Did you read Jess’s awesome piece a while back entitled “Dear Doctors, Quit It With the Weight Bullying?" If you didn’t, I’ll wait patiently while you go read it.
One of the very important points that Jess makes in this essay is that weight shaming from doctors not only makes you feel bad, it actually discourages people from getting check-ups as often as they should.
Last Tuesday, I went to my gynecologist for my annual. My doctor is a cool lady, and even gave me a recommendation for her favorite sex toy shop, so I have a lot of respect for her. I was not so cool with what happened after the exam, however.
“So, I’ve noticed that you’ve gained 19 pounds in the past six months. Maybe you should think about changing your lifestyle habits.”
Given that I am aggressively working on dealing with the stress-related eating and lack of exercise that led to this weight gain, I was predictably pissed. I immediately thought of Jess’s article, and how common of a problem this is. We spend a lot of time talking about things that are screwed up on XOJane, but it wouldn’t hurt to spend some time coming up with active strategies for changing things for the better.
I am currently applying to grad school to become a women’s sexual health advocate, and I decided it was time to start some doing some advocatin’ and playerhatin’ on my own behalf.
Unlike Jess’ experience, I was lucky that my doctor was actually respectful enough to listen to me. I told her that, as my gynecologist, I don’t feel like it’s her place to police my weight.
She replied that many women will see their gynecologists for their annual pap smears, but may not get to see a general physician for regular checkups if nothing seems wrong. (I imagine this is especially true for uninsured women who have access to low-cost women’s health services through Planned Parenthood but cannot otherwise afford doctors visits).
She also said that she brought up my weight because studies have shown that when doctors ask their patients who smoke to set a date to quit smoking, they’re more likely to follow through. (I don’t think losing weight is anything like quitting smoking, but this was the analogy she used.)
OK, so I get where she’s coming from. I understand that she’s trying to show interest in my overall health, and that a major weight gain over a short period of time might be a legitimate indicator of a serious health problem.
However, there are a lot of reasons why people are fat and gain weight, and it’s not OK to make assumptions about someone’s body without any context. I’m aware that I’ve gained weight, pointing this out doesn’t actually motivate me improve my lifestyle habits (which are already pretty good); it just makes me feel bad. It’s one thing if my GP tells me I need to lose weight because tests show that I’m borderline diabetic. It’s another thing to have a gynecologist remark on my weight when my blood work is consistently perfect.
I can’t say we were able to see eye to eye on everything, but when I expressed that her comments felt like a disrespectful violation of my privacy, she replied by asking what should could have done differently, which is actually pretty cool.
I suggested that she ask patients about their general lifestyle habits in non-weight specific ways, and ask them if there was anything they’d like to work on improving. If the patient says no, that’s the end of the conversation. You can’t force a person to quit smoking, eat vegetables or take up jogging if they have no desire to do so. And it might be that they’re already a non-smoking, vegetable-eating jogger who happens to be fat.
I also pointed out that weight talk is a major psychological and emotional trigger for many patients (especially people with eating disorders), and that if she feels that it’s absolutely necessary to bring weight issues, she should first ask the patient’s consent to discuss the matter.
I encourage all of you -- regardless of your size -- to speak freely with your doctor if they speak to you in a way that feels disrespectful or insulting. You do not have to be submissive, apologetic or ashamed of your body. This person is being paid ridiculous amounts of money to perform a service for you, and if the service is lousy, you have every right to write a nasty review of them on Yelp and go find a new doctor who isn’t an asshole. (I realize that a lot of us don’t have insurance, and this isn’t an option for everyone, and it seriously sucks.)
Here are some strategies for turning your doctor’s office into a safe space:
• Ask around to find a body-positive physician. Ask to speak to the doctor before you even make an appointment if possible.
• You can decline to be weighed. If they make a fuss, continue to politely but firmly decline. An eating disordered friend tells the nurse that being weighed is a trigger for her, and they usually back off.
• Don’t be afraid to tell your doctor upfront that you’d like to focus on your health, rather than the number on the scale. Don’t be afraid to print out a copy of Jess’s article and hand it to your physician. Do your homework, and be prepared to advocate for yourself. I find that speaking assertively in a calm tone of voice is a million times more effective than becoming upset or angry.
• If they still refuse to take you seriously, explain that you will not be seeing them again, and walk out.
I am very interested in hearing what strategies other people have cultivated in order to deal with fat shaming in medical settings. Have a suggestion? Leave it in the comments!