Yes, I'm venting about fat issues again. No, I haven't run out of material.
This time around, I just wanted to share a few thoughts about the health care industry in consideration of fat biases.
One of my biggest issues with the fat stigma is that it's the only form of discrimination that's still socially acceptable because it's "for the fat people's own good". This boils my blood because when has dehumanizing someone ever helped heal or solve a problem? Where would we be if civil rights were given only to those groups or ethnicities that could prove they fit the "norm" of the dominant culture and we told everyone else that we're being exclusionary "for their good"? Wait, I think that's happened before . . . a few times . . . and decades and centuries later, we're still trying to deal with the repercussions. With such a P.C. conscious society, why are we okay with the fat hate in our modern world!?
This time around, I just wanted to share a few thoughts about the health care industry in consideration of fat biases.
One of my biggest issues with the fat stigma is that it's the only form of discrimination that's still socially acceptable because it's "for the fat people's own good". This boils my blood because when has dehumanizing someone ever helped heal or solve a problem? Where would we be if civil rights were given only to those groups or ethnicities that could prove they fit the "norm" of the dominant culture and we told everyone else that we're being exclusionary "for their good"? Wait, I think that's happened before . . . a few times . . . and decades and centuries later, we're still trying to deal with the repercussions. With such a P.C. conscious society, why are we okay with the fat hate in our modern world!?
To me, the worst aspect is that this is one of the few biases where the stigmatized group actually takes the blame and responsibility of the hate upon themselves; they end up believing it's their fault they aren't thin and therefore deserve to be shunned. Think about it. According to our society, thin is always attainable . . . just as long as you're dedicated enough to eat nothing and exercise your brains out. Because of this view, fat people figure it really is their own fault when they can't lose weight and all they have to do to reinforce the blame is to remember that they ate that extra scoop of ice cream a week ago Tuesday at Bob's 50th Birthday Party. Then they curse themselves because they really think that the extra scoop of ice cream over the course of two weeks of dieting is the reason they are not losing weight.
Let me share with you a few things from comedian Ricky Gervais. You may best know Ricky from the BBC version of the Office where he was the show's director, writer and producer as well as played the role of dreaded boss, David Brent. At the beginning of this year, Ricky hit headlines for his controversial stand-up routine that makes fun of fat people.
In an interview with the Telegraph, Ricky says, "I don't think there's enough stigma. With all the political correctness now . . . there's no stigma any more. I laugh about being fat, but I should be ashamed. I should walk down the street and have people shouting 'Fatty!' and according to his theory, branding overweight people as 'fatty' would help cut rocketing obesity rates . . . what's interesting is that, as his comment implies, weight is something for which Ricky himself sometimes gets grief over. Being somewhat overweight, interviewers have been known to ask him if Celebrity Fit Club has come calling yet.
The scariest part of Ricky's tirade against fat people is that he reinforces the negative stigma people continually find in health care. He implies that a doctor should not coddle an overweight person "just because someone can't be bothered to go for a ___ing run."
When I first ran into fat stigma in health care, I thought that my experiences were probably exceptions and not the rule. I had no idea that such discrimination was rampant inside and outside of the industry.
Just to illustrate, when I was 13, I decided to go out for sports. This was a big deal to me because, at that time, I was definitely inhibited by a fear of people making fun of my weight. (I'd like to note that this is the same height and weight I am to this day. I was tall and big for my age, but I was still the same proportion I am now). Anyway, I don't think my weight fears were necessarily out of the ordinary teenage experience, but it caused anxiety nonetheless. So, I made a conscious decision to get over my fear and sign up anyway.
As part of the process, I signed up for the obligatory doctor's physical in order to get sport approved. I arrived to my appointment sheepishly (as only a 13 year old is) and a new, young, male doctor whom I had never met before walked into the room. He looked at my chart, confirmed that I was seeking a sport physical and then told me I was fat and should be concerned about my health. All I could muster was a, "yeah, that's why I'm hoping to do sports". He said, "okay", went back to his chart, signed my physical and left again. The whole thing lasted about 3 minutes. (Please note that I'm not forgetting to mention that he was very soft, kind and/or considerate in his approach or that he had helpfully handed me a "How to Manage Your Health" pamphlet. Just an abrupt statement with no offer of solution.) Needless to say I was mortified.
Since that experience, my adult self reflects back and thinks "WHAT THE HECK?" 1. I was 13 and a girl; no one needed to tell me I was fat, or that it was concerning . . . I was in middle school for goodness sake, it crossed my mind 10 times a day! 2. "Hello Dr. Distant, I am getting a physical to go out for sports so I can exercise! I think this is a very clear sign I'm trying to be aware of my health." And 3. I realize now that he asked no questions regarding my eating habits, exercise or general wellness. Not one. All he had was the obligatory check-marked chart telling him my allergies, surgeries, pre-existing conditions, etc.
Unfortunately, he is not the only doctor who I've had this experience with. Just a couple years ago, I went to get a checkup and my doctor, who had a slightly better approach than the first guy, commented that I was at an unhealthy weight. Her approach was kinder, softer and offered me some more solution, but again she did not ask or know that, at that time I had been eating a very balanced and well-portioned diet, I'd been doing aerobic exercises 3-4 times a week, toning exercises twice a week and taking all my vitamins. This time around I spoke up and told my doctor that I was in fact healthy and told her my habits. I believe she was more willing to believe me when my test results came back and my insulin levels were normal, my blood pressure was fine and my cholesterol was low.
I guess I'd like doctors to be more like a doctor I saw about 5 years ago. I went in to see him because I was having occasional breathing problems when I exercised. I was hesitant to do so because of my experience before. I was afraid the doctor would say, "well, you're fat, of course you have breathing problems when you exercise." It took me a while to go, but after months of exercising regularly and still having the issue, I went. This doctor asked me questions. He asked me about my diet and exercise. He asked me how it felt when my breathing was difficult. He took my vitals and checked me for asthma. He didn't find anything wrong. But you know what? He said that I appeared to be in great health so he would guess that I was having exercised-induced asthma problems exacerbated by the Utah altitude and climate, to which I was not very accustomed. Can you imagine how I felt when I'd been emotionally preparing to go to bat with a medical professional over my weight? It was such a breath of fresh air!
I often look to this experience with hope, because, sadly, according to research and statistics, these good experiences are more of the exception than the rule. There's evidence both in qualitative and quantitative studies that more and more health professionals are opting not to deal with fat patients because they are viewed as lazy, overindulgent, non-compliant and unsuccessful. (Yes, this is a supported statement . . . watch the video further down.)
It was only this summer that I read an article in Reader's Digest called "41 Secrets Your Doctor Would Never Share". The very first submission straight from a doctor read, "I am utterly tired of being your mother. Every time I see you, I have to say the obligatory 'You need to lose some weight.' But you swear you 'don't eat anything' or 'the weight just doesn't come off,' and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to." . . . Talk about a serious disconnect. This doctor even says that the patient claims innocence. Our society is predisposed to assume people are lying about their good health habits or diet regulation if they're fat. So, rather than investigate further, the doctor shuts them down. What if the weight really is a result of another confounding variable? Like thyroid problems, or PCOS, or the patient ruined their body's homeostasis with an extreme diet they tried the year before . . . which is another tangent coming to a blog near you. :)
Maybe these thoughts don't seem so crazy to some of you who heard about the baby who was denied insurance for being too big just a couple months ago. Yes, a baby!
But if they do seem a little far fetched and you wanted even more corroboration, there is also a blog called "First, Do No Harm" which illustrates fat prejudice in health care. The blog is of individually submitted posts that express the frustration many of us have had in going to the doctor (consider that national statistics show that 3 out of 5 patients are in the overweight or obese category) I encourage you to take a look at some of the horrors of people's experiences at the doctors office . . . the people who are supposed to be encouraging you to be healthy and who's attitudes and interactions can encourage or discourage your preventative health care opportunities. This blog outlines stories about overweight patient's maladies being overlooked because "their weight is the real problem".
In truth, the examples I've shown so far are all case studies, so may not seem very valid to some of you, but I am happy to show you that the research from Yale University agrees with me. Their wonderful Rudd Center for Food Policy and Obesity has a great deal of statistics and information about weight stigma and that the effect of the biases are only making our health concerns worse, not better. They put out the following video that gives some insight into the issue of weight stigma in the health care world.
According to the Yale Rudd Center and this video, overweight and obese patients report that physicians are the second most common source of weight bias in their everyday lives. They found that 69% of those surveyed had run into discrimination with physicians, 46% with nurses, 37% with dietitians and 21% with mental health professionals. Again, I have to consider that these statistics are not just from obese patients . . . these statistics include those who are in the "overweight" category of the BMI as well. Another disturbing statistic from this video states that one third to one half of nurses feel uncomfortable working with obese patients, one third would rather not deal with obese patients at all, one quarter are repulsed by obese patients and a handful prefer not to touch obese patients.
It is a long video, but it provides some great information. I know I've been a little zealous about this topic lately, but the feedback I hear is that people want to know the truth here. I'm obviously not the only one concerned and I keep forgetting that this issue affects the skinny people to. Weight can fluctuate and so the stigma created for fat people really can affect anyone, fat or thin. If this were just affecting the people who fit in the BMI categories of overweight and obese . . .we wouldn't have such a prevalence with eating disorders and body dysmorphia. I think I'm just going to keep talking about this until enough people tell me to stop.
Let me share with you a few things from comedian Ricky Gervais. You may best know Ricky from the BBC version of the Office where he was the show's director, writer and producer as well as played the role of dreaded boss, David Brent. At the beginning of this year, Ricky hit headlines for his controversial stand-up routine that makes fun of fat people.
In an interview with the Telegraph, Ricky says, "I don't think there's enough stigma. With all the political correctness now . . . there's no stigma any more. I laugh about being fat, but I should be ashamed. I should walk down the street and have people shouting 'Fatty!' and according to his theory, branding overweight people as 'fatty' would help cut rocketing obesity rates . . . what's interesting is that, as his comment implies, weight is something for which Ricky himself sometimes gets grief over. Being somewhat overweight, interviewers have been known to ask him if Celebrity Fit Club has come calling yet.
The scariest part of Ricky's tirade against fat people is that he reinforces the negative stigma people continually find in health care. He implies that a doctor should not coddle an overweight person "just because someone can't be bothered to go for a ___ing run."
When I first ran into fat stigma in health care, I thought that my experiences were probably exceptions and not the rule. I had no idea that such discrimination was rampant inside and outside of the industry.
Just to illustrate, when I was 13, I decided to go out for sports. This was a big deal to me because, at that time, I was definitely inhibited by a fear of people making fun of my weight. (I'd like to note that this is the same height and weight I am to this day. I was tall and big for my age, but I was still the same proportion I am now). Anyway, I don't think my weight fears were necessarily out of the ordinary teenage experience, but it caused anxiety nonetheless. So, I made a conscious decision to get over my fear and sign up anyway.
As part of the process, I signed up for the obligatory doctor's physical in order to get sport approved. I arrived to my appointment sheepishly (as only a 13 year old is) and a new, young, male doctor whom I had never met before walked into the room. He looked at my chart, confirmed that I was seeking a sport physical and then told me I was fat and should be concerned about my health. All I could muster was a, "yeah, that's why I'm hoping to do sports". He said, "okay", went back to his chart, signed my physical and left again. The whole thing lasted about 3 minutes. (Please note that I'm not forgetting to mention that he was very soft, kind and/or considerate in his approach or that he had helpfully handed me a "How to Manage Your Health" pamphlet. Just an abrupt statement with no offer of solution.) Needless to say I was mortified.
Since that experience, my adult self reflects back and thinks "WHAT THE HECK?" 1. I was 13 and a girl; no one needed to tell me I was fat, or that it was concerning . . . I was in middle school for goodness sake, it crossed my mind 10 times a day! 2. "Hello Dr. Distant, I am getting a physical to go out for sports so I can exercise! I think this is a very clear sign I'm trying to be aware of my health." And 3. I realize now that he asked no questions regarding my eating habits, exercise or general wellness. Not one. All he had was the obligatory check-marked chart telling him my allergies, surgeries, pre-existing conditions, etc.
Unfortunately, he is not the only doctor who I've had this experience with. Just a couple years ago, I went to get a checkup and my doctor, who had a slightly better approach than the first guy, commented that I was at an unhealthy weight. Her approach was kinder, softer and offered me some more solution, but again she did not ask or know that, at that time I had been eating a very balanced and well-portioned diet, I'd been doing aerobic exercises 3-4 times a week, toning exercises twice a week and taking all my vitamins. This time around I spoke up and told my doctor that I was in fact healthy and told her my habits. I believe she was more willing to believe me when my test results came back and my insulin levels were normal, my blood pressure was fine and my cholesterol was low.
I guess I'd like doctors to be more like a doctor I saw about 5 years ago. I went in to see him because I was having occasional breathing problems when I exercised. I was hesitant to do so because of my experience before. I was afraid the doctor would say, "well, you're fat, of course you have breathing problems when you exercise." It took me a while to go, but after months of exercising regularly and still having the issue, I went. This doctor asked me questions. He asked me about my diet and exercise. He asked me how it felt when my breathing was difficult. He took my vitals and checked me for asthma. He didn't find anything wrong. But you know what? He said that I appeared to be in great health so he would guess that I was having exercised-induced asthma problems exacerbated by the Utah altitude and climate, to which I was not very accustomed. Can you imagine how I felt when I'd been emotionally preparing to go to bat with a medical professional over my weight? It was such a breath of fresh air!
I often look to this experience with hope, because, sadly, according to research and statistics, these good experiences are more of the exception than the rule. There's evidence both in qualitative and quantitative studies that more and more health professionals are opting not to deal with fat patients because they are viewed as lazy, overindulgent, non-compliant and unsuccessful. (Yes, this is a supported statement . . . watch the video further down.)
It was only this summer that I read an article in Reader's Digest called "41 Secrets Your Doctor Would Never Share". The very first submission straight from a doctor read, "I am utterly tired of being your mother. Every time I see you, I have to say the obligatory 'You need to lose some weight.' But you swear you 'don't eat anything' or 'the weight just doesn't come off,' and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to." . . . Talk about a serious disconnect. This doctor even says that the patient claims innocence. Our society is predisposed to assume people are lying about their good health habits or diet regulation if they're fat. So, rather than investigate further, the doctor shuts them down. What if the weight really is a result of another confounding variable? Like thyroid problems, or PCOS, or the patient ruined their body's homeostasis with an extreme diet they tried the year before . . . which is another tangent coming to a blog near you. :)
Maybe these thoughts don't seem so crazy to some of you who heard about the baby who was denied insurance for being too big just a couple months ago. Yes, a baby!
But if they do seem a little far fetched and you wanted even more corroboration, there is also a blog called "First, Do No Harm" which illustrates fat prejudice in health care. The blog is of individually submitted posts that express the frustration many of us have had in going to the doctor (consider that national statistics show that 3 out of 5 patients are in the overweight or obese category) I encourage you to take a look at some of the horrors of people's experiences at the doctors office . . . the people who are supposed to be encouraging you to be healthy and who's attitudes and interactions can encourage or discourage your preventative health care opportunities. This blog outlines stories about overweight patient's maladies being overlooked because "their weight is the real problem".In truth, the examples I've shown so far are all case studies, so may not seem very valid to some of you, but I am happy to show you that the research from Yale University agrees with me. Their wonderful Rudd Center for Food Policy and Obesity has a great deal of statistics and information about weight stigma and that the effect of the biases are only making our health concerns worse, not better. They put out the following video that gives some insight into the issue of weight stigma in the health care world.
According to the Yale Rudd Center and this video, overweight and obese patients report that physicians are the second most common source of weight bias in their everyday lives. They found that 69% of those surveyed had run into discrimination with physicians, 46% with nurses, 37% with dietitians and 21% with mental health professionals. Again, I have to consider that these statistics are not just from obese patients . . . these statistics include those who are in the "overweight" category of the BMI as well. Another disturbing statistic from this video states that one third to one half of nurses feel uncomfortable working with obese patients, one third would rather not deal with obese patients at all, one quarter are repulsed by obese patients and a handful prefer not to touch obese patients.
It is a long video, but it provides some great information. I know I've been a little zealous about this topic lately, but the feedback I hear is that people want to know the truth here. I'm obviously not the only one concerned and I keep forgetting that this issue affects the skinny people to. Weight can fluctuate and so the stigma created for fat people really can affect anyone, fat or thin. If this were just affecting the people who fit in the BMI categories of overweight and obese . . .we wouldn't have such a prevalence with eating disorders and body dysmorphia. I think I'm just going to keep talking about this until enough people tell me to stop.
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