Sunday, 20 March 2022

My Experience Of Medical Weight Stigma



A few years ago, one unremarkable midweek afternoon, I took myself off to a routine appointment at the GP.

I'd been having some concerns about various symptoms that had been ongoing for a while, and after frightening myself with Dr Google...I wanted some reassurance.

I was a little anxious about the appointment, as I always am - I've always suffered with health anxiety and generally have a touch of white-coat syndrome whenever anything medical crops up, but I expected it to just be a very quick chat. I hoped I'd get a bit of advice and maybe a blood test or something...and then I'd be on my way.

That was not what happened.

What happened in that room was something that damaged me for many years to come, in ways that I've only just really begun to process years later.

My primary reasons for visiting were that I'd been having some pretty unpleasant gastro symptoms - intense bloating, pain etc.  I reeled this list of symptoms off to the GP - a woman in her late 50s - and then I mentioned in passing that I was a bit worried about the fact that I'd been trying to lose weight for the past few months with little success. I mentioned that I was following the Herbalife diet plan to the letter and although other people I knew were having great success with it, my weight loss had plateaued after the first week and I was concerned that this wasn't normal given the tiny amount I was eating. 

Now with the benefit of hindsight and much more knowledge about the human bodies response to these sorts of crash diets, I understand completely that my body had likely entered starvation mode and was desperately trying to preserve fat to keep me well...but at the time, I was baffled and worried that it could indicate an underlying health problem.

As soon as I mentioned this weight loss problem, the Dr became immediately agitated.  She told me that "if" I was eating in the way I was describing to her that I would be losing weight without question.

I felt genuinely confused by this response, and thought perhaps she'd misunderstood what I had said - so I reiterated again what I was eating every day (almost nothing - a piece of grilled chicken, a protein ball and 2 diet shakes) and how much exercise I was doing (couch to 5k) - this time it was obvious right away that she was annoyed by the conversation, as she raised her voice and repeated her words ...

"If you were eating what you're telling me that you're eating, you would be losing weight."

When I realised that she was insinuating  I was lying about my diet, I felt upset of course...but I don't deal well with confrontation and my go-to response is always tears rather than tantrums - I'm not the sort of person who argues back, least of all with a Dr!

I felt the tears pricking at my eyes, as I meekly said "I promise you that's what I'm eating..."

Her response to this seemed to come out of nowhere, as she slammed both of her fists down on her desk and shouted at full volume ..

"IF THAT'S WHAT YOU WERE EATING YOU WOULD BE LOSING WEIGHT!"

She then carried on barking at me, making comments about how it was a simple matter of "calories in vs calories out", how it was "Basic science" and how the issue clearly wasn't just with bloating as I was "Fat everywhere"....she then went on to say "even IF you had a thyroid issue, you should still lose something..."

I quietly remarked that I'd had autoimmune thyroid disease since I was 18 years old. 

She stuttered for a moment at this, but soon continued on her tirade...before I knew what was happening she ordered me up onto the examination table, and had lifted my top up. As she prodded roughly around my abdomen, she kept on spitting the words "There's just lots and lots of fat!" at me...over and over again.

She must have seen the tears in my eyes but she didn't relent. I felt as though I was somewhere else watching this all happen, which I suppose is the reason why what happened next didn't really register with me at the time.

She told me to turn onto my left side, so I did...I didn't really think about why she was asking me to do this because I was too preoccupied with what was happening and the words she was shouting at me, wondering how this situation had escalated so quickly from a simple visit for advice to this horrendous experience I was now enduring...

Before I knew it, she was giving me an internal rectal examination...without any warning or discussion about it, without asking for consent. I was taken completely by surprise. I'd never had any examination of that nature before, and I'm not sure I would have consented to it if I'd been given the chance.

I was mortified. In shock. Too traumatised to speak...to say or do anything other than cry quietly and wait for it to be over.

Then, when she was done, she told me to get down from the table, and that there was "nothing wrong with me".

And that was it. She was done with me. Without even looking up at me again, she dismissed me and sent me on my way.

Instead of leaving her office that day with any advice or reassurance, I walked out feeling violated and ashamed.

I went to pieces when I got home that evening, and although I did discuss some of what happened with family members who then made a complaint on my behalf to the surgery...I never took it any further.

I didn't have it in me, I didn't want to relive it.  I tried to process it the way I always did back then, by pouring it all out in writing...I published a post about what had happened on my blog and it was met by comments from people insisting that she was right to treat me that way because the only way to "cure fatness" is to shame fat people into forcing a behaviour change. Because of course, the only reason for fatness is over indulgence, right?! (WRONG)

Those ignorant comments made it all the worse, as at my lowest point I had to realise that there was so much hatred out there for fat people that nobody saw me as worthy of being treated with any respect.

From that day on, I pushed that experience and all of the emotions it brought up for me deep down inside.

I was already someone who was struggling with PTSD from domestic abuse experiences, and I was a new Mum recovering from 3 c-section births in the space of 3 years whose post-natal mental health was far from good. A little kindness would have gone such a long way, but instead I endured another trauma...because what she did to me that day was not ok. In fact it was assault.

I carried so much shame and anxiety with me from that experience. I felt sub-human, completely worthless...as though there was no safe space available to me, if even someone as trusted as a Dr could be so cruel.

I realise now that I never deserved that treatment. 

That the only person who should have felt any shame after that experience was her, and that a GP license does not make someone well-versed in nutrition and weight (or human kindness, apparently).

 I wish I'd had even a smidgeon of the knowledge then that I have now as I would have been able to point out not only all of the reasons that she was completely wrong in what she was saying about diet and weight, but also that she was actively going against the World Health Organisations guidelines on reducing weight stigma in medical practice.

But I didn't. 

So instead I internalised all of those feelings, and I was left with a deep seated fear of doctors.

Since that day, I have avoided going to the doctors as much as possible. Something that is all too common an occurrence among people living in larger bodies, as the fear of mistreatment and abuse by medical staff causes many of us to avoid these situations altogether and often results in delayed diagnoses and, sometimes, unnecessary fatalities. 

In fact it was only when I was faced with some worrying symptoms last year, that I had to finally confront my fear and go for investigations...which prompted me to bring my experience up with my therapist and work through it....allowing me to process all of my feelings. It wasn't until my therapist labelled her actions that day as assault that I really accepted that was true.

I'm now actively working on learning how to advocate for myself with Drs and health care professionals - something that I've been able to do thanks to the incredible work of people like Dr Asher Larmie aka The Fat Doctor, and Dr Joshua Wolrich. 

I'm learning that I have a right to health care that is free from weight stigma and misinformation, and free from shame and judgement. As does every single human being.

As stated by the World Health Organisation, medical Weight Stigma is known to directly contribute to increased mortality in patients with obesity.* 

The WHO state that  medical staff should "explore all possible causes of a presenting problem, and they should avoid assuming it is a result of an individual’s weight status." *

They also state that promoting mental health resilience and body positivity within obese people is important. *

I am resharing this experience because it needed to be reframed...when I initially shared it, I did so from a place of sadness and shame...I felt that I deserved what happened to me, and I was apologetic for my existence as a fat person.

I should not have been. My body was never the problem.

What I experienced that day was not a Dr using "tough love" or "having my best interests at heart", it was not something I or anyone else deserved....it was an example of an individual doing their job unbelievably poorly, an example of weight stigma and it was assault.

I deserved better, and so does any person visiting their GP regardless of their weight. 

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