My Weight Has Always Been My Biggest Problem — It May Have Prevented Me From Knowing If Something’s Actually Wrong
The number on the scale has been the focus of every doctor’s appointment for as long as I can remember. Multiple failed attempts to lower my weight had been frustrating my pediatrician for years. Weight Watchers, hour-long treadmill sessions, cutting out sugar — you name it, I’d tried it. Something had to be wrong with me; why else would I still be fat?
Desperate for an answer to my fatness, my doctor ordered blood work be done as soon as possible. When I was 16 years old, we uncovered that answer: Polycystic Ovary Syndrome (PCOS). The condition, caused by a reproductive hormone imbalance, is notorious for making it difficult to lose weight. At the time, my pediatrician explained that my high blood sugar, low HDL cholesterol, and high LDL cholesterol pointed to insulin resistance, which is common in those with PCOS. She confidently stated that this was just something I would have to deal with; there was nothing else to be done.
I attempted to do research on the condition in order to better understand my diagnosis. Some quick digging told me that PCOS is associated with a myriad of health issues, including ovarian cysts, excess hair growth (known as hirsutism), heavy or irregular menstrual cycles, uncontrollable acne, and infertility. This left me confused; I had none of these symptoms. Sure, I had a hard time shedding fat, but could this be my only problem? Infertility was an unknown, but it didn’t matter to me at 16. Considering myself lucky, I shrugged off my concerns and continued on with my life, my doctor’s words echoing in my head: there was nothing else to be done.
Seven years later, I am still without any glaring symptoms of my seemingly groundbreaking diagnosis. A retroactive look at my pediatrician’s obsession with my weight has me asking myself questions. Had my actual bill of health been suppressed by my doctor’s need to diagnose me with something, anything, in order to explain my fatness? Is there even anything wrong with me? Now, having heard so many people’s stories about their own experiences with anti-fat rhetoric in the medical field, I can’t help but wonder if I have a misdiagnosis on my hands.
While misdiagnoses may seem like the stuff of TV dramas, they’re more common than one might think; more than half of pediatricians surveyed in a 2010 study reported making a diagnostic error at least once or twice per month. Though that may seem low, it isn’t to those who make up those one or two errors. Healthline indicates that in the United States alone, 12 million people are affected by misdiagnoses and medical errors every year.
A misdiagnosis can also be a “missed” diagnosis; an inability to find anything wrong when there may actually be an underlying issue. For people who are overweight, these missed diagnoses are usually due to medical professionals’ anti-fat rhetoric: if something is wrong, it’s because you’re fat.
But where did this anti-fat mindset come from? To find the answer, we must go back to the transatlantic slave trade. In a 2020 episode of the NPR science podcast, Short Wave, Associate Professor of Sociology Dr. Sabrina Strings explained the origins of fatphobia:
“Effectively, what they determined was that, you know, we wanted to be able to have a mechanism for ensuring that we could recognize who was slave and who was free, right? And it was easy in the beginning of the slave trade; it was simply skin color. But as you might imagine…after 200 years of living in close proximity, skin color really no longer works as a mechanism, right? Because now we have all of these people who are…we would consider them today to be biracial. And so what they did was they decided to articulate new aspects of racial identity. And so eating and body size became two of the characteristics that were being used to suggest that these are people who do not deserve freedom.”
With the knowledge that fatphobia is rooted in racism, it’s no surprise that today, women and minorities are 20–30% more likely to be misdiagnosed than their white and male counterparts. An unfortunate but true scenario, many have experienced negative consequences as a result of their doctors’ biases.
Kelly Coffey, now a personal trainer and wellness coach, wrote of her own experience with fatphobia in medicine. Having gone to the gynecologist for answers about her debilitating period cramps, 17-year-old Coffey was stunned when the doctor simply glanced at her 300lb body and told her to just “lose weight.” According to her doctor, losing 100 pounds by any means necessary would be the solution to her nauseating, crippling cramps. Because of the insensitivity and coldness she faced, Coffey avoided going to the doctor for years after. It wasn’t until almost 20 years later that a doctor finally diagnosed her with endometriosis, a painful disorder where tissue typically found inside the uterus also grows on the outside. Decades of pain could have been avoided had Coffey’s gynecologist listened to her cry for help. Instead, the doctor’s bias prevented Coffey from receiving the diagnosis and treatment that she required.
Though disheartening, it isn’t surprising that medical professionals will usually place blame on fatness rather than digging deeper to identify underlying issues. Of 310 medical students surveyed between 2008 and 2011, over half were deemed to have a “significant implicit anti-fat bias”, though many of them were unaware of that bias. The root cause of this bias may be in lack of nutritional education, as United States medical schools average only 20 hours of it across all four years of their medical programs. This absence of proper nutritional knowledge continues to fuel doctors’ anti-fat biases, and it seems this rhetoric is never-ending.
In the years following my diagnosis, I all but forgot about the potential issues I could face later in life. What should have drastically changed my life simply faded into the background. It all came back to me during the third year of my undergraduate studies, when I was tasked with creating a short documentary for my film class. After struggling to formulate an interesting topic, I decided to look inward for a more personal idea. Despite my diagnosis leaving me with little to no symptoms, I decided I would aim to highlight the experiences of those who had felt heavily impacted by their reproductive conditions.
Two friends graciously offered to be interviewed; one discussed her debilitating periods, and the other explained his experience with a varicocele, or enlargement of veins in the scrotum. I was the third interviewee. Though it was rewarding to be able to give my friends a platform, I felt guilty. I’d had no negative experiences with my alleged condition, and it was blatantly obvious in the final cut. While the others openly spoke of long bouts of pain and infertility, I only provided hypotheticals.
I could have cysts on my ovaries.
I could develop diabetes later in life.
I could be infertile.
But up till then? I’d felt nothing.
With proper education on nutrition and a growing urge to move my body, I have successfully lost weight in my early adulthood. My cholesterol and blood sugar levels have gone down with a commitment to eating right and forming better habits. However, my pediatrician’s eagerness to explain my adolescent fatness still irks me. Why did there have to be something wrong to explain my weight?
It’s crucial that we reflect on how we’ve been taught to think about those who carry a bit more weight. Our thin-centric society has instilled in us a fear of looking big. In the eyes of doctors, fat people are sloths with no drive to better themselves. Those in the medical field feel that these patients are a waste of their time, that every problem they face could be resolved by shedding weight. It is obviously not as simple as that. However, with lack of proper nutrition education and no plans to change this, we will continue to see the blatant mistreatment of fat individuals by the ones who are meant to care about their health the most.
I’m still without concrete evidence of the validity of my diagnosis. For years, I’ve undergone repetitive testing at my own request in order to prove once and for all that nothing is actually wrong. I’ve recently gone to an endocrinologist and gotten blood work done under her watchful eye. To put it bluntly, there’s simply no evidence of PCOS. However, because an official diagnosis was made, it can’t be erased from my chart just yet. I’d have to go off birth control for at least half a year in order for my body to reset back to its natural hormone levels. Only then would we be able to definitively tell.
For now, I’m choosing to live like I have for the past seven years: without truly knowing. At least I know there may be an explanation, and that there is, indeed, something that can be done.
