The Doctor Will Shame You Now: Ending Fatphobia Before it Ends Us
My name is Audra.
I’m 23 years old. I have a master’s in International Studies. I’m a researcher, an only child, a cat person, a coffee lover and an enneagram type 4. I have brown hair, hazel eyes and freckles.
I’m also fat.
Being fat feels like something I’ve danced around for years—the ways it affects my life varies by age and context. For a long time—as long as I’ve considered myself a writer—writing about being fat has never been much of a priority for me. It’s felt alternately trite, forced or just not particularly interesting.
This isn’t to say being fat hasn’t impacted my life. Quite the opposite, in fact. I can still remember every comment about my weight that has been levied at me (and many offhand remarks made about other fat people) since I was about four or five years old. I remember the words and the tone in which they were said. I remember who said them, and maybe that’s what hurts most—sometimes it’s bullies or anonymous Twitter trolls, but it’s just as often family members, close friends or sorority sisters.
Maybe that’s something you, reader, should know about fat people—we have awfully good memories. We don’t forget what you say about us, or people who look like us, no matter how much you try to hurriedly roll back your words so we know we’re not one of those fat people.
There have been times throughout my life when my appearance in comparison to other people has become a fixation, an obsession with the geometry and structure of the body, as I would walk to class or through a restaurant calculating hips and thighs and upper arms with laser precision. Am I bigger or smaller than her? Well, I’m bigger than her, but my hips are shaped differently. And the worst question of all, especially when the answer is a resounding yes—Am I the biggest person in the room?
I think part of my reluctance to write about fatness is simultaneously a desire for invisibility and a wholehearted rejection of misplaced pity. The logic, however warped, is that if I don’t refer to myself as fat or make a big deal about fat activism, my fatness will somehow fly under the radar. My thin friends will let it slide, and we’ll just agree not to bring it up. A few months ago, a fat friend was talking about our similarities and matter-of-factly mentioned that “we’re both fat.” I froze. The jig was up, but I’m not stupid. I know it’s been up for as long as my pant size has been roughly equivalent to my age. But on the other hand, I dread the sometimes well-meaning but ultimately annoying possibility of being met with a chorus of simpering skinny people telling me I’m “brave” or “confident.” I do not particularly care to hear what anyone thinks about my body, unless they’re telling me that I’m hot, because I am.
Even when I’ve been riding a wave of body confidence (or more frequently and desirably, body “normality”— when I don’t really think about my weight at all), getting on a plane will snap me back into reality in no time flat. But over the past few years, since gaining the “freshman 15” (times like, three) and starting antidepressants (notorious for their weight-gain side effects), another thing has trumped the sheer terror of a too-short airplane seatbelt—the doctor’s office. This isn’t just about me anymore. It’s about all of us, all of us fat people, and how the very people who are supposed to be looking out for our well-being are killing us.
The reason I’m writing about any of this at all is thanks to a recent article in the Huffington Post’s Highline—a piece provocatively titled “Everything You Know About Obesity Is Wrong” by a writer named Michael Hobbes. There’s a certain amount of fatigue that I, at least, have as a fat person reading about fat people. Articles usually fall into one of a few categories:
This fat woman posted bikini pictures on Instagram and she’s soooooooo brave!!!
Being mean to fat people is bad, but being fat is still bad, you unhealthy fatties.
I’m fat and my health is none of your damn business.
These are all perfectly standard takes with varying degrees of validity. That’s fine. But Hobbes’s article is a little different, and if I had to sum it up, it would be along these lines: “Being mean to fat people is shitty, and it’s literally fucking killing them.”
Hobbes uses the stories and perspectives of a diverse group of fat people, noting that “I have never written a story where so many of my sources cried during interviews, where they shook with anger describing their interactions with doctors and strangers and their own families.”
I had an inkling of where he was going, but I had no idea the personal pain, remorse and sheer anxiety that the article’s latter half would bring back to the surface of my mind. There are so many standout statements and statistics in the article, but this is a good reference point:
Doctors have shorter appointments with fat patients and show less emotional rapport in the minutes they do have. Negative words – “noncompliant,” “overindulgent,” “weak willed” – pop up in their medical histories with higher frequency. In one study, researchers presented doctors with case histories of patients suffering from migraines. With everything else being equal, the doctors reported that the patients who were also classified as fat had a worse attitude and were less likely to follow their advice. And that’s when they see fat patients at all: In 2011, the Sun-Sentinel polled OB-GYNs in South Florida and discovered that 14 percent had barred all new patients weighing more than 200 pounds.
This is when my feigned nonchalance about Hobbes’s writing began to crumble. This was me, and this was why I’ve avoided going to the doctor as much as possible over the past four years.
Like I said, I’m 23. There’s a lot going on with my body that I have to keep on top of. Pap smears, birth control, vaccine boosters, cholesterol—and my mental health, which has been an ordeal of its own. When I was a sophomore in college, I decided to make a good faith effort to get on top of it all, and I started at my university’s student health clinic. After a counselor referred me to a physician to get my antidepressant prescription, I sucked it up and made an appointment. Going to the doctor had always been vaguely uncomfortable—hearing your weight announced to you and God and whoever else is in the doctor’s office hallways is a very specific and very shameful experience, especially for young girls. But I made the damn appointment, because I knew it was worth it. I didn’t realize how much it would spiral away from me.
At my first visit, the doctor noted that my blood pressure was a little high—something I’m fully willing to attribute to my family history, subpar nutritional habits, and lackluster-at-best commitment to regular gym attendance. But my next question, about birth control, was shut down immediately—not until I lost weight, the doctor said. How much do you want me to lose? I asked, nervous, knowing in the back of my mind that permanent weight loss is often unattainable to begin with. Oh, just 15 to 20 pounds, she replied, her tone the equivalent of a simpering pat on the cheek. I remember how my face felt hot with shame, because it feels like that again as I write this. Scolding, then dismissal—par for the course when you’re fat and seeking healthcare. After another horrible experience with the same doctor, I never went back. Like many fat people, my weight had a way of coming up at every appointment, for every ailment. It’s grueling and relentless, and eventually you’ll probably decide that you’ve had enough.
And that’s killing us.
I’m lucky, because I was still on my parents’ insurance, so I was able to see our primary care physician—a kind man who had shockingly never mentioned my weight, just congratulated me on taking up kickboxing—in Tulsa when I got sick. But now that I’m on my own again and establishing a life outside Tulsa, the idea of finding a new doctor literally paralyzes me with fear. Mentally walking myself through the appointment is enough to prevent me from trying to make one at all, even though I need to for my own health. When you’re fat and a woman (and a person of color, and queer), healthcare is always a crapshoot. Maybe you’ll have someone wonderful, but maybe you’ll have to endure thirty minutes of poking and prodding and shame and never get the chance to articulate the reason you actually made the appointment to begin with.
There is so much to being fat, because there is so much to being human. I’m doing much better at loving and appreciating myself the way I am and working toward my own personal wellbeing, but it’s articles and statistics and tragedies like this that remind me that, even though it sucks and I’m dreading the potential backlash I could get for writing any of this, fatness is simply not understood or respected by the medical community at large. And even more disheartening, I have little faith that most doctors care at all about compassionate interactions with fat patients or understanding the factors and complex circumstances behind fatness.
It is not my job to prove my humanity to my doctor or anyone, but it is everyone’s job to treat one another with empathy and open-mindedness.
The ball’s in your court. Choose how you want to play the game. ♀
Audra Brulc is a writer, researcher, and car karaoke star most recently from Tulsa, Oklahoma. She graduated with a master's degree in International Studies in 2018, and currently works for her alma mater while she figures out what exactly she's going to do with her life. Audra's favorite things include great libraries, autumn, good coffee and cats, and her dislikes include mornings, sad movies and pretentious academic writing.