Navigating Medical Weight Stigma While in Eating Disorder Recovery
Happy Weight Stigma Awareness Week!
In the age of Ozempic—the newest, flashiest and supposedly magical weight loss med—celebrities, influencers, our next door neighbors and Great Aunt Jane are all shrinking before our eyes. Sure, prior to the Ozempic craze, diet and wellness culture was ubiquitous. But there was a small period of time when “body positivity” was trending on social media. It seemed as though we were moving the needle ever so slightly away from promoting anti-fat rhetoric. Offering dignity and respect to all people, regardless of size was becoming more acceptable. Social media was inundated with influencers and businesses launching campaigns empowering people to love their bodies. And just like most trends, there came a point where that school of thought stopped trending. Now that this “magical cure” has appeared on the market—a cure that is supposed to eradicate fatness once and for all (hate to break it to you, but there have always been fat people and there will always be fat people)—it feels as though that progress we were making has sent us in a time machine back into the 90s and early 2000s where anti-fat rhetoric was normalized and celebrated. The whiplash is real.
What is Weight Stigma?
Simply put, weight stigma is the discrimination of people based on their body weight and size. Weight stigma and anti-fat bias permeates our society. From medical care, shopping, public transit, harmful tropes about fat people, media (mis)representation, accessibility to public events (ie: stadium seats, amusement park rides, seating at restaurants), overt anti-fat rhetoric etc. – the list goes on and on. Our society was created to exclude fat folks, unless they are the brunt of the joke, the comedic relief or the dimwitted sidekick.
Weight stigma is a leading cause in the development of eating disorders. I firmly believe that every person in eating disorder recovery, regardless of size, must be given the opportunity and tools to divest from anti-fat bias in order to enter a meaningful place in recovery. In order to do this work, we must understand the impacts of weight stigma from multiple areas in society. This blog will work to highlight weight stigma within medical settings and will offer tips for how to navigate weight stigma while in eating disorder recovery.
Medical Weight Stigma
Stepping on the scale is the first thing that happens at a doctor’s appointment. This sets a precedent for weight being the focus, the cornerstone, and the determining factor of one’s “health.” It is not uncommon for a person of size to seek medical attention and be greeted by a doctor who immediately makes assumptions about their intake and movement habits, blaming the presenting issue on the patient’s body size and then prescribing weight loss as a solution. Whereas a thin person in the room next door could present with the exact same symptoms and they will likely receive adequate care and a treatment plan appropriate for the condition that brought them into the office.
Personal Story of Medical Weight Stigma
As a child, I had recurrent bouts of tonsillitis. Every 3-4 months, I had to go to the doctor. At each visit, the doctor would look at my mom and tell her that if I wasn’t so large I wouldn’t be getting sick as often. There was another girl in my class at school who was going through the same thing. The difference between us was that she was thin and I was fat. She got her tonsils removed, and I was offered prescriptions for antibiotics served next to a steaming hot side dish of weight stigma and shame.
Fast forward to age 23, I was still getting recurrent bouts of tonsillitis. Who knows how many rounds of antibiotics my body had gone through at that point in my life and how that impacted my overall health. With each round of tonsillitis, my tonsils never fully went back to their original size. Even when they were not inflamed, I would joke that my tonsils were like the size of California and Texas combined. When I visited the dentist, they would get their staff to come in and look at the size of my tonsils. They were the talk of the town.
And then I got tonsillitis one last time, but this time my infected tonsils swelled and closed off my airway, causing me to lose consciousness. Luckily, I was surrounded by people who rushed me to emergent services, where I was hospitalized until I could breathe freely and my infection was gone. It wasn’t until my life was threatened that I was finally scheduled for a tonsillectomy.
Impact of Medical Weight Stigma on People with Eating Disorders
Weight stigma kills. Because of weight stigma, I battled an undiagnosed, untreated eating disorder for 19 years. I faced many medical unnecessary complications – because when doctors saw me, they dismissed eating disorder symptoms I presented with and they chalked each issue up to my size being the problem. Doctors encouraged my eating disorder behaviors. They worsened my eating disorder.
On the flipside, had I shown up to the doctor presenting with the same issues but in a thin or emaciated body, they would have immediately diagnosed me with an eating disorder. Instead of adequate medical care, I received a prescription of how to sink deeper into the throes of my eating disorder. And my story is just one voice that echoes that of scores of others.
We know that early intervention is the strongest predictor of sustained, meaningful recovery. Medical weight stigma makes early intervention nearly impossible for people of size to obtain.
Navigating Medical Weight Stigma in Eating Disorder Recovery:
One of the most difficult aspects of recovery is shedding the rose-colored, thin-ideal lens and confronting the true impact of weight stigma—both in your personal experience and in your recovery journey. This presents a unique challenge when having to then then re-enter environments where weight stigma is still deeply ingrained—environments like the doctor’s office.
Facing medical weight stigma is traumatic. Having to walk back into a doctor’s office, knowing there is a strong likelihood that weight stigma will be present in the appointment – triggering doesn’t begin to describe what that can feel like.
People of size report delaying or avoiding doctors altogether, due to the stigma they face. I have been one of those people who delayed seeking medical care because of my fear of the stigma and shame I would face. The problem is…this avoidance only exacerbates medical issues that might be going on.
There are some incredible Health At Every Size (HAES) doctors out there, but unfortunately, they aren’t accessible to everyone. I believe doctors chose their profession because they truly want to help people. However, the reality is they were trained in a system that is steeped in anti-fat bias and weight stigma. If you are unable to find a HAES doctor near you, the next best thing you can do is work to advocate for yourself and your needs at the doctor’s office. This is something you can also ask your eating disorder therapist or dietitian to help you accomplish, too. Everyone’s individual needs are different, but here are three tips I offer folks as you work to advocate for yourself at the doctor’s office.
Three Tips for Advocating for Yourself at the Doctor’s Office:
Plan what you want to say before you go.
This is especially important for those who have experienced trauma in healthcare settings, as it can be so easy to shut down in the moment. There is no such thing as too many details or a “stupid question.” Write out your pertinent medical history, your presenting concerns and your questions. Take these notes with you for reference.
Take a loved one with you to your medical appointment – physically or virtually.
If at all possible and if it feels safe to do so, take a trusted support person with you. They can be a waiting room support or an in-the-room support. If they're coming in the room with you, brief them on what your hopes are for the appointment and how you would like them to offer you support.
“Will you check in with me before the doctor leaves and ask if there are any other questions I have?”
“These are my main concerns today. If I don’t bring one of these topics up, will you remind me in the moment?”
Remember that you are the expert on your body.
This might be the most important of the three tips. Regardless of the behavior of the provider or the outcome of the appointment, remember that no amount of letters behind someone’s name can surpass your expertise about yourself and your experience. You are receiving a service. Your doctor is not the “authority.” You have autonomy. You get to decide what type of medical care you consent to receive.
Final thoughts…
Eating disorder recovery is already a difficult journey, and weight stigma adds another painful layer of complexity. However, I strongly believe there is hope for recovery, especially when we are equipped with the right tools and a strong support system. Weight stigma might be a part of our journey, but as we work to dismantle our own internalized anti-fat biases and surround ourselves with others who are committed to doing the same, may we be emboldened in our recovery journey and on our path to body liberation. I’m in this work with you, friend. There is hope.
Meet the Writer:
Sharon Maxwell (she/they) is an educator, speaker and fat activist. With compassion as a guiding principle, Sharon is a leading force in dismantling systemic anti-fat bias. She dedicates her work to eradicating weight stigma on both a social level and within healthcare settings. Drawing from her previous career in education, she combines her knowledge of curriculum development with her lived experience battling weight stigma to offer unique insights and practical tools that foster safe and accessible environments for people of size. Sharon's story has been featured in The New York Times Magazine, on The Tamron Hall Show and numerous podcasts. Her activism work has been highlighted in news outlets including 60 Minutes, The Wall Street Journal, The Washington Post, The New York Times, NPR and more. You can follow Sharon’s work on social media platforms through @heysharonmaxwell. For collaboration, speaking or consulting requests, Sharon can be reached through her website: heysharonmaxwell.com.
Stark Therapy Group’s Services:
Stark Therapy Group offers therapy for all types of eating disorders, including Anorexia, Binge Eating Disorder and Bulimia. We offer a 3-tiered family based support for teens in eating disorder recovery. We also provide cutting edge trauma therapy called Brainspotting. We treat anxiety, depression and general mental health conditions. We offer 3-tiered family based support for teens with general mental health issues. We offer culturally competent therapy for BIPOC folks. We also offer couples therapy. We would love to help you on your mental health journey. Reach out today!