On Fat and Health: A Personal Anecdote

[Content note: Both external and internalized fat hatred, health issues, diet talk, CICO thinking.]

The recent news out of New York has a great many members of the blogophere talking about "public health" and fatness, with an attendant uptick in public shaming of fat folks. If anyone is tempted to to buy the argument that all of this somehow improves public health, and any fat-shaming is just a harmless side effect, I share my own recent experience.

Three things to know:

1. I have hypothyroidism. It is fairly easy to treat, but needs monitoring; when it worsens, the signs are often subtle. Among its symptoms is weight gain.

2. I am fat. Recently, I gained some additional weight.

3. Because US health insurance is garbage, I lost access to the physician I have been seeing for the last seven years, with whom I had an excellent rapport.

Putting these facts together meant that I knew I needed to find a new doctor, and I knew I probably needed to get him or her to check my thyroid. I knew there was a strong possibility that my weight gain was a symptom of falling thyroid hormone levels.

But based on my experiences with physicians, based on a lifetime of living in a culture that demonizes fat and relentlessly tells fat people that "all" they need to do is diet and exercise and CALORIES IN CALORIES OUT and blah blah evil fattiez!

...I didn't go.

If you aren't fat, you may find this hard to believe, but if you ARE fat, then you know exactly why. If you're fat, then chances are good you've had a physician refuse to listen to anything about your health other than your weight. I know I have been told "just go lose some weight" for maladies ranging from ankle sprains to endometriosis. The latter misdiagnosis ended up costing me an ovary. Whooooops your "healthy" fat-shaming!

In fact, it took me two years to get diagnosed initially with hypothyroidism, because the doctors I saw about my weight gain, hair loss, snoring, feelings of lethargy, depression, all said the same thing: "Lose some weight." Never mind the classic symptoms of hypothyroidism. Never mind the family history of thyroid disorders. When I told one doctor I was having trouble exercising because of tiredness and increasing aches and pains in my legs, he suggested I just needed to "keep at it."

Thanks, buddy. What a splendid idea! I will take two "keep at its" and call you in the morning.

And so, before hieing myself to another physician, this time I was determined to show that I had already been doing everything right, that it was something other than "fatness" causing the problem. I wanted to get my ducks in a perfect row. I didn't diet, but I tracked what I ate, and fretted over my occasional swings in appetite.... even though I knew from experience that those swings were likely related to an underperforming thyroid not properly regulating my insulin. I struggled to run at least three times a week, and tried not to feel too bad about the many times I was just too tired to run, or ran poorly... even though I knew that this was likely thyroid-related lethargy. I tried to get the requisite 8 hours of sleep, and worried that the fat was causing the snoring...even though I knew that hypothyroidism had previously caused me to snore.

In short, I was internalizing all of the pernicious fat hatred that masquerades as a concern for health. Somewhere this became not just about the possible attitude of my yet-unknown new physician. It was also about me ignoring or downplaying the increasingly clear signs that my thyroid was off because I, too, was buying into the idea that I wasn't worthy of health because of my fat.

Rather than viewing my fat as a symptom like any other, it was a special source of shame. Three months went by, and I still had not seen a physician. Until I was less fat, or at least could show beyond a doubt I was *trying* to be less-fat, I did not deserve health.

And I am aware of fat hatred, I am a believer in HAES, I moderate and contribute to Shakesville. How much harder is it for someone who hasn't been exposed to those things to counter the relentless fat-shaming?

My story has a happy-ish ending: a UTI forced me to go to Dr. New Doctor, who agreed to check my thyroid without too much hassle. And yep, my thyroid hormone numbers are off. I'm on a new prescription. And I hope to work with my new physician and to build a relationship wherein fatness myths don't interfere with my medical needs.

But there are so many stories like this one out there, and so many that do not end happily, or even acceptably. Almost every fat person can relate horror stories related to medical visits. The reality is that fat-shaming is a serious and important barrier to health care. Instead of banning large sodas, how about we downsize the fat hatred? It just might save a life.

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