Addressing Medicine’s Bias Against Patients Who Are Overweight
Yesterday my new endocrinologist did the exact thing this article says not to. I want to print the article for her and highlight just that part in yellow highlighter.
There are lots of reasons for being fat. Calories in, movement, metabolism, stress hormones, genetics. Eleven years of being on a bipolar cocktail of powerful psych meds? Poverty, living in a food desert? Disability. The people who are working two jobs and raising kids and don't have time to cook. Capitalism.
She reminded me of a psychiatrist I had a long time ago. "You can't gain weight if you don't eat too much, right?" He's prescribing seroquel to unsuspecting mental patients who gain a hundred pounds then think they're bad and cry in group, hating themselves. Talk about blaming the victim.
"Hello, I'm Dr Richness. You're terribly vulnerable and powerless. I'm all-knowing and omnipotent. My science is bullshit and I don't know what I'm doing. There are no tests for the multiple maladies I diagnose you with. All I can offer you is pills, and the pills will harm you. Then I'll blame you for being harmed. Give me two hundred dollars. Gotta go--the drug reps are here with lunch."
I'm feeling mad writing this. Maybe I should stop. But I wanted to tell you.
I'm listening to the endocrinologist. I can tell Ming is getting upset. I'm just listening, thinking my thoughts, thinking "diets don't work" and feeling shocked when she suddenly suggests gastric bypass surgery.
"No, I'm not going to do that," I said. Thinking of my relatives who had the surgery, my aunt who gave me black garbage bags full of her old clothes, when she lost 150 pounds.
The endocrinologist's telling me things that contradict everything I believe. I always thought it was "better" to be fat and exercise than to be thin and sedentary. She's telling me to get thin at any cost--nothing else matters.
I'm thinking how for 15 years I went for a walk almost every day, how it helped my anxiety and voices and moods and eased my back pain. And yoga, and dancing in the living room. Then I lost all my energy.
That couldn't have been all body positivity propaganda, could it have been? No, I knew it myself, that exercise helped me. I thought it was keeping me alive.
So I'm feeling confused on top of my confusion. I pretty much know I need a new endocrinologist. But how will I find one who listens to me and will hear what I need and what I choose?
She was lying to me when she said I'm fat simply because I eat too much. We know there are lots of reasons. She doesn't know me, my past, my trauma. Does she lie to all her patients, or does she think Ming and are simple-minded in particular?
Cried in the minivan, cried at home--I've seen so many people torture themselves. I've mostly avoided it.
I wouldn't mind being lighter. It would be an easier life, to fit in all the chairs and not need a seatbelt extender and not have people think I'm lazy and stupid just by looking at me.
It's just I don't want to do that to myself, the weight loss roller coaster. I wouldn't wish it on my worst enemy. Wouldn't wish it on a dog.
My appetite is different, and my diet is limited by a handful of problems. My stomach ulcer bled so bad I became anemic to the point of not functioning. (In our hotel room in Arizona, I couldn't get from the bed to the bathroom in one trip. I had to stop and rest in the chair by the mirror.)
"Oh, you lost weight," the nurse cooed at my annual wellness appointment.
"Yeah, I was in the hospital," I said, and she apologized, hadn't read my chart.
https://jamanetwork.com/journals/jama/fullarticle/2725893?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=022019&fbclid=IwAR2Clr65smSFTP-C5qXd409re7TVoogycM5mwJx1kl8Qt8rm2NBlrPGA7jw#.XG38gHpv_ug.twitter
There are lots of reasons for being fat. Calories in, movement, metabolism, stress hormones, genetics. Eleven years of being on a bipolar cocktail of powerful psych meds? Poverty, living in a food desert? Disability. The people who are working two jobs and raising kids and don't have time to cook. Capitalism.
She reminded me of a psychiatrist I had a long time ago. "You can't gain weight if you don't eat too much, right?" He's prescribing seroquel to unsuspecting mental patients who gain a hundred pounds then think they're bad and cry in group, hating themselves. Talk about blaming the victim.
"Hello, I'm Dr Richness. You're terribly vulnerable and powerless. I'm all-knowing and omnipotent. My science is bullshit and I don't know what I'm doing. There are no tests for the multiple maladies I diagnose you with. All I can offer you is pills, and the pills will harm you. Then I'll blame you for being harmed. Give me two hundred dollars. Gotta go--the drug reps are here with lunch."
I'm feeling mad writing this. Maybe I should stop. But I wanted to tell you.
I'm listening to the endocrinologist. I can tell Ming is getting upset. I'm just listening, thinking my thoughts, thinking "diets don't work" and feeling shocked when she suddenly suggests gastric bypass surgery.
"No, I'm not going to do that," I said. Thinking of my relatives who had the surgery, my aunt who gave me black garbage bags full of her old clothes, when she lost 150 pounds.
The endocrinologist's telling me things that contradict everything I believe. I always thought it was "better" to be fat and exercise than to be thin and sedentary. She's telling me to get thin at any cost--nothing else matters.
I'm thinking how for 15 years I went for a walk almost every day, how it helped my anxiety and voices and moods and eased my back pain. And yoga, and dancing in the living room. Then I lost all my energy.
That couldn't have been all body positivity propaganda, could it have been? No, I knew it myself, that exercise helped me. I thought it was keeping me alive.
So I'm feeling confused on top of my confusion. I pretty much know I need a new endocrinologist. But how will I find one who listens to me and will hear what I need and what I choose?
She was lying to me when she said I'm fat simply because I eat too much. We know there are lots of reasons. She doesn't know me, my past, my trauma. Does she lie to all her patients, or does she think Ming and are simple-minded in particular?
Cried in the minivan, cried at home--I've seen so many people torture themselves. I've mostly avoided it.
I wouldn't mind being lighter. It would be an easier life, to fit in all the chairs and not need a seatbelt extender and not have people think I'm lazy and stupid just by looking at me.
It's just I don't want to do that to myself, the weight loss roller coaster. I wouldn't wish it on my worst enemy. Wouldn't wish it on a dog.
My appetite is different, and my diet is limited by a handful of problems. My stomach ulcer bled so bad I became anemic to the point of not functioning. (In our hotel room in Arizona, I couldn't get from the bed to the bathroom in one trip. I had to stop and rest in the chair by the mirror.)
"Oh, you lost weight," the nurse cooed at my annual wellness appointment.
"Yeah, I was in the hospital," I said, and she apologized, hadn't read my chart.
https://jamanetwork.com/journals/jama/fullarticle/2725893?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=022019&fbclid=IwAR2Clr65smSFTP-C5qXd409re7TVoogycM5mwJx1kl8Qt8rm2NBlrPGA7jw#.XG38gHpv_ug.twitter
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