Not gonna lie: I genuinely think this is setting healthcare progress back about 50 years for fat patients. Possibly more.
It brings tears to my eyes to think about how much harder we have to fight to overcome this, and about all the fat people who are entirely unaware and are trusting their healthcare providers to provide evidence-based healthcare.
Searching for someone to replace my hip it's clear to me I don't have a right to health care. I have to prove myself worthy in order to get a replacement everyone says I most certainly need. I'm sure they believe it's for my own good. Although I can consent to other treatments that have definite risks, I'm not allowed that right in the instance of joint replacement.
I had hernia repair surgery delayed for 3 years for lack of meeting their weight loss standards. When I did finally get surgery, it was on an emergency basis after bowel, which had always been looped into the hernia, caused a complete blockage. I have no colon so the threat of losing more intestine put me at greater risk of ending up with a permanent ostomy bag. The hernia surgery, 3 years beyond when needed, was so much more severe and put me at such risk for a much worse outcome. Just trying to get the same care as lower weight people, it's exhausting - and very dangerous to our health.
Do you have advice? Frankly, I don't know what to do. I do not think WLS is good for my health long term. I am trying to lose the weight through exercise. I refuse to go back into disordered eating so I am not doing the diet route. But WLS will put me right back there permanently. I did have one surgery but the doctor is saying whatever was holding it together is coming undone. I have had GERD for 2 years since that surgery and the doctor seemed to care about that not at all for a year. Then when she finally did something she said the only way she would fix it is with bariatric surgery which is a terrible surgery. The insurance company would not cover it and she was going to fight it but I told her I wanted my HAES dietician involved and a HAES doctor and her response was no and I hope you find a way to lose weight. Then I went to what I thought was a HAES doctor but she would not advocate for me against WLS. I cannot believe I am in this situation. I finally get my eating disorder under control and have been so proud of that. Now they are just trying to drag me back in by basically threatening my health. It is a nightmare.
India, I'm so sorry for the trouble you're having with your providers. They also have been trying for 10 years to get me to do WLS. I went as far as to take the required 6 months of nutrition counseling required by insurance, but missed one meeting due to snow and was going to have to repeat the 6 months. Before I could start over, I was diagnosed with 57 colon polyps which required the removal of my colon. All I could think was "imagine if I'd had my stomach cut out like I'd planned? What kind of quality of life would I have with no colon and no stomach?! So when the hernia doctor suggested I get bariatric surgery to get ready for his surgery (how can I be healthy enough for one surgery but not the other? More proof that they're making this stuff up as they go along, none of it makes sense), I just said NO WAY. Living without a colon is hard enough, I would not put myself into that level of permanent malnutrition, and as a person on permanent disability, I also could not afford the huge array of supplements needed for life after WLS. If I have a Dr who won't work with me, or who thinks WLS is correct for me, then I know I have the wrong dr. But it's frightening, because I don't want to be viewed as a problematic, non compliant patient. But I do know that I know more about my complicated health status than any new doctor, so I hold my ground and speak very carefully "in my lived experience, that is not the case" or "my daily lived experience lets me know that that plan of care would not work for me". A doctor who has issues with my concerns is not the doctor for me. I'm trying for health now, not necessarily weight loss. I'm trying to end the battle and hatred I've had with food. I'd like to lose weight, but I'm 62 and I've spent my whole life trying my best to do so. You don't have to tell me twice that 95% of diets fail! I'm going for flexibility, increasing stamina and strength through movement. As a result, my blood sugar, blood pressure and cholesterol levels are improving. Proof that what I'm doing is working, so their comments on my weight are unwanted and unnecessary. I gain a lot of insight and good ideas of how to advocate for myself right here with these newsletters. They are lifesaving.
I'm so sorry for your struggles too, Pat. Good for your for setting good boundaries!. I will keep at it too. It is just so exhausting. I have nightmares about this situation.
It is exhausting! Keep doing the best you can. They are bullies and hard to deal with -- but you deserve the best care, I'm just sorry that we have to work so hard to try and get it. I hope you find a better doctor :)
What I find so scary about all of this is that they can frame this as compassionate care, which makes it hard for anyone to push back.
I am reminded of when I worked in a hospital and one of our e-learnings was about how to treat "bariatric patients" ("bariatric" meant anyone in a larger body, not those being subject to bariatric surgery!). It was so patronizing, but anyone who doesn't know better might have read it and thought that this came from a place of kindness.
I'll just add, I am not a person in a larger body, so I like to be cautious in what I add to these sorts of conversations. But, it all enrages me! As a therapist, I hear about frustrating instances that people encounter with doctors all the time...and I end of feeling so helpless on their behalf, and so upset that doctors can use their power in this way. The problem is that a lot of doctors truly do not know any better and truly believe that they are providing compassionate care.
There is a lot of money and power in this. It feels like a losing battle. And it is going to make health care worse for those of us with bigger bodies. It is already bad enough.
The whole thing reminds me of Henry Ford's famous quote that you could get a Model T in any color you like so long as it's black. You have the right to any care your fat body needs so long as it's intentional weight loss.
Not gonna lie: I genuinely think this is setting healthcare progress back about 50 years for fat patients. Possibly more.
It brings tears to my eyes to think about how much harder we have to fight to overcome this, and about all the fat people who are entirely unaware and are trusting their healthcare providers to provide evidence-based healthcare.
Searching for someone to replace my hip it's clear to me I don't have a right to health care. I have to prove myself worthy in order to get a replacement everyone says I most certainly need. I'm sure they believe it's for my own good. Although I can consent to other treatments that have definite risks, I'm not allowed that right in the instance of joint replacement.
Same with my hiatal hernia. They are insisting on WLS instead of fixing it in my body as is.
I had hernia repair surgery delayed for 3 years for lack of meeting their weight loss standards. When I did finally get surgery, it was on an emergency basis after bowel, which had always been looped into the hernia, caused a complete blockage. I have no colon so the threat of losing more intestine put me at greater risk of ending up with a permanent ostomy bag. The hernia surgery, 3 years beyond when needed, was so much more severe and put me at such risk for a much worse outcome. Just trying to get the same care as lower weight people, it's exhausting - and very dangerous to our health.
Then they blame weight for our health problems when it is really just weight stigma and their hatred of our bodies.
Do you have advice? Frankly, I don't know what to do. I do not think WLS is good for my health long term. I am trying to lose the weight through exercise. I refuse to go back into disordered eating so I am not doing the diet route. But WLS will put me right back there permanently. I did have one surgery but the doctor is saying whatever was holding it together is coming undone. I have had GERD for 2 years since that surgery and the doctor seemed to care about that not at all for a year. Then when she finally did something she said the only way she would fix it is with bariatric surgery which is a terrible surgery. The insurance company would not cover it and she was going to fight it but I told her I wanted my HAES dietician involved and a HAES doctor and her response was no and I hope you find a way to lose weight. Then I went to what I thought was a HAES doctor but she would not advocate for me against WLS. I cannot believe I am in this situation. I finally get my eating disorder under control and have been so proud of that. Now they are just trying to drag me back in by basically threatening my health. It is a nightmare.
India, I'm so sorry for the trouble you're having with your providers. They also have been trying for 10 years to get me to do WLS. I went as far as to take the required 6 months of nutrition counseling required by insurance, but missed one meeting due to snow and was going to have to repeat the 6 months. Before I could start over, I was diagnosed with 57 colon polyps which required the removal of my colon. All I could think was "imagine if I'd had my stomach cut out like I'd planned? What kind of quality of life would I have with no colon and no stomach?! So when the hernia doctor suggested I get bariatric surgery to get ready for his surgery (how can I be healthy enough for one surgery but not the other? More proof that they're making this stuff up as they go along, none of it makes sense), I just said NO WAY. Living without a colon is hard enough, I would not put myself into that level of permanent malnutrition, and as a person on permanent disability, I also could not afford the huge array of supplements needed for life after WLS. If I have a Dr who won't work with me, or who thinks WLS is correct for me, then I know I have the wrong dr. But it's frightening, because I don't want to be viewed as a problematic, non compliant patient. But I do know that I know more about my complicated health status than any new doctor, so I hold my ground and speak very carefully "in my lived experience, that is not the case" or "my daily lived experience lets me know that that plan of care would not work for me". A doctor who has issues with my concerns is not the doctor for me. I'm trying for health now, not necessarily weight loss. I'm trying to end the battle and hatred I've had with food. I'd like to lose weight, but I'm 62 and I've spent my whole life trying my best to do so. You don't have to tell me twice that 95% of diets fail! I'm going for flexibility, increasing stamina and strength through movement. As a result, my blood sugar, blood pressure and cholesterol levels are improving. Proof that what I'm doing is working, so their comments on my weight are unwanted and unnecessary. I gain a lot of insight and good ideas of how to advocate for myself right here with these newsletters. They are lifesaving.
I'm so sorry for your struggles too, Pat. Good for your for setting good boundaries!. I will keep at it too. It is just so exhausting. I have nightmares about this situation.
It is exhausting! Keep doing the best you can. They are bullies and hard to deal with -- but you deserve the best care, I'm just sorry that we have to work so hard to try and get it. I hope you find a better doctor :)
What I find so scary about all of this is that they can frame this as compassionate care, which makes it hard for anyone to push back.
I am reminded of when I worked in a hospital and one of our e-learnings was about how to treat "bariatric patients" ("bariatric" meant anyone in a larger body, not those being subject to bariatric surgery!). It was so patronizing, but anyone who doesn't know better might have read it and thought that this came from a place of kindness.
I'll just add, I am not a person in a larger body, so I like to be cautious in what I add to these sorts of conversations. But, it all enrages me! As a therapist, I hear about frustrating instances that people encounter with doctors all the time...and I end of feeling so helpless on their behalf, and so upset that doctors can use their power in this way. The problem is that a lot of doctors truly do not know any better and truly believe that they are providing compassionate care.
That has to change. I don't know how we are going to change it though.
I just…
They hate us so much.
There is a lot of money and power in this. It feels like a losing battle. And it is going to make health care worse for those of us with bigger bodies. It is already bad enough.
The whole thing reminds me of Henry Ford's famous quote that you could get a Model T in any color you like so long as it's black. You have the right to any care your fat body needs so long as it's intentional weight loss.
Right. :(