“Health” and the Medical System
We don’t ask much of our readers, but we are asking you to support Casey in improving her mobility while fighting the fat haters. Read more here or click the image above to donate.
Trigger warning: Talk of weight loss and disordered eating histories.
The past month has been an utter blur as my university began summer term and I began a mentored teaching course on top of my other work duties. As I’ve become busier, I’ve obviously become more stressed… especially with regards to dealing with healthcare providers like my pain clinic. [Cue horror movie music]
Because of scheduling SNAFU’s, it looked like I was going to have to see the Evil Physician’s Assistant who harassed me so much about my weight, while outright disbelieving me about my health and physical activity behaviors (along with denying my scholarly work in kinesiology). I should have reported her for verbal abuse to the hospital network. Instead, I did get a note put on my record that I hoped would keep our paths from ever crossing again, but she is the backup person for my doctor when scheduling issues arise.
As the appointment with Evil PA got closer and closer, I noticed that I was reacting to my fear of fat shaming in several very unhealthy ways… and I think a lot of fat folks deal with this, which is why so many of us delay necessary health care or attempt to skip it altogether (both of which contribute to more ill health in the long run — take that, “obese people are more expensive” propaganda!). Since I can’t skip this appointment without screwing up my pain medication contract or without losing my prescriptions altogether (which is the only thing allowing me to remained employed and working on my PhD), I’m forced to cope as well as I can.
The first thing is that I’ve been lapsing into old disordered eating behavior. I’m skipping meals despite being hungry. I’m trying to take my pain medication without food (which screws up its absorption rate). I’m becoming obsessed with the math of food (e.g., calories, fat, serving sizes). This isn’t in a good way like Shaunta’s Eating the Food experiment; this is self-destructive dieting behavior. The worst part is that I know it’s happening and I’m trying to fight it with all the tools in my Fat Acceptance and Health at Every Size® (HAES) toolbox.
The next problem is that I’m trying to jam physical activity into my schedule with the goal of weight loss. My brain spent so many years of my life doing this that it’s not even a conscious thing. My spine injury makes physical activity pretty difficult at best, so spreading small bouts of exercise throughout the day is definitely not a bad thing in and of itself. I generally do things like that in my normal life because I like to multitask (like doing calf raises while the coffee brews at work) and because I like earning points on Fitocracy. The problem is that it’s become an obsession. I overdo it consistently, which messes up my work life and my dance life, and I’m really upset that I’m ruining my ability to dance. Being able to dance requires very careful management of my time, body, and energy just to take one or two classes a week.
The last problem is the variety of awful things that many folks with disordered eating histories go through (despite the trigger warning, I’m not going to go into detail). Every little thing becomes about ways to manipulate that damned number on the scale just so I can be a little less “morbidly obese” on the BMI readout on my chart. It’s not healthy at all.
This has been eating at my self-esteem and self-worth, and has created a hell of a lot of stress, most notably when I recently gave a guest lecture on healthism and ableism to a class of undergraduate kinesiology students. When you challenge a person’s fundamental beliefs about how society impacts one’s health, many times the speaker gets challenged on a personal level. When the speaker is fat, some listeners see my lecture as me justifying my place in a health-oriented field. That process is tiring and stressful in itself, so when I’m struggling with my own internalized healthism, sizeism, and ableism, I’m not an effective educator. When I’m hungry and hurt and feeling harassed, I’m not healthy.
As I try to tell the students I talk to, fat stigma can be exponentially more harmful than any supposed causal links between fatness and disease. My story is just a drop in the sea of fat people with serious histories of weight cycling (repeated weight loss and regain) and disordered eating. It’s not easy being a fat health and physical activity educator, but I hope that pulling my story apart like this will help health professionals realize that bullying and abuse do not create healthier people.
p.s. The appointment I was afraid of? Got re-re-rescheduled back to my actual pain management physician. I’m trying to switch to a different pain clinic in hopes that I will get harassed less and have better treatment to get me to an activity level that both my mind and body can agree on.