From the Eyes of an Obese Patient

Have you ever wondered what your patient was thinking when you counseled them on diet choices and increasing their exercise regimen? Whether or not they were actually listening or if your words were just flowing out of the other ear. Well we do listen, but we are listening to more than just your recommendations. We hear the judgement behind the concern, the tone at which you give these recommendations and the scare tactics you use to try and make us follow them.

At nine years old, I began realizing I looked different than other kids in my class. I couldn’t run as fast in gym class and it wasn’t because of my asthma, but because I was larger than the average nine year old should be. And since I was nine, I have been lectured about my weight at each doctors visit.

Now you may say well it’s your doctor’s job to care about your health and try to make you the healthiest version of yourself. And to that I agree, but it is not the intention of the question, it’s the additional comments, the judgement and the consequences your question could have. My most recent doctor’s visit started off with the normal vital signs, reason why I am there and quickly turned into “you have gained some weight so I want to get your bloodwork done because you probably have diabetes now.” You may wonder why months later I can still quote my doctor, but in that moment all I could think about was did he really just say that? Is my weight gain that severe that he can make that judgement so quickly? How can he be that blunt when speaking to me, without even knowing if his assumptions are true? I can give my doctor the benefit of the doubt and say he was probably not trying to come off rude, but in that moment his words and tone turned fat-phobic quickly. Now, I shouldn’t lump all health care workers into the same category as my doctor and assume they see my weight as a death sentence as well, but from a patient who has dealt with this line of questioning and fat-phobic language, it’s hard not to.

In the video below, Kelli Jean Drinkwater touches upon the fear that is instilled into many obese people. The fear of looks from strangers on the sidewalk, or the fear that the numbers on the scale will define us in every aspect of our lives. In her talk, she explains how the media and society, our doctors and our own thoughts, can turn our weight into something so debilitating we can no longer live our lives. Bravely enough, she stands on that stage accepting her body for what it is and taking endless amounts of criticism with stride. Kelli isn’t glorifying the idea of being overweight or saying you shouldn’t try to lose weight if thats what you want. Her point is, if it’s not your body then it’s not your place to make judgements or fat-shame. Fat-phobia is real, it’s defeating and it can come in many forms. You may be fat-phobic to someone without even knowing it.

There are many factors that can go into someone becoming overweight, whether socioeconomic, genetics, or psychological. All of these make up the complexity that is obesity and they should all be considered before labeling a patient as lazy or assuming they just let themself go. Did I want to be an overweight child? No. Did I have much of a choice when both of my gene pools are overweight? Probably not. Have I tried endless amounts of diets and fluctuated my weight trying to amuse my doctor and society? Of course. Did my doctor think about my genetics or ask what I have tried in the past to lose weight, or whether I want to lose the weight? No. You may be wondering, did I end up having diabetes or even pre-diabetes. No, in fact my blood pressure runs low, my cholesterol is great and my A1c was 5%.

My point is, if you are a physician, nurse, pharmacist, mother or friend, your words can turn fat-phobic without you knowing it. The way you say them, the context and the reason can be debilitating for someone. Fat-phobia can cause depression, anxiety, body dysmorphia and other severe consequences. Fat-phobic language, tone and shame has no place in healthcare, but empathy, compassion and encouragement do.

In 24 days I will have a Doctorate of Pharmacy and for the last 15+ years I have been considered an obese patient, and even though these may seem unconnected, I have felt like a fraud to my profession for continuing to be overweight while preaching about bettering one’s health. Working in a community pharmacy, I am expected to counsel patients on lifestyle changes like diet and exercise while dispensing their new ACE-Inhibitor, but I question will they take my advice? Will they look at me and think I should take my own advice because for decades society and the media has glorified a skinny body? As I look forward to being on the frontlines of the healthcare field, I can’t help but wonder if my weight will effect the impact I have on patients. What I do know is my weight has impacted my goals and the intentions I have for my future with patients. I have learned to take the criticism I have felt from doctors and turn it into empathy. Empathy is not weakness, especially in healthcare. It’s a valuable trait to have and patients crave it when it comes to bad news or counseling sessions. Whether you have 5 minutes or 50 minutes with a patient, there shouldn’t be any room for criticism or shame.

I leave you with the words of Ellen Degeneres, be kind to one another.

Best,

Frances Nixon-Simon