Thursday, May 20, 2010

It's because you're fat

I once worked with a woman who said that she had had a headache every day for the last five years. The doctors didn't know what caused it and there was nothing to be done about it. Aspirin or other palliative medicine didn't work, so she had simply learned to put up with it. I felt bad for her, and wondered what sort of mystery could bring on such a condition.

A few years after working with this woman, a woman who was around 50 years old and absolutely average weight, I developed a headache that wouldn't go away for over a month and gave in and went to a doctor. The doctor did a lot of tests including various neurological tests and X-rays. In the end, he could find no cause so what did he tell me? He told me that “sometimes fat ladies have headaches for no reason.” He then advised me to “lose weight” using the “color method” where I should try to eat foods in various colors in small portions every day. He talked to me like I was an idiot who needed some sort of explanation that a child might understand because clearly I was stupid. This would be clear to anyone who saw my body because, you know, “fat = stupid.” It's not like overeating is often related to psychology rather than intellect. No, fat people are too dumb to understand how food and weight have a relationship.

Now, my coworker and I had the same problem, but because she was average and I was fat, my weight caused my headaches when no other cause could be tracked down. Here is reason one why I hate, no, DETEST, doctors. If you are fat and have a health problem, it must be because you are fat and if you lose weight, that will fix the problem. It doesn't matter what the problem is, cold sores, athlete's foot, pimples, etc., it is because you are fat. In the end, I didn't change my eating, even though I wanted to, and the headache finally went away after 6 months.

My experiences with doctors have lead me to believe a good many things about them and none of them are good:

  1. They are lazy and impatient. Doctors will jump to the fastest and simplest conclusion about a patient rather than listen carefully and consider all possibilities. What is the point of years of medical school and training if you're going to jump on the easiest cause without considering other possibilities? I haven't been to a doctor for years now because I don't want to pay someone to tell me I'm sick or in pain because I'm fat and then give me a vague recommendation to “lose weight.”
  2. They believe they are infallible. If your health fails to improve under a doctor's care, the doctor believes it is because you haven't done as he or she has recommended. It's not about the fact that they may have ascribed your illness or problem to the wrong cause (fatness), and given you an ineffective treatment, but because you failed to comply adequately to his or her wishes. Even if you lose weight and are still sick, it won't be enough.
  3. They fail to realize you are “a customer”. The doctor-patient relationship is fascinating from an economic viewpoint. You pay someone to help you get well, and they treat you as if they are doing you a favor by treating you if you are fat. They think it is okay to be patronizing, judgmental, and rude to you even though you pay them. This is like a porter who carries your bags to your hotel room and complains about how heavy they are and expects you to tip him heavily for the privilege.
  4. They are dictatorial and sensitive to having their authority over you disobeyed. Doctors believe they have the right to tell you how to live your life, and get angry and dismissive if you don't follow their dictates to the letter. Even if you do follow their instructions, they will believe you are lying if you don't show the improvement they expect of you. It's always that you're disobedient and a liar, not that they are wrong about the underlying notion that your fat causes every health problem known to man.
I've read again and again that being overweight shortens you life, but I'm beginning to wonder if what we're seeing is a correlation and causation mistake. Yes, being overweight can contribute to certain health problems, but what it also very much relates to is an avoidance of seeking regular medical treatment as well. Fat people don't go to doctors because the doctors zero in only on their fatness (which often can't be fixed, or if it can, not quickly, easily or, more often than not, medically) to the exclusion of all else and are patronizing, rude, or dismissive.

If you don't receive regular medical treatment, you are less likely to get an early warning on diseases like cancer, heart disease, diabetes, etc. You're more likely to seek treatment when it is too late and die earlier. Maybe being overweight doesn't cause you to die at an earlier age. Maybe it causes you to avoid medical treatment such that you are more likely to die of illnesses that thin people receive help for at a much earlier stage and therefore they survive. Fatness may not cause early death so much as the doctors' responses to overweight patients and the emotional damage it causes.

I don't know if my speculation is true, but certainly my aversion to doctors because of my weight could contribute to an early demise from some budding problem which I do not get tested for. I can't say one way or another. I can say that I hate doctors, and I don't think that will change even after I lose more weight and fall into a “normal” range because I can only take being treated like crap by the entire medical profession so many times before I write them all off as arrogant jerks. I'm sure that won't break any doctor's heart. After all, the last thing they want is another fatty patient who won't do what they say.


Anonymous said...

I didn't think anyone could dislike MDs as much as I do (I'm an RN), but it seems I was wrong. The stories I could tell. Ugh.

Another great post!


screaming fatgirl said...

Thanks, Rebecca. I think nurses have it worse than anyone, because they are underpaid, overworked, underappreciated, and have to put up with Doctors all day!

Anonymous said...

I just thought of another example of how fat discrimination (based on stereotypes) hurts all women. I've noticed a tendency to overlook heart disease symptoms when the woman patient is slender. This was brought home to me this week when I heard a family member say, "Even though mom had all the symptoms, they didn't suspect heart disease because she has been thin all her life." ARGH! This poor woman, in her late forties, had been having TIAs for the past year. The thing is, she had been under intense medical care throughout the past few years because of breast cancer treatments. Talk about myopic physicians. Okay, rant over. :)

Thanks for the nice salute to nurses. Many folks would be surprised to know that a lot of us have had it up to HERE with doctors and with the failures of our health crisis system in the U.S.

I'm a big fan of alternative health care approaches because evidence-based practice is so highly skewed by capitalist influences. Okay. Rant officially over.

Your posts are certainly thought provoking. Not your average weight loss blog, thank you very much!


screaming fatgirl said...

Hi, Rebecca, and thank you for the kind words!

I think that I have heard that people are often similarly not checked or monitored sufficiently for diabetes because of the rush to judgment about weight. Thin people think they can't develop diabetes. My uncle (by marriage) had both diabetes and heart problems and he was always very slender. It really has more to do with genetics than age, and it is possible that people who are fat would get sick with the same problems even if they are thing, but doctors just blame their being overweight.

Anonymous said...

Excellent points, dear Girl! It reminds me a little of the feedback received by gays and lesbians when they come out to their (unsupportive) families. They are told that "society is so judgemental", THAT is the reason the family members feel oh, so terrible for the family member who is "afflicted" in this this manner. They miss the point that THEY are a part of the SOCIETY who judges the loved ones. A bit off subject but hopefully you see the parallel I was trying to make.

Anyway, I tried to make this point on a blog where I was a frequent commenter. The topic was Plantar Fasciitis. Many people indicated that weight is a major issue in the "curing" of plantar fasciitis, as well as shoes XY or Z, inserts AB or C, not to mention a variety of truly uncomfortable contraptions that made it virtually impossible (for a person who already sleeps poorly), to get even one hour's good night of sleep. Though I knew it may be shocking suggestions (in an "Emperor's New Clothes" manner), I offered that there might be a possibility that plantar fasciitis simply goes away by itself after a while, REGARDLESS of what one does.

What brought me to this controversial conclusion? The fact that once you suffer from this painful condition, every Tom, Dick and Harry tells you about his own experience with it, or somebody else's. A lot of reading also takes place, in the hope of finding a solution. One theme seemed to be relatively consistent. Dozens of "interventions" were offered as THE ONE that "cured" the plantar fasciitis. It did not matter what the person's weight, activity level, time spent on one's feet, was. Whatever happened to the THE LAST intervention an individual tried, was THE one that worked. I liken this to the lost item that was "in the last place one looked". I'd wonder about somebody who would keep looking for the object, once it was found. Of course it was in "the last place".

Similarly, no matter what one tried for the painful condition of plantar fasciitis, MUST be the intervention that worked. Why would one keep trying other interventions, once the pain stopped? What if we consider, just for a moment, that this condition simply goes away on its own, after a certain period of time. There may simply be a remission and the symptoms subside if the fascia is not torn.

I am not suggesting that it is not a good idea to lose weight, wear shoes with plenty of support, certain inserts, etc. etc. One of the most effective interventions may simply be to stretch the fascia PRIOR to stepping on the floor, upon getting out of bed. Everyone who has suffered from this condition knows that the first few steps are the most excruciatingly painful, until the facia stretches out a bit.
In any event, this off the topic analogy was intended to illustrate that whenever the medical profession, as well as society at large, is uncertain why particular symptoms are experienced by some of us, they point ONLY to the obvious. Weight is such an easy, lazy, obvious scapegoat of an excuse, for this as well as something as ubiquitous as plantar fasciitis.
In my case, EVEN the blogger who indicated she could not exercise AT ALL due to her plantar fasciitis and who was willing to do anything and everything that everyone suggested, was unwilling to consider that perhaps in this one circumstance, her weight was not the only reason she suffered from this painful condition and appeared to be disinterested in the hope that the condition may, possibly, disappear on its own.

screaming fatgirl said...

I think what you experienced with that discussion was the powerful need to feel one is in control of ones body and health. If they accept that such things may simply go away without intervention, then they have no control over the process. Some people find comfort in the idea that there is no cure rather than believing it may eventually disappear without intervention. It confirms that we either have complete control or none at all. Randomness and unfairness are harder to accept.

The truth is that many conditions will get better on their own with no intervention. As someone who suffered from severe chronic back pain, I discovered in my research that the success rate was nearly equal regardless of treatment or a lack thereof. Surgery, massage, medication, injections, or nothing at all yielded about a 33% rate of relief from back pain. Doing nothing was as successful as something something and just about anything (even acupuncture) was as successful as anything else.

With weight, you see this as well. People believe it's no way or one way, not that sometimes one way works for them but not for others or that sometimes one way works for them for awhile and then it ceases to exist. People like concreteness (as well as simplicity).

Thanks for your very interesting comment!