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One of the most common questions I’m asked as a blogger who posts resources for fat people is this: “How do I find a fat-friendly doctor?”
Let’s just think about that for a second: a “fat-friendly” doctor. This implies that the doctor won’t just be kind to me as a fat person, but that they’ll also approach my health free of hidden fatphobic agendas. That should be the default, shouldn’t it?
Unfortunately, it’s not.
Advocating for yourself at the doctor as a fat person isn’t easy.
A lot of us fat people can’t trust our current doctors to see us as anything but a statistic – a problem to be solved. And it can be scary trying to find a new doctor. A lot of fat people, including myself, avoid seeking treatment at all because the anti-fat medical bias we face can actually be traumatizing.
Fat people risk misdiagnosis, disrespect, oversight, shame, unnecessary and harmful side effects of medication, and in some cases even death, when trusting our doctors completely. A lot of us simply – and fairly – don’t want to risk that.
With something as intimate as our health, we should be able to trust those trained to treat us. So what do we do in order to get our needs met? We go above and beyond – and take matters into our own hands when seeking treatment.
But if you’ve never done this before, it can be hard to know where to start.
So here are some tips on advocating for yourself at the doctor, in hopes of making that a little bit easier.
Do your preliminary research
My first suggestion is to look into Health at Every Size (HAES) – which is a framework for medical care trademarked by the Association of Size Diversity and Health. The core principles of HAES are weight inclusivity, health enhancement, respectful care, eating for well-being, and life enhancing movement. This approach aims to challenge medical professions to treat individuals as just that – individuals.
This is an approach that many medical professionals are aware of or can easily find information on.
While HAES isn’t the catchall to solve it all, I believe it does a great job of bridging the gap between patient and doctor in a way that puts power back into the patient’s hands and encourages medical professionals to approach health in a more holistic way.
Linda Bacon, PhD, a researcher and advocate of the body positivity movement, wrote a book called Health at Every Size: The Surprising Truth About Your Weight, which might be a helpful resource for understanding your relationship to your body and how to communicate your experiences to your doctor. Sometimes it takes speaking the language of notable and reputable sources to get through to people that we want to teach how to be our allies.
EDIT: Linda Bacon was kind enough to reach out and add, “the appendix contains letters you can share with health professionals, which provide guidelines for providing sensitive care. [The book] also includes general educational letters. The entire appendix is available by free download here.”
You can even bring in a fact sheet (like this one) or other sources with you to your first appointment!
Ask around… and around
If you’re lucky enough to have a fellow fat friend that you trust, ask them about their healthcare experience. The best way to get in with a doctor you can trust is from word of mouth via someone who has similar values as you do. It can also help you know which professionals to avoid.
Of course, not everyone has the pleasure of having close friends who are marginalized in the same ways that they are. But that doesn’t mean you can’t harness the power of referrals.
Networking is one of the greatest benefits of living in the age of the Internet. Ask online – whether on a forum or through your social media accounts!
For example, I’ve really come to be quite fond of joining Facebook groups that align with my interests, needs, and values. Check out the “Caring For Our Fat Bodies” Facebook group: a diet- and weight-loss-free safe space for fat people to ask questions, share resources, and be vulnerable.
You’ll be surprised at how many safe spaces you can find in groups online that aim to share these resources. This worked out especially well for me when I turned to the Internet to find a “fat-friendly” doctor in my area. I simply put it out there that I was taking recommendations and I’d be thankful to anyone who was willing to share their experience. I noticed a few people recommending the same practice in my city, and I made an appointment!
The best way to get in with a good medical professional and minimize trauma is to get that referral – and there are plenty of people out there who are open to helping you.
Look into the accessibility of the facility
Another issue I’ve come up against in my life as a fat person seeking medical care is accessibility of the facility – or, more accurately, the lack thereof. Oftentimes, I worry about the weight capacity of machines, especially if they look outdated. Giving a urine sample is, physically, a nightmare. Hell, even just sitting in the waiting room feels scary when they clearly didn’t have bodies like mine in mind when choosing seating options.
When you go in for your first appointment, remember that you’re scoping out the venue to see if it suits your needs – and you’re allowed to expect it to do that.
Here are some questions to ask yourself:
- How is the seating in the waiting room? Do they have options of chairs without arms and wide seats?
- Are the examination rooms large enough to be comfortable to move around in?
- Do they have alternate medical devices on hand to use if their current models aren’t accessible to you? (For example, traditional blood pressure cuffs tend not to fit around my meaty biceps, but many facilities have extra long ones on site.)
- Are there fatphobic posters on the walls or pamphlets in the waiting area? The literature available often reflects the values of the site.
I want to recognize that being able to do this, to have choice in the facility you use for your medical care, is a privilege. Not everyone has insurance that allows them the freedom to treat doctors’ offices in this way. Often, low-income health insurance allows for one option for medical, dental, and therapeutic treatment, especially in impoverished areas.
If you have this privilege, use it as a power to get your needs met. If you don’t, hang in there. Check out databases like this one where you can search for low-cost/sliding scale health care clinics in your area.
Speak with your doctor
Having conversations about your body with a medical professional can be hard. And scary! When you’ve experienced anti-fat bias in the medical world, it can feel like setting yourself up for trauma just making an appointment. We have to build ourselves up over and over again after each encounter.
This isn’t how we’re supposed to feel when seeking treatment.
You deserve the treatment that is best for you. Remember that your doctor, for all intents and purposes, is working for you. Think of this appointment as an interview where you hold the hiring power.
Be clear. Confident. Bring in notes or a list of what you’d like to go over, especially if you’re prone to forgetting what you want to say when you’re nervous. Ask, “Are you familiar with Health at Every Size?” Whip out your literature to show them you came prepared – and describe the kind of care you’re looking for. Ask them if their values align with that kind of approach.
In addition, ask them to note certain accessibility concerns you have for them to keep on file for you. For example, it is personally very difficult for me to provide a urine sample. Holding the cup between my legs is nearly impossible because of my belly. I found out recently that they can offer a “hat” to anyone who needs a way to provide a urine sample without having to hold the cup underneath them. The hat is a plastic bowl with long edges and you just place it under the toilet seat, put the seat down, and it catches everything you need. Hands free. I have no idea why this hat isn’t the default. It’s so much easier! And cleaner.
Ask doctors to note this in your file to avoid feeling uncomfortable having to ask again if a nurse or substitute doctor is in and doesn’t know to ask if you need one.
And if you find yourself in a situation where the doctor you’re seeing is treating your fatness instead of your medical concern, ask them this question: How would you treat this medical concern if you were speaking with a thin patient?
I want to make this very clear: It should not be our responsibility as fat people to teach medical professionals how to treat us like people. The onus should not be on us to demand respect and proper care. That is the doctor’s responsibility.
However, if you’re like me and have needs that only a physician can fill, and you’re tired of waiting for the right doctor or avoiding medical care altogether, why not do so with an arsenal of resources to make the experience go as smoothly as possible?
Your health is yours. And your doctors work for you. You should get to be in charge of your healthcare.