A reader writes:
I feel like this is nearly insignificant compared to some of the horror stories up on the site. In fact, I nearly didn’t send it. In the end, I am, because I feel like it’s significant for several reasons – it has made me much less likely to seek medical attention, it’s made me much more body conscious, and it’s an indication of how little some practitioners trust their patients – to tell the truth about their diets or their bodies or their experiences.
I was diagnosed with migraines when I was twenty. I have classic symptoms, although only occasionally do I get an aura. Migraines differ dramatically between people, and mine vary dramatically between episodes – sometimes I can grit my teeth and bear through, and sometimes they are incapacitating, and very occasionally I can only rock back and forth and weep. I’ve always, always been uncomfortable around doctors, and this got much worse after several bad experiences in college, where the doctors at the health clinic refused to prescribe cough medicine for me, despite my nearly retching coughs, because they were afraid I’d sell it on the black market. Combined with a lack of health insurance, this made it much easier to avoid doctors.
When I got my current position, it took 6 months for health insurance to kick in, but I scheduled an appointment and went anyway. I chose a nurse practitioner, because I believed they were generally less blinded by their own egos. I wanted drugs for my migraines, and I wanted to discuss my difficulty with weight loss. I was 192 at 5’2″, my highest weight.
When I told the nurse practitioner I had migraines, she nodded, and told me that “of course” they were caused by my obesity, and triggered by certain foods and overeating. She used the word “preventable.”
In real life, my migraines are actually not triggered by foodstuffs – I’ve kept a journal, and food is not one of the things that triggers them. So I told her that, no, my triggers are mostly barometric pressure changes, fluorescent light overexposure, sun stroke-type conditions, where I exercise too hard in hot conditions, and exercising very strenuously. Some of these things are easy to avoid, but good luck with barometric changes and fluorescent lights.
She didn’t acknowledge this, and repeated advice to stop eating chocolate, red wine, and cheese. These *are* triggers for *some* migraineurs. Just not me. But I think she assumed that because I was giant size 16/18, I couldn’t knock off the dessert, booze, and cheesesteak long enough to see if that would stop the blinding pain behind my left eye. (Fish can also trigger migraines in some people, but notice this wasn’t on the list. Hmmm.)
I told her I’d worked myself down to 1500-1800 calories a day, and anything less than that and the hunger was overwhelming. I thought about food all the time, and I felt miserable about my weight. I was also exercising some, although less since I’d started my restrictive diet, because I was hungry and tired all the time.
It was clear she didn’t believe me, but she let it go for a while. Then she asked if I was eating greens. I told her I was trying, even though I’m not really a big fan. She told me I was going to get osteoporosis, “especially with your body”, and instructed me to start drinking 2-3 glasses of milk a day. Apart from the fact that I don’t really like milk that much, I was concerned about the increase in calories.
“Well,” this medical professional said, “just cut back on the desserts.”
After I agreed, and begged her for drugs, she gave me a prescription for the migraines, but urged me to “move more, eat less.”
I walked three miles home in 95 degree weather (developing a severe migraine), and didn’t eat for a day. I also did not go back for blood tests on cholesterol and pre-diabetes.
I’m exercising much more now – and eating more, including bad food and good food and green food (but no milk – I may never drink the stuff straight again). I have a doctor who doesn’t discuss my weight unless I bring it up, and, despite suggesting Weight Watchers, nods understandingly when I tell her I’m afraid it will only exacerbate my already disordered eating. Despite the fact that I should have been losing weight then, it’s only after eating more like what I want that I’ve begun (very very slowly) to lose weight. I’m 186 now, and every time I have a migraine, I wonder if it’s my fault, even though I know it’s not.
First, Do No Harm 
sannanina
/ June 29, 2009I assume she meant with “your body” “your fat body”… in that case this statement is ridiculous and untrue since fat people have a *lower* risk of osteoporosis than thin people.
Jenny Rose
/ June 29, 2009I 2nd the lower risk of osteoporosis. Could she have meant osteoarthritis?
If you are overweight, it is always assumed your “lifestyle” is the cause. I think you had a double whammy the weight and a condition that cannot be seen or measured. The nurse had to rely on you for information. Migraines are not easy to treat. I have a think friend with them and she takes meds that help significantly. Then the meds stopped working. It has nothing to do with weight but weight is easy to diagnosis as the cause of all ills. You had a diagnosable problem and she still wanted to focus on your weight. Sheesh – lazy, fatphobic or both?
Lindsay B
/ June 29, 2009This site is a free space to talk about bad experiences with doctors and weight discrimination, as far as I’ve understood. There are horrendous, terrible stories out there, but the sad truth is that most of the discrimination comes in these smaller stories. The smaller ones lead to the bigger ones; assuming that your migraines are caused by weight and “eating poorly” may not be a BIG deal, but what if you weren’t able to get treatment for it because this woman *decided* that it was because of your weight?
There are hundreds of small stories just like this one, and I’ve had some people react in surprise when I tell them that a lot of doctors mistreat/refuse to treat fat patients. I often link them here to read through and decide for themselves. Thank you for contributing your story, and don’t ever think that something that makes you uncomfortable to see a doctor is ever “not big enough”, because the experience that breaks your trust in medicine leads to not going back when it’s more serious. It’s what creates the more horrifying stories.
Piffle
/ June 29, 2009I’m absolutely baffled why she required you to beg for migraine drugs, they’re not controlled substances or suchlike. My husband and son get migraines, with very different triggers. My husband’s biggest trigger is dehydration, if he’s out working in the sun and doesn’t drink a liter of water an hour he gets bad migraines; and he also gets them frequently and fairly randomly when he doesn’t take his topomax. My son’s biggest trigger is noise, not easy to avoid as an elementary school kid, assemblies are torture for him. He also gets an occasional “migraine” when he doesn’t want to be at school; these are easily diagnosed by his not retiring to a dark room and reading quietly, which is what normally happens when he gets one. Weight is unrelated to migraines AFAIK, certainly it’s never been brought up to my hubby; and he’s well over 300lbs.
Also, if you were only eating 1500-1800 calories a day; what desserts did she think you were eating? A piece of fruit or some lucious low fat yoghurt? That’s about all that would fit.
Piffle
/ June 29, 2009Oh, and migraines are *not* your fault, at all. They are a neuronal disorder, related to epilepsy (one reason medications overlap between the two).
Amananta
/ June 29, 2009Migraines because your too fat? Ha. I’ve had them my entire life, from when I was an underweight, malnourished child to now when I’m obese. Ironically enough, I get them if I let my blood sugar drop by going too long without food.
They are genetic, largely. My mother gets them, my grandmother, and my son.
BuffPuff
/ June 29, 2009If she did mean osteoporosis, she was talking out of her arse. It’s pretty well documented that fat people rarely get osteoporosis because their bones are well-versed in the art of load bearing.
MargB
/ June 30, 2009Experiences like this, where you struggle to receive proper medical care, information and treatment for a widely-recognised problem that affects people of all ages, weights and ethnicity, make my blood boil. In your case you had good reason to believe that your migraines were hereditary but supposing there was no family history? Migraines can (very occasionally) be a symptom of a brain tumour – it makes me sick to think that this may be missed by a medical practitioner who can’t see the patient for the fat.
Jannie Funster
/ June 30, 2009I developed migraines in the past few years but I almost always stave them off by the following.
— a glass of water when I wake
— my one cup of coffee
–good protein early, yes meat
— no sweets by themselves, only after meals.
— adequate sleep.
— and avoiding stress
That’s it! My story and I’m sticking to it.
AllThingsToNoOne
/ June 30, 2009I’ve had migraines for years. This is the first I have ever heard about them being caused by being overweight. Why do they assume you even need to “lay off the desserts?” Geez…
Bianca
/ June 30, 2009No chocolate, wine or cheese? What kind of BS medical advice is that?
Krystal
/ June 30, 2009Bianca, red wine, chocolate and cheese are fairly well-known migraine triggers, especially red wine.
I would consider it fat bias that these were what the doctor recommended before anything else, but not completely devoid of any value.
lilacsigil
/ July 1, 2009Your story is not insignificant – it’s part of a consistent pattern of mistreatment and considering anyone who isn’t very thin to be a greedy, lazy liar. Someone will read this and relate it to their own experience – it might help them stand up to a bullying medical practitioner, it might help them help a family member, it might help them be less prejudiced as a medical practitioner.
Weight and exercise protect against osteoporosis. If you have other risk factors (such as a family history of osteoporosis or difficulty absorbing minerals) you might want to supplement with calcium, as I do, but that’s entirely up to you.