Trigger warning for talk about self-harming
This isn’t exactly all fat discrimination by doctors but more detailing the incompetence I’ve had to deal with in regards to my PCOS and also my mental health, and incredibly dangerous advice given to me about weight loss by a doctor. Just as a warning, this could be triggering for anybody who struggles with self-harming.
I first started having problems with my periods when I was 14 (I’d started when I was 10). At first my doctors brushed it off as being perfectly normal but I persisted and eventually she sent me for an ultrasound (external one) when I was 15. (She didn’t do any blood work!) It came back as being clear except for a very thick womb lining which was consistent with me not having had a period for 10 months. So I believed her and just accepted that it was a normal thing for a teenage girl to go through, especially as she told me it was to do with being overweight.
Fast-forward to when I was 16. I wanted to go on the pill to manage my periods. This was because I would be going backpacking for 6 weeks when I was 18 and I didn’t want to deal with having one of my very irregular and very heavy periods deciding to make an appearance during that time.
They tried me on a variety of different combined pills, all with awful side effects, until eventually they put me on a mini-pill/progestogen-only pill called Cerazette. It worked. It stopped my periods completely and everything was fine during the time I went backpacking.
A few months after going backpacking I started at university. By that time I felt really strange just not having periods so I decided to come off Cerazette. I had one normal period 2 months after stopping it and then nothing.
During that time I was now going to the GP surgery in the city where I was at uni, rather than my doctors back at home. I usually saw a wonderful doctor. I’d actually mainly been seeing her about dealing with my depression after deciding to stop taking the anti-depressants another doctor at the same surgery had forced me to take (by saying that if I refused to take them I wouldn’t be offered any other help like counselling or therapy) . The no period thing was just a worrying side issue. During my time at uni I had also started smoking, part of that was because I’d heard it was an appetite suppressant (stupid, I know) and I was desperate to lose weight.
Anyway, this lovely doctor ordered for me to have blood work done and it came back with hormonal imbalances. However, this was done right before I was due to go back home for the summer so she told me to take it up with my doctors back home.
Now the fun really started with the NHS. The first doctor I saw, as soon as I mentioned that I had no periods and that I had abdominal cramps asked me if I was sexually active. I said yes (as I had been at uni) and she said that I would have to have a pregnancy test. I told her that it would be impossible for me to be pregnant as I was a lesbian but she still insisted that I had to have a pregnancy test because it was the standard procedure for any teenage girl even if she had lied about being sexually active!
I stormed out of there and demanded to see the practise manager, lodged a complaint and made sure it was noted on my files that I was to never have another appointment with that doctor (there are about 12 different GPs that are based in that surgery. )
I then had weeks of trying to contact my surgery back in my university city to get them to send my blood work over to my doctors at home. Didn’t happen. So the doctors finally did blood work on me and, you’ve probably guess it, still hormonal imbalances but it was a week before I was due to go back to university.
Anyway, went back to uni. Had to have more blood work done because they’d lost the other results and I couldn’t be bothered with trying to deal with getting my notes from my home doctors. Finally, I managed to see the lovely doctor again, who had to order more blood tests. She then explained that she thought I had PCOS and what it was but she wanted to send me for an ultrasound to check. I told her I’d had an ultrasound before and she explained to me that an external ultrasound wouldn’t be able to pick up the very small cysts that can be present with PCOS and I would need an internal one.
That ultrasound was incredibly painful as she pushed it right in and then out to the side. (As a side note, the evening after that ultrasound I got raped. There are only two people in real life who I have told. One of them is the therapist I’ve been seeing for over a year now and I only told her a few weeks ago because I’d convinced myself that nobody would ever believe that a fat girl had got raped. )
So I finally had that ultrasound and it confirmed that I did have polycystic ovaries. By this time was 15 months since my last period, so she kick-started my period using pills. Once the hell of that period was over, I’d finally got relief from the pain I’d been in.
Then she left as she was moving across the country. After 6 years I’d finally got a diagnosis that something was wrong with me.
So I went back to see another doctor about how to manage my PCOS. She told me that my only option was to go onto the combined pill. I explained to her that I had tried 4 different types of combined pill before and told her the side effects I’d suffered and asked if going back on Cerazette would help. All I wanted was to be able to manage my periods so going back on something that stopped my periods completely and that I had no side effects from would have been fine for me.
She told me that there was no way Cerazette could help with PCOS and I would have to go onto the normal pill. She then gave me a lecture that because my BMI was over 35 I was at high risk of getting a blood clot when taking the normal pill and this risk was even worse as I smoked. She told me to go lose 10kg (about 22lb), and quit smoking and go back to see in her 6 weeks time after I’d done both of those things. I asked if it was possible to healthily lose that weight in that time frame. She told me to stop eating all the cheese and cakes I obviously eat (umm.. I’d been vegan for nearly 3 years at this point) and to eat no more than 800 calories a day and that with my fat reserves I would be perfectly fine.
I didn’t argue with her. (Notice how I took action over the doctor who said that all teenage girls had to have pregnancy tests if they had those problems? Well in my mind that was discrimination towards all teenagers and it wasn’t my fault I was that age. However, with this doctor, it was my fat, so it was my fault so I was certain that if I complained everybody would laugh at me and side with her. Besides, I tried so many diets before that had never worked so maybe one that a doctor told me to do would actually work? )
Now, remember above I said I suffer from depression? Well, that includes self-harming and suicide attempts. By this time I’d started to use my smoking instead of self-harming as I really didn’t want to cut anymore but I needed to do something. So it was my crutch. One that wasn’t very healthy but would be better for me than cutting and I could get a lot of support with helping to quit smoking when I felt ready do that rather than dealing with the social stigmatisation I got from my self-harming and the risk of when I have a really bad bout of self-harming I have been very close to killing myself even if it wasn’t actually a suicide attempt.
So, there I was trying to quit smoking and lose 10kg by nearly starving myself at the same time. Yeah, my depression (which had been getting better) spiralled down and I nearly hospitalised myself with the self-harming. Actually, I probably would have died if my friends hadn’t found me before I’d done enough damage.
So, as you can guess, I failed at both quitting smoking and the diet. (Once my friends had got me cleaned up and bandaged they shoved a bar of my favourite chocolate in my face and light up a cigarette for me while putting my favourite film on the TV before they started to cook a meal for me. It was bloody wonderful. )
I went back to the doctors. After listening to her berate me for just not trying hard enough I finally plucked up the courage for her to see my arms and the healing cuts. Her response? “So? That’s not an excuse for being obese and refusing to quit smoking.”
I then tried to calmly explain to her that I smoked as my crutch instead of cutting myself and that when I try to quit my self-harming can get so bad I can nearly end up killing myself. All the while I was terrified that she was going to section me and have me carted off to the mental health hospital (which is actually why my friends took care of me themselves instead of getting anybody else involved – the thing I am most terrified of is being sectioned).
She laughed at me. She then told me “Cutting would be much healthier for you than smoking. Plus, if you quit smoking you will be able to exercise more so you will lose weight and you won’t have any reason for being sad anymore. ”
Yep, that’s right. Nearly killing myself outright is healthier for me than smoking. Oh and the only reason I have depression is because I’m obese. Even though it’s right on the bloody notes in front of her that I’ve had depression (and anxiety) since I was 10 years old and that my weight gain (which started when I was 13) was due to comfort eating thanks to the stuff that happened in my childhood! Oh and also a broken ankle when I was 13 which never fully healed (I’ve also been lectured that was because of my weight, although when I finally managed to get it x-rayed again 7 years after I broke it, they discovered they’d missed the fact the bone had chipped and I had a lovely bone chip floating around in there which was causing me all the pain. ) which meant I was unable to do any of my favourite activities (horse-riding, mountain hiking etc) anymore.
Anyway, I dropped out of uni a few months after that to my depression and the pain that I was in from the PCOS meant I was having trouble just functioning. Oh and also because I had days when I couldn’t get up out of bed because my hips are screwed up thanks to my ankle and I get severe shooting pains radiating from my hips, so painful that I can’t even breathe, let alone move.
I’ve had two more years of hell with my doctors back at home. Although they understand the reason for me smoking and don’t want me to quit until I’m ready to quit. They are also starting to accept the fact that I do eat healthily (I keep a food diary now – I eat vegan diet with minimal processed foods (I have an occasional bit of dark chocolate, cakes/scones I bake very rarely and I have mock meat things once or twice a year) and have done for 5 years) and that I get way more than the 30 minutes of exercise 3 days a week they usually recommend to people of my size for weight loss. I did take a lot of joy out of showing them a copy of my job contract which details what I have to do at work and explaining to them that on average I walk over 12 miles a day at work, and on days I’m not at work I go out on at least 5 miles long walks with my own dogs. So they are finally starting to accept that my grand total of 2kg (4lbs) weight loss in the year since I’ve started my job might actually be to do with the fact my PCOS means my body wants to cling onto every single fat cell and not because I’m a lazy fat person who sits around stuffing her face with junk food all day.
Anyway, I am finally back on Cerazette and it’s wonderful. I’m also finding that my job, and being a lot more active than I was at uni, is helping my hip problems a lot. In fact, I can’t sit down in a chair for more than an hour without my hips playing up when I try to stand back up. So with my hip problems it wasn’t my weight that was causing them/making them worse, it was just having to be a university student and spending hours sitting in lectures or in the library doing my work, that was causing me all the hip problems.
Oh and despite being obese and a smoker, I manage to do my job and keep up with (and most of the time out-walk) the “healthy weight” people at work.
And best of all? Apart from a little shallow blip on Christmas Day, I haven’t cut since 6th October 2011, and without thinking about it, just doing it naturally, I’m down to 1-3 cigarettes a day instead of over 20 a day. It’s all down to my wonderful therapist who worked out that I actually have an avoidant personality disorder as well as my depression/anxiety and she also doesn’t mention my weight at all, unless I bring it up. And even then all she does is ask me if my weight stops me from doing anything that I want to do, and I realise that it doesn’t.