Reality Check: Why Don’t Fat Women Get Checked for Cancer of the Nasty Bits?

The Rotund points out a recent Reuters article about how clinically obese women are less likely to be screened for cervical, breast, and colorectal cancer. And of course, researchers and journalists just can’t imagine why.

It’s not certain why obese women are less likely to get these screening tests, as few studies have been designed to look at the underlying reasons

Well, here’s one: Stigma and Discrimination in Weight Management and Obesity, by Kelly Brownell and Rebecca Pugh. A few highlights (with my emphasis):

24% of nurses said they are ‘repulsed’ by obese persons

Numerous studies2-6 document explicit negative attitudes about obesity among physicians, nurses, dieticians, and medical students. These attitudes include: obese people lack self-control and are lazy, obesity is caused by character flaws, and failure to lose weight is due only to noncompliance.

Among physicians, 17% reported reluctance to provide pelvic exams to very obese women, and 83% indicated reluctance to provide a pelvic exam if the patient herself was hesitant.12 Given that overweight women may hesitate to obtain exams and that physicians are reluctant to perform exams on obese or reluctant women, many overweight women may not receive necessary preventive care.

Efforts to reduce bias toward obese people have been limited. One intervention study17 attempted to reduce stigma toward obese patients among medical students. Before random assignment to a control group or an education intervention using videos, written materials, and role-playing exercises, the majority of medical students in the study characterized obese individuals as lazy, sloppy, and lacking in self-control, despite the students indicating that they had an accurate understanding of obesity’s cause. After the intervention, students demonstrated significantly improved attitudes and beliefs about obesity compared with the control group. One year later, the effectiveness of the intervention was still evident.17

Here’s another one: Barriers to routine gynelogical cancer screening for White and African-American obese women, by Amy, Aalborg, Lyons and Keranen.

The lower screening rate was not a result of lack of available health care since more than 90% of the women had health insurance. Women report that barriers related to their weight contribute to delay of health care. These barriers include disrespectful treatment, embarrassment at being weighed, negative attitudes of providers, unsolicited advice to lose weight, and medical equipment that was too small to be functional. The percentage of women who reported these barriers increased as the women’s BMI increased. Women who delay were significantly less likely to have timely pelvic examinations, Pap tests, and mammograms than the comparison group, even though they reported that they were ‘moderately’ or ‘very concerned’ about cancer symptoms. The women who delay care were also more likely to have been on weight-loss programs five or more times. Many health care providers reported that they had little specific education concerning care of obese women, found that examining and providing care for large patients was more difficult than for other patients, and were not satisfied with the resources and referrals available to provide care for them.

I find that bit about having been on weight loss programs five or more times fascinating. Because the logical conclusion is, these are women who know bloody well that diets won’t work for them–and also know bloody well that no matter what they see their doctors for, including a fucking pap smear, they’ll be told to go on yet another diet.

24% of nurses are repulsed by fat people. 17% of doctors don’t want to put a speculum up a fat woman’s vagina. (Do they enjoy giving pelvics to thin women? ‘Cause, ew.) A majority of medical students think fat people are “lazy, sloppy, and lacking in self-control.”

Yeah, it’s a total fucking mystery why fat women don’t want to have their most vulnerable body parts, the ones culturally designated as most shameful, poked and prodded by medical professionals. How could we ever begin to figure that one out?

98 thoughts on “Reality Check: Why Don’t Fat Women Get Checked for Cancer of the Nasty Bits?

  1. I’m currently being treated for a pre-cancerous condition called atypical endometrial hyperplasia, and I thank God that neither my GP nor my ob/gyn seem to think my weight is in any way a problem. I had put off getting my symptoms looked at for so long partly because of my size, and studies such as these are part of the reason why – although, duh, who needs a study to realise there are a lot of health care professionals who seem to think health is only for the slim and seemingly ‘self-controlled’.

    My mother finally made me go to her doctor, who is lovely and non-judgemental and only interested in making people well. And she was instrumental in finding an ob/gyn who’s the same. I’ve still a way to go, but I’m now confident I’m getting the best treatment available.

  2. If I didn’t need Birth Control I would never go to the doctor for any kind of routine visit. For several years I only went to “urgent care” facilities if I urgently needed to see a doctor.

    The humiliation just isn’t worth it otherwise.

  3. I’m pretty much terrified of going for the first time to the gynecologist, and I’m 22.. I am fat and on top of that have an unusual amount of body hair (tmi I know), so the reactions that I may get are really scary to me.

    On top of that, there are no gynecologists in my area that are female that will take me on my insurance since I am not pregnant. I am on military insurance and there are no female doctors on the base. I’m not really sure what to do, but I’m not comfortable with having a man do it.

    My periods are very irregular (maybe 2 periods a year) and I have been married for 2.5 years and have not become pregnant despite using no birth control. I fear the worst, but I still can’t bring myself to get it taken care of.

    I hate I feel this way.

  4. THANK YOU for posting this. When I heard this news this morning about how “obese” women are less likely to be screened, I immediately thought, “DUH!”, for all the reasons you mentioned. But you actually linked to the factual information describing what I was assuming was true. You rock.

  5. GAHHH. Why do bloggers have to do the paid journalists’ work for them? It’s like we’re their frigging fact-check interns or something.

  6. Aaaand, it took a whopping six comments on the Shakesville thread before someone said fatties ARE lazy and won’t take care of their own bodies, so no one should help them. Including doctors.

  7. Hey Kate? Maybe your headline was meant to sarcastically resonate with the quotes in the article about nurses being “repulsed” by fat people, but I know my recent cancer scare and check was not about my “nasty” bits, because none of my bits are nasty.

    Except maybe my uvula. Ugh.. uvula.

  8. Maybe your headline was meant to sarcastically resonate with the quotes in the article about nurses being “repulsed” by fat people, but I know my recent cancer scare and check was not about my “nasty” bits, because none of my bits are nasty.

    It was indeed meant to be sarcastic, Elusis, and to point to the way the culture encourages us to think about the body parts in question, which is exactly why shame is such a huge factor here.

  9. I weigh 200 pounds and I’ve been treated horribly by doctors, even screamed at and told “you’re going to DIE” if I didn’t take their statin drugs. Does this keep me from going for routine check-ups and getting standard breast / cervical / rectal exams? Hell yes.

    Medical care in the US is horrendous. I’ve even filed complaints to the hospitals and the Department of Health, but it’s usually to no avail. When I speak up against abuse I’m labeled a chronic complainer, or the latest label “bipolar” because I was “agitated” when the doctor became confrontational towards me. It’s pathetic.

  10. So I never really felt uncomfortable going to doctors before I started reading around the fatosphere. I know it is better to be aware of all of these issues so I can take responsibility for my health, but sometimes ignorance really is bliss.

    Thankfully, I have never had a doctor make me feel weird for being fat, except for once when I was being examined for what likely is a continuing gallbladder problem. The doctor asked me if I had ever been pregnant, and when I replied “no”, he said that was strange, since usually only pregnant women have stretch marks on their stomachs. I called my ob/gyn (because I LOVED her) after that to have her check out my symptoms…

  11. So, how fitting is it that rather than addressing this, CNN currently has a story about how belly fat increases your risk of dementia as its front page story?

    Of course, they bury a quote waaaay down the line about how this study can’t actually prove that, and use scary sounding percentages like 82% more likely (when, in reality, this doesn’t even equal twice as likely).

    Fat causes everything. It’s official. We are the source of all that is wrong in the world.

  12. As far as the breast exams, I thought it was a lot more difficult (and potentially more painful) to get accurate mammograms on very large or dense breasts, and there is often a link between fat women and large breasts. That would account for my not doing one, to be quite honest. I honestly don’t want my very big boob squashed painfully flat, especially if there’s a poor chance of them finding anything even if it is there.

    Pap smears…well frankly I only started having them when I was pregnant and they hurt like hell so I didn’t go back for more. It’s likely that they hurt because of all the hormones, as I’m told by most that they really don’t usually hurt. So…well we’ll see on that.

  13. Callicebus- well, I bet you didn’t notice, this, but there was, like, a picture of a headless fatty, all you know, big bellied, with grey chest hairs. So they totally have an old person with a big belly who has Alzheimer’s. This is so OBVIOUSLY related to fat.

  14. Dude, I know. Old people with Alzheimers – who knew? Expecially people in their 80′s. Anyway, I think I am going to go download the actual paper and stop jacking this thread. :)

  15. Has anyone done the study that cross-references negative health outcomes in fat people with fat people’s lesser likelihood of getting proper preventive care? I’ve been wondering about whether that’s just an anecdotal correlation or if it’s statistically significant.

  16. I am overdue for a pap smear and very scared.

    Perhaps something to do with the last doctor (at a hospital gyno clinic) who kindly adivsed me how much better sex would be if I lost weight.

    I still nearly vomit when I think of it. Of course, if he enquired to my health he would have been told I was in the midst of an eating disorder and had lost too much too quickly. Hence the no periods and fainting and stuff.

    It is of no surprise that I got much worse after that before I clawed my way up to recovery.

  17. This is appalling. I’ve been on birth control of one kind or another since I was 17, and they won’t let me have the birth control prescriptions -unless- I submit all of the above tests. I tried asking to skip a Pap smear one year due to negative HPV status and my doctor had a HUGE problem with the very suggestion. it had not occurred to me that women would be allowed out of a checkup without these standard exams, at least not without a fight. (Speaking of unpacking and recognizing the privileges we don’t know we enjoy…)

    My reaction, though, is also at least 40 percent: “….wait, what?” Like, even if you’re a huge bigoted jerk, which many of the respondents obviously are–if you’re only dealing with the internal parts…why would the weight be a factor at all? It’s not only that they shouldn’t care, I honestly don’t understand why they DO. Ladybits are ladybits, no?

  18. iiii- You know, it actually might be possible to statistically model those relationships. If one had access to medical records (with no identifying information, of course), such a study could probably be performed solely with secondary data. Since most people have a “permanent record”, so to speak, of their medical history, a researcher could look at preventative care history alongside their weight and other factors…

    Someone interested in grad school should do this for their research…seriously.

  19. The doctor asked me if I had ever been pregnant, and when I replied “no”, he said that was strange, since usually only pregnant women have stretch marks on their stomachs

    *boggles*

    I’ve had stretch marks on my belly since I was 12. And no, I was not pregnant then — hadn’t even had my period, in fact.

  20. I’m 54 and just had my first mammogram last year. I delayed and delayed having one because the first time I went in I was told they would have to take 2 pictures of each breast because mine are so large they won’t fit one x-ray. Thanks, I really want to have the rack o’doom squeezed painfully twice, yepyepyep.
    The tech was matter-of-fact about it, but it’s still embarrassing to be told your boobs are too big for the x-ray plate (like I don’t know how ginormous they are, I only carry them around all day long every damned day). Since there’s no history of breast cancer on either side of my family, I don’t think my insurance would pay for an MRI for breast cancer screening,. Sucks all the way around.

  21. Sweetmachine, I had stretch marks on my ass when I weighed 95 lbs and was a total beanpole. Before I ever reached a normal weight.

    So much for stretch marks (rolleyes)

  22. SM, AnnieMcPhee- I am glad to hear other people have them, too :) I rarely see other women’s bare bodies, and when I do (you know, on billboards!) they never have stretch marks on their bellies.

    I am pretty self-concious about mine, partly because of the stupid things people say. I was out to breakfast with a sort-of-friend, who was 2 weeks away from having her baby, when she announced with pride that she had gotten through her second pregnancy without a single stretch mark. It made me feel really uncomfortable, not only because I actually HAVE stretch marks (and no baby!) but also because this woman was about to bring life into the world, but her biggest accomplishment was no stretch marks…

    Anyway, I’ll stop now…this is SO off topic…

  23. This totally infuriates me. You’d think people who work in the healing and helping professions would have a bit of compassion and human understanding. I don’t know how medical school works, but shouldn’t ethics toward a variety of people be part of the course?

    But it’s just another example I WORK for doctors but I don’t see ‘em. And I always secretly wonder what my employers actually think about my weight. Sigh…..

  24. *joining in the stretch mark parade*

    I have stretch marks on my hips and booty! Sexy stretch marks! YAY! Have had since I was 12 or so. And I’m 19, and no baby, so there!

    *dances*

  25. I’ve been struggling with this for years, too. For me, the key to overcoming the fear of going for checkups has been to realize that the doctor doesn’t have any real power over you. If the doctor doesn’t treat you well, you go to another one. Anything the doctor says is their own opinion. You’re allowed to talk back. It’s all easier said than absorbed, but I really do consider them to be a service provider. If there isn’t good service, I will go find someone else. If I’m really stuck with one provider (which I have been in certain insurance situations), I do the polite smile-nod-”Thank you for your concern”, making it obvious that I don’t really care what they’re saying. I have probably been lucky not to ever have a real asshole as a doctor, though, who denied me care that I thought I needed. I admit I’m not sure what I’d do about that.

    Speaking of stretch marks – I don’t mind the ones on my belly, but the ones on my boobs really hack me off, especially since I’ve developed eczema in the same areas. I’m sure I’ll hear about it when I start with the mammograms this summer. Yea.

  26. I saw this on my lunch break (the measly little half hour) and just had to post about it right then, but I didn’t have access to the studies. Thanks for linking to everything, Kate!

    And, yeah, that dude at Shakesville…. He’s a prize, ain’t he?

  27. …, you might want to check out the symptoms of PCOS. It sounds like you might have it, at least, from what I have heard of it.

    Has anyone done the study that cross-references negative health outcomes in fat people with fat people’s lesser likelihood of getting proper preventive care? I’ve been wondering about whether that’s just an anecdotal correlation or if it’s statistically significant.

    As far as I know, no one has done such a study. There is one with race showing that doctors do not spend as much time talking to certain races and classes, and they interrupt those individuals more. I would like to use the same methods to look at doctors’ interaction with fat people. When I finish this project.

  28. Can’t believe y’all missed this – they actually KNOW WHAT CAUSES TEH FATNESS!! Definitively, it would seem…

    …Before random assignment to a control group or an education intervention using videos, written materials, and role-playing exercises, the majority of medical students in the study characterized obese individuals as lazy, sloppy, and lacking in self-control, despite the students indicating that they had an accurate understanding of obesity’s cause.

    *headdesk*

  29. …, PLEASE get checked for PCOS. You have many of the symptoms. I tried to get diagnosed when I was your age and told that I did not have it and that my problems were because of my fat. I only got a proper diagnosis in my late twenties when I was unable to become pregnant.

    Which brings me back to the topic of the post. I am dreading finding a doctor because they all parrot the same line about losing weight to help with symptoms of PCOS. As far as I’m concerned, someone with a wasting disease wouldn’t be told to “eat more,” and I shouldn’t be told to “eat less” like I have been countless times when I clearly have a hormonal imbalance. This has really been upsetting me lately, to the point of triggering disordered eating again. I’m very sad about it.

  30. ((Robotitron)) It’s so awful that you have to go through this and I am so sorry it is making you feel so terrible. Also …, kristin, and Sarah.

    I guess the only advice around, not that anyone asked (and it is poor and inadequate given insurance excluding some providers, and the dearth of fat-friendly drs. in general) is the usual, to try and go to one of the fat-friendly health professionals listed at http://cat-and-dragon.com/stef/fat/ffp.html. Or to go to multiple doctors until you find one who can treat you like a human being. For example, I wouldn’t call my doctor or the NP who did my last pap-smear “fat-friendly,” but both treat me with compassion and I think I can safely say neither would ever make comments like those you guys have had to endure. (Both are in Lansing, MI; email me at scowgirl at gmail dot com if this is of use to anyone–although I have obviously not had a chance to observe them with anyone other than me and I guess they could be total monsters, at least to me they seem better than some of the drs. described here and could be a starting point.)

  31. Two days ago, my mother flew out to be with her sister while she dies. My aunt, who has always been fat, has cervical cancer that metastasized to her spine and brain. She hadn’t been to a doctor in years; she didn’t go until the pain was so bad that she couldn’t sit up straight long enough to drive to work.

  32. I had my first mamogram last year, and it was what I would consider a far more pleasant experience than I was expecting. I don’t know how typical it was, but the technician was extremely nice and considerate, there was even a hot pad on the cold glass to warm it before I was “compressed” and not only did it not hurt, I didn’t find it anything more than a little bit uncomfortable. I was 38 at the time, and following up on some painful lumpiness that so far has turned out to be just lumpiness. I wear around a size 42 DDD. I had some really bad experiences in my early 20s with doctors, but I’ve had a run of good luck with providers for the past 10 or so years. So, as hard as it is to put yourself on the line, I recommend seeking out someone really great, if you can.

  33. I have to be honest, I’m dreading the day I have my first gyno check up. The whole experience sounds really uncomfortable, and to learn that there’s a possiblity that my specialist will be repulsed by my body…*shudders*

  34. I honestly believe there isn’t enough medical research done on women’s “naughty bits” just to begin with, and the horror stories I’ve heard of misinformation doctors spread makes me want to scream (had a friend get pregnant accidentally because *her doctor* told her she couldn’t get pregnant while she was breastfeeding!). How much research has been done *recently* about cycles and PCOS and ovulation? (Versus how much about erectile dysfunction?) It seems like doctors and med school books are stuck in the 50s. There’s still too much taboo around a woman’s hoohah, unless it’s plucked/waxed into a porn queen’s favorite shape.

    (The pervasiveness of porn has something to do with it too – idealized vaginas. God forbid you have a fat pussy. Or one with too much hair. Or too much labia. Or get too old. Then you get relegated to the “fetish” porn.)

    We’re women – we’re meant to have cycles that are unique to our bodies, and we should be trusted to know when something has gone wrong with them. We’re supposed to have vaginas and hair and labias, of all colors, sizes and textures. They’re all exactly as intended. We know our bodies and shouldn’t be forced to fit into someone else’s outdated or misinformed box, whether that be a particular weight, the number of days in your cycle, or whatever.

    Sorry – this one touches a really raw nerve.

  35. Sheila, I think the problem (or at least part of it) is that a lot of fat women aren’t getting checkups. Many fat women skip them because the doctors ignore their concerns and spend the whole checkup berating them for their weights.

  36. Everyone has stretch marks. Not only that, but men sometimes have them on their bellies, fat or no. They’re just scars from where the skin has been stretched, which happens with ordinary growth as well as pregnancy or weight gain. So, myself, I’d not just be surprised to discover people who really didn’t have them — I’d suspect they were grown from pods.

    I’ve been putting off a mammogram myself — as I told my internist the last time we locked horns about it, the one time I went the procedure was excrutiating (I have big, dense, naturally lumpy and very tender boobs, a bad combination) and served up with a hefty dose of ridicule and humiliation disguised as ‘friendly teasing.’ So, I asked my doctor, could she guarantee that I would be treated with respect and compassion at the lab she had referred me to?

    She admitted she couldn’t — though she did think I would, and if that wasn’t the case, she wanted to hear about it immediately. Still. The fact she couldn’t give me that guarantee gives me the heebie-jeebies, and I keep putting off that call.

  37. I’ve a problem too with getting my “girly parts” checked. Mine isn’t completely due to weight, but due more to psychological problems (prior abuse), previous poor/inconsiderate treatment by doctors and the physical effects of myxedema caused by non-treated Hashimoto’s. (specifically darkened and thickened skin in “skin folds”)

    I went a decade between my previous gyn exam and my recent one in 2007. I’m currently underweight (due to medication to treat my bipolar and epilepsy) and have been for years. It’s embarrassing when I’m trying to get help for something not related to my weight and it circles back to “eat more”, “have you been seeing the dietitian?” and blaming my thyroid for most everything.

    I was humiliated into not seeking care for my Hashimoto’s by my previous GP when I was slightly over-weight (bmi of 26.2) due to Zyprexa and Depakote and perhaps my TSH of 44. (TSH target levels are .3-3 btw) The doctor stated that my hypothyroidism and meds were “no excuse for not taking care of myself, my poor eating habits and lack of exercise.” Even when I informed him that I wasn’t hungry, not eating due to the Depakote upsetting my stomach AND walking a minimum of 10 miles everyday MON-FRI to get to a bus stop for my mandatory mental health treatment, he told me “then you’re obviously ingesting more calories than you expend.” Not to mention the fact that he told me (and I was ignorant at the time) that my TSH levels “weren’t serious enough to warrant treatment”. The implication that I was fat and seeking a “quick fix” or “excuse” was so degrading to me that I left the doctors office feeling guilty and demoralized. I wouldn’t seek treatment again for my Hashimoto’s until my TSH level was 178.

    The only reason this was discovered was because of my GP’s physician’s assistant, who is the ONLY “doctor” I will see now. He asked all the important questions, didn’t chastise me for my weight (which by then I was VERY underweight) and HE LISTENED TO ME. He even had me get my thyroid scanned because of nodules and a suspicion of thyroid cancer.

    The main reason for not getting my girly-parts checked sooner was because the previous doctor had pinched me with the speculum and when I told him he told me “I’ll be done in just a second.” As if the speculum wasn’t painful enough all on it’s own.

    Sorry for the rambling rant.

  38. … , I echo Robotriton saying that you are describing classic PCOS symptoms. Any family doctor should recognise these, let alone an ob/gyn – if they don’t, try someone else! – or you can go along and specifically request to be tested for it. It starts with blood tests, if you are concerned about embarrassing procedures (though blood tests may give a false negative). I hope that you will be able to approach a doctor – there’s loads of good info. about PCOS on the web if you want to inform yourself first.

  39. Pingback: Today is a birthday… « Thornacious

  40. I might just be crazy here, wouldn’t a perspective nurse or doctor be considered not fully in for the practice, if they’re disgusted with a set group of people? I mean, wouldn’t it be obvious they don’t care about people to the extent they should to be in the medical profession.

    Oh wait I forgot, due to First Do Not Harm, being left out of the medical profession, anyone from an idiot fast food worker to a PH.d can be a medical professional now.

  41. Fatgirlonadate, ((hugs))

    Madicated, your whole story makes me furious for you, and I have to comment on this:

    The main reason for not getting my girly-parts checked sooner was because the previous doctor had pinched me with the speculum and when I told him he told me “I’ll be done in just a second.”

    Same thing happened to me when I was 18 fucking years old. Fortunately, it wasn’t my first pelvic, and I’m a compulsive reader about any subject that remotely affects me, so I knew a) the speculum wasn’t supposed to hurt going in and b) it hadn’t hurt me the last time. (Otherwise, naturally, I would have convinced myself it was some sort of problem with my body.)

    So I tell this guy he’s hurting me, and he gives me the same fucking line–oh, just hang on a minute. And I’m like, NO. YOU ARE HURTING ME WITH AN INSTRUMENT THAT IS NOT SUPPOSED TO HURT IF IT’S INSERTED PROPERLY. GET IT THE FUCK OUT OF ME. (I paraphrase.) So he takes the speculum out and reinserts it, and what do you know? Doesn’t hurt anymore!

    But I had to FIGHT for that, which is just so boggling to me. I mean, I suppose a male doctor can’t know what it feels like, so maybe they’re just thinking one woman’s normal discomfort is another woman’s pain, and there’s nothing they can do about it. But since they have no idea what a speculum is supposed to feel like or what it DOES feel like if they screw it up, they need to FUCKING LISTEN to their patients. I know the difference between “I have a weird metal thing shoved up me, which isn’t exactly what I’d be choosing to do right now, but wev” and “I have a weird metal thing STABBING/PINCHING ME on the inside.”

    Ahem. Sorry.

  42. I have PCOS. Like Rosiecakes, I had endometrial hyperplasia. Going on the pill resolved it, however it doesn’t treat the underlying cause: insulin resistance. I had to go to an endocrinologist for that, and it made all the difference. This type of specialist is really great at understanding the kinds of METABOLIC DISORDERS that CAUSE WEIGHT GAIN and which make weight loss very difficult. It’s not impossible, but it can take medication and a lot more effort than metabolicly normal people have to go through.

    I read medical blogs, and you would not believe the entertainment that medical professionals get in making fun of fat patients. Some of the worst are the folks in labor and delivery. Heartless, heartless bastards.

  43. Hi all — first time poster and long time lurker. I had to comment on this post because I just had my first OBGYN exam in over 5 years (I am 30) because of a previous bad experience with a different doctor. My appointment was yesterday, so the timing of this post could not have been more perfect and I want to share my experience with you today, so that I can hopefully INSPIRE others reading who are afraid to go to the doctor — just as I was.

    After reading a post on the NYTimes blog “Well” about people not seeking medical treatment b/c of the “dreaded weigh-in” a few weeks ago, I made an appointment w/ a OBGYN that a friend recommended. I have a grandmother that died of ovarian cancer at 63 and a mother who was diagnosed with breast cancer at 54, and I finally said to myself “WTF — how can I be more afraid of being weighed than of CANCER???”

    HOWEVER I was prepared for battle. I decided before the appointment that I was not going to get weighed nor discuss my weight at this appointment. If the doctor or assistant tried to force me to do this then I would simply leave. This appointment was for discussing my painful periods, preparing for getting pregnant (or not) and most importantly the gene test for the possible breast/ovarian link in my family. End of story.

    The GOOD NEWS — the battle never happened. Not once did my lovely and kind doctor ask about my weight or comment on my weight. She was much more concerned about what she was supposed to be concerned with — the increased cancer risk due to family history and the painful cramps.

    I walked out of the appointment so glad that I went and I promised myself going forward that I cannot skip out on vital medical exams because of fear of the doctors or the scale. The key is finding that doctor that you like — who understands that not all of the evils or health issues of the world are about weight. I don’t care if you need to walk out of 20 appointments before you find the right person…KEEP LOOKING. You are too important to your family and loved ones to neglect your health because of some ignorant fool who wants to berate you about your weight.

    My doctor has now ordered the BRAC genetic test which checks to see if you have the breast/ovarian cancer gene. She also is starting mammograms earlier than the recommended age and is doing a yearly ultrasound to look at my ovaries. Its the medical treatment I deserve..and so do all of you.

  44. I had stretchmarks on my hips and breasts from the age of about 12 or 13, when I developed very quickly. And then in my late teens/early twenties when I put on more weight, I got them on my stomach/abdomen too. But my mum, who’s had five children, hasn’t a single stretchmark, and in fact, one of the most humiliating memories I have from my early teen years was when my mum came in my room when i was in a towel after a shower, which can’t have been covering everything, and said, “you shouldn’t have stretchmarks at your age.”

    if my own mother could say that to me, is it any wonder i avoided doctors like the plague unless i thought i was dying (which i did, once, when i was 16 and found a lump between my breasts – it took me months to get desperate enough that i could force myself to go to the doctor).

  45. I put off going to the gyn for years due to the fear, also. When my irregular periods became just too worrisome, I asked everyone I knew who was remotely overweight about their doctors, and found someone I thought wouldn’t judge. Lucky I did, since I also was diagnosed with endometrial hyperplasia w/atypia. The good news is, with a D&C and going on the Pill, that has resolved.

    On the PCOS thing: I’ve just gone through 20 months of trying to get pregnant. I have “textbook” PCOS according to my reproductive endocrinologist. (As Celeste said, they are really the way to go for this issue.) I am insulin resistant, and take metformin to address that. It also helps regulate cycle. But the other part is, when we finally gave up, I was despondent because I was sure it was my weight. I already adored my doc, but I loved him even more when he took my hands, looked me right in the eye, smiled, and gently said, “You’re 42. It’s not your weight.” Doctors with a heart are out there – they are.

    I’ll end this lengthy post (sorry!) with something a doc told my family years ago when my father was in the hospital for emergency cardiac surgery. He said, “I work for you. If you don’t like my work, or the time I spend with you, or my attitude… heck, if you don’t like the way I walk in the room, you have the right to fire me. Right now, or at any time in this process, you get to say I’m outta here, and I am. Don’t forget that.” And I try really hard every time I see a medical professional to remember exactly that. I’m the boss. This person works for me. That doesn’t mean treat them like crap… but it means they listen to me and address what I’m there for… or they’re fired.

  46. i am an oncology RN. it saddens me to read about so many negative healthcare experiences.

    everyone, regardless of size, body hair distribution, psychological health, sexual habits, religious practices, what-have-you: everyone deserves to be treated with respect and compassion when they are seeking healthcare.

    while it would be awesome if everybody who went into healthcare was a naturally empathetic and compassionate person, i would be the first to testify that this is not always so. unfortunately, they don’t take away your license to practice because you’re an asshole.

    however, it is your power as a patient to choose your healthcare provider. if you don’t like the way someone talks to you, or how they manage the time they spend with you, don’t give them your business. and never be afraid to refuse a treatment, seek a second opinion, request more information, or change healthcare providers. we are at your service, not the other way around.

  47. Shoutz (and other PCOS women), my take is that a REGULAR endocrinologist is the way to go for PCOS. Reproductive endo’s are just getting into the insulin resistance connection, but most only prescribe Metformin and at very low doses. My regular endo had me on Metformin for increasingly higher doses and when that didn’t work, he decreased the Metformin and added Avandia. Six weeks later I got pregnant at 39 and delivered at 40. So it might just be that both medications are needed–one to address the liver (Metformin) and the other to address the muscle tissue (Avandia or ACTOS). These are the only two tissues that store sugar as glycogen, and sometimes the feedback between BOTH of them and the pancreas is disrupted. I took 1000 mg Glucophage XR (extended release) and 2 mg Avandia, both at dinner time, in case anyone is interested.

    Another thing about seeing a REGULAR endo vs. a reproductive endo is that insurance is infinitely more likely to cover the visits.

  48. I hate going to the doctors.

    When I was in my early twenties I was having a miscarriage. I know it was one because no period has ever been that bad before or since, it wasn’t a period at all.

    However the doctor I went to, did a pelvic with a look of distaste on his face, was in and out and told me that it was a doubled up period because I had missed the period before and dropped two eggs this time instead of one.

    That is medically impossible. If I dropped two eggs it wouldn’t have made my period more painful, more bloody, and shorter than previous periods. He lied to me to get me out of the room and out of his hair.

    I will never forgive him of that.

  49. This post will be a bit graphic.

    The functional equipment issue is very real.

    My very thin girlfriend of 13 years is a physician assistant in a family clinic. The clinic is a corporate clinic that places cost reduction above care, IMO.

    My girlfriend was performing a pelvic on an obese woman. The clinic only uses plastic specula. While doing the pelvic, the speculum shattered inside the woman, and blood (menstrual) splashed onto my girlfirend’s lips.

    The patient (who was having trouble with a prolonged period) was attended to (she wasn’t injured by shards of plastic, amazingly), and my girlfriend began the anti-viral series for the blood exposure. The patient wouldn’t return to the clinic (surprise!) for an HIV test and my girlfriend had to continue the series. The anti-virals make you crazy sick.

    All of my partner’s rage was directed at the patient. I tried really hard not to take it personally, and finally told her that her supervising physician is the party responsible, because he refuses — REFUSES — to spend the extra $$ on metal specula. Which don’t tend to shatter while holding the vagina open.

    We had a productive discussion on barriers to treatment for fat women. I’m pleased to say my partner has come around.

    But the doctor is still cheap and greedy.

  50. I’m 16 weeks pregnant, and just had a HORRIBLE ultrasound experience with a maternal/fetal medicine doctor (who came very highly recommended).

    From the moment he set foot in the room, I could tell he was repulsed, and didn’t want to touch me. He told me I was too fat for the ultrasound, and too fat for an amnio. It was humiliating.

    Maybe the clinics should start hanging “No Fat Chicks” signs in their lobbies, so we know to look elsewhere for care.

  51. Hi Kate-

    Saw your face today on the front page of wordpress– congrats!

    In one of my articles on women and body image, I wrote about this topic. Here are a few more disturbing details:

    “Physicians have also adopted stereotypical attitudes towards overweight and obese individuals. Clinicians tend to view obese patients as awkward and ugly as well as lazy,
    sad, and lacking in self-control. Results of a study about family physician attitudes (regarding their obese patients) indicate that 38.5% attributed lack of willpower as one of the most significant contributors to their patients’ obesity (Harris, Hamaday & Mochan, 1999).

    Given their mentors’ open biases, it is not surprising that medical students appraise overweight and obese
    individuals similarly. While medical students rated moderately obese patients as ugly, awkward, weak, sad, and low in self control, they judged morbidly obese people more negatively. In addition to the appraisals they provided on the moderately obese patients, students viewed morbidly obese individuals as worthless, bad, and awful.

    Interestingly, these ratings remained unchanged even after the medical students spent two months treating extremely obese individuals.”

    –From: Silverman, R. J. A. (2005). Body types, Appraisals of. Applied Developmental Science Encyclopedia, 1, 164-169.

    Thanks for your great work-
    Dr. Robyn

    Dr. Robyn Silverman
    (Kiss My Assets)

  52. Interesting timing on this thread. I have a Dr. Appointment tonight with a lady I’ve never seen before for some irregular bleeding issues. I’m crazy nervous. I rarely get sick enough to go to a doctor (it’s probably been a year or more) and generally know what’s wrong and what treatment I want before I go. I have a severe needle phobia, and because of the humiliation factor, haven’t had a gyn exam since I went on birth control for a brief time five+ years ago. So right now I’m really, really stressed. I’m also wondering if I should refuse weighing or not, since if all signs point to PCOS, the weigh-in might tell them something (or not since it’s been so long since I’ve been there), but I’d like to refuse if it’s really unnecessary. Any ideas? Other than “don’t freak out” which isn’t especially helpful at the moment.

  53. Kriss, I just read your account of your ultrasound, and wanted to direct you to the How To File a Complaint section on First, Do No Harm. (You might submit the story to the site, too.)

    Cindy, too right the tightwad doctor is to blame. Hint: If your equipment puts your patients and employees in danger because you’re pinching pennies? Your patients aren’t the problem. Glad your girlfriend came around.

    JoGeek, is your weight relatively stable? Weight gain and loss can be associated with menstrual issues, and I can understand them wanting a baseline to evaluate future weight changes… but you’d also know if you’d recently gained or lost a great deal of weight. If you feel you can tell them everything they need to know without numbers, I’d say to go ahead and refuse the scale if it makes you uncomfortable.

    Personally, I usually go ahead and do it. They already know I’m fat, and if they’re going to treat me differently because of it, I’ll just fire them. But I wonder if I can start skipping the blood pressure reading… I get horrible white coat syndrome that makes the readings pretty useless. The only time I’ve had an accurate BP reading recently is when they had me on a BP monitor for a minor investigative procedure, so I got a chance to chill out a little bit and see how the reading changed (from normal to pretty low… I worry about the inaccuracy because I sometimes get low-BP side effects, but my BP is always recorded as being in the normal range).

  54. Perhaps another part of it is that the minute you step in a doctor’s office for any reason they want to put you on the scale and take your blood pressure – neither of which is necessary for a pap smear as far as I know. (If they are, I hope some medical professional will let me know because I’d be really curious to know.)

    And the minute you step on a scale you’re open to Yet Another Harangue About Your Weight. Again, even if you’re in there for a problem that has nothing to do with it. And articles like the above are actually surprised that people tend to avoid painful situations.

  55. I’m also wondering if I should refuse weighing or not, since if all signs point to PCOS, the weigh-in might tell them something (or not since it’s been so long since I’ve been there), but I’d like to refuse if it’s really unnecessary

    One thing you can do if it IS necessary is stand on the scale backwards and tell them you don’t want to know the number. And let the doc know that if there’s been a substantial gain that might be relevant to a diagnosis, then you can talk about that symptom, but you’re not there to get information on weight loss. You still get the message across that you’re not interested in the number for the number’s sake, but you’re compliant as far as what they need to know for diagnosis and dosage of any meds.

    Also, I know telling you not to freak out isn’t going to help, but really… for all the horror stories, there are plenty of good or at least neutral ones. And as other people have said, you need to remember that you have the power to fire the doc if s/he makes you uncomfortable. Finding another one is a PITA, but you are in the driver’s seat.

    Perhaps another part of it is that the minute you step in a doctor’s office for any reason they want to put you on the scale and take your blood pressure – neither of which is necessary for a pap smear as far as I know. (If they are, I hope some medical professional will let me know because I’d be really curious to know.)

    One time, I went into Planned Parenthood for a pap so I could get my BC refilled, and after sitting in the waiting room for an hour and a half, I was fucking loaded for bear. I let the healthcare worker take my BP, ’cause it’s always normal and I don’t suffer from white coat syndrome, so I don’t give a rat’s ass. But then she asked me to get on the scale, and I just lost it. “WHY? WHY IS MY WEIGHT RELEVANT? I’M HERE FOR A PAP SMEAR AND I’VE BEEN WAITING FOR IT FOR NEARLY 2 HOURS.”

    Her: “Uh, I guess we don’t have to weigh you if you don’t want to be weighed. It’s just… what we always do.”

    So I learned two things from that. 1) Don’t yell at innocent healthcare workers who haven’t actually done anything to you. (I stopped and apologized to her on my way out.) 2) They do it because… that’s what they always do. Which means it’s going to keep being what they always do unless people question them (politely) about whether it’s really necessary.

  56. So I tell this guy he’s hurting me, and he gives me the same fucking line–oh, just hang on a minute. And I’m like, NO. YOU ARE HURTING ME WITH AN INSTRUMENT THAT IS NOT SUPPOSED TO HURT IF IT’S INSERTED PROPERLY. GET IT THE FUCK OUT OF ME. (I paraphrase.) So he takes the speculum out and reinserts it, and what do you know? Doesn’t hurt anymore!

    Wow, that you had the guts to call that doctor out at 18 y/o is fucking inspirational! I don’t know if I could have had the wherewithal to do that at 39 — but now I’m realizing I bloody well can and will. This thread is so timely as I enter my 2nd trimester and have to deal with more and more of the medical profession. Thanks.

  57. Thank you for this post.

    It came at a very tumultuous time in my life, where I am trying to change many disordered behaviors that really are ruining my life. (Disordered eating is one of them, but not the only one.) One of the things I would like to change is the fact that I haven’t been to a doctor for anything other than a “checkup” (in which I get weighed, ask for birth control pills, and get sent out the door) in seven or eight years.

    I was going to add my bad experience to the comments here, but it occurs to me that maybe I should submit it to First, Do No Harm instead, but I will just say here that it’s definitely due to “eeew, gross, a fatty!” attitude that I haven’t been seen.

    This post came at just the right moment to cement my determination that I deserve to take care of myself, dammit, and if someone else doesn’t like it they can bite my fat butt. :D

  58. Wow, that you had the guts to call that doctor out at 18 y/o is fucking inspirational!

    I have a low threshold for pain and a lower tolerance for assholes. Didn’t even occur to me not to. :)

  59. Want to know why I love my GYN (she also delivered my baby, but no longer practices Obstetrics :( ) so very, very much?

    When I got pregnant, at 35, I weighed 188, about what I’d weighed since I’d started seeing her. For my height, I was defined as “very obese” by the stupid BMI chart. I ate good food, walked, limited caffeine, took my vitamins, did prenatal Yoga…you know. Regular stuff lots of pregnant women of all shapes and sizes do. My Dr., bless her heart, never ONCE told me to “limit my weight gain” or anything stupid like that. Never ONCE gave me a problem about ultrasounds, tests, exams, NOTHING due to my weight or anything else. I never had high blood pressure. Never had gestational diabetes. Never even got short of breath, except in the last week when baby was literally taking every inch of space in my bod. When I delivered, at 225 pounds, I still never heard one freaking word about my weight, through 3 months of PP checkups.

    When I went to see her a year later, I had lost a considerable amount of weight. She noted it and asked “Are you feeling all right? I see a big change in your weight.” Not “good for you!” automatically, not “it’s about time!”…she inquired after my health due to the weight loss. She was concerned about a large change from my previous weight, instead of automatically cheering and assuming it was wonderful. THAT is a good doctor, to me.

    When she retires I may mourn for years.

  60. JoGeek, PCOS is mostly determined with bloodwork and can be verified with ultrasound. (I’m geeky enough myself to have been totally intrigued by looking at my ovaries that way, but anyway…) I’ll totally out myself by saying that I weigh more than most of those funky “move the little square counterweight” scales can register, so when they tried to weigh me I told them not to bother.

    As far as the functional equipment goes… plastic specula just seems foolish to me, regardless. Plastic breaks down and collapses with use… it could happen as easily to someone who weighs less as more. Heck, I didn’t even know those were used! Aside from that, I did have a doc change me to a different exam table once, but that was a matter of weight and access, both. And it only ever happened once.

  61. We all must remember that the doctors work for us. I let my doctor know that the next time I have an extended wait past my appointment time that I will be presenting HIM a bill for my time.

    I understand his need for my weight for tracking puposes- so I tell him what I weighed that morning before I ate and without clothes. I don’t think they really want be getting buck naked in the hallway (where the scale is). They also don’t need to weigh me before taking my blood pressure.

    If it’s an appointment for a specific problem, I don’t see a need to weigh me. It’s not like they increase the amount of medication based on my weight (like with dogs or horses).

    But most importantly we must all remember that the medical profession is also a service business and they must treat their clients respecfully. There are plenty of doctors to choose from.

  62. When I went to see her a year later, I had lost a considerable amount of weight. She noted it and asked “Are you feeling all right? I see a big change in your weight.” Not “good for you!” automatically, not “it’s about time!”…she inquired after my health due to the weight loss. She was concerned about a large change from my previous weight, instead of automatically cheering and assuming it was wonderful.

    Coco, I just want to chime in and say that I am totally with you on cheering your doc on. I lost a bunch of weight recently because of illness, and for every 10 people who’ve “congratulated” me, one has warmed my little heart by basically asking if I’m okay first (including my hairdresser! I gave her a giant tip that day and told her how thankful I was that she didn’t assume that weight loss is everyone’s goal in life). Yay for your good doctor! What area do you live in, in case other Shapelings live near you?

  63. This seems like as good a thread as any to share my recent good doctor story. I’ve been lurking here and at some other FA sites for the last couple of months. And you all really helped me know what I wanted to do.

    I hadn’t been to a doctor in almost three years. The last time, I had gone into a GYN with suspicions that I had PCOS. She put me on birth control (low dose to start with, which I now know can actually make PCOS worse and should have been a signal that she didn’t know squat!), ordered the wrong kind of blood testing (claimed it didn’t need to be a *fasting* test), and gave me an Overeaters Anonymous pamphlet. She didn’t see the point of putting me on metformin unless I was actively trying to get pregnant. Of course, if I’d just lied and said I was trying to get pregnant then my insurance would have considered that a fertility treatment and not covered it.

    Anyway, cut to last week. I’ve had planter fasciitis for the last several weeks and it was just getting worse. Enough that both walking and yoga (my two favorite forms of excercise) were getting almost impossible. So I sucked it up to go to a doctor. With a lot of thoughts floating around my head from reading what all of you had to say, I finally decided “Screw it. I’ll go in for a whole physical. If the doctor sucks, it’s not my fault.”

    So I picked a new doctor (internal medicine). When they asked me to wigh in, I thought “ok, base line data for them. I’ll do it.” But I told the nurse I didn’t want to know the number. Then when I met with the doctor, I told her up front that I wasn’t interested in talking about my weight, and that I hadn’t been to a doctor in years because of it. She was fine with it! She said she’d like to do some labs and talk about other numbers, because of family history of heart disease and diabetes. And here’s where it’s most relevant to this thread — I tried to wriggle out of doing a pap and she was totally reassuring but pretty firm that I should do one soon. So I got up in the stirrups and had my first pap in three years in under five minutes!

    She wanted me to get all this done, and it was clearly more important to her that I come to a doctor regularly than that she yell about my weight.

    And finally (whew, this is long, but I needed to tell you guys). My labs came back, my insulin is high and SHE brought up PCOS, metabolic syndrome and put me on metformin!

    And she’s also treating the plantar fasciitis, of course.

    So thanks, you guys! I wouldn’t have gone at all without discussion threads like this one!

  64. Perhaps another part of it is that the minute you step in a doctor’s office for any reason they want to put you on the scale and take your blood pressure – neither of which is necessary for a pap smear as far as I know.

    Are you getting a birth control prescription? My doctor told me the reason she checks my blood pressure is because I’m on the birth control pill, which is risky for women with high blood pressure. The weight on the other hand, is not necessary, but if it’s as part of a yearly physical they like to weigh you to see if you gained or lost a significant amount over the year, because that can be a sign of an illness.

  65. I read First, Do No Harm several weeks ago and thought about submitting my doctors for the “friendly” page. Now I’m kicking myself for not doing it sooner.

    I’ve been seeing the same OBGYN practice (two docs in particular, though with two pregnancies I’ve seen just about everyone on staff once) for 7 years. The docs there were the first to sit me down and explain to me that I was *actually healthy*, regardless of my upper-30s BMI. The only time my weight has been mentioned at all was during my second pregnancy, when I so sick I couldn’t keep anything down and was anemic and losing weight. My docs practically begged me to find some source of calories that would stay in my body, even if it meant living on milkshakes for the entire third trimester.

    My internist/pediatrician is great, too. I never thought about how lucky I am in this regard until I started reading these blogs. I’m in the Orlando area – and I will list my docs at FDNH, I promise!

  66. Coco, did you submit your doc to the Fat Friendly Health Professionals list? She sounds awesome.

  67. JoGeek–I’ve had great success writing a letter to any new physician that I’m seeing. It was modeled on one that Hanne Blank wrote:

    http://www.cat-and-dragon.com/stef/fat/hanne.html

    I changed it up a bit for myself but the main idea–that I know I’m fat and that I don’t need to be lectured about it–was the same. I also tried to include some humor and general humanity so that it would be difficult for any medical professional to read it and think of me as “just another fat woman.” My doctor actually read it in front of me, and it was totally unnerving, but she thanked me for it and we’ve never had a problem.

    There’s a copy of it in my file now, and I keep the basic letter on my computer for use with new doctors.

    Good luck!

  68. My doctor told me the reason she checks my blood pressure is because I’m on the birth control pill, which is risky for women with high blood pressure. The weight on the other hand, is not necessary, but if it’s as part of a yearly physical they like to weigh you to see if you gained or lost a significant amount over the year, because that can be a sign of an illness.

    According to my GYN, some birth control pills (like most medications) are sensitive to the woman’s weight; the lower dose ones are reported to be less effective in heavier women. Not that performing most of the height-weight-bp measurements is probably mostly just routine, but it does serve some purpose.

  69. I said this over at Shakesville on this thread and I may have said it here before but for me obese + queer = endometrial cancer treated with high dose hormone therapy and then radiation when it recurred. My GYN/ONC has been telling me all along that it the cancer is because my fat produces too much estrogen. The last time I saw him he said “Now that we’ve gotten it, you really need to work on your weight for your health.” I am almost to the point where I don’t want to go back because I am completely crazed from the time I make the appointment until I actually go. I didn’t go to the GYN for about 10 years because I had such a bad experience with the nurse practitioner when I went for the first time. I think queer was the bigger issue than fat that time. Anyway I was bleeding and in pain for a very long time (probably years) before I finally went and voila, cancer. Then I had trouble finding a GYN/ONC who would even consider letting me keep my uterus and ovaries. I was 34 when I was first diagnosed. Fuckers.

  70. (((Bean))) Anyway, we already know weight does not have jackshit to do with survival rates for ovarian cancer (see here and that the ballyhooed reduced-fat, reduced-calorie, high-fiber diet that was supposed to foster weight loss and keep breast cancer from recurring doesn’t do that either (see here. I don’t imagine that the results for endometrial cancer would be much different, if at all. Lots of women get these cancers who are already very thin; what do doctors tell them to do to “prevent recurrence”?

  71. This sounds obvious, but I don’t think it’s been said yet: I’m pretty sure it’s because of fat bias that you guys get weighed so often at the doctor’s.

    Because, while my BMI tells me that I am overweight, I don’t look fat, and I don’t *ever* get weighed. I think maybe once as an adult (and I’m 30). And I’ve had about 8 different doctors in 12 years because I move so much. So, yeah, unless you’re going to doctor explicitly because of weigh gain/loss issues, it seems like the weigh-in is unnecessary.

  72. btw, some of these stories are horrifying and my hat is off to everyone who has to brave this level of shitty care and bias.

  73. er, sorry to post three times in a row, but rereading my first sentence, I realize that “Duh, it HAS been said before.” The point of my post was really to reinforce the idea that weigh-ins are unnecessary, NOT to make myself sound like the world’s biggest idiot. So.

  74. Coco, I just want to chime in and say that I am totally with you on cheering your doc on. I lost a bunch of weight recently because of illness, and for every 10 people who’ve “congratulated” me, one has warmed my little heart by basically asking if I’m okay first (including my hairdresser! I gave her a giant tip that day and told her how thankful I was that she didn’t assume that weight loss is everyone’s goal in life). Yay for your good doctor! What area do you live in, in case other Shapelings live near you?

    SM, What’s especially depressing is, as SP noted in a recent post, that people will often go on and on about how they’d like to “get what you have” even after finding out someone has lost weight due to illness. As though weight loss is so desirable that even ending up in the ICU is worth it as long as you lose 15+ pounds right quick! Yay for near death experiences! Sigh.

    I’m in Las Vegas, incidentally, and if someone will point me to the proper place to post my FABULOUS Doctor’s info, I will be happy to share. She is also gentle, knowledgeable, thorough, and pretty darn funny.

  75. Just to follow up on my question yesterday about weight and pap smears: no, there are no prescriptions of any kind involved, nothing other than the test. In fact, the doctor has a recent weight/BP on me because I was in for my annual check up about 6 weeks ago which do involve looking at the meds I’m on and making sure they’re working/doing the right things/no adverse side effects and I understand having the numbers is medically necessary for that kind of check.

    Which is why I wondered if there was a medical reason they needed that data for something that didn’t seem like it required it to me.

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  77. In regards to what Coco said about ‘getting what you have,’ I’m remembering a time in early high school when I a girl I’d known previously had cancer. At the benefit dinner they held to raise money for her treatment, someone mentioned how she’d lost 50 pounds while in chemo. At that time, I clearly remember thinking that I wished I could get some horrible disease or cancer or something so I could lose 50 pounds.

    It makes me really sad to see just how much self-hatred is ground into people at a young age.

    I’m lucky in that I don’t think I’ve had a lot of problems with doctors/nurses/etc treating me badly because I’m fat, but I have been notoriously oblivious to such things in the past.

    From now on, though, I’m going to do my best to stand up for myself at doctors’ offices. I don’t mind the weighing, but I honestly don’t want to know the number, because I’ve been working very hard to stop associating my worth as a person with that number.

    I am deathly afraid of getting a pelvic, though. At 25 I’ve never done it, but will be looking over the list of fat friendly health professionals to try and find some in my area.

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  79. I type medical reports and I have heard doctors dictate biased reports when it comes to thin versus fat patients. “This very pleasant thin woman…” or “Jane is a well-developed, well-nourished thin woman in fabulous shape” versus Mrs. Jones is a morbidly obese patient…” or “John Doe needs to lose 30 pounds in order to be in better shape”. I even remember one doctor stating, referring to a thin patient, “Well, we don’t get those too much around this neck of the woods!” It stands to serve that the bias that many so-called health professionals’ attitudes when it comes to serving fat folks is the reason most fatties defer seeking preventative health care.

    There are very few fat-friendly health professionals out there because are taught that fat is bad, thin is good, no matter what, and it shows in how they treat patients.

    As for myself, I think I’ve been lucky in that my primary docs and GYN have never really harped too much about my weight, though when I did go for my physical last year and asked not to be weighed, the medical assistant/nurse said that I HAD to do it and weighed me anyway. However, on my most recent visit, interestingly enough, I got that same assistant, and when I asked not to be weighed, she didn’t weigh me. Hmmm…maybe she “got it” that time.

    I hope it gets better, but who knows?

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  81. Just finding this thanks to a link from a friend and it’s both sad and heartening to know I’m not alone in having negative experiences with doctors.

    I was spoiled for a while, having a doctor for a father and hearing nothing remotely close to weight/shape bias from him. Then I was spoiled further by an excellent gynecologist who only mentioned weight when I’d gained much more than usual in a single year (and that was “It looks like you’ve gained a good deal of weight this year. Anything going on?”).

    Then I got a mysterious rash I couldn’t figure out the cause of. All the allergists and skin specialists in my area were booked solid for a 4 month minimum, so I finally made an appointment with a GP. Total asshole. Despite going in to get a referral for someone to see me about the rash I ended up getting a half hour lecture on my weight and eating habits (which he was totally wrong about, btw, and wouldn’t believe me about). When I saw him again two months later the nurse weighed me with my coat and boots on, as opposed to the prior visit when I’d been in a t-shirt and sock feet, then berated me for gaining a pound. Again, he went on about weight, even though the reason for my visit had nothing to do with it.

    I never went back. They can kiss my ass.

  82. Hoorah for this thread! I end up being weighed almost every time I go to the doctors (I live in England) and yes, I am very very fat, but if I go along with an earache I don’t think my weight has a direct causal effect on that… Maybe I’m wrong… But I don’t think so!

    In England it seems that fat-hate is inculcated into doctors at medical school, and nurses too. However due to the vagaries of the NHS I have never actually met my GP, just a succession of locums.

  83. As someone who has had endocrine problems for probably my whole life (first one was diagnosed at about age 20), I can say that my generally warm and personable GP is fat phobic. I went in because my energy level was abysmal – I was pretty sure I needed my thyroid med upped, or that some other endocrine thing was out of whack.

    Now this GP has known me for about 100 lbs now, through multiple diagnoses that I had to push to get recognized, but when I went to him about this, he basically told me that my energy was most likely awful because of my weight, and didn’t do the additional testing or up my thyroid med, as I had requested.

    I’m not the most assertive person in the world, but after 20+ years, I ended up finding another doctor, who immediately agreed to double my thyroid med dose and re-check my bloodwork in a month. Amazing – once again, I was right – I feel much better on the doubled dose, All it took was a doctor who saw me as a whole person and not the cumulative effect of my weight.

    P.S. to the 22 year old who was having trouble conceiving and also has excess hair, please find a doc and ask to be tested for poly-cystic ovaries. This is something you want to know about, and you can be treated for it. (It’s one of my several endocrine issues, and probably the main one that affects my weight.)

  84. Pingback: Nifty and/or Useful Links « Living ~400lbs

  85. I have only read this today and I know it was posted a little while ago. I’m a nurse myself and I’m fat. I’m shocked that 24% of nurses are REPULSED by fatties. I make sure that when I have a patient I treat them the same. I work in mental health nursing, I treat my anorexic patients the same as any other, so why should someone fat be treated different? I make sure that all of my patients know that I care about them no matter what. The NMC (Nursing Midwifery Council, the governing body in the UK for nurses that we must adhere to,) states that we should treat all patients the same, regardless of gender, religion, spirituality, culture.. Regardless of anything.
    Personally I am repulsed by the amount of nurses who are repulsed by fat patients.
    Devon
    http://www.fat-nurse.com (My blog. This post relevant to me? Oh, only a little bit.)

  86. The last time I went to see a gyno it was because of symptoms of PCOS…not only did she behave rudely and invasive at my first ever proper check-up (I was 20 at the time); after the ultrasound she looked at me and said “You have a lot of cysts, if you lose a lot of weight they will go away. If not, you’ll never have children.” That visit still has me traumatized, and seeing how several people seem to have somewhat similar experiences I can totally understand the fear of seeing a gyn…having your parts probed and squeezed by people who clearly find you disgusting is not a pleasant experience. I find it sad that doctors actually find obese people disgusting; in my dream world health care professionals should understand that weight isn’t merely about food and diets, and that skinny isn’t necessarily awesome or healthy (just like being fat doesn’t automatically make you sick or a lazy slob).

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