White Coat Syndrome, or why Fat Folks hate the Doctor

In my sophomore year of high school, I came down with mono.  My parents weren't sure it was mono at first, thinking I was being a usual lazy oversleeping teenager.  So my Mom took me to the pediatrician.  During the exam, the nurse decided to talk to me about my weight, even giving me a slip of paper with the title of Covert Bailey's bestseller "Fit or Fat?" for me to read.  I was in there for swollen glands, swollen spleen, stemming from a virus, and here I was being lectured about my weight.

This was the first, but not the last, of many, many encounters of inappropriate conversations about my weight challenges by the medical profession. I hadn't thought about that situation until just now, when I was trying to remember the first time I was fat-shamed in an doctor's office.

I want to make sure I'm clear on how I feel about this issue, as I am sure that this will raise a lot of discussion and arguments.  Yes, you should talk with a doctor about your weight, if you feel it is a problem for you.  Yes, your doctor should be able to bring it up as a medical concern as your primary care physician.  However, I feel there is a time and a place for this, and currently that is not happening.  Because of this, way too many of my chubby kin avoid whitecoats, and are letting other major health issues get the best of them.

One day in the fall of the late 90's, I woke up not feeling right.  I made it into work, not realizing I couldn't talk until I opened my mouth to say good morning to my boss.  What came out was something that sounded like Muppets underwater.  I had to have a coworker call and make an appointment for me with my primary care physician.  When I got to the office, the first thing they did?  Put me on the scale.  I ended up having life-threatening tonsilitis (I had tonsils that would swell to the point they almost blocked my airways).  Instead, I got the "lose weight" lecture from a nurse until the doctor saw me and realized my situation.

I avoided doctors and getting physicals for the majority of my 20s.  I didn't want to hear the lecture about my obesity.  I knew I was fat, and I knew I was at risk for other health conditions because of it.   Knowing that every other health concern I had would be overlooked because of my fat left me using CVS for my ailments.

In my 30s, I got more confident in my size and rights as a patient, if I wasn't in the office for a physical exam, I would refuse to get on the scale.  I did get some confrontation, but I was insistent that my weight did _not_ have anything to do with my fever of 103.

I had some gynecological issues in my early 30s.  I went to a Gynecologist who treated me with condescension and disbelief of my issues.  Whenever I called to discuss my problems, he would threaten me with putting me on birth control to stop getting my period, like a cancer patient, is that what I wanted?  I finally snapped at him, telling him no, I'd like him to treat me like a human being with things I know aren't normal for my body.   He did a uterine biopsy on me a)without warning me or b)giving me any pain relief.  I am not sure this was weight-related treatment, but it was his attitude that led me to one of the worst exams I've ever had.

After this horrid experience, I decided to go with a new GYN that a friend recommended.  This friend was also on the plus-size side, so I figured she would be a safe bet as doctor's go.  After getting the usual pre-checkup stuff done, the doctor walked in, and with barely and introduction, launched into telling me I needed weight loss surgery.  I was floored.  She told me that at my height, I should be somewhere around 110 pounds, and seeing that I was nowhere near that, surgery was my only option.  When I told her that i had never dieted or had a regular exercise regime, and I'd like to try that route first,  she told me flat out, "I don't think that would ever work for you."  She then proceeded to give me an internal exam that to this day...I felt violated by, with her rudeness and coldness.  She then told me that my issues would only be solved with scarring procedures, or a hysterectomy. Either way, children would never be in my future.

After I spent a day balled up on the couch bawling my eyes out, the next day, I got up, and I worked out.  I got a nutritionist who taught me about portion control and healthy eating.  In about a year and a half's time, I lost about 50 pounds.  More importantly, I got HEALTHY. 

When I was pregnant with my first child (something the evil gyno said would NEVER happen...HA!), I was worried about going to the OB and getting the "talk."  I knew that there were different guidelines for obese pregnant women.  However, I never was scolded or lectured to during the pregnancy.  The OB knew I was doing prenatal yoga and walking when I could, and she said "different studies come out all the time about how much you should gain.  As long as you're doing fine, I'm not worried."  I gained the average weight for a pregnancy, and had a healthy baby girl.


This OB became the total OPPOSITE with my second pregnancy.  As I wrote about in this CC entry,  she was relentess in harassing me about my weight.  Even though I was lighter and healthier in this pregnancy.  She didn't care.  She was dismissive, and wouldn't believe me when I assured her I was making healthy choices.  Again, I had a healthy baby boy, no thanks to the stress she added to my pregnancy.

Now here I am today.  A month ago, I had my first physical in about four years (pregnancies, not fear, kept me from them).  I got on the scale, saw the number.  As the doc looked at my charts online, I saw the words MORBIDLY OBESE screaming from the monitor.  She asked me about my overall health, my activity, my lifestyle.  I kept waiting for the lecture, it never came.  At the end of the exam, as she as leaving, I said to her, "Doctor, I just want to thank you for not bringing up or lecturing me about my weight.  I know that it is a concern and that I am working on it, and I was prepared to tell you all that.  Thank you for treating me like a human being."  She came back over to me, put her hand on my arm and said, "You told me all that you're doing for your health.  Why am I going to lecture you on stuff you already have a handle on.  You are in great health for your age, and you are raising two little ones that are your first priority.  You're doing what you can, and that's all I can ask of my patients. "  I would be lying if I didnt say that I cried with joy on the way home.

That's right.  I cried because a doctor treated me the way we should be expected to be treated by another human being, even more so by those who want to help us stay healthy and current customers; with respect.


I'm writing this entry because recently a friend asked for doctor recommendations on FB, and I knew, through the unwritten understanding between people of size, to make sure when I made recommendations, to state they were size-friendly.  I shouldn't have to DO THAT.  We should have the expectation that people who in a profession that deals with all walks of life, should have tact.

Instead, I read articles like this one.  I read articles where doctors don't want to treat overweight patients because it raises their insurance rates.  Or I read blogs and horror stories of how overweight people aren't treated for medical issues because doctors can't look past the fat.

As I mentioned.  There is a time and a place to have the weight discussion.  Doctors need to be trained better on how to handle that.  Stop treating patients like children.  As patients, we need to be more assertive, and stand up for ourselves.  They're our bodies, no one else is going to care about it more than you!