Recently, popular body-positive Instagrammer, Corissa Enneking shared the gut-wrenching details of her “dehumanizing” appointment with a doctor who exhibited shocking weight bias. In the series of video clips, she explains that she went to the doctor proactively for testing on her heart. She was finding it difficult to resume her previous activity level after a recent illness. The heart tests came back “perfect and normal,” yet the doctor recommended calorie counting. She warned Enneking that she would be dead before she was 65 if she didn’t lose weight.
(I guess this doctor is also a fortune-teller.)
As if this dismissive attitude isn’t despicable enough, Corissa Enneking has a documented history of anorexia. The doctor dismissed her medical history and denied her lived experience, even asking if she is sure her history wasn’t with bulimia, because she found it so hard to believe that a fat person had ever restricted their food intake to a dangerous degree.
Horrified, Enneking expressed that counting calories would result in a return to her disordered eating patterns, and that it’s not an option for her. The doctor offered no other solutions. Twice, this physician used childish hand gestures instead of words, once making a motion meant to mimic shoveling food into one’s mouth.
Weight bias is often dismissed because being fat is still widely regarded as a choice.
During one particularly emotional moment, Enneking expressed hesitation to bring her partner to future appointments because they are overweight, too. She wanted her doctor to believe her, and that seems more likely if she brought along a thin person to “validate everything she says.”
The entire experience sounds like a nightmare, but it’s real life. Many fat people have experienced this kind of weight bias firsthand.
Enneking tells Scary Mommy, “Finding a doctor who wants to treat me as a patient without prerequisite weight loss has been nearly impossible throughout my life. Even as a “normal” sized teen, I was congratulated for weight loss when I tried to get treatment for nausea and anxiety – I was anorexic, and my parents told my doctors I wasn’t eating.”
I have been in frustrating and humiliating situations with physicians, too. A few years ago, I went to see an obesity specialist. I left confused and humiliated. This man makes his living assisting patients in losing weight. He performs weight loss surgeries, but he also runs a clinic that assists in non-surgical weight loss. I booked an appointment to discuss my history and talk about participating in the clinic. My hope was that I would see a nutritionist and be linked to support from other patients.
I never got that far.
During my initial consultation with the physician, he ran through a list of questions about weight-related issues, pop-quiz style. I answered every question correctly, demonstrating an understanding of science that he apparently did not expect. He said, “I’m shocked you’re overweight, honestly. You must be one of the rare people that has an actual underlying cause for this level of weight gain. I actually believe what you’re telling me about your eating habits and activity level. There’s no way you eat enough to warrant this weight. You’re so smart.”
My reasonable level of intelligence amazed him. I guess he expected me to be an idiot or a liar. I was mortified.
There are just so many problems with his attitude. First, he was was completely ignoring the gazillion types of privilege that equipped me to answer fairly difficult scientific questions aloud on the spot. (I’m thinking my education and media training probably played more of a role than inherent intelligence or body size, but okay, Doc.) Second, what the hell does my intelligence have to do with whether or not I overeat? How did he reach that conclusion? Most importantly, why is it so surprising to an obesity specialist that a fat person would be knowledgeable?
Doctors have to do better, and it’s going to take some work.
Resident physicians Kunal Sindhu and Pranav Reddy admit, “Throughout medical school, we learned how to challenge a diverse range of implicit biases. But we received little to no education on the topic of weight bias and stigma. In an era when over 70 percent of American adults are considered overweight or obese, this oversight is simply inexcusable.”
Doctors receive absolutely no training in how to be inclusive to fat patients. Nobody is emphasizing to new doctors that fat people deserve adequate and fair medical treatment that goes beyond weight management.
If that’s not happening in 2019, we can be pretty certain anti-weight-bias training wasn’t happening decades ago when many practicing physicians received their initial training.
The fact that obese patients get worse care isn’t really up for debate. They don’t design hospitals with fat bodies in mind. Sometimes, in the absence of equipment that can accommodate our size and weight, we receive sub-par care and face humiliation.
According to a 2016 article in the New York Times, “When an obese patient cannot fit in a scanner, doctors may just give up. Some use X-rays to scan, hoping for the best. Others resort to more extreme measures. [Dr. Scott Kahan, an obesity specialist at Georgetown University,] said another doctor had sent one of his patients to a zoo for a scan. She was so humiliated that she declined requests for an interview.”
Weight bias and stigma doesn’t motivate fat patients to lose weight. We just choose to suffer in silence and avoid the humiliation of seeking medical care.
“Perhaps unsurprisingly, many fat patients delay or avoid seeking medical care—just like I did, “one writer shares on self.com. “A 2018 study in the journal Body Image surveyed 313 women from a U.S. health-panel database; they found that higher BMI was associated with both experienced and internalized weight stigma, which was linked to increased shame and guilt, which in turn was associated with avoiding healthcare altogether.”
Fat patients have legitimate medical concerns. A salad and a jog won’t cure us.
How many more fat people have to be misdiagnosed, untreated, and left to suffer before changing weight stigma becomes a priority in the medical community? This is a matter of life and death.
It is absolutely nonsensical that a doctor would shame, dismiss or disbelieve a person because they perceive them as unhealthy. Fat patients have legitimate medical concerns. A salad and a jog won’t cure us. We deserve the same treatment as people in smaller bodies. It is reasonable for us to expect a physician to address our most pressing medical need before bringing up our weight. BMI alone is not an adequate indicator of health.
Corissa Enneking knows this well. “It seems that physicians can’t hear patients or their advocates unless they have a specific (thin) outward appearance,” she laments. “It’s created a lifetime of fear for me around seeking care for illnesses. I’m terrified that one day I’ll need emergency care and some fatphobic doctor will decide I don’t deserve their best. Nobody should have to fear that, we are all worthy of the best care, no matter our body size.”
Even if doctors insist on seeing fat people as inherently unhealthy, it should be irrelevant to them when we present with a non-weight-related issue. Perfect health should not be a requirement for respect and adequate care. People of every size, race, gender and station should be able to trust that our medical complaints will not fall on willfully deaf ears.
Sick people should be able to see a doctor. And this should not even need to be said.