When medical professionals fat-shame

What is fat-shaming? Humiliating, discriminating, and judging a person based on her/his body weight. Weightism is a prejudice in our culture. “The shaming may be performed under the guise of helping the person who is overweight/obese to realize they need to lose weight or they will die, become ill, and/or never succeed in life or relationships,” according to a 2015 article in Psychology Today. www.psychologytoday.com/.

“Medical fat shaming” can come in the form of disrespectful lecturing, embarrassing remarks, and a less thorough examination. Well-intentioned physicians that badger about the battle of the bulge need to review current research studies.

Physical Health

Fat-phobia by doctors when treating patients is a lame blame game. The results of a 2012 study by the University of Washington, which surveyed 2,000 medical practitioners, revealed that doctors have similar levels of a fat bias akin to the general public. “Overweight patients report weight discrimination in health care settings and subsequent avoidance of routine preventive health care.” www.journals.plos.org/.

Fat-shaming doesn’t help people lose weight. When individuals in larger bodies are body shamed by healthcare professionals, many avoid seeking further services. One study by University College London surveyed 3,000 British adults, and found that weight shaming does not encourage weight loss. America is not alone when it comes to fat-shaming. The drill-instructor-style of shaming a patient, under the guise of concern, increases self-guilt and self-rejection.

In a 2015 article in People, Elly Mayday, a plus-size model, acknowledged that doctors blamed her backache pain and other symptoms on her weight. A later biopsy revealed a rare ovarian cancer. Discrimination against people in larger bodies isn’t a motivator in weight reduction—it’s dehumanizing to fat-shame.

However, most general practitioners have not studied the field of obesity or nutrition. Referral to a dietitian is recommended as well.

And it’s easier for individuals in larger cities to change doctors, however not so easy in rural areas with a shortage of medical providers.

“The effects of a lifetime of shame and stigma can be profound. Fat people are more prone to anxiety and depression, and weight shaming can set off rounds of binge eating and avoidance of exercise because of embarrassment at how they look exercising and wearing workout clothes,” writes Gina Kolata in a 2016 article in the New York Times. She reported on a study that found doctors spend less time with obese patients www.nytimes.com/.

Mental Health

Fat-shaming by doctors can jeopardize mental health. Studies show that negative attitudes among medical providers can cause psychological stress in overweight patients.

A 2017 article by the American Psychological Association surmised that fat-shaming in the doctor’s office can be physically and mentally harmful. Joan Chrisler, PhD, presented at their 125th Annual Convention. She stated “Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice.” Doctors may assume weight is the cause of symptoms and fail to order appropriate tests. Chrisler recommends referring physicians to her 2016 article in the journal Fat Studies, “Sizeism Is a Health Hazard.” www.apa.org/.

Camps of Controversy

The controversy continues to brew, bubble, and boil surrounding the causes and solutions for weigh gain and weight loss. In one camp is the Fat Acceptance movement that downplays medical complications of obesity. In the other camp is the fating-shaming approach that blames weight solely on overeating and lack of exercise. The third camp surmises there are many paths to obesity and considers evidence from decades of research that demonstrates obesity is a complex genetic, physiological, biological, psychological, and socioeconomic condition.

Health at Any Size Movement

Health At Every Size: The Surprising Truth About Your Weight (2010) by Linda Bacon surmises that fat isn’t the problem, but a medical establishment that perceives a thin body as a healthy body—and a fat body as an unhealthy body. www.haescommunity.com.

The Adverse Childhood Experiences Study-ACES found that victims of childhood sexual abuse are more likely to become obese adults. Research shows that early trauma can disrupt and damage a person’s metabolism. Trauma that occurs during critical periods in the brain’s development can change its neurobiology and make this group more vulnerable to obesity. The trauma of sexual abuse can be a precursor for eating disorders, dieting, and preoccupation with food. www.cdc.gov/violenceprevention/acestudy/.

Hashtag #FatSideStories declares, “Fat-shaming is everywhere — in the comments section, in our workplaces, on the street, and yes, in our doctor’s offices.”

Obesity as a Health Risk

A physician communicating about weight loss to help alleviate a medical condition is not fat-shaming when spoken with respect and compassion. Health conversations with your doctor about weight and obesity is important for education and knowledge when decision-making about treatment. And many doctors do approach the topic with sensitivity.

“If you really want change to happen, if you really want to “help” fat people, you need to understand that shaming an already-shamed population is, well, shameful.”—Lindy West, Shrill: Notes from a Loud WomanMelissa Martin, Ph.D, is an author, columnist, educator, and therapist. www.melissamartinchildrensauthor.com. Contact her at melissamcolumnist@gmail.com.