For the sake of your health, you must demand respect from every person on
your medical team. Yes, your medical team. These are people you pay
to advise you on all aspects of your physical and mental well-being. It is
imperative that a good working relationship is established that involves
an honest, objective exchange of information. A good doctor and staff who
lack bigotry against people of size are to be treasured. Anything less is
unacceptable, stressful, unpleasant, and dangerous.
Speak frankly to a
physician on your first visit. Let her know that you are aware that your
weight may have an impact on your health, but that you expect to have any
health problems you may have treated as they would be for any other
patient. Politely set your boundaries when it comes to weight loss. This
is your health. Guard it with your life.
If you have difficulty
speaking up for yourself to a doctor, feel free to print out the letter
below and take it with you on your first visit. Or, give it to your doctor
now. Hand it to them, mail it to them, do whatever you feel most
comfortable doing.
An Open Letter to
Physicians
Dear Doctor:
Nothing personal, but few places are as unpleasant for a
fat person to visit than a medical office. It isn't the
tests, the poking and prodding, the cold speculum, the
needles, or even that heart-stopping bill that keeps us
away. And it isn't that we don't care about our health.
It's you, your staff, and those narrow seats in your
waiting room. Let's start at the top:
When I place my health in your hands, it is my hope you
will take my concerns seriously and will find some way to
look past my size and beyond personal prejudices, if you
have any. I am not asking you to marry me or even take me
dancing . . . I am asking that you use your education to
address any health problems I may be experiencing. Please
listen to my concerns, then consider how you would test
and treat these symptoms if I were not fat. Treat me with
respect and I will return the favor.
I am aware that some diseases may be related to or
aggravated by being large, and I want you to help me
avoid or deal with those. But don't expect superhuman
attempts at starving myself to achieve an impossible goal.
Please be realistic. Diets don't work . . . ask me, I've
tried them all. Help me to be as fit and healthy as
possible at any size.
Subscribe to publications like Healthy Weight Journal to help keep yourself up-to-date on the latest research
and to Radiance or Rump Parliament to
make yourself aware of issues I face that may affect my
health. (Keep these magazines in your waiting room for
the education of your patients and to show that you are
size-friendly.) Request copies of informational brochures
and other publications from Largesse or the National
Association to Advance Fat Acceptance. (Of special
interest are their pamphlets Facts About Hypertension
and the Fat Person, How to Weigh Your Supersize
Patients, and Guidelines for Therapists Who
Treat Fat Patients.) Become a part of finding
solutions to problems encountered by your fat patients.
If I ask you for help controlling or changing my weight,
offer your thoughts and suggestions. Alert me to health
problems truly affected by weight . . . and be current
with your information. Please don't hand me a low-calorie
diet sheet and preach to me about self-control. Chances
are good I've already heard it, tried it, and moved on.
Unless you have good, solid evidence that a weight-loss
treatment will work for me on a permanent basis, don't
demand that I lose weight. You may become a part of my
health problems by creating diet-induced diseases.
Please drop the terms
morbid obesity and
gross obesity from your vocabulary. They
are offensive medical terms assuming disease. Not all fat
people are sick . . . even fewer of us are morbid or
gross. If you think I am either of these things, you are
not the doctor for me.
Please don't demand that I be weighed unless absolutely
necessary. If there is a compelling reason to weigh me,
make sure your scale is in a private area. And please don't
use this opportunity to shame me, thinking you can drive
me to weight loss through shame. (There have been
instances of doctors or their staff making mooing or
oinking noises after weighing a large patient.) Record
the information, use it when necessary, and please keep
the number confidential.
When prescribing medications, make adjustments for dosage
if necessary. Consider not only weight, but body mass
index.
When taking my blood pressure, use the appropriate cuff.
A standard cuff can be used for arms up to sixteen inches
in circumference. Larger cuffs are available and should
be kept handy. If those cuffs are too small, take the
reading using my forearm.
Whatever you do, don't assume I am lying when we discuss
my eating habits (or anything else). Some people who are
fat have eating disorders and/or consume huge quantities
of food. Research shows most eating disorders appear in
people of moderate, if not downright low, weight. Most of
us who are fat have lowered our metabolism through
dieting to the point where even "normal"
amounts of food can cause weight gain. Many people who
are fat have been made to feel so guilty about eating
anything beyond a dry salad they automatically admit to
being "bad" when in truth they eat normally.
Even fat people buy into some of the stereotypes. Recent
studies have proven what fat patients have been saying
all along . . . "I don't eat that much!"
Your staff: Just as you wouldn't allow your staff to
snicker about the color of a person's skin or the lack of
mobility of any individual with a disability, please make
certain the same courtesy is extended to all your
patients. Remarks are often overheard when a doctor,
nurse, or assistant thinks the patient is out of earshot.
Prejudice is born out of ignorance; educate your staff
and insist upon a professional manner at all times.
Your office: Make your office comfortable, non-intimidating,
and accessible. When choosing furniture, assume that many
of your patients will be large . . . some may be more
than 400 pounds. Choose sturdy chairs without arms. Make
sure the cushions are firm and that the seat is not set
too low to the floor. Few things are more embarrassing
for the large person than trying to struggle up from a
soft, low seat in front of others.
Examining tables should be braced to keep them from
tipping. The steps up to the table should be wide and
sturdy. (While you're at it, can you do something to warm
up those metal tables?) Doors should be wide, allowing
easy access to examining rooms, offices, and bathrooms.
Now . . . about those examination gowns. Get real! "Average"
size people struggle to keep themselves covered while
wearing them. It is difficult to have a serious
discussion about health concerns when my most pressing
problem is an overexposed backside. Gowns that fit up to
size 10X are available; please keep some handy. I suspect
many of your other patients would appreciate them as well.
What I need from you is respect, professional concern,
and your best medical advice . . . the very things all of
your patients need. Given these conditions, I look
forward to a long, healthy relationship with you.
Signed,
Your Patient,
In Search of Good Health
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