Dear Medical Professionals

Published November 9, 2011 by Fat Heffalump

Well, yet again the amazing Marilyn Wann has inspired me.  She shared this article on her Facebook page and of course I popped over to read it.  It’s an excellent piece on the damage caused by fat stigma and the responsibility the medical profession has towards it’s patients.  I was reading the comments and I was just struck with the desire to tell my story as a fat T2 diabetic to members of the medical profession.  I started to type a comment to the article, and what happened is I found myself writing a letter to medical professionals in general.  I have submitted it as a comment on the site (it’s awaiting moderation over there), but I decided I wanted to copy it and share it with you here.

It is of course nothing we haven’t all been saying in the Fatosphere over and over again, and it’s nothing I personally haven’t said before (repeatedly!), but I believe that we really do need to be telling our stories over and over and over, we do need to be addressing all kinds of different audiences about our experiences and perspectives, if we’re ever going to get real change in our culture towards fat stigmatisation.

So, without rambling on any more, here is my letter to medical professionals (any that care to listen).

Dear Medical Professionals

My name is Kath and I am fat (by the pointless BMI standards, I am morbidly obese at around 300lbs, but I prefer the term fat) AND I have Type 2 diabetes.  I am the one so many in the medical profession use as a cautionary tale against what happens to “bad/lazy/greedy” people who don’t live a “healthy” lifestyle.  Until I found my current doctor, not one health care professional would believe that I was not a sedentary glutton, and as a consequence I developed an eating disorder from about 13 years of age until my early 30’s, and was suicidal during that time as well.  I was starving myself and abusing both prescription weight loss drugs and other substances to try to lose weight.  Medical professionals I went to praised me if I lost weight, but chastised and even bullied me if I gained.  I always gained eventually, always what I had lost, and always some more.  When I confessed disordered behaviour, several health care professionals actually sanctioned it, and encouraged me to continue, since it was “working” (albeit temporarily).   I was rarely asked as to what I was actually eating and what exercise I was doing, but if I was, it was met with disbelief.   After all, calories in, calories out right?  How can one be fat if they are consuming less than they are expending?

In my mid-30’s, I decided that if nobody would believe me, and I couldn’t be thin and therefore worthy of space in this world, I would end it all and relieve myself and the world of suffering.  Thanks to the love of a good friend, I didn’t succeed.  But it was at that moment I opted out.  Opted out of the constant barrage of hatred that is poured towards fat people.  Opted out of dieting and employing any other methods of attempting weight loss.  I didn’t know where I was going at first, I just knew I couldn’t live that way any more, and I wanted to live, but not like I was.

Eventually, I stumbled across the concept of Health at Every Size (HaES) and my world was changed.  First step, find a doctor who listened to me and treated me as a human being, not an amorphous blob of fat to be eradicated, cured, prevented.  Second step, find a decent psychologist to help me heal the trauma of the stigmatisation I lived all my life just for existing in a fat body.  Third step, learn to eat again.  And when I say learn to eat, that means both for nutrition of my body AND for the pleasure food can give.  It means listening to hunger and satiety cues.  It means feeding myself what I need, and what fits within the life I live.  I still struggle with some disordered thinking and behaviour, but I will keep working at it until I have it beaten.  I also reclaimed my right to appear in public as a fat person, which has enabled me to do things like swimming at the beach and riding my bicycle, despite the fact that I am still ridiculed and shamed for daring to be a fat person who is active in public.

It has been about 5 years since the moment I opted out, and in that time I was diagnosed with Type 2 diabetes.  I should have known, on my maternal side, my Grandmother is diabetic, on my paternal side, two aunts, an uncle and several of my older cousins (all T2).  I am built like my Grandma and my aunts, as are my female cousins, but the male relatives with diabetes are all tall and thin.  Nobody has ever shamed the men with T2 diabetes in my family, but all of we women have experienced shaming for it.

On diagnosis of T2 diabetes, I became even firmer in my resolve to practice HaES.  Since my diagnosis, my doctor and I have worked together and with HaES and appropriate medication, my blood sugar levels are in the normal range.  I am still fat, but all my vital measures are within the robustly healthy range.

I was far more a drain on society when I was trying to get thin than I am now that I live a HaES lifestyle.  I’ve gone from suicidal, frequently unemployed due to depression and the damage I did with my eating disorder, and constantly needing medical care.  Now I have a successful career in a field that I am passionate about and contributes to society.  I am a passionate campaigner for social justice and inclusion, and I contribute strongly to the public coffers via taxes, my private health care and the work I do in social justice and inclusion.

My point in telling my story here?  “The Obese” are not a disease to be eradicated, prevented, cured.  We are not some disgusting medical condition that is costing society millions.  We do not sit at home on the sofa eating cheeseburgers.  Nor are we stupid or liars.

We are people.  We are human beings with lives, loves, emotions, needs, aspirations and value in society like any other human being.  We deserve to be treated as such and allowed to advocate for ourselves.

Please remember that.

Thank you for your time in reading this.

48 comments on “Dear Medical Professionals

  • You are indeed a “passionate campaigner for social justice and inclusion.” Thank you for inspiring me to do the same.

  • This has come at a really good time for me. Today for the first time when picking up a prescription for my psychiatric medication I was weighed, repeatedly asked about my weight, whether I had gained weight and set up for blood sugar and cholestorol tests.

    I feel if I had been thin then this wouldn’t have been done with so much dissaproval, that I would have been listened to when I said I hadn’t gained any weight, that I would have been allowed to not know my weight.

    So thank you so much for writing this. It really resonates strongly with me.

  • kudos to you!!!

    While not diabetic, I have struggled with many of the same issues you have, especially medical “professionals” who can’t fathom that I’m happy at 300-ish lbs, and imply that it’s my weight & (assumed) craptastic diet causing my depression, gall bladder attacks, probs getting pg, etc not the actual issues at hand.

    Thank you for your letter & all your work on fat acceptance. I appreciate it.

    • Thank you Chelle. It really doesn’t matter how healthy or not healthy or whatever a fat person is, many medical professionals just assume that one is unhealthy, and if one has health issues, well of course it must be fat that’s causing it. That’s why so many of us actually have health struggles, because we’re frequently misdiagnosed!

  • What a beautiful letter, Kath. I for one am very happy you are here. You are an amazing human being and woman and activist. I hope your letter gets published in the comments, but even if it doesn’t you’ve done your part. As one of my favorite philosophers says, “Change starts at home” (‘home’ referring to your own brain!).

  • Hi. New commenter, long time reader – did you read the comment section of the article? The article was lovely. Apparently, though, the writer of the article is bothered by the use of the word “epidemic” rather than the idea that obesity automatically means unhealthy.

    I was a little disappointed by that, but maybe, just maybe, we’re starting to see steps in the right direction?

    • I did Steph, and that’s part of why I was impelled to write the above letter. I’ve kept up with it over the past few days as well. If we can get them to look from a different perspective, perhaps they might just think about the impact of what they’re doing a little more.

  • As usual Kath an intelligent and insightful post from you. I wanted to contact you today because I have just seen a horrible link on a social networking site that is used in my workplace. It is yet another article on the “cost of obesity” but with a new and very disturbng slant. For any who read please be aware that the content may be triggering but I wanted to bring peoples attention to this new attempt to marginalise and stigmatise fat people. It is on the “Australian School of Business” site and was posted on 7 November. I started to read it as I thought by the title “A Mindshift on Obesity” that it may contain something useful. Well how wrong was I. It turns out that now us fatties have cognitive impairments!! I am more angry than upset and Kath I would love you to comment on the article. Kath – I am posting from work in case you dont recognise the address.

    • Janine there are several variations on that article that have been floating around for the past few weeks. It’s a hateful piece of shite and people more talented than I have had a go at responding to it.

      Personally, I don’t respond to hateful pieces of shite any more. I have better things to do with my life than pay them attention.

  • Thanks again for a fabulous post. Reading your posts have formed part of my ‘therapy’ to not lapse back into full depression. It is so wonderful that there are awesome people out in the world who celebrate being who they are and want to share their awesomeness. Bless you

  • Excellent post.

    I’m currently going through some very disordered eating- and have already have a medical professional tell me to keep it up because I’ve lost weight. I want to develop a healthy relationship with food but it sounds so impossible at this point.

    • I’ve been there Rachel – even to the point where I was told to add MORE disordered behaviours to my repertoire, because it might “ramp things up a bit”.


      I wish you a peace treaty with food and eating.

  • I really wish there was an “AGREE (1)” button that I could click! My experience almost completely mirrors yours (except my suicidal period came much younger). Thanks for a great post!

  • Standing Ovation!! Thank you for “coming out” as a diabetic yet not being afraid to demand good care, not letting the “shame” of such a diagnosis get you down or sidetrack you from HAES and healthy living. Too many fat people get diagnosed with something and feel too ashamed to tell others or to advocate for themselves with medical professionals.

    It always floors me when people applaud eating-disordered behavior in the name of losing weight. In a thin person, these behaviors would be cause for alarm. In fat ones, it’s cause for admiration? I think not. Disordered behavior is disordered behavior, whatever the size of the person engaging in it.

    • Thanks WR Mama. I actually went through a stage when I was first diagnosed where I really wrestled with that decision. But ultimately I realised I would just be giving in to further stigmatisation and oppression if I did so.

      And I hear you on the encouragement of disordered behaviours in fat people. It goes to show that “thin at any cost”, even death, is preferable to many than fat and happy.

  • Thank you for this post! I should have printed it out and taken it to my doctor today. I went three weeks ago complaining about just not feeling right, feeling anxious and overwhelmed, and I figured I would head her off at the pass and tell her one of my problems was an inability to lose weight depsite numerous lifestyle changes. She ordered blood work and today I went for the results. Everything is normal except my blood sugar is a little high -[pre-diabetic], so the focus of the visit was her telling me I NEED TO LOSE WEIGHT. The conversation was pretty cliche – calories in, calories out, eat less, excercise more, cut out sweets and starches, blah, blah, blah. What about my feelings of tiredness, being overwhelmed, lack of energy? LOSE WEIGHT and you will miraculously feel perfect. I walked out with a prescription to see a dietician and a complete lack of respect for her as a medical professional. I’m beyond disgusted and now wondering if I should have just told her I was depressed [which I’m not] in order to get her to focus on that instead of my weight.

      • Yes, she did. They were normal, yet I’ve had these symptoms for 15 years and had my thyroid checked on numerous occasions. So maybe it’s something else, but I’ll never know until I ‘lose the weight’ – then maybe someone will care enough to consider testing me for other problems.

  • I don’t have much to add: I neither possess the repertoire to express my disgust nor the experience of most people here….but…we have T2 diabetes in our family, high cholesterol and a high rate of heart disease (it has literally wiped the majority of my relatives out (on both sides) and yet most of them were very slim, non smoking/drinking folks, and relatively ‘healthy’ eaters.
    I think that there is far too much emphasis on body weight as a signifier of overall health, without a great deal of evidence to show for it. People tend to blindly believe what they are conditioned to swallow, we are trained to live in terror of our flesh. Society tempts us into consumption then expects us feel profound guilt afterwards, it strikes me a some sort of curious sadism, yet on a cultural scale. (hope this makes sense!)

    Oddly, I have sat in front of my doctor, presenting severe trauma issues (sleep disorder, low weight as a result of anxiety, the aftermath of rape, etc) and due to my diminutive size the doctor has never once suspected that anything might be wrong with my health, even though I am approaching 40, the age when our genetic family crap usually kicks in. They have never suggested weighing me, or enquiring about my diet, even when my (so called) BMI was pretty damn low due to stress. Luckily, I don’t suffer an eating disorder, but I still consider it pretty piss poor service considering the experiences listed here at your blog. It is obvious that medical professionals are only quick to suspect disease or psychological issues are present if weight is gained, rather than lost – which isn’t only hypocrisy, but pretty bloody dangerous.

    This says a whole lot about our culture’s terror of fat. I have little more to add, but thought an example from the other side of the scale might be helpful.

  • Thank you for sharing this letter. I do not take the time to read as much as I should within the “Fatosphere”. The issue you raised here — pushing so hard for weight loss at almost any cost…”do no harm”, really? — was part of the basis of the “twinkie” project that went viral last year. I would bet many of the same MDs that were negatively pushing you to lose weight were likely talking negatively about me even though I was doing what they were pushing you to do. I will try to visit more often as your posts are truly enlightening.

    Cheers — Mark Haub

    • Thank you for your comment Mark. Personally, I found your “experiment” seriously problematic, particularly as it only consisted of a data base of one… you. The scientific method calls for a much larger group of subjects to obtain data from, and a control to measure the data against. It also assumed that the vastly redundant “calories in – calories out” method would actually work for more than 5% of the population, which we know now, it doesn’t. Human bodies are not lawnmowers, they do not simply process fuel by burning it.

      Doctors have never pushed me to eat just junk food (not even low caloric counts of it) – therefore they were NOT pushing me to do what you were doing at all. What they did do was encourage and approve of my rampant eating disorder – which if you read my post, was one of starvation and purging (and substance abuse), not overeating, eating junk or living a sedentary lifestyle.

      Please do take the time to read more about fat activism, fat acceptance and Health at Every Size, as it’s an important message that we are collectively trying to impart.

  • Yes! Medical professionals so often fail to see their patients as individuals. I’m thin, but I have a family history of heart problems (grandmother died of a stroke, grandfather had arteriosclerosis, etc) and two years ago, my cholesterol levels had climbed to the higher end of the “normal” range. This absolutely terrified me so I called to request further testing or at least some information on why my cholesterol counts had jumped, but all of my concerns were met with a comment that my weight is normal so I should have nothing to worry about. I’m quite certain that their only advice for lowering cholesterol is to lose weight (because this is what they told my dad when they put him on Lipitor), and if they can’t tell you to lose weight, then they tell you that you have no problem. GAH!

    • Absolutely J. What many people fail to see is that basing health on weight harms everyone, not just fat people. It means fat people have the real causes of their health issues overlooked (and are pushed into disordered behaviours) while not-fat people are not checked thoroughly for those illnesses that are written off as “weight related”. It’s not helping any of us with our health!

  • Standing ovation!

    It’s depressing when medical professionals don’t care to look at everything and are just satisfied with a diagnosis of “fat”, and writing a prescription for weight loss, missing things that could injure a patient more and could probably kill them.

    I think I would have actually walked out of the doctor’s office if I started to get the Weight Loss Lecture that I’ve gotten from my mother a bazillion times already. I know it’s not very adult behavior, but I have the right to be treated as such, not lectured like a misbehaving child when I’m trying to see what the hell’s wrong with me.

  • Comments are closed.

    %d bloggers like this: