Welcome to First, Do No Harm

You can read about the genesis of this blog here.

The posts to come will be yours. If you’re a fat person who’s been treated poorly by a health care professional, please send your story to fathealth at gmail.com.

The following is a repost of an entry I wrote for Shapely Prose and Shakesville.


I’ve rarely gotten so many comments on a Shapely Prose post as I did on Thorn’s post outlining how a doctor’s callous words led to the death of her mother.

So when I was about 11 years old, and Mom went to see her doctor because of some problem she was having, and he scathingly told her that her problem was she was fat, and not to come back to him until she’d lost 50 pounds? Yeah. It hurt her. It hurt her bad. But she believed in the rules. And so she tried to ignore how hurt she was and focused on trying extra-hard to get back to following those rules…

Having been unable to meet her doctor’s demand that she lose 50 pounds, she followed the only part of his stated rule that she could: she didn’t go back.

From that point on, whenever she got sick or injured and someone suggested she go see a doctor, she brushed them off. “Oh, they’re just going to tell me I’m too fat. Don’t worry, it’s just a cold/a sprain/a whatever. I’ll be fine.”

If you haven’t read the whole post yet, go do that now.

And if you haven’t read the comments, which are full of heartbreaking stories about the way doctors treat fat people, I’ve collected some of the highlights here.

I have PCOS and am overweight. My husband and I had serious infertility and loss issues. I was told by several OBGYNS to lose weight and I’d get pregnant. If only it was that simple.

I wish that the medical community would read this, and really take it to heart. They must be reminded of the words they swore to uphold, “First do no harm.”

I went through a disturbing incident last winter when my husband, Jeff, suffered two bad falls on the ice in less than a month. The orthepedic surgeon he was referred to didn’t want to write him out of work or even do an MRI because he was just looking at my husband has a fat, out-of-control man who he couldn’t help at all until he lost 130 lbs! Jeff weighed at that point 350 lbs, the doctor ordered him down to “at least” 220 lbs before he could really treat his condition!

Fortunately, he was referred to a physical therapist who was very good to him, and rather than view him as lazy, viewed him as one of his most hard working and dilligent patients. He was the one who insisted that Jeff take some disability time for his recovery. My God, the man could hardly walk, he simply was in no condition to make it in until he had a chance to heal from the accidents! But that one doctor just wanted him to go to work like that, as some kind of punishment for being fat.

I’m glad Jeff is better now, but I won’t forgive that doctor for the shabby way he treated him anytime soon.

My mom has been getting very sick over the years and refused to go to the doctor because she didn’t want to be belittled for her weight. But I have a wonderful doctor so I pressured her and pressured her and she finally went to see her a few months ago. Afterwards I asked her how it went and my mom just started crying, “She was just so…kind…”

That was the first time she’d seen a doctor since walking out of the hospital after giving birth to me 28 years ago.

My father’s discomfort with going to the doctor (a lot of which has to do with his weight) resulted in undiagnosed lung cancer. Luckily, it was successfully treated with surgery, but he’d probably had this for over a year before it was discovered.

I would toss a “just wow” into the ring, but unfortunately this outrageous crap is all too common. My MIL met a similar fate, not going to the doctor when she was panting like a German Shepherd just walking to her car, and when I told her that was NOT “normal,” she said she wasn’t going to bother going to the doctor about it because when she mentioned it to him before she’d just gotten the “lose weight and it will go away” lecture. And next thing I knew, she was dead.

My Mom died a few years ago, and your post is making me revisit all of the fury I had with her doctor, all the while thinking, “Well shoot — at least when she could afford health care, maybe I should be glad she went to the damn doctor.”

My Mom struggled with her weight and smoking her whole life. When I was really young, our family doctor “helped” her with her weight “problem” by prescribing “diet pills” (speed, to which she became highly addicted) to suppress her appetite and Valium (also addictive) to help her relax from the speed. To say that it made her moods erratic would be quite the understatement, and was pretty confusing to us kids!

Later on in her too short life, she would only visit a doctor (who was a friend of a friend) who she felt wouldn’t shame her about her weight and smoking because he was a heavy man and a heavy smoker. I am by NO means saying he was a bad doctor because of those things — but she had a bureau full of pills pills and more pills and then pills to counteract the side effects of those pills (blood pressure, diuretics, blood thinners, inhalers and fucking Vioxx) so I was pretty concerned. Any attempt to talk to her about getting a second opinion was met with “No, I know what they’ll tell me.” And I have to wonder … if I had been magically able to get her to the best doctors in the world (whatever the hell that means) would she have been able to put down her defenses and then listen to their advice? Shit, I’ll never know. But I do know that fighting with her about it until her (suddenly) last day was not the way I would have preferred to have our relationship play out.

Even though I am a fat activist with a supportive partner who comes with me to doctor visits, and even though I have told each and every one of my doctors, in writing, that deliberate weight loss efforts are not going to be part of my treatment plan, they bring it up anyway. One comment about my weight or one momentary disgusted look on a doctor’s face will add months to the period between visits. I know they are my employees, but the societal pressure for me to feel that they are authorities over me is really strong.

And if it’s this hard for me, I know how much harder it must be for people who don’t have the fat-acceptance knowledge I have. Something really must be done. I wish I knew what.

What also resonated with me, though–and my own mother’s experience–was the part about “following the rules” and dieting, only to find that the rules didn’t work. My mother tried everything to lose weight, including two stomach stapling surgeries. She was lucky enough to have a sympathetic doctor she liked and saw on a regular basis, but her body went through a lot over the years and through all the efforts.

She never learned to be healthy at her size. She didn’t eat well or exercise because for her these things were punishments that didn’t “work” since she couldn’t lose/keep off the weight. When she got cancer she wasn’t in a very good condition to fight it, because by then, failed dieting and the weight problems that came with it had convinced her that her body was a lost cause.

I hate that. I’m still angry about that. I can’t be angry at a doctor or point to any one thing that should’ve been different, that would have given her more time. But I’m angry that fat has been so misunderstood so many years, because that ignorance definitely took its toll on my mother.

I remember bursting into tears at the doctor’s office about 10 years ago…because she was kind to me. Simply kind. She did a comprehensive physical and asked about all sorts of things not related to my weight. For the first time at the doctor since becoming fat, I felt like I was actually receiving health care, not just scolding for being fat. It was so transformational to be treated with care and kindness rather than hostility and shame, I was overwhelmed with emotion.

My mom had a similar experience. She went to a (male) doctor for her severe depression, and he told her it was just PMS and he couldn’t help her. She didn’t have the confidence to stick up for herself and tell him it was more than that, so she continued to suffer for 20 years… until I started suffering from depression, and saw a (female) doctor who prescribed me Prozac. I convinced her to see my doctor and she got on medication that’s really helping her. But 20 years of depression because some sexist ass assumed any problem with a woman’s mood must be PMS. I’m not a violent person but I want to hurt that man (and the one who was dismissive of Thorn’s mom, what the fuck is wrong with doctors?)

The scariest part is, you just described me.

Your post describes the precise reason that I stopped seeing a “regular” doctor — I now visit an MD/ND — a male, which is a surprise for me — because he doesn’t give a rats ass about my weight — he cares about helping me to be healthy.

Insurance doesn’t cover most of his services, but I’m healthier than I’ve ever been in my life, with his help, and it’s been worth every penny out of my pocket
-Portly Dyke

It’s been eight years since my aunt died and I still get pissed about it. She was fat too, about the same height and size as your mom. She’d been having pain and symptoms for a looong time, but never went to see a doctor (and she worked in a fucking ICU!!! She saw doctors every damned day!) because she didn’t want them to tell her it was all because of her weight. She was treating her symptoms on her own, taking samples from work. And then, when she was 42, she had a stroke. And even when she was having the stroke, she still wouldn’t go to the hospital. She had talked to her brother that morning, told him she wasn’t feeling well. He was concerned, so he asked their other brother to check on her that afternoon. And so, nearly five hours after her stroke started, her younger brother gets her on the phone, hears her slurred speech and freaks out. He gets her to the hospital, but by then it was too late. She died less than a week later, after having another series of strokes that left her pretty much a vegetable.

They found out, via autopsy, that she had an undiagnosed autoimmune disease. It was causing her blood to clot and destroying her blood vessels. She’d likely had it for years, up to as many as 20 years, undiagnosed. If she’d been diagnosed? The treatment is one pill, one small, stupid, ridiculously inexpensive pill, once a day. But she wouldn’t go to the doctor, because she was so very ashamed of being fat.

Doctors tried to do the same to me, too. I’d been sick for years, but they couldn’t find anything wrong with me. Just told me I needed to lose weight and learn to relax. Gave me antidepressants. For years this went on and finally? I got tired of putting myself through it. So I stopped going to doctors too. And then my aunt died and, once I got over being horribly sad, I got mad. Extremely mad.

And I finally, finally found a doctor who would listen to me. (And yes, like so many others, I started to sob in her office because I was so expecting her to dismiss me.) And within a month, I was diagnoised with Lupus and Fibromylgia. My test scores were so high initially that they were afraid I was having organ damage. Years and years dismissed and it onlly took two doctors who were willing to listen to me, to treat me as a person, to figure out what was wrong and to start fixing me up. So now, six years later, I’m back to being healthy and happy. It’s just a shame it took my aunt’s death to get me here.

About 10 years ago I went to see a strange doctor whom I’d picked out of book when I changed jobs and got new insurance.

I had just lost 20 pounds. He looked at me and said, “you didn’t gain all that weight through immaculate conception.”

I cried all the way home.

What I have to add doesn’t parallel it in severity obviously, but I thought I should add my own experiences to the discourse. I’ve suffered from a rare and life-threatening respiratory disease for nearly ten years now (since I was in my late teen years). While I always struggled my weight, I crossed the 200 lb. mark due to steroids. Once I got truly fat, I couldn’t get doctors to take my disease seriously anymore. I was literally passing out from lack of oxygen at one point because they refused to acknowledge the severity to which my breathing had become compromised. All they could see was the weight *that they had caused me to gain.* Although my graduate school performance never suffered in terms of grades, the in-class difficulties I faced were never excused because I was – let’s face it – considered ugly. Life was hell. When I got a spot of melanoma, I had a doctor leave a ragged, keloid 5-inch scar with stitch marks (prone to infections and splitting open) instead of using a skin expander like she should have because, what did it matter? It would be covered with clothes. God forbid I ever want to take them off in front of someone. I’ve been starving myself at about 600-800 calories for several years to get to a low weight where my collarbones and cheekbones pop and my stomach is flat. I’m not underweight, but I look thin now (calories in, calories out, my ass-I should be invisible). My disease, at this weight, makes me look nearly as sick as I am, all black circles and veins and frailty. And, finally, I get proper medical treatment without judgment. In other words, I have to hurt my body to get it help. Nice world we live in, huh?

I’m 54 years old, ‘morbidly obese, and I haven’t seen a doctor in four years. The last time I went was when I had taken a six mile hike, gotten covered with tick’s and developed Lyme Disease. By the time I got to the Doctor, I’d been running a 102-3 degree fever for almost two days and my blood tests came back with elevated liver enzymes. Immediately, and despite that I had saved all the ticks that bit me, he said the spike in liver enzymes was due to chronic gall bladder disease secondary to morbid obesity. He wanted to take my gall bladder out! But since I’m a nurse and it was my dime, I told him to treat me for Lyme and (to be on the safe side) ehrlichiosis, another tick-borne disease. Grudgingly, he did so. Voila! A week later I was nearly 100 percent cured and a month later my liver panel showed normal values across the board. I remain fat, healthy and active to this day.

What fat woman hasn’t gone into a Doc’s office only to hear him say, “You know, you’re very overweight!” It doesn’t matter what you’re REALLY there for, whether you have poison ivy or tennis elbow or got a piano dropped on your foot! No, no, the first thing the Doc has to tell you is that you’re FAT. Like you don’t already know. Like you’ve lived in a house without mirrors for fifty years and never caught a glance of yourself.
“Gee Doc, but for you I would never have known I was fat. Thanks, Doc, from the bottom of my fat, old heart.!”
-Maggie Kamp

This is the exact thing that scares me, my mother is about the same size yours was. She is always depressed, talking about herself (in reference to her weight) as ‘a giant waste of space’ like nothing she does is meaningful because she’s fat. She’s a smoker, a drinker, and one of those people that spread themselves so thin they barely have time to think. Everytime she tries to fix one area she magnifies another problem, she tries to stop smoking and gains more weight, she tries to lose weight and ends up working even more, she tries to work less and ends up drinking and smoking more.

Every doctor she’s ever been to has told her that she needs to lose not 50 but 80lbs. So like your mother she doesn’t go to the doctor unless her problem is serious, the last time she’s been to a doctor was when she had an ear infection that she let get so bad it affected her balance and couldn’t walk without the room feeling like it was spinning. The first thing the doctor said to her was “Ma’am you seriously need to lose weight.”

My sister had a horrible time with lots of doctors when she was bigger- she was in and out of hospital for a long time before she got a doctor who took her seriously (probably because that doctor was also quite big).

I’ve just qualified as a RN, and having seen what my sister went through, I swear I will *never* treat any of my patients like that, whether they’re overweight or have any of the the problems commonly thought of as “self-inflicted”. Unfortunately, despite the mandatory ethics course, I can’t say the same for all my classmates.

I am about your mother’s size and it is difficult to live in a world that has decided that you are bad because your body is out of style. I am so lucky that my slender little doctor is not a fat hater, never tells me I need to lose weight because she can see that dieting doesn’t work for me. How I wish that your mother could have had a doctor like mine.
-Maya’s Granny

And if you complain about leg pain (a college problem I had), you are told “well, you are 100 lbs overweight…” and no one ever checks to see if there could be another problem, because being 100 lbs overweight wasn’t exactly a new condition in my life!

My mom’s death was also preventable. A week before she died of an aortic aneurysm, we took her to the emergency room because she was short of breath and her face was greyish. She mentioned that she’d run out of her thyroid meds and was told “Well, then you’ve gained some weight and it’s making it hard for you to get your breath.” And she was handed some samples and sent home.

A week later she was back with crushing chest pain, but her EKG was normal (it wasn’t her heart after all). She was retaining water severely, short of breath, and her chest had a bluish tint. All symptoms of a bleeding aneurysm. She was given lasix and put in CCU for observation. 24 hours later she was dead, and no attempt had been made to find out WHY her chest hurt and she couldn’t breath. After all, she was fat.

This is the “obesity crisis,” people. Doctors neglecting, terrifying, dismissing, and misdiagnosing people because all they can see is fat. People in pain and suffering, too afraid to go to the doctor, because they know they’ll be scolded and shamed for their weight — and whether they’ll actually be treated is much less certain.

My own story is nothing compared to these, but I’ve got one: when I fell down some stairs and twisted my knee, the best pain management advice my doctor had for me was “lose weight.” Same doctor once said, “So, what are we going to do about your weight?” while giving me a breast exam — ’cause that wasn’t a particularly vulnerable moment for me or anything. And I’ve never even been over 200 lbs.

If you aren’t outraged enough yet, check out some of the stories at Fatshionitis.

Stef, the fat acceptance activist quoted above, maintains a list of fat-friendly health professionals and tips on obtaining good health care. These are amazing resources, but the need for them is tragic and shameful.

Anybody want to tell me again how fat people don’t take care of themselves and burden the system with their doctor visits?

— Kate Harding

Leave a comment


  1. KC

     /  October 26, 2007

    My mother’s doctor thought she was just fat………..she actually had a 35lb tumor in her abdomen.

    I am tired of fighting with people b/c of my weight. They didnt live my life, or walk in my shoes.
    How does one exercise when one can’t walk for 10 minutes with pain and leg numbness from sciatica?
    It has only been recently that I bought a gazelle crosstrainer to work with.
    I recommend it to anyone.
    I did it for me. Not b/c some ass said I needed to lose weight.
    and for those who do get on my weight, I tell them “Yes I can loose the weight but you will still be an ASS!” Whats your excuse?

  2. AF

     /  January 1, 2008

    My mother died of breast cancer. Her doctors said she had likely been sick for years, possibly as long as a decade. She was not diagnosed until it had metastacized, causing constant unbearable pain. The primary reason she didn’t seek treatment earlier, despite the fact that she was in constant pain was that she didn’t want to take her clothes off in front of a doctor because she was fat and ashamed of her body. Her doctor told me that the type of cancer she had is very treatable, and had she sought treatment early, she likely would have recovered and been fine. Instead, my younger siblings grew up without their mother.

    I’m 100 pounds overweight, and I don’t relish taking my clothes off in front of strangers, but you’d better believe I get a breast exam from my doctor every year. I plan to be here for my children, and no fat-hating social norms are going to keep me from doing that.

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