If you are in a larger body, chances are good that going to the doctor hasn’t always been an enjoyable experience for you. Go in for a sore throat? They prescribe weight loss. Sprained wrist? Lose some weight, of course. Diabetes diagnoses? Weight loss is the first line of treatment. Practitioners often do not know, let alone communicate, that weight is not a good indicator of health or that losing weight is the greatest predictor of future weight gain.
Unfortunately, this fat shaming and discrimination can be traumatic. It often feels more humane to stay home and ignore health needs than to face dehumanization and triggers in a physician’s office.
Dear fat friends, we are worthy of loving, caring, inclusive medical care! Our physicians work for us, not the other way around. We do not have to accept discrimination and trauma triggers as a given when it comes to our medical care.
The Association for Size Diversity and Health (ASDAH) maintains a directory of physicians and other professionals who practice from a Health at Every Size (HAES) perspective. Lindo Bacon maintains a wealth of resources and information for you and for your providers. Mosaic Comprehensive Care has drafted a practitioner letter to help you advocate for the care you want and need. Consider using these resources, not only as a reminder of what is true when it comes to weight, but also as a way to advocate for yourself in medical settings.
When searching for compassionate and inclusive medical care, remember that you can interview physicians before you agree to an exam. Look for the following things in a size-inclusive provider:
- They do not believe that you can judge health based on weight.
- They do not believe that you can judge nutrition based on weight.
- They do not believe that you can judge activity level based on weight.
- They do not advertise weight-loss services.
- Chairs are size inclusive, with armless options available.
- Appropriately sized blood pressure cuffs are available.
- Stepping on the scale is not pressured or required during appointments.
- They believe in enjoyable movement, not exercising to change your body.
- They believe in eating for well-being, not to change your body.
- They are respectful of your boundaries and treat you with kindness.
- Consent is valued as integral to quality medical care.
- They understand trauma and how to provide trauma-sensitive care.
- They understand the harm caused by diet culture.
- They understand eating disorder recovery and are sensitive to the needs of people in recovery.
- They value mental health as integral to overall health.
Consider having a few pocketed responses for troubles you might encounter in a non-HAES medical environment. For instance, you might say, “I don’t do that,” when asked to step on the scale. Or, if your provider is suggesting weight-loss as a treatment, you might ask them what treatments they would prescribe to a thin person with the same diagnosis. You are also free to get dressed and leave a medical appointment at any time.
You might also consider your self-care strategies in advance. Perhaps you can schedule an appointment with a therapist or coach for immediately following your appointment. Maybe you can bring an HRV biofeedback device with you, to help ease stress and increase your ability to advocate for yourself. If you have a service animal, maybe ask for some deep pressure therapy or focus on doing tasks with them while you wait for the doctor and after you leave. Consider bringing a HAES-friendly loved one or friend as added support and as an additional person who might advocate on your behalf.
Also, if now is not the time for you to make that next medical appointment because of how past trauma is impacting you, know that you are not alone. Medical trauma is epidemic for those of us in fat bodies and it can take time to process your experiences with doctors and hospitals. Trauma-sensitive coaching with a HAES practitioner can help you navigate what you have experienced. So can modalities like HRV biofeedback, where you learn to transform stress into resiliency, or neurofeedback, where your brain processes trauma without revisiting or retraumatization. Healing is possible for you, and you are worthy of a community of people who will support you on that journey.