I am a “good fatty” in the sense that I haven’t engaged in long-term unrestricted eating in many years and I make an attempt at an exercise regimen. I am a “bad fatty” in that I occasionally take breaks from my restricted eating plans, don’t engage in physical activity on a consistent basis, and am unapologetic about the fact that health can be attained even by those dubbed overweight or obese based on the BMI.
The cruelty regarding my weight started when I was very young and only got worse as I got older. It seemed to me that social interactions were all opportunities for people to be mean to me about something I didn’t know how to manage or control. Before I had learned to count high enough to track my caloric intake, I was certain that, by merely existing in my body, I was asking for poor treatment.
Others’ reminders that I was fat did me no favors not only socially, but also medically. Although I do appreciate the data about the harms of fat stigma — it’s a metaphorical glove by which I can more aristocratically slap the anecdote police — my health history bears witness to how anti-fat stigma can lead to adverse health outcomes.
I knew other women and girls who thought they were fat. Others would tell them that as long as their doctors said that they were healthy, they shouldn’t care. I, on the other hand, was medically overweight, and later, obese. To make matters worse, the ways in which my doctors handled the matter were not quite as professional as you’d imagine. For example, when I was twelve, my doctor pointed out that she, a mother of three who was two inches taller and two decades older than me, weighed twenty pounds less than I did. I needed to get my BMI in order, she chided, while I was still young.
To my relief, moving away from the area a few months later meant that I could I stop seeing Dr. Smug Comparison. To my chagrin, I was to find that other doctors weren’t much better. Even if the doctor didn’t shame me using herself as a counter-example, doctor’s visits were a minefield. I would have to be weighed by a nurse who wouldn’t announce my weight aloud as she did with the other patients my age, then led to a room where the entire conversation would be about my fat body while I shivered in a thin paper gown. As you might expect, incredible amounts of anxiety built up in me in the days leading up to any doctor’s visits.
During one such visit when I was fourteen, I produced a rather high blood pressure reading. Assuming that I must be gulping down copious quantities of unhealthy food, my doctor told me to eat less food, especially the salty kind. If I didn’t shape up, she warned, she’d have to put me on blood pressure medication. That my period had stopped around that time allegedly corroborated that my fat was out of control. I spent a lot of time freaking out about it, obsessively exercising and monitoring my food intake.
A few months after that doctor’s visit, I stayed in London for a month. After I returned home, I got my first period in eight months and my follow-up visit yielded a normal blood pressure reading. My doctor briefly praised what she assumed had happened — that I’d lowered my salt intake — before issuing an even-more-frantic version of her usual “lose weight” refrain. This was because, hilariously, I had stopped fretting so much about my body during my trip thanks to the intervention of a sympathetic cousin — and had actually gained weight eating saltier foods than my usual. I found out later that though amenorrhea and high blood pressure can be associated with being overweight, they’re also associated with stress.
More frighteningly, when I was fifteen, anti-fat bias nearly impeded a correct diagnosis for the issue with my right knee. My doctor claimed it must be a minor sprain upon which my overweight body was putting too much pressure. My insistence that I could definitely feel something moving inside my knee led to her reluctantly order a CAT scan. The resulting images clearly depicted symptoms of synovial osteochondromatosis, a rare chronic disease of the cartilage.
This story has a happy ending because I no longer believe doctors to be unquestionable authorities on all things. As an adult, I’ve managed to find excellent doctors, caring medical professionals who I consider part of my team rather than stern figures unhelpfully lecturing me. Sadly, too many others’ stories have quite a different outcome. There are plenty of fat people who avoid going to the doctor to avoid shaming — and the ones who do go can be misdiagnosed and underdiagnosed. I’m sure most doctors mean well and I doubt that there was an intention to harm feelings and health outcomes in the case of even Dr. Smug Comparison. If we actually want fat people to become healthier, though, we need to consider the fact that doctors are people and don’t always behave in the best interests of their patients’ health.