Open Letter: Medical Fat-phobia

To the Management Team at Mount Airy Family Practice;

When I first started coming to Mount Airy Family Practice, I found Vincent Tyson to be a very helpful caregiver. He gave me great advice for navigating my way out of Acute Stress Disorder and helped me find a lifesaving treatment for my depression—I will never stop being grateful for his help.

However, some things were just not right. During exams where a second person was required to be in the room, he would joke that “They just don’t trust us to be alone together.” What’s the joke there? That harassment precautions are silly?

And then there were the reports: Although I have never been treated for anything weight/heart/blood sugar related, I always had to read the phrase “morbidly obese” on my reports. (I understand that that may be a requirement of the insurance companies, but it still reads as a reminder to feel “less than.”) Though I’ve never visited Mount Airy Family Practice for vein trouble, “varicose veins” were always listed on the reports as well. Those two factors combined gave me the feeling that I was being assessed aesthetically rather than (or, I guess, as well as) medically.

Then, a few months ago, I did have a question about weight. I had gained a bunch of weight without significantly changing my exercise or diet routine, and I just wanted to make sure that all of my other vitals were okay. Weight gain is a common side-effect of Prozac, and it seems like a small price to pay for mental health. I did not ask Vincent for any help with dieting or losing weight.

Nonetheless, my report said that I had “weight gain from excessive calorie consumption” even though I had just finished explaining to him that my diet and exercise had not changed.

This is a common problem, often discussed in the body positive community worldwide. Physicians often dismiss and ignore true symptoms, data, and information from patients, listening instead to their own biases about fat people being lazy, gluttonous, and stupid.

I wrote to him on the Patient Portal to inform him that this was not okay, suggested some reading sources on the consequences of medical fat-phobia, and reiterated that I was not interested in dieting, citing the fact that the workup he had just done pointed to health. I told him what I still believe, which is that ignoring my actual data in favor of preconceived biases is just bad science.

Vincent then ignored the boundary I had just set and wrote back to again suggest that I go on a diet.

I then called my insurance provider to switch to a different PCP within Mount Airy Family Practice, but was informed by the practice that I would no longer be allowed treatment there.

After that, I received a letter from Vincent (whom I had told in no uncertain terms not to contact me again) gaslighting me, calling me a liar, and saying that I had been “unfair.” It seems that he felt it was unfair that I expected him to hear and respond to information that I gave him (and that medical tests gave him) about my body.

Though I have found a kinder and more humane doctor, it still makes me so angry and sad that your practice refused me medical care because I expected to be treated like a human being, because I didn’t want to be shamed for my size anymore, because I refused to accept Vincent’s skewed version over what I knew to be true. I was afraid, after that, that I wouldn’t find a doctor, that I couldn’t be treated medically without learning to apologize for taking up space in the world.

Your team put me in a dangerous, unfair place, but it seems I am one of the luckier of Vincent’s patients. When I reached out to neighbors about my experience, one woman wrote to me that he ignored her symptoms for months, and because she was losing weight, he “even joked that feeling crummy sure was a great diet.” This woman turned out to have ovarian cancer—due to Vincent’s dehumanizing refusal to hear her symptoms, this neighbor of mine could have died.

Not all forms of harassment are shocking and Weinstein-esque. Some forms of harassment are more mundane, the everyday reminders that we are expected to feel less-than, to apologize to our size, that we must reach a culturally acceptable weight in order to have our symptoms treated at all. They are dangerous and deadly habits that most medical practitioners accept and most insurance companies require.

Everyone can do something about this problem I want to urge you to find ways to remember to treat fat patients with the same dignity and respect that you give to normatively-sized people. The book The Body Is Not an Apology by Sonya Renee Taylor is a wonderful place to start.

Best,

Sharon Wiedmann