cookbooks for a hobby and she still thinks magically. My gastroenterologist told me that my habit of eating 2 eggs a day for breakfast is quite healthy and that eggs are a very nutritious food, something I’ve verified by actually doing research. (I’m not a scientist, but I have an MA in history and a sound background in biology.) My general doctor was aghast when she heard that I eat all those eggs. She said, “They’re too high in cholesterol. Eating cholesterol will give you high cholesterol.” This is not true.

    Whenever I visit a doctor the first thing they do is run a full panel of tests on me even though I tell them I am perfectly healthy. And they are always amazed to see that I don’t have diabetes, my cholesterol is normal, my thyroid is normal, and everything else is within normal ranges. Two sessions of this ago some of my liver statistics were high. I told her I’d been taking a lot of acetaminophen, which will make your liver stats artificially high. She diagnosed me with “fatty liver” and told me that if I don’t lose 50 pounds immediately I’d get cirrhosis of the liver and require a liver transplant. Fast forward a year and I’ve gained five pounds, but I didn’t take any acetaminophen for two weeks before my doctor’s appointment and amazingly enough my liver was fine.

    I walk between 3.5 and 5 miles a day as part of my job. My doctors tell me that *on top of that* I need to walk an additional 5 miles a day. I have plantar fasciitis. If I were to do that, I would quickly become unable to walk at all.

    Right now there’s something wrong with my leg. It hurts and I’ve been limping for weeks. There’s no point in going to the doctor. There’s nothing they can do about it and I’ll just be told to lose weight.

    I am 5’4″ and weigh 270 pounds. I have been at this weight for five years, but I have been “overweight” since puberty. I used to range between 140 and 180, but I put on weight in grad school when I was drinking too much sugar and sleeping 4 hours a night. I eat less food than most people I know, but when I saw a nutritionalist for my jaw problem (you can only chew certain foods while your jaw heals) the first thing she did was lecture me on portion size. I quit her, too.

    • I am the same height and weight as you and also have PF, mine is partly due to a genetic condition that makes my connective tissue weak. When i finally got diagnosed and referred for physio, she didn’t assess my joints properly or give me any specific exercises to do (which is the appropriate treatment), and she wanted me to come in and walk on a treadmill! I was already walking to school twice a day with my son and dog and struggling to manage that due to the foot pain and other joint pain, and her solution was for me to come in and walk on a treadmill!

    • I started feeling the tell-tale pain of PF this summer and did a lot of rolling my foot on a tennis ball at my desk at work, and other bits and stuff. It wasn’t really helping.

      Fast forward to October. I bought some crazy cool handmade boots at the Renaissance Festival. Wore them for a full day there and I was the only one not in pain by the end of the day. Not my PF, not my oogie ankles, not my back–I felt pretty fine!

      A week later I wore those boots all week at work because I was helping out at a booth 2.5 hours a day, standing on awful cement floors. The first day I couldn’t wait to get the boots off upon getting home–I felt claustrophobic or something. Woke up the next morning–huh–no PF pain getting out of bed. After a week I swear the PF is gone.

      Now, mind you, it hadn’t yet gotten bad enough to go to the doctor–I was trying a lot of the tricks I watched people use in physical therapy. I’ve been there a few times for back and ankle. The insoles are custom designed out of a carbon-fiber blend and fitted with double riveted steel shanks. The steel shanks give you extra support and rigidity in your every step; particularly over uneven terrain. I’m pretty sure that it’s that rigid construction that makes them so wonderful. They are pricey… I got boots that lace up in back and go to the knee–they are amazing but the most pricey footwear I’ve ever gotten.
      http://sonofsandlar.com

  20. I recently got a new doc, and gave a written medical history and what I thought might be wrong with me. On the second visit, after the test results were in, she said everything was normal, but that the things I was worried about are caused by weight, so why don’t I get some bariatric surgery. I said no, and she agreed that weightloss works less then 5% of teh time, but to do it anyway, even after I told her I had a 22 yr anorexia and over exercise. Most of the my extended family suffers from the same problems and they are all low “normal” or “underweight”. They got the accepted standard treatments.

  21. I’m a Brit and have a genetic condition that makes me more likely to have various issues that would requite surgery eg hernia, prolapse. Thanks for addressing the Devon decision. It is deeply scary for me. I am already bascially being denied proper treatment for my condition as I have been told the first port of call is to “lose weight and get fit”, by a physiotherapist who seemed just utterly unable to believe the fat person in front of her might have been fit and active before she got more sick (never mind that I told her I was 130lbs then!). I don’t live in Devon but am scared this will spread across the country, as well as deeply concerned for those in Devon who will be affected.

  22. I recently had an episode of Shingles. (I’m not yet forty–surprise!)

    The very first patch of rash looked odd… kinda like a cross between eczema and poison ivy. It didn’t itch or hurt, really… I found it odd. I called the doctor’s office that morning. My doctor wasn’t available until the second day. My previous doctor I didn’t like at all was available same day. I told the receptionist, “If it’s all the same, I’ll wait for my doctor, I really don’t like the other doctor. I don’t see her anymore for good reason.” The receptionist said she didn’t blame me, she didn’t like her either.

    Turns out, the next day a second, larger patch of rash showed up on my back and looked like a textbook picture of shingles. My doctor was a little wishy washy about the rash that first appeared, but said there was “no doubt” about the rash on my back. Gave me a pained expression (I had a few infections this year and Lyme–it’s been fun) and pulled up some informational stuff on his computer, put me in for meds…

    I mentioned that I was happy I’d waited the extra day to see him, and he asked why–the medications are more likely to work the sooner you take them. Well, because if he wasn’t certain it was shingles with the first rash I had (and really, I didn’t suspect shingles when all I had was that rash) his colleague most definitely would not, and she would have come up with some way to put me in for another Diabetes test. And that would have just pissed me off. He sighed.

    He is well aware of my feelings with regard to that other doctor, and from what I’ve gathered from numerous others at the practice, I’m not the only one. I believe her to be a fat bigot. She missed major issues I had and at every corner warned me of my impending diabetes and ran my blood for diabetes every time I got a test for anything else. My A1C is perfectly in the normal range, has been every single time.

    And I’m not really all that fat, I’m 5’6″ and wear 18/20 in USA sizing. I can’t imagine how horrid she would be to someone larger than me.

  23. Your post was spot on. It’s appalling how doctors think it’s their job to remind us we are fat. I’m a cancer survivor and I had a mastectomy and went to the plastic surgeon. One look at me and he said he never operated on such large breast. It turned out I was allergic to what they use to make a new breast. The only time he treated me with kindness was when he realize my life was in danger if it was not relieved. I wish people especially doctors realize that when you say I’m fat your not telling anything new. We can’t all be a size 2.

    • Yeah, what is it with that? Do they think we didn’t notice?! What, we just sort of feel around the clothing store with our eyes shut and try on new clothes by touch, and never notice the tags?

      I mean, how much denial do you have to be in to think that somebody who has to shop in the fat people clothes section doesn’t realize why?

  24. It’s just not happening in Devon. I experienced this first hand this summer. My Ob-Gyn oncologist wanted to do a hysterectomy, as I’ve lost some weight since my my initial diagnosis of endometrial cancer in 2008. I’ve had no cancer cells the last two years, which is a blessing. At my appointment this year, she asked if I wanted a hysterectomy, and I said yes. She scheduled a consult with a plastic surgeon, as I’ve had a hip to hip incision about 10 years ago, and she was concerned about the scar tissue. I go to the plastic surgery consult. I get weighed and height taken. My DH and I go and sit in the room to wait. The plastic surgeon walks in, looks at me, and states “the insurance company will deny any surgery due to your BMI”. I tell him that the oncologist was concerned about my scar tissue. He said “I guess I can look at it”.

    When I received the EOB, that plastic surgeron office had coded the visit as ‘non covered obesity services’.

  25. I know someone who 5 years ago needed hernia surgery. Docs said “go lose 100 lbs and then come back.” They suggested WLS,but required her to lose 40 lbs first, to demonstrate commitment to changing her eating habits permanently (since WLS creates a situation requiring extreme eating changes.). She decided not to take the risks of the surgery, and instead lost 150 lbs through diet and exercise alone. Recently, the hernia has been called “the worst ever seen” by the last person to look. Except now the surgeons are saying lose another 50 lbs, AND do weight loss surgery, and ONLY THEN we’ll do the hernia surgery.

    W.
    T.
    F.

    • Gorramit! If they wanted her to lose 200 pounds, they should have said so, in the first place!

      And how to they *realistically* expect a HERNIA patient to exercise down 200 pounds?

      Clearly, they believe that fat creates endorphins, and that’s why fat people must not really feel any pain, and if we say we have pain, then we are lying, because surely, a person with a HERNIA would be in too much pain to exercise, but a fat CREATURE, would feel no pain, and it’s OK.

      Or maybe they just don’t care about the excruciating pain, and just want us to torture ourselves for them, so that they can sadistically enjoy the fat-creature being in pain, without having to actually face the consequences of physically inflicting that pain, because someone might look at them, and say, “Stop torturing that person! She’s not just some lower-life form, just because she’s fat. She’s an actual human being, and torturing human beings is bad.”

      I am absolutely astounded that she was able to lose 150 pounds! Her inner-strength amazes me. I wouldn’t be able to do that, at all.

      Is it possible for her to get better doctors? I know it’s not always possible. But if it is possible, I wish her good luck in finding one. If it’s not possible, then I wish these jackasses would have some VERY severe nightmares about being fat, and tortured accordingly.

      Sort of like “Christmas Carol,” but for fat-hatred instead. Dr. Scrooge can be visited by the ghosts of fat patients past, present, and future.

      • “A Fat Haters Christmas Carol” sounds like a terrific fanfiction story.

      • Oh yeah, now I want to read that story!

    • Hernias are no laughing matter. I saw a few on Mystery Diagnosis, and some people lived 60 yrs with one and doctors would never take them seriously. There was even a child who was born with one and had symptoms right after birth, which were given the “pfft” response.

      An uncle has a hernia, but I don’t think he’s ever had treatment, probably because he’s in his 70s.

  26. This post is amazing. I have epilepsy and have had it since I was four years old (I’m 24 now) and have been seeing the same neurologist since then. I’m also fat-because apparently that matters. Anyways, I’ve been on the same medication for years now, because it works-it controls my seizures and has fairly minimal side effects, a blessing in the epilepsy community, when seizures can be hard to control. Some people need multiple doses of different drugs multiple times a day.

    Anyways, I had no issues with my medication or my doctor, so to my surprise at one of my last visits he said “I’m thinking of switching your medication to X drug.” I replied, “Uhm, why?” He said, “Because it’s been proven effective at weight loss as well.” So…you’re going to switch me from a drug that I have no problems with, which does what it’s supposed to do, to a drug that has weight loss as a side effect? Along with a host of other terrible side effects I might add. I’m now in the process of switching neurologists. I’ve aged out of his practice anyways, but it left me with a bad taste in my mouth and I’m not happy.😦

  27. Last week my family went to Emory Hospital in Atlanta, GA to find out about getting a kidney transplant for my daughter, Meg. According to their policy she must lose 20 lbs to get on the list of recipients, and 35 more pounds to qualify for surgery. Also any living donors have to have a BMI of 37 or less in order to donate a kidney. Is this even legal? It has been two years since she began having problems and one year since the kidney failure was finally diagnosed and now she has to wait to get a transplant? I am too tired to think of what to do next.

  28. Cammie, that’s terrible. (But did you mean a donor has to have a BMI of 27 or less? That seems like it would be harder to find than someone with a BMI of less than 37.)

    • I’m not sure of the BMI number. It was mid-range, but my BMI is 56, so I can’t qualify even to be tested or considered as a donor. Her twin sister is diabetic and cannot donate, so is her father. It is all very frustrating. We have to pray that her cousins will be moved to volunteer, but I’m not sure we’re that close. What has Meg in tears is that 30 of her pounds were caused by steroids given to her by her nephrologist. She keeps saying, “It’s not my fault!” What do I say to that?

  29. On Well Rounded Mama blog recently, she linked to an article published by Canadian Family Physician: http://www.cfp.ca/content/60/11/973.long

    In it they discuss misconceptions, but are still on the whole “fat is baaaaddd” bandwagon. Have a look at Kmom’s analysis: wellroundedmama dot blogspot dot ca/2014/12/widespread-misconceptions-about-obesity.html Ragen is also linked 😛

  30. The problem is most definitely institutional – no surprise to all of us who have experiences like all those described here.

    I recently read the book Five Days at Memorial, about literal life-and-death decisions made at a private hospital in New Orleans in the days after Katrina. It’s extremely well-researched and a great read – and yet again confirms fat (and intersectional) bias in healthcare. Though I don’t think the author realizes about fat bias.

    There is also a good article (link below) that is a shorter version of the book, if interested.

    http://www.nytimes.com/2009/08/30/magazine/30doctors.html?pagewanted=all


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