I remember being in high school.. and my doctor never – never – mentioned my weight. I can’t say, for sure, exactly why that was… but this very cheery, young, happy doctor would tell me “Well, you’re 215lbs, but that’s ok.. you’re just tall.” He wouldn’t look at last years chart to see whether or not I’d gained 20lbs in one year. He wouldn’t talk to me about food or activity levels at all. He’d just bypass the subject altogether.
I’d eventually go on to gain weight at a pretty ridiculous rate for the next few years.
Needless to say, I didn’t experience that which I’m about to write about… but that doesn’t mean I can’t highlight the confusion, here.
Welcome to First, Do No Harm: Real Stories of Fat Prejudice in Health Care. This is a website that chronicles stories of medical bias and prejudice occuring between doctors and their patients.
Every so often, I get someone who comments about their doctors and how uncomfortable their doctors have made them in regards to their health. There’s even a tale on this site of a woman who’s doctor clearly overlooked signs of pneumonia because the doctor wanted to primarily focus on the patient’s weight. It’s easy to see that many of us fear going to the doctor – something all too common in the Black community – but you’ve got to admit, this poses a big problem for us. For those of us who can move beyond the “Ahhh, I don’t neeeeed to go to no damn doctor” attitude and actually go… if we – Black Americans, of whom, approximately 60% are overweight – go to the doctor and are met with bedside manner like that mentioned below… how many of us will actually keep going?
Last April, after four months of hard exercise and healthy eating with only four pounds of weight lost, my mom suggested I get tested for hypothyroidism. She had recently lost about 40-50 pounds after getting her hypothyroidism under control, and it had also been diagnosed in my grandfather, aunt, and cousin. Considering it’s hereditary, I figured I might as well and set an appointment with a doctor at Austin Regional Clinic to get tested. I’d heard a lot of negative feedback about ARC, mostly that they treat illnesses, but don’t deal with/care for preventative treatments. They were the only people I could afford that took the s—ty insurance I had though, so I really didn’t have much of a choice.
When the doctor came in to see me, she didn’t even look me in the eyes before she flipped a page on her chart and said, “You know you’re obese, right?” She didn’t even make fucking EYE CONTACT with me before she just came out with her b—s— BMI calculations to tell me that I needed to lose weight. I said, “Well yeah, that’s why I’m here. I work out hard and nothing happens, so we thought it might be a thyroid problem.” She lectured me for a bit about needing to eat better and work out longer, but didn’t let me explain that I do eat well and I do work out.
The most commonly accepted threshold for TSH levels is 5.0, but I had read some studies saying that the reason those TSH levels were so high was that there were a lot of people with untreated hypothyroidism included in the studies to determine the average. My mom’s doctor, who spotted and subsequently treated my mom’s hypo, follows a couple of studies that came out a few years ago saying that the recommended TSH levels are actually 3.0, with another expected drop to 2.5 in the next few years. To accurately diagnose hypothyroidism though, you need to compare those TSH levels to triglycerides, blood sugar, blood pressure, cholesterol, etc, and you can’t base a positive or negative diagnosis just on TSH levels. It also helps to have a family history when diagnosing, so you can determine when the spike in TSH levels generally occurs in your family, but when I tried to tell her about the other members of my close/immediate family that experienced this, she shushed me.
After the embarrassing lecture from the completely inept doctor, I tried to bring up the new studies with the lower TSH levels, but I was so frazzled and she was so uninterested that she wrote me off with what amounted to “I’m a doctor and you’re not so shut up.” She shuffled me off to the lab so I could get my blood tested, without telling me what she was actually going to test. I guess I figured “she’s a doctor so she knows what she’s doing” and didn’t question the lab tech about what was on my chart. I got an automated call two days later with my results, a TSH of 2.56, but no explanation or diagnosis of those results.
I called and left three messages for the doctor before getting a returned call from her one week later. She succinctly said, “You don’t have hypothyroidism,” and when I asked her about the other aspects she was supposed to test, she said, “I decided not to test those.” When I told her about the specific scientific journals where I read about the new TSH levels, she basically said she hadn’t read/heard about that and didn’t really care.
I was talking to my mom over Christmas about something I thought was entirely unrelated (okay it was constipation you guys, are you happy?) and she said that was something she experienced a lot of before she started getting her thyroid under control. I went home and looked at related symptoms for hypothyroidism, besides unmanageable weight, and it was basically like a checklist of s— I deal with that I thought was just my own bad luck – unnaturally heavy and unreliable periods, very dry skin, sensitivity to cold, brittle nails, and achy muscles.
So now here I am, almost a year later, and still basically the same exact weight. I work out HARD for about 1.5 hours a day, I eat remarkably well, and have even started eating m—–f—– vegetables. I do everything a person is supposed to do to lose weight, and I’ve made practically no progress. My mom and I have decided that I really need to be tested again, and this time by a doctor who actually knows her s— and not some worthless s—head at ARC.
Which leaves me in a jam. I am broke. I make like negative dollars in my paycheck, and I have a lot of bills to pay every month. I don’t have $100 to spare on a monthly basis, but I need insurance if I want to get this treated. My only other option is to pay $353 for the initial tests and hope the doctor can figure everything out on the first try because I can’t imagine being able to scrape that together more than once.
What would you do? Would you stay chubby and hate yourself a little more every day, while losing the will to continue working so hard to lose weight and because you see absolutely no results? Or would you go into debt in the hopes that you do have hypothyroidism and all of this could change, while risking the chance that it isn’t and you’re back to square one? [source]
I’m 22 and I have multiple mental illnesses – complex PTSD, OCD, social anxiety disorder, depression and a sleep disorder – most of which are the result of surviving rape and sexual abuse. I’ve had disordered eating for most of my life, which is currently manifesting as compulsive overeating disorder.
I had lap-band surgery in 2007 and lost a lot of weight, but my doctors kept telling me I needed to lose more. My psychiatrist told me that she thought my social phobia would go away if I achieved a ‘nice figure’. Since my metabolism has been affected by the various medications I’m on, as well as years of yo-yo dieting, it is exceedingly difficult for me to get to a BMI below 28.
My psychiatrist decided to adjust my medication 8 months ago, which caused me to start regaining weight. Since the new antidepressants didn’t work, bingeing was the only way for me to regulate my emotions in order to stay alive. I am now back on the original antidepressant, but it hasn’t been as effective since then.
I saw her a few days ago. Within the first 10 minutes she started attacking me about my weight. It started with the usual spiel about the supposed link between high weight and various diseases, but she seemed angry which was out of character for her. I calmly told her that my weight gain was mostly due to a higher dose of anti-psychotics (which I take to get to sleep). I admitted that I had been eating more, but said that if I didn’t binge I would probably kill myself. She responded by saying, “You are killing yourself” (meaning I would give myself diabetes or hypertension). I told her that I didn’t wish to discuss it any further. When she persisted, in an increasingly censorious tone, I got up to leave and told I wasn’t there to be lectured about being fat. She told me that I was being irrational and making ridiculous accusations. I have low self-esteem and am very sensitive to criticism, so this made me feel as though I’d been struck.
At this point I was sobbing and feeling like I was watching myself from outside my body. I now realise that I was having a panic attack. I thought the gate was locked and I was waiting for her to unlock it (she works from her home and has a locked gate in front of the door for security). Feeling trapped is especially triggering for me because I was raped in a locked house when I was 13. I was struggling to breathe, and being ordered to “stop hyperventilating” wasn’t helping matters. I told her, between sobs, that my problem was my trauma and not the fact that I’m fat. I also kept saying that I wanted to leave. When she asked me why I didn’t just leave, I told her that I couldn’t get out. This seemed to enrage her, and she said, “You’ve been coming here for 6 years and you know you can always open the door, you’re being ridiculous”. I didn’t know this because she is always the one to open the door and the gate and I hadn’t thought to check whether the key was in the lock (which it was).
I left feeling like my stomach had been ripped open. I don’t think I’ve ever felt so betrayed in my life. I’ve told her every detail of every trauma I have, and I trusted her completely. It’s very hard for me to trust anyone, and I’m so angry with her for making it even harder. I don’t know how she can justify what she said when she knows that I’ve been struggling with suicidal thoughts and that I’m not able to handle any more stress at the moment. I’m scared that I’ll have to either stop taking my medication when my prescription runs out or go through the hell of trying to find another psychiatrist, who most likely will turn out to be just as ignorant and judgmental as she did. [source]
One more, sigh:
When I was 10 years old I went my pediatrician for tonsil problems. However, all that seemed important after getting off the scale was my weight. While I was sitting there in terrible pain from tonsillitis (which I’ve been seemingly getting monthly my whole life), he just kept going on about how dangerous it was that I was 10 pounds “overweight.” He guaranteed her that I’d get type 2 diabetes. This is not the first time my doctor visit has went like so. As soon as I was at risk of being “overweight” when I was about nine, he’s been telling my mom to put me on a diet.
In fact, my parents have already tried to put me on a diet. They’ve been trying since I was 8 years old. After that doctor visit my parents humiliated me and said they’d pay me $10 for every 10 lbs I lose. I decided to go on a diet. By the time I was 12 I was 5’5′ and 72 lbs. I was very underweight and couldn’t go to the mall without passing out from exhaustion. My mom brought me to a doctor to see if I was anorexic. I would not admit it then but I was. I ate no more that 400 calories a day and thought about nothing but calories. We went to my pediatrician (the same one as earlier) and he said that I was going through what all teenagers do as far as worrying about my weight and that my parents shouldn’t worry. I ended up having to go to the emergency room a week later because I was unable to defecate in over a month due to starving myself. After that ordeal I was sent to a eating disorder clinic. Point being, my doctor saw being 10 pounds “overweight” and even at risk of being “overweight” as a serious issue. Anorexia however, was not. [source]
I have words for this… but I’m not going to share them just yet. What are your thoughts? Have you experienced this kind of fat prejudice? Has it affected your desire and willingness to visit your physician? How prevalent do you think this is in our community?