I originally created these cards as part of a post about what to say at the doctor’s office to help get the appropriate evidence-based care you should be getting in the first place from doctors and other healthcare professionals. They have been shared around a lot, and I love hearing from people about how they used them and how much they helped (even though they shouldn’t be necessary to begin with, but that’s a subject for another post!) If you’re looking for a little more support, I have a video workshop specifically about techniques for Dealing with Fatphobia at the Doctor’s Office, there’s a pay-what-you-can option and you can find it here!
A reminder that nobody is obligated to engage in activism at any time, but especially at the doctor’s office where there can be an extreme power imbalance. While medical weight stigma (in the forms of both practitioner bias and structural inequality) becomes our problem, it is not our fault – the problem is never fat people existing, it’s healthcare providers who are working from a place of weight stigma. While there are techniques and arguments we can make when a healthcare provider says that a health issue is caused by being fat. you can also do what you have to do to get the healthcare you need.
You might also want to check out my Weight and Healthcare Newsletter about the intersections of weight science, weight stigma, and healthcare, as well as the HAES Health Sheets which include diagnosis-specific weight-neutral practice guides for practitioners, patients, and advocates as well as a resource and research bank.
English Versions
Spanish Versions
Translated by Camila Oda
French Versions
Translated by Marilou Morin
German Versions
Translated by Dorothée (Dot) Jankuhn at Larger Living
German Version
Translated by Christina in Munich
Hilfreiche Formulierungen beim Arzttermin
- Zeigen Sie mir bitte eine Studie, in der die Mehrheit der Probanden erfolgreich so viel abgenommen hat, wie Sie mir vorschlagen.
- Bekommen schlanke Leute dieses Gesundheitsproblem? Was würden Sie in so einem Fall empfehlen?
- Chirurgie wie z.B. die Magenverkleinerung ist keine Option wegen der niedrigen Erfolgsrate und der ernsthaften, irreversiblen Nebenwirkungen (einschließlich Tod).
- Die Studien, die ich gelesen habe, zeigen, dass die überwiegende Mehrzahl der Menschen beim Versuch abzunehmen scheitert. Viele davon nehmen langfristig sogar zu.
- Bitte bieten Sie mir evidenzbasierten Medizin an und die Möglichkeit für informierte Zustimmung.
- Stigmatisierung ist schlecht für meine Gesundheit. Ich würde Sie bitten mir zu helfen und nicht zu schaden und mich ohne Stigmatisierung zu behandeln. *
- In unserer begrenzten Zeit würde ich mich gerne auf X konzentrieren.
- Im englischen ist das „First do no harm“ die allgemein bekannte Eingangsformulierung des hippokratischen Eids, also die ganz große Keule. Im deutschen fällt mir keine griffige Formulierung ein, die nicht absolut furchtbar klingt. (Ich möchte Sie an den hippokratischen Eid erinnern, mir nicht zu schaden?)
Hilfreiche Quellen für den Arzttermin
Dickenstigmatisierung und Gesundheit
https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-8-128
https://ajph.aphapublications.org/doi/10.2105/AJPH.2009.159491
(Mangelnde) Erfolgsrate beim Abnehmen
https://pubmed.ncbi.nlm.nih.gov/17469900/
Probleme mit der Forschung zur Gewichtsabnahme
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-30
Erfolg von „Health at every Size“
https://pubmed.ncbi.nlm.nih.gov/15942543/
https://jamanetwork.com/journals/jama/fullarticle/192035
https://www.jabfm.org/content/25/1/9.abstract?etoc
Gefahren der Magenverkleinerung
Ich praktiziere Health at every Size
HAES ist eine evidenzbasierte Denkrichtung, bei der der Fokus auf Gesundheit und gesunde Lebensgewohnheiten gelegt wird, statt auf Gewicht und Abnehmen.
Damit wir im Interesse meiner Gesundheit möglichst gut zusammenarbeiten:
- Verschreiben Sie mir bitte nicht „Gewichtsabnahme“ als Behandlung
- Wiegen Sie mich bitte nicht, solange es nicht medizinisch notwendig ist (z.B. für die Dosierung gewichtsabhängiger Medikamente) und teilen Sie mir das Gewicht nicht mit, es sei denn ich frage danach
- Ziehen Sie bitte in Betracht mir die gleiche Behandlung zu verschreiben wie einer schlanken Person mit dem gleichen Gesundheitsproblem
- Behandeln Sie mich bitte evidenzbasiert und geben Sie mir die Möglichkeit informierte Entscheidungen zu treffen
- Bieten Sie mir bitte eine nicht-stigmatisierende Behandlung an.Vielen Dank
Quellen
https://pubmed.ncbi.nlm.nih.gov/17469900/
Fast alle Abnehmenden haben das Gewicht wieder zugenommen, meistens mehr als das Ausgangsgewicht
https://pubmed.ncbi.nlm.nih.gov/10449014/
Die existierende Datengrundlage zeigt fast ausschließliche Rückfälle nach 3-5 Jahren
https://pubmed.ncbi.nlm.nih.gov/15942543/
HAES resultierte in verbesserten Markern für Gesundheit
https://jamanetwork.com/journals/jama/fullarticle/192035
Fitness verringert allgemein das Mortalitätsrisiko
https://www.jabfm.org/content/25/1/9.abstract?etoc
Gesunde Lebensgewohnheiten sind mit signifikanten Verringerungen der Mortalität verknüpft, egal bei welchem BMI
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Excellent. Most should work, depending on the entrenched position of the doctor in question and how quickly they can come up with legitimate responses to factual rejoinders.
In the limited amount of time we have….”
Winner winner, that!
Those are fucking awesom!
OMG, just discovered your blog through Sally Cronin’s “Smorgasbord Daily.” I recently got a cut my leg and the cut got infected. My regular doctor wasn’t available, so I had to go to another. Her first suggestion: weight loss surgery! For an infected cut on my leg. Yup. Because thin people never get cuts on their legs. I needed this card.
Ugh! I’m so sorry, at that point I feel like it’s medical malpractice. I’m so sorry you had to go through that.
WAY! I read that and had to read it to my Mom. OMG! Is right. Infected cut, I’m sure in medical year one text book; cure by offering invasive, dangerous weight loss/nutrient denying surgery! THESE PEOPLE DO NOT HAVE OUR BEST INTERESTS AT HEART.
And you can’t educate bigotry away in all cases! Clearly. Then again, what other path of higher education has such a biased focus on fixing fat people? Gym Teachers, doctors, nurses…