My husband said something that ticked me off this morning, and it is all your fault.
We were talking about how he’s made an appointment for a checkup because he’s out of refills on his diabetes meds and needs a new prescription, and he mentioned in passing that he was nervous about going to see his doctor because he “didn’t want to get scolded”. And I agreed with him, because I completely understand that–I haven’t seen a doctor in three years, because I didn’t have medical insurance until very recently and because I was not about to pay y’all’s ludicrous rates just for the opportunity to get lectured about my weight. And it took a second for the emotional response to set in, but now it’s here, with a vengeance.
Here’s the thing: I don’t know a blessed thing about medical law. Maybe there’s something in there that has led you all to believe that in order to protect yourselves from lawsuits (we’ll discuss my opinions on our sue-happy society some other time), you have to make a point of telling overweight patients just exactly how bad their life must be, y’know, on account of all that being fat and being at ZOMG INCREDIBLY HIGH RISK for all these ZOMG SO HORRIBLE DISEASES and how they are ZOMG ABSOLUTELY GOING TO DIE DIE DIE PROBABLY NEXT WEEK unless they change their lifestyle RIGHT THIS MINUTE NO I MEAN RIGHT NOW LIKE DROP AND GIVE ME TWENTY RIGHT THIS SECOND.
Maybe you’re just trying to cover all your bases.
Maybe you’re trying to drum up business for your pals in the bariatric surgery department.
Maybe you just think you’re being honest, in a “sometimes the truth hurts a little bit but it must be told nonetheless” sort of way.
Look, I understand the concept of the Least Common Denominator. I understand that you probably deal with patients every day who actually don’t realize that being overweight can cause complications health-wise, and so you’ve just gotten used to assuming that every overweight patient needs to hear the lecture as a result.
I’m here to tell you that that’s not the case. Some of us are actually quite intelligent, and have done a lot of reading on our own; some of us get all our information from The Biggest Loser, which is of questionable authority but means that we have, in fact, already heard the litany of Weight-Related Problems That Kill Fat People; and some of us have heard it before, over and over, from every doctor we’ve ever seen, and are frankly sick to death of hearing it. We are sick of the part where you roll your chair right up close to us (or stand and look down at us), we are sick of the part where you lean in confidentially (or cross your arms across your chest and look stern), and we are sick of the part where you lower your voice (or sigh heavily) and start in on how we absolutely cannot continue doing these terrible things to ourselves because it is just all so very, very bad.
Lemme tell you a little story: Once upon a time I went to the doctor because I had an issue that needed medical attention. He examined me, made a diagnosis, prescribed treatment, and then gave me a ten-minute dressing-down about weight and exercise and nutrition and the boatload of problems I would almost definitely experience as a result of being overweight, ending with a very strongly worded suggestion that I get myself to a nutritionist immediately. The issue that led me to go see him in the first place that day? I had broken my finger.
So I dunno, maybe you can start including a little check box on the intake form, something that says “I am already aware of the risks of my weight and do not need your condescending lecture”?
Or here’s a better plan: maybe you just stop fat-shaming us. Maybe you stop trying to use fear tactics on us. Maybe you try approaching all your patients with equal courtesy, dignity, and respect. Maybe you drop the condescending tone, maybe you drop the judgement, and maybe you try asking us if we want your “Top 200 Reasons Fat Is Bad” routine instead of just assuming we need it.
Part of the problem, see, is that I’m a Very Nice Person(TM). The other part is that I come with a history that includes a certain amount of abuse. I believe in letting people speak their peace, because it is a polite thing to do; and I spent a lot of time being trained to believe that if you are being yelled at and you do anything other than stand there and take it, you get hit. Yes, I understand that I am a paying customer and therefore I theoretically have the right to speak up when something is not ok; and yes, I understand that the doctor is probably not going to beat me if I dare to defy him; but on behalf of all of us who carry this particular baggage, maybe you, dear doctor, could meet us halfway and agree to at least be aware that triggers exist, and that by lecturing us, you might be stomping on some of them.
Here’s the bottom line: it is just ridiculous that Moon Man, many of my friends, a lot of my family, and I should all be nervous about going to see you because we are afraid you are going to yell at us. We know that you can perform your job best if we don’t go out of our way to make it harder on you by damaging our bodies. We know that carrying excess weight is risky, and we know it can cause complications.
Now what we need you to know is that a lot of us are depression eaters and comfort eaters, so when you freak us all the way out by being rude, you are pretty much guaranteeing that we’ll be halfway through a pint of Ben & Jerry’s before we even realize what we’re doing. And that doesn’t help either of us, now does it?
So stop it. Stop being cruel, stop being patronizing, stop using fear and shame as tactics. We don’t need you to be our BFFs, but we also don’t need you to be a source of stress and anxiety. We’re tired of crying every time we come home from visiting you–and as you may have pieced together by now, a lot of us solve that by just never coming to visit or by self-medicating with the very addiction that got us into this obese boat in the first place. And I can’t imagine that’s what you want.
P.S.–This is one of the best quotes I’ve ever seen on the topic. Maybe print it off, laminate it, and put it in your wallet, and recite it to yourself before every patient.