How To Go To The Doctor In A Larger Body
It was 9am on a weekday morning in April 2020, and I was sitting in the waiting room at the doctor’s office, 2 panic attacks deep.
It was the first time I’d seen a doctor in 5 years.
Not because I hadn’t been sick in 5 years. I’d suffered through flus and sinus infections and bronchitis and near-constant migraines and strange, unexplained symptoms for 5 years.
Not because I didn’t have insurance, or access to doctors, or transportation, or the ability to take off from work to go to the doctor.
No, it was none of those things.
I hadn’t seen a doctor in 5 years because I’m fat.
I got tired of being diagnosed as fat, so I stopped going to the doctor altogether.
I stopped going to the doctor until I absolutely had to go. And even then, it was a nightmare.
And turns out, I’m not alone.
I recently did an anonymous survey in hopes of getting some honest feedback from folks in larger bodies about their experiences with going to the doctor. And wow, did I get some honest feedback.
I asked what feelings come up when you think about going to the doctor, and the most common were anxiety, shame, and fear.
I asked what keeps survey participants from making or keeping doctor’s appointments, and a few of their answers were:
“Anxiety about weight and exercise talks.”
“I didn’t go for years because I knew all I would hear AGAIN would be ‘lose weight and you’ll feel better.’”
“I just don’t want to deal with their judgment.”
“I feel like the answer for all of my problems, to them, is ‘lose weight.’”
When asked what they would change about their experience at the doctor’s office, a few of their answers were:
“[The doctor] actually listening to me and not just hinting about how this would go away if I lost the weight.”
“For doctors to actually listen to symptoms without blaming it on weight and putting blame on me.”
“Healthcare that focuses on actual health indicators, such as bloodwork.”
No weigh-ins required. My doctor to actually listen to my concerns instead of making a judgment of what they ‘think’ I should need help with.”
“Getting them to stay on task and address the reason I’m there without bringing up my weight.”
For a place that is meant to be safe, the doctor’s office seems to be missing the mark by a mile.
So, what do we do? How do we make this supposed-to-be safe place…well, safe?
I’ve been through hell and back again on this mission. I’ve come to the realization that avoiding the doctor’s office forever is not realistic or healthy. In fact, it is dangerous and pretty scary.
- First, if AT ALL possible, find fat-friendly, Health At Every Size practitioners.
Fat-friendly doctors recognize that people can be healthy in both thin and fat bodies, says Dr. Lesley Williams, a family medicine physician and eating disorder specialist. On the flip side, they don’t assume thin patients are exempt from health issues often associated with fatness.
In general, these providers are as vigilant about detecting, preventing and treating disease as anyone else in a white coat. They just pay far less attention to BMI when assessing how patients are doing and recommending ways to optimize their wellbeing. They believe patients can manage conditions like heart disease, diabetes and PCOS without pursuing weight loss.
Health At Every Size is exactly what it sounds like: the belief that health-promoting behaviors are accessible to people of every size. It is a weight-inclusive, body-respectful, health-increasing, life-enhancing movement. There is a database where you can search for HAES practitioners in your area. This is the original database, and at the time of this writing the new and Improved database is still coming soon. - Be your own advocate.
Unfortunately, at the doctor’s office, we don’t have people lining up to be our advocates – which is why we must become our own advocates. I want to share a few ways I’ve learned to do that.
👉🏻Know your rights!
You can refuse to step on the scale.
On her weight decline card, Dr. Maria Paredes says, “I understand weight may be helpful when determining anesthesia dosage, determining pediatric & some adult drug dosages, low weight anorexia treatment, tracking child growth trajectory, kidney failure, & a handful of other health scenarios. I will be happy to comply with being weighed in such medically necessary circumstances. I also understand weight is not necessary for routine check-ups, sore throats, or many other general visits. Unless my weight will impact today’s treatment recommendations, I decline being weighed.“
MIC DROP.
Seriously though, can we just talk about that for a minute? Those words are powerful. I decline being weighed. The power is in your hands, friend. You get to choose. You are in control. You are in the driver’s seat. It’s your body. If it feels more comfortable, you can use the words, “Please do not weigh me unless it is actually medically necessary.” And if they say it is necessary, you are allowed to ask why it is necessary, so you can give your informed consent. That’s right…CONSENT. It’s YOUR body. You have the right to give consent or decline.
If it’s easier to hand the nurse a card and let the card do the talking, trust me, I GET IT. I’ve been there. Some days I am there. That’s why I created these “Don’t weigh me” cards. I’ve been wanting to create them ever since I saw someone create something similar a few years ago. I just had to put my own spin on them. 💁🏻♀️
Get your own “Don’t weigh me” cards here!
Change what you can’t stand. I also talked to the office manager in my doctor’s office, because I got sick of seeing my weight and BMI in the after visit summary every single time I went to the doctor, after I went to all the trouble of asking not to be weighed, or doing a blind weight. As someone with an eating disorder, it was incredibly triggering. However, I’m sure to someone even without an eating disorder, the wording in the app would be very triggering as well. (See the example here, and join me in a colossal eyeroll on behalf of patients everywhere who have to put up with this BS.🙄) I was convinced that there had to be some kind of setting in the app that could hide or block or turn off that feature.
After several phone calls and in-person complaints, my voice was finally heard. The office manager worked directly with the app developers to create a setting that could turn off the weight and BMI in the app, as well as other potentially triggering items.
I also asked for a note to be placed in my chart for nurses and doctors stating that my weight is not to be discussed. This is helpful in case I happen to see someone other than my usual practitioners.
Last – but not least – be persistent! Ask, and ask again! Keep asking. Will they get tired of you? Maybe! Is that your problem? NOPE! 😉 Remember this: You are worthy of asking for what you need, and you are worthy of getting it. - Enlist the help of others.
In the beginning, before I was comfortable asking myself, I asked my therapist to write a letter, explaining that it would be detrimental to my recovery for me to see my weight. Here is a template of that letter. If you have a dietitian or other professional you trust, you could ask them for the same type of letter.
Take a support person with you to your doctor appointment. Going to the doctor can be scary and overwhelming, especially if you’re in a larger body. Taking someone with you can help give you support when you need it most. They can help you stand your ground, ask questions, listen to diagnoses, and understand next steps. This is helpful so we don’t miss anything, and so we have the support we need, in the moment!
This isn’t for everyone, but for some people this makes all the difference! Give it a try! Ask a supportive friend or family member to go with you to your next doctor appointment. Even if they just sit with you in the waiting room! That would be a huge help to me! - Be armed with resources.
This is a good, quick explanation of what Health At Every Size is.
I highly recommend the book Health At Every Size, too (though, I admittedly have not finished the whole book yet).
This Doctor’s Office Survival Kit is a lifesaver! So many great resources here.
These “Don’t weigh me” cards can help explain why you don’t want to be weighed, and they take the pressure off of you to do all the talking. - Ask the hard questions.
I am *SO* tired of being prescribed weight loss when I walk into the doctor’s office for a sore throat or a weakened tendon from years of overexercise or depression or chronic migraines. I am tired of being told weight loss will solve those problems.
There’s a question I saw that really grabbed my attention. I’ll admit…I haven’t gotten the courage to ask this question yet. But it’s coming. I’m working up to it.
👉🏻What intervention would you recommend for a thin person with the same condition?
Jenny Weinar wrote in Philly Magazine, “There are also ways to advocate for yourself if you’re prescribed weight loss for any number of health conditions. One strategy is to ask your provider what intervention she would recommend for a thin person with the same condition. If the doctor’s office refuses to send you for appropriate testing or procedures until you’ve lost weight, you can request the staff document this in your chart. Family medicine doctor Elliot Goodenough recommends this printable card of other helpful phrases from fat activist Ragen Chastain.” - My last piece of advice is simple, yet probably one of the more difficult ones:
Don’t take no for an answer.
You are the expert on your own body.
You get to choose. The power is in your hands. Please, please, please NEVER forget that!
Listen, I now this was a lot. I know thinking about going to the doctor can bring up a lot of anxiety, shame, fear, and so many other feelings. I know, because it does for me, too. So please do something to take care of yourself right now.
I hope this gave you some practical ways to navigate your next doctor appointment. I know I feel a little more prepared and a little less anxious.
If this was helpful for you, let me know in the comments below! And if you think it could be helpful for someone else you know, please share! You never know who desperately needs to read this today.
