Fat

on being fat and trying to find healthcare providers that get it

I’m fat. I have been for most of my life. For a few years, as a kid, I was fat even though I ate a regular amount, exercised by biking, playing tag with my brothers, and other kid activities. Despite my active lifestyle, I was still putting on weight. I remember the day I reached 150 lbs as a kid. My doctor hung her head and said something had to change. I vowed to not gain another pound, and for years, I didn’t.

I started slow. 100 crunches a day. Then I started restricting my eating until I was down to 300 calories a day. This sharp trend down had consequences. I stopped having a period, I grew irritable and restless. My bones hurt. When I was 10, I was diagnosed with Marfan syndrome, a connective tissue disorder that caused my joints to dislocate. I was kept from exercise for months. I sat out with a doctors note during gym class. I stopped playing because of the fear of pain.

When I developed an eating disorder, this all went out the window. I exercised obsessively, despite the pain and my joints going haywire. Doctors were thrilled. I was no longer fat. They didn’t care that I had lost 60 lbs in a matter of months. All they cared about was not looking at a fat body anymore. When I reached college, I was right around 100 lbs.

When I look back on pictures of that time, I have to laugh at how I looked. My huge head and frail body made me look like a bobblehead. I looked gangly and uneasy, but I felt strong. Sophomore year I started to gain weight back until I was creeping up on 200 lbs as a 25 year old. Then I passed 200 lbs. I was mortified, I thought I was going to die from humiliation. But I didn’t. I’m alive and healthy. But let doctors tell it, I’m far from that.

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I recently met with my PCP where, after gaining four pounds over 6 months, she brought up Ozempic. My hemoglobin A1C was a little high, but “not enough to be concerned” to use her words. Still, the specter of weight loss drugs had been brought up with another doctor, one who I had grown to like. Her small talk and cheery disposition made me let my guard down. I trusted her. Now, I felt the walls going back up.

My doctor wasn’t just bringing up any old weight loss drugs, she brought up the trendy one, the one accompanied by images of svelte celebrities with invisible waist lines and gaunt faces. My blood pressure was good, my cholesterol trending down, even my hemoglobin A1C was going down. By all standards, I’m a healthy woman. But weight trumps all.

Even doctors that tell you the BMI is trash still hold you to that standard. At 5’5” and over 200 lbs I’m morbidly obese by BMI guidelines. But the BMI doesn’t factor in my history with food, exercise, or genetic factors. It’s true I live a pretty sedentary life as I write and edit for a living, but I eat well. I’ve been vegan for the past 12 years. My diet consists of plant based proteins and veggies.

Somehow, when you’re fat, none of this matters. You have to be less. You have to be smaller. You have to conform.

One of the things my doctor said that stuck out to me was that “if there were more things wrong with you, I’d recommend a weight loss drug,” but she still went on to recommend it. In the absence of real numbers that would show I was unhealthy, only left with the number on the scale, I was being treated like my body was a problem.

There are many lists now that show size inclusive and friendly doctors in your state. My state only has about two and they are both men. I like having an all woman healthcare team, but I often feel bad about the way I’m treated. When my period was gone for almost a year, I was told to lose weight and see if it would come back. So I did lose weight, and it didn’t come back.

I’m afraid to bring up my knee pain, because I’ll most likely hear weight loss will solve that too, despite the fact that my knees were their worst when I was a size 0.

All doctors have biases. It just so happens that you can hide your anti-fat bias under the umbrella of being “considered for your patient’s health.” But healthy isn’t the same for everyone. A number of factors, including genetics, region you live in, and financial status can determine whether a person is getting enough exercise or eating a balanced diet.

I don’t know why I’m writing this. I guess I’m just sad. I guess I’m just defeated. I’m tired of hearing that losing weight will solve my every problem. Tired of being treated like I am a problem. To be fat is just another way of being. You can’t judge someone’s overall health based on their weight. We know this now, but still, this notion prevails.

I just want to be free and happy. I don’t want to be tethered to a scale, not again.

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If you know of a fat queer doctor I can chat with for this month’s episode, please get in touch with me on here or via Instagram!