Multiple studies show that doctors have tacit prejudices about patients with larger bodies. A study published in Criticism of obesity found that doctors spent 28 percent less time with overweight patients. Another study, published in American Journal of Emergency Medicine, suggests that emergency physicians often prescribe antibiotics to overweight patients. And a study examining autopsy records from 300 patients found that those who were overweight were 1.65 times more likely to have an undiagnosed medical condition.
These studies do not look at the clear emotional and psychological impact that medical prejudice has on patients. As a result of clear prejudices and poor treatment, overweight patients can avoid going to the doctor. In turn, their health is endangered – and this is unjustly due to their weight.
Ultimately, treating lipophobia in healthcare settings can be exhausting, but there are signs. We asked experts what to look out for, how to prepare and how to take care of yourself afterwards.
Three red flags indicate that your provider may have a weight bias
1. Assume how much you eat or exercise
How much you weigh depends on factors such as genetics, medications, place of residence, your sleep and more. But doctors who have harmful weight prejudices can automatically assume that your weight is a result of how much you eat and exercise, according to Melissa Landry, MEd, RDN, LDN, an anti-diet dietitian who helps women with larger bodies find freedom of food. If your provider tells you to ‘lower your sugar’ or ‘exercise’ without asking what you eat, your exercise routine or other aspects of your health (such as drug use and any pain you may have), this may be is a sign that they are putting too much emphasis on weight.
2. Ignore a history of eating disorders
Landry adds that your provider should also ask about your relationship with food, your weight bike history and how you tolerate weight changes. Not asking for it is a red flag. “So many people are experiencing poor nutrition and poor mental health at the hands of weight loss programs – why don’t doctors ask for more about it?” says Landry. “Registered dietitians see a lot of chronic diet problems.” Your mental health is important and you do not have to sacrifice yourself for weight loss.
3. Encourage weight loss regardless of healthy vital and workshops
You deserve respect and attention regardless of your general health. And even if you do not have healthy animals or workshops, this does not mean that weight loss is the best treatment. However, it can also be frustrating when you are healthy and your doctor prescribes weight loss anyway.
Katie Tomaschko, MS, RDN, a partner at Sporting Smiles, has experienced it first hand. “It’s amazing to me that when I go to annual appointments with my doctor at great lab prices: low blood pressure, I look perfectly healthy and happy, I get tips on how to eat, exercise and lose weight,” she says. If you have a provider who seems to focus exclusively on your weight without investigating other factors, you may be experiencing medical bias.
How to respond to medical prejudices
If you suspect that your provider has medical biases, it is natural to have feelings about it. You may want to shout at them, follow the flow to avoid conflict, or feel silent from the shock.
Landry recommends being proactive when you can. “Many times, informing your doctor that weight is not your priority before starting the visit is a good start,” he says. “If applicable, reporting a history of eating disorders or eating disorders may be helpful.” This can help professionals stay “on the job” and offer you the help you are looking for, he says.
You can also tackle the problem by asking providers (or their office staff) questions when scheduling your appointment. Whitely suggests asking if the team is trained in weight bias and if they have clothes that include size.
You can also set limits during the appointment. “You can also just tell them you do not want to be advised about your weight,” says Tomaschko. He adds that if they do not respond well or you do not feel comfortable talking, you owe them nothing — you can see a different provider. You deserve effective, comprehensive and thoughtful treatment.
Finally, support yourself and your beliefs. Whitely recommends getting tested, saying you would like to discuss your (overweight) medical needs and reminding providers that food restrictions can cause you to.
Ways of practical self-care after a visit
Listening to your doctor’s weight prejudice can be emotionally debilitating and clearly provocative. Landry recommends contacting people who “understand”. (If you do not have friends to understand, there are always Reddit and Facebook groups!)
Tomaschko suggests doing whatever makes you feel good. That could be meditation, reading, eating good food, the skin care mask – everything that makes you feel like yourself, he says.
Finally, Whitely emphasizes the importance of treatment – especially with a fat-positive provider. They can play a role with you, so that you feel more comfortable the next time you need to see your doctor and remind you that your weight does not determine your worth.
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