The Soapbox: For F#$%’s Sake, Fat People Need To Go To The Doctor Too

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As some of you may have noticed, I’m really rather fat. I mention it only because it’s relevant — it has a significant impact on my life; people treat me differently because I am fat.

Or, in some cases, refuse to treat me. Which is what happened recently to Ida Davidson, who was turned away from her new primary care physician. The stated reason? Ida Davidson weighs too much for the doctor’s office to accommodate her.

In fact, Dr. Helen Carter of Shrewsbury, MA (if you were curious and wanted a name to add to the list of Doctors To Avoid) claims that her office has seen three consecutive injuries from trying to provide care for people weighing over 250 pounds.

That’s injuries to patients, by the way. Fat people who go to her office tend to get hurt.

Going to the doctor is already fraught for many fat people. And a lot of fat people just don’t go. As a group, we’re more prone to avoid medical treatment for fear of shaming. People yammer on about how we should lose weight for our health but then create an atmosphere where we really actually are afraid to participate in health care. Because that’s logic, right?

This kind of thing truly does make me livid. Fat shaming in the doctor’s office is so counterproductive. And it’s such a common occurrence. This incident with Ida Davidson is getting a lot of press — but it is far from the first time this has happened.

Studies have found that not only do doctors and nurses tend to regard fat patients as noncompliant regardless of what is actually going on with the fat people in question, but that doctors are themselves complicit in providing fat patients with lower quality care. Many doctors blame their fat patients for being fat and treat them like they don’t deserve good health care. Fat patients are even the targets of painful jokes.

You know that’s disgusting, right? I mean, regardless of how you personally feel about my fatness (or my attitude in general), would you really advocate for me not receiving quality medical care if and/or when I need it?

I’m making this personal because the first comment I read on an article about Ida Davidson was a person saying, “Hey, maybe it’s time for the fatties to be shamed.”

If there were a way for me to sit down, very seriously, across from you right now in a literal instead of metaphorical sense, I would do so. I would look you in the eye and say, “Hey, let me tell you, the fatties are already being shamed.” This is not a new tactic. And the only things shaming fat people accomplishes are broken spirits and dead people.

You can’t die of a broken heart (despite what Where the Red Fern Grows teaches us) but you can sure as shit die of never going to the doctor even when you are ill because you have been shamed and told you don’t deserve to be cared for. You can die from emergency responders making jokes at your expense while they tell you that you’re too fat for them to carry to the ambulance.

All of that said, I think people are angry with Carter for some of the wrong reasons. If she’s not furnished her office in such as a way as to deal with fat patients safely, then she should absolutely be turning away fat patients. But I want Carter to be equally absolutely clear on something: She’s turning patients away because of her own lack, her own inability to treat them. Not because they are special cases who need to be sent off to an obesity center.

An obesity center, for those not in on the medical language of fatness, is not going to provide the same services as a primary care physician. An obesity center is not where a fat person goes when they have the flu. No, this primary care physician, who is meant to be treating the whole patient as a general care provider, is saying that patients really ought to go to that diet place down the road.

Obesity centers are focused on weight loss through dieting, supplemented by weight loss surgery.

None of that is going to deal with your hay fever or whatever else you’d go to your primary physician for.

The discussion of medical equipment that will accommodate the extremely fat patient has been going on for a while. I’m used to asking spas if their massage tables are rated for my use. I’m careful at my doctor’s office if the table isn’t bolted to the floor (many are not and I want to bet that’s how Carter’s patients got hurt) — those things can tip. Hell, I’m used to scales not going up high enough to weigh me (which would be an issue if I were the kind of person who weighed myself).

But none of that justifies the larger issue of a medical professional who thinks “Go on a diet” is a suitable response to “Doctor, I have a fever.” Carter says she has patients who are motivated — which is totally code for “going on a diet” — but given the failure rate of dieting, I have to wonder how long she’s going to be so supportive.

Medical equipment is, of course, not cheap. I understand that the small-practice physician might not be able to accommodate all the bodies who come in for a visit. In those cases, I think respect and honesty are both key, which is the part many folks struggle with. Carter seems to have the honesty down, but not the respect part. Again, not surprising in a world where medical staff think it is appropriate to make jokes about sending very fat patients to the zoo for an MRI.

And, yes, that does happen to some people. With about as much fat shaming as you’d imagine. Check out the comments here, if you’ve got the stomach for it, for example.

When situations like Ida Davidson’s happen, which they do with depressing regularity regardless of media coverage, part of me is always glad that someone has been so explicitly fat hating. I don’t have to guess with that person anymore. They have removed themselves from my consideration.

But framing things that way doesn’t actually improve the situation for fat people who need to go to the doctor. Medical professionals are no less subject to cultural construction than the rest of us — and when they go into practice, they carry their biases and prejudices with them. Including the belief that fat people just don’t deserve to be taken care of.

I’m so angry about this. But I am also so tired. People talk about making fatties pay more for treatment that doctors don’t even want to give us in the first place. People ignore our health and well-being and insist we either shouldn’t be bothered by it or we should lose weight. People act like they are so concerned for our health while making it harder — both physically and mentally — to access health care.

Carter has, well within her legal rights, turned away one patient from her own practice. I wish Ida Davidson well in finding a health care provider who actually cares about her health enough to welcome her into the office. I just wish I didn’t believe this story is going to result in other people staying away from the doctor, too.

Marianne Kirby co-authored, with Kate Harding, the book Lessons from the Fat-o-sphere: Quit Dieting and Declare a Truce with Your Body. She’s an unashamed nerd, with a passion for both Star Trek and the architecture of federal buildings.

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