Friday, October 28, 2016

Size Stimga in the Medical Community: my recent reminder.

For as long as I can remember my weight has been the topic of conversation and concern. I was “treated” by many physicians and specialists as a child and young adult for my weight problem- generally unsuccessfully.

The many doctors appointments were a source of great shame and fear for me, never knowing what would be said by nurses and doctors either to my face or to my mother as if I was a non entity in the room. Even worse was the occasional quip one medical professional would say to another in my presence about me, I was an object… just another “fat kid.”

I keenly remember the trauma of having my weight yelled out from nurse to nurse in a busy waiting room, my face flushed, wanting to disappear. I remember the frustration of my endocrinologist when he saw weight gain despite a new medication regiment, and the self-flagellation that I engaged in on the drive home that day.

I have always known that size stigma from the medical community is one of the most pervasive, insidious and damaging forms of stigma towards individuals of size from my personal experience and now as a professional I am aware of research that supports this experience.

In a 2001 (Hebl & Xu) study that investigated attitudes towards individuals who were obese and presumed to be seeking medical care found that physicians viewed patients who were obese as less self-disciplined and more “annoying” and reported less desire to help them than to help thinner patients.
In “Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults,” Puhl and Brownell (2006) found that over half of the sample reported that they had experienced “inappropriate” comments from doctors regarding their weight at some point in their lives.

When asked about the interpersonal sources of weight stigma, participants in sample 1 cited doctors as the second most common source (reported by 69 percent), and similar results were obtained in sample 2; women cited doctors as the most common source of weight bias.

I have vowed to not allow myself to be shamed and stigmatized any longer by medical professionals for my weight, however I recently found myself in a situation that felt wrong to me… and I was silenced, despite my premeditated resolve to stand up against size stigma. Let me preface this story my saying that if you have ever been over weight you will know that you can go to the ER with a railroad spike sticking out of your head and have the doctor tell you “have you ever thought about losing a few pounds?”

What I mean is, most health problems can be correlated with weight in some way, but (as my statistics professor always liked to remind us) correlation does not equal causation! So here is my story: my husband and I had been trying for nearly a year to conceive our first baby and I had been diligently tracking and confirming my monthly ovulation through expensive ovulation predictor kits.

I decided to reach out to a doctor to see if there was anything else that could be wrong as we had not yet been successful. I brought in my ovulation chart-my well researched year-long documentation, and a heavy heart, hopeful to receive compassion and direction with my quest. I was shocked when the doctor’s answer was “you should watch your weight, overweight women sometimes don’t ovulate.”

I had just showed him proof that ovulation was not the problem in regards to our difficulty conceiving, and yet that was the weight related infertility issue that he chose to advise me on. I did not return to this doctor again (who incidentally also referred to me as “girl” instead of Dr. Wood or Mrs. Wood) and my husband and I became pregnant with our daughter the next month. 7 months! Although this is not the most egregious of incidents in my experience of weight stigma in the health care field it is a good reminder to me that there continues to be a need for awareness here.

If I could go back to that day I would do things differently, I would point out the stigma, but because I cannot I want to share the story to help illustrate this issue. For all of those who take the courageous step of reaching out for medical care in light of the potential risk of emotional pain- we support you! WEARETHEREALDEAL.

Hebl MR, Xu J. Weighing the care: physicians’ reactions to the size of a patient. Int J Obes Relat Metab Disord. 2001;25(8):1246-1252.

Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring). 2006;14(10):1802-1815.

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