Planned Parenthood threatens to withhold birth control unless weight is lost.

KC writes:

I went to Planned Parenthood last month for birth control. I’ve been especially avoiding doctors since I officially entered the “overweight” category about a year ago, but I just couldn’t get around it this time, and I told myself that I was being paranoid and my weight wouldn’t be an issue – after all, I am by every measure the healthiest I’ve ever been!

I filled out the intake papers, and really hesitated on the health history form when it asked if I’d had a change in weight of 25+ lbs in the last year and if I had any mental health problems. I feel like doctors almost never handle weight or mental health in a helpful way, so I don’t like to bring it up, but when it comes to prescriptions, I don’t want to be prescribed something that has been discovered to contribute to things like depression, changes in weight, etc. I struggled with anorexia, bulimia, and major depression for 7 years, and I have finally been free of them for one year. I had been severely starving and puking when I was diagnosed with anorexia, and then after my inpatient treatment I still starved and puked, but not as severely, so I maintained a “normal” weight for a few years by skipping meals and throwing up and being hungry most of the time. My dietitian finally convinced me to fully give up starving and purging a year ago, and also convinced me to add some more fat to my diet. I also started on a new anxiety medication at this time. Not-so-coincidentally, I started gaining weight quickly – within 6 months, I’d gained 45 lbs by eating normally and was in the middle of the overweight category. I moved cities and had a new dietitian who was puzzled by my weight gain because apparently “this never happens.” About 8 months ago I decided to go off my medication, and I also had a couple relapses when I really restricted my intake for about a week at a time – so I have lost some weight since then (and still have no clue what my natural weight is).

Fast forward to my Planned Parenthood appointment. First I refused to be weighed even after they insisted, so they asked for an estimate. I told them 180 (I’m pretty sure I’m within 5 lbs up or down of that), and since I’m 5’11”, that means that, depending on the week, I’m either at the high end of normal or fat (but still 30 lbs heavier than I was a year ago, and 60 lbs heavier than I was a few years ago). According to the weight I told them, I’d be okay by their standards if I lost just 2 lbs.

Well a nurse called me to her desk to look over my health history. There actually was one relevant issue – my osteopenia – because bone density seems to be affected by hormones and birth control. Did she mention that? Of course not! Instead she brought up the two issues I did not want to hear. First, “Was it a weight gain or loss?” “Gain,” I said. “And what are you planning to do about it?” I said, “Excuse me?” And she repeated, “What are you going to do about it? Exercise?” (Nevermind that I already walk, bike, hike, swim, and dance regularly! Fatties obviously don’t do those things, right?” I said, “Uh, eat healthy,” and hated myself for playing along. Then she said, “And the depression and stuff, that’s better now?” Hello, I call LEADING QUESTION! I told her yes – which was actually the truth, fortunately, because had it not been, and had she said this to me even a few months ago, I would have gone home and cried, starved, thrown up, and maybe cut myself to relieve the anxiety – things I really can’t afford without health insurance now!

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9 Comments

  1. Argh! I’m really sorry you had to go through this. It’s tempting when people say crap like that to let them have it: like by telling them exactly what you could do about it in graphic detail. Seriously, can you imagine the look on her face if she asked, “What are you going to do about it?” and somebody said, “Take diet pills and laxatives!” Given the difficulty of getting adequate medical care, it’s generally not a good idea to antagonize the people we rely on for prescriptions, but my god, it’s tempting. I personally try whenever possible to give details about the chronic diarrhea that I had when I was actively engaging with my eating disorder…that one tends to shut people up.

    And what is up with clueless medical practitioners being obnoxious when people decline to be weighed? It’s so obviously an indication of a history with an eating disorder–they really ought to train nurses to be more sensitive about it. I don’t understand why the protocol isn’t to say okay, take a blood pressure reading, and then have the doctor ask the patient about their reasons for asking to skip it and how they are doing with their relationship to food and body image.

    Reply
  2. KellyK

     /  September 21, 2009

    I’m sorry they were pushy and insistent with you. It’d really be nice if medical professionals actually respected, you know, personal boundaries. If someone doesn’t want to be weighed, they probably have a reason. Hell, even if they don’t, it’s their body and they have a right to refuse any treatment/test/whatever that they don’t want.

    On the plus side, I’m glad you’re taking the doctor’s insensitivity in stride & not starving, puking, or cutting.

    As a side note, I’m not sure the headline matches up with the story, because I’m not seeing where they actually threatened to withhold your birth control–or maybe a paragraph was cut off at the end?

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  3. erin

     /  September 21, 2009

    personally i have a 20 year battle with bulimia. The ONLY way i can manage not to puke everything i eat is to not pay attention to my weight. I simply tell the nurses “no i am bulimic you CANNOT weigh me. Its a big trigger for me and your protocol with my health is not worth weeks of emotional ups and downs.” You’d be surprised how the weight and diet talk STOPS when you tell them about an eating disorder. (for once the bulimia is useful!)

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  4. This makes me nervous about the fact that I’ll probably be needing to get my birth control from planned parenthood one my parents’ health insurance wears off cos I’m an adult now and all. Last I checked I was just over the line into overweight. (5’9 3/4″ which I round up to 5’10” and last I checked 175lbs)

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  5. FYI, hormonal birth control can worsen depression. I have been on 3 different formulations, including the mini-pill, and found that they put me right back on antidepressants. So I quit trying to use hormonal birth control.

    (I do know depressives who are okay with birth control pills, but often they are taking the pill to also control endometriosis or other conditions too, which might raise the bar of what they’re willing to put up with in birth control.)

    Reply
  6. hi – thanks for the support! and thanks for posting my story! to clarify, they did not threaten to withhold birth control, I was surprised to see the title. Living400 – thanks for the tips about depression! I had no idea. Ugh. Fortunately I’m doing well now, no depression. And yeah, I would totally think that refusing to be weighed should be a big flag that this is a sensitive issue! Erin I’m glad that they treat you better when you tell them about your bulimia – but isn’t it unfair that you have to give them a reason at all? I wish I could just say, “no thanks,” and have them respect that.

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  7. Sarah

     /  September 24, 2009

    The only times I let them weigh me is when *I* feel its relevant. If they ask me to step on the scale I just say “no, thanks” and repeat until they quit asking, or if they can give me a logical reason for it. My GP weighs me once a year and that’s good enough for me. There is no need to weigh someone for HBC, while it can impact your blood pressure that impact is independent of your weight.

    Reply
  8. Women's Health Advocate

     /  September 27, 2009

    @Livng400 – have you talked to your doctor about trying the NuvaRing? Since the hormones are absorbed vaginally instead of through the digestive tract, a much lower dose can be used. Many women experience fewer side effects, but all the usual disclaimers about hormonal birth control apply – no smoking, best for women under 35, etc.

    Reply
  9. PW

     /  October 12, 2009

    Funny! My daughter could not take birth control pills as they caused severe migraines. She tried the IUD and nearly bled to death. The planned parenthood counselor suggested the NuvaRing. She used it for 2 months, June-August. When I saw her in early August I did not recognize my own child. She looked like a bloated balloon and was covered in a rash. The counselor advised that she discontinue the NuvaRing, suspecting that she was having a severe reaction to the hormones. In researching the product, we found that she was only one of MANY that had experienced this very dangerous side effect. It has been two months since she discontinued using the ring. She has lost quite a bit of the water weight, but still feels very tired and worn down…another symptom that started with the use of the NuvaRing. Before June, she was 5’8″ and 145 lbs. and an active, healthy mother of two, and a elder care nurse.

    Reply

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