Anxiety before making a doctor’s appointment is common, especially if you occupy a larger body.
Often, this is due to the fatphobia that people encounter during their visits.
Fatphobia is the discriminatory behavior and ideals towards folks with larger bodies.
In a general sense, this looks like judgements and assumptions about things like larger folks’
This discrimination
Because we’ve seen that this can lead to folks having their pain dismissed or even their eating disorders ignored, it can lead to an overall hesitance to be seen by a healthcare professional.
“A common theme is the tendency to avoid or delay care because people feel their doctor will be disappointed in them for not losing weight, or that they will get the same lecture about weight they’ve heard dozens of times. A visit to the doctor’s office becomes a source of shame and stress,” says Melissa Alazraki RD, CDCES with Culina Health.
It’s understandable that if you aren’t feeling great, the last thing you’d want is to be fat-shamed by your doctor, but skipping your annual exams or ignoring an ongoing issue may not be the move.
To aid in navigating these (very valid) fears, we spoke with Alazraki along with Clara Nosek RDN of Clara Nosek Nutrition, Patrilie Hernandez, founder and CEO of Embodied Lib and Christyna Johnson, MS, RDN, LD of Encouraging Nutrition for guidance.
Read on to see what these four experts say about how you can best advocate for yourself at the doctor’s office in spite of fatphobia.
When it comes to an office visit that you’re feeling anxious about, starting your prep before you even make the appointment could be a good place to begin.
Some ideas include:
- You could jot down your questions on your phone or a notepad and bring it with you to your appointment. That way you aren’t tasked with remembering in the moment.
- If this is a follow-up, bring along or send any necessary documentation or results prior to.
- Do your own research. We all know internet searches don’t stand in for a real-life clinician. But, doing some reading from credible sources could leave you feeling a little more grounded in background information before you head to the clinic.
All four experts agreed that you can always enforce your right to not be weighed if it isn’t truly needed.
When you first arrive and vitals are being taken, you can ask if being weighed is medically necessary. If they say no, simply decline.
“Be assertive!” Alazraki says.
“If you receive pushback, or if it is medically necessary for the doctor to obtain your weight that day, you can ask for a blind weight.”
A blind weight means you stand facing away from the display on the scale, and they don’t share the number with you. If this is the route you want to go, Alazraki reminds us to:
- Inform all members of the health care team — including medical assistants, nurses and doctors — that you do not want to know your weight
- Ask them to note this preference in your chart
- Be aware that weights and BMI calculations may be automatically pulled into after visit summaries
Alternatively, if the weight is needed and you’d feel comfortable with your provider versus the medical assistant, you can ask for this as well.
Johnson says that you can say something like, “‘I’m comfortable with being weighed, but I’d prefer for the doctor to do it.”
Many of us have experienced situations where we go to the clinic for an issue that our weight isn’t connected to, but somehow it gets brought up.
Or worse, it’s blamed for the issue without any testing being done or thorough questions being asked.
Hernandez and Johnson shared an option if you feel that your weight or BMI was seen as the culprit prematurely.
Ask your provider what their opinion or course of action would be if your weight wasn’t seen as an issue. This could sound like:
- “What would you tell someone in a smaller body?
- “How would you move forward if I had an ‘average’ BMI?”
- “If you didn’t feel that I needed to lose weight, what tests would you consider?”
If they answer the question directly, request the tests or next steps they mention. If they don’t answer, ask for the refusal for further conversation to be documented in your chart.
This could persuade them to take action, and at the very least, you can bring this documentation with you to the next provider you see.
Speak up
Johnson says that she’s come across many doctors who feel that addressing a person’s weight is their due diligence.
But, she believes this ignores the fact that giving an opinion on someone’s weight when it’s unsolicited or medically irrelevant can be actively harmful. Because of this, she suggests being frank about the negative impact that addressing your weight could lead to.
Nosek acknowledges that because of the way our healthcare system in the US is set-up, it can sometimes be difficult to feel comfortable sharing your feelings with your provider.
“I have seen so many patients who feel like their providers don’t listen to them and granted knowing that a visit is 15 minutes max, there’s not much room for rapport building,” she says.
“ [But] saying something is better than saying nothing.”
Bring a friend with you
The experts suggest bringing a friend or loved one along that you’re both comfortable with hearing your medical history and that you trust to advocate.
If you know that you’re feeling a little anxious and you tend to clam up, who’s going to be there to remind you of the questions you had, or to stand firm if those questions are ignored?
And sometimes, just knowing that you aren’t alone can provide the needed support to get through the visit a little easier.
Use your other healthcare providers as allies
Alazraki shared that she’s experienced situations where a person is presumed to need a lifestyle change due to their weight, but notes that this isn’t always necessary.
“As an RD I have sometimes acted as an ally to patients in these situations, coordinating care with MD’s to explain why a structured weight loss plan might not be indicated, or confirming that a patient has healthy eating and physical activity behaviors.”
If you see a dietitian, nutritionist, or another recurring medical provider who can vouch for your lifestyle habits and health concerns, you could consider speaking with them about connecting with your other doctor if you need support from a professional.
Get a second opinion
Nosek recommends, if possible, shifting to another provider or a different facility entirely if your needs aren’t being met.
Because of healthcare and insurance costs and coverage, this may not be an option for everyone. But if possible, consider searching your insurance’s website or through provider reviews to connect with a professional that is openly weight-inclusive.
For many of us, going to the doctor can take a lot out of you. Of course, sometimes your visits are wedged in-between work meetings or school and soccer practice pick-up and drop-offs.
Despite all of this, it’s important to take a beat to care for yourself before and after a visit (especially if it’s a tough one), even if it’s brief. Below are a few tips.
Before
Taking some time to center and align your thoughts and feelings could be beneficial before heading into an appointment.
“If you’re already feeling really anxious about going, your responses are heightened so you can take care of yourself before you go do some things that help you feel a little more calmer, a little more safe when you go in there,” Johnson says.
This could look like:
- Do some deep breathing or meditation
- Talk with a friend about your anxiety beforehand (but with enough time to some of that deep breathing after)
- Move your body in a way that feels good to you
- Listen to music that puts you in a good mood
After
Nosek emphasizes the need for post-visit self care, suggesting options such as finding a friend to vent to, some quiet time alone, or a nice scream into the void.
Even if that scream isn’t possible, finding a way to release any built up energy or tension can be useful, which could also include:
- Going for a brisk walk
- Dancing around to loud music
- Scream-singing your favorite song in the car on the way home
- Scribbling in a coloring book
We have to advocate for ourselves until things universally shift, but Johnson has a simple suggestion for clinicians:
Ask your patients what they need.
“There’s an assumption taught to us that if someone’s in a larger body, they ‘don’t care’ or they ‘did it to themselves,’ which couldn’t be further from the truth,” Johnson says.
“So if we remove that bias and we just ask, ‘What are you looking for?’ ‘Did I cover everything that you wanted to cover today?’ That gives the person the opportunity to say what’s actually going on.”
Fatphobia is a prevalent issue within society and healthcare isn’t exempt.
The effects of this weight-based discrimination can have damaging effects on a person’s mental health, self-esteem, and ultimately their physical health.
Nosek offers a reminder that a provider’s discrimination isn’t reflective of you.
“…If the provider is not actively practicing from a weight-neutral perspective, that their discriminatory biases have been reinforced by their formal education,” she says.
“Not to excuse the dismissal or discrimination, but to know that it is not a you-problem, but that it’s a systemic issue.”
While there are experts like the ones we’ve talked to that are intentional about size inclusivity, other providers could benefit their clients by centering their asks and needs and forgoing assumptions.
Feeling shame about your body is hard, especially when you’re not feeling your best.
If switching your care to a healthcare professional who is intentionally size inclusive isn’t an option, there are other ways to advocate for yourself with, which can include bringing a friend to an appointment and clearly stating your needs.
You know your body best — feel confident in standing your ground when it comes to asking for what you need.