I’m disturbed whenever I meet with a client who’s had difficulty with the medical community due to being higher weight. That’s because there’s such rampant fat bias and weight stigma among these professionals. To remedy that situation, Paige O’Mahoney, MD, and I wrote Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers a review of which can be found at https://www.karenrkoenig.com/blog/my-new-book-is-out-helping-patients-outsmart-overeating.

Study after research study provides evidence of doctors, nurses and health providers offering inadequate treatment to higher-weight patients. Some admit to their bias about people they consider to be “fat” or “obese” and some fail to recognize their prejudice while it continues to inform their practice and harm their patients mentally and physically. Common problems include blaming the patient for being high weight and for their health problems; expressing patronizing, condescending, and contemptuous attitudes toward them; and misdiagnosing medical conditions based on the assumption that if patients lose weight they’ll feel better and their health problems will abate.

It’s true that health providers are just as suckered into our culture’s hatred of fat as the rest of us. Few understand weight stigma’s deleterious mental effects on people of higher weight, though by now these conclusions have been well documented in health as well as general publications. They need more education, as do we all, on the subject.

However, I’m also disturbed when I hear or hear of higher weight people refusing to go to health care professionals for preventive or remedial care because of how they are/were treated by some of them. After reading about a higher weight person dying an early death because she refused to go to the doctor based on how she’d previously been treated by the medical establishment, I felt angry at her poor treatment by people I believe should know better. But I also felt sad for the woman who didn’t think enough of herself to press on until she found doctors who would treat her better—without judging her weight and offering nothing less but effective, compassionate treatment.

As you know, I’m all about self-care, self-care, self-care. Dysregulated eating most likely has genetic components. And poor self-care most assuredly has its roots in our histories, all the way back to childhood. But higher-weight people, in spite of being victims, must push past that mindset and act in empowered ways, one of which is to stop blaming the medical system for poor care, cease all-nothing thinking about health providers, and keep at it until they find professionals who can and will treat them well.

Change in the health care system will not happen until providers are better educated about what causes higher weights, end fat prejudice and recognize how weight stigma negatively affects people mentally and physically, and until people of higher weight demand better treatment.

Best,

Karen

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