If you’re like me, you’ve never been a big fan of going to the doctor. I’ll admit it—I don’t make the best choices when it comes to my diet. In the last couple of years, my activity level has really dropped. I’ve gained some weight, and I’m not happy about it.
But going to the doctor for guidance on getting healthy and fit isn’t fun. Under those fluorescent lights, I feel like I’m being interrogated about my bad choices. And don’t get me started about stepping on that scale!
As it turns out, I’m not alone. According to a recent review of the research presented at the 125th Annual Convention of the American Psychological Association, fat-shaming at the doctor’s office is real. And medical discrimination based on a person’s size—along with the stereotypes of being overweight—takes a toll on both physical and mental health.
A Road Paved with Good Intentions
The American Psychological Association (APA) reported that a doctor’s attempt to motivate someone who is overweight via medical fat-shaming does way more harm than good. This is the message that Joan Chrisler, Ph.D.—professor of psychology at Connecticut College—shared during a recent symposium titled “Weapons of Mass Distraction—Confronting Sizeism.”
“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behavior, is stressful and can cause patients to delay health care seeking or avoid interacting with providers,” Chrisler said.
Sizeism Can Negatively Affect Treatment
People may delay medical treatment or avoid doctors altogether because of the stress a trip to the doctor’s office can bring. However, fat-shaming is also a problem for those who choose to address it and make an appointment.
Chrisler believes that sizeism can have an impact on how doctors treat patients. She says that doctors often exclude overweight patients from medical research because they make assumptions about their health. That means that the standard dosage for medication might not work for larger bodies.
One recent study about obesity, emergency rooms, and antibioticsIt was found that doctors over-prescribe chemotherapy and antibiotics to overweight patients. Chrisler pointed out that doctors often recommend weight loss for overweight patients while recommending other forms for patients of average weight. Chrisler says that this is unethical.
“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average weight patients.”
Not Taken Seriously
Chrisler noted that health care providers may not take complaints from obese patients as seriously as they would for someone of average weight. Or, doctors might assume that the person’s extra weight is responsible for the symptoms.
“Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
Obese patients are at greater risk of developing undiagnosed medical problems. While researching more than 300 autopsy reports, it was discovered that “obese patients were 1.65 times more likely than others to have significant undiagnosed medical conditions.”
This research showed that overweight and obese patients are often misdiagnosed, or have insufficient access to health care.
Microaggressions At The Doctor’s Office
The results are in when it comes to medical fat-shaming—it doesn’t work. Research has shown that doctors and other medical professionals can have negative attitudes towards overweight and obese patients. This can lead to overdosed medication and undiagnosed medical conditions. However, psychological stress should not be underestimated.
“Implicit attitudes might be experienced by patients as microaggressions—for example, a provider’s apparent reluctance to touch a fat patient, or a headshake, wince or ‘tsk’ while noting the patient’s weight in the chart,” Chrisler said. “Microaggressions are stressful over time and can contribute to the felt experience of stigmatization.”
Maureen McHugh, Ph.D.—a psychologist who also shared fat-shaming research at the sizeism symposium—shared that the view among the medical community is that fatness is a disease and weight loss is the cure. She believes this viewpoint must change.
“A weight-centric model of health assumes that weight is within an individual’s control, equates higher weight with poor health habits, and believes weight loss will result in improved health,” she said.
Chrisler agreed and stated that there is no research on how much weight is considered too much. Doctors assume that being overweight indicates that someone is unhealthy.
And, she pointed out that genetics, diet, stress, and poverty play a role in a person’s health and are predictors of illness. But weight seems to be more important than all of these.
McHugh stated that stigmatizing overweight and obese people is a serious threat to their psychological health. McHugh and Chrisler agree that fat-shaming needs to be addressed in the medical field. Treatment should be focused on both physical and mental health, not weight.
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