This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing! In part 1 we started discussing the study “Working toward eradicating weight stigma by combating pathologization: A qualitative pilot study using direct contact and narrative medicine” by Rachel Fox, Kelly Park, Rowan Hildebrand-Chupp, and Anne T. Vo.
Poking at one thing out of a terrific article -- "'fat, forty, female' [in reference to gallbladder diseases]"
This phrase is a perfect example not just of how medicine makes pathological assumptions of fat=unhealthy but also how medicine is full of non-scientific assumptions that get passed down in medical training like rumors that will not die.
The most common people to get gallbladder disease are men in their 30-50s with a family history of gallbladder disease.
I firmly believe that the biggest problem in medical training (doctors, nurses, NPs, PAs, etc.) isn't just learning garbage in the classroom, but what they learn in their hospital rotations and residency from senior people who pass along the same BS they learned when they were the newbies. It's bad when your classroom instructor insists that A=B, without any actual proof of it being so, but when you're surrounded by peers who are all telling you that of course A=B is correct, you really start believing it has to be true.
I actually didn’t know the “3 F’s” were a real assumption until reading this. Many years ago (like more than 10), my mom had her gall bladder out. She presented with abdominal and pelvic pain, and the doctor immediately assumed gallbladder. He flat out TOLD HER “you’re the 3F’s!” Fat, female, and over 40!” And I thought he was just being a dick.
Her gb did need to be removed (it was necrotic), but her pain didn’t go away after surgery. It turns out she had an ENORMOUS ovarian cyst on the same side, so she needed a 2nd surgery to remove that. I genuinely think the doctor’s haste and anti-fatness are why my mom needed two separate surgeries to the same area of the body, making her endure double the surgical risks.
The thing that’s always stuck with me about that whole thing is that I’ve never thought of my mom as fat. She was thin before she had kids, and after pregnancy, she never wore larger than a size 16– a fairly average size these days. So I guess doctors think anyone who isn’t single-digit sizes is “fat”?
I think every fat woman in her 40s is automatically diagnosed with gallbladder problems whether or not they exist. "Oh, you have an upset stomach? PROBABLY GALLBLADDER!"
of course... the healthcare industry sure loves to amputate our perfectly functioning digestive organs! good grief.
now that you mention it, when I was first having really bad gut pain in my early 30's (which, in healthcare's defense, was in the classic gallbladder location), they were INSISTENT that it was my gb, even though I went through multiple tests (including a hida scan, multiple CT's and countless ultrasounds, and an upper endoscopy to look for "micro crystals" that could be excreted by the gallbladder) that all showed my gallbladder functioning normally. They almost considered removing it anyway, but luckily we didn't have to have that fight. They diagnosed me with gastroparesis and gave me a drug that carried a high risk of tardive dyskinsesia, because they found the previous evening's meal in my stomach during the scope. they didn't look into it any further. I asked if it could be celiac (and why not do biopsies since they're already doing the scope?) and I was told that people my size don't have celiac, and that was that.
fast forward several years, and surprise, surprise: I have celiac.
Poking at one thing out of a terrific article -- "'fat, forty, female' [in reference to gallbladder diseases]"
This phrase is a perfect example not just of how medicine makes pathological assumptions of fat=unhealthy but also how medicine is full of non-scientific assumptions that get passed down in medical training like rumors that will not die.
The most common people to get gallbladder disease are men in their 30-50s with a family history of gallbladder disease.
I firmly believe that the biggest problem in medical training (doctors, nurses, NPs, PAs, etc.) isn't just learning garbage in the classroom, but what they learn in their hospital rotations and residency from senior people who pass along the same BS they learned when they were the newbies. It's bad when your classroom instructor insists that A=B, without any actual proof of it being so, but when you're surrounded by peers who are all telling you that of course A=B is correct, you really start believing it has to be true.
This is absolutely true and I agree.
I actually didn’t know the “3 F’s” were a real assumption until reading this. Many years ago (like more than 10), my mom had her gall bladder out. She presented with abdominal and pelvic pain, and the doctor immediately assumed gallbladder. He flat out TOLD HER “you’re the 3F’s!” Fat, female, and over 40!” And I thought he was just being a dick.
Her gb did need to be removed (it was necrotic), but her pain didn’t go away after surgery. It turns out she had an ENORMOUS ovarian cyst on the same side, so she needed a 2nd surgery to remove that. I genuinely think the doctor’s haste and anti-fatness are why my mom needed two separate surgeries to the same area of the body, making her endure double the surgical risks.
The thing that’s always stuck with me about that whole thing is that I’ve never thought of my mom as fat. She was thin before she had kids, and after pregnancy, she never wore larger than a size 16– a fairly average size these days. So I guess doctors think anyone who isn’t single-digit sizes is “fat”?
I think every fat woman in her 40s is automatically diagnosed with gallbladder problems whether or not they exist. "Oh, you have an upset stomach? PROBABLY GALLBLADDER!"
Sheesh.
of course... the healthcare industry sure loves to amputate our perfectly functioning digestive organs! good grief.
now that you mention it, when I was first having really bad gut pain in my early 30's (which, in healthcare's defense, was in the classic gallbladder location), they were INSISTENT that it was my gb, even though I went through multiple tests (including a hida scan, multiple CT's and countless ultrasounds, and an upper endoscopy to look for "micro crystals" that could be excreted by the gallbladder) that all showed my gallbladder functioning normally. They almost considered removing it anyway, but luckily we didn't have to have that fight. They diagnosed me with gastroparesis and gave me a drug that carried a high risk of tardive dyskinsesia, because they found the previous evening's meal in my stomach during the scope. they didn't look into it any further. I asked if it could be celiac (and why not do biopsies since they're already doing the scope?) and I was told that people my size don't have celiac, and that was that.
fast forward several years, and surprise, surprise: I have celiac.
at least I still have my gallbladder!
“All weight stigma interventions must begin from the premise that fatness is not pathological.”
“[W]eight stigma research should treat fat people the way that fat people would be treated in a world without weight stigma.”
I needed to read those words today. ♥️