After reading the title of this article, you may think, wow—how’s that a thing?! The answer is, unfortunately, it is and here’s why. With surveys detailing how doctors perceive plus-size patients with less patience and spend less time with them, we feel like the only way to stop the bias is to talk about it. Bias can take different forms. Doctors can neglect to fully examine a patient, telling them to lose weight to get rid of symptoms that may have nothing to do with their size. Assumptions can be made about a person’s high blood sugar or cholesterol and patients get misdiagnosed because of those assumptions.
Here’s a personal anecdote: Kathy went for an eye exam recently and when the results of a retina scan showed a broken blood vessel, the perfectly nice, concerned ophthalmologist insisted that the only cause could be diabetes and that a visit to a primary care physician should happen as soon as possible. However, Kathy had been to three different doctors within that year, all who had taken blood that tested negative for diabetes, with sugar levels nowhere near a tipping point. Even when the doctor was informed of this, she still insisted on writing a referral. When investigating further, we discovered another cause for a broken blood vessel behind the eye: conjunctivitis, which Kathy had treated with eye drops a few days before this visit. It never occurred to the doctor to mention an ailment that actually related to her specialty. A scary side‐effect to this bias is that fat people avoid visiting the doctor altogether, and research has proven when a doctor treats poorly, it has actual negative physical side‐effects on patients.
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Because being a plus‐size patient means added anxiety during visits, it helps to go into a doctor’s office prepared and empowered. We often hand over our power to a person in a white lab coat because we see them as authority figures; here are ways to keep that balance in check:
1. Write it down. Before your appointment, write down any questions or concerns you want to discuss with your doctor during your visit or give the list to your doctor so that he or she can go over them with you. If your doctor maintains that symptoms are only about your weight, you can refer back to your list.
2. It’s your body. You are the authority. During your appointment remember that you are the authority of your body because you live in it. Every. Single. Day. You may gently mention that you didn’t feel this way yesterday and your weight hasn’t fluctuated since then.
3. Speak up. If you’re feeling bold, ask your doctor how they feel about health and size. Get a dialog going with them. This might be an excellent opportunity to get them thinking about this subject and maybe awaken them to their weight bias because honestly, so many people aren’t aware they have them. Maybe even you don’t know—you can take this Harvard quiz to find out if you have a weight bias (or any other kind of bias).
4. Be true to your feelings. If your doctor still speaks to you in a biased way, remember that your doctor is human too, and when we communicate our feelings honestly, we get better results. Try saying something like “I’m feeling defensive and emotional, and I’d like to ask if we can set aside my weight, just for right now, and evaluate my symptoms.” or “I’m just curious. If I didn’t have a perceived weight issue, what might your diagnosis be?”
The “War on Obesity” has not even come close to working; in fact, it has instead brought on a slew of damaging behaviors like food fixation, body obsession, more self‐hate, more eating disorders and discrimination rather than eliminating obesity which was the objective goal. Out of this frustration, came the “Health at Every Size” HAES community. Founded by Dr. Linda Bacon, the HAES community hails itself as a “peace movement,” and includes all shapes and sizes of advocates moving towards self-acceptance and living well. You can go online to take the pledge yourself or search the community for a physician, or other health professionals in your region. If you don’t have a HAES physician in your area, ask your own doctor if they might consider joining the HAES community; it could benefit not only you but those in your neighborhood.
Actor/influencers Kathy Deitch and Eva Tingley spearheaded PlusThis!, the multimedia brand which features pop-culture, fashion, debates regarding food and health and the societal negativity and stereotypes that surround women who dare to take up a little bit of space. The duo broadcasts live every Thursday at 6 pm PT from Universal Broadcasting Network and simultaneously across several platforms including Facebook Live and YouTube Live.
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