Doctor Assumptions

I haven’t posted anything vaguely ranty here in a while, so I suppose I’m overdue.

This article showed up in my Twitter feed a couple days ago, and I completely agree. I’m also going to be leaping off of it to talk about something separate but related: please note I’m not trying to say that my problems are more important than what she talks about in her post, but this is also my blog and I’ll rant if I want to.

For those who don’t click the link, she is largely discussing her experience with doctors who are willing to boil any physical problem down to, “It’s because you’re fat.” And as she points out, while being fat can be a cause of physical ailments, it is not the only cause.

To broaden the statement, I just want to say that as a culture we are far too concerned with weight. Not just with fat, but also its lack, and I hope that isn’t news to anyone.

I realize I’ve come out on the more fortunate end of the stick from the standpoint of societal acceptability, but I have the opposite problem: I’m naturally very thin.

And I shit you not, every single time I go to a doctor they assume I have an eating disorder.

Every. Time.

This makes me snarly.

Now, doctors are hardly the only ones that make this assumption, but I don’t give a shit what most people think of my body, because it isn’t relevant. A doctor’s opinion is supposed to at least be relevant.

Yes, I know eating disorders are a real and serious problem. But I don’t have one. When I talk about physical problems and the only kinds of responses I get are, “Do you think you’re eating enough?” or “Are you throwing up after you finish meals?” Well. I won’t take you seriously.

I have flat-out said, “I promise you I am not anorexic,” and I get that smugly calm smile as they repeat their desire to describe a typical day’s meals. So I do, in detail because I am very aware of what’s going on with my body at all times, and they look troubled for a moment before then asking if I’m sure that’s representative. Before I turned 18, my mother might be with me to testify to my eating habits (I can only imagine her incredulity the first time she was pulled aside by a PE teacher when I was in like 1st grade), and they usually believed her. I’ve had doctors run tests that determine there is an actual problem but when they can’t identify the source, they still try to make an eating disorder fit somehow, because that’s what they expect.

Can we — as a culture, and as individual people — try not assuming all girls have unhealthy relationships with eating? Or that, you know, they’re not mentally unstable, and don’t require someone else to verify that they’re not mentally unstable? Because both of those assumptions help perpetuate problems: when the doctor’s first question is always about weight and its link to health, they can internalize that. When a doctor, or any person in authority, doubts the truth of whatever they say, they can learn not to trust themselves.

Or they can go the other way like me, and learn never to trust doctors and to ignore my weight entirely. I judge my health by how I feel, not by a target number.  And I never go to the doctor if I can possibly avoid it because I know perfectly well what they’re going to tell me, and I know how useless it is, so why waste my time? And that’s not great either.

Yes, I’m thin. I am active, I eat healthy, and frankly I have a ludicrous metabolism. These things have always been true for me. And you know what, doctors? I also have a medical history sitting RIGHT IN FRONT OF YOU that you could reference before telling me, once again, that my weight is the problem or the symptom, and if only I weren’t so mentally unstable I could see that for myself.

I get it. Weight can be tied to so many things that it’s an easy answer, and we’d all like it if life gave us more easy answers. But when you assume you know better than me without even paying attention, then you’ve undercut your own credibility. When you demonstrate a complete inability or unwillingness to consider a problem thoroughly and really think about it before dispensing advice like it’s gospel, then your advice is worthless.

As with many things in life, if you can’t bother to listen, you can’t understand.

Basically I just wish doctors would respect their patients enough to at least start with the assumption that patients are neither stupid nor insane, no matter their body shape or equipment. Is that really so much to ask?


One comment

  1. Much sympathy. I am less strikingly thin than you—height, partly!—but have clocked in as “underweight” for every doctor’s visit except while I was pregnant (when I gained a textbook-average amount of weight, ~25 lbs). It seems to have improved a little with age, or my staring down of medical professionals has improved: if a doctor or nurse queries my weight, I say firmly, “Normal for patient.” And by now, I really know it is.

    I agree with your rant’s general tenor, regardless: assuming that anyone carrying little body fat is ill is also a form of shaming, and it has the same potential as fat-shaming to instill anxiety.

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