Fat-shaming happens, even if you aren’t “fat”

EB writes:

I have never been anything that anybody could reasonably call fat. At 5’5.5″ I stayed around 125 from the ages of fourteen through 26. At 27 I weighed myself (usually a bi-yearly event or so) and discovered my weight had crept up to 135. This didn’t bother me because I was getting fat (because I wasn’t) but I thought maybe I was consuming more calories than I needed. I hadn’t noticed because at this time I wore mostly drawstring-waist clothes and hadn’t seen a change in the way they fit. I kept a cursory eye on what I ate, keeping in mind that I was clearly getting as many calories as I needed and maybe a few more. With no further effort on my part my weight came down to 130.

Then I found out I was pregnant.

And then I got hungry. Constantly, crushingly, insistently hungry. This was not the normal First World hungry or even the “I’ve been hammering boards together all day and boy am I famished” kind of First World hungry. This was something different. And I had to feed it. So I adapted my diet as best I could, in the interests of staying a functional human being.

I went for my ten-week checkup and was scheduled with a nurse practitioner who I had not seen before that day. She walked in, stood by the door, didn’t bother to introduce herself, and asked me how I was feeling. I didn’t feel much like discussing how I was feeling, since I’d discussed it to death with everybody, including having discussed it five minutes prior with the woman who took my blood pressure, but I answered dutifully with a response along the lines of “I’m making it”. She queried me more closely and I told her that I was constantly hungry, eating all the time, and kind of fatigued.

She told me this was normal for pregnancy. Which I already knew, which was why I didn’t want to discuss it because what was she going to do to fix it? I told her I wasn’t really feeling nauseous but mostly it was just that I got sick of certain foods because of eating them when I had no desire to eat them. She didn’t seem to understand this concept and I said “You know how sometimes you’re like ‘Man, a sandwich would be really tasty?’ Well, it’s the opposite now. It’s more like ‘Man, I really don’t want a sandwich, but I’m starving and I have to eat SOMETHING.'”

She asked me how often I ate and I told her honestly that I would eat five times a day and snack in between.

She then proceeded to jump to conclusions about how MUCH I ate at each of these meals, telling me I’d gained 10 pounds since before I was pregnant and that during the first trimester I was only supposed to gain about a pound a month. [Let’s not discuss here how much of that might be breast tissue; I’d also gained a couple of cup sizes by that point.] Wait. WHAT? I challenged this and she said that my record said I had weighed 125 before I was pregnant.

Now let’s discuss the poor data-gathering I observed at this office. At the first prenatal appointment the provider asks how much you think you weighed prior to getting pregnant. You answer and that, apparently, gets added to your record. If you happened to be wrong about that, then how are you going to know? My guess would be I said my pre-pregnancy weight was 125, 130 or so, and she wrote down 125. They would then weigh you at each visit and the medical assistant taking the weight seemed not to care if you leave your shoes on or take them off or if you’re wearing your coat or who knows what all else. So you have to figure any reported weight could be off by 2-3 pounds. Add in the effects of, say, wet hair, a full bladder, having your wallet in your pocket, or having just eaten breakfast. That’s another 2-3 pounds that you could be off. Therefore, if you are the provider and looking at this number, you need to bear in mind that it is a ballpark figure.

But what the heck. Look at a garbagey number, compare it to an equally garbagey number, and criticize a starving pregnant woman and tell her to eat less.

Anyway, she said that I’d weighed 129 at my last appointment a month previously. So if I was supposed to gain a pound a month, I was 5 pounds over and apparently deserving of this lecture? I was distinctly irritated by this point and commented about full bladders, and she dropped the mention of specific numbers but then said something about how if I was eating five meals a day and snacking in between that was probably too much, as if she knew how big of meals I was eating. Then she started to say something about how maybe if I wanted a sandwich I could just eat a really small sandwich, which I cut off by saying “I know about portion control.”

Then she shifted gears to talking about exercise. I admitted that I didn’t exercise much because I felt lousy most of the time. She asked, in the same sort of perky voice that she had been using through the entire conversation, what I liked to do. I said walking and she said I should shoot for walking 30 minutes a day. I pointed out for the second time in two minutes that I feel lousy, fatigued, not up to it, and she pointed out that exercise produces endorphins that make you feel better (which I knew, but I so did not need this lecture on this particular day). I cut off this conversation too and said that this wasn’t even what I wanted to talk about and I had other questions, and she mercifully dropped the subject.

So, short version, I got criticized for supposedly gaining too much weight, for almost no reason whatsoever, after I’d just told her I was hungry constantly.

I ended up switching practices. I never reported this lady, though I wish I had. I ended up gaining almost 50 lbs before delivering my daughter, and the new providers I saw never said word number one about it—at each visit they told me my weight was fine. My daughter was an average weight, neither of us had any complications, and I was back to 125 by six months postpartum. Apparently whatever horrible thing was supposedly a risk because of those extra 5 lbs never materialized. I wonder if it is worth reporting this provider as this was 2 1/2 years ago. I shudder to think of the effect of this conversation on someone who actually had an eating disorder or even food issues (since aside from food aversions in pregnancy I have the least food issues of anyone I know.)

Too old and too fat to be pregnant (FFS!)

Amy Finn says:
I was 36 years old, 5 feet tall and about 170 pounds when I went in excitedly to my initial ob appointment for my third pregnancy. I was stoked about this little surprise the Universe had dropped into my lap.

I had delivered my second baby through this practice just five years earlier and admittedly, while I liked one doctor more than the other four, I didn’t have any issue with them throughout my care despite my gaining 50 pounds during that pregnancy.

That changed immediately with this visit.

The doctor walked in holding my chart. The first thing she said was, “We all know you don’t want to be here.” I laughed just because I couldn’t figure what she was on about. She continued, “Thirty six years old and a third baby. Hmm. We all know your eggs aren’t any good any more.” My eyes darted around the room looking for just who “we all” were in the room. Nope, no one else there. Just the two of us and of course, my baby.

She spoke on and on about why it probably wasn’t a good idea for me to have the baby and that time was running short for me to terminate the pregnancy. I finally held my hand up and said, “I am not terminating the pregnancy. Let’s just move on from there.” She sighed and looked down at the chart, her eyes popped out a bit.

“Well, you’re rather obese, aren’t you?” At this point I was looking around the room for the hidden cameras because clearly, this could not be real life. “If you look further in my chart you’ll see my blood work and health markers are all terrific.” I felt frustrated having to justify my size to her but I was in shock and truly regretting sitting on that cold table clad only in a paper sheet being berated by this woman who didn’t know me at all.

“Well, you can’t gain much more weight. It’s detrimental to your health and… and your baby’s health. You will only be able to gain nine pounds this pregnancy.”

At that point I guffawed so broadly, I’m sure patients two rooms over could hear me. “Listen, doc, if you again check my chart you’ll see that my two previous babies were each nine pounds. How could I only gain nine pounds? How do you accommodate a baby, extra blood flow to me and what not?”

“Nine pounds,” she repeated. She turned on her heel and left.

If I had been further along in my size acceptance philosophy, I would have calmly gotten dressed and walked out refusing to pay. However, I was still struggling with my size and so I continued at that practice. I made sure to never see that doctor again. I did complain to the senior practitioner about this doctor’s behavior, but I do not know if anything was ever done about it.

For the record, I gained 50 pounds with this baby. Not one of the practitioners said a word about it to me. And my baby was exactly nine pounds at birth.

This took place about a year before I realized and fully accepted size acceptance and health at every size. My life is much different now and I am thankful for that.

Shamed by ob/gyn – health not important, weight more important for pregnancy.

Emily writes
I am 5’4″ and weighed about 153 lbs before my current pregnancy (I’m about 8 weeks along). When I went to my doctor in December and mentioned to her that my husband and I would be trying for baby #2, she immediately told me that I should lose a little weight because I was carrying a little too much and that it would help me get pregnant.

I felt terrible about that for several weeks. I have been trying to get back to my personal ideal weight of around 135 since baby #1, and it’s been a struggle, even though I pretty easily got back down to my pre-pregnancy weight of 150. I also resented the fact that she brought up my weight when talking about pregnancy since my husband and I have never had any problems with fertility. (Three pregnancies within a month of starting to try, with one healthy baby, one miscarriage and my current pregnancy). I weighed about 150 pounds all three times. My doctor was basing her comment on absolutely nothing that had to do with me, as she doesn’t know my eating habits (very nutritious) or my exercise habits (I run 12 to 20 miles per week).

When I went back to my doctor for the pregnancy confirmation appointment this week, she told me that the maximum ideal weight for my height was 126. She seemed to be using the chart as the bad guy so she wouldn’t have to tell me directly that she thought I was fat. I told her that was ridiculous and that my personal ideal weight was around 135. She then told me that living in an overweight culture means that your view of normal gets skewed. Again, I told her I was in my absolute best shape at around 135, and asked if she would say that meant I was fat at that weight. She said “I wouldn’t use that term. I would say overweight.”

I sobbed in my car for 10 minutes and I am now feeling like I’m doing nothing right. I have already switched doctors, but this woman’s bugaboo about weight (when again, she knows NOTHING about my level of cardio health, nutrition, etc) has really hurt me and made what should be a joyful time stressful and unhappy.

Thank you. I’m so glad your website is out there. I felt so isolated and ashamed after this happened, and because I’m not yet revealing the pregnancy to friends, I also felt as though there was no one I could tell about this.

Woman doesn’t know she’s pregnant because missed periods are because she’s fat

Reader Sarah writes:

Just saw this clip from the show “I Didn’t Know I was Pregnant,” and thought of your blog.

24-year-old woman took the morning-after pill when the condom broke. Started missing her period. At first she doesn’t worry because her periods had been irregular, but finally she goes to the doctor. He says it’s normal for such an overweight woman to miss her periods. No mention if he did a pregnancy test. But guess what, she was pregnant with twins, whose health was compromised because the mother received no pre-natal care:

Miscarriage, D & C scheduled, doctor suggests WLS

A reader writes:

First I want to say thank you so much for this blog. It makes me angry, but it also helps me feel understood.

I have always been fat. I was a fat child, a fat teenager, and now am a fat adult.

When my husband and I decided to try to have a baby, we discovered that I had a fertility issue (unrelated to my weight) that would prevent any sort of natural conception. Fast forward six years to our second IVF try and we were ecstatic that it worked. Until week 10 when I went in for my first scan and they found that the baby did not have a heartbeat. We were crushed. We decided that I would go off all medication that was supporting the pregnancy and wait for my body to spontaneously abort.

Unfortunately a week later, I ended up in the emergency room, bleeding heavily and in a significant amount of pain. I will say that I in all of these situations, my fertility doctor, the OB who did the first scan, and the ER staff & doctors, all of them treated me with respect and compassion. After receiving some pain medication, I opted to come back the next day for a D&C, considered a same-day surgery.

Here is where my story turns so awful. Because of my husband’s work duties, he was unable to accompany me to the surgery wing the next morning, although he was able to be there before I actually went into surgery and for my recovery. I waited alone for my file to get processed, for the nurse to take my blood pressure and temperature and finally I sat and waited for the anesthesiologist.

I got called back by Dr. H and walked back to sit at his desk. He ignored my medical history (which showed no prior problems with anesthesia at my weight) and began to detail all of the complications that can happen under anesthesia at my weight. Fine. Whatever. I was in a haze and pretty much ignored him unless I was asked a direct question.

But then he looked me in the eye and said, “You know, we have a really excellent bariatric surgery program here. You should think about doing it. You can always get pregnant again later. Your knees will thank you if you do it. I know you’re fine now, but that much extra weight will have a lot of repercussions later on.”

I sat there, stunned. And shamed. And to this day, thinking about it makes me cry. I said nothing in my own defense.

Later as I was laying in pre-op, a chaplain came by and prayed with me. Then he just stood and talked to me for awhile. Out of nowhere, Dr. H comes up to my bedside to check in before surgery. He looks across the bed at the chaplain and says, “I’ve been trying to talk her into doing our bariatric surgery program.”

Did I mention that pre-op is just a bunch of curtained off areas?

Thank God for the chaplain who glared at Dr. H until he left and then just stood with me and held my hand. The shame I felt was indescribable. I was already blaming myself and my body and my weight for being the reason that my baby was gone.

I didn’t tell anyone about what Dr. H said. I didn’t write an angry letter to the hospital. I tried to forget it, but even though that was almost 3 years ago, I remember every second of the horror that I felt. The way that my shame almost choked me.

You don’t have to post my story on your blog, but I felt that this was the time and place to share what happened. Maybe I will go ahead and write that letter telling the hospital how I was treated. I’m fairly new to the Fat Acceptance blog world and it’s going to take me some time to change the way my mind works. I’m hopeful that I can work to put that shame behind me and stop blaming myself for what happened.

Thanks for the venue and for reading this far.

Pregnancy and Doctor Doom – He was wrong, wrong, wrong!

Jennifer writes:

During my first pregnancy, I got regular checkups from my in-network provider, a group medical practice, as well as from a midwife. The visits with the various doctors at the practice were punctuated with uncomfortable silences and long looks. Finally, when I was about four months along, one of them said hesitantly, “Well, I don’t know if anybody has raised this as a concern, but you’re . . . well, you’re obese.”

What I wanted to say was, “Gosh, I never knew that! No wonder my clothes have to be so big! Thank you for clearing up this mystery, doctor!” What I said was, “Yes, I’m aware of that.”

“Well, we were worried that you would get upset if we raised the subject.”

“No, that’s fine.”

So she went down the laundry list of Awful Awful Things, such as blood pressure (always normal), blood sugar (ditto), hauling around the baby weight on overstressed joints (I told her that my weight had actually gone down just before I conceived), and so on and so on and doobie doobie doobie. She started looking a little unnerved as the fat lady just sat there giving assorted variations of, “Yes, I know, and as you can see from my chart, I’m perfectly okay.”

So on the next visit, another member of the practice flipped through the last doctor’s notes and said, “I see that you’ve been made aware of our concerns about your obesity.” I nodded and smiled and he went on to tell me solemnly that I was so fat inside (or as he put it, I had so much “excess tissue”) that I could never have a baby without medical assistance, so my planned homebirth would just have to be canceled, and he looked forward to working with me if I got him on rotation in the labor and delivery suite at the hospital.

And I took a copy of his notes to the midwife, who–gasp, shock–did an internal exam and said that Doctor Doom was full of shit. I had a good set of abs under my flab due to the crunches I had been doing faithfully for years, I had a classic gynecoid pelvis, my tissue health was excellent (I had been taking high-powered vitamins recommended by my midwife and eating well), and she even had me do a Kegel around her fingers to prove that I did not have a flabby incompetent twat. In her opinion, I was not likely to have a problem even if my baby was twins.

I had that baby at home, after a four and a half hour labor. In fact, I had all of my babies at home. They’re fine, I’m fine, and Doctor Doom has never retracted his ridiculous assertion. Not that I see him for anything if I have a choice!

I live in a midwife-unfriendly state and I don’t want to cause her any trouble, even indirectly. So just sign me,
Big Fat Mama of Three

Pregnant? You are carrying too much weight to have a healthy pregnancy. Whatever the medical tests say.

Marg writes:

I am currently 22 weeks pregnant and probably in the best health I have been in years. Unfortunately instead of enjoying it I’m finding myself for the first time wanting to skip medical appointments because I am totally fed up with dealing with the worst fat-prejudice I have ever encountered in my life.

Except it’s not just fat prejudice (although this is how it is expressed in my case). I have discovered it’s more the systematic bullying of nearly every pregnant woman I’ve met, no matter her age, weight, overall health or whatever by the medical profession.

You see there is no perfect ideal pregnant patient. We’re all doing something wrong.

In my case, I tick a lot of high-risk factors – I’m overweight, over 35, became pregnant through IVF and have a mother who died of a diabetes-related illness. About the only risk factor I don’t tick is being of indigenous descent. So I totally get that the doctors want to keep a close-eye on me during my pregnancy and this is fine. It’s just the way they do it.

During my 16-week appointment the doctor said (and I swear I’m not making this up although I may have got the words a little wrong): “Your blood pressure is good, your kidney function is normal, you have good iron levels, low cholesterol and normal insulin levels BUT you are carrying too much weight to have a healthy pregnancy.”

As evidenced by what???

If he had just said: “All your medical tests have come back fine but I still want to keep a close eye on you because of your high risk factors” it would have been fine. It would have been better than fine.

Instead I get “It’s really important that you don’t gain any more weight during this pregnancy. I don’t want you coming back in a month another four kilos heavier.”

So are you are saying that I shouldn’t report for medical check-ups if I’ve gained any more weight?

It’s actually really really important that I get regular check-ups – whether I gain, lose or maintain my weight – especially given my high-risk factors. We need to ensure that if my blood pressure soars or that develop gestational diabetes – both very common conditions that can affect pregnant women of all ages and weight – they are caught early and treated appropriately, both for my health and the baby’s. In fact all pregnant women should be encouraged to have these check-ups. I met a 21-year-old within the ‘healthy’ weight range who delivered a 10 pound baby because her doctor didn’t think she was at risk of gestational diabetes. Which shows that you can never tell just by looking at the outside.

So I keep returning for my check-ups because I am interested in keeping an eye on my health, whatever my weight is that week.

I vent my frustration to my other pregnant friends and discover I am not alone in dealing with insensitive doctors. One friend who had a higher than average risk of Downs Syndrome was being hounded by her hospital to have a diagnostic test that carried with it a 1/200 risk of causing a spontaneous miscarriage. She had worked for 3 years with severely disabled children and knew what she was saying when she told them “I don’t want the test as there is no way I’d abort the child even if it is disabled”. In the end the phone calls only stopped when she sent them a legal letter via her GP who explained that she had “informed consent” regarding this decision.

Another friend, who had twice been hospitalised for mastitis (severe infection of the breasts) was told off by the breast-feeding police for her decision to go straight to formula-feeding with her third. Didn’t she realise that she was putting her newborn’s development at risk? The fact that she had every medical reason not to breast feed (how healthy is pus- and blood-filled breast milk anyway for a bub?) and that she thought it more important to be a healthy mum able to care for all three kids at home was of course irrelevant.

And so on. There are 100s of stories each worse than the first, but us overweight pregnant women come with a ready-made condition to be bullied with. The dietitian cross-examines me over a glass of apple juice I had at breakfast (the first one in nearly a year I might add). Don’t I know what harm I could be doing to the baby?

Probably not as much as the harm you are doing, madam. You see there is one pregnancy statistic that all the studies around the world have confirmed time and time again. While gestational diabetes and high blood pressure are definite risks, if they are caught early and managed properly there is little or no impact on the developing baby. But stress, anxiety or depression during pregnancy all carry with them a very high risk of impacting negatively on the development of an unborn child. So why do so many doctors and nurses and other medical professionals act in a way that increases the likelihood of this happening through their bullying of pregnant patients?

Pregnancy, blood sugar, eye exams

The following are Meira’s experiences –

1.  During the birth of my first child, I was hoping for a vaginal birth.  I had been contracting consistently but without progress for 36 hours when my OB/GYN talked me into a c-section.  During the c-section I could feel them pulling and tugging.  When they got him out they held him up for a moment and then whisked him over to some table & cleaned him up and left him there, alone.  I sent my S.O. over to be with him and as I was watching father and son meet for the first time, I could hear my OB/GYN complaining about dealing with all my fat.  One of the nurses was so appalled that she apologized for my OB/GYN as I was leaving the OR.

2. May or may not be fat related:  When I was 11 weeks into my second pregnancy (twins!), the nurse at my PCP’s office called to tell me that my blood sugar was high (upper limit of this test was like 6.9, my result was 7.  My diabetic aunt says her doc tells her to keep her level below 13 . . .).  I asked the nurse if pregnancy, and specifically twin pregnancy, would have an impact on those numbers and she quickly backtracked.  For the record, 15 weeks later I passed my gestational diabetes test with flying colors.

3.  I go to the eye doctor for a new prescription & I get new glasses.  Almost immediately I am not thrilled with the new prescription — things that should be clear are blurry.  I go back to the doc who does a couple things and then tells me to get my blood sugar checked, and IF that’s ok, he’ll look into other things.  I explain that my blood sugar has been fine and even great the past couple times it’s been tested and he just shrugs.   A couple months later I go to a new eye doc who figures out that the prescription the other guy gave me was wrong.

“There’s Nothing Worse than Being Fat and Pregnant”

Another story from Kelly

There’s nothing worse than being fat and pregnant. Every single prenatal visit, the nurses would check my blood pressure 3-4 times, despite the fact that it was perfect at every visit. They also made me do a stress test every month “just in case.”

I asked them just in case of what and they told me that people “your size” have high blood pressure. I said, but I don’t and never have … It didn’t seem to matter. In fact, they monitored my blood pressure, cholesterol and sugar levels throughout the pregnancy (which I paid for bc insurance will only cover so much) — even though I have NEVER had a problem and did not ever show signs of developing one.

Now when I go in for postnatal visits – it’s like everyone’s first astounded and then amazed that I’m consistently losing weight. One nurse even said, “Wow, most overweight people don’t seem to bother losing their baby weight.” I did speak up for myself that time and they’ve been much better since then.