Peggy Elam at On the Whole has a terrific post (inspired partly by La Di Da) on going to the doctor as a fat person. It includes tips and resources for finding a good doctor and educating her about Health at Every Size — as well as some information that will make you furious.
A study in the 1998 Archives of Family Medicine found that the higher the weight of women, the less likely they were than thinner women to have had either a clinical breast exam, a gynecologic exam, or a Pap smear in the previous three years, even though they had as many or more doctor contacts. (The only cancer screening performed regularly on larger women was mammography.)
In Women Afraid to Eat, Francine Berg reports that a study of 1,316 physicians showed they were more reluctant to perform pelvic exams on very fat patients. Higher weights of female patients was related to negative physician attitudes about patients’ appearance, which in turn was related to lower frequency of pelvic exams. She noted that researchers warned that the lower level of preventive care large women are getting may account for some of the increased health risks found with “obesity.”
Emphasis hers. Oh, and then there’s this:
By the way, a 2003 Obesity Research article by M. Schwartz et al also reported that health professionals specializing in “obesity” displayed significant anti-fat bias, endorsing stereotypes of fat people as “lazy, stupid and worthless.”
Obesity “specialists” tend to be anti-fat? Oh, I’m stunned. Fetch the smelling salts.
So, the doctor who specializes in your “condition” thinks you’re lazy, stupid, and worthless. The gyno doesn’t want to touch your fat vagina. (Which is just disturbing on so many levels. I mean, do they especially enjoy giving pelvic exams to thin women, then?) If you go to the doctor to have a suspicious mole checked out, you’ll be lectured on weight loss. You might even be counseled to consider dangerous surgery to become thin — when you showed up with a cough. If they can’t come up with a diagnosis for your stomach problems, say, the prescription will inevitably be: “lose weight.” If you’re immobilized by arthritis, you’ll be told a replacement joint would be “wasted” on you. If you need surgery, you might not get it unless you diet.
Peggy also mentions a 1994 study that showed 32% of health care workers with a BMI above 27 put off going to the doctor because they knew they’d be weighed — and, presumably, given crap about it. Who would know better what it’s like to be a fat person in a doctor’s office than the people who live it every day?
Marilyn Wann became a fat activist in the first place because she was denied health insurance because of her weight. (Which was 245 lbs.) Are the people who won’t shut up about how fat people are so unhealthy, and taxpayers will have to foot the bill for their ER visits, and they just won’t “take care of themselves” aware that some fat people are not even allowed access to doctors?
And it gets worse. One of my readers recently lost her mother. In 1984, her mother’s doctor declared that her whole problem was being fat, and he didn’t want to see her again until she lost weight.
So she didn’t go to the doctor again for 23 years.
And someone lectured this (also fat) reader of mine, at her mother’s funeral, about how her mother would have lived if only she’d lost weight.
Yeah, either that or if only her doctor had offered her medical treatment instead of a judgmental, impossible ultimatum.
Fat kills, all right. Just not in the way people think it does.