Navigate Medical Weight Stigma By Creating an Appointment Action Plan

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It is all too common for fat patients to have their healthcare appointments hijacked by a healthcare practitioner who becomes completely obsessed with talking about weight and weight loss, no matter what they came in for. Obviously, this shouldn’t happen, but it does and one option to try to navigate it is to create an appointment action plan prior to the appointment.

The goal of this is action plan is to prepare yourself to ask for what you need/want and stay in control of the appointment. For extra support you can it with you on your phone, write it out, print it out, however you prefer to get it to your appointment. You can also bring somebody with you who is also aware of your plan.

Before we get into it, I want to reiterate that this shouldn’t happen, and point out that due to power and privilege imbalances you may or may not be able to control the appointment and get what you need. If this doesn’t go the way you want, then please understand that it’s not your fault.

Ok, so let’s get planning. Here are some components you might want to include:

Goal(s) for this appointment

What is it you are trying to get out of this appointment? Is it a medication refill, a diagnosis/diagnostic test, a referral to a specialist? An in-depth conversation with the practitioner? Write down your goal(s) for the appointment. Then, if the practitioner tries to pull the focus to weight loss and you don’t want to address it head on, you can try saying something like “Thanks for bringing that up. I’ll make another appointment to talk about that, but today I’d like to focus on [my goals.]

Symptom(s) I have

If you are asking about something that’s going on with you, be as specific as you can. Where are you feeling the symptom(s)? How often? At what intensity? If the provider starts talking about weight loss you can refocus them with “I’m happy to have that conversation separately, but first I want to talk about this [symptom] I’ve been having, it’s my understanding that people of all sizes experience this” and then move into the specifics to move the conversation back to your goals.

Concern(s) I want addressed

In addition to (or instead of) symptoms, are there other concerns you want addressed? Are you having concerning side effects from your existing course of treatment? Do you need a medication refill? Do you want to see if there are other treatment protocols available? Do you want a second opinion? Do you want a referral to a specialist?

Question(s) I want answered

Include any questions you want to make sure the practitioner answers before you leave the appointment.

Numbers

If there are any numbers, measurements, etc. that might be helpful, make sure to bring them. This could include:

·         log of when/how often you use your inhaler

·         Pain level record

·         Glucose monitor/numbers

·         Medication side effects experience log

Research

If there’s research that you might want to discuss with the practitioner you can save it on your phone or tablet or print it out. Talking about research with practitioners can be a tricky business. If you have a practitioner who doesn’t seem willing to discuss research with you (perhaps they are giving you “don’t confuse your Google search with my Medical degree vibes) one trick is to say something like “Another practitioner mentioned this research to me and suggested that I discuss it with you.”

Again, we aren’t totally in control of our appointments and so these techniques may or may not work so remember that if you can’t get your practitioner to pull their focus from weight/weight loss, that’s not because you did something wrong, that’s because weight loss culture is insidious and ubiquitous. I believe that weight-neutral care should be standard, but even if it’s not, it should still be available to those who want to focus on their actual health instead of on body size.

If you want more support and techniques around navigating medical weight stigma, I have a video workshop about dealing with weight stigma at the doctor’s office (and there’s a pay-what-you-can-afford option to make sure that money isn’t a barrier!) You can find it here.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.