Thursday, January 11, 2007

If Fat Women Die Young . . . .

On my on-line support group, we are discussing women who don't go to the doctor because it doesn't matter why they are there, they get the weight lecture. Woman after woman has posted about times she didn't get medical help because of this or women she has known who avoided doctors for this reason.

My own experience has been that doctors will lecture me about my weight if I come in for a sty. I remember once, going in to see my doctor about a sore throat, and the nurse automatically walking me to the scale.* I have been weighed because I had flu, insomnia, indigestion, a sinus condition, headaches that turned out to be a need for reading glasses, and a variety of other conditions. I have been told that I need to lose weight by doctors who then advised a number of what I now realize were totally screwball ideas (take Malox before each meal, consume only calorie free herb tea until you are at your target weight, eat only protein, eat no protein, take these pills, take those pills, eat only fresh fruit, stay under 800 calories a day), all of which took weight off before they rebounded and put it all plus some back on again. Eventually, I said to hell with it, and stopped dieting and stopped discussing it with doctors and have become very good at giving a new medical practitioner the raised eyebrow and "my weight isn't up for discussion until you can prove to me that you have a method of taking it off that reliably, 100% of the time, does not lead to rebound. A method, in other words, where you don't have to decide that the reason everyone who tries it ends up fatter is because they are weak willed, because no one who tries it regains any of the lost weight."

But, I know from experience, that unless you are as outspoken as I am, if your BMI is higher than the AMA has decreed, you will get the lecture. And you don't have to be my size to get it -- you can be a size 12. Hell, I've heard of women who were size 8 being told they should be size 4 and getting the lecture.

When you know that this unpleasant reminder that you are a failure of a weak willed slob of a woman is going to greet you, why would you ever seek out medical care when you aren't almost dying? And how many women suffer needlessly because they aren't getting the medical care that they need? How many of them are dying early because they didn't catch the cancer when it was manageable or they just got sicker and sicker until it was too late?

*This was early in my life as a non-dieter, and I had explained at my previous visit that I wasn't interested in what the scale said, I didn't own one any longer, I could see in the mirror and by the size (not the number, the amount of fabric involved) of my clothing that I was not a slender woman. This time, instead of standing on the scale and closing my eyes, I asked, "and how does my weight effect my sore throat?" I have to say, I have a wonderful doctor and she has a wonderful assistant, because I am only taken to the scale once a year, for my annual physical, and I am never told what the number is, if it has gone up or down, or scolded because of it.

10 comments:

joared said...

I guess I have a different perspective than yours. I'm carrying around more pounds than I should. My doctor's automatic procedure is to have his nurse take "the vitals" which includes automatically weighing every patient each time they visit his office with the figures then recorded in the person's medical chart -- just like temperature, blood pressure -- whatever the ailment, and, of course, especially for the annual physical. If the Dr. did any less, I'd say you didn't have a very good doctor.

Monitoring any changes in an individual's weight, whether they're underweight, average weight, overweight, or anywhere in between, provides a doctor, medical personnel in other settings, important information, including taking note if there is any change in weight status. If there is, it then becomes important to find out why -- is the person making an effort to gain weight, or to take off weight and what and how are they doing this? Gathering this information becomes even more important for our benefit as we age.

Yeah I hear the weight lecture with discussion about possible solutions, but I look at it as his professional obligation to bring to my attention anything impinging on my health status, which is what I pay him to do. If he brings up subjects I don't want to hear about, I'm not going to kill the messenger. The choice about how I deal with his message is mine. ;-)

Maya's Granny said...

Joared,
I know I weigh more than the doctor wants me to. I weigh more than I want me to. I also know that 98% of diets result in regain of up to 20% more than you lost and if you have had that happen on more than two diets, it will always happen. I've been on over 35 diets and it always happened. Medical science has nothing to offer me that won't make me fatter and I'm already as fat as I want to be. Much of this weight was gained as a result of doing what some doctor told me to do. So, I get weighed (and don't look at or get told the number) when I have my annual physical so that if there is something untoward going on my doctor will know it. But, I'm not getting weighed when I have a cold. Since I've been wearing the same size for over six years, I think my weight is pretty stable.
Since diets make people fatter and weight loss surgery also makes people eventually fatter (your body doesn't care how you lost it, it learns to get it back on because bodies are built to survive famines, not to get unnaturally slender), the doctor has nothing to offer me that won't make the situation worse. So, I don't want to get a lecture on how I need to do something that won't work. I've told my doctor that I'm willing to listen to information about something that will work, and she has told me that there isn't anything.
Being told I'm too fat is like being told I'm too short -- except that they don't offer you a cure for short that makes you shorter.
The choice I've made about how I deal with the message is that I don't want a lecture about something I can only make worse.

J said...

I hate being weighed at my physical. I always feel like they're judging me, even though, 80% of the time, I weigh less than the person weighing me. I feel like they're thinking I should weigh less. I can't imagine how much worse it would be if I got the lecture on top of it all.

Anvilcloud said...

In my adult life I have always weighed quite a bit more than I should. Three years ago, I lost a fair amount of that on the Dr Phil plan, which he says isn't a diet. After moving, I lost focus and have put too much of it back on, but I'm still NOT as heavy as I was 3 years ago, so it's not exactly a yo-yo diet, and I seemed to have regained my focus. I just picked up YOU, On a Diet yesterday and have read the first chapter. It's not that I need a new plan, but I might get a bit of new information and a bit of new motivation, and I really respect the authors from having seen them on TV. The first chapter addresses a lot of the things that you mention, and they prefer you not to weigh; a better indication is the tape measure. Anyway, about your main point about getting lectures: it seems sexist as I don't get them. What my new doctor did ask at my checkup was, "Have you put on a bit of weight this year?" That seems like a fair question.

kenju said...

I don't mind being weighed at each doctor visit; I just don't want to be lectured because of my weight. For years and years I was too thin, and told often that I must eat more. Now that I do eat and weigh more, I am told I must cut back. Pooh! I was told to stay out of the sun due to the effects of aging and skin cancer. In Nov. I was told to get out in the sun more because I was deficient in Vitamin D. I am tired of all of it, so I suppose I feel like you do MG, even though I know it is in my best interests.

Betty said...

My doctor, his nurse and I have an understanding. I don't do scales. If he can't tell I need to lose weight just by looking at me, he's blind. So, he never makes me get on the scales. And, I keep my appointments. Everybody is happy.

Ally Bean said...

You're the second blogger where I've read about doctors and the fat lecture. You're heavy and the other blogger is quite thin. I'm somewhere in between and I've not once heard this lecture.

I've always heard that "doctors don't to fat." Meaning that a MD will always avoid conversations about weight. And so far that's been my experience.

Joy Des Jardins said...

Boy does this post ring a bell with me J. I hate getting weighed and the possible lecture that follows. I've done just what you've mentioned...stayed away from the doctor's office because of it. I have an appt. this coming Monday for a blood test to get my prescriptions refilled. I just know weighing-in will be part of it. It took me forever to finally make this appt....and, you've explained why beautifully.

Rain said...

I also am over the weight I should be and know it but don't like reminders when I visit the doctor. Unless it's for a physical, I just say I don't want to be weighed. So far, they have never done more than nod okay. I have never had a doctor tell me I should lose weight but it's obvious and I don't kid myself that because they haven't, it means I don't need to. It's unlikely I will so I am trying to emphasize eating healthily (something I certainly don't always do) and walking more to keep bp down (lately I haven't done that enough either).

Star said...

You can refuse any medical procedure, including getting weighed. After losing the same 100 lbs three times, I tossed the scale and just live. I say "pass" when they lead me to the scale. I have had to duke it out or get on the scale backwards before surgery...but I do what I please. I had a doc say recently, "You need to lose weight." I said, "Really?" He said, "Many people don't know they are obese." I said, "I just read that in the paper, too. Probably a writer like me wrote it." He said, "Oh, you're a writer--I can't tell you anything then." No, he can't--I fired him.