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Owwww.

zuzu

I just got back from my immigration physical, and my hand hurts. The doctor, a sweet old guy, had a hard time finding a vein in my arm so he had to draw blood from my hand. And he wasn’t entirely steady, and now I have a great big lump on the back of my right hand which means that it huuuuurrrrts to hold a pen.

The bit I was dreading, of course, was being weighed. I knew I couldn’t avoid it, given the nature of the appointment (when I’m being treated, I refuse to be weighed on the grounds that, unless you’re putting me under general anasthesia and you need to know, you don’t need to know. And neither do I).

I know I’m fat. Everyone can see that. I know what size of clothing I have to wear, and how much my ass spills over the subway seat. What I don’t need is to quantify the amount in pounds. I don’t want to get obsessive if my clothes fit fine. I don’t want to provide my internal judge and jury any evidence to punish me with. I don’t want to know how much ground I’ve lost in the last several years, after having had a triple-digit weight loss beginning in college.

So I closed my eyes and/or looked away while the doctor was weighing me, and was grateful that he didn’t announce the amount in pounds (although he didn’t zero out the scale, so I had to look at it while sitting on the table so I had an idea anyhow). The kilos he converted it to don’t mean anything to me conceptually; I have no sense of how much that is.

I was also grateful he didn’t judge, didn’t lecture. Perhaps it was just because he wasn’t treating me so it was no skin off his nose what I weighed. But it depresses me no end that I can consider that a small mercy.

62 thoughts on Owwww.

  1. Believe it or not, zuzu, I sort of know the feeling.

    I come at it from a different angle. I grew up thin. Tall and thin. Now, the social stigma isn’t exactly symmetrical, I know, but I think that being thin can work against you if you are male because you’re expected to be more “filled out”. That never really happened to me and so I spent many of my teenage and young adult years as a cheery yet self-conscious guy because I was convinced I was too skinny.

    I started to gain weight in my late 20s, and I have to say it felt like a complement when people noticed it.

  2. i have a strict policy that i announce to the nurse who weighs me before my annual exams: i’ll get on the scale if she promises not to tell me what it says. that’s the only way i’ll do it!

  3. When my fiance and I were in Costa Rica last, we had to take a hop plane that was so small they have to weigh you and all your luggage to balance the plane correctly. My fiance thought it would be funny to urge the person behind the counter to call out my weight – mid-afternoon, clothes and shoes (when I weigh myself at home it’s in the morning and I don’t even wear a scrunchy). The airport was very small and everyone in earshot heard. I put in the pre-nup that by no means was he EVER to do this again, or he would have to jump out of said plane over the Osa Penninsula. It is great ammo whenever I do something vaguely inappropriate – “well at least it’s not as mean as announcing to an entire airport . . . . Zuzu I avoided the scale for the last 6 months while I went though a lot of life changes, but my husband and I just went on Nutrisystem together which is a GREAT program for the terminally busy. It’s no more expensive than buying groceries, there are no meetings, I’m losing a bunch of weight, and all I do is dig in a box three times a day and pull out a package labeled breakfast lunch or dinner. Then I just make some salads, steam some vegetables, and carry apples around all the time. I still have one drink on Fridays and Saturdays, and the pounds are still coming off. I totally understand the avoidance thing because I’ve been there, but when you are ready, it’s worth checking into.

  4. If I’m having a particularly bad body day/week/year, I have been known to weigh backwards, and tell the weigher not to disclose the number. I know a few girls who have recovered from eating disorders that do the same thing.

    And yeah, I know the feeling of wanting to avoid medical professionals altogether because of the obligatory lecture. My favorite question, “Have you ever thought about trying to lose weight?”

    No shit, Sherlock, that never occurred to me! Wow, thanks for the new world view!

    Sorry about your hand.

  5. With all due respect to zuzu, Kristen’s response is a little better– although I have a caveat even there.

    Your doctor SHOULD know how much you weigh. It is relevant to all sorts of things, from how high the dosage of any medicine you are prescribed will be (including even things like birth control pills), to whether observed symptoms are a result of illness or pathogens, or a result of your weight.

    Refusing to allow your doctor to know your weight makes no more sense– from a health standpoint– than not going to the gynecologist because you don’t want a doctor to see your genitals.

    Kristen is correct that the doctor doesn’t have to tell you your weight if you don’t want to hear it, and given the extent to which we live in a society where women are constantly scrutinized over their weight, I’m not really going to condemn that as a bad solution. I should mention, however, that even Kristen’s solution to the issue comes with a caveat. As much as the lecture from the doctor about weight control may be embarrassing, it also is something that some people need to hear. If one has a weight problem or needs to lose weight for health– not aesthetic– reasons, shutting down all voices who might express that doesn’t really solve the problem. The reason, however, why I still think Kristen’s solution is a good one is because I have a feeling that most people who are overweight to the extent that it is a health issue actually are quite aware of it.

  6. Dilan, fat people KNOW they are fat. We don’t need a doctor to tell us. Believe me, we KNOW.

    The thing is, a lot of problems just get blamed on weight, even when they may or may not have anything to do with it. The doctors don’t even test for other things, or explore other possibilities, they just look at a fat woman and think obesity = bad health. It never goes beyond the first consult.

    My mom has to be on her deathbed before she’ll go to a doctor because they always default everything to weight. Your knee is bothering you? Lose some weight. You have swelling in your foot? Must be the weight. Can’t exercise to lose weight because of the swelling in your foot? Maybe you should lose some weight if you want to exercise.

    You think I’m kidding but I’m not.

  7. Your doctor SHOULD know how much you weigh. It is relevant to all sorts of things, from how high the dosage of any medicine you are prescribed will be (including even things like birth control pills), to whether observed symptoms are a result of illness or pathogens, or a result of your weight.

    But do any of those things require a precise number? Birth control pills aren’t precisely calibrated to weight, nor are other medications. And even in a case where the doctor thinks that the patient’s weight has something to do with observed symptoms, what value is it to know exactly the number? Wouldn’t a trained medical professional be able to look at a patient and figure out that the patient is overweight such that the weight might be affecting symptoms?

    The reason, however, why I still think Kristen’s solution is a good one is because I have a feeling that most people who are overweight to the extent that it is a health issue actually are quite aware of it.

    You think?

  8. For what it’s worth, I think weight is completely over-rated. When I was in the best shape I’ve ever been in — working out 5 days a week, doing an hour and a half of cardio and another hour and a half of strength training — I weighed 15 pounds more than I do now. And I’m 5’3″ and have a small frame, so 15 pounds is a lot on me.

    That’s not a great example, and I still weigh myself obsessively every day, but when I gain a pound or two I try and remind myself that the number doesn’t correspond to how strong I am, or how good my body feels. We know when our bodies are healthy and when they aren’t. Putting numbers on them isn’t all that helpful.

  11. I started to gain weight in my late 20s, and I have to say it felt like a complement when people noticed it.

    Not for me. I only get comments when my mom visits; everyone else leaves me alone. And her comments are not flattering.

    I went from 102 pounds as a college freshmen to 143 pounds now (I was too thin in college, although it was never on purpose). I’ve just had a huge drop in metabolism as I got older (I dread thinking about waht pregnancy will do). The attention I get from my parents about it is not good–now every time I pick up a fork and take a piece of food, my mom starts in about “Do you know how many calories/carbs/fat/whatever is in that?”

    Last time she was here, she nitpicked me for picking up the margarine for my breakfast toast, the sugar in my coffee, the dressing on my salad, and the ONE beer I had with dinner (that I always have on Saturdays when she’s not around anyway).

    She’s also been known to pat my stomach and say, “If I didn’t know you better I’d think you were expecting.” (!!!!)

    The thing is, by doctor’s standards I am not obese. I’m not even chunky. I used to have a bit of an “extra chin” in pictures, and something of a gut, but very slight, and it’s gone away since I started exercising. I am not fat, but the way my mom talks to me about food, she treats me like I weigh 300 pounds and look awful.

    Hence I don’t care if my doctor knows my weight. He doesn’t complain. He only complains about my cholesterol, which is life-and-death. But he knows I am not as obese as my mom likes to make me think I am.

    Maybe it’s because she and my sister both are obsessed with weight, and think that a woman’s collar bones should be showing before she’s considered “thin.”

  13. That’s okay Zuzu. You just need to hear the singing in Whoville on Christmas morning — all the young Whos singing “ba-hoo-do-ray.” It made the Grinch’s small heart grow three sizes that day!

  14. And even in a case where the doctor thinks that the patient’s weight has something to do with observed symptoms, what value is it to know exactly the number?

    Which do you think is the worse alternative – being confronted with the things about your body you aren’t happy about when you go to the doctor; or having health professionals withhold information about your physical condition because, in their judgement, it might hurt your feelings?

    As it happens, not everyone who is overweight knows that they’re overweight. And some medical situations might manifest themselves as a change in weight. Sorry but I think it’s entirely wrong-headed to sacrifice medical precision lest a patient be confronted by the stigma of poor body confidence.

  15. Hey bmc, I think if she wanted weight-loss tips she would have asked for some. I’m not fat by most folks’ definition (though my BMI is overweight), but I do swing between 215 and 175. I can tell you lots of ways to lose weight, but not one likely to keep it off for five years.

    And neither can anyone else. Because there is not a single peer-reviewed study that shows statistically significant weight loss over five years.

    Not one.

    For further reading, look for the fat acceptance posts at Alas:
    http://www.amptoons.com/blog.

  16. Which do you think is the worse alternative – being confronted with the things about your body you aren’t happy about when you go to the doctor; or having health professionals withhold information about your physical condition because, in their judgement, it might hurt your feelings?

    Not to nitpick or anything, but did you miss all the fat people in this thread reporting substandard care?

  17. The attention I get from my parents about it is not good–now every time I pick up a fork and take a piece of food, my mom starts in about “Do you know how many calories/carbs/fat/whatever is in that?”

    Marian, do we share a parent?

    I love my mom, she’s really wonderful and sweet and supportive. But every time we talk it’s, “What did you eat tonight? Did you go to the gym?” etc etc. She was stick skinny growing up, her mother and sisters were skinny, and my little sister is really skinny too — I’m the only non-stick-like one in my immediate family (one of my aunts is heavier now that she’s almost 60, and we never hear the end of it). She mails me articles about how sushi isn’t really as lean as people think it is, how low-carb diets are ideal, how Dr. Atkins was right, and on and on. She’s never come out and said “You’re fat,” but it’s definitely strongly implied that I should be thinner. I think a lot of it is family norms — my entire life whenever my grandma came over, the first question out of her mouth was, “How much do you weigh now?” followed by a comment about how you look like you’d either gained or lost weight. I think that the women in my family talk about it when they don’t know what else to say.

    But back to doctors. I agree that, sure, they should say something if their patient appears to have unhealthy habits, whether those involve eating or anything else. But doctors have their own biases too. I remember being 16 and going to my doctor (who I had been seeing since I was a little kid), who stared at me and said, “When did you break your nose?” Confused, I replied, “I never broke my nose.” “Huh,” she said, “Because it’s really crooked.” I had never realized there was anything wrong with my nose before, but after that comment I was obsessed with it. Even now I try and position myself in pictures so that the “good” side of my nose — the one where you can’t see the crooked bump — is featured. I hate straight-on photos, because you can see that I “need” a nosejob.

    During the same visit, said doctor weighed and measured me. I was 5’2″ and 105 pounds. She told me that I was overweight, and would be much healthier if I lost 10 pounds. At 16, that advice was devastating. And, in hindsight, wrong. But I didn’t realize that at the time. She was my doctor, after all.

    I know this is getting off the topic of Zuzu’s post, but just wanted to second what Marian said, and add that doctors don’t always know best.

  18. omg, I beg of all the folks who weigh themselves every day – throw out the scale! Nothing helped me to quiet down the obsessively self judging and belittling comments in my brain more than tossing the damn thing. Weigh monitoring now happens via pants fitting/getting snug and making a note if i’ve been exercizing or not.

    and marion – that’s bullshit behavior, even if it’s your mother. do you call her out on it?

  19. Maybe it’s because she and my sister both are obsessed with weight, and think that a woman’s collar bones should be showing before she’s considered “thin.”

    That is completely insane, plus it doesn’t even guarantee thinness. My collar bones show quite prominently, but I’m actually a bit chubby. I’m not obese or really even that overweight, but after two pregnancies, I’m not thin by any stretch of the imagination. However, I’m lucky in that I grew up really skinny in a family full of overweight women who also grew up skinny (and surprisingly, all just accept that that is what their bodies are supposed to look like and don’t worry about it). I knew exactly what I was heading for as I grew up and I was never given any body image messages from my family that weren’t entirely positive.

    And really sorry about your hand, Zuzu. I hope you feel better.

  20. I was 5′2″ and 105 pounds. She told me that I was overweight

    See? Insanity! Professionals merely regurgitating conventional wisdom, cloaking it with authority. All you people thinking, “but they’re doctors, they must know what they’re talking about,” think about this. The only people who should weigh 95 pounds at 5’2″ are competetive athletes in endurance or weight-sensitive sports.

  21. I’d like to echo zuzu’s (and Jill’s and others’) sentiments on this topic. As a man who’s always thought himself chubbier than he probably is (I look back at pictures and think, ‘I wasn’t chubby then!’–but ‘then’ I thought I was, etc.), I’ve had the most success regarding health AND body image by just ditching the whole numbers game. Which isn’t to say I think there isn’t a weight at which I would be unhealthy or anything; it’s just that any correllation between number of pounds and health isn’t easily calculatable, especially at weights which are sort of middlin.

    And as Jill pointed out explicitly, when you’re doing weights and cardio (to whatever degree), how much you weigh really ceases to be helpful in determining anything. The numbers that start to matter are # of lbs I can lift and # of miles I can run/bike/walk, number of floors I can walk upstairs and the like.

    I’ve never had a doctor ask me if I had thought about losing weight, with one exception. My DENTIST, who is a big health nut, asked me, after a discussion about my eating habits and my teeth, if I had ever thought about losing some weight. I was sort of shocked but he had brought it up in a larger context of eating, health and exercise in general, so we talked some about it, but it’s just really a stupid question, in general. The whole ‘but the doctor CARES about your health’ thing just doesn’t fly, because in that case the doctor could be taking the time to discuss nutrition and exercise in a more holistic way, because the absolute number just doesn’t hold much (ahem, sorry) weight.

  22. You know, I don’t know if this is just a thin girl thing, but I don’t keep a scale at home, I hardly weigh myself. I don’t really think of my body as in weight, I dunno. I just go by how I look to myself or how I feel. I tend to feel depressed when I’m not active..so it’s a sign for me to get off my ass. (and hypoglycemia has gotten a lot worse since I’ve became inactive.)

    According to those stupid height/weight charts, I am grossly underweight. But in my eyes I look healthy, I have meat on my bones now..*shrug*

    But for parents to sit there and make you feel bad about your body, it makes me so mad. It’s like they mean well but they don’t know what to do but berate and belittle until you give in. or something equally stupid.

  23. I never used a scale because the eyeball measure offers so many more details to obsess about.

    But for parents to sit there and make you feel bad about your body, it makes me so mad. It’s like they mean well but they don’t know what to do but berate and belittle until you give in. or something equally stupid.

    Yup. I don’t think parents always understand how desperate their children can be for their approval and acceptance.

  24. Yup. I don’t think parents always understand how desperate their children can be for their approval and acceptance.

    Yeah it’s just like one my friends she is trying to lose some weight and she has been making good progress last time I saw her. So I told her that she’s looking really good. But also, I have this guilt thing about pointing out someones weight. I feel guilty if I go WOW! YOU LOST SO MUCH WEIGHT! I dunno…I feel guilty. I feel like it’s same as saying You’re so fat.

    I told her this too, and she was like “NO NO! that’s a good thing! I ask my my parents if they noticed my weight loss and they were like, You have a lot more weight to lose before anybody is going to notice.” That made me mad because this girl is working hard to lose weight and is trying sooo hard to get her parents approval and they’re putting her down.

  25. I remember being 16 and going to my doctor (who I had been seeing since I was a little kid), who stared at me and said, “When did you break your nose?”

    One time I went to the doctor and she asked if I had any chronic conditions. “Well, ADHD, ” I said. She wrote that down, and then she also wrote down “acne.” (I had a pimple on my forehead at the time.) I went around for a month wondering if my skin looked really terrible and no one ever told me.

  27. Again, I don’t think there’s anything particularly wrong with Kristen’s solution, where the doctor knows your weight but you don’t hear it.

    But as for some of the arguments made here, I respond as follows:

    1. Some people DO NOT know that their weight is a threat to their health. Many others do– and I have a feeling a person who doesn’t want her doctor to tell her the number is the type of person who actually would know this. Nonetheless, we should understand that at least some people are shutting out information they should hear.

    2. The fact that there are some unprofessional doctors out there who are apparently telling normal-weight and thin people to lose weight doesn’t really indicate, to me at least, that if you have a good doctor (and really, if you don’t have one, you should switch doctors) who is sensitive and not a sexist jerk, that doctor should know what you weigh, and even, ideally, that you should be comfortable talking about your weight with him or her.

    3. Weight may be just a number, but that’s a bit of an inane argument. One’s precise, to the pound and the ounce weight may not be that important, but one’s weight RANGE is, and, by the way, it can’t always be determined by just “eyeballing” a person. And while it is certainly true that some people are quite healthy despite being overweight, and others are thin and unhealthy, nonetheless, ON AVERAGE (and all preventative health is based on what happens on average), being overweight increases a whole bunch of health risks.

    Look, in the end, it’s a free country. A person has a right to maintain any weight he or she wishes to. But one shouldn’t fool onesself that when you play these games with your doctor, you are making it somewhat more difficult for the doctor to do his job. And as I said, I don’t think anyone here would endorse a woman not going to the gynecologist because she is embarrassed to show her genitals to a stranger. Really, in the end, isn’t the feminist position to try ensure that women (and men) having the self-esteem to talk about their weight (and any other health issues) with their doctors and deal with the issue rationally, rather than to be so embarrassed that the issue cannot be discussed no matter the effect on the patient’s health?

  28. My mom has to be on her deathbed before she’ll go to a doctor because they always default everything to weight. Your knee is bothering you? Lose some weight. You have swelling in your foot? Must be the weight. Can’t exercise to lose weight because of the swelling in your foot? Maybe you should lose some weight if you want to exercise.

    You think I’m kidding but I’m not.

    Amber, I know you’re not kidding. I’ve been there. I recently put off seeing my heart doctor for a year for the very same reason. When I finally worked up the courage to see her I found out that my pacemaker battery was almost dead and I need to have it replaced. THAT’S what fear of doctors does to fat people.

  29. Marian, I suspect the difference is gendered. You get comments that you’re getting too heavy, and I would get comments that I was too thin.

    Now, I would say that at one point, I was too thin. I think, however, that the “range” of what was considered too thin was a bit wider for me because I’m a man.

  30. Er, there are some medications that use weight-based dosing. Enoxaparin, daptomycin, dalteparin, heparin, integrilin… and that’s just off the top of my head. Other medications like gentamicin and vancomycin use a calculated measure of kidney function that includes height and weight. There are other medications that have to be dose-adjusted in kidney dysfunction, using that same calculation. (I’m a pharmacist. It’s my job to know these sorts of things.)

    When I do diabetes education, I get a weight every visit, because weight gain can correlate with worsening sugar control, and weight loss can improve it. Oh, and insulin is often dosed initially based on body weight. So is chemotherapy, come to think of it.

    But I never berate patients for being heavy. I encourage exercise, find out what barriers they have (one of my patients has club feet, so he can’t run, but he does enjoy swimming and biking), and encourage them when they make progress AND when they backslide. I let them know it’s OK, because we all slip sometimes, and we just have to get back up. I’ve been there. Maybe not as much as them, but I’ve lost 30 pounds and kept them off. I have 15 more I want to lose, mostly as a self-image thing (I hate my sub-navel pudge!) I was about 50% over my “ideal” body weight (110 lbs at 5’2″), and I’m aiming for what I think would be a healthy, non-skeletal 125, with my broad shoulders and wide hips.

    While it’s true that weight can contribute to a whole lot of problems, it’s not the ONLY thing that can. Weight loss can help, but it’s not the panacea a lot of doctors act like it is.

  31. Am I alone in being disturbed by the number of readers of this blog who buy into the BMI, fat being unhealthy, etc?

  32. Heh. You want to see some more of that, read any of the fat issue threads at Alas.

    C. Diane, your information is well-taken. I understand that there *are* medications that must be calculated to weight, which is something I know very well from vet visits. However, I am a perfectly healthy person without any kidney, liver, or diabetic disorders. I have very low cholesterol, good blood pressure and a low risk of heart disease. There’s little to no relevant reason for me to get weighed for routine doctor’s visits or gynie exams.

    Chet, who are all these fat people whose weight is high enough to affect their health yet don’t know they’re fat?

  33. The same way doctors blame all of fat people’s health problems on their weight, in my experience they also have a tendency to blame all of a depressed person’s problems on depression. Or someone who used to be depressed but isn’t any longer.

    I have been having health issues which I won’t go into, that I’m certain are physical in nature and not the result of depression. However, I have been depressed in the past (although I actually believe my depression was the cause of health problems I was unaware of at the time). It’s tricky because I’ve been tested for many things, and nothing’s come up, so I can understand how it must appear from a doctor’s POV. However, every doctor assumes that it must be depression, or I must have some other mental illness. The possibility that maybe they don’t know everything, or are maybe missing something just doesn’t enter their minds. That’s my rant.

  34. Medical professionals of all stripes could stand to think a little more about their approaches.

    When I first went to the school psychiatrist to discuss going on antidepressants, he decided to put me on one that doesn’t cause as much weight gain overall. Luckily it worked, but – I would rather gain weight than continue feeling suicidal.

    (5’4″, 230 lbs. Just for future reference.)

  35. I don’t know if there’s absolutely no reason to get weighed at the GYN. If I hadn’t been weighed every year, I wouldn’t have had the steady progression upward — even on the lowest-dose Pill — in my chart, so my request for something else because I was gaining on the Pill (while cutting out sodas and other extra calories and exercising more) wouldn’t have had any verification. Within 3 months of going off it, I’d lost 15 pounds by continuing what I’d been doing the previous 6 months. (Estrogen and I are not friends.)

    I have to admit, though, I tend to use the “hmm, pants are getting tight, oughtta cut out the cheesecake” method of weight control.

  36. When I first went to the school psychiatrist to discuss going on antidepressants, he decided to put me on one that doesn’t cause as much weight gain overall. Luckily it worked, but – I would rather gain weight than continue feeling suicidal.

    So would I, but I think a lot of doctors like this one are practicing defensively: for a lot of women, gaining weight would be a bad thing and would negate some or all of the effect of the anti-depressants they were on. May not have been why he specifically was doing it, but I know that it is a concern for some.

    That’s not saying that a lot of doctors aren’t just as screwed up as the people they treat. I’ve had and dumped a couple (like the one who first told me that I was showing symptoms of severe depression, then proceeded to lecture me about my weight, my exercise and eating habits, and my general attitude towards life. Yeah doc, that helped with the root of all of the above: the fact that I was severely depressed and had been for a couple of years. Not.).

    I think a lot of people need to feel more secure in shopping around until they find a doctor whose manner is compatible with what they need/want. And a lot of doctors could use some education in the fact that they need to focus on what is realistic for a given patient, not what is theoretically best but practially unachievable. You can often help people change small things slowly. Very few people can make drastic changes stick.

    Which reminds me that it’s time for me to hit the gym and sweat. /sigh

  37. Doctors, particularly surgeons and gynecologists, get a little peeved with the morbidly obese, simply because it’s harder to do an adequate complete physical exam (liver edge? what liver edge? ovary? what ovary?), and for surgeons, harder to get good exposure and good wound healing (particularly when abdominal fat is 6 to 8 inches thick). No, doctors should not take out their craftly frustration on the patient – but it is true that many think “oh no” when the 400+ # patient crosses their office threshold..

  38. Hmm. When my doctors weigh me, it’s to see if I’ve *lost* weight, because unexplained weight loss is a sign that something is seriously amiss. I’m sure that most women would notice if they were gaining weight. But it seems likely to me that a lot of women would not think it was a problem if they were *losing* weight. They’d think “ooh, that’s cool,” not “I should tell my doctor about this, just in case there’s something really wrong with me.”

  39. OT: Just as being fat doesn’t mean you’re unhealthy, being thin doesn’t mean you’re in some Magical Safe Zone. My mother, who’s always eaten whatever she wanted while remaining skinny as a rail, was quite alarmed to find out that her cholesterol level was too high and, on the doctor’s advice, is on a low-fat diet.

  40. A Pang and Heather:

    No, fat does not mean that you are automatically unhealthy, and thin doesn’t mean you are automatically healthy. But again, it amazes me the extent to which people want to avoid the issue. Being overweight makes you STATISTICALLY more likely to have a lot of health problems. Telling yourself “well, it doesn’t automatically make me unhealthy”– when used as a rationalization– is sort of like telling yourself that the fact that an act of unprotected sex does not automatically cause a pregnancy or transmit an STD is a reason not to use a condom.

    Let’s be clear here. There are a lot of emotions tied up with weight. There are also a bunch of sexist people out there who push an unnatural ideal of thinness on women.

    I must say, however, that some of these comments about doctors sound to me like they contain some projection, i.e., hypotheses about what the doctor MIGHT say, rather than what the doctor WILL say. There are surely plenty of doctors out there who raise their patients’ weight issues in a sensitive way and know how to talk with their patients without insulting them.

    Also, and without in any way denigrating people who have had stupid comments made about their weight– should such comments, even when made, be considered so psychologically scarring that one should interpose obstacles into the doctor-patient relationship in order to avoid even the possibility that these comments are going to be made?

    If you stay fit– not artificially thin, but fit– ON AVERAGE, you will live significantly longer. And doctors– whose job it is to try and help you live longer– certainly need to know how much a person weighs, and ideally should be able to discuss these issues with their patients. I in no way defend idiot doctors or a sexist society that puts ridiculous pressure on women to maintain their weight, but understandable resistence to these unfortunate aspects of our society should not morph into denial about the benefits of maintaining a healthy weight.

  41. Might not’ve been a choice since it was an immigration physical, but *never* let a doctor take your blood. They just don’t do it often enough; ask for a phlebotomist (blood specialist) if you can, or at least a nurse – they have a lot more practice, and it tends to go much smoother. (And remember … when the nurse-in-training comes in and your veins are all flat ‘cuz you’re dehydrated, you can ask for someone who’s not training. I wish someone had told me that years ago.)

  42. Being overweight makes you STATISTICALLY more likely to have a lot of health problems.

    I think everyone’s aware of that. But what evidence is there that if an overweight adult loses weight they’ll be statistically less likely to have a those health problems? (It’s a genuine question – I’d like to know the answer.)

    And what evidence is there that telling overweight people that they’re overweight and lecturing them about it leads to weight loss?

  43. Dilan – I don’t think anyone was projecting what a doctor might say, but what doctors have actually said. I’ll certainly concede a doctor should mention it, but my ex-GF had every medical problem related back to her weight, on every visit. Did the doctor seriously think she’d forgotten she was fat since the last visit.

    BTW, The very same doctor didn’t feel the need to remind me I shouldn’t smoke on every visit to him. I’m no medical type person, but surely smoking is at least as dangerous as being 30lbs overwight.

  46. The idea that one can get a significant amount of information about the health of an individual from the number of pounds a scale says is bizarre. While I don’t doubt that body weight has some predictive medical uses, far more useful are measures such as percentage of body fat, blood cholestrol, lung capacity, blood pressure, or resting heart rate.

    And yet, weight is the number that I know without checking. If I ever forget, I have a device in the bathroom that will tell me that number in seconds any time I want. Weight and height are the only two measures that go into BMI, the new way to sound scientific when nagging people about the natural human variation in body shape. (the last time I had a BMI in the “normal” range, I was 15, a high-school wrestler with all the weight-starving craziness that implies, and had just come off a nasty run-in with the flu that meant I ate very little for a week)

    Although some of those measures clearly aren’t things people can do themselves at home, heart rate is easy to measure, and there’s a free device at many pharmacies to measure blood pressure.

    And yet, weight is the number I know.

  47. You know, I don’t know if this is just a thin girl thing, but I don’t keep a scale at home, I hardly weigh myself.

    It’s not just a thin girl thing — I’m at the top of the “healthy” range of the BMI for my height and don’t keep a scale, only weigh myself at the doctor’s or on a whim at friends’ houses.

    I am very grateful that my mother never criticized my weight. Since she’s a lifelong dieter who once told me, “I know it’s ridiculous, but I used to envy the willpower of anorexics,” it is almost a miracle that she didn’t pass many of her body issues on to me. It does make me sad to see her still having a “diet” and feeling bad for not sticking to it, though. She’s 65 and healthy, for christ’s sake — who gives a damn about those last five pounds?

  48. The very first time I went to a gynecologist (meaning, I was already a tad nervous, not knowing exactly what to expect) the doctor said to me at the end of the exam, “You need to lose some weight.” My face instantly got red, and I was completely embarassed. I just said to her: “I know,” because I was incredibly self-consious about my weight and was constantly beating myself up about needing to lose weight.

    I don’t remember exactly how much I weighed at that point, but I was 5’1″ and wore a size 14. I was surely overweight by medical standards. However, had she noticed any particular medical problem? No. Did she give me any reason that I needed to lose weight, other than that I was overweight? No.

    I was young and she knew it was my first trip to the gynocologist, so basically, screw her for saying that to me. I never went back to that gynecologist again.

  49. Oh, and just to be clear, I wasn’t there to get birth control pills or for any reason other than a general exam. My mom had decided that I was at an age that I needed to have my first gyno exam. I was perfectly healthy in all respects, yet the doctor felt the need to tell me that I was overweight, which OF COURSE I was well aware of. All it did was make me feel bad.

  50. Not to nitpick or anything, but did you miss all the fat people in this thread reporting substandard care?

    Yeah, I guess I did. What I saw were a bunch of people who went to the doctor with problems commonly related to weight, and the doctor telling them the problem was probably related to their weight.

    What I didn’t see was any indication that that doctor’s diagnosis was wrong. So in what sense was the care substandard?

    Obesity causes certain health problems. It doesn’t take Dr. Gregory House to make the diagnosis. When a guy comes in bleeding from a gunshot wound, there’s a pretty obvious cause for his anemia. You don’t start treating him for sickle-cell or something.

    I’m sorry but I don’t want medical professionals witholding their medical opinion simply because it might hurt my feelings, or because they don’t have any reason to believe I’ll take it. That’s my choice, not theirs. That’s not to say my doctor should say “How ya doin’, fatso!” when I walk into his office. But being overweight isn’t having cancer. Like an Onion article once said, it’s been scientifically linked to “eating the whole fucking bag of chips.”

  51. Obesity causes certain health problems.

    Such as? Direct causes, not correlations or co-morbidity or whatnot.

  52. Another tail of an insentitive doctor:

    I am a recovered anorexic (I spent eight years under 90 pounds and I’m 5’9″). My medical chart has pages and pages detailing my eating disorder. Yet this didn’t stop my (ex)doctor from telling me I need to lose weight (at the time I was 155 pounds, which medically speaking is within a “healthy” weight range).

  53. What I saw were a bunch of people who went to the doctor with problems commonly related to weight, and the doctor telling them the problem was probably related to their weight.

    What? Where?

    Seriously, I don’t see anyone mentioning that in this thread. Just reread it, still not seeing this. I do see people saying that doctors have told them to lose weight for no apparent reason, which is not medically reasonable at all.

    My doctor wants me to lose weight because I have a family history of type 2 diabetes. But she also knows that I’ve had BED, that I exercise, and that my cholesterol and insulin levels are perfect for someone my age. So she doesn’t press it. I’m phenomenally lucky to have her, and it’s one of the things that I’ll really miss when I leave my hometown.

  54. What’s also being missed here is that sometimes, you don’t GET to just change doctors on a whim, or even for a good reason. Depends on your insurance, assuming you have any. Certain clinics will take certain insurance and not others, and if like me, you prefer a member of your own sex poking around at you, especially your private bits, you can have very little choice.

    Don’t even get me started on how a lot of people still put up with actual bad treatment from doctors because they’ve been conditioned from childhood to shut-up and listen to the doctor because he knows best. Many of them don’t, and bedside manner (customer service?) isn’t really being taught. So there are a lot of really brilliant doctors with awful people skills out there. (Trust me — worked in the Ophth. dept. at a medical school for too long. Generally bright and caring individuals with some serious superiority issues here and there.)

    I’ve had 3 different doctors and one PA over the last 5 or so years, and that would be at one clinic, at one general physical (“thump and poke”) per year. This also does not help with any anxiety over stuff you “should” be doing, since your charts are not always thoroughly read by the new doc. AND you have no idea how they personally feel about a few extra pounds here and there.

    It’s kind of like dreading the flossing lecture from the dental hygeneist. (Sp?) You KNOW you need to floss more, and hearing about it really doesn’t help any.

  55. What? Where?

    Post 6. The poster’s mom complains of symptoms associated with being overweight; the doctor tells her the symptoms are probably due to her being overweight.

    And that’s supposed to be substandard care? Look, when the cause is obvious, you make the diagnosis. Anything else wastes time, money, and valuable resources.

    It’s kind of like dreading the flossing lecture from the dental hygeneist. (Sp?) You KNOW you need to floss more, and hearing about it really doesn’t help any.

    So they should stop doing their jobs so that your fee-fees don’t get hurt?

    It’s really a surprising thread. For as often as Zuzu and the others (rightly) ascerbically dismiss the idea that they should muzzle painful truths about gender inequity and male privilege because a man’s feelings might be hurt, she appears shockingly ready to demand the same treatment from her doctors.

    I get it that there’s a powerful influence directing women to be too thin, to have unrealistic expectations about their weight, and doctors are the last people who should be a part of that. But there’s also legitimate medical concerns about being obese. The doctor’s job is to be concerned about your body. That’s what you pay them for. I get it that society puts a pressure on women that might make them dread the scale. But just because your feelings are being hurt, that doesn’t make it a feminist issue. Doctors have an entirely legitimate reason to both record your weight and render medical advice about life choices that negatively impact your health. But they can’t force you to do anything (as many have pointed out) so what’s the problem?

  56. So they should stop doing their jobs so that your fee-fees don’t get hurt?

    I hate this attitude. (And I say that as a thin person who spends a lot of time at the doctor.) Having decent bed-side manner is part of their job. If a doctor’s interactions with you are so unpleasant that you stop going to the doctor, then they are failing to do their job well.

  57. For as often as Zuzu and the others (rightly) ascerbically dismiss the idea that they should muzzle painful truths about gender inequity and male privilege because a man’s feelings might be hurt, she appears shockingly ready to demand the same treatment from her doctors.

    Uh, pardon?

    Hey, Chet, what part of we all know I’m fat don’t you get? I’ve said that I have no issue with being weighed if there’s a valid reason for it, and I’ve never said that I demand that my doctors not discuss weight at all. Certainly, if I come in with a symptom that is possibly weight-related, I’d expect it to be brought up. But I also demand that any doctor examining me go beyond merely attributing something to my weight.

    For example, a few years ago, I had ankle surgery. Why? Because I had fallen a few years earlier while running and twisted it, and there were chips of bone and tissue in the joint. I could have become emaciated and that would not have fixed it because losing weight would not have taken care of the root problem — the bone chips in the joint. It may have alleviated some of the symptoms, but ultimately, the problem could have worsened as the chips floated around and did more damage.

    Now, had I gone to a doctor complaining of ankle pain and he just told me that the pain was “caused” by being overweight — the diagnosis you made based on Amber’s description of her mother’s knee pain and swollen foot in comment 6 — and recommended I lose weight, that doctor would not have been doing his job. Had he made that recommendation as a matter of symptom relief, and referred me to a specialist to determine the root cause of the pain, THEN he would have been doing his job.

    As it was, I simply cut out the middleman and went to the specialist myself on the recommendation of a friend whose ankle he had rebuilt. The sports-medicine doctor never put me on the scale.

    So there, Chet, is a concrete example of how dismissing any and all symptoms of a fat patient as being related to or caused by weight is just piss-poor medicine.

  58. I’m overweight too. I went to the doc. Doc says you need to lose weight. Yeah, I know. I went, now get this, for an ear infection. He prescribed for the ear infection.

    So, I couple weeks later, Blue Cross sends me letter saying they don’t pay for weight reduction therapy. The Doc had written down weight as a diagnosis.

  61. What Zuzu said. Plus, other anecdotes on the thread (including mine) make it clear that sometimes doctors see being overweight alone to be a problem they need to address, when there is no other medical problem that exists. My doctor just said to me “You need to lose weight,” disconnected from anything else – no symptoms of anything, no complaints by me about anything, no troubling test results, no prescription drug issues. What is the purpose of that? I was there for a pap smear, a pelvic exam, a breast exam, and whatever else they do for a general visit to the gynecologist. It was pretty damn clear to me that she just looked at me (and looked at the weight on my chart), thought I was too fat, and told me so. And I was not morbidly obese or anything. (As I said before – 5’1″ and a size 14.)

    Being overweight in and of itself is not a medical problem.

  62. Zuzu, you made my point exactly. The doctor wouldn’t even bother to check whether her swollen foot was a result of something else, leaky vein/gland or whatever, fracture that never healed, injury of some kind. He didn’t even take an xray.

    Chet, the point isn’t that we don’t wanna hear about how we should all lose weight because it hurts our feelings. The point is that we’d like to get the same medical care, attention and consideration a thin person gets, not just everything defaults to: LOSE WEIGHT.

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