Anytime you go to your doctor with a health concern, you expect that he or she will listen to you attentively, explore all possible avenues, take your thoughts and opinions into consideration, and ultimately do their best to help you find a solution. What you don’t expect is to be brushed off and not taken seriously because of the way you look. This is an unfortunate reality that overweight and obese patients face regularly, and it tragically cost this woman her life.
Jan was a 59 year old woman who despite being athletically gifted as a child had been overweight for most of her life. She had been experiencing vaginal bleeding, unexplained weight loss, and constant pain in her pelvis. Jan described these symptoms to a friend-recommended OB-GYN, who completely disregarded her concerns and performed a simple routine exam.(1)
“He didn’t do anything for me, and he didn’t find anything. He just saw me as a fat, complaining older woman,” Jan told her sister. (1)
This demeaning experience caused her to delay looking for a second opinion, opting to explore other causes of her pain such as removing gluten and dairy from her diet and taking over the counter pain medications. Months later, Jan saw another doctor in San Francisco on the advice of her sister, with a similar result. Despite having given her a detailed description of her symptoms and the pain she was in, the doctor, this time a woman, refused to give her anything because she thought she was just trying to get opioids. (1)
This doctor at least ordered some blood tests; when the results came back Jan got the call to head straight to the emergency room due to extremely high calcium levels in her blood. Sure enough, an MRI an endometrial tumor the size of a volley ball. It had filled her pelvis with cancer, and had also spread to her bladder and other organs, including her lungs. Jan died six months later. (1)
Endometrial Cancer is not hard to Diagnose
Jan’s sister Laura googled endometrial cancer, and the first few sites that came up stated all of the symptoms Jan had been describing to these doctors. Why she recognizes that physicians are people who can miss things or make mistakes, she is surprised that nothing Jan said to them gave them any concern. (1)
“Those symptoms — the ones the patient came in worried about — should’ve raised red flags far more than the fact that she was overweight.” Laura wrote in a piece about the discrimination and fat-shaming her sister faced from the medical community. (1)
This is not the only experience a member of Laura’s family has had with sizeism and weight discrimination. Her oldest sister who is also on the heavier side was told to “lay off the hamburgers and cokes” by a doctor when seeing them about a rheumatologic problem. Her sister never eats fast food. (1)
Sizeism, Fat-Shaming, and Weight Based Discrimination in the Medical Community
Discrimination and poor treatment by physicians and medical staff is something that happens regularly to overweight and obese individuals, and is not just an isolated event that happened to Jan and her sister. (2, 3, 4, 5)
Several studies and reviews of those studies have been done on the subject of weight bias in medical care, all with the same outcome: There is an overwhelmingly negative attitude and stereotypes from physicians and health care workers towards their overweight and obese patients. (2, 3, 4, 5) One study even found that 24% of nurses admitted they were “repulsed” by obese patients. (5)
To make things worse, these bias, stigma, and negative views against overweight patients affects their quality of care. It not only decreases the quality of the doctor-patient encounter, but it also puts a large amount of stress on the patient themselves. This stress can impair the patient’s ability to think and therefore communicate clearly, perpetuating stereotypes and leading to problems such as depression and other complications brought on by constant stress. (2, 3, 4, 5)
Other studies have found obese patients, and especially female patients, are less likely to seek screening and tests for certain types of cancer and related conditions out of fear of embarrassment, judgement, and discrimination based on their weight. (2, 3, 4, 5)
While there are organizations working on providing education to the medical community about this issue and attempting to end these dangerous biases, it is still a problem that many patients face on a regular basis. The problem is many physicians don’t even realize that they are doing it, as fat-shaming and stereotypes about overweight individuals have been so ingrained in our society. Until the stigma has been done away with, these patients need to be extra vigilant when seeking medical advice and attention. (2, 3, 4, 5)
What You Can Do if You are Being Discriminated Against
If you find yourself the victim of fat-shaming and weight bias the next time you have a health issue, there are several steps you can take to ensure that you receive proper care regardless of the opinions of the medical personnel you are dealing with.
Before visiting your doctor, write down a list of all of your concerns. Do not leave until each concern has been addressed and your needs have been met. Leave space after each concern so you can write down what the physician tells you: What the problem is/might be, next steps, what you need to do on your own, etc.
Keep a diary of your symptoms and any changes to your health that you can show to your doctor if you think they are being dismissive. Include steps you have already taken in an attempt to help your problem to avoid being told you’re not doing things or you are or that you should try something that you already have. If photo evidence of changes or the progression of symptoms is an option, include them.
Do some preliminary research on your own before your appointment. Write down what you find and how it compares to your symptoms, as well as questions you have regarding your findings.
Ask plenty of questions (this is where preliminary research comes in handy). If a doctor waves off a condition without much explanation, ask them why and make them explain their rationale.
When in doubt, always get a second, third, or even fourth opinion. If you think you are being discriminated against and not receiving proper care no matter what you do, find a different doctor.
Discrimination and shaming because of weight and appearance is something that overweight and obese people face on a daily basis at home, school, work, and in the media. It is not something they should also have to worry about when seeking medical care, and they should be treated with the same respect and given the same attention as any other person would. Together we can help decrease weight discrimination and sizeism by checking our own biases and challenging ourselves to look past them.
Share this article if you agree that the medical community is no place for weight discrimination and fat shaming, and to help spread awareness and education about this issue.
(1)Fraser, L. (2017, August 14). My sister’s doctors saw her weight – but missed her cancer. Retrieved August 29, 2017, from https://www.statnews.com/2017/08/15/cancer-diagnosis-weight-doctors/
(2) Phelan, S., Burgess, D., Yeazel, M., Hellerstedt, W., Griffin, J., & Ryn, M. V. (2015, April). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Retrieved August 29, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/
(3) Forhan, M., & Salas, X. R. (2013, June). Inequities in healthcare: a review of bias and discrimination in obesity treatment. Retrieved August 29, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/24070845
(4) Health care professionals’ attitudes about obesity: An integrative review. (n.d.). Retrieved August 29, 2017, from http://www.sciencedirect.com/science/article/pii/S0897189709000706
(5) Puhl, R., & Brownell, K. D. (2001, December). Bias, discrimination, and obesity. Retrieved August 29, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/11743063