How to Find a Fat-Positive Doctor Who Won't Just Tell You to Lose Weight
In many doctors’ opinions, weight loss is the only treatment for fat patients regardless of their health concerns, as though the answers to our problems are written all over our bodies. But I have the right to be fat and healthy.
I’ve been over 200 pounds for the majority of my adult life. When I went to see doctors as an adolescent, my weight was the main factor considered to indicate my health. As an adult with mental health issues exacerbated by that, I decided to avoid being judged and chided for something I spent so much of my young life trying to change. If I didn’t have a healthy mind, there was absolutely no way the rest of my body would be healthy, so I protected myself by avoiding general practitioners from my late teens into early 20s. Though I have health insurance, I went over seven years without a physical examination until very recently.
My anxiety about doctors took hold at age 13, when my parents took me to the “best” primary care provider in Boston, known for her Harvard education, quick diagnoses, and aggressive, my-way-or-the-highway treatment plans. She was roughly my mother’s age, tall, wiry, and very blunt. Immediately upon meeting me, she entered my measurements into the Body Mass Index chart (which we now know is outdated, inaccurate, and misleading) and said, “So, what are we going to do about your weight?” My heart sank: I’d scored a 25 on the BMI chart—right between the “healthy” and “overweight” zones. I felt like I’d failed a test I never knew was coming.
My weight was somehow always at fault for any illness or ailment, according to the myriad doctors I saw in my adolescence, no matter how unrelated they seemed. Sprained ankle? My fat body was the reason. Have a cold? I clearly don’t take care of my body, so of course my immune system was weak—I needed to lose weight so I wouldn’t get sick. A plus size friend recently told me that she went to get a cavity filled, and the first thing the dentist said to her was the exact question that my prickly doctor asked me at 13. At one urgent care facility I visited when I had a sore throat, I preemptively lied to the doctor, saying I was on a “weight-loss journey”—100 lbs down, 100 to go—so they wouldn’t question my (real) commitment to my health. It felt easier to say that I’d recently lost a lot of weight than explain that I’m OK with being fat—that being fat is my right, and not the failure my former doctors perceived it to be.
In many doctors’ opinions, there’s nothing else to diagnose once a fat person walks into their office—the answers to our health problems are written all over our bodies. Over the past few years, the negative bias and stigma impacting people of size has become more widely seen and understood as ill-informed and destructive: They lead to misdiagnoses and missed diagnoses, and discourage fat people from getting the care they need. I know all of this, just as I know far more than the average person about nutrition, exercise, and dieting, by way years of disordered eating. But in the moment, it feels different advocating for yourself when someone is making you feel terrible about your body.
After starting a job in plus size fashion about a year ago, I became surrounded by women who loved their bodies. They changed my thinking about my own through their words, their actions, and even their clothing. Most important among the many things they taught me: Not only am I allowed to feel upset about the way my body is perceived, I’m allowed to be angry about it, too. So I got angry: at the medical system; at the doctors who diminished me to a number and told me that all of my problems would end when I lost weight. I was angry that I wasn’t supposed to feel angry about it. My fury became an asset: I decided to embark on a search for a doctor who would treat me with the respect and dignity every patient deserves. That I deserve.
I’d heard in passing of “fat friendly” doctor lists circulated among the fat community to help one another find health care where the emphasis isn’t only on weight. I found a few crowdsourced documents online, but they were out-of-date, unvetted, and incomplete. Parsing the patchwork of information, I called a doctor with a great review anyway, hoping he could see me within the month. Turns out, he could see me that week—even that day. Hm. I looked up directions to his office, which was very close to an airport an hour away from my apartment. Hmmmm. I felt uneasy about the prospect of seeing a doctor in an out-of-the-way, more residential area with seemingly infinite availability…and if there’s anything I’ve learned in my 29 years on earth, it’s to trust my (big fat) gut.
Googling “doctor for fat people” got me the exact opposite of what I was searching for. There were no results for those who wanted to stay fat and be healthy—just results for those who wanted to change what I was at peace with. (It was kinda like when, in middle school, I searched the AOL keyword “friends” looking for actual companionship—sad, I know—and wound up only getting results for the TV show.) Hoping for more personalized results, I posted a Facebook status asking if people could “recommend a kind, preferably fat-friendly primary care doctor, someone who'll take into account factors other than my weight when providing medical care.” Two friends—one straight size and one plus size—suggested One Medical, a medical concierge service in eight cities. You pay $199 a year for access to highly rated doctors, among other benefits. Their reviews were promising, but I wasn’t about to shell out a couple hundred dollars just to get an appointment.
Another three comments were about the wonderful experiences my friends had had with a female doctor in Manhattan. Here she was , at last! I called her office, only to find out she didn’t have availability until October. I made an appointment anyway—just knowing there was one doctor out there that would treat me well made me hopeful.
I wanted to see someone sooner, while I still had this newfound courage in my system. On Zocdoc, an online directory of doctors, I used a highly scientific method to sort out potential bad eggs: scanning the list of the doctors’ headshots for the most compassionate smile that also took my insurance. (Since there’s no filter for fatphobia, that’s truly all I had to go on.) I chose a young female doctor, since, in my personal experience, the older the doctor is who is treating me, the likelier they were to subscribe to antiquated forms of medicine, like referencing the BMI chart.
On the last page confirming the appointment, there was a small box for a “note to the doctor.” On a whim, I typed a brief message:
Hi! I’m very sensitive about my weight. I’d prefer to not be weighed and not talk about weight. Thank you!
On the day of my appointment, I practiced my “defense” speech in my head for the entire subway ride over. I know I should’ve come in sooner, but I’m here now. I’ve spent the last six years working on my struggling mental health, and am finally ready to work on my physical health. I know that weight is a factor in my health, but it’s not the only factor. I rapidly cycled between strength and fear. I visualized the appointment going well—and also prepared for the worst. Fighting tears through the elaborate eye makeup I had worn to trick myself into keeping a brave face, I thought, You can’t cry in Fenty, Charlotte. It’s illegal.
I entered the office and apprehensively scanned the waiting room, grinning instinctively when my eyes landed on the plus size receptionist. After I filled out the prerequisite forms, a cheerful nurse showed me to an exam room. He checked my blood pressure and oxygen levels checked, asked me how tall I was— then closed his notebook with a smile and told me the doctor would be in shortly. What just happened? The nurse was aware of my note and respected my request. The note that I almost didn’t write!
The visit was far from over, which I became more and more aware of as I waited. When the doctor knocked on the door and shook my hand, I immediately burst into tears. The only accurate way to describe her expression is, Ohhhhh, shit. I blurted, “I’m okay—it’s just an automatic reaction to being in a doctor’s office,” explaining that it’d been a long time since I’d had a physical, so I was nervous. She smiled, commended me for coming in, and said we’d get through it together.
The rest of the appointment was totally fine. The doctor asked me more questions, listened to my lungs and heart, stuck her flashlight in my eyes a liiiittle too long, and gave me options for what kind of bloodwork I’d like done. In the past, doctors had decreed the panels I’d take. For the first time, that was my choice, so I asked for the full workup. If there was anything wrong with me, I’d know, and how to solve it would be up to me—and I felt newly equipped to handle that. I’d finally come to the realization that my body is my own. I harnessed my shame and used it to shift my perspective: I could either keep doing everything in my power to avoid even the potential of a diagnosis, or learn everything I could about the current state of my body and use that knowledge as power.
It can be harrowing enough trying to find an adequate doctor that both takes your insurance and is currently accepting new patients. Finding one that would also treat me body with dignity? It seemed impossible, but it wasn’t. Doctors had made assumptions about my body and in turn I made assumptions about doctors—none of them turned out to be correct.
The next day, I received my blood test results, and guess what? I’d spent seven years avoiding a completely healthy diagnosis. While part of me was still mad at myself for not coming in sooner, I did my best to take it all in. I’d spent so long assuming that I wasn’t healthy that, when I did get a healthy diagnosis, it was almost more shocking than an unfavorable one. Working from the ever-present shame about “neglecting” my health to receiving the official stamp of approval from a medical professional, I finally felt like I had autonomy over my health. It was the biggest and most satisfying fuck you I could ever give to the medical professionals who had belittled me and contributed to the shame that kept me away from the doctor’s office for so long. I realized that I had the right to stand up for myself and the right to seek out respectful care. I had the right to remain fat and healthy.