The Lazy Diagnosis

Published April 21, 2011 by Fat Heffalump

I want to talk about death threats against fat people today.  Not literal ones, like “I’m going to kill you!”, which we do receive sometimes, particularly if we commit the “crime” of being publicly and unashamedly fat.  But the more subtle ones.  Brian over at Red No. 3 wrote about them a while back, in his post “A Culture of Death Threats“.

It’s the kind of message that fat people hear every day.  The message that boils down to “You’re going to die, fatty!!”  All those times you hear “But don’t you know being fat is unhealthy??” and “You’re going to get diabetes/high cholesterol/heart disease/bowel cancer/etc.” right through to the ridiculousness of “Your fat is crushing your bones!  Your organs are going to liquify into fat!  Obesity destroys your immune system!”

We, fat people, hear those messages every day.  From sources near and far – friends and family, the diet industry, mainstream media, the government, strangers on the street, and indeed, from many health care professionals.

As Brian says in his post, this is a method of control, trying to get us to do as we are told.  We must diet, punish ourselves, be invisible, feel shame, loathe our fat bodies.  Be a good fatty and do whatever we can to stop being fat.

However, something else happens too.  Even if we opt out of the societal norm of loathing and shame for fat bodies, something happens to us that even the most deeply entrenched fat activist can be susceptible to.  We begin to fear our fat bodies.   We stop listening to them as part of ourselves, and see them as the enemy, something to be feared and fought, other than/outside ourselves.

It happened to me this week.

I’ve mentioned plenty of times before that I suffer from anxiety.  Some of it is genetic (most of my family on both sides have some form of anxiety issues) and some of it is a result of PTSD.  Of course, my anxiety has been blamed on my fatness too, but I have thin relatives who also suffer it, and that never gets acknowledged.

Most of the time, it’s well managed these days.  I recognise many of the triggers, I see the warning signs, and I have learned the skills to mitigate most bouts.  But sometimes it blindsides me, and then it’s very difficult to work through it, even with the recognition and skills I have learned.

So I got a cold a couple of weeks ago.  It swept through my office like a brush fire, and as I had a nice open tattoo wound at the time, I could hardly avoid it.  My doctor (who is awesome and I am very lucky to have found) and I have noticed this phenomena of me getting a cold every time I have a fresh tattoo – otherwise I hardly get the bugs that go around.  I had a pretty full on cough, got a rather interesting husky voice for a couple of weeks, felt a bit run down and tired, but wasn’t that bad so I didn’t have any time off work though many of my colleagues who got the same lurgy did.

However this week, I noticed a pain in the left side my chest.*

And every voice that ever told me that I was going to die because I’m a disgusting fatty, fat, fat came flooding back to me.  Every concern troll, every narrowminded bigot, every doctor who didn’t bother to examine me and just looked at my fat body and made a diagnosis, every arsehole on the street who told me I would die because of my fatness was suddenly back in my head, telling me that my fatness was going to give me a heart attack and I would die.  I was hearing those old recordings in my mind, and I was afraid.

It was stupid.  But it happens, even now.  Because the relentlessness of those messages, that are literally inescapable, means that even though I’m consciously rejecting them, they still get through from time to time, when I’m not feeling at my strongest.

This is what we’re up against in our culture.  Relentless messages that tell us, regardless of any actual facts about our personal situations, that we’re going to die, and it will be all the fault of our fatness.  People who are not fat, or who can pass as not fat, don’t have to constantly brace themselves against that avalanche of negativity every day.  But those of us who have unhideable bodies, bodies that can never pass as “not fat”, are subjected to it, everywhere.  Dozens and dozens of variations of that same basic message, “Fear your fat body.”

The thing is, having that kind of constant threat of death spouted at us is what makes many of us sick, not the fatness of our bodies.  Having that much negativity, shame and loathing constantly thrown at you has got to wear at times.  It’s the nocebo effect – where those messages are so deeply ingrained, that we start to believe that we are going to get sick, that we are going to die and that message is so powerful that we actually DO get sick.

But it’s still our fault.  Because we’re fat, and being fat means that you caused all bad things that have happened to you.

Of course, we are then accused of being “weak” when those messages weigh too heavily on our shoulders.  When the constant call to fear our own bodies actually filters through, and we succumb to that fear.  If we admit anxiety or stress, then it is somehow our fault, and we’re to blame for that as well.   If we go to the doctor, we’re often told that we’re hypochondriacs, or that we’re being overly dramatic, if we would just go and lose weight this wouldn’t happen.  Our anxiety and stress is dismissed as whinging or attention seeking, with no question as to what is causing such anxiety and stress.  We are tossed out the door yet again, with “lose weight” as the cure for all that ails us.

So what do so many of us do?  We ignore the REAL messages our bodies try to send us.  When we feel pain, we avoid going to the doctor, because we’ll only be told that we’re weak, that we should just lose weight and the problem will go away.  We won’t get a real diagnosis, they won’t care how we feel.  We’ll just be shamed and sent packing with instrutions to eat less and exercise more.

Is this ever factored into “studies” into mortality and health of fat people?  Is it ever acknowledged by those supposedly researching into issues around obesity that the very culture we live in is a) making fat people sick and b) preventing us from getting adequate health care when we do get sick?

It strikes me that the lazy ones aren’t those of us who are fat.  It’s those who don’t bother to actually listen, and investigate the health of individual fat people on a case by case basis.  It’s those who take one look at our fatness and diagnose every ailment we have as “obesity”, merely on sight.  It’s those who don’t ask WHY there may be evidence towards fat people having health issues and just assume that fat is always to blame.

Wouldn’t you say that’s pretty hypocritical?  I know I would.

*It’s ok, the pains in my chest turned out to be pulled muscles in my ribcage due to coughing with that damn cold.

11 comments on “The Lazy Diagnosis

  • Girl, I have been abolutely paralyzed with fear when I haven an unexplained pain. All that goes through my head is….OMG, they were right!!! I am going to die now!!! 99.9% of the time – it’s a panic attack. I’ve learned to recognize them and I know that’s what it is when it’s happening (not a heart attack), but that doesn’t really seem to make me calm down any. I am so pissed off about what the media is doing to our children right now – the obesity epidemic! I know what I went through when I was in school and I can only imagine how these kids are treated now – especially with all the publicity and negativity about them. It’s really been bad since Michelle Obama started putting here agenda out there.

    Guess, I’ll get off the soapbox. I’m so glad that your pain was just a pulled muscle. That does happen… everyone!!!!

    • I am SO glad someone else knows what that is like – though I’m not glad that you suffer in the same way I do. There are times where every twinge, every tweaky stretch of a muscle, sends me into a panic attack. A panic attack for me involves a racing heart, the blood pounding in my head and dizziness… all symptoms of heart problems.

      I went to a doctor about them once and they told me my weight was straining my heart, to go on a diet. I genuinely thought there was something wrong with my heart because of my fatness.

      The same year, my tall, thin brother went to the doctor with the same symptoms, and he was sent off for a barrage of tests, including an ultrasound of his heart, because they were sure he must have a congenital heart defect. He was coddled and treated with so much sympathy.

      Turns out, both of us have the same kind of panic attacks.

      Now, anyone want to tell me that fat people aren’t given sub-standard health care based simply on their fatness?

  • I’m glad it was just a pulled muscle, too!

    Thank you, thank you for writing this. Thank you. You know what happened to me with a concern troll earlier this week, and your point about
    “The thing is, having that kind of constant threat of death spouted at us is what makes many of us sick, not the fatness of our bodies. Having that much negativity, shame and loathing constantly thrown at you has got to wear at times.”

    • CRAP thinks just went wonky! My message sent as I was typing. Boo.

      Anyway, to continue directly from above:

      My concern trolling incident earlier this week has absolutely effed with my health. I am having stress headaches, which I haven’t had for a very long time (sinus headaches, yes, I get those a lot, but stress headaches haven’t been occurring for quite a while). Emotionally, I have no buffer to be able to deal with other small emotional upsets–I feel raw and naked and unequipped to deal with things. Those two examples are *directly* related to someone telling me, this Monday, (someone who I had my guard down with, not a stranger, someone who I felt safe with)that I needed to lose weight because DIABETES!!!!!!! (which I don’t have)

      So thanks, lady, in your “concern” for my “health”, you have ACTIVELY worsened my health this week. My fat didn’t do it, you did.

      Thank you, Kath.

    • Thanks hon – I’m glad it was too! It’s not the first time I’ve done that either, and a friend of mine even broke a rib coughing once!

      I really think that they don’t actually think about our ACTUAL health at all. It’s about what they’ve heard/read, and they feel a moral duty to spout that stuff at us, without any thought as to how we might actually feel, or what our health actually is.

  • Recently, I had a run-in with an MD who fills in for my own. I was in pain, I thought I had a UTI, but tests were clear. She said I might have an inflammation, but the drug to treat it causes weight gain, so I could not have it. She intentionally told of me of drug that would treat my pain (I wasn’t, you know, screaming bloody murder, but this pain had been going on for days and it was maddening) then told me I was too fat to have it. She ushered me out, told me to seek a specialist. It turned out, I had a kidney stone. I didn’t know until it had passed, until it was over and the pain was gone. I’d been suffering with the kind of pain most people go to the hospital over, and no one looked twice. If I hadn’t been fat, would they have? Idk. But the chances were better. I remember, thought it was a month ago, just sitting in my car after the visit and breaking down into sobs. This was actually a recent thing. Years ago, when I had sharp chest pain on the left side, I panicked ( the same messages you had gone through above ate at my head) and I went in for an EKG/stress test. It turned out I DO have an abnormal (usually not dangerous unless I’m taking meds.) heart beat, but the pain was caused by a kind of severe heartburn…severe heartburn a few people get when pregnant (which I was). The death-fatty negativity was never poured upon me during the exam. There were a lot of congratulations, it was a nice thing to go in for an ailment, be treated like a human BEING, and get good and better news.
    But I know now that at any time I am in danger from providers I don’t know well or am not comfortable with. And it’s a horrible, haunting thing…

    • That’s horrible! And the really horrible thing… it happens all the time. And if you haven’t had the time to “break in” a health care provider, even more likely.

  • Glad you shared this. I am currently underweight due to a year of crippling anxiety, stress issues, and I have recently suffered a heap of concern for my health (plus a whole round of tests). Whilst enduring this, I have been taking note of the messages which we are continuously bombarded by via the media, this obsession with spotting the early signs of disease, and how our many multifaceted lifestyle choices are always, inevitably going to be the death of us! Oh my god, and to imagine this relentless shit from a fat persons perspective doesn’t bear thinking about. I believe that we live in a culture which has become saturated, so obsessed with body policing in general, and of course the larger folks are such terrific scapegoats. I wonder why nobody ever celebrates the positive aspects of fatness, of which I hear there are many (thinness, of course, is currently experiencing its heyday). All things health related seem to be viewed from such a disturbingly skewered, hysterical perspective. It’s insidious. And who amongst the strongest of us can truly shield themselves from this? it shoots straight to the very core of our vulnerabilities as living beings.

    And perhaps worse are the concern trolls mentioned in the above comment. Somebody may have to inform/educate these overbearing dip-shits as to how many types of congenital heart disease, high cholesterol issues (of which I suffer personally) are most usually (in the main) hereditary. I’m in the firing line myself.

    Of course this hysteria is responsible for many of the freakouts mentioned above, and yes, it does serve to keep us all terrifically distracted, fear focused and obedient.

    So glad you’re addressing this. The very concept of being able to assess the intricate details of an individuals health by a passing glance at their body type is preposterous. And as raindelayed says, this perpetual misconception probably serves to cause more harm to fat folks than their weight on a set of scales ever could.

    • It’s interesting you raise the issue of thin people having health issues too. I was just talking to a fellow recently who is wiry and lean, and he has developed Type 2 diabetes in the past year or so. He was astonished at the thought of anyone blaming him for the onset of this, because it just doesn’t happen. However it constantly happens to fat people, even when we DON’T have blood sugar/insulin issues!

  • I’ve been thinking about this a lot lately too. I have two chronic health issues (endometriosis and migraines) both of which I’ve suffered from since puberty, when I was as skinny as a rake. But whenever one of these conditions drives me to need time off work, my boss always blames my poor health for my fat. It doesn’t help that both conditions are “invisible”. The fat = unhealthy mentality is so pervasive that it’s very, very difficult for anyone to see past. But the more people like you stand up and say “this is wrong”, the more that pervasiveness is pushed back.

  • That’s horrible. I’m an in-betweenie, and my parents are both doctors, so people tend not to randomly give me medical advice, and I hadn’t thought of this as yet another horrific consequence of accumulated fat-hatred. Thank you for being brave enough to share. If I get a little paranoid about aches and pains after watching too much House, I can’t imagine what it must be like for fat people who hear such fucked up messages every day.

    I think our culture needs to chill out about mortality in general. We have totally skewed perceptions about what is dangerous and risky and what is not. Lightning is dangerous, driving is not. Fat is dangerous, risky surgery is not. WTF? You can’t predict when you’re going to die and by what cause, so why not just do the best you can, take care of yourself, and live your life?! And more importantly, don’t pretend you’re some genius doctor-psychic who can predict the hour and cause of death by someone’s BMI, I mean, REALLY! Especially with so little and such biased evidence. Bleh. Let other people live their lives, and give them the best, nondiscriminatory care that you can!

    Generally our medical establishment tries to dismiss any symptoms that are not easily explained/so apparent as to be unmissable. It’s fucked up that fat people are so much more often dismissed – as if the only things that could possibly go wrong with a fat body are “obesity-related” (haha) conditions. Guess we should start spreading the news! Fat protects against broken limbs, strained muscles, intestinal dysfunctions, ulcers, cysts, cancer, etc!

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