To think a doctor telling you that you need to lose weight isn't "fat shaming?"

[FrankieDoyle]

Genuinely interested in opinions.
I follow a plus size Instagram blogger/influencer who normally posts about fashion, inspirational quotes etc.

Today she posted about a trip to hospital that she had. The doctors there were apparently unhelpful and told her that they couldn't operate on her because, amongst other reasons, her weight. They told her she would need to lose weight before they could consider it.
I think she's about a size 26-28, from her posts about her wardrobe where she's mentioned the size she wears.

So she posted a video stating that she was sick of being fat shamed, something needs to change, and the doctors don't take her seriously etc.

It got me thinking that actually I disagree with her viewpoint that it's "fat shaming" to inform a patient that they need to lose weight? The doctors have to check that it's safe to perform an operation on someone don't they?

I say this as an overweight person myself (currently a size 20 but following a diet plan and trying to lose weight. )

Maybe I'm wrong I don't know, but it seems unfair to criticise doctors on a public platform with thousands of followers, simply for doing their job.

I understand some doctors can be patronising or seem to focus on a person's weight, and that can't be a nice experience. But I really disagree that it's "fat shaming" actually I quite dislike the phrase being used to criticise these medical professionals.

@Vates

Also I was surprised that surgeons were just like on tv medical drama shows. Stuck up and thinking they are demi-god like. The surgeons that saw my Mum whilst I was there were just plain rude.

Sorry to hear about that

That hasn't been my experience luckily. At my biggest I was a size 24 (bordering on a size 26).
I have PCOS which doesn't help!
My doctor and the nurse who has checked my blood pressure etc have always been respectful and made me feel comfortable. They mentioned my weight and said obviously its something I have to address. Which I agreed with.

Maybe I've just been lucky to have supportive health care professionals.

A doctor telling you you need to lose weight for medical reasons = not fat shaming.
Someone yelling out Oi you fat cow in the street or tweeting or massaging the same/similar thing at you = fat shaming

messaging

There are ways to say it without being a dick about it (I've certainly heard many variations upon this theme in my time in GP surgeries), but when it comes down to it, surgeons and anaesthetists generally aren't too keen on their patients dying under anaesthesia. Or breaking their necks when the equipment collapses or they topple off because they're too big for it.

Which is why they say surgery can't be performed unless it is utterly vital that they do so - a life or death situation. Even those undergoing bariatric surgery have to lose a significant amount of weight in the run up to surgery, as it reduces the likelihood of bleeding out from their enlarged liver getting in the way.

As her desired surgery was refused, the risks outweighed any potential benefit. So it wasn't life or death.

YANBU

What a total drama queen 🙄🙄 there are huge risks with surgery when you are over weight, what would she have liked the doctor to do? Lie to her ? Being over weight can be linked to post surgical complications, as well as a whole host of medical issues in general. Thankfully medical professionals aren't being forced to ignore the science in favour of being PC.

It’s not uncommon for doctors to fat shame though, even though this wasn’t. Being told to lose weight as that’s the cause of your depression (rather than a symptom), breathlessness blamed on weight when it was actually asthma, menstrual pain attributed to weight rather than PCOS causing pain and weight gain. Doctors seeing weight as the only issue is a problem (and I’m a non medic HCP)

@Longdistance

It’s not fat shaming per se, but would be more helpful if the GP gave some dietary advice or referred them to a dietitian.

We don’t actually know that they weren’t offered support in weight loss though?

Operations and anaesthesia can be risky. Obesity can cause complications wether we like that or not. It’s not fat shaming for a medical professional to advise someone they cannot operate/complete a procedure at a higher weight. Now we may not like being told that and the guard is up straight away and it’s branded fat shaming.

The issue isn't them telling you. It's how they tell you.

I had something I probably needed to hear (non medical) delivered in such a way that it was devastating. It still very much upsets me. It simply needn't have been that way. Can imagine, with the lack of bedside manner some people have, that they could casually destroy.

@Longdistance

It’s not fat shaming per se, but would be more helpful if the GP gave some dietary advice or referred them to a dietitian.

How do you know they didn't? In any case, it wasn't a GP, it was a hospital consultant.

A balance to be had.
Some increased long term risk should associated with obesity, definitely.
Some outcomes likely to be affected by obesity (hips/knees) certainly.
Wound healing often worse for the obese. Higher risk of VTEs. Higher cancer risks.
Very reasonable for a doctor to provide information to allow people to make choices and to advise on weight management.

Suggesting anyone over a size 16 is likely to die on operating table - scaremongering and unnecessary.

Of course it’s not fat shaming, it’s sound medical advice. And I say that as someone with a BMI of 39.

Doctors wouldn’t be doing their job if they don’t point out risks to health and procedures. I’d imagine they quite often have to mention weight, smoking, drinking etc.

It's not actually proven weight has a negative impact on health but doctors have been taught this is true and have no reason to learn off their own backs so keep spouting this as truth.

After my first anxiety attack (I didn’t know that’s what it was at the time)- I was on anti depressants that just weren’t right for me - I was 18, I had gone to the docs a few days after and told them all about it, he came back and told me it was probably to do with my weight (a small 16 at the time) but I did have 34J boobies so made me look massive but I was dismissed with do more exercise and eat better, he gave me a sheet with like healthy food groups etc, when it happened again went to hospital who actually managed to help. I’ve not really had any trouble since though and I’m bigger now 😁 but damn did that GP shatter my confidence, eventually made me bulimic (wasn’t just the doc but my mental health wasn’t great at the time) and had a few years fight with that. I think sometimes it helps to be sensitive but if there is a real risk of her being operated on because of her weight then that’s fair enough but as long as it’s done with good bed side manner.

This is absolutely not fat shaming.

However, doctors DO have a really annoying tendency to blame every possible issue you could ever have on your weight, especially if you're female, so I can maybe imagine if she's put up with that for a while this could feel like the final straw even though there are higher anesthesia risks.

YANBU and I speak as a size 26 so not a moral high ground here. It’s not fat shaming it’s merely a fact. Being very overweight (and size 26 is most likely in the morbidly obese category) is medically risky especially for surgery. I’m sure there are healthy fat people but statistically speaking being fat puts you at increased risk of so many things.

@Flatdisco

It's not actually proven weight has a negative impact on health but doctors have been taught this is true and have no reason to learn off their own backs so keep spouting this as truth.

Maybe things have changed since the study in 2007

www.webmd.com/diet/news/20070314/surgery-risks-higher-for-obese

Oh FFS it isn't 'fat shaming'. Having said that, when I was a size 20, I was advised to lose weight by a nurse who was even fatter than me . My sister also had to see a dietician at the local hospital, as she had been referred due to a medical condition she had and said she struggled to take him seriously as he was very overweight.

I had thyroid surgery and weighed just over 10st at the time. The aftercare nurse said "now you'll need to watch your weight???" Preceeded to give me exercise and dietary advice, even though I trained in a gym as well as horseriding and swimming. Not being rude but she was at least double my weight, so I smiled sweetly and asked if she followed her own advice. Practice what you preach

I think it has to be pretty risky for them to even mention it. I'm a size 16/18 and probably had a BMI of about 36 when I had spinal surgery, my weight wasn't even mentioned as an issue (I pinged awake, had a v quick discharge and a great recovery)

Hmm..

It's all in the 'how' really.

'Yo, fatty, eat fewer pies or you'll die'..

Not acceptable.

'We need a chat about your weight and diet, there is a risk to your health'..

Acceptable if uncomfortable to hear.

However...

The medical profession DOES have a nasty habit of blaming EVERYTHING on weight (or alternatively, old age, and if you old AND fat... well you're screwed).

From my own personal example...

Me: Fat, morbidly obese in fact.

Dx with heart failure at 29. This Dx took 2 years to achieve with classic symptoms of congestive heart failure the whole time (wheezing, sloshing, pitting edema, enlarged heart seen on xray, almost dying in my sleep.. blah blah etc).

I was laughed at when I suggested heart failure. I was told it was ridiculous. I was told the episodes of waking up, heart racing, heart skipping, gasping for breath were panic attacks. Have some sleeping pills, go on a diet, go for a walk.

My other symptoms of back pain, lower limb issues, joint problems... all fat. Fat fat fat.

I actually have Ehlers Danlos, a mitral valve issue, an ejection fraction barely compatible with life (slightly better now due to meds)...

Two years!

My sister, normal weight aged 31.

Symptoms of wheezing, palpitations, fatigue... two false starts where the symptoms did not manifest in front of a Dr.

Third time around (two weeks after the first onset of symptoms), this time I told her to run up and down the hospital corridor immediately before examination.

This she did. Oh, you have heart failure.

THEN they looked at my history as well as hers, dx Ehlers Danlos, affecting her heart, on medication straight away.

Now yes, my overloaded frame does struggle more, but my condition is far more serious than hers and always was, hence I got fatter and she did not.

But a difference of TWO YEARS for a dx vs 2 weeks.. when the only significant and obvious difference in patients is weight...

That is indicative of a problem within the medical profession.

The misdiagnosis of panic attacks and the sleeping pills almost killed me, my OH woke up to find me non responsive and blue in bed as a result and it was lucky he basically shoved me out of bed and i started breathing. Had he not woken up for a piss that night, I would be dead (not over dramatic, the GP who dx and prescribed admitted this!).

So yes, the attitude towards fatness and obesity whilst not occuring in the OP's example, IS a massive issue.

It's not fat shaming to say for an elective or non emergency operation that losing weight is required to make the surgery safer for all involved. It is fat shaming when countless doctors put every single symptom an overweight person encounters down to their weight and does not investigate any other options. Someone I follow on Instagram has had real life affecting symptoms for more than a year and has been constantly fobbed off as just being overweight and if she loses weight it will all go away. After going private for tests, it turns out she has cancer and 99% of her symptoms were indicators of this, her outcomes have been impacted by the delay in diagnosis.

There is a difference and it is true, some GPs will dismiss a lot of concerning things as a side effect of weight without looking at the whole person and their overall health despite their weight.

I agree it's not fat shaming but at the same time some Drs prefer to say you have X problem simply because you are over weight instead of investigating. My sister and I am both over weight, she a bit more than me. We both use the same surgery. She went one week with a very sore swollen elbow that had come up and gone down a few times over the previous six weeks. He didn't even physically examine her, just glanced at it and told her she needs to lose weight. I went to the same locum the following week to discuss my results from my ultrasound and the shocking blood loss.... I'd already been told I had fibroids by the sonographer but the Gp was absolutely adamant that the problem would resolve itself if I just lost 15lb . It didn't 😂. Because I had fibroids that required gynea intervention.

So I think some drs prefer to just blame everything on excess weight instead of doing investigations. But that's not fat shaming, just laziness.

DH was refused simple day surgery at the private hospital because of his weight, the surgeon was happy but not the anaesthetist, who took one look at him and insisted he had it done at the local hospital where there were ICU beds available, if there were any problems.