Reader Question: What to do if you experience medical weight stigma

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Reader Kendra asked “What can I do after I experience weight stigma in my healthcare – is there any recourse that I have?”

Unfortunately, weight stigma is ubiquitous in healthcare and takes many forms, from implicit and explicit practitioner stigma, to internalized and structural weight stigma (I got into this in more detail here.)

How you choose to respond when it happens may involve a lot of factors including what type of weight stigma you are experiencing and in what context, how you are feeling that day, how much power/privilege you have in the situation, how much free time you have, how much of an emergency this healthcare issue is and more.

First and foremost, weight stigma is never your fault, even if it becomes your problem. Whatever way you respond to it (whether you make a complaint or not) is completely valid. I’m going to give some overall ideas and then a sample letter that can be used to craft a verbal or written complaint.

Note: The below suggestions assume that the situation does not rise to the level of medical malpractice and/or that you do not want to pursue this through legal channels. As always, I’m not a lawyer and none of the information here constitutes legal advice.

In the moment/at the appointment

You might choose to address it when it happens. Either with the provider themselves and/or with a supervisor onsite, and/or with a social worker/advocate if you are at a facility that has them. You can utilize the sample complaint framework below in real-time.

To the facility after the appointment

You can submit a complaint to the facility (urgent care, hospital, podiatrist’s office etc.) They may have a person or department that handles complaints. They may have a set process by which to make a complaint, an escalation process, a form to use etc. Here you can start on the facility web page or by calling or having a friend/advocate call for you. You can also make this call anonymously.

Review Sites

Sites like ZocDoc, HealthGrades, and others can be a place to share your experiences , though the information may or may not make it back to the provider and/or their supervisor and they are typically told that due to HIPAA laws, they cannot respond even if they do see them.

Social Media

This is another place where you might choose to share your experience and possibly get support.  

File a Complaint with the State Medical Board

Here you will have to do some research to find out how to file the complaint with your state medical board but if you want to pursue this seriously, this can be a good option. While a single complaint might not lead to disciplinary action, a group of complaints might. EDIT: Reader Rebecca pointed out that due to weight stigma on the part of the State Boards these reports may be met with hostility and be re-traumatizing.

This brings me to my final point before we get into the sample complaint. The thing about taking this kind of action is that we can never know the outcomes, we can only choose to take action. Often our actions might result in change without us even knowing about it. I just heard from someone who has trying to get her facility to host weight stigma training and had no luck until the facility got several complaints about weight stigma from patients. It’s possible that none of the people who made those complaints are aware of it, but if they hadn’t taken the time and effort, then the weight stigma training might not be happening. (Though, again, you are under no obligation to take action and you may choose not to for whatever reason.)

Sample Complaint Structure

This is, of course, just an idea. Please feel free to take what you like and ignore the rest. Please also feel free to share your own ideas and/or experiences in the comments.

Set the scene

Explain why you were there, why you selected this practitioner (were they recommended by a friend? Did they have good reviews?) Explain your original expectations.

Clearly state the issue

Explain what happened that led you to lodge this complaint. Be clear.

Explain how this constitutes stigma/inequality

Unfortunately, due to the prevalence of weight bias and stigma in healthcare, it’s possible that the person who is reading/listening to your complaint won’t understand the problem and/or will be coming from a place of implicit or explicit weight bias and stigma. In this section, you want to make clear what the issue is and exactly why it’s a problem.

Explain what you want to happen

Here you can discuss what you want in your individual care and/or what larger changes you hope the practitioner/facility will make.

Example

Hello. I recently came to your facility for a mammogram. You were referred to me by a friend who said that she had an excellent experience.

Unfortunately, I experienced weight stigma during my appointment. The gown I was given was too small for me. When I asked for a bigger gown I was told that was the biggest size that you had. Stella told me “if you’re too big for the gown you can just wear two.”

I am writing to let you know that what happened isn’t ok. First, that you don’t have gowns to fit patients of all sizes, and then that Stella blamed my body for being “too big” instead of acknowledging that the gown being too small. I also recommend that anyone who thinks wearing two too-small gowns is a viable solution try it for themselves, because it’s not. Overall, this means that your higher-weight patients don’t receive equitable healthcare, and that’s a serious problem.

I am writing to ask that you order larger gowns and that you get weight stigma training for your staff. The person who purchases your gowns may not be aware of the need for larger ones and Stella may not realize that blaming patients’ bodies for failures of accommodation are weight stigma, but both of these things are weight stigma and experiencing them can make people less likely to come for preventative care which can mean that they miss out on early diagnoses and have worse outcomes. Please feel free to contact me if you would like to discuss this further and/or have any follow-up questions at [insert email and/or phone number.]

Thank you,

~Name

Again, this is just a suggestion, please feel free to change it to work for you!

Resources:

If you want/need resources to support you/your statement, here are some places to look:

This piece is about the harm of weight stigma specifically

This piece is about weight-based healthcare inequalities

If you’re dealing with a BMI- or weight-based denial of care, there are resources here

If you are looking for general research around the weight-neutral paradigm and/or research questioning the weight-centric paradigm, you can find that 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’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.