Thursday, July 22, 2010

America’s Obsession with Weight: Health Care System Edition

The way medical professionals talk to women about weight makes me so angry sometimes. The conversation never seems to be about nutrition or fitness when we talk about women- even in a doctor’s office. It is about weight loss, weight management, and weight control. My doctor never asks me if I exercise regularly or if I eat my 5 fruits and veggies a day- he just weighs me, like that reveals all there is to know about my overall fitness level.

This obsession with weight is not only a reductive way to look at overall health, but it can be dangerous. Eating disorders
are on the rise in the U.S., partly due to our culture’s obsession with weight. If you are a young person who is at risk for an eating disorder, the last thing you need is your physician reinforcing the attitude that weight is everything.

Of course, like with most bad things, women suffer from our health care system’s obsession with weight more acutely than men do. A
recent study revealed that doctors “recommend greater weight loss to female patients than to equivalently overweight male patients.” It is unclear why this is, but the study’s authors suggest “societal bias is one possibility.” I understand that doctors are just people, and that they internalize the same impossibly thin images of women that we all do. But, really, if doctors can’t be objective about what is a healthy weight for a woman, who can?

I am particularly upset about this tonight because of an experience I had in doctor’s office waiting to be tested for strep earlier today.

I had waited for four hours when a young-ish physician’s assistant called me in. He took my temp (I still had the fever I had that morning) and asked me to step on a scale.

He asked me how much I weigh as I stood on the scale and I gave him a rough estimate. As the numbers got larger he said, “Well, someone has been eating some barbeque.” As the numbers got even larger, he said “Well, someone has been eating a lot of barbeque.”

I let him know, in words only someone with strep who has been waiting four hours can, that he should shut up.

Later, the asshole came in again. As he was putting the cotton swab down my throat he remarked, “For someone so uptight, you don’t have much of a gag reflex.”

I reminded him that there are laws against sexual harassment, finally got someone else to help me, and later filed a complaint.

When he made the first comment about barbeque, I thought maybe he was just an asshole, not necessarily a sexist one. When he made the crack about my gag reflex, I knew he was sexist and suspected that might have been the reason he thought it was okay to insult my weight.

When I heard from the other room that his response after weighing an obese man was “Alright, step down, please,” my suspicions were confirmed.

So what have your experiences with medical professionals been? Have you ever experienced them making inappropriate comments about your weight or seen them treat women differently than men?

Come on; don’t leave me ranting here alone.


Jacquelyn said...

I'm sorry you had to endure that crap. It's disgusting that he said any of those things to you! I once had a male physician give me Vicodin for severe period cramps and told me there was nothing else he could do. I went to a female physician who told me that other one was an idiot, to get on the pill and take ibuprofen for the cramps if they were ever that bad again. Derrr...

Anna said...

I had an experience like this yesterday, actually, when I went in for my annual exam:

After 45 minutes of “Oh, that’s good, those numbers are good, you’re obviously taking care of yourself,” and so on, to walk out the door to a footnote of, “Your BMI is a little high” is just a tad insulting. Because a. no shit, lady, I do have a mirror and a scale, and b. you JUST got through telling me I was healthier than most of the people who walk into your office, so maybe my BMI is not a real fucking issue? And then to follow that with “Eat right and exercise!” in a cheery voice like I’m clearly not already doing that because OH NO PEOPLE WHO ARE OVERWEIGHT NEVER EXERCISE AND ONLY EAT MCDONALDS.

Fuck you. You can bet I’ll be requesting someone else next time I come in.

Sleepydumpling said...

As a woman with PCOS, I went for 20 years with doctors only concerned about my weight and my breeding ability.

I firmly believe that when a man presents to a doctor with pain, exhaustion, an issue with his reproductive system and various other things that lesson his quality of life, his weight and breeding ability are not very high on the radar of most doctors.

Thank God I have a fabulous doctor now!

Anonymous said...

After I hit menopause and was put on an antidepressant that causes weight gain, I of course gained weight. I gained seventy pounds over four years.

Every time I saw my doctors, I complained about the medication and asked why my body wasn't responding to exercise the way it used to. My psychiatrist has tried various medication changes without much success, but at least admits that the weight gain is the result of the menopause/medication combination. He has, in fact, said that if I weren't so conscientious about healthy eating and execrcise, I would probably have gained more.

My primary care physician has been very blaming. He insists that I'm eating too much and not exercising enough. I have even shown him my workout journal complete with pulse rates (from an accurate heart monitor) showing that I get about seven hours of aerobic execise a week. He acts like I'm lying. Of course when I ask if he thinks I'm lying, he denies it.

The worst part of dealing with this doctor was the lectures on diet. Apparently he is a vegan. Every time I saw him I got what I call "The Bean Lecture" about how I should eat beans instead of meat.

I finally got tired of the self righteous vegangelical rants and found another doctor. SHE doesn't take a blaming attitude and is trying to be helpful. I also have a new psychiatrist who is working on medication changes and the possibility of coming off of the offending drug

I'm not losing weight but for the past eighteen months, I haven't gained.


Caylynn said...

I... would not have been able to keep myself from chomping down on that asshole's fingers in that position, so kudos to you for handling it maturely and filing a complaint. Too many people let that crapola slide.

Spilt Milk said...

So relieved to read that your response was to make a complaint. Because that man? Needs to lose his job. How appalling!

We're not weighed that often in doctor's offices here in Australia, it's not routine. Which is fine with me, as a fat woman. But I do think that gender affects weight bias - women are often admonished for gaining too much weight in pregnancy for example, or for setting a bad example for our kids, or for not losing the 'baby weight' whereas fat men are given far more leeway when it comes to judgements on their parenting ability due to their size.

Amelia said...

I was reading this with my boyfriend and we both were shocked by what you experienced. I agree that you did a great job of handling yourself maturely. I can't even imagine experiencing the type of behavior you described here.

AngryFatWoman said...

In my early 20s, I went to a doctor's office seeking help for severe depression. While there, the doctor -- who I'd never seen before and have never seen since -- decided that was the appropriate time to discuss my weight. She ended the conversation by saying, "Will you lose weight for me?" Bitch.

In my teens, when I wasn't overweight at all, told me I'll never be able to lose weight after I told him a story about a birthday party I attended. He said something to the affect of, "If you like cake, obviously you're not serious about your health."

In my later 20s, I visited a therapist turning a particularly difficult time in my family. She told me to eat anything I want.

About two years ago, as a P.A. relayed the good news that I was in perfect health -- despite my weight -- he warned I shouldn't be excited about the news because I'll obviously be riddled with disease soon enough because I'm fat. The then showed me a food journal on his iPhone and suggested I download it.

Fuckers, all of them.

Tiberius said...

Well I have yet to hear what they tell you about this in med school, but in my EMT training our instructor made it VERY clear to us that we need to be tactful and respectful to all patients. He drew particular attention to patients who are overweight but also told us to keep in mind that many people may be sensitive about their weight (whether or not they would be medically defined as overweight). A doctor certainly has a right to tell a patient if his/her weight is of possible concern, but is it too much to ask to be professional about it? If the "barbecue" comment was made to someone with an eating disorder or body image issues, that could start a big downhill turn.

And on the side, calling someone "uptight" is just condescending and a doctor has no place telling a patient something like that. In real life, some patients just won't like you. Deal with it.