I received an e-mail from a reader who is worried that she is having some health problems, but has been afraid to go to the doctor because of the fat-shaming that she received the last time she went.
This is not the first time I’ve heard this. Sadly, it’s not even the hundredth time. It’s mostly been from fat people, but also people who have dealt with eating disorders and just those who struggle with being weighed and then feeling judged.
All too often, this is shrugged off by healthcare professionals as a “they need to get over it” thing, but it matters and it needs to be taken seriously because anything that gets in the way of people getting healthcare matters and needs to be taken seriously.
Unfortunately, it can also be profitable, as insurance companies have specific codes for “obesity counseling” (which, sadly, is not counseling to help doctors stop pathologizing bodies based on their height/weight ratio, or counseling about why we should give every fat person a pony.)
Let’s start here: In a fatphobic society, being weighed and/or negatively judged by a person of authority – including and especially a healthcare practitioner – can lead to trauma that interferes with the person’s future ability to engage with their own healthcare. That needs to be taken seriously, and solutions need to be offered (and let’s all be clear that “how about you just stop being traumatized” is NOT a solution.)
In good news, getting someone’s weight is almost never actually necessary – only in special cases (like medications that are dosed by weight) is this something that even needs to be done, and the need to tell patients their weight is even more rare.
Not to mention that focusing on a patient’s weight can cause healthcare practitioners to miss important diagnoses when, overcome by their weight stigma, HCPs fail to provide competent, evidence-based care.
Speaking of competent, evidence-based care, there is no point prescribing body size manipulation (aka weight loss) anyway since:
1. The same conditions happen in thin patients, meaning that thinness is neither a sure preventative nor a sure cure
2. Treatments besides “try to look different” are available for all of the conditions for which weight loss is often recommended (Pro-tip, they are the treatments that are prescribed to thin patients, so if a Healthcare Provider recommends weight loss, try asking “How do you treat this in thin patients?”)
3. There isn’t a single study where more than a tiny fraction of people succeed at significant long-term weight loss and the majority of weight loss attempts result in weight gain, which is to say that weight loss as a medical practice does not meet the basic criteria for an ethical, evidence-based intervention since the most common outcome is the exact opposite of the intended effect
Until they stop with this bullshit, we have the option to refuse weigh-ins, just like any other medical procedure (of course, getting weighed isn’t actually a medical procedure, but if they are going to act like it is, then we can treat it like one.) More-Love.org has created these cards to help!
I have found it effective to just say “no thanks” and keep on walking. If they push you can say something like “If we find that knowing my weight is actually necessary then I’ll be willing to discuss it, otherwise let’s move on.” You can explain that you have a history of disordered eating (dieting counts!) or eating disorders and that a weigh-in can be triggering, with no actual upside for you. If they ask to guess your weight (yes, it happens!) you can explain that this is not the County Fair and refuse that too. You can also agree to step on the scale facing away, but that won’t guarantee that they won’t bring it up, or print it on paperwork that you’ll eventually see.
It can also be extremely helpful to call ahead, let them know that for your psychological wellbeing you cannot be weighed in, and ask them to make a note of it, then remind them of it at check-in.
Taking someone with you can also be incredibly helpful. They can help advocate for you, and HCPs tend to behave more appropriately
This sucks, it should not happen, we should not have to strategize just to go to the damn doctor – and the difficulty is compounded by additional oppression due to things like racism, health issues like anxiety, depression, chronic illness and more. Our medical system is currently rife with fatphobia and that’s not our fault but it becomes our problem, so it can help to think about our options.
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Poem for a Diet Free New Year
My adorable dog and I have a poem to help you resolve (for the first time, or again) to ditch diets. I’m having fun doing videos like this so there will definitely be more – if you want to make sure not to miss future videos, you can subscribe to my YouTube channel!
Like this blog? Here’s more cool stuff:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now.
($79.00 for DancesWithFat members – register on the member page)
Love It! 234 Inspirations And Activities to Help You Love Your Body
This is filled with thoughtful advice from the authors Jeanette DePatie, Ragen Chastain, and Pia Sciavo-Campo as well as dozens of other notable names from the body love movement, the book is lovingly illustrated with diverse drawings from size-positive artist Toni Tails.
Price: $9.99 softcover, $7.99 Kindle, ($6.95 + free shipping for DancesWithFat Members)
Book and Dance Class Sale! I’m on a journey to complete an IRON-distance triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here! (DancesWithFat Members get an even better deal, make sure to make your purchases from the Members Page!)
I’m (still!) training for an Iron-distance triathlon! You can follow my journey at www.IronFat.com .