The Fat Girl's Guide to Living

Keep your cool at your next check-up. Image by House of Sims on flickr.

Karen R. Koenig, LCSW, M.Ed., is our inaugural guest blogger (and the crowd goes wild!). Karen is a psychotherapist and author who specializes in the psychology of eating. Please give Karen a warm FGG welcome, share your experiences, and ask any questions you may have in the comments section. –The FGG Editorial Team

When you’re fat, the only thing more worrisome than the bad news you might hear when you visit the doctor is agonizing about what might be said about your weight. You’re likely to get an unsolicited earful. One of my clients was admonished that she could positively not see the doctor unless she weighed in. Another never got a chance to share her health concerns because her physician spent the entire visit urging her to get lap-band surgery. Yet another was told she’d be refused treatment by her nurse practitioner unless she dropped 40 pounds.

What’s a girl to do if she needs a check up or has a health emergency and happens to be a few score overweight?

Be a smart shopper. Remember that you are first and foremost a consumer of services and that it’s up to you to see that you get what you (or the insurance company) are paying for. Everyone is entitled to go to a health professional and have their concerns heard and responded to in an appropriate and professional manner. Everyone is entitled to be shown respect, kindness and compassion when they walk through that office door. And, everyone is entitled to assert their needs and express dismay/anger/frustration when they’re not met—including fat girls.

Speak up. If you’re unhappy with how you’re treated by health professionals, say so, not only to teach them about how you want to be treated, but to empower yourself. If you’re seeing a healthcare provider for the first time, just be yourself and try not to be anxious. There are no rules. Maybe you want to talk about your weight and maybe you don’t. It’s fine to say that weight is a sensitive issue and that you prefer to talk about it when you know the provider better. It’s also fine to say nothing at all in defense of your reticence.

If providers insist, stand on the scale so you’re facing away from the mechanism that measures your weight, and ask staff not to say the number aloud if you don’t want to hear it. Or be bold and tell them that you know you’re overweight and don’t need the scale to tell you so. Better yet, volunteer whether your weight has changed, even if it’s gone up. Take charge—ask why they need to know the exact number, why a weight range isn’t sufficient. If you’re receiving medication, medical staff might want a specific number to assess correct dosage.

Think ahead. Call before an appointment if you’re worried you won’t receive a gown large enough to discretely cover your body. Maybe even suggest the practice invest in plus-size gowns if they lack them. If you require help getting up on the table, ask for a stool and take your time climbing on. You’ll probably end up waiting for the doctor anyway, so what’s the rush?

Be prepared. In the case of visiting a health care practitioner who has hassled you about your weight in the past, feel free to provide some education that it’s fitness and health that count, not simply poundage. Do some Internet research and bring it along. If you’re taking action to lower your weight and feel like it, tell the doctor. Maybe you’ve joined a gym, started therapy or are reading my books. Most importantly, stay calm and maintain control of the agenda. Doctors’ visits seem to be getting shorter and shorter, so write down your questions and concerns ahead of time and tick off items as you get responses. If the doctor brings up your size, try a gentle reminder that weight isn’t the issue at hand. If he or she presses on, make the reminder a teeny bit less gentle.

Go for a team or collaborative approach, not a combative one. Most health care professionals really do want you to improve your health and often feel powerless to help you. Leave the chip on your shoulder behind and try not to personalize or read intentions that aren’t there into well-meaning or professional remarks. Although you don’t want a provider who treats you like a naughty child, you also don’t want to act like one.

Exercise your right to walk. Don’t be afraid to change practitioners. People do it all the time for any number of reasons. I’m on my third GP since I moved to Sarasota almost four years ago. Keep at it until you find someone you trust who listens to your questions and concerns. You deserve to have health care providers who will help you take excellent care of yourself.

Karen R. Koenig, LCSW, M.Ed., is a psychotherapist, educator, national speaker and international author who is an expert on the psychology of eating. She has a private practice in Sarasota, FL and does world-wide telephone therapy. Learn more about her and her books at EatingNormal.com and NiceGirlsFinishFat.com.