It's 'Lazy Medicine' When Doctors Blame Everything on Your Weight
I’m fat. It’s nothing new to me to go to the doctor and be told that all of my ailments could be cured by losing weight. I classify this as “lazy medicine” because in reality, many health problems are not caused by being overweight. I’ve had pelvic pain caused by endometriosis and been told that it was due to the size of my body. I’ve had neck pain associated with trauma and I was informed by a doctor that a low-fat diet and exercise would cure it.
Recently I lost vision in my right eye. I went to the doctor, and after she looked into my eyes with that bright light we all know so well, she told me I had to see an ophthalmologist immediately. Less than 24 hours later and after an extensive eye exam with scans of my optic nerves, I was sent to the emergency room for further testing. I had an MRI and a spinal tap, which coupled with the swelling around my optic nerves, led to the diagnosis of idiopathic intracranial hypertension (IIH), or pseudotumor cerebri.
IIH is diagnosed when an individual has either too much cerebral spinal fluid production or the absorption rate is too low. It causes inflammation around the optic nerves, which can cause visual impairments and is usually the symptom that leads people to seek medical care. IIH typically causes severe headaches and a feeling of hearing your pulse inside of your ears. I was experiencing all of these symptoms.
The first thing the doctor said to me when he brought me this news was, “This diagnosis is most common in obese women of childbearing age.”
I didn’t get upset, but was caught off guard nonetheless.
Despite being told that it was idiopathic, or of unknown cause, I was essentially led to believe that the diagnosis was strictly due to my weight. They started me on a medication to help with absorption of cerebral spinal fluid and told me that weight loss would help my symptoms decrease and hopefully prevent permanent vision loss.
I hold the identity of being a person in recovery from bulimia. Though I haven’t used behaviors in awhile, I know I could easily slip back into this pattern. I immediately called a dietitian who works with eating disorders and is knowledgeable about Health at Every Size (HAES). It became clear to me that if health professionals were telling me to lose weight, I was not capable of doing it on my own in a healthy way. I needed help.
As a result of the lumbar puncture, I came down with a massive spinal headache. I received a blood patch from an anesthesiologist to fix this problem. I was having spinal fluid continuing to leak from the hole that they punctured, and they transfused my own blood into that hole during a separate procedure. The anesthesiologist had significant trouble with the needle and it took much longer than it normally would.
He refused to use any radiological equipment like the professionals who did the initial spinal tap, and had me bend over on the gurney while I squeezed a nurse’s hand in pain. I yelped, cried despite being given an anti-anxiety medication, and screamed in pain while in a room full of people only separated by curtains.
The anesthesiologist said, “The problem is that I keep hitting bone because you’re a big girl.”
I was in a lot of pain and had a giant needle in my spine at this point, but my physical pain quickly turned to shame.
Since getting home from the hospital after this procedure, I’ve done my own research about IIH. I’ve learned that while it is most common in obese women of my age category, there are other risk factors. One risk factor that caught my eye was the potential for lithium carbonate to cause IIH, therefore not making it idiopathic at all. My symptoms began six months ago when I was put on lithium for bipolar depression. I hadn’t put two-and-two together until I continued reading about this in online journals, and despite stating that I had mental health disorders to the doctors, nobody asked if I’d taken lithium. I no longer take it due to other side effects, so it wasn’t in my chart as a current medication. I understand that they had no way of knowing this information, but if lithium is a major risk factor for developing IIH, why didn’t they ask me about it when they saw that I have a history of bipolar disorder?
This leads back to the “lazy medicine” discussion. Health professionals who have years of training, including doctors and nurses, don’t receive quality nutrition education. They are taught that body size equates to health, and for good reason. They are shown study after study that certain diseases and disorders are more common in people of larger body size.
We can’t put all the blame on them, as it is all they have been taught. Good physicians, however, have also read studies relating to HAES. They know that people of any body weight can be healthy. They know that prescribing a diet will likely fail their patient rather than help them manage a disease, because dieting can cause physical and mental health damage. Good physicians agree that it isn’t about telling a client to lose weight, but encouraging health.
Health looks different for everybody, since we all have different bodies. Health can look like maintaining a meal plan for someone in recovery from an eating disorder, or eating intuitively if they are further along in recovery or don’t struggle with disordered eating.
It can look like someone challenging herself to go for a walk while struggling with depression, meeting with friends for dinner when having a hard time meeting a meal plan, or going for a hike because it feels good. These are things tied to health, but are not described as weight loss mechanisms. The moment that a person is told to lose weight, the mentality changes and can quickly become disordered.
It is essential that healthcare providers take responsibility for their shortcomings and stay up-to-date on current research regarding weight loss and diet plans due to their ineffectiveness. Bedside manner and the way a physician tells a patient that they have a condition which may be due to their size needs to be improved. Rather than blaming every ailment on weight, providers need to perform their job like they would on any other patient to rule out other diagnoses or causes.
The size of my body does not define how I view myself anymore, but it still defines how the world views me.
Fatphobia is growing like bacteria cultures in a petri dish within our healthcare system, and it needs to change.
I am more than my weight.
And I need and deserve to be taken seriously.