Fat-shaming happens, even if you aren’t “fat”

EB writes:

I have never been anything that anybody could reasonably call fat. At 5’5.5″ I stayed around 125 from the ages of fourteen through 26. At 27 I weighed myself (usually a bi-yearly event or so) and discovered my weight had crept up to 135. This didn’t bother me because I was getting fat (because I wasn’t) but I thought maybe I was consuming more calories than I needed. I hadn’t noticed because at this time I wore mostly drawstring-waist clothes and hadn’t seen a change in the way they fit. I kept a cursory eye on what I ate, keeping in mind that I was clearly getting as many calories as I needed and maybe a few more. With no further effort on my part my weight came down to 130.

Then I found out I was pregnant.

And then I got hungry. Constantly, crushingly, insistently hungry. This was not the normal First World hungry or even the “I’ve been hammering boards together all day and boy am I famished” kind of First World hungry. This was something different. And I had to feed it. So I adapted my diet as best I could, in the interests of staying a functional human being.

I went for my ten-week checkup and was scheduled with a nurse practitioner who I had not seen before that day. She walked in, stood by the door, didn’t bother to introduce herself, and asked me how I was feeling. I didn’t feel much like discussing how I was feeling, since I’d discussed it to death with everybody, including having discussed it five minutes prior with the woman who took my blood pressure, but I answered dutifully with a response along the lines of “I’m making it”. She queried me more closely and I told her that I was constantly hungry, eating all the time, and kind of fatigued.

She told me this was normal for pregnancy. Which I already knew, which was why I didn’t want to discuss it because what was she going to do to fix it? I told her I wasn’t really feeling nauseous but mostly it was just that I got sick of certain foods because of eating them when I had no desire to eat them. She didn’t seem to understand this concept and I said “You know how sometimes you’re like ‘Man, a sandwich would be really tasty?’ Well, it’s the opposite now. It’s more like ‘Man, I really don’t want a sandwich, but I’m starving and I have to eat SOMETHING.'”

She asked me how often I ate and I told her honestly that I would eat five times a day and snack in between.

She then proceeded to jump to conclusions about how MUCH I ate at each of these meals, telling me I’d gained 10 pounds since before I was pregnant and that during the first trimester I was only supposed to gain about a pound a month. [Let's not discuss here how much of that might be breast tissue; I’d also gained a couple of cup sizes by that point.] Wait. WHAT? I challenged this and she said that my record said I had weighed 125 before I was pregnant.

Now let’s discuss the poor data-gathering I observed at this office. At the first prenatal appointment the provider asks how much you think you weighed prior to getting pregnant. You answer and that, apparently, gets added to your record. If you happened to be wrong about that, then how are you going to know? My guess would be I said my pre-pregnancy weight was 125, 130 or so, and she wrote down 125. They would then weigh you at each visit and the medical assistant taking the weight seemed not to care if you leave your shoes on or take them off or if you’re wearing your coat or who knows what all else. So you have to figure any reported weight could be off by 2-3 pounds. Add in the effects of, say, wet hair, a full bladder, having your wallet in your pocket, or having just eaten breakfast. That’s another 2-3 pounds that you could be off. Therefore, if you are the provider and looking at this number, you need to bear in mind that it is a ballpark figure.

But what the heck. Look at a garbagey number, compare it to an equally garbagey number, and criticize a starving pregnant woman and tell her to eat less.

Anyway, she said that I’d weighed 129 at my last appointment a month previously. So if I was supposed to gain a pound a month, I was 5 pounds over and apparently deserving of this lecture? I was distinctly irritated by this point and commented about full bladders, and she dropped the mention of specific numbers but then said something about how if I was eating five meals a day and snacking in between that was probably too much, as if she knew how big of meals I was eating. Then she started to say something about how maybe if I wanted a sandwich I could just eat a really small sandwich, which I cut off by saying “I know about portion control.”

Then she shifted gears to talking about exercise. I admitted that I didn’t exercise much because I felt lousy most of the time. She asked, in the same sort of perky voice that she had been using through the entire conversation, what I liked to do. I said walking and she said I should shoot for walking 30 minutes a day. I pointed out for the second time in two minutes that I feel lousy, fatigued, not up to it, and she pointed out that exercise produces endorphins that make you feel better (which I knew, but I so did not need this lecture on this particular day). I cut off this conversation too and said that this wasn’t even what I wanted to talk about and I had other questions, and she mercifully dropped the subject.

So, short version, I got criticized for supposedly gaining too much weight, for almost no reason whatsoever, after I’d just told her I was hungry constantly.

I ended up switching practices. I never reported this lady, though I wish I had. I ended up gaining almost 50 lbs before delivering my daughter, and the new providers I saw never said word number one about it—at each visit they told me my weight was fine. My daughter was an average weight, neither of us had any complications, and I was back to 125 by six months postpartum. Apparently whatever horrible thing was supposedly a risk because of those extra 5 lbs never materialized. I wonder if it is worth reporting this provider as this was 2 1/2 years ago. I shudder to think of the effect of this conversation on someone who actually had an eating disorder or even food issues (since aside from food aversions in pregnancy I have the least food issues of anyone I know.)

Chris Christie fires back at doctor who diagnosed him from 2,400 miles away

Brian writes:
I know First, Do No Harm, is primarily about private patients’ stories, but today’s Chris Christie spat is such a perfect example to bring up.

Dr. Connie Mariano, a former White House physician, went on CNN and made the following comments about Chris Christie:

“I like Chris Christie a lot, I want him to run, I just want him to lose weight.”

“I’m a physician more than a Democrat or a Republican, and I worry about this man dying in office. I worry that he may have a heart attack, he may have a stroke…it’s almost like a time bomb waiting to happen unless he addresses those issues before he runs for office.”

A doctor looking at nothing more than our weight and telling us we’re going to die? We all know that story. But what’s amazing is that Christie responded with probably the strongest statement against fat discrimination and doctor prejudice I’ve ever heard from a national politician, and it’s one we should all feel free to borrow when dealing with our own prejudiced doctors:

“You know, I find it fascinating that a doctor in Arizona who’s never met me, never examined me, never reviewed my medical history or records, knows nothing about my family history, could make a medical diagnosis from 2,400 miles away. She must be a genius. She should probably be the Surgeon General of the United States, I suspect, because she must be a genius. I think this is just another hack who wants 5 minutes on TV”

“And it’s completely irresponsible. Completely irresponsible. My children saw that last night. And she sat there on TV and said ‘I’m afraid he’s going to die in office.’ I have four children between 9 and 19. And my 12 year old son comes in last night and says, ‘Dad are you going to die?’ This is irresponsible stuff. And people who have a medical license, who have the privilege of having a medical license, should in my view conduct themselves more responsibly than that. If she wants to get on a plane to come here to New Jersey, and ask me if she wants to examine me and review my medical history, I’ll have a conversation with her about that. But until that time she should shut up.”

If anything it’s too nice to the doctor (the sarcasm covers up the fact that she was grossly wrong even on statistical analysis–a 50 year old “morbidly obese” man with no comorbidities (I assume), who doesn’t drink or smoke, and is reasonably fit is fairly unlikely to die before 62, the age Christie would be when he leaves office if he runs and wins in 2016). But still, it’s pretty damned impressive to see a politician fire back with righteous anger at a bigoted doctor rather than abase himself and apologize for his weight.

My take on this is that the good doctor isn’t taking into account the amount of stress that anyone who is POTUS has to face on a daily basis. And it’s that stress that has a more deleterious effect on one’s health than only being fat ever could. But how many of our doctors ever ask about the stress in our lives? How many of them look at us, see a fat person, and automatically assume that we’re lazy and eating nothing but junk food? How many of them ignore things that could help improve our health in favor of prescribing the Nightmare On ELMM Street? This doctor isn’t any better or any worse than any of the doctors we’ve had to face who looked at us and saw nothing but their prejudices about fat people, she just happened to pick on the wrong man – a governor who has the guts and the media attention to strike back at her and tell it like it is: “You aren’t my doctor, you don’t know me, you don’t know my family history, you don’t know what I do or don’t do, you don’t know anything about my health, so you need to shut up and quit diagnosing long-distance.” I may not agree with his politics, but I say “Hooray for you, Governor Christie, hooray for standing up to a fat-phobic, bigoted doctor.”

Too old and too fat to be pregnant (FFS!)

Amy Finn says:
I was 36 years old, 5 feet tall and about 170 pounds when I went in excitedly to my initial ob appointment for my third pregnancy. I was stoked about this little surprise the Universe had dropped into my lap.

I had delivered my second baby through this practice just five years earlier and admittedly, while I liked one doctor more than the other four, I didn’t have any issue with them throughout my care despite my gaining 50 pounds during that pregnancy.

That changed immediately with this visit.

The doctor walked in holding my chart. The first thing she said was, “We all know you don’t want to be here.” I laughed just because I couldn’t figure what she was on about. She continued, “Thirty six years old and a third baby. Hmm. We all know your eggs aren’t any good any more.” My eyes darted around the room looking for just who “we all” were in the room. Nope, no one else there. Just the two of us and of course, my baby.

She spoke on and on about why it probably wasn’t a good idea for me to have the baby and that time was running short for me to terminate the pregnancy. I finally held my hand up and said, “I am not terminating the pregnancy. Let’s just move on from there.” She sighed and looked down at the chart, her eyes popped out a bit.

“Well, you’re rather obese, aren’t you?” At this point I was looking around the room for the hidden cameras because clearly, this could not be real life. “If you look further in my chart you’ll see my blood work and health markers are all terrific.” I felt frustrated having to justify my size to her but I was in shock and truly regretting sitting on that cold table clad only in a paper sheet being berated by this woman who didn’t know me at all.

“Well, you can’t gain much more weight. It’s detrimental to your health and… and your baby’s health. You will only be able to gain nine pounds this pregnancy.”

At that point I guffawed so broadly, I’m sure patients two rooms over could hear me. “Listen, doc, if you again check my chart you’ll see that my two previous babies were each nine pounds. How could I only gain nine pounds? How do you accommodate a baby, extra blood flow to me and what not?”

“Nine pounds,” she repeated. She turned on her heel and left.

If I had been further along in my size acceptance philosophy, I would have calmly gotten dressed and walked out refusing to pay. However, I was still struggling with my size and so I continued at that practice. I made sure to never see that doctor again. I did complain to the senior practitioner about this doctor’s behavior, but I do not know if anything was ever done about it.

For the record, I gained 50 pounds with this baby. Not one of the practitioners said a word about it to me. And my baby was exactly nine pounds at birth.

——–
This took place about a year before I realized and fully accepted size acceptance and health at every size. My life is much different now and I am thankful for that.

Shamed by ob/gyn – health not important, weight more important for pregnancy.

Emily writes
I am 5’4″ and weighed about 153 lbs before my current pregnancy (I’m about 8 weeks along). When I went to my doctor in December and mentioned to her that my husband and I would be trying for baby #2, she immediately told me that I should lose a little weight because I was carrying a little too much and that it would help me get pregnant.

I felt terrible about that for several weeks. I have been trying to get back to my personal ideal weight of around 135 since baby #1, and it’s been a struggle, even though I pretty easily got back down to my pre-pregnancy weight of 150. I also resented the fact that she brought up my weight when talking about pregnancy since my husband and I have never had any problems with fertility. (Three pregnancies within a month of starting to try, with one healthy baby, one miscarriage and my current pregnancy). I weighed about 150 pounds all three times. My doctor was basing her comment on absolutely nothing that had to do with me, as she doesn’t know my eating habits (very nutritious) or my exercise habits (I run 12 to 20 miles per week).

When I went back to my doctor for the pregnancy confirmation appointment this week, she told me that the maximum ideal weight for my height was 126. She seemed to be using the chart as the bad guy so she wouldn’t have to tell me directly that she thought I was fat. I told her that was ridiculous and that my personal ideal weight was around 135. She then told me that living in an overweight culture means that your view of normal gets skewed. Again, I told her I was in my absolute best shape at around 135, and asked if she would say that meant I was fat at that weight. She said “I wouldn’t use that term. I would say overweight.”

I sobbed in my car for 10 minutes and I am now feeling like I’m doing nothing right. I have already switched doctors, but this woman’s bugaboo about weight (when again, she knows NOTHING about my level of cardio health, nutrition, etc) has really hurt me and made what should be a joyful time stressful and unhappy.

Thank you. I’m so glad your website is out there. I felt so isolated and ashamed after this happened, and because I’m not yet revealing the pregnancy to friends, I also felt as though there was no one I could tell about this.

THIS is one of the reasons the war on childhood obesity needs to end, NOW!

Kris writes:
I came across your blog recently and it made me recall two things that happened to me when I was younger. I’ve been overweight for most of my life – it’s definitely in part because of genetics, as the women in my family are all about my size (and the men are even bigger) and also, I’m guessing, in part because my mother overfed me when I was younger because I was two months premature. It’s something I’ve always struggled with.

When I was eleven, I started having strange symptoms. Headaches, tiredness, dizziness, blurry vision. I went to doctor after doctor, and they all said one of two things. It was puberty or it was my weight. I’m not sure how being overweight gives you a headache (apart from having to listen to people be jerks about it) but my mother took it at face value. After all, they were doctors, right?

A few months later, it all got a lot worse. I wound up passing out, and was rushed to the hospital. Finally they gave me a CAT scan and found orbital cellulitis – I had an infection in the orbits of my eye, that was dangerously close to affecting my brain. If it’d gone on, it could have caused blindness, deafness, or a blood clot in my brain and killed me.

I got a new doctor, one who I saw for a few years after that. She must have suggested weight loss about 500 times to me while I was going to her, which caused a lot of discomfort and self-esteem problems for me. I felt like saying, trust me lady, I know I’m fat. The kids at school would never let me forget it. Do you think this is news?

At about fifteen, I started having weird periods. They’d come and go at random; sometimes I’d go months without having any, and sometimes I wouldn’t stop bleeding for weeks and weeks. I went to the doctor and mentioned it. She did that test where they press on your stomach. I had intense pain when she pressed on a particular spot, to the point where I cried out.

Her response? “Oh, poor baby.” And to suggest weight loss to make my periods more regular, of course.

At 18, when I left for college, I was in constant pain. The cramps were unbearable, so I finally visited the ER. I was given an ultrasound and they found a large ovarian cyst – about the size of a large grapefruit. “If you weren’t so overweight, your doctor would’ve felt it,” the ER doctor said. Because it was completely my fault that my doctor didn’t do an ultrasound or follow up on the pain and symptoms I was having. I wound up having it removed, and it was a whopper – 18cm.

When you’re fat that’s the only thing that can be wrong with you. Every disease is obesity. If I was bleeding out my eyeballs, some doctor somewhere would insist that it could be fixed with diet and exercise.

Lots of strange symptoms? Nothing that weight loss won’t cure!

Kae writes:

I have always been heavy for my height. However, as a child and teen I was also very active and generally healthy and so for a long time I only weighed 15-25 lbs more than I was “supposed” to. However, around the time I turned 16 my family’s regular doctor (whom we all loved) was preparing to retire and her office hired a new doctor to replace her. Unfortunately, this new doctor had a bad reputation for being dismissive and impatient. One friend whose mother used to go to him at his former office had nothing good to say about him. He had misdiagnosed her and the medicine he put her on made her illness worse. She switched doctors and warned everyone to avoid her old doctor if they could. Sadly, our insurance gave us limited options as far as primary docs were concerned and so we had to see him until we were eventually allowed to change providers.

My father hated him. He said he was rude and arrogant toward him. My mother disliked him because he never fully listened to her and basically ignored what little he did hear. Then I met him. At the time I was experiencing some strange symptoms. My periods were irregular and very heavy and painful, I was growing hair in unwanted places, and I was losing the hair on my head. Worst of all, I began to gain weight rapidly even though my eating habits and mobility had not changed. At the time I also suffered from terrible allergies that made it impossible to breathe through my nose. It was primarily because of the allergies that I went to see him. He took one look at me and suggested I lose weight. I then explained about all of the things I was experiencing and he dismissed it all, saying that all I needed was to try harder to lose weight and that everything would magically right itself.

His dismissal of my symptoms dismayed me, but as he didn’t indicate anything else might be wrong, I let it go. However, his blithe attitude also made me wary of doctors and I only ever saw one after that if I was really sick. Fast forward five years. I was 22 and newly married and I had just learned that I was pregnant. Because I now had different insurance I had to scramble to find a new OB/GYN. After a few let-downs I ended up with the nicest of doctors. During my first exam my new doc shook my hand, looked me over (while I was still fully clothed) and said, “I want you to get your thyroid checked.” When I asked why, she said that I had several very obvious outward signs of hypothyroidism and she was very surprised that no doctor had had me tested for it yet. We talked for a while about my symptoms: Unusual body hair growth, thinning head hair, painful and irregular periods, abrupt weight gain, and the fact that exercising wasn’t helping to take it off. She ordered the blood work and I had it done the next day.

Sadly, it was not quickly enough. I had a devastating miscarriage a week later, and although my doc said that anything could have triggered it, she surmised that my severe hypothyroidism was an attributing factor. The blood tests came back the day after the miscarriage and I was immediately put on thyroid medicine. Within three months my periods became lighter and more regular, my hair became thicker, and I dropped 30 lbs. I also became pregnant again and 39 weeks later I gave birth to a healthy baby girl.

Still, whenever I think back on it I get angry. If that bastard doctor had actually taken the time to listen to me or to see more than my weight, would my first child have survived? I do know that if I had been properly diagnosed when I was 16 I wouldn’t have had nearly as many problems as I ended up with.

Unexplained Weight Gain? – You must be gorging yourself, no other explanation for it.

Hi – I found your blog in the aftermath of a visit to my doctor about my rapid unexplained weight gain that left me shocked and in tears.

I have always been super health and exercise conscious, but over the last year I have gained 25 pounds and no amount of dieting or exercise will shift the scales. I consider myself very nutrition conscious – in fact health and nutrition have always been personal interests of mine. After trying several doctors, who all simply referred me to community dieticians who: 1. told me about calorie intake and the food pyramid 2. Advised me to ‘move more eat less’ 3. gave me a printout of the Paleo Diet from the internet, I decided to visit an eminent and expensive doctor in my area. After explaining that I tried everything, that I was very well informed about exercise and nutrition and was looking to discover if there was another cause of my inability to lose weight, he started a barrage of the most astonishing comments. The worst part was, these comments were not addressed to me, but to a very young, very slim med student who was sitting in on the consultation. I won’t bore you with a blow by blow description, but a selction of his comments included:

“No one ever went into a concentration camp and came out fat”
“Have you ever read the book “Why French Women don’t get Fat”?
“Cut out those chocolate biscuits at morning tea” ( I hate chocolate)
“Don’t you have any other interests, hopes dreams that you could be thinking about instead of food?”
“Have you ever been to Europe where people really respect good food?” (I guess the assumption here was that I live on burgers and fries? In fact I lived in Europe for 20 years and am very interested in cooking and food of different countries)
And my favourite – directed to the student: “What do we call people who make the same mistakes over and over and expect a different outcome?”
To her credit, the young med student looked mortified, but not as mortified as me..My lip was quivering and I could barely speak. I walked out of there with a pathology referral whch was not explained to me, shell shocked and devestated.

I now find myself even more humiliated, feeling worthless and not entitled to having anyone give a damn about helping me resolve my weight issues. And guess what, if this rate of weigh gain continues, I will represent a worse health risk and get treated even worse by the medical profession!

Young? Chest pain? Fat? It’s your weight, it can’t be your gallbladder (even if tests say otherwise).

Tod writes:

I think it would be relevant to note that although I am a guy, I am FtM transgender and at the time the doctor in question considered me a young woman. I don’t think she would have treated me this way if I had been a cis man; the stigma against overweight women seem much worse than overweight men.

Anyways, this happened about a year ago, when I was 19. I had a terrible relationship with my doctor, primarily because she spent most of every checkup questioning me on my eating habits, and clearly did not believe what I told her (I live a pretty healthy lifestyle, and still manage to be 5’5″ and weigh 220lbs). She was convinced I needed to lose weight to help my asthma (still not sure how that one was supposed to work) and my somewhat high blood pressure that I couldn’t seem to mitigate regardless of changes in lifestyle.

I started having fairly severe pain in my upper chest, especially at night. Being as I lived at school at the time, I went to see the campus health center, which is staffed by extremely nice and competent nurses. The woman I saw there told me it sounded like a very bad case of gallstones. She suggested I change my eating habits, come back the next day and see if that helped. It did indeed help; no fats or oils, no pain. I also talked with my mom around this time and found out women in our family have a history of developing pretty severe gallstones around this age. So I called up my doctor and scheduled an appointment for that weekend, when I could get home.

She seemed very skeptical of the nurse’s conclusion when I told her, and insisted I get her notes from when she met with me. The people at the campus health center were also somewhat bewildered by this, but happy to comply after working out what forms I needed to sign.

So I go home, then to the doctor with these notes; she barely glances at them before stuffing them into her file and asking me to describe what was going on. I do so; she cuts me off as I start talking about how eliminating fats from my diet had done a lot to help with the pain (although at this point it was starting to come back if I so much as twisted too suddenly). She asks me if these ‘fatty foods’ were pizza and nachos that I was eating in the middle of the night.

I was rather stunned and told her no, I was talking about salad dressing, some fatty red meats, and the occasional side of french fries. And I don’t eat in the middle of the night.

She insisted, though, basically telling me she thought I was sneaking junk food in the middle of the night and that it was just causing me heartburn. She also insisted I was too young to get gallstones, even though I told her my family has a history of it.

I argued with her about it and finally she consented to schedule me for an ultrasound to have a look, as well as several blood tests to ‘cover all the bases’. I happily complied with the blood tests, went for the ultrasound the next weekend. By this point I am restricted to eating things that contain absolutely no fat or oil, and am in a constant, although somewhat low level of pain; I’m having attacks every night after dinner regardless of what I eat.

The ultrasound tech was very nice, and when I described my symptoms also immediately concluded it was gallstones. It didn’t take him very long to locate them; I could see them on the screen before he even started to point them out to me – there were a lot; my gallbladder was (quite literally) about half full of gallstones. Afterward we discussed the standard treatment (removing the gallbladder) which he said would be the best option in my case, and should be done soon. He sent the results along to my doctor and said she would help me get a surgeon.

So I go back to school, wait for the call from my doctor to schedule an appointment. A week goes by; no call. The technician said she should have gotten the ultrasound results the day after the procedure. I decide to call and find out what’s up.

Turns out yes, she did get them! No, she hadn’t been intending to schedule an appointment with me. Why? She doesn’t think the gallstones are the problem. It’s my weight, she insists.

Apparently at this point she wasn’t even bothering with the sneaking junk food idea any more; I was just in pain because of my weight.

At this point I decided enough was enough. I stopped seeing her and immediately found a new doctor (the one my dad went to, so she was somewhat familiar with our family). She was able to fit me in that weekend when she found out what was going on; she then immediately scheduled me for an appointment with a surgeon, who scheduled me for surgery within the week; he was somewhat alarmed by the fact that I was in constant pain now, implying that the gallbladder was probably becoming infected.

After the surgery, he informed me that if they had waited much longer (as in a matter of days) there was a high likelihood I would have died or, at the very least, had a much longer recovery; my gallbladder had been so swollen it had started to fuse with other neighboring organs. Much more vital ones.

At the next appointment I had with my new doctor (my first proper appointment really, since at the first one she had been mostly concerned with getting me to the surgeon) we started going over medication I was taking and she was shocked to find that old doctor had instructed me to take Albuterol (an inhaler for asthma symptom relief) preventatively, twice a day, every day. Apparently this is not how Albuterol is meant to be taken, and is in fact fairly detrimental, since it causes – wait for it – high blood pressure!

As soon as I started taking my inhalers the way they were meant to be taken, my blood pressure dropped right down into a very healthy range. What a surprise.

Too fat to get pregnant – need WLS, ob-gyn doesn’t believe patient

Mel writes from Australia:

Hi
I found your blog and thought my story would fit right in.
I don’t have a good relationship with doctors. Frankly they terrify me, and I avoid them at all costs. Before we started trying to conceive I only went once a year for my annual pill prescription and pap smear if needed. My gp is good though, a really lovely person who never tries to tell me it’s all about how fat I am. Unfortunately not all doctors are as helpful.
I have been trying to conceive for more than a year now. In that time I have been to my gp for preliminary tests, taken vitamins every day, cut out the caffeine, watched what I eat and have recently taken up exercise at the gym. Unfortunately I have still not managed to get pregnant and have been having long long cycles with irregular temperatures and heavy bleeding. Off to my gp in January-she was very helpful, sent me off for an ultrasound and some blood tests, mainly general stuff since I hadn’t had any tests for around a decade, but also a GTT. It came back fine-no diabetes, nothing wrong with my girly bits on the ultrasound. She told us to keep trying and come back in a couple of months.
I returned to her in April, still with some crazy issues relating to long long cycles, long periods and no pregnancy. She told me it was fine to keep trying but would like me to see a gynaecologist. She wrote on the referral “Mel has been trying to conceive for more than 12 months but has been unsuccessful. She has a family history of PCOS and is overweight. Please help her with her fertility issue”. Okay I have no problem with what she wrote, it’s all accurate.
Off I trudged to the gynaecologist, test results in hand. In the time between January and May when I saw the gynaecologist I had been exercising and had lost around 15kg, which I thought was a stellar effort and showed I was trying to address the inevitable “you need to lose weight”. My gp had told me to lose 5% of my bodyweight and if my weight was the problem then my cycles would miraculously sort themselves out-after losing the weight there has been no improvement so I thought I had pre-empted their comment.
The first thing out of the gynaecologists mouth was “How much do you weigh”. 135kg. “Do you realise how obese you are?” I then told her I have been working hard to lose weight through diet and exercise, thinking to cut her off before she got into her fatbashing rant. As i explained that I had lost 15kg since January, was doing 90 minutes of cardio at the gym 5 times a week, and eating a low GI low fat low carb diet she rolled her eyes at me in disbelief. Her reply was “You are too fat for a baby. You need to get down to 65kg before I will help you”.
At that point I should have stood up, told her to go f*** herself and walked out but I was stunned. I guess she took the stunned silence as agreement because then she whipped out the lapbanding pamphlet and told me I had to have weight loss surgery. I told her no, not under any circumstances would I do that, it doesn’t work (my aunt had it done and is bigger than she was before), and she then continued to patronise me. She told me I was infertile because I had been on the pill for 15 years, that taking basal body temperatures was a waste of time as they don’t show ovulation, and that I would need ivf to conceive. She could tell all this apparently from looking at me and reading my full blood count, my GTT results and looking at my completely normal ultrasound results. I just sat there as she lectured me about how I had to take pre-natal vitamins (because of course, being fat, I must be stupid and incapable of reading). She told me I must be very lazy because she only had to walk for 30 minutes a day to lose 1/2 a kilogram.
Not once did she ask me about my symptoms, and when I pointed out that I didn’t have the crazy cycles and issues before I went on the pill and I was fat then, she ignored me and kept bringing up the weight loss surgery as the only option available to me. As I left she handed me the weight loss surgery pamphlet and told me to think about it for next time I came. No hope was given, no suggestions on how she was going to investigate or manage the issues I am having in terms of cycles and some pretty severe bleeding, just “you are fat. you are fat. you are fat”.
By the time I left her surgery I was in tears, and as I walked away I had never felt so depressed in my life. All I wanted was a baby, just one, I had walked into her office so full of hope and had been in a really good place before she opened her mouth. I rang my husband and could barely speak, I was so upset. As I told him what had happened he got more and more angry till finally he said “How can you let someone speak to you like that. You are worth so much more than that”. At that point I realised that the strong assertive Me had been turned into the compliant humiliated voiceless Me by someone who didn’t know me, didn’t care about me, and didn’t even behave in a professional manner towards me.
I don’t know what box of cornflakes she got her medical degree off the back of, but if she actually genuinely wanted to help me (even if in her opinion the only possible option was helping me lose weight) then did she really think she was going to get very far by just humiliating me? As for me I am now needing to go off to my gp again for another referral, but I have put it off for the last few weeks because I am not sure if I can face going through that again with another specialist. I thought the Hippocratic oath said “first do no harm” but I guess that emotional damage to a fat person doesn’t count as she didn’t see me as a person, just a big pile of lard.

Size prejudice hurts us all – no matter what size we are.

Another reader writes:

Fat Prejudice Kills Thin Women Too

I work at a university where staff are given a membership at the school gym as one of our benefits. A few months ago I was in the weight room working out when I overheard a conversation between two of our better professors, let’s call them Sue and Nancy. Nancy told Sue that she was looking good lately, had she lost weight? Yes, said Sue! She’d been working out harder lately and had lost a lot of weight. Now, Sue’s not a fat woman by any means, so “a lot” is a relative quantity. But still, I remembered the conversation.

A couple of weeks ago the university received an email. Sue had died suddenly. I was struck by the loss of an excellent teacher and role model to our students.

It fell to the gossip network for me to learn what had happened. Sue had felt numbness in one of her arms and had gone to get it checked out. Shockingly, she was diagnosed with cancer. Some have said it was lung cancer, others have said it wasn’t. She underwent treatment, and perhaps because of the treatment experienced a severe stroke. Within a few weeks of her diagnosis she was dead at 35.

When I heard this my mind went back to that conversation in the gym. What if her weight loss wasn’t the result of diet and exercise? What if it was the first symptom of her cancer? Not knowing her closely, I have no way to know. But I wonder…

And I wonder how often weight loss, which can be a symptom of cancer and a host of other serious diseases, is ignored or welcomed! How few women of any size would see weight loss as a problem, and ask a doctor to try to find a cause? If fat is something to hate, no matter your size, to want to remove or reduce, then a person is very unlikely to see sudden weight loss negatively.

Could Sue’s cancer have been detected earlier? If it had, could she have faced a more gentle treatment that wouldn’t have killed her?

I think this is a moment to reflect that size prejudice endangers us all, no matter what size we are.

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