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Doctor’s don’t say that… unless you are fat

September 26, 2013

Fat HealthExerciseDickweed

Two areas of my life crashed in to each other recently, both related to fatness and exercise behaviors; more specifically, how my stated exercise behaviors couldn’t possibly be enough (or even true) just because I’m fat.  Thanks weight stigma!

The first happened with my new pain management doctor.  I had my second appointment with this fellow that I markedly don’t like, but he’s the first pain management doctor that I’ve had that Fat and Fitdidn’t give up when the first medication didn’t work. At the first appointment, I declined another round of physical therapy because I was perfectly content with my exercise schedule of three belly dancing classes a week, despite the pain that movement causes me. The doctor insisted that I couldn’t possibly be that active, but he dropped the discussion.

At the second appointment, the doc continued to doubt my current activity level and brought up aquatic physical therapy again. To make matters worse, my nerve pain combined with school, work, and financial stress was making me anxious, driving up my blood pressure even more than just being in pain. This time I acquiesced because of fear that his weight stigma would lead to be being labeled as “treatment non-compliant” (fancy medical jargon for “patient refuses to do what I tell them to do”). I told myself that maybe the aqua PT would allow me to get back to swimming laps at the pool like I used to (something that I enjoyed doing). However, I was still livid that my fatness immediately was attached to sedentary behavior, despite telling him about my scholarly work in physical activity, my status as a doctoral student in a kinesiology department, and all the active things I used to do that I missed doing (powerlifting, triathlon, CrossFit, all sorts of dance styles, endurance cycling, etc.).

Fast forward to last week in my Physical Activity and Health class. I’m the only fat person in the class, and the only person with a visible disability. The lecture is on the history of physical activity and exercise guidelines from the US government and the professor asks the class “how many of you have had a doctor talk to you about physical activity?” I’m the only one that raised a hand.

Thanks to weight stigma, doctors only see physical activity as something fat people need to do to become thin people. They are ignoring the impact of sedentary behavior on all bodies, and are ignoring the literature that shows that physical activity is more indicative of health status than how fat someone is. They are reading my body, and fat bodies as a whole, as texts that somehow scream “DISEASED” whether or not the health markers agree.

This is why I am a believer in Health At Every Size®: weight stigma impacts every body.

Casey Sig

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10 Comments leave one →
  1. Nof permalink
    September 26, 2013 12:03 pm

    It is infuriating; I imagine especially so when you’re working hard despite being in pain!

    I don’t understand why people persist in believing they know better about other people’s lives than those people do. It’s the height of arrogance and intellectual dishonesty.

  2. vesta44 permalink
    September 26, 2013 12:33 pm

    You articulated so well what infuriates me about doctors – activities that I do are seen as detrimental to my health, but those exact same behaviors in a thinner person are seen as “normal”. I’m fat, therefore I have to work twice (or three or four) times as hard as a thinner person in order to be seen as “trying” to become healthy – never mind that in spite of my arthritis, spinal stenosis, fibromyalgia, migraine headaches, a failed WLS, and my “weight”, every damned one of those parameters that is supposed to signify “health” is in the “normal” range. I’m sedentary as hell, can’t exercise because of the severe pain I’m in (that doctors refuse to adequately treat), and have a very limited range of foods my body will tolerate. In spite of all of that, if my health markers were given for a thinner person, they’d be considered healthy as a fucking horse. But, because I’m fat, those markers don’t mean shit – my fat is going to catch up with me one day and kill me dead dead dead if I don’t “do something” about it yesterday (never mind that I’m damned near 60 years old and have been almost this fat for nearly 40 years). The hypocrisy of being told that my doctor is only concerned for my “health” continues to astound me, as well as infuriate me.

  3. Kala permalink
    September 26, 2013 2:02 pm

    It’s hard to know what to do in this situation. You’re really at an impasse if the doctor refuses to believe that you do what you actually do. Good luck with it either way.

  4. September 26, 2013 3:19 pm

    I had a very similar experience when referred for physiotherapy for a chronic (genetic) joint condition. I was told to “focus on cardio and weightloss” and she continued talking to me as if I was a long term sedentary person with no experience of exercise despite me repeatedly bringing up my background of running, swimming, weight training and Iyengar yoga. Her conclusion- my symptoms were due to being “so unfit and overweight”, despite me describing my fitness regime prior to having to cut down due to worsening symptoms.

  5. Dizzyd permalink
    September 26, 2013 7:32 pm

    I’ve said it before and I’ll say it again – I bet I could do a better job doctoring with my little ol’ biller/coder certificate than a lot of these quacks with their emphasis on weight loss, weight loss, weight loss! Heck, I would probably be more inclined to trust the Three Stooges as doctors (“Calling Dr. Howard, Dr. Fine, Dr. Howard!”)

    • Elizabeth permalink
      September 27, 2013 9:05 am

      When my husband was a CNA at our local hospital, he referred to the doctors of a certain practice as the Four Horsemen of the Apocalypse. You didn’t want to be one of their patients!

    • Nof permalink
      September 27, 2013 10:06 am

      This is why I get so pissed when people say, “Well a DOCTOR said…” or “you’re refusing to face facts” when you fire a doctor.

      Doctors are not infallible diagnosing machines immune to the effects of prejudice!

  6. mrbigmuscles permalink
    September 27, 2013 1:55 pm

    > At the first appointment, I declined another round of physical therapy because I was perfectly content with my exercise schedule of three belly dancing classes a week, despite the pain that movement causes me. The doctor insisted that I couldn’t possibly be that active, but he dropped the discussion.

    I’d be skeptical of that too. You’re in so much pain that you’re seeing a pain management doc, but you can belly dance 3x/week? I’d think either you are not really in that much pain, or you aren’t really belly dancing.

    > despite telling him about my scholarly work in physical activity, my status as a doctoral student in a kinesiology department, and all the active things I used to do that I missed doing (powerlifting, triathlon, CrossFit, all sorts of dance styles, endurance cycling, etc.).

    Scholarly work is not physical activity; studying kinesiology is not physical activity; and you say you “used” to be physically active. What does any of that have to do with your current activity levels, which is what’s relevant to your doc?

    > At the second appointment, the doc continued to doubt my current activity level and brought up aquatic physical therapy again.

    I don’t see what any of this has to do with weight stigma (which I agree is a real thing, and a problem). Aquatic therapy is not typically used to get patients to lose weight, it’s to improve strength without stressing the joints.

    What exactly do you want your pain doc to do?

  7. lucy permalink
    September 27, 2013 4:34 pm

    A piece of advice: Do the Physical Therapy. Belly dancing classes and exercise are great and all, but in terms of pain and physical disability management, therapy’s the only option. Even pills are just temporary measures.

    • October 6, 2013 9:31 pm

      Because clearly *you* are the expert on the author’s experience of (and history with) belly dancing and physical therapy. Also, no, pills are not necessarily ‘temporary measures’ for people with chronic pain.

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