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

Fat and Happy and a Little Befuddled

Inspired by this Radiolab episode about an artist who is creating and island of fat in appreciation for the substance itself.

            I tend to forget (at least consciously) for long spates of time that there’s supposed to be anything wrong with the size of my body. In the past twenty-five years, since reaching adulthood, I’ve wavered between size 18 and size 24, with a brief Southern California stopover at size 14. I’ve always loved clothes and love them even more now that there’s more cuteness available in my size(s). In general, I forget to not feel beautiful, assuming anyone who thinks otherwise is just a creep. My Aunt Connie always told me that “fat is jerk repellant,” and although I wish it were truer than it is, it’s comforting advice.

            I never really thought about Fat Liberation or saw myself as having a marginalized body until the last few years’ deep dive into trauma work and feminism. Two of my favorite sources for body-positive fat advocacy are the She’sAll Fat Podcast and Lindy West’s book Shrill. These and lots of other sources have helped me to clarify my view of how body positivity fits into the overall project of justice.

            Although I’ve never been all the way convinced (at least as an adult) that my body isn’t beautiful, there’s one insidious societal message that did get in there: “Fat women need to take what they can get when it comes to men.” When I first (polyamorously) returned to dating men back in 2011, one of my first guy-loves was someone who terrified me. I went almost immediately into an abusive not-relationship with a (not always consensually) sadistic jerk partly because I was so shocked and delighted to find a man attracted to me. Luckily at the time I was still with Amy who has always thought that I’m perfect (even when I’m really, REALLY not) and had a lovely FWB who treated me like a Mystery-Science-Theater-watching goddess. Still, the “you’re lucky to have anything” mentality was my accomplice in many, may nightmare scenarios with men who were more than willing to take advantage of that vulnerability—that was their fault, not mine, but I’m happy to be in a kinder-to-myself place.

            Of course, my reluctance to have standards and boundaries was tied to the trapped-and-helpless residue of trauma, but a lack of general worthiness, especially when it comes to men, has made the trauma harder to come to terms with.

            After a powerful year of trauma work, I feel fully entitled to decide my own body size, but I’m not sure my actual body agrees. There have been so many years when I’ve resolved to lose 40 pounds, and it has always been the most elusive (and honestly, least-cared-about) goal. They say if you keep not doing a goal, you don’t really want it, so I dropped it. Kept exercising and eating lots of produce and mostly forgot about it.

            Then at a doctor’s appointment last fall, I found out that I weighed almost 300 pounds, and a few weeks later at the follow-up appointment, I was at 303. That’s the highest weight I’ve ever had measured. I gained 25 pounds last fall (I’ve been half-jokingly calling it my #metoo weight…) and I am freaked. I’m also freaked that I am freaked, because it feels like I’m letting my body positive sisters and brothers and non-binary siblings down.

            Nonetheless, there’s that stupid goal on the list again—lose 40 pounds. I chose 40 because it feels like a reasonable amount to lose in a year, but it also feels impossible and stupid and embarrassing. I eat pretty well, just more than I am supposed to, but putting ANY restrictions on food makes me feel deeply anxious, like I’m holding myself up for judgement and taking my own privacy away. Mostly food is just delicious, and I don’t know why it feels like privacy, but also maybe I do.

            Friday night on the way home from yoga I was listening to this interview with Roxane Gay  that reminded me she also sometimes thinks of her body as “unruly” and that rang a bell. The 25 #metoo pounds made me feel out of control and made me worry that I had lost touch with myself.

            So that’s where I’m at right now, just asking my body what it needs from me and doing my best to listen. I love my body so much for always being with me through this not-always-easy life—though trauma and bad classrooms and a housefire and those GODDAMNED election results, but also for niece-and-nephew hugs and gorgeous adventures and ramen at Morimoto and a long marriage and a wonderful time taking back the term “spinsterhood.” I’m proud of myself for keeping alive, for keeping safe, and I hope that my body knows I’m grateful. 

Triads and Quadrangles: On Being Not-Skinny and Pajama-Envy

It was a good date. We went to The Academy of Natural Science for Mega-Bad Movie Night. I forgot how much I loved watching a bad movie while a panel makes snide comments about it, MST3K-style. Also we got to visit the butterfly garden.

He was cute, tall, and had a million pictures of his little son in his phone. I just go bonkers for dads, in case you didn’t know.

Anyway, we’d just had some post-movie pie in a cute little diner and he was walking me back to my 11^th and Walnut bus stop. He’s a shy guy, so he surprised me by talking about a clothing-optional beach he likes to go to. That’s when this conversation happened:

She: “Oh, I would be much too shy for that!”

He: “Well, you’d be surprised, there are more not-skinny women there than skinny women. I know I don’t have the best body-image either.”

She: “………………Um, I have a good body image……………”

I’m sure I said wrong things too, but sheesh, that’s hard to come back from.

I admit that I am heavier than I want to be and that a scale has once again joined the household. Being unconditionally loved and kind of a sensualist, I do tend to gain weight if I am not paying attention. And I’m sure my size is part of the reason guys generally just want to be friends, BUT.

I do love my body. If I can look at it objectively, I can see how someone, even a male someone, might think it’s beautiful. And I always want to be on my body’s side. I don’t want anyone to settle for it, or tolerate it. I just want someone to love it.

At the moment he made that assumption, I felt how cold out it was. I’d had fun but I’d also missed Thursday shows AND the Project Runway finale. I called Amy and she told me she was in her monkey pajamas and very fuzzy socks. I just missed the warmth of my home. I texted her when the bus was ten minutes from home and she had tea waiting for me. I snuggled with her and the cats and felt like the luckiest person in the universe. Who could measure up to that? I feel for the gentlemen, I really do. I wish that everyone could always feel as cozy and loved as I did last night when I got home.