One of the Ways Doctors Kill Their Patients

A fabulous piece ran in xojane today, which I is incidentally written by one of my oldest, dearest and kickassest friends.

He asked what I ate, but he didn’t wait for an answer. I had to exercise more, he said, having no idea how much I was exercising. I also needed to eat less than whatever it was I was eating which I hadn’t gotten a chance to tell him. Dear god, what cutting-edge medical research! I certainly never thought of “eat less and exercise more,” especially not when I was bulimic, which incidentally is in that file of papers you’re holding which we like to call “records.”

“I’m not concerned about it,” I said tightly, “and if it comes up again I’m going to have to find another doctor.”

“Any other doctor would tell you the same,” he said, as though I hadn’t been coming to him, just as fat as now, for several years.

“Well, I prefer a doctor who at least waits to hear what I eat before telling me to eat less.”

He looked exasperated. “There’s no possible way you’re not eating too much.”

I’m pretty lucky not to have encountered the circular fat logic when I’ve been on the patient side; I suspect one of the privileges of future doctors is exemption from the shaming ritual. But I this assumption is sooo widespread and sooo insidious. The thinking goes that everyone’s weight is a direct result of the quantity that they eat. Therefore, all fat people are eating too much because any amount of food that is eaten while being fat is too much. Any fat person in recovery from an eating disorder can explain to you what’s wrong with that line of reasoning, but, you know, they shouldn’t have to.

Another excerpt I want to make sure you notice (although, really you should just go read the whole thing):

Obese women — by which, just to make it clear, I mean women whose weight divided by their height squared is greater than 30, not any of the more colloquial uses of “obese” like “too fat to be attractive to me” — are more likely to get cervical cancer, and more likely to die from it.  Sure, we could blame this on the very fact of obesity, because blaming things on obesity is a fun party game for some people, but then there’s the inconvenient fact that obese women are also way less likely to get regular cervical cancer screenings.

Since the Pap smear is a towering triumph of public health, with an incontrovertibly strong correlation between regular screenings and lowered cancer rates, it’s not too far-fetched to posit that fat women would be less likely to get lady cancers if they were more likely to get regular exams.

And why, oh why, might you not get regular exams if you were a fat woman?

This is one of the ways doctors kill their patients.

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