Being Ill While Female.
The two most common symptoms that reveal a serious systemic problem with the human body are:
Sudden dramatic weight loss
Sudden dramatic weight gain
However, particularly when you’re a woman, in this country, doctors don’t take those two symptoms seriously. Frequently women who go to the doctor with concerns that include their weight, or with a sudden weight gain, are told to diet. This winter I went to the doctor and asked her about my gaining weight after several years of my weight holding steady, and no major changes to my diet or exercise levels.* Without asking me how much or what I eat, or whether or not I exercised, her response was, “Don’t eat so much and exercise.” She then went on about food journaling and blah blah blah…
When I stopped her, which took some doing, and said, “Look, I eat well. I don’t eat junk food, we’ve cut HFCS out of our diet. The last several times I went to a nutritionist I was informed I needed to eat more. I don’t want to eat more. My body doesn’t want me to eat more. I’m in recovery from an eating disorder, so I won’t food journal just to reassure you, particularly when you’ll just accuse me of lying about how much I eat anyway. I want you to help me figure out why my weight is changing with NO CHANGES TO MY EATING OR ACTIVITY LEVELS.”
She continued to bleat about eating too much, eating too much junk food and candy, and drinking too much soda. She told me I was obviously delusional about what I ate.
We’ve discussed my soda intake here before. I don’t drink it. One dark chocolate bar can last me months. In fact, I just finished one I bought BEFORE WE MOVED IN DECEMBER night before last.
Then she told me I was being difficult because I wouldn’t lie to her to reassure her that she was right, that I really was mainlining a lard and powdered sugar combination while rubbing myself with frosting.
I really need a new doctor.
Well, after moving, my stress levels dropped significantly, and my weight started to even out again. Go figure.
Yeah, instead of asking me about any other factors in my life, or even asking me how or what I ate, she just assumed I was gorging myself on candy, sugar and fried foods 24/7. Fucking god damn, you have no idea how angry writing about this makes me.
In my case, the weight gain was just stress. But what if it hadn’t been?
http://fathealth.wordpress.com/ The website First Do No Harm chronicles what happens when the weight gain isn’t just stress. When there’s a real reason, like a fifteen pound ovarian cyst, or thyroid issues, or side effects or bad reactions to medication, or cancer, or…
Weight loss is the other big symptom that something is seriously wrong. Even moreso when, again, your eating levels haven’t changed, yet your weight keeps dropping. And again, particularly where women are concerned, doctors will frequently ignore that, and praise the woman for her efforts, even as she’s relaying to them other symptoms of ill-health.
My mom lost over 50 lbs before her doctor finally tested her thyroid levels, and HOLY SHIT!! They were off the chart (https://health.google.com/health/ref/Hyperthyroidism). She had to have her thyroid killed with radiation, because as she said, while the weight loss was nice, the insomnia, restlessness, inability to concentrate, being too hot, being shakey, feeling weak and everything else, really sucked.
Although a month ago, she did say that if she’d realized how amazingly impossible it would make it to lose weight, she would have just suffered through it. Even while knowing that hyperthyroidism places undue stress on the heart.
*head/desk*
There are over 2,000 medical reasons for unexplained weight loss, http://www.wrongdiagnosis.com/symptoms/weight_loss/causes.htm, including cancer, diabetes, hyperthyroidism, and a bunch of others. But doctors frequently overlook any and all of this in favor of telling you what a good job you’re doing, until you do finally lose too much weight for them to ignore the problem.
On the other hand, there doesn’t seem to be an amount of weight you can gain before doctors quit calling you a lying pig and actually look into treating you.
I wonder how many medical hours and dollars would be spared if doctors would just listen to their patients when they say things like, “I haven’t changed my food intake or exercise levels and I’m losing/gaining weight. What’s going on?” But they don’t. They either tell you to diet, or call you a “good girl” for doing such good job of conforming to their bullshit thinness standards.
There is a reason that diseases like cancer and heart disease affect fat women disproportionately, but not the reason you’d think.
Fat women don’t want to go to the doctor because when we do, we’re told we’re liars, delusional, bad, recalcitrant, uncooperative, a problem patient, non-compliant… Frequently fat women are told doctors can’t help them with a problem unless they lose weight first, whether that’s true or not.
*I* go to the doctor for regular screenings because I have a family history of both heart disease and breast and ovarian/uterine cancer and I’m more afraid of dying than I am of the bullshit shaming tactics. And I’m belligerent. But for women who don’t know about Fat Acceptance, or Health at Every Size, or who haven’t come to grips with their bodies, being scolded like a naughty child or being accused of lying is fucking humiliating and awful. Even I have left the doctor’s office in tears after a particularly brutal appointment.
Non-compliant. Even if you are a model patient in every way, except your inability to shed the pounds your doctor thinks you ought to, you, too, can be labeled non-compliant and, it’s possible, be “fired” by your doctor. Because, yes, even though I follow all of your other prescriptions to the letter (evidenced by the drop in asthma symptoms, being able to take birth control for over 17 years with only one pregnancy scare, etc…), I am COMPLETELY ignoring you when it comes to my gluttonous ways.
Do these people really listen to the shit that comes out of their mouths? “Well, I realize that you’re a model patient in every other way, and your blood sugar, cholesterol and blood pressure are perfect, but you’re obviously a filthy lying fatty fat fat about what you eat.”
I learned a long time ago not to lie to doctors, because of a bad drug interaction. When I was younger and using recreational drugs like candy, I told my doctors, frequently to their shock and amazement. When I was younger and drinking myself steadily to death, I told them. When I was sleeping around with many, many different partners, I told them.
Why on earth would I lie about this? Why would I lie about eating which is not an illegal act for which I could do jail time, when I told you about doing pot, acid, speed, drinking more than a fifth a night (while underage), smoking cigarettes, and the orgy on New Years?
Yeah, I don’t get it, either.
*Other symptoms I asked her about included hair loss (on my head), hair growth (not on my head), fatigue, my periods coming more frequently and for longer, and insomnia.
Polimicks 
Thank you. You have exactly explained why I hate doctors and don’t go unless nearly on death’s door. Right, I enjoy being called a liar and having my real problem ignored while Mr. Righteous M.D. lectures me like a child about my weight. And I have to pay a hefty co-pay for the insult.
Doctors don’t care, anyway. Most of them go into the practice for the money and prestige. I think most of them are abusive fucks.
Mary MMM
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Yeah, I have a whole nother rant about stuff like that, that I did about dentists over on the CA NOW site.
Tell me again why you NEED a new Mercedes every two years, and why your fees are so fucking expensive?
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Actually, most of the doctors I’ve met go into medicine in order to care for people. And sustain a lot of debt getting there. If money and prestige were the aim, there are a lot of better professions to go into. Investment banking, for example.
Caveat: I’m a doctor, and I do get a lot of abuse from people I’m trying to help. But often I assume it’s because I’m really not catching anybody at their best when they’re in pain, tired, unwell, throwing up etc. Most patients I treat, on the other hand are very nice and make me glad I went into medicine, esp if I can make them feel better.
And by the way, the last car I replaced was 14 years old, and replaced with a second hand car. Not all doctors are rolling around in their wads of cash mocking their unfortunate patients. It’s not an easy job, and to do it well you have to be patient, caring, attentive and hardworking to a degree most people don’t normally reach. Almost everyone I know in the field tries really hard.
Oh, addendum – the 350lb limit is an annoying thing put in place by insurers – the folks who insure medical equipment. Last time I tried to put a 400lb patient on a CT scanner, I had to get special permission because insurance won’t pay if the table breaks under the weight and it can cost thousands to fix. But General Electric told me that the table can theoretically take up to 400lbs, insurers just won’t cover above 350lbs on most tables, pelvic exam tables, sliders etc unless it’s one of those 1000lb weight limit special ones. It’s retarded, really. Kind of like designing things that wont’ work for anyone over 6’6″ or under 5’1″. (or economy class seats that only tiny people fit in)
Closed MRIs, however have a size limit that tracks the 350lb weight limit pretty closely because of strength of the magnetic field – for bigger people, you need a much stronger coil and not everyone has that. The Open MRI will do the trick.
That said, I agree with – sudden weight gain or loss with no change in habits is a very concerning symptom, and needs thyroid testing among other things. Personally, sudden, unplanned weight loss scares me more, since I’ve picked up a number of people with cancer who had that as a symptom.
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Yeah, but I think you’re exceptional in lots of other ways.
Truthfully, you’re probably right about most doctors getting into it to help people. BUT just like some of the dentists I’ve met who are more concerned with things like the Dental Hygeine Aides* eroding their profit margins fuck it up for all dentists, it really just takes one or two dickheads to fuck up everyone’s perceptions for all time.
*Which of course ignores the fact that DHAs will not be treating anyone who could afford their services, or in areas where they want to set up practices.
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this is grounds for immediately finding a new doctor for me, whenever I am in a position to do so (like… oh… having insurance). I will *not* put up with getting bad care from a doctor. Having been hit with Fibro and CFIDS at 9 (when I was a perfectly normal sized child, not overly thin or fat) and then being told as a teen that I needed to lose “about 10lbs” because I was just that much “overweight” when my *tits* weighed “about 10lbs” but were not considered in the math… Yeah. I have the biggest case of ‘no, really, FUCK YOU and your BULLSHIT’ about that sort of treatment. If it is clear to me that the doctor I am going to is an ASS, and *not* going to be at all useful to me. Time for a new doctor.
Which is why I have been telling you to GET A NEW DOCTOR GODDAMN IT since you first mentioned how yours treats you. Fuck that doctor in the goddamn ear.
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She used to be better.
I don’t know if I’ve passed some mystical “Fat Barrier” or if the HMO she works for is cracking down and enforcing dickheadedness.
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better is still not very good. Now she is a blatent bitch and needs to be replaced.
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I concur. Particularly after our last round of “I know you’ve been bleeding for a month and a half, but why don’t we wait one more month….”
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seriously, if you had called her after 3 weeks and she said “lets wait and see what happens” I would still be saying ‘new doctor time!’ … but 6 weeks and to get that??? yeah.. so fired.
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An ARNP got a lot less accepting when I went from 350 to 390 due to depression. Suddenly she wasn’t sure it was “safe” to give me a pap or anything else that would put me on an examining table.
I haven’t been weighed yet at my new doctor’s office. I shook my head when waved to a standard 350-lb scale and before I had a chance to say it didn’t have a large enough capacity they’d hooked up an XL blood cuff and were pumping it up. So I’m just down as a “prefer not to be weighed” and I’m okay with that. (I do have a scale at home, so I can check if my weight changes by a significant amount.)
Oh, and a relative of my mine was thrilled to lose 50lbs in a few months without even trying. Turned out to be uncontrolled diabetes.
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I’ve been tempted in the past, when asked to get on the scale, to just tell them, “Write in Fatty McFat Fat, and get it over with.”
I haven’t, because I like to at least start the appointment without antagonism. But, yeah, I’m looking for a new Doc in the Seattle-area, if anyone has any tips.
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I honestly wasn’t being antagonistic – I knew I was too heavy for their scale. I was smiling when I shook my head, and intended to ask if they had a larger-capacity scale hidden, but the assistant had me moving on so quickly I didn’t really have a chance. It was later that I thought, hm, maybe “don’t ask don’t tell” could work.
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I can support that.
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Holy shiznit, I didn’t know you lived up here. I’m up by Everett, and yeah, I’m looking for a new doctor too, one who will… you know, support me and actually investigate my hormonal problems instead of throwing me back on the Pill.
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Yeah, I’m in the Greenwood area.
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Which HMO? I’ve been seeing Cathleen O’Farrell at Group Health in North Seattle, and while I don’t know if she is explicitly doing a HAES approach, it sure feels like it.
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Virginia Mason. That’s not my insurance anymore, but I’ve seen their doctors for a long time. With my insurance I can go just about anywhere I want, so I think I’mma gonna start.
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Yeah, I’ve been told that a fasting blood glucose of 113 is technically diabetes. That was one in a long, long list of doctors I’ve fired over the years.
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Yeah, I’m starting to get really tired of the “ZOMG! UR GOIN TO DIE! LOOK AT YOUR… perfect numbers… I… ITZ GOIN TO HAPPEN FATTIE!!!”
Sigh.
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Is this the one who was blowing you off about some problems recently? Is she associated with the school I happen to go to? I’ve had HORRIBLE luck with doctors there. I know they aren’t all assholes (got a couple on my friend’s list who’re cool people), but they certainly give doctors a bad name. (And explain why I’m so phobic.)
When I injured my back, the one doctor I saw told me to exercise and lose weight. (I saw a guy who’s no longer there who hooked me up with actual muscle relaxants and told me to LIMIT physical activity until it was better.) When I went in with walking pneumonia, I was told it was just asthma (and oh yes, to lose weight.)
And people wonder why I have a doctor phobia.
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No, she’s someone I’ve seen on the Eastside since coming back from Grad School. I thought that since she sees some of my family members, having that family medical history right there might not be a bad thing…
Not so much…
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Sweetie – you told me to find another doctor based on the background the guy who took over my old doctor’s practice had. He hasn’t had a chance to do anything that your doctor HAS done. I know looking for a new doctor is a pain but this woman has no respect for you, considers you a liar, doesn’t listen, and so isn’t giving you good care. I just have to wonder how much more bad it has to get before you leave her??
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See my latent superpower – Super Human Capacity for Bullshit
Aided by my supplementary superpower – INERTIA
No, this latest period bullshit tipped the scales, but I didn’t want to switch in the middle of that until I quit bleeding to death out my twat.
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I just want to join the chorus of people telling you to get a new doctor.
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Already on it.
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I’ve got a cool one. Would you like contact info for her?
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They talked about this in Mindless Eating (a great book on food psychology). Basically, he argues this attitude – even if being overweight isn’t a symptom of something else – is ineffective anyway.
“Scientists, physicians, and counselors have often blamed overweight people for trying to fool others (or themselves) about how much they’re eating. Some dieticians, physicians, and family members tell them flat out that they’re ‘lying’ or ‘in denial.’ Hurtful accusations like these only make diet counseling effective at scaring off overweight people, rather than changing them.”
They also found that overweight people are NOT less accurate than thinner people at estimating caloric intake (we’re all pretty bad at it).
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This, this and this.
I have no more to say because you have covered it all.
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Thank you.
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Dangit, if you lived near me, I’d send you to my GP and my OB/GYN, who are both fat-friendly AND childfree-friendly.
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