Fatphobia is very common in health care. Here’s How to Deal

Fat shaming, also called weight discrimination, occurs in the doctor’s office when a patient is given inadequate care or is blamed for their health because of their body size. This is a persistent problem in the medical system that can distress patients or even cause them to avoid care all together.

What some providers see as a tough-love way to motivate people to lose weight, on the contrary, inspires prejudice against obese people. harmful health effects, This covers everything from a provider being less likely to bond with their patient if they perceive them as overweight, the wrong dosage of medications and more.

“No one should have to choose between whether they get preventive care, or cancer screening, or treatment for active symptoms because they’re afraid that not only will they be fat shamed, but they won’t get the care they deserve.” are demanding,” says Annie Janzen (who styles her name with all lowercase letters), operations and project leader at the Association for Size Diversity and Health, a nonprofit.

You may already have had an experience where you felt that your health was ignored or mistreated in lieu of a hyperfocus on your size, especially if your body mass index is in the “overweight” range or on a BMI chart. is more. What can you do about it?

First, it’s important to realize what you are owed as a patient: quality care. If you don’t get it, it is not your fault as the person seeking health care services. Second, it’s important to realize that if a health care provider looks like they don’t know what they’re talking about when it comes to advice for large bodies, it’s because they probably don’t.

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How doctors go blind when caring for a large body

Dr. Fatima Stanford is an obesity medicine physician and scientist with Massachusetts General Hospital and Harvard Medical School. She says she learned more about nutrition and weight management through wellness magazines than in medical school. (This was before his special training.)

“The answer to your question is we are not trained,” Stanford said, when asked about the training doctors receive to discuss weight with patients. “It’s not a nice thing to say, but it’s the reality.”

This lack of training in large body care is visible in a number of ways, including offering nutrition advice (sometimes sought, often not) that will only work for a small proportion of patients, because alone diet usually are not effective long term, When the reason shown to the doctor is not addressed, or is generally dismissed as a form of social prejudice against large bodies, it can leave a patient feeling defeated, which is equally widespread in the medical community. Is.

How to Get Better Care When You’re Navigating Fatphobia

Feeling comfortable with your doctor starts in the waiting room. If you want to set up this office as your place of care, make sure there are seats that are accessible to you, and that you feel comfortable with the staff at the front desk. Once inside the exam room, you can also make your own decisions on further details such as the blood pressure cuff being adjusted and most importantly, how well you are being understood by the provider.

For some layout materials, you may call or message prior to your appointment if possible. Janzen also suggests presenting your goals for appointments or concerns ahead of time, with a letter you give to the person at the front desk, who can share it with your care team ahead of time.

“It’s not going to change anybody’s mind when you enter the waiting room and when you go back to the clinic, but it gives providers a second to sit with them,” she said.

Janzen says that within the next few weeks, ASDAH will finalize a list of providers who follow the organization’s Health in Care framework of every size, which should make it easier to find weight-neutral care near you. Is. But finding a provider that subscribes to this specific label may not be the most important thing, Janzen says. As providers, being able to “center” the patient and “meet the person in the room where they are today without judgment” is a fundamental standard of care that can improve the health care system overall.

All this to say: Don’t settle. If you don’t feel good about the care you’re receiving from your doctor, remember your rights as a patient and find a new provider.

A patient in a red shirt smiles while talking to a doctor

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reach out to the community

Joining a local group of like-minded people, such as the Twin Cities Fat Community, is a good way to get recommendations for providers near you or even tips for personalized care, says Jenzen. is the way. Another advantage of reaching out online or finding similar groups is that you may also find a support person, or someone to accompany you to a doctor’s appointment.

A friend or loved one who comes with you can also serve as a patient advocate — someone who will help coordinate your care, help come up with questions for your doctor, and more. Sometimes hospital systems or clinics have their own patient advocates.

You can also refine your search based on the type of care you’re receiving. For example, we found a fat-friendly Facebook group for people who are pregnant or trying to conceive.

redirect the conversation away from your weight

Getting yourself weighed is often a routine part of a doctor’s visit. However, you do have choices about how — or if — you step on a scale. The “Don’t Weigh Me” card, which you can order from More-Love.org, is a way for you to tell your provider that you do not want to be weighed unless it is deemed medically necessary. . But you can also ask that whoever is taking your vitals at the beginning of the appointment not read the number on the scale out loud, or tell them you’re facing the outside of the scale.

If you feel like your weight or size is becoming the focus of your health care journey, and there is a pressing issue at hand (as it usually is when you are seeking health care services), don’t say so. be afraid

Stanford offers a direct example of how to change directions. Something like: “I hear you’re pulling my weight, I have an ax in the middle of my head,” he said. “I’ll focus on getting the ax out of my head. It hurts—I’ll actually be able to keep my sight.” Then, if you’d like to discuss anything weight-related, you can suggest a follow-up appointment or actionable resource.

If your provider keeps insisting on weight loss as a topic against your wishes, take a page from this post on tips for medical self-advocacy from author Virgi Tovar: “Doctors Have a Special Area of ​​Knowledge that you are employing to use – such as the way you would employ an electrician to deal with electricity.” They should treat you for what you are paying for.

In a 2019 post, the ComfyFat blog recommends asking your doctor to note requests for your care, such as details for urine samples. That way, another nurse or doctor in the practice will have the note in your file and can save you from repeating yourself.

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remember your rights

“As a patient, you have rights,” Janzen said, adding that there is a strong power dynamic in the health care setting when doctors are expected to have all the answers and access to drugs is also controlled.

“They’re the key to your treatment, to your care, to your prescriptions,” she says. For this reason, it can be really frustrating – discouraging, even – to be in a setting that is hostile to you and your needs. But that doesn’t make it right, or something you have to tolerate. You have the right to dignified care, and the right to choose your provider.

“As a patient, it is your right to navigate your health and your health care the way you want,” Janzen said. “The idea of ​​body autonomy is incredibly important in the provision of health care services.”

The information contained in this article is for educational and informational purposes only and is not intended to be health or medical advice. Always consult a physician or other qualified health provider with respect to any questions you may have regarding a medical condition or health objectives.

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