I'm just moving Fat Tuesday up a bit...

[tacosforlife]

Aaaaaaand go.


My Doctor's Advice To "Lose Weight" Almost Killed Me

www.refinery29.com/doctor-advice-overweight-person?utm_source=huffingtonpost.com&utm_medium=referral&utm_campaign=pubexchange

"Doctor, my skin is breaking out in a rash."
"CeCe, you really should lose weight."

"Doctor, I slipped and broke my arm."
"CeCe, we really need to get your weight under control."

"Doctor, I’m on fire!"
"Well, if you’d lose some weight, maybe that issue would go away."

Doctors regularly and without fail have a hard time seeing past my weight. I don’t have a problem with medical professionals advising me to lose weight in general — obesity is, of course, a legitimate health concern — but I take issue with this practiced response being the cure-all for any ailment I report.

Instead of listening to me describe my symptoms, what I'm experiencing physically and sometimes emotionally, the doctor would rather just sum it all up into one neat, little assessment. I'm not a doctor, but I think there's got to be a better bedside-manner technique when it comes to us overweight folks.

Because they can’t view me as a patient without making my size the biggest consideration, doctors often dismiss things completely unrelated to what the scale reads. It almost feels as though any medical training they received regarding diagnostics flies out the window if the patient in the room is fat.

This is a problem so serious it almost killed me.

Three years ago, I pushed for a same-day appointment with my doctor after a few days of not feeling right. I explained that I'm a very active person who went to the gym three to four times a week. I had been taking vigorous, hour-long classes at the gym and had no problem getting through them. Then, out of the blue, I became winded mid-class and later couldn't even walk up a single flight of stairs without feeling totally drained.

“Mmmmm," the doctor said, not looking up from her clipboard.

I went on to explain that the only time I’d felt like this before had been in college, when I developed a blood clot in my calf because of my birth control. (You know all of those risks they rattle off at the end of prescription drug commercials? Yeah, those things can actually happen.)

My doctor didn’t seem fazed by anything I was saying. She just nodded politely, still not meeting my eyes. “You seem fine…it's probably your thyroid. Let’s see if we can get your weight under control in the new year,” she finally said, jotting down a note.

I had never had a thyroid issue, but I knew this was kind of a token "weight-related health issue.” The doctor didn’t seem to think I was dying, even though the thought had certainly crossed my overactive mind.

I said that I had a flight to California the next day, and since flying is the absolute worst thing to do when you have a blood clot, I wanted to be 100% sure I didn’t have one. She pumped hand sanitizer into her hands and told me to check in after my trip.

Somewhat reluctantly, I flew to California and back. When I landed at JFK, I fainted while exiting the plane. After being rushed to the ER in an ambulance and given multiple tests, it turned out that I had blood clots in my lungs — a pulmonary embolism.


According to the APS foundation, each year, more than 600,000 people in the United States have a pulmonary embolism, and more than 60,000 of them die. Most of those who die do so within 30 to 60 minutes after symptoms start. My symptoms went on for close to two weeks, including two six-hour flights, so I'm not kidding when I say that I'm constantly grateful I survived.

But, the trauma of my health scare was made even more frightening by the fact that I had gone to see a medical professional about my symptoms and had been dismissed because of my weight.

As a plus-size person, I have learned to be my own health advocate. I have to; clearly not every medical professional I visit is going to be one for me. Although I still go for regular check-ups and when I'm not feeling great, I no longer accept the broken-record “lose weight” medical advice.

I am, in fact, on a fitness journey, and I’ve lost 55 pounds. The health improvements have been vast, and I feel better the fitter I get, but that doesn’t mean that weight loss is the general, one-size-fits-all advice for every medical ailment I experience.

If you’re a plus-size person who feels that doctors discriminate against you or don’t listen to you, I understand the temptation to just stop going to the doctor altogether, but that's not the answer, either. You and your body are valuable, and you deserve medical care at any size. Turning the conversation around in the examining room isn't easy, but it can be done, and you can get your doctor to listen to you. It might just save your life.

[downtoearth]

That is terrible - I'd be so pissed if I knew what this was and wanted confirmation and my doctor just said to chill and we'll talk when you get back or lose a few pounds!!! That doctor was not listening well.

I think this comes back to having one or two caregivers that you have a connection with is better than our current health care system where we see who we need for the moment, but don't often have a trusting connection. But... we don't allow doctors to work like that and even I don't have a primary doc who I like. Maybe there is a better way, like a social worker for our health so they can connect you with doctors, be your advocate, connect with you on nutrition and weight loss, check on you annually to remind you to get labs etc. Is this such a thing?

[tacosforlife]

I missed the last third of the article when I first pasted it. Whole thing is up now.

[penguingrrl]

That's horrible! I can't imagine ignoring real symptoms under the assumption that it's all weight related. And couldn't that story lead to a malpractice suit?

[meshaliuknits]

Jan 26, 2015 11:39:13 GMT -5 tacosforlife said:

I missed the last third of the article when I first pasted it. Whole thing is up now.

I thought it ended rather abruptly.

[redwino]

It's horrible that she was treated like that. I've experience quite the opposite. I feel like my doctors are willing to throw a pill at every issue and will only talk about weight if I bring it up. The exception to that is my primary care doc but I started seeing her because of hypertension. Weight's directly related so the discussion is part of every visit. My other physicians basically skim over weight including the two REs I saw who just gave me the general 5% loss can help fertility line.

[stephm0188]

I'm not surprised at all. I've had my fair share of issues with various doctors not listening to me. "I think I have mono. I think it's maybe my gallbladder. I'm having an asthma attack." I've always been discounted and told that I'm probably wrong for whatever reason... and then it turns out, I'm right. It's so frustrating. It would be that much worse to have my problems discounted because of my physical appearance.

Just finding a doctor who listens to you as a person is half the battle.

[tacosforlife]

I went to see a new PCP last year. They weighed me, and the medical assistant just handed me a flyer about weight loss. My BMI is high - way too high, I know. But I found it absurd that I was handed the flyer without any discussion. The exercise tips for the fatties were stuff like:

Walking is great exercise. Start walking 10 minutes a day.
Park farther away and walk across the parking lot.
Remember, your exercise doesn't have to all come at once - you can do 5 or 10-minutes throughout the day.

Um, OK, great. Nobody actually talked to me about if and what kind of exercise I do. It came across as so condescending and insulting.

I feel for doctors because I know that people are touchy about their weight and bringing it up is important but not pleasant. But damn.

[kadams767]

Jan 26, 2015 12:00:41 GMT -5 tacosforlife said:

I went to see a new PCP last year. They weighed me, and the medical assistant just handed me a flyer about weight loss. My BMI is high - way too high, I know. But I found it absurd that I was handed the flyer without any discussion. The exercise tips for the fatties were stuff like:

Walking is great exercise. Start walking 10 minutes a day.
Park farther away and walk across the parking lot.
Remember, your exercise doesn't have to all come at once - you can do 5 or 10-minutes throughout the day.

Um, OK, great. Nobody actually talked to me about if and what kind of exercise I do. It came across as so condescending and insulting.

I feel for doctors because I know that people are touchy about their weight and bringing it up is important but not pleasant. But damn.

When I was overweight and I told my doctor what I was doing for exercise, I am pretty sure he thought I was lying.  Same with when we talked about nutrition and what I eat.  I never once got the impression that we were having a serious conversation about weight-loss and actual plans or solutions, because he was dismissing the things I was currently doing.  It was like those "tips" for saving money that tell you to stop going to Starbucks every day.  Sure, but WTF do you do if you already don't go to Starbucks, you know?

[ringstrue]

OMG scary .

How does a doc usually test for that? Or do you have to go to the hospital for tests? I wonder if they even listened to her chest with a stethoscope.

I wonder if it's our "Biggest Loser" culture, where you hear all these stories of people losing weight and all of a sudden all their health issues disappear. So then docs just assume it will help and don't look further.

[Deleted]

I think a big problem too is that doctors blame weight on everything but have no actual helpful, long term advice in getting someone to lose weight.

So basically they are just throwing their hands up in the air.

[wambam]

I honestly think weight management needs to become a larger part of medical education. Obviously what the medical community is doing now (either ignoring it or saying "eat less") is not working.

My best friend has experienced a lot of difficulty from doctors for this issue. She has had to doctor shop because most of them could not give her answers as to why she is unable to lose weight. It's been infuriating for her.

[msmerymac]

Last time I went to the doctor they never said a peep about my weight, but on my office summary they had listed under diagnoses "obesity."

Not a peep, otherwise.

I kind of get it. It's a thing. That can lead to other things. Is it a disease in itself? Eh. It wasn't why I was at the doctor, that's for sure. But just having that automatically print out on my visit summary is pretty much the least helpful way to address it.

[pixy0stix]

I don't think it's just a weight issue. Doctor's just don't listen anymore. Period.

[Deleted]

As a fatty in the medical field, I can see both sides of the issue (un)fortunately, and I've experienced both kinds of doctors who either blame ERRYTHING on your weight, or never talk about it ever because they don't know if you'll throw a shitfit and who wants that.

People self diagnose via Dr Google, people cry persecution if you talk about their weight, Doctors who have given up trying to really doctor because a lot of people suck and the entire medical system here in the US is fuuuuuucked left and right. Its a giant ball of shitty wax.

[penguingrrl]

Jan 26, 2015 12:00:41 GMT -5 tacosforlife said:

I went to see a new PCP last year. They weighed me, and the medical assistant just handed me a flyer about weight loss. My BMI is high - way too high, I know. But I found it absurd that I was handed the flyer without any discussion. The exercise tips for the fatties were stuff like:

Walking is great exercise. Start walking 10 minutes a day.
Park farther away and walk across the parking lot.
Remember, your exercise doesn't have to all come at once - you can do 5 or 10-minutes throughout the day.

Um, OK, great. Nobody actually talked to me about if and what kind of exercise I do. It came across as so condescending and insulting.

I feel for doctors because I know that people are touchy about their weight and bringing it up is important but not pleasant. But damn.

That sounds as far along the spectrum in the extreme other direction than the doctor who delivered Emma. At my 6 week pp visit she berated me about my weight and told me it was my fault that I ended up hypertensive and put my baby in danger. The best part was that my 39 week pregnancy weight was only a hair into obese territory and I was hypertensive and retaining fluids, so much of that was water weight.

[nomad100]

Jan 26, 2015 12:17:03 GMT -5 pixy0stix said:

I don't think it's just a weight issue. Doctor's just don't listen anymore. Period.

I was just going to say this.  

Just in my family, my father, who is in great shape, had something miss by his doc.  That miss with my dad ended up with him in the hospital because "there was no way he could have a staph infection with no open wounds."  Well, yeah, he could.   And that miss meant he ended up in the hospital for 3 weeks.

This miss had nothing to do with his weight since he is is great shape and wouldn't be classified as overweight.

And my dad is even a retired physician so knows he has to be an advocate for his own care.

[darnkatz]

Jan 26, 2015 12:06:19 GMT -5 kadams767 said:

Jan 26, 2015 12:00:41 GMT -5 tacosforlife said:

I went to see a new PCP last year. They weighed me, and the medical assistant just handed me a flyer about weight loss. My BMI is high - way too high, I know. But I found it absurd that I was handed the flyer without any discussion. The exercise tips for the fatties were stuff like:

Walking is great exercise. Start walking 10 minutes a day.
Park farther away and walk across the parking lot.
Remember, your exercise doesn't have to all come at once - you can do 5 or 10-minutes throughout the day.

Um, OK, great. Nobody actually talked to me about if and what kind of exercise I do. It came across as so condescending and insulting.

I feel for doctors because I know that people are touchy about their weight and bringing it up is important but not pleasant. But damn.

When I was overweight and I told my doctor what I was doing for exercise, I am pretty sure he thought I was lying.  Same with when we talked about nutrition and what I eat.  I never once got the impression that we were having a serious conversation about weight-loss and actual plans or solutions, because he was dismissing the things I was currently doing.  It was like those "tips" for saving money that tell you to stop going to Starbucks every day.  Sure, but WTF do you do if you already don't go to Starbucks, you know?

My doctor straight up told me that she didn't believe me when I told her what my exercise and food intake was. I was so pissed. I switched doctors right away and told her that I was doing it, too. I had to laugh because I had perfect blood pressure, low cholesterol, and I could bike 50 miles a day without any problems. Some of her actual words were, "Are you sure that you are actually running and biking? Or are you just saying that to me because you think I want to hear it? It doesn't seem like you could be doing that when you weigh as much as you do."

[delawarejen]

I've had such negative experiences with doctors lecturing me on my weight (even when I've lost weight) that I won't go for routine screenings any more. (I know I should not be getting my only medical screenings from my blood donations and my optometrist.) I know the solution is to find different doctors, and now that my new insurance is settled I need to get on that, but it's just exhausting and tends to cause anxiety (and eating issues) knowing that the lecture is coming.

[ESF]

Jan 26, 2015 12:17:03 GMT -5 pixy0stix said:

I don't think it's just a weight issue. Doctor's just don't listen anymore. Period.

I mean, yeah, sure, you are right.  But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."

There's a fair argument to be had about how standard of care has declined for everyone.  That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."

[Deleted]

Don't get me started on how much the medical and insurance (health and life) communities love BMI....

[ESF]

I'm amused by the reference to the thyroid issue in the article, because I'd love it if a doctor actually had every suggested that to me. I once asked for it to be checked, and the doctor was like, "yeah, it's probably fine, but if you really want to have it checked, I'll schedule you for that since you need to be checked for diabetes anyway." All while giving me a look that said, "here's another fatty, coming in and wanting a medical justification for their fatness."

[tacosforlife]

Jan 26, 2015 12:45:25 GMT -5 ESF said:

Jan 26, 2015 12:17:03 GMT -5 pixy0stix said:

I don't think it's just a weight issue. Doctor's just don't listen anymore. Period.

I mean, yeah, sure, you are right.  But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."

There's a fair argument to be had about how standard of care has declined for everyone.  That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."

Yeah, I just don't think that someone with a normal BMI would have been dismissed the way this author was when she described her symptoms. They would have been all, "Huh. Sudden change in energy level and shortness of breath. Something is up."

[frlcb]

Jan 26, 2015 12:07:05 GMT -5 ringstrue said:

OMG scary .

How does a doc usually test for that? Or do you have to go to the hospital for tests? I wonder if they even listened to her chest with a stethoscope.

I wonder if it's our "Biggest Loser" culture, where you hear all these stories of people losing weight and all of a sudden all their health issues disappear. So then docs just assume it will help and don't look further.

I was in the ER earlier this month and they did a bunch of blood tests and there is one to test for blood clots, mine was slightly out of the normal range so they sent me for a ct scan, which was normal. There are definitely tests for it.

[Deleted]

The first time I saw my current doctor he ordered a blood panel done and was VISIBLY shocked when it came back because as he said "Your blood sugar level is nowhere near diabetes and your cholesterol is perfect." Thanks, ass.

[pixy0stix]

Jan 26, 2015 12:45:25 GMT -5 ESF said:

Jan 26, 2015 12:17:03 GMT -5 pixy0stix said:

I don't think it's just a weight issue. Doctor's just don't listen anymore. Period.

I mean, yeah, sure, you are right.  But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."

There's a fair argument to be had about how standard of care has declined for everyone.  That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."

But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.

[runaways]

I have so many thoughts about this that I can't piece them all together coherently. It often feels like physicians are damned if they do and damned if they don't. It's frustrating.

[meshaliuknits]

Jan 26, 2015 12:00:41 GMT -5 tacosforlife said:

I went to see a new PCP last year. They weighed me, and the medical assistant just handed me a flyer about weight loss. My BMI is high - way too high, I know. But I found it absurd that I was handed the flyer without any discussion. The exercise tips for the fatties were stuff like:

Walking is great exercise. Start walking 10 minutes a day.
Park farther away and walk across the parking lot.
Remember, your exercise doesn't have to all come at once - you can do 5 or 10-minutes throughout the day.

Um, OK, great. Nobody actually talked to me about if and what kind of exercise I do. It came across as so condescending and insulting.

I feel for doctors because I know that people are touchy about their weight and bringing it up is important but not pleasant. But damn.

I get a flyer like this every time I visit the doctor. That time I went in b/c some kid stepped on my foot and my toe swole up like a cantaloupe and I thought it was broken? Flyer. The time I went in because I had hives on my face? Flyer.

[Vespasia]

Jan 26, 2015 12:19:32 GMT -5 @fucksticklegit said:

As a fatty in the medical field, I can see both sides of the issue (un)fortunately, and I've experienced both kinds of doctors who either blame ERRYTHING on your weight, or never talk about it ever because they don't know if you'll throw a shitfit and who wants that.

People self diagnose via Dr Google, people cry persecution if you talk about their weight, Doctors who have given up trying to really doctor because a lot of people suck and the entire medical system here in the US is fuuuuuucked left and right. Its a giant ball of shitty wax.

I agree with all of this, especially the bolded. Our patients are kids so it adds an extra layer of complication. No matter their other health issues,* the vast majority do not lose weight and I think doctors just give up. 


*Most of the kids I see have other obesity-related illnesses, otherwise they wouldn't come to us. We're starting a new study soon that will look at an intervention with kids who are just obese and i'm curious to see how it works out. 

[tacosforlife]

Jan 26, 2015 12:56:54 GMT -5 pixy0stix said:

Jan 26, 2015 12:45:25 GMT -5 ESF said:

I mean, yeah, sure, you are right.  But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."

There's a fair argument to be had about how standard of care has declined for everyone.  That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."

But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.

I guess we'll never know since she didn't go in with a normal BMI, but given the reaction of the doctor, I think the patient is right that she was blown off because of her weight.

Someone with a normal BMI who goes in and says, "I've experienced a sudden drop in energy level and shortness of breath while doing things that didn't bother me last week," is not going to be told, "Let's try to get your weight under control in the new year." The doctor is probably going to run some tests or at least ask some follow-up questions.