I have always been proactive about my health. Even when I was more disconnected from my body in the past, I still worked hard to address issues as they arose. I have dealt with a variety of issues over the years, and often had to take my health into my own hands. I have read and known about fat discrimination in the health industry, but really thought I had been fairly lucky, until recently. I was diagnosed with a chronic illness a couple of months ago. With this diagnosis came some clarity around my experiences in doctor’s offices over the last twenty years.
Sizeism is discrimination based on someone’s size and it can significantly affect access to healthcare.
This discrimination in the doctor’s office can range from fat shaming as a method to embarrass and motivate a patient to lose weight to lack of access to proper treatment. Often the experience of being mistreated in a doctor’s office prevents patients from seeking treatment, which leads to worse health overtime. According to the New York Times, certain symptoms of overweight patients like pain or shortness of breath are often attributed to issues with weight, when in fact they are pointing to much more serious disorders like life threatening blood-clots or tumors. Often these patients are refused care and scans like a CT or MRI when the machines cannot accommodate bigger bodies. Bigger machines exist, but many hospitals and medical centers do not have them.
In my early twenties I almost went blind and had to have major optic nerve surgery to save my sight. As I was healing, I started to go back to college part-time and was utilizing public transportation because driving was still an issue. I was almost hit by three cars in one week while trying to walk through the parking lot to the light rail station. I approached my general practitioner at the time to inquire about getting access to a handicapped placard for my car, since I was scared for my safety. She said she would not sign the paperwork, because the extra walking would do me good. That was the last time I went back to that doctor.
I have experienced severe abdominal issues for over twenty years. I have worked hard to find out what was wrong. When I was twenty, I was told I was experiencing Irritable Bowel Syndrome (IBS) which is a common catch all when the doctor can’t figure out what is actually causing the problem. Even though I was the thinnest I have been in my adult life, I was still considered overweight according to my doctor and the BMI.
When I asked for additional treatment options, alternate medications or supplements, I was given handouts for weight loss and shamed. I had already lost sixty pounds, but that was not enough.
Over the next twenty years, I gained weight and continued to experience abdominal issues. Five years ago, my intestines perforated and abscessed due to undiagnosed diverticulitis. Despite pursuing health advice from doctors for all those years, I wasn’t offered any additional tests or labs to check on my ongoing symptoms. I was, however, spoken to and shamed about my weight gain at many doctors’ visits. I have experienced this discrimination first hand but am conscious that as a white cis-gendered woman, I have had better outcomes than others. As Joan C. Chrisler writes, “Intersectional identities can result in a greater cumulative burden for people who experience sizeism as well as other forms of oppression.”
In 2013, the therapist I was seeing referred me to information on the Health at Every Size book and community. It was eye-opening and empowered me to go even further with my advocacy of health. It helped me see that there could be another way. The first time I declined to be weighed in a doctor’s office was scary and empowering. I now will only be weighed if I know it is a particular wellness appointment, or if we need that information for medication. I have recently found doctors who are just as invested in my health as I am. I have had frank conversations with them about my complicated history with my body and diet culture. It has been a breath of fresh air to be treated for my symptoms, not my size yet I know I will probably have to deal with this again as I continue to pursue care.
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The Association for Size Diversity and Health (ASDAH) offers great questions and answers about the Heath at Every Size Principles and they can be helpful in navigating this process and your own exploration of how healthism and sizeism have affected your access to health care.
There is also a great deal of resources to individuals who value the Health at Every Size pledge who you can reach out to for care and services. There are also a variety of resources to help whether you are beginning this journey or someone who is already actively fighting the battle of sizeism and healthism. I am hopeful that the more doctors and professional health workers who are confronted with the consequences of size discrimination, the more change we will see.
[Featured Image: A photo of a person with long dark hair. Their hand is resting on a purple wall. Their eyes are looking downward and they are smiling. They are wearing a lavender shirt. Source: pexels.com]