Does your doctor fat shame you?

Some of them peg all health issues on the patient’s weight, leading to misdiagnosis and delayed treatment

Fat shaming may be prevalent in the society but comes as an unplesant surprise when medical professionals also indulge in it. Malavika Shiv was around 15 years old when she suspected she was having problems with her thyroid. “The blood tests I took showed varied results but all my symptoms pointed towards my suspicion. However, my doctor made multiple jokes about how ‘fat’ I was and how I was lying about being an athlete as he believed I was too heavy to take part in sports,” she says.

He pegged her weight as the root of all her problems and asked her to shed a few kilos.

“I did lose weight before I saw him the next time but there were still no changes in my symptoms. He insisted I lose more weight. This was when I switched doctors,” she says.

Her second doctor diagnosed her with a hormone imbalance and treated her accordingly.

She describes the entire episode as embarrassing and insulting.

This kind of fat shaming by a medical professional results in the actual problem going undiagnosed and also causing mental stress to the patient.

Doc focussed on weight gain, missed out on PCOS and tumour

Tasbeera was 13 years old when she started gaining weight at a rapid rate. In addition to gaining over 20 kg within a few years, her menstrual cycle too was disrupted. “We visited a highly recommended doctor, but he was nonchalant and dismissive,” she says.

Tasbeera didn’t get a proper diagnosis. The doctor concentrated on her weight and said everything will be fine once she loses a few kilos.

This, she says, was despite the fact that she and her mother explained how unusual and sudden the weight gain was and repeated her other problems.

Her mother asked her to visit another doctor who diagnosed her with Polycystic Ovarian Syndrome (PCOS). Subsequent tests also revealed that there was a benign tumour in her brain, causing a condition called prolactinoma which was the reason for her weight gain.

Along with the physical consequences of her delayed diagnosis, she was deeply affected mentally. “My self esteem dropped quite a bit after that and I started starving myself since the earlier doctor told me I had to lose weight. Even though I’d dropped close to 10 kg in around a year, none of my primary problems were going away,” Tasbeera says.

One could argue that weight gain is a symptom of many illnesses but it is dangerous to blindly focus on just that. Aakanksha Mishra’s ordeal is an example. She went to the doctors for menstrual issues that were isolated from her weight but the doctors were not convinced.

“I had been overweight much before the irregularity in my cycle but the doctor kept insisting that my weight was a symptom of PCOS,” she says. She was asked to take a number of tests, all of which cost her over Rs 5,000. The results came back negative for PCOS.

“It was only after this that my doctor shifted the focus away from my weight and asked questions about my lifestyle and mental health,” she says.

Along with a quick check of her blood pressure, it was concluded that her issues were due to high stress.

While this may seem like the doctor was being meticulous, Aakanksha feels otherwise. She says that though she mentioned her struggle with stress and anxiety at the start, the doctor had dismissed it and chose to concentrate on her weight.

“Because I didn’t have the time and resources, I was unable to switch doctors. It was my bad luck that I ended up with one who dismissed my actual problems solely because I was overweight,” she feels.

‘Gynaecs need to pay attention to weight, it is not fat shaming’

Thankfully, both Malavika and Tasbeera were able to get the right diagnosis later on. Many doctors are known to conflate weight to health, equating heavier patients as lazy ones and proceeding to treat them with that bias in mind.

They are not apologetic about it either. When Metrolife spoke to a gynaecologist about fat shaming and bias in her line of work, she defended the practice. Her only grouse was that doctors need to be able to communicate it in a less offensive manner.

“As gynaecologists, weight is something we need to pay extra attention to as it is an indicator of PCOS. The condition has no cure and can only be controlled with lifestyle changes like weight loss,” she says.

When we told her about cases such as Tasbeera’s and Malavika’s, she said that while certain doctors can be harsh while conveying information, it is not done with the intention of shaming people.

Doctors’ fixation on weight dangerous for patients

In a 2014 study regarding physician-patient communication, it was found out that doctors showed less respect for what overweight patients had to say and spent less time with them as compared to those that were not.

This lack of attention towards a patient solely because of their weight is highly dangerous and can result in more consequences than just a bruised self-esteem.

Dr S Manohar, the director of internal medicine at Sakra World Hospital, says that patients should always be clear about what their symptoms are so as to help the doctor arrive at an accurate diagnosis. “Regardless, no doctor should focus on just the weight of a patient when diagnosing them,” he says.