Fat People and Our Knees

Ragen Chastain - fat dancer, no fat suit needed.  Photo by Richard Sabel

Photo by Richard Sabel

There’s a thing that happens to me a lot. It’s happening even more now that I’m training for an IRONMAN. Perfect strangers, upon seeing or hearing that I’m a fathlete, will ask me “how are your knees?”, often wincing like it pains them to even think about it.  When I say that my knees are fine, people suddenly become psychic.  “It will catch up to you,”  they tell me. They ask my age and then add five or ten years. My knees were going to go when I was 25, 30, 35, now it’s 40. (Again I ask: If they can tell the future would it kill them to give me some lottery numbers with their bullshit judgments?)

Let’s get a couple of things cleared up before we get into this.  First of all it’s possible that I’ll have trouble with my knees someday, many people – of all sizes – do for lots of different reasons.  As I’ve spoken about before, using the possibility of future disability to try to insult fat people or manipulate our behavior is fucked up ableism that needs to stop right the hell now. Also our joint health isn’t anybody else’s business unless we ask them to make it their business so asking random fat people about their knees is just weird – so maybe don’t do it. I have been known to respond to “How are your knees” by saying “Great!  How are your bowel movements?” or “Great! How’s your erectile function?”

The subject came up recently when I was giving a talk to a group of soon-to-be personal trainers about working with fat people. One of the guys said that he was worried about working with fat people because of the potential for knee injury.

I asked who in the room had had a knee injury in the past.  Almost everyone (not surprising in a room full of jocks.)  I asked who had been given an option for treatment of their knee injury other than weight loss.  Almost everybody.  I asked them to raise their hand if they had only been given weight loss as a treatment option.  Nobody.  I asked whose knee injuries had responded to treatment and gotten better. Almost everybody. Just like the ideas of weight causing health issues, the discussion about fat and joint health is also much more complicated than many people would have us believe.

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

When I had knee pain 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 other issues until I lost weight.  What with the who now?  So I left the doctor’s office and did some research.  I started working with a massage therapist and when we cleared up the tightness in my quads and IT bands the knee pain disappeared.  Losing weight would have done NOTHING to help the actual issue.

In fact, continuing to work out so that I could get thin so that I could somehow “deserve” evidence-based healthcare would have been more likely to have exacerbated the problem from one that could be solved through a couple good massages to a more serious issue which would then have been blamed, not on my doctor’s incompetence, but …wait for it… on my weight!

In general I think that a diagnosis of “fat”  and a prescription of “weight loss” is always just lazy medicine.  Anytime someone tells you that weight loss is the “solution” to your health problem, I would suggest that you ask if thin people have the problem that you do.  If they do (and they definitely do), then ask how they are treated and insist that you start with that.

A medical model that suggests that in thin people “knee pain” is the diagnosis and “interventions shown to help knee pain” are the prescription, but that in fat people “fat” is the diagnosis and “attempt to be less fat” is the prescription is seriously sketchy.

And let’s remember that there’s not a single study that shows that weight loss works long term for more than a tiny fraction of people long term.  So prescribing weight loss to cure joint pain (because it almost never works, but it will be great if it does) is roughly the same as prescribing flying.  I’m mean, if you jump off your garage and flap your arms really hard you probably won’t fly, but think of the joint pain relief you would feel if it worked and your feet never had to touch the ground!

I don’t know about you but my healthcare professionals need to do a little better than trying to sell me a big bag of magical weight loss beans. Because it isn’t just phenomenally lazy medicine, it’s also medically unethical without informed consent – which requires your healthcare professional to explain that weight loss is almost never successful and most of the time results in weight gain (and when’s the last time I doctor ‘fessed up to that during your appointment?)

So if you are dealing with joint pain and you’re being told that weight loss is the only thing that can help, you are absolutely, positively, one hundred percent being lied to. It may be that strengthening the supporting muscles,  correcting movement patterns that lead to imbalances, massage, stretching,  physical therapy, ultrasound, surgery, mobility aids or the many other things that are prescribed for knee problems in thin people might help.

Or maybe the pain is something that’s not curable and/or those solutions aren’t something you want to/can pursue (remember that lack of access to healthcare due to everything from oppression – including racism, ableism, ageism, sizeism, classism etc. – to financial situation, to geography and more can limit people’s options) – there is absolutely no shame in that regardless of your size or situation – fat people shouldn’t be shamed because people believe that our knee problems are our “fault” any more than athletes should be blamed because people believe that their knee problems are their “fault.” Everyone should have access to whatever they need to navigate the world. and nobody should be shamed or made to feel guilty about that. We should also have access to compassionate, competent, evidence-based health care and that includes our knees.

Hey, speaking of my IRONMAN, I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

If you’re looking or support for talking about fitness from a weight neutral perspective, you are welcome to join us at the Fit Fatties Forum, it’s for anyone, of any size, who wants to talk about fitness without weight loss talk, diet talk, or negative body talk.

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Published in: on May 20, 2015 at 12:15 pm  Comments (59)  

59 CommentsLeave a comment

  1. I am just five months to the good from a TKR. When I went to the orthopedist he never mentioned my weight. Ever. He was the first doctor to ever do so,or perhaps I should say “never do so”. He never weighed me either. Actually, your post made me think more about that doctor. I’m going to see him again in about two weeks, maybe I should thank him….

  2. I have a hereditary hip issue, and people always make it about my weight. They disregard the fact I had the problem since birth and that my thin brother also has it (he has had hip replacement). I’m thinking the fact that I was diagnosed while I was an underweight baby who had never walked a step would make it clear it is not a weight issue, but I guess I am no expert.

  3. I have runner’s knee in both knees (from running, go figure!) Neither my doctor nor my physical therapist has said anything about losing weight. Thankfully my 20 minutes daily of PT exercises is helping the pain! But it doesn’t seem to be making me lose weight … hmm …

  4. Weak knees run on my mother’s side of the family. One of my brothers inherited those knees. He started having issues with them when he was a thin teenager. He’s had knee problems for forty years, no matter what his weight. His ankles are also on the weak side.

    I do have some issues with my right knee these days. Of course that’s the knee I hurt badly several years ago tripping over the cat down half a flight of stairs. I landed on my right knee and couldn’t walk for days. I had no access to health care at the time, so I just did my best to treat a badly wrenched knee on my own. So yes, I am a fat woman with intermittent knee pain… in one knee since I had a bad injury with no medical treatment.

    But even if I got knee pain at the same time I got fat I would still deserve to have my pain treated via methods that have a proven track record of ending/reducing pain.

    Weight loss? Has no proven track record of much of anything other than making people fatter in the long run.

    • I too have developed knee probs because of falls and a bus accident! No treatment though, since I’m too fat.

      • When I tripped over a juice-can-sized stump hidden in the tall grass at the top of a shallow slope and did the Flight of the Hyperextended Knee, I discovered that the local hospital didn’t have a brace that would fit me and furthermore saw no reason to even look for one. I will remember the blank, bored stare of that medical attendant for the rest of my life. Like “Fat = nonperson, no medical care needed here, stop making mouth noises and leave.” Like they had a decision tree in their head and the only step after “Is this patient fat?” was “Deactivate brain, next patient please.”

        I wouldn’t leave until they’d managed to rig up something that would keep my knee where it was supposed to be on my leg. At the time I wasn’t thinking like a fat activist–it was more “I am going to be billed no matter what you do, so will you please do, I don’t know, YOUR JOB?”

        Then they gave me a prescription for muscle relaxants so powerful that I spent days dazed on the couch–the weird taste of those pills is coming back to me now–and acted surprised and offended when I asked about when I could stop taking them and actually get up and have some physical therapy. They’d thrown some “care” at the fat lady; why was I still complaining? (I got the PT.)

        • Ms. Hansen- Wow. Just…wow.

          I gotta hand it to the folks at Kaiser Hospital when my sis broke her leg. The tech who fitted her for a leg brace had a bit of a time with it. But to his credit, he kept the conversation light and friendly. Asked about how she’d broken her leg. See, she doesn’t know exactly how it happened. There wasn’t a fall or other distinct action that led to the fracture. So the tech joked about how it must have been some party she’d been to that she didn’t even remember how the fracture occurred. (“Oh man, wish I’d been there too!” he said).

          The tech, while working, caught the eye of another tech to assist with making the brace. The second tech was equally friendly. This put her at ease. They also checked and re-checked the fit to be sure she was comfortable.

          No fat jokes or anything demeaning. See, folks it is entirely possible to treat all patients with kindness and respect

          Good guys.

  5. “In general I think that a diagnosis of “fat” and a prescription of “weight loss” is always just lazy medicine.”

    I would argue that it’s not actually medicine at all.

    • I’m with you, Courtney. It certainly didn’t help my husband when he had pneumonia.

      • Pneumonia? Do you mean to say that your husband’s doctor prescribed weight loss for PNEUMONIA?!

        What???

        OK, I have to get off the internet now. It has broken my brain.

        • He didn’t precisely prescribe weight loss for pneumonia. That would have required him diagnosing the pneumonia in the first place. What he did was simply assume my husband’s breathing problems were weight-related and not bother to properly examine him. Oh, and prescribed the world’s most expensive bottle of Prilosec to help him deal with the indigestion his rapid overeating was so obviously causing even though my husband specifically said he was unable to eat more than a few bites at a time.

          But when my husband went to the ER three days later, he spent two nights in the hospital with pneumonia and severe edema.

          • I am so sorry this happened to your husband. It makes me so livid!

          • I wish I were Karma, and could zap these guys with a dose of their own medicine.

          • SO ANGRY.

          • This happened to me last year. I went to the doctor because I knew at best I had a bad respiratory infection, although my hunch was pneumonia. A month later, and after nearly dying in my sleep from inability to breath I went back and lo and behold got medications. I swear when I looked in her eyes, it was like one of those old cartoons where words float across the character’s eyes. Her eyes screamed “Oh god, I’m going to get sued!” she threw 5 different steroids, 2 cough medicines and an antibiotic at me so fast the room span. lol. But yeah, because of my weight, it took a month of serious illness to get treatment.

  6. OMG, this drives me nuts. I get this all the time, especially in workout classes when I refuse to do exercise that hurt my knees (lunges, squats, deep steps, things like that).

    I have had screwed-up knees since high school. When I was a senior, I weighed half what I do now, but I had to wear a brace on my knee just to ride my bike a few blocks on level ground. Driving an hour in traffic had me in tears just from holding down the gas pedal.

    Every doctor I talked to advised weight loss. One (the only one who ever actually did a physical examination of my knees) said I had arthritis and should take Advil. In the end, I had to just trust my own common sense. By cutting back on activities that hurt my knees (stairs, running, biking), walking at least a mile a day to keep everything loose, and just letting years go by without routinely abusing them, I’ve finally gotten to where my knees don’t hurt most of the time, and I can ride my bike again as long as I remember to downshift early and walk it up particularly steep hills.

    I’m getting fatter, but my knees are getting better. So, winning?

    I do miss mountain biking, though.

  7. I laughed so hard I disturbed the cat when I read “I’m mean, if you jump off your garage and flap your arms really hard you probably won’t fly, but think of the joint pain relief you would feel if it worked and your feet never had to touch the ground!”
    Ragen, you are wonderful. Thank you!

  8. Hi Ragen,

    I saw this awful article in the Washington Post and really appreciated all of your work that I have read over the years about the War on Fat Children. Without you I would probably have agreed with the writer and instead I read the headline “95 percent of parents think their overweight children look “just right”” and thought, “yay for parents!” instead of “the horror, the horror” which I suppose was what he was going for.

    Here’s the link to the article http://www.washingtonpost.com/news/to-your-health/wp/2015/05/12/95-percent-of-parents-think-their-overweight-children-look-just-right/
    in case you want to write about it but warning it’s pretty bad. Interestingly there’s no discussion of why it’s bad to be fat, that’s just assumed. 😦

    Thanks for all you do, and good luck with your Ironman training!

    Whitney

  9. My knee pain started back when I was very slender. Now it’s blamed on the fact that I am fat. I guess my fat went back in time to give my thin self knee pain.

    I hate when doctors tell you to lose weight as if you’ve never considered or tried it before. “Oh I am fat and should lose weight? The idea of that never occurred to me before today. Thanks doc!”

  10. I developed bad pain in my right knee back in 1999 that I was repeatedly told was because of my weight. Until 2001, when I managed to shatter my right pelvis because of the bone tumor that had been growing there. The oncologist explained to me that the tumor was causing pain to “transfer” to my knee because of how it was situated.

    • this hurts my heart. I am so sorry

  11. Ragen, as always, you tell it like it is. I have joint pain and have been told by doctors and my parents that it’s because of my weight. Thank you for clarifying the issue and helping us to remember that all our health issues are NOT related to weight. You’re a badass! xoxo

  12. Trying to explain to doctors that I would probably weigh 80 lbs less if I had never started dieting has always been a nonstarter for me, but I know it’s true.

    Not about knees, but my latest one is having an actual two-way conversation with my doctor where I explained that I eat lunch on a short break and walk for an hour on my lunchbreak, being sure to get in at least 10,000 steps a day, about four miles.

    Looked at my chart online a few days later and saw that she had noted I was “inactive.”

    • AGH! Is there somebody you can tell? I raised holy hell when I discovered that somebody had noted my “history” of gestational diabetes in my chart, even though flipping back a few pages would have seen the results of the near-obsessive blood sugar pokes that I agreed to do at home in lieu of doing the barf-inducing syrup test for my third pregnancy. Just like the previous two pregnancies, I’d had results of “nope, no, negative, nope-a-roony, not even borderline, this fat lady does not have GD, not even close.” But all fat people MUST be thisclose to dying at any moment, so I MUST have had GD.

      The file has been fixed to reflect actual reality instead of somebody’s fear of the size of my ass.

      Hopefully you can also get this done.

    • You have the right to correct your medical record if it is inaccurate. I would insist the physician correct that and I would make sure I actually watched her do that.

      Then I’d ask her how she’d like it if I went on Angie’s List or other medical review sites and lied about her. This type of bullshit drives me batty.

      • Can it be removed? I was told that there is a complicated process for requesting that a note be added but that even if it’s incorrect they can never remove something or strike it from a medical record once put in there. (I requested my full record and found so, soo, soooo many things wrong in it. From the just flat out “WTF?” like someone putting a cause of death for my grandparents, at a time when all of my grandparents were still alive, to the infuriating like my pediatrician heavily implying she thought I was lying about my headaches and claiming that I never got them on weekends or school breaks- a total lie and also I had never missed school due to migraines either, so it was not a lie to get out of school. And what do you know, 18 years late I still have chronic severe migraines. But tell me again Dr how I was just making it up -_- Also the probably not important but it pisses me off on principle, like the doctor who wrote that I had normal results of a physical examination he never performed. He just talked to me and wrote a prescription. But in the end it seemed like it just wasn’t worth it to try to get them to add notes to my record marking my “disagreement”)

        • Hmm. Why do I think they trotted out that But It’s Soooooooo Complicated!!! whinewhinewhinegetmesomecheesetogowothitwhinewhinewhine
          dog and pony show solely so they could intimidate into not having to do anything at all to correct the error?

        • It’s very frustrating! As noted below I had a couple of odd errors on my history that I tried to correct; the incorrect diagnosis of CVA (I have NO idea where that came from; I think she just clicked a wrong box looking away from the computer) was simply changed to “inactive,” and, more amusingly, my ethnicity was changed from “Hispanic or Latino” to… “NOT Hispanic or Latino.”

      • I intend to correct it next time I see her. I’m currently choosing my battles because CVA (cerebrovascular accident) was also listed on my chart, which happily is not something I’ve suffered, and I was listed as “Hispanic or Latino,” which I’m not, and their system managed to lose a referral which I’ve spent sixteen phone calls and counting on…One thing at a time.:-/

  13. Knee problems run in my family. My grandfather had them, I don’t think he was particularly fat. My mom and her siblings have all had knee replacements. My cousins and I are thinking it’s only a matter of time for us… we come in a variety of sizes and levels of athleticism. It’s good to know there are things I can do to keep my knees in good health and delay the need for knee replacement surgery as long as possible. I just hope i can find health professionals who are willing to advise me on my particular needs and not just prescribe weight loss.

  14. so I’m supposed to exercise to help me lose weight when I can barely put weight on my knee because it got injured and that will cure my knee issues – forget the fact that it got a very bad jolt from something hitting it and I had a bruise on the top of the kneecap. – YEAH, RIGHT

  15. And consider the implications of that advice and “treatment” when people take it very seriously and do whatever they can figure out on their own to lose as much weight as possible in an attempt to ease the pain. Overtraining is a surefire way to aggravate knee pain and cause further injury.

  16. My knee bone actually has a bump in it that rubs against my nerve and causes extreme pain. My doctor told me that while a physical therapist could help strengthen the muscles around it to diminish rubbing, the best way to stop the pain would to be avoiding inflammatory movement such as climbing stairs, crouching, and excessive twisting. So I use elevators and escalators. I think now I was probably lucky to get this diagnosis before I started edging into the ‘overweight’ category on the BMI. It’s not bad yet, but weight loss has started to infiltrate otherwise sound medical advice. If someone had told me the solution to my knee problems was to lose weight, I would be doing things that could royally screw up my poor knee.

    Of course, doctors can be super unhelpful sometimes. I’m still working on finding someone who will look at my liver issues and actually do something about it instead of telling this nondrinker not to drink.

  17. So glad to see this post as I have been struggling with recent diagnosis of osteoarthritis and knee pain. As per protocol it seems, my doctor felt he had to suggest weight loss as part, but not all of my options.
    He did do cortisone injection and recommend PT.
    Does anyone know where to get more information about other options for those who can’t or don’t wish to lose weight?
    My research hasn’t been very informative.

  18. Ragen! I AM SO EXCITED!!! I finally, FINALLY got my husband to order the book and the dvds because of the Ironman special you’re offering on this blog entry. Yaaaay!!!! **skippy happy dancing**
    My dodgy knees (busted up one in speed skating trios decades ago and presumably the other one went out in sympathy. Or maybe it’s a hereditary thing on both sides of my family regardless of size? Seems like an awful lot of the family have similar knee issues. But hey what would I know, Doc?) and I will be busting a move with you in my living room some time real soon. It’s only taken four years. I’ve been wanting the book since before my wedding when you were so supportive of my grand plan to tap dance down the aisle. Thank you so much!

  19. My own mother, who means well, has said that my heart has to work harder due to my size (almost 300 pounds).

    I’m a terrible debater, so I usually don’t know how to respond.

    “It’s common sense!” is what she likes to say.

  20. OHMYGOD YES. I get this all the time because I use a cane. For my birth defected spine and hips. My knees are actually awesome. I like doing crouches to prove people wrong.

  21. Here! Here! I just had knee replacement. I am overweight, but the problem was caused by a torn ligament 12 years ago. Before the surgery, I lost 50 pounds. My knee hurt worse. It did not get any better. But with total knee replacement it got better, even 30 pounds heavier. Weight can sometimes exacerbate injury or illness, but it does not cause it and I’m agreed, it’s time the doctors treated the illness or injury instead of coping out to a loose weight diagnosis.🙂

  22. I went for physiotherapy for my knees awhile ago and my therapist told me that if she picked out eight random people on the street, she’d bet they have knee problems. For some people, these problems manifest earlier in life, and for some, they go through their whole life without any pain. She explained that what we put our bodies through today is a lot more vigorous than a few generations ago – e.g. running for long periods, overdoing it on our workouts/sports… so ANYONE is susceptible to knee injuries, which have nothing to do with weight!!

    I also think back to a time when I was a size 8, and I went to a doctor about pains in my knees and he told me it was because I was overweight and should lose some weight!! Like, WUT! Haters gonna hate….

    This is a great article, thank you for writing it. It’s so necessary!!

    • Size 8= overweight?

      Geez, maybe the doc should just prescribe amputation as a remedy. Makes about as much sense.

      • Alas, doctors already DO prescribe amputation as a remedy. It’s better known as Bariatric Surgery, but it’s amputation all the same.

        • And Size 8 is borderline “Plus Size” territory as far as the fashion industry is concerned. Hate that term, “Plus Size”! Why the F is it Plus anyway just cause the number is 12 or 14 or 16 on up. Why can’t it just be the number without the Plus. Like Sizes 00-10 are. With men and boys clothes their sizes for larger bodies are Big & Tall and Husky, which annoys me much less for some reason I can’t define.

  23. I am 41 and have arthritis in my knees. I was sent to an orthopedist to try and find a way to get some relief. He told me (in front of my daughter and my mother) that I need to have bariatric surgery (gastric bypass) and that, without it, I will be dead in 5 to 10 years. He then, adding insult to injury, said “I don’t know that a knee brace would help at all and quite frankly I doubt if I have one that would fit you.”! I was so disgusted when I left that office.

  24. I have read about this issue before. One of the main problems is that medical professionals often perceive the overweight as “medically non-compliant” and assume they will not follow their directions. This bias may happen without conscious thought; the medical professional simply does not treat a condition as aggressively with a fat person as they do with a thin one. It is awful.

  25. Ugh, this is my mom’s latest in a series of Why You Should Lose Weight. Yes, my grandma was fat and she had bad knees. She also smashed them in a workplace accident when she was young and never had any problems with them before that. *headdesk*

    At least I know now that a physical therapist and/or sports massage therapist might be able to help if I ever do injure my knees! Massage can be downright magical. It’s extremely hard for me to tell my doctor about any medical problem that might be considered weight-related, even though he’s been nothing but competent and courteous to me. The doctors before him blew me off, and now it’s so hard to trust medical professionals. I’ve been suffering from a condition called hidradenitis suppurativa since puberty, and only got the courage to see a dermatologist about it this year. Thankfully she was nice about it, explained my treatment options, and didn’t tell me that it was because I have fat thighs (the lesions commonly appear on the inner thighs and can be exacerbated by chafing). Just like I was a real patient, imagine that!

  26. Ragen, I want to read more about your experience with the class of proto-personal trainers! It’s great that you’re in there talking with them. The more exposure and training they get the better they can accommodate all kinds of bodies.

    When I started running, everyone worried about my knees (I think my mom even begged me to stop). Luckily they’ve been fine; any issues have been solvable with a little extra stretching and strength training (and some rest when needed).

    My smaller friend has been told by her doctors that they only way to manage her chronic knee pain is to lose weight, so she’s been trying very hard, walking miles and miles, and has succeeded in giving herself plantar fasciitis on top of the knee pain (of course the dr’s advice after that was, exercise more and lose weight, not rest your feet! argh!)

    • What!?! That makes me concerned for this incompetent doctors’ patients… Too bad your friend doesn’t seek a seccond opinion.

      Btw wanted to say love your avitar and that webcomic.😀

  27. You are brilliant! I am so thankful you were able help better inform personal trainer students.🙂

  28. I am certain I will develop increasing problems in my left hip as I age. It’s already giving me some trouble. Has off and on for years. Dates back to when I was 15 and fell while running and broke my leg near the hip joint. Funny how it still gives me trouble even though I am the size of your average 10-12 year old child. Us scrawnies just never develop any kind of of those kind of health problems at all do we? Just ask any Fat Phobic incompetent doctor

    • I have fallen many times, as well as a vehicle accident, which periodically comes back to haunt me. You hear about athletes who claim an old “foot ball injury is acting up”, and even soldiers who were shot or experienced nerve damage have recurring problems, but they are not shamed for it.

      Seems like doctors these days don’t consider past injuries, or that time can compound an issue.

  29. I’m seeing a doctor this coming Monday about continuing pain in my left hip and down my left leg – he’s a locum (my own GP left the practice quite recently), and I’m afraid I’m just so cynical, I’m sure he’s going to advise me that “losing weight won’t do any harm”, even though I know for sure that it’s nothing to do with how much I weigh. It’ll either be that, or “it’s your age” (being 49, and inevitably hormonal at times), but I don’t see how hip pain can be down to my hormones, either! We shall see…..

  30. I injured my knees at the thinnest and fittest point of my life, thanks to crappy treadmill, a hard fall onto my knees while on it, and subsequent over-training while it was injured. I had just dropped 60 pounds at 17-18. I continued to work out and to keep up the ridiculous diet because I was scared that if I slowed down or treated the injury, the fat shaming I experienced my entire life would start again. I tell this to new docs when I try to get more help for the knees (still injured), and still weight loss instructions are issued. Thanks so much for writing this post and for this forum!

  31. I have a ‘bad knee’ that’s exacerbated when I carry more than a certain weight on it. But even below that weight, at my alleged ‘ideal’, it still tells me when the weather’s changing and when that is quite enough time on the elliptical, thank you. Some years ago, I decided that I’m gonna be fat indefinitely, and the knee is what it is, so adventure doesn’t have to wait until I’m 100%. So I hike things, and climb things, and do things to the fullest extent of (and perhaps a little further than) my capacity. This flummoxes a lot of people. People will notice my current slight limp and attribute it to ‘fat people knee damage’. I explain “It’s a wave-runner injury I should have rested. I climbed a pyramid instead,” and utterly refuse to walk them through the process of “the fat girl did a thing I probably couldn’t face” gently. They have such a problem with “someone who looks like you shouldn’t be able to do the things I can!” At the top of a very steep trail once, I had some Fitness Bunny look at me, exhausted from her climb, and say “Oh, there must be an easier way up than the one I took! I wish I’d known about it!” I would like six karma points and a glass of fine whiskey for not showing her the easiest way *down*.

  32. After the death on my son, I gained a lot of weight and also developped pain in my joints and grew very tired. When I went ot the drs, they all told me my pain and tiredness were due to my weight. I was walking 1 hour a day at the time. When they found out I had anemia, they said it was due to my poor diet. I was a member of a CSA at the time, have a vegetable garden, cook everything from scratch and haven’t changed my diet compared to before my son’s death. When I tell them that my weight gain is a sympom of whatever is happening to me as a consequence of my son’s death, they all say no. Weight is not a syntom, never, it is always proof you are a lazy person who does not deserve medecine or care.
    Cheers,
    Lucía (who cannot spell symptom)

  33. When I was 40, I blew out my ACL in karate class. The orthopedist said to me: “We don’t usually do ACL surgery on 40 year old women.” I looked at him and said, “I’m a landscaper. I can’t work without my knees.” I got the surgery, but I was pretty furious that the doctor attempted to deny me care because of my gender.

  34. This. I developed tendinitis in my knee and Advil wasn’t touching the pain. The doc ended up sending me to PT, but not until he’d very pointedly said that it wouldn’t get better until I lost weight. It didn’t matter that the X-ray also showed arthritis, that my past medical history of hip dysplasia, flat feet, and being knocked kneed, and years of marching band and horseback riding would be a potential issue. The derision in his voice when he talked about my weight and the revulsion in his body language told me I wasn’t worth bothering to help until I lost weight.

  35. I am fat, in my fifties, and I have ankle and knee problems. And through my (fat) forties, I fended off the trolls with – I’m fine; blood pressure OK, cholesterol OK, knees and ankles fine.

    And now – BP controlled with drugs; cholesterol only just OK. Ankles and knees kinda stuffed.

    And I’ve felt guilty about this, and angry with myself, and I’m so grateful for this article putting it into perspective. My current problems probably WOULD be ‘better’ if I magically lost weight, but I won’t so … irrelevant.

    And if I hadn’t ‘let myself’ get this fat – well – I might have injured myself some other way; or died running across the road, or …who cares.

    I just saw a new physio today, who works extensively with professional sports ppl so I was very nervous she’d pivot back to my weight, but she was GREAT – supportive of exercises building very slowly to increase strength and mobility, listened to my experiences and believed me. Then gave me hope.

    Such a relief.

    And now this timely reference from Ragen – I’m feeling so much better and will try for more positive self-talk, which should make my head a nicer place to spend time.

  36. Thank you, Thank you, thank you!


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