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It's OK, You're Just Fat: Achieving Good Medical Care for the Obese

I don't tell these stories to get people to feel sorry for me. I'm telling them because this is the standard of care for fat people, it seems. I'm by far not the only person who's been written off because of her weight.
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This is not something that many fat people talk about when they are ill and need to see the doctor. Like many things surrounding obesity, most people in this situation prefer to swallow their hurt and pride and try to access treatment for their illnesses, anyway, despite the roadblocks that are thrown up. But as an overweight woman, I'm tired of being someone who smiles tightly and stays silent whenever my weight is brought up at any doctor's appointment, no matter if I'm there for my blood pressure or if I'm there for a sore throat. I'm sick of the fatphobia that seems to plague the medical community when it comes to treating fat patients. I have tons of experience with this. It doesn't seem to stop.

To illustrate what I mean, here's a timeline of my medical history from the past six or so months:

I go into the doctor for a routine check up. I feel generally fine, no issues. I'm fairly surprised when the doctor tells me that I have high blood pressure.

"Oh," he says, his blood pressure cuff on me, "your blood pressure is high. Well, lose weight and you'll probably be fine."

"Should I have other tests done?" I ask, frowning slightly. I'm overweight and I know that can be a contributing factor, but I'm also active and trying to eat a lower-salt diet. I tell the doctor this, and he just shrugs.

"No, you're just overweight. Lose weight and you'll probably see your blood pressure fall."

I go into the doctor two months later for my stomach issues. I have chronic gastritis and IBS. They started after I had my very diseased gallbladder out at 23 and are common secondary conditions related to cholecystectomy. Lately, my gastritis has been awful, acting up badly no matter what I do to take care of myself. I'm fairly proud of myself, actually: I've recently lost 10 pounds and have seen a difference in my energy levels. I'm certain that my high blood pressure will have fallen, as the doctor said. I'm also certain that I just need new medication for my stomach to help it feel better.

The doctor shakes his head slowly. "Your blood pressure is very high. You know, you're quite overweight. Probably most of the complaints you have are due to this."

I shake my head slowly, trying not to feel hurt. "I'm actually losing weight. Shouldn't my blood pressure be going down, not up? Maybe I need other tests done."

"No. You're fat," he says, his voice like a whip, sharp and disgusted. "Try losing weight and see if you feel better. I don't think we need to do any other tests at this time. I'm not going to prescribe you anything right now -- see if you can lose weight and come back."

I suffer with my stomach issues for another month before going into another walk-in clinic, this time in desperation. The doctor there prescribes me pills, but looks me up and down, his lip curled slightly in disgust. My blood pressure is again mentioned. It's high, as usual. Nothing I'm doing is causing it to drop, and I feel tired and frustrated. I'm doing as the doctors have said. Why isn't it working?

Again, I'm told no tests need to be run. Again, I'm told to lose weight. It will take another two months before I'm prescribed blood pressure medication that finally makes my blood pressure drop. I'm finally told that tests need to be run another month after that.

I don't tell these stories to get people to feel sorry for me. I'm telling them because this is the standard of care for fat people, it seems. I'm by far not the only person who's been written off because of her weight. I've been told by someone who went in for a strep culture that she was lectured about her weight before any medication was prescribed for her strep throat. I've been told by others like me that further medical testing is waved aside, that every ailment fat people present with is due to being fat, and being fat alone. People have gone without medicine and without any help for conditions that may or may not be related to their weight.

I'm tired of being treated like a second class citizen because I'm fat. I'm aware that many illnesses can be related to obesity. I read the research and I'm not stupid. I know that obesity can cause serious health issues. And I'm not here to argue that one can be healthy and fat, though it's true for many people. There are lots of people that advocate health at every size -- and I'm one of them.

I have seen four doctors over the past six months. Every one of them has looked me up and down in disgust. My truthful assurances that I am losing weight, that I am trying to eat a healthier diet, are waved aside and brushed off. After all, I'm still fat. If in six months I've only lost 10 pounds, then I must not be trying hard enough. The general impression I get is that I deserve to feel disgusting. I deserve to not feel well because of my weight.

There are a lot of people, some in the medical community, that I've spoken to. And they sneer at people who refuse to see doctors for their illnesses. They sneer at people who end up very ill, very fat, because they "brought it on themselves." But I wonder if these people realize that if you are ridiculed and brushed off every time you ask for medical help, you eventually stop asking. No one wants to hear over and over that they're fat and everything that's wrong with them is due to their fatness. No one wants to be sneered at, to be looked upon in disgust, to walk away empty-handed and still feeling disgusting with the entreaty to "lose weight and you'll probably feel better."

Fat people are as deserving of medical care as thin people are. If a doctor wouldn't ignore a thin person's high blood pressure, why is it okay to ignore a fat person's? Not everything is due to being fat alone. There are very often underlying issues -- some of which may be CAUSING the obesity -- and those deserve to be looked into.

I don't know what happened to "good beside manners." I certainly haven't experienced it in the past year of trying to obtain help for my medical issues. While I may be fat, I'm also still human, and I'm coming to you for help because I want to feel better. If all a medical professional can do is sneer in my face about the way I look, then I think you need to examine why you got into the medical profession in the first place.

First do no harm?

Not if you're fat.

For more by Elizabeth Hawksworth, click here.

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