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

Mel writes from Australia:

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.

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  1. Nicole

     /  May 23, 2011

    Oh, I am so sorry that you had to go through this. How horrible. Please don’t take her word as law.

    I weighed just a little less than you (and a whole helluva lot more than 65 kg!) when I got pregnant with my son. I did BBT and the other things recommended in Taking Charge of Your Fertility and had a perfect pregnancy and healthy son. Taking Glucophage/Metformin seemed to help with my cycles. I also found out later that many women with PCOS have the best chance of conceiving the month after they go off the pill, because their cycles get increasingly strange the longer they are off the pill. With my first pregnancy I followed the standard advice of being off the pill for a while before TTC–not actually a great idea for a PCOSer! With my second baby, I got pregnant in that first month off the pill (also using BBT to time things).

    Both pregnancies were great, and my babies were/are healthy.

    Of course I have no idea what your situation is and don’t want to imply that my experiences are applicable, but I did want you to know that there is no magic cutoff for being able to get pregnant, either with IVF or the “regular” way. I hope you can find a doctor who will see you as a person–sounds like this one was sorely lacking.

  2. That this shit for brains so called doctor never once addressed the PCOS, which I would think is a big part of the issue, tells me that she did indeed get her license to practice medicine from
    I avoid doctors like the plague for the most part too, although my regular doctor is fairly good about these issues and doesn’t humiliate me about my weight.

  3. This is almost exactly what happened to me a week ago. The doc took no history and when I tried to argue about the effectiveness of WLS she just smirked at me and told me I was wrong.

    I’m still mortified, humiliated, and mad as hell.

    One little recommendation I have is to have your doc test your thyroid. I had crazy periods until my gp started treating my subclinical hypothyroidism, now they are 27 days on the nose.

    I’m not pregnant, but still hopeful, though I won’t be getting medical help. I can’t face the possiblity of being humiliated again by a doc.

  4. i am so sorry. and while i have no advice about the medical issues, i can make a small recommendation for the fertility. if you can afford it, the clearblue easy fertility monitor is one of the best investments we ever made. it tests for hormones and will tell you exactly when/if you’re ovulating. at the very least, this could give you a starting point for further conversations with your doc. you’d know one way or the other if you’re ovulating. i got mine on ebay, new, for about $100 american.

    i hope you get a better gyno and are able to find the source of your infertility issues.

  5. sistercoyote

     /  May 23, 2011

    I am so very sorry to hear this happened to you.

    I don’t know where you are, but perhaps this list might be of assistance in finding a physician to help you instead of humiliate you?

  6. na

     /  May 23, 2011

    Oh, my dear. What a horrible experience. I feel for you. I weighed about the same when I talked to my first medical professional about TTC – this was before I even tried, I was just raising the issue because of some genetic concerns with my husband. The nurse I talked to told me that I wouldn’t be able to conceive because I was too fat. I have two children now, but I sure didn’t continue getting my care from that nurse.

    Other folks have made some really good suggestions, but may I add that I found the Billings Method very useful when I was TTC. I never used it for contraception, but it was much more exact at identifying my fertile periods than just basal temps. You’ll definitely want to get better advice on PCOS, but I think Billings is helpful for everyone, because it helps you to understand your cycle better. And it’s pretty much free!

    I have had moderately good luck at writing to physicians before a first appointment and telling them what my needs are. Sometimes you can screen out the jerks that way. It works especially well with midwives – I simply asked whether they had assisted women of my size before and whether they had any special recommendations. It worked out really well.

    Best of luck to you, and remember that you deserve good medical care, as we all do.

  7. La

     /  May 24, 2011

    I went through the same thing when I was pregnant…..I weighed 300 pounds at the time and I had nice healthy boy. He is going to be a senior in high school next year. I have PCOS and hypothyroidism as well, so it did take awhile to get pregnant. We didn’t do anything special to get that way, just perseverence!

    I am so sorry that a doctor treated you this way. Of course, they want to sell that WLS, they get a profit from it, to be sure. It’s all about the kick-back from the big pharmaceutical/medical companies. So, they try to shame you into it.

    I had a new doctor shame me about my weight and told me I would die and not be able to care for my son until he was an adult. Needless to say, I never went back to her again. And, my suggestion…..find the website that reviews doctors in your area and write a bad one for the one you had. I did that and I called the insurance company and turned her in. A lot of people must have done that about that particular doctor, because she had to open a new practice. She was let go from the place where I saw her.

    Good luck to you and your husband as you begin to start your family!

  8. I’m so sorry she was an ass, and I’m angry too – that doctor, excuse my language, needs to STFU. What part of her training led her to trying to treat her prejudices rather than your symptoms? Arbitrary weight claims, ignoring actual symptoms – it makes me angry. I hope you found a better doctor after that.

  9. lilacsigil

     /  May 26, 2011

    I have found that when doctors say “It’s your fat!” they actually mean “I’m very lazy and don’t want to do my job!”

    Have you seen this Australia-specific list of fat-friendly healthcare providers? I put one gynaecologist on there – Dr Liz Uren in Warrnambool & district, Victoria – but I’m sure she can’t be the only one in the country!

    • “I have found that when doctors say “It’s your fat!” they actually mean “I’m very lazy and don’t want to do my job!””

      @lilacsigil, so true!

  10. Christine

     /  June 5, 2011

    I am going through the same situation… I live in South FL.. anyone know any obgyn’s or fertility dr’s that wont blame my weight on my infertility?

    • Amy

       /  December 19, 2011

      we’re have the same problem in North Central Florida. We have a good ob/gyn Dr. Iobst in Gainesville at All About Women. But we cannot find a reproductive endochronologist who will even agreed to see us. If anyone knows of this sort of help that will treat fat women in Florida please let us know or post the information.

  11. viajera

     /  June 13, 2011

    Yep, I had a similar experience last week. I went to see an ob-gyn I’d seen before – 1.5 years and 25 pounds ago – for a regular checkup. Last time she was very friendly, we chatted for a long time, her exam was very thorough, she warned me about everything she was about to do or doing, and only once briefly mentioned that I should watch my weight. This time she was very brusque, dismissed everything I said or asked, was quick and rough with the exam, gave me no warnings about anything, and harped on my weight. When I asked her to order a thyroid workup and tried to describe my symptoms – including gaining weight despite eating a 1300 calorie, low-carb, low-fat diet and exercising – she just snorted and said “you’ve got a lot more problems than just your thyroid” while storming out the door.

    Tomorrow I go to see a primary care physician. I’m going armed with a ream of paperwork including FitDay printouts documenting my eating habits dating back a year, an Excel sheet listing my basal temperatures (95-96F average!), checklists of hypothyroid and estrogen dominance on which I’ve marked my dozens of symptoms, and etc. I sooo hope this doctor actually listens to me, for once!

  12. One of Those....

     /  June 26, 2011

    65kg? What has that doctor been smoking? That’s not just thin, that’s TOO thin for a lot of people.

    I’m in the US, did the conversion and was stunned. People weighing more than 143 pounds can and do get pregnant =all the time=. That gynecologist is going to have some big problems, pun intended, if that’s her attitude.

  13. Danielle

     /  July 18, 2011

    Wow… pregnancy and weight-loss surgery? I hope that doctor understood that weight loss surgery forces you to eat less than you need, which isn’t good for a pregnant woman or her child. Why do you think people lose their periods when they go on crash diets? Their bodies know they shouldn’t be having babies while they’re eating so little.

    She was probably right the second time–being on the pill for fifteen years could have easily messed with your hormones.

  14. Dorothea

     /  August 16, 2011

    I was in a very similar situation to yours. I had been seeing multiple GYNs because my cycles have been a mess since getting off the pill. I actually did research on my own and found that I had symptoms of a hormone imbalance. When I went to my last GYN (who is now my current one), I made sure to tell her I that I had been charting my temps., had crazy cycles, and symptoms of hormone problems. She looked at me like I’d just told her I was an extra terrestrial, and told me that things would just “bounce back” after I had lost weight. She sent me for a slew of fertility tests (all of which I’d had before), including a painful dye procedure to check for endometriosis, of which I (and my family) have no history of. All the tests came back fine. Then she proceeded to push me into fertility treatments, because, apparently being fat trumps good health. I got pissed, and demanded that she refer my husband for testing, which she did after telling me that in 90% of cases the problem was with the woman not the man. Turns out it was my husband who had a problem, a minor one at that, and I got pregnant 3 months after he had it taken care of. I’m not switching OBGYNs anymore, because I find the attitude is the same regardless of who I see. But it still gets me mad when my doctor seems overly surprised that I don’t have gestational diabetes and when she casually mentions that I should lay off fast food for the sake of the baby. I don’t eat fast food, I’ve never been a fan of it, and the next time I’ll let her know what happens when people assume.
    Good luck, and don’t listen to idiot doctors who’ve known you for all of five minutes.

  15. anise

     /  January 9, 2012

    I’m sorry you went through this, it’s terrible how powerless we can be made to feel in these situations. I’d love to know how you’re getting on now?

    I’m in Western Australia and am in the middle of the same experience. I’m 39, 113kg and have been trying to conceive for 3 years. Everything’s good mechanically with me, regular cycles, clean tubes, healthy ultrasound, no PCOS and all’s good with hubby, but the kicker is I’ve got failing ovaries (an AMH result of 1.3pmol/L (i.e. very low/undetectable)) meaning time’s running out and fast. I’ve been to two fertility specialists and neither of them will give us any fertility treatment until I have a BMI of under 35 (99kg)

    Nothing to do with my chances of getting pregnant; they say it’s an ethical matter, that obesity itself is enough of a health challenge for the body without adding the impact of pregnancy. Getting an obese woman pregnant would be seen as doing harm. The second OBGYN informed me it’s a state-wide guideline according to the Fertility Council which covers public & private health (I’ve yet to find it written anywhere so am still curious about that!)

    If anyone knows any OBGYN’s in WA who will treat an obese woman PLEASE reply. I was 95kg when we first sought treatment and weight wasn’t even discussed. I then moved state and over the course of a very stressful time gained a lot of weight, topping out at 146kg, I’ve since lost 34kg. I’ll lose the weight, but just don’t have time to spare to do so first.

  16. I know your pain I had a similar situation. My gyno was wonderful ran all the tests and did his part to see why I wasn’t getting pregnant. Everything was coming back normal he said anything my weight could have been interrupting it wasn’t. He was unable to complete a laproscopy though because of my weight and that’s when he said okay but I have done my part now to a fertility specialist.. I get to the fertility specialist and we start talking about the tests that were done I said we attempted laproscopy and was unsuccessful his response “I figured” as he rolled his eye. Then we go back he performs an ultrasound all looks normal and takes me in his office at which point he goes well your too big to have a baby you have to be under this before we can help you I said okay thinking well at least he is honest BUT he wasn’t done he went on to tell me how I probably have type two diabetes and that there is no way I was eating healthy or in good health, I couldnt believe i was sitting here listening to this and when I thought it couldnt get any worse he tells me the only way I can loose weight is to go have gastric bypass because he couldn’t help me. Needless to say I left crying thinking I thought doctors are supposed to be sensitive at least. The worse was yet to come when he sent me a bill charging me 400 dollars for morbid obesity. I about lost it because the insults couldn’t stop at the office they had to be carried into my bill to remind me. Luckily I got pregnant naturally and have a bouncing baby boy my gyno was thrilled to see me prego and was my friend through it all but to the fertility doc its a big in your face buddy saying it would never happen because I was just way to fat. Good luck to all you bigger girls trying to have babies being fat doesnt mean you cant be a mom.

  17. carla

     /  February 6, 2012

    i think what it all comes down to is you went for help and the so called doctor dint know what to do so just blame everything on you and scold you so it can be your fault

  18. I’m also in Australia and I’m so sorry this happened to you.
    I was 135kgs+ when I fell pregnant with BOTH my children.
    I’m extremely fertile – my weight has never been an issue for my falling pregnant. I hate it when doctors choose the lazy route and spout the “It’s ’cause your fat” crap. God it bugs me.

  19. I find myself in the same boat as a lot of you beautiful women. I have had two miscarriages and, by the third doctor I went to during my second miscarriages, I was finally getting results. However, he ran a multitude of tests and finally told me I have PCOS and a “touch of diabetes.” He then prescribed me Metformin and flash forward a year, narrowly escaping the clutches of lactic acidosis, I am finally feeling like myself again. I am terrified to try to conceive and my boyfriend hardly makes love to me anymore because he’s more afraid than I am about the mistreatment I may have to endure again.

    My doctor took ONE look at me, not kidding — the first five minutes during our first appointment, and he already determined I had diabetes and PCOS.

    It’s a shame. It really is just a shame.

  20. Lil

     /  April 19, 2012

    I have been overweight since I was very young – except it was called puppy fat and ‘nothing to worry about’ right up until I was 14 and then those very same doctors who had laughed at my worries about being over weight switched to ‘why have you let yourself get so big?!’. I was blessed with being able to fall pregnant quite easily but had problems after my first c-section. My periods became irregular, painful and so very heavy. I had slightly more problems conceiving the next baby…but was blessed with twins. One died invitro late in the pregnancy, but the doctors said this was good as it was one less risk! I delivered the twins by C-section and was treated very badly due to my weight postnataly. I tried hard to conceive, and then miscarried late. Again I received poor care due to my weight….I nearly died during the eventual miscarriage (it took 10 weeks after the baby had died for my body to lose it) and was blue-lighted to hospital – the doctor walked in, I was laid on the bed in labour with all the pain that goes with it, and devastated because i has stupidly believed that maybe the early scan was wrong and the baby was okay after all, there was blood everywhere as I’d been bleeding at home for 4 hours…the consultant’s first words? ‘Oh my goodness! Do you know you’re obese?! Have you tried to lose weight?’. My husband went nuts, he was so angry that the doctor felt it was okay to make such a comment at such a low moment in my life.

    It took me over a year to conceive the next baby and my hospital was again lousy in their care, so I opted out (as is my legal right) and only had midwife care. At a scan, where I was humiliated and ridiculed by the consultant and her registrar, I had really had enough and I walked out and informed my husband that I wasn’t setting foot in there again. I had already discovered that the hospital’s unwritten policy was to c-section anyone who was very over weight or obese (despite the extra risks involved). The midwives were nervous, but supportive when they realised I was serious, and supported me in my choice to have a home birth. So I had a home birth. It was a wonderful experience. Then my BP dropped and my midwife suggested I go for a check-up at the hospital – just to sort out some BP meds. Whilst there the hospital decided I was obviously diabetic (just from looking at me – no need for tests!). I told them I wasn’t. They took my baby and put him in SCBU, told me he was going to suffer from withdrawal due to my diabetes! They put him nil by mouth and then his blood sugar dropped (anyone else spot the obvious reason…clue: nothing to do with diabetes!). They told me my milk would be useless as it would contain too much sugar so made me throw away all that important first milk!!! Eventually I forced them to test me – no diabetes! Oh, so then it was GESTATIONAL diabetes. I pointed out I’d been tested during pregnancy and was fine. The doctor declared that the tests were useless and many women of my size managed to pass the tests despite so obviously have diabetes! He told me my son was seriously ill, and it was caused by my size. It wasn’t until I looked into his claims and was far enough away from the situation to think straight, that I realised he had lied – all the problems my son had were caused by the 5 day nil by mouth and a dairy intolerance. Their main proof of it being my fault was he’d lost so much weight after birth…he was on nil by mouth. How on earth was he meant to gain any weight?! Well I put in several complaints about the treatment my son and I received…things like sitting in a room filled with posters of ‘kangaroo care is best’ and then told *I* couldn’t do kangaroo care because I was too fat and would make people feel sick! ‘Breast is best’ but told my milk would be ‘filled with the crap you stuff in your face’ . I was even made to sleep in a seperate room because ‘fat people smell’ and ‘they might have nightmares about whales!’. All absolutely humiliating, especially the laughs and smirks after the comments!

    My relationship with my GP hit rock bottom at this point too. I had failed to listen to medical advice, (home birth) and he seemed to see this as a personal affront! It was nothing, apparently, to do with the fact that one of the doctors I reported was a personal friend of his! I tried asking him for help with my still heavy periods. He told me to have a hysterectomy! I refused and said I would have as many children as I was blessed with, and didn’t think I should have such drastic surgery without even a test before hand! I then asked for advice and help with a discharge – he gave me antibiotics – the discharge stopped and I ended up with thrush. I got thrush treatment from my GP and the discharge came back. I asked for more treatment, got different antibiotics, got thrush again and yet again the discharge came back. My GP said ‘live with it. It’s due to your weight’. Then everything was my weight -even an injury from falling over. I gave up seeing my GP, and only saw him whilst taking my children to him.

    Then my GP reported me to social services….unexplained injuries to my child? No. Something my children have said or implied? No. The reason? I am fat, ugly and smell! This apparently is emotional abuse as my children have to live with me as a mother! The fact that the smell he stated was the discharge he refused to investigate or treat (not a single swab was ever done) seems to be by the by. He also told social services that as I had refused and ignored the medical advice of a doctor for myself (ie refusing to have hospital care and a c-section) it was only a matter of time before I started to ignore medical advice for my children too! This, social services decided, counts as neglect. The fact that I am fat also was proof that I am uneducated (I am very well educated actually) and shows that I can’t see to ‘even the basic care’ of my children (the only one of my children to be over-weight is the oldest and she is 23 and only been over weight since she was 18-so not when I’m the one having to provide ‘basic care’). The conclusion of social services was that I am a bad parent who does see the damage I am doing to my children by looking the way I do! They have insisted that I am the one that collect my children with no exceptions (a comment of ‘the exercise will do you good’ was made but not included in the formal minutes!)…so when I have a period, and I’m flooding and have to sit on folded towels and change my protection every 20-30 minutes? Yep, I have to walk to pick up my children! My youngest children are on the at risk register for neglect and my social worker doesn’t offer any advice. I went to a dietician whilst breastfeeding, and the diet she gave me I followed exactly – I was so hungry and my size 4 sister was horrified as she eats more than I was allowed. I lost 3 lb and my milk dried up…the dietician said I must have been cheating as someone my size would lose 7lb or more on week one! I was so humiliated by the ‘child conference’ held by social services – where school teachers etc sat and listened to how fat I was and how sick I make people feel because of my size, that I have started to have panic attacks…I thought I was having a stroke or heart attack to start with, but they are now 2 or 3 times a day and I haven’t dropped dead yet! I have had to self-diagnose as I can’t bare to visit my GP…and social services say any attempt to change any health professional will be viewed as an attempt to hide something. I am petrified that if I don’t lose weight they will take my children away. I have tried to diet again – it started well with 2-3 lbs every week…but then it dropped to 1lb a week and then stopped. My heavy periods continue to dominate my life and I could do with proper medical advice – but I doubt I’ll get it, even if I could muster the guts to visit my GP. I haven’t had any contraception for 2 years now, but no sign of pregnancy…which is possibly for the best. I know I am blessed to have lots of children, but as long as my husband and I can take care of them financially I don’t see why the doctors have a right not to help us. I really don’t see why my weight is abuse to my children – they are healthy sizes, they have friends and those friends visit and even stay over…surely if I was that much of an embarrassment my children wouldn’t bring friends over and if I made people feel sick to look at me, those friends wouldn’t want to stay over either. I am so embarrassed and worried about ‘the smell’. I thought the discharge (which is only really smelly during the last few days of my period and a few days after) wasn’t bad enough for other people to detect. Now I am fearful of sitting too close to people incase it’s that bad they can smell it. I am so depressed, but trying to hide it as I know depression will count as more neglect towards my children in social services’ eyes. I weigh far too much to just lose it over night – I was 25 stone, but am now just below 22 stone. I should weigh no more than 8 stone…so that’s a huge difference. I am worried that my heavy periods are a sign of some problem that is just being ignored due to my size.

    I spoke to a nurse at my GPs practice, and she told be that government policy was for surgeries to lose money from their budget for patients with high BP and over-weight or obese patients. This is meant to encourage doctors to help these patients become fit….from my experience it just makes the doctors despise the patients and give them bad health care. But if my GP thought he could get rid of me this way, he’s shot himself in the foot! Because now social services won’t let me change doctors! If he’d just asked I would have left his ‘care’ quite willingly.

  21. melhoneybee

     /  July 4, 2012

    As an update to the above-the story was my story. I went on to find a fantastic and supportive endocrinologist who was able to treat the PCOS symptoms effectively, and I am now 30 weeks pregnant. Looks like weight loss wasn’t the answer-being given the correct medication and sorting out my hormones was.


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