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My family doctor was asking me what I ate in a typical day ... and then asked me about juice and pop consumption and I laughed in his face. They are sad sad people - their (false) assumptions about fat people are beyond ridiculous. The family doctor stopped asking me about my diet after I laughed at him. I'm a medical statistician so I know the evidence way better than any family doctor I have ever met (I'm fortunate, I know). I still get pre-emptively angry when I go to the family doctor and they still want to weigh me. I refuse unless I'm with a specialist and I'm going to get dosed with some anesthesia. I do get pushback or the distant cold stare. My favorite pushback time is when they responded with "well you are going to have too" and I said, "No, I really don't" in the coldest voice I've ever had. It was a beautiful moment for me. I was prepared to be refused to be seen. I wasn't. But I would quite happily write a complaint letter to the College of Physicians and Surgeons, and try another family doctor or clinic.

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My biggest pet peeve is when a doctor gets hyperbolic about how my fat body will make me more likely to die of something, as a way to encourage weight loss.

In 2020 I was finally trying to communicate to my primary care doctor that I don’t want to be prescribed intentional weight loss, and I shared your excellent HAES reference cards with all of the research laid out… and the response was pretty horrific…

telling me I was more likely to die of COVID and to research Metabolic syndrome (which I did, and the only one of the cluster of conditions that make up metabolic syndrome that I have is my fat body 🙄)

I ended up finding a new primary care doc 😡

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When they do not believe me that I need the larger b.p. cuff and they keep trying to use the smaller one!!!

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1. Any healthcare provider asking me "have you thought about losing some weight?' No, I'm a 40 year old woman in America who consumes media, is on social media, and has been to a doctor at least once in the past. I've never even considered it! Thank goodness I found a doctor to come up with this life-changing idea. #sarcasm

2. When the medical care provider talks about something like food tracking apps or a fad diet like it's the best thing that's ever existed for weight loss. I've told dozens of providers that I refuse to track my food because of what it does to my mental health (and I'm not good at estimating portion size). Still, MyFitnessPal is recommended ALL THE TIME.

3. When durable medical equipment like braces or bandages don't come in a size large enough. I needed padding for my elbow after surgery and the sleeve thing they wanted to use only came in an XL. I probably needed a 2XL or 3XL. Because my arm was too fat and I didn't want the elastic digging into my skin, I went home with less padding and a bandage that fell off. This was at a sports medicine facility. Even if they don't want to take care of fat people, what do they do for people with large arm muscles?

4. An obvious one, but the assumption that my joint pain would go away if I lost weight. My connective tissue is defective. Some of my tendons are twice as long as they should be. Maybe the fact that my tendon is twice as long as it should be and my knee cap is almost in my thigh is the cause of pain? Idk, I'm not a doctor. Or, how is weight loss going to help my wrist pain or jaw pain?

5. I need to lose weight (according to doctors), but doing any kind of exercise beyond stretching/strengthening and aquatic therapy cause my joints pain. So I'll need more pain meds to deal with that. But they won't give me more pain meds. They send me to an "exercise consultant" who does helpful things like measure my percentage of body fat and tell me that I need to get in 20-30 minutes of cardio per day. I ask her how, considering my pain issues. "Well...you just have to do it" was her answer.

6. Little to no recourse from administration or patient experience departments or advocates when these issues are brought to them.

7. Health care systems who want people to lose weight and eat healthy, but still sell food that is considered by those who buy into diet mentality not helpful for losing weight in their vending machines, cafes, and cafeterias. I'll eat whatever I want, but talk about mixed messages.

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The worst example I have is when I went to a new gynecologist after moving to a new city in my 20s and she focused on my weight instead of...you know, my gynecological health... and told me I was overweight per the BMI chart. I asked her how much I *should* weigh and she told me around 160 pounds. Folks, I am 6'2". I haven't weighed 160 lb since middle school. The whole interaction made me feel like giving up entirely and I am pretty sure I cried when I got home thinking about how completely impossible it would be for me to ever get to that "target weight". Nowadays I just feel angry at her. I think to myself how irresponsible it was for her to just spitball some random number like that. She was like 5'2" so maybe she had no idea? But even on the BMI chart that would be verging on underweight for my height.

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When I go to the doctor for something like a sore arm and they have to weigh me. My weight and the fact that I have a rotator cuff injury are not related. I refused to be weighed.

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The chairs! At a minimum, please have some chairs in the waiting room without arms. Benches would be good.

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Oooh - just thought of my other pet peeve. Those blood pressure machines that don't work on fat arms. What they do is crush the arm until the blood vessels burst and then error out - sometimes because the cuff is the wrong size and sometimes just because. FYI - the gold standard for blood pressure is when they take it manually. You have a right to this (at least so says Kaiser's customer care) - and it is especially important because healthcare professionals tend to assume we all have high blood pressure. So accurate measurements are important!

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I HATE how, no matter why you are there, they want to weigh you. I went in for some pretty severe cat bites - and the first thing was, "Get on the scales." I usually don't care one way or another about weighing - but this time I was just all "You've got to be kidding me. No." And when I visited my doctor's 2 days after my last visit because they had screwed up by scheduling outpatient surgery instead of in the hospital (because of BMI restrictions); I let them have it - it had been 2 flipping days and apparently, either they don't write this stuff down or nobody looks at it. So, again, NO. (I can be a little ray of sunshine like that when pushed.)

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Who trained all these doctors that asking, “So, what are we going to do about your weight?” was somehow the best way to communicate the doctor’s discomfort with their fat patients bodies?

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This is not just about doctors, but includes them. I hate the way that it doesn't matter how much I exercise or what I eat - by definition, it will never be good enough. If someone asks me (assuming the answer will be "no") if I ever exercise, and I reply that I exercise for an hour almost every day, their response will inevitably be to try and discover the way that the exercise I'm doing is wrong. I'm not doing intense enough exercise, or cardio when I should be doing strength, or strength when I should be doing cardio, etc.

The same for my diet. If I tell them my most commonly eaten meal is a salad, then I'm eating the wrong kind of salad, or I'm using the wrong dressing, etc etc. If I ate at fast food once in the last month, they act like I'm eating fast food every day. (Which would be fine if I did, but I'm not.)

It's a completely rigged game.

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Assumptions! Even if you say you exercise, they’ll assume you don’t do “enough,” are lying, don’t know anything, etc.

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I hate it when they send you to a dietitian since obviously you must be completely ignorant about nutrition, since that’s the only reason anyone would be fat (sarcasm.) seriously, most fat people probably know as much about nutrition as the stupid dietitian since we’ve been dieting most of our lives. They tried to explain macros to me FFS. Bitch, I been counting macros since before you were born!

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Dunno what it is about me but I find, and others have echoed the sentiment, that fat women (esp. fat WOC, which I'm not but they're the first to say "Same!") are extremely likely to be seen as drug seekers, even when it's obvious we're in severe pain. I can count -four- times in a hospital bed when I've been treated like a drug seeker. Why didn't the admitting ER doctor write for a real pain killer for this obviously painful problem? I dunno, ask them! Don't ignore me and shut the door as you leave, saying, "You're bothering other patients." And that wasn't even the worst one. The irony is: The hospital HCPs who seem to think I'm a drug seeker are always nurses, but I get my best healthcare in offices from Nurse Practitioners, who I've found are more likely to be compassionate and be more about whole-body healthcare without obsessing about weight. Go figure!

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I have been lucky to have some great HAES or downright explicitly fat positive doctors in the past five years (because I specifically moved to a place that I knew had them) but that never seems to extend to the rest of the healthcare professionals on their team.

I always decline to be weighed and it’s only once not led to pushback that activates all the past trauma from the doctor’s office, and then as you know that leads to a higher BP reading — which is made even higher by the fact that they cuff is too small and it hurts me, and NEVER has my BP been taken in the way you’re supposed to for an accurate reading: as a short person my feet don’t touch the ground, usually I’m getting peppered with (fatphobic) intake questions during the reading, and the cuff always is too small and hurts my arm as it repeatedly gets too tight and fails to get a reading. (When it’s taken correctly, usually by the doctor when they realize their staff did it wrong, my BP is always normal.)

My pet peeve also extends to dealing with the fat shaming horror that always get stuck in my chart no matter how valiant of an ally I have in my doctor — even when they don’t have my weight and ask for it to be removed. I do appreciate that all the doctors who know that I will see weight stigmatizing language in my chart warn me, but it still impacts me.

Worst of all: the one doctor’s office that was explicitly Health at Every Size as an entire practice (Hands on Medicine in Portland, OR) and great about declining the weigh in and having proper blood pressure cuff sizes ended up being a nightmare for me when I was first diagnosed with ADHD. The doctor made me jump through a lot of hoops that upon reflection were about assumptions made about my fat body (a month of testing my BP at home when as mentioned my BP is normal and making me do an insanely expensive and extensive heart tests with a specialist when I have no indication of heart issues and none were found) only to have the doctor tell me she doesn’t believe that ADHD meds are helpful, doesn’t prescribe them, and have I tried using a calendar to keep things straight? (I had been seeing an ADHD specialist therapist for a year at this point and using all the tools possible and still failing to manage.) After I spent months with her not telling me this belief but making me do all the tests (which cost thousands of dollars out of pocket) she claimed were necessary for her to prescribe any stimulant medications!

I finally found a doctor who doesn’t fat shame me who has been wonderful about helping me find the right med and dose for ADHD meds — life changing! — but I just moved and she’s apparently out of network even though I have the same insurance, so I’m really feeling this topic right now.

If anyone knows of any good, fat positive Kaiser doctors anywhere in the Seattle area (or anywhere in WA state really) I would love to hear it. I moved from the Portland area which is truly rife with fantastic doctors and I’m really scared about finding one here (I lived in Seattle before for a decade and found it to be a pretty shitty place to be fat, moving back was never my plan but, you know, it’s been a weird 20 months for making plans.)

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“ I’ve lost weight and kept it off- so can you!”😡

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Fat male doctors judging me and my body.

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They way they seem incredulous when I mention exercising. Or the "limited by habitus" comment in the chart when they made the most cursory effort to do a particular exam and would rather blame your body for their laziness.

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When the doctor absolutely insisted that I had to be weighed at every appointment and one of the reasons she gave was "It makes the nurses nervous when you refuse." I'm guessing that the nurses were nervous about her reaction. (I broke up with her.)

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Reflexively assuming the patient is lying drives me up the wall! I'm severely disabled (bedridden) and also fat. I'm not bedridden because I'm fat, for me the disability came first - not that people who are bedridden due to weight are any less deserving of excellent healthcare of course! But one of my specialists REFUSES to believe this for some reason I can only assume is due to his own bigotry and insists I am wrong and my weight caused me to become bedridden.

The most bizarre thing is that he's a hospital doc at a hospital I have attended since before I became fat. If he only bothered to look at the records on the computer in front of him he could corroborate my story quite trivially, but he won't look, because he is SO sure that my dysautonomia is due to my weight and I am lying and he is right!

To make things even more bizarre, he has also apparently forgotten who I am (I only see him every 6 months for a few minutes) now that we are all on telehealth via phone appointments, and he is finally treating me like a human being since he can't see me. The whiplash is very odd

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I've mentioned to you elsewhere that I've in general been very happy with my doctors, despite some of their remarks. Some of the things I've heard in the past that didn't necessarily annoy me at the time, but sunk nonetheless in (not in the best possible way):

1) Of my patients a large percentage (I've heard at least 25%, 30% and 35% in the past) have successfully lost weight or kept it off - you can do it too!

2) Even what you say about diets failing 95% of time would be true, it just means that you need to seriously try 20 times to succeed!

3) People who try to quit smoking/drinking have a failure rate of over 98% - should I tell them not to try quitting smoking/drinking too?

4) Alcohol has a lot of calories, many people lose a lot of weight when they stop drinking alcohol.

5) You've been extraordinarily lucky not having gotten type II diabetes, but sooner or later you will.

6) Did you know that damage accumulates and every year you remain obese, you permanently destroy your health.

7) Caloric restriction is the key to longevity - it's been tried with fruit flies, rats, and primates so eating less is the key to health.

8) All you need to do is count calories, do cardio and be consistent with the plan for 2 years and you'll be a normal-sized person.

9) If you want to have a child, you need to lose weight first as women your size are practically infertile and being pregnant would put the health of you and the child at risk.

10) Even Linda Bacon mentions in her HAES book about trying smaller plates and portions as a way to control your caloric intake.

11) It's great that you're engaging in HAES. Caloric restriction is an important healthy behavior and could be the next step in your HAES journey.

12) You don't need you to lose weight, you just need you to stop eating sugar and this health problem of yours will go away. Okay, I confess on this one, I fought it tooth and nail for two years and eventually gave in and it kind of, sort of, worked.

For the record, I've only tried dieting a few times in my life and they all failed. They failed, because losing weight is miserable and I get a lot of enjoyment from food. The way it looks, the way it smells, way it feels in my mouth, the way it tastes, the way it fills my belly - I love all of it. I can substitute an ingredient for another with difficulty, but there's no way my appetite will ever let me lose a significant amount of weight.

Edit: Pasted this comment earlier, but had to fix grammar and repost based how bad the first one was.

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Sadly, when my doctor wants a bp, I have to make a special appointment with the doctor (because apparently, the pa's don't know how to do it manually) and last time, they had a terrible time finding a sphygmomanometer that actually worked!

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