I know a lot of fat folk HATE going to the doctor because they are afraid of being yelled at or getting the diet talk; but putting off going to the doctor doesn’t keep you healthy or make you well if you are ill so ….
First off, remember — you are paying the doctor. The doctor is working for you. If you don’t like the way your doctor treats you, find another one. Immediately. And let your doctor know exactly why you are leaving his or her care.
Finding a doctor can be difficult. I think the best method is to be totally upfront either before you walk into the office or at your first meeting with the doctor. Kaiser Permanente has a great service in that when you are looking for a new primary, you can look at the bios of the doctors who are taking patients – which includes specialties and their hobbies. I avoid the obesity specialists – I don’t want to deal with someone who has already made the decision (and based their career on) me being fat creates a medical condition. It may not be fair or open-minded, but I avoid the marathon runners and ultra-athletic folks too. If I was more into exercise (which I admit I’m not – I know it’s important, but I have trouble making time in my own schedule and don’t make it a priority most of the time), I would probably reconsider this. I am looking for a healthcare professional who has a mindset most like my own.
Some folks do a telephone interview before making their first appointment and discuss their concerns with their new doctor, or they come in with something in writing addressing their concerns about weight bias. If your doctor is reasonable, he or she should not have any problem with this, and some doctors are very interested in learning about fat acceptance and HAES.
I don’t have an issue with the weigh in. For the most part I don’t weigh myself at home, and I think it is important to track unexplained weight loss and gain.
I do request an extra large blood pressure cuff. I tell them that the smaller cuff breaks blood vessels in my fat arm (which it does). If they don’t have one that fits, I request that they take the blood pressure lower on my arm and if they aren’t willing to do that, then I ask them to do it the old fashioned way instead of using the machine. They don’t have the right to hurt me; and so far, I’ve never run into anyone who feels otherwise.
I own my own gown (AmpleStuff.com), which is a godsend when I have a mammogram or something that requires me to wander around. It just saves me the stress and the hassle. Should they have gowns that fit everyone? Of course. If you don’t want to buy your own gown and they can’t provide you with one, complain. Verbally or in writing – in writing, especially if you are dealing with a large HMO. I have found they are pretty responsive. Some of the departments at Kaiser did not have armless chairs. I wrote and complained, and I got a great response thanking me – they admitted they had never even thought of the issue and since they were already planning on redecorating this was something they would keep in mind. And I seldom find places in “my” Kaiser that lacks armless seating now.
If your doctor wants to talk diets, explain your position to them – if you don’t feel sure of yourself, bring a friend to be your advocate or again, bring something in writing (I’m hoping to get some kind of brochure together for this purpose at some point that you’ll be able to print out and take with you). Tell the doctor the statistics of dieting (95%+ failure rate), the results of dieting (you become fatter), and if they bring up WLS, provide the stats for that (basically the same failure rate as diets over a 5 year period plus dangerous). If your doctor is reasonable, he or she will listen to you and act according to your desires. If not, find a new doctor.
Another biggie – ask your doctor why. Find out why they want this or that test, why they are prescribing this or that medication. I have found asking why puts many healthcare professionals on alert – they realize that they are dealing with someone who does not just take their word that this is for your own good. You have a (legal) right to understand your own treatment, exercise that right!
We have all heard the horror stories about doctors refusing to give treatment for a current condition or blaming everything on the patient’s weight. Another good time to ask “why”. And a good time to ask what the doctor would suggest for an average sized patient and why wouldn’t they treat you the same.
The doctor is working for you! One way or another, you are paying his or her salary. You deserve to be treated with respect. It may not be easy, but the best thing you can do is complain. Don’t let them think they are getting away with their snide comments or poor treatment. This is a person you are entrusting your health/life to; if they are unable to get past their personal bias and prejudice, how can you trust them to treat you appropriately from a medical perspective.
Take care, be good to yourself and be well.