How many times have we heard this same story? A vibrant, active young man goes to the doctor, in this case, with knee pain. The doctor does a routine test and doesn’t see a problem. The doctor does see a young man who fits into an “undesirable” segment of the BMI chart. The solution, the young man is diagnosed as fat, is told that his “extra weight” is probably causing the pain in his knee and sent home. Now Kaleb is an active kid. He plays rugby, and he loves to sail. But once the doctor sees Kaleb’s place on the BMI scale, he just might think something like this: “Aha! I don’t have to say that I don’t know what’s wrong with this kid’s knee. I can write obesity in the kid’s chart and then we have a diagnosis!”
Unfortunately, in Kaleb’s case there was another diagnosis besides “fat” to be found. A short while later, he was taken to the hospital via ambulance after he fell down some steps. At that point, he was referred to a specialist that he saw two weeks later. The specialist ordered an MRI and during the scan they found a serious bone infection. Kaleb was scheduled for emergency surgery the same night. He is recovering well. So thankfully, the story has a happy ending.
But how much pain could have been avoided without the “fat diagnosis”? It appears that had this infection been detected earlier, it could have been treated with antibiotics rather than emergency surgery. Now there’s no guarantee that had Kaleb been thin, they would have found the infection sooner. They might have still sent him home and told him to take some aspirin and take it easy. Thin people are misdiagnosed too. But I’ve heard time and time again about people who are “diagnosed fat” and sent home. Remember this guy who was diagnosed fat, and it turned out to be a brain tumor? Remember his emergency surgery? I wonder if doctors, frustrated by a lack of diagnosis and discouraged from ordering expensive tests don’t lean on the BMI chart as a way to have something to write in their diagnosis box. I imagine in many cases, once patients are “diagnosed fat” and are shamed and blamed, they stop asking annoying questions. They stop demanding that doctors figure out what is wrong with them. In some cases, they stop going to the doctor altogether. This is part of the collateral damage and opportunity costs in the “war on obesity”. This is another example of the casualties that arise from singling out a body type as unacceptable and trying to eradicate it.
And we’re not just dealing with misdiagnosis here. We’re dealing with fat people suffering and dying from the mutilation of otherwise healthy tissue via gastric bypass and banding surgeries. We are seeing the development of more and more new strategies for trying to make fat people “healthy” by making their digestive systems mimic eating disorders and limited blood flow to the gut. We are so focused on helping fat people get healthy by making them thin that we are willing to make them really, really sick to help them get there. And sadly, in so many cases, the fat people who undergo these treatments end up fatter or sicker or less happy than they were in the first place.
There are weapons we can use in this war. One of them is to ask the doctor if thin people also experience the same problem. In Kaleb’s case, he or his mom might have asked, “Do thin people also have knee pain? What tests might you do if I were thin. Can we do those tests please?”
Another weapon is to help make doctors and other medical professionals more aware of the pain and repercussions of fat bias. And it just so happens that we have some terrific tools to do that. The Association for Size Diversity And Health (ASDAH) along with the Size Diversity Task Force are compiling videos about fat bias in healthcare. The project is called RESOLVED. Some folks at ASDAH have informed me that the deadlines are being extended. You can hear more about the project and see my sample video HERE. In addition, the Size Diversity Task Force has a unique opportunity through one of our members to help train medical advocates about fat bias in healthcare. But in order for your video to be used in both places, you need to submit your video by March 18. If you’re interested in participating in the project and/or have any questions or concerns, please leave me a note in the comments below. Or send me an email at jeanette at thefatchick dot com. I’d be glad to help.
Let’s do what we can to limit the number of casualties in the war on fat. Let’s help kids like Kaleb get the attention and care they need at the first doctor’s appointment–not the third. Let’s see what we can do to have “diagnosed as fat” be a thing of the past!
The Fat Chick
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I agree, but I have to say that I find the doctors office the HARDEST place to face down bias. This week I got back the results from blood tests done for my physical, and it all looked great except that the fasting blood glucose was 103. The top of the normal range is 99.
The doc said that weight loss should fix it. I said that in my experience, efforts to lose weight make me crazy and fix nothing, but I was willing to get a glucose monitor and see what lifestyle changes would bring the number down. She just kept talking about weight loss. Sigh.
I have relatives of all sizes with Type 2 Diabetes, and I will go with my plan: monitor, learn, make changes that work. It is discouraging that I am stuck with this doc (insurance reasons). Tho I know, I am lucky to have access to care at all in this misshugenah world.
I know, the doctor’s office can literally be a mine field. I know both from research and from personal experience in working with my students that moderate lifestyle change–especially exercise can have a profound effect on blood glucose levels, even when NOT accompanied with weight loss. So all I can do is reassure you that I think you’re on the right track. oxoxoxo TFC
I’m approaching this as my own personal opportunity to educate a doc. Those numbers are going to look better when next I see her, by increasing my exercise and making some changes in food choices. I do not expect to lose weight (that generally takes major lifestyle upheaval for me.) I will be healthier, and maybe her mind will open a bit. It will all be good.
Reblogged this on Jewish Film.
Reblogged this on Jewish Film.