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. And my level of activity has really gone down in the past couple of years. 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 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 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. But fat-shaming and disrespect also affects those who decide to deal with it and make an appointment.
Chrisler says that sizeism can influence how doctors treat their patients. She points out that overweight people are often left out of medical research based on assumptions about their health. And that means the standard dosage for medications might not work for larger body sizes.
One study about obesity, emergency rooms, and antibiotics found that doctors often under-dose overweight patients when they prescribe antibiotics and chemotherapy. Chrisler noted that doctors will advise weight loss for overweight patients, while recommending other forms of treatment for patients with an average weight. This different treatment of patients is unethical, says Chrisler
“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 pointed out that in some cases, health care providers might not take the complaints from a fat patient as seriously as they would with someone who is of average weight. Or, some doctors might just assume that the extra weight is causing the symptoms the person is experiencing.
“Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
Undiagnosed medical conditions is actually an issue with obese patients. 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 indicated that overweight and obese patients are often misdiagnosed or have inadequate 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. Studies have made it clear that negative attitudes among doctors and other medical professionals toward overweight and obese patients can lead to underdosed medication during treatment and undiagnosed medical conditions. The psychological stress, though, 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. And she thinks that viewpoint needs to 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, saying that there is no research to indicate how much weight is too much. Yet, doctors automatically assume that being overweight is an indication that a person 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. Yet, weight seems to trump all of that.
McHugh said that the stigmatization of obese and overweight people is a serious risk to their psychological health. Both Chrisler and McHugh argue that fat-shaming must be addressed in the medical profession, and treatment should be focused on both mental and physical health instead of weight.