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Dear Virgie,

I don’t have very good health insurance, so I am stuck with the doctors they assign me, who pretty much all fat-shame and encourage weight loss. Do you have any advice for emotionally and practically dealing with fat-shaming doctors?

Girl,

Fatphobic medical care providers are probably my absolute #1 rage-inducer.

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Can I just say that when it comes to fat patient care, medical care is atrocious – and at times barbaric?! There is a growing group of individuals who are advocating for humane healthcare for fat patients but it’s taking time. I went to the Rebellious Nursing Conference in Philly in 2013, and before I went I asked fat people to fill out a survey about their medical care experiences. I got over 60 responses that detailed some of the most awful things you can imagine that had been done at the hands of doctors. I was so angry after reading them that I was shaking.

I grew up with a doctor who encouraged me to lose weight by telling me that I could date his sons if I did. Hellooo, sexism. Then when I was in grad school and was going to the university clinic to get care, I went in for literally ANYthing and my doctor (a very, very thin woman) would turn it into something about my fatness and order unnecessary tests for me. I remember the first time I went in and she asked me “how long have you had a problem with your weight?” I said “well I’ve been fat all my life, but I haven’t had a problem with it for about 2 years.” She ended up wasting a bunch more of my time but I set her straight every time she tried to pull that fatphobic shit.

[RELATED POST: Ultimate Guide to Understanding Fat Phobia]

In short: I commiserate, this problem affects a lot of people, and you have the right to advocate for yourself.

So here’s my advice

1. Don’t panic
Even if you’ve already had experiences with your doctor that lead you to believe they are an irredeemable fat shaming jerk, fear not! Even if you can’t change their mind you CAN change the way they treat you. Yes, it’s going to take work and that sucks but think of this situation as temporary.

2. Recognize the bias & remember doctors are just people (not the Baby Jeez)

Doctors exist in a professional environment saturated with bias. I know medical practitioners and other people who work with SCIENCE think they are just purveyors of “objective truth” sent from on high, but about 200 years of medical history would say differently. One example of bias: the idea that weight loss (by any means necessary) is more important than any other outcome, including mental health which we could be promoting by adopting a no-shame philosophy around bodies. Sometimes when we recognize that the doctor just has a different bias than we do it helps to empower us to advocate for ourselves.

3. Have THE TALK
“The Talk” doesn’t have to be long or formal. You can use the few minutes when they do the intake to tell them that you are not interested in discussing weight loss during this and future visits. You can also politely – and assertively – remind practitioners that you don’t have to do anything you don’t want to do and that you expect your boundaries to be respected. If you don’t feel comfortable verbalizing this, then you can print out the Health At Every Size Manifesto and/or this letter to healthcare providers and hand it to your doctor.

I also have a little script I just made for you, girl:

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“I’m here today to discuss ______________. Before we start, I wanted to tell you that it’s really important to me to feel that I have a say in the medical care I receive. I want to do my best to ask for the medical care I need, and I can’t do that if I feel pressured to lose weight. So, I am not interested in pursuing or discussing weight loss. Can we agree on this?”

And if your doctor says no, then ask them what they need to proceed, but make sure not to budge on the non-negotiable: that you aren’t interested in pursuing or discussing weight loss or being made to feel ashamed of your body size.

4. Repeat THE TALK & remember it’s OK to hold the line
Have the talk as many times as you need to. When they say or do something fatphobic, just remind them that you don’t play that game.

5. Remember you can always reschedule an appointment

There are instances when medical care is urgent, but in the instances when it’s not then sometimes you just need to reschedule. I have requested to reschedule appointments because I felt emotionally overwraught (by fat shaming or callous care). It not only acts as a self-care tool for you, it conveys the message that you are serious about your boundaries and you won’t take fat shaming.

Finally, please please don’t let this BS stop you from getting the medical care you need. You are TOTALLY worth fighting for.

xo,

Virgie

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Dear Virgie is a weekly advice column by Virgie Tovar, MA, author, activist and one of the nation’s leading experts and lecturers on fat discrimination and body image. She is the editor of Hot & Heavy: Fierce Fat Girls on Life, Love and Fashion (Seal Press, November 2012) and the mastermind behind #LoseHateNotWeight. She holds a Master’s degree in Human Sexuality with a focus on the intersections of body size, race and gender. Virgie has been featured by the New York Times, MTV, Al Jazeera, the San Francisco Chronicle, NPR, Huffington Post, Cosmopolitan Magazine Online, and Bust Magazine. Find her at www.virgietovar.com

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