You’re a plus-size person at the doctor to check out some new and worrying symptoms. The doctor immediately focuses on your weight, asks if you’ve tried dieting, and maybe even suggests that your illness is caused by your weight. You wonder if the same symptoms presenting in a thin body would receive a different kind of attention. You leave upset and defeated.
This happened to me over and over again when I gained weight in my late teens, resulting in several autoimmune disorders staying undiagnosed and untreated through my mid-20s. I often felt I was failing my body. When I found body positivity, the political movement that says all bodies should be treated with equality and justice, I realized that a medical system that didn’t listen to or respect my expertise about my own fat body was failing me.
I’m not alone in this experience. Cat Pausé, a PhD and scholar at Massey University in New Zealand, has analyzed the many studies showing that fat patients receive worse health care than thin ones. One of her papers notes, “Fat individuals are less likely to access health care, and are less likely to receive evidence-based and bias-free healthcare.”
Natasha Dang, MD in internal medicine, notes that doctors are often trained to fall back on “fat” as a diagnostic catch-all. She says, “It’s not a surprise that most docs go to the simplest solution. … This misses a lot of actual medical issues.”
When I started advocating for myself, I finally found diagnoses and the proper care for my body. Until bodies like mine are treated with the same respect as thin bodies, here are some ways to advocate for yourself at the doctor’s office.
1. Find a doctor you can trust
Summer Innanen, a certified nurse practitioner and body image coach, says, “I encourage clients to try and seek out a practitioner who takes a Health at Every Size approach.”
Health at Every Size, a philosophy created by Dr. Linda Bacon, “supports people of all sizes in addressing health directly by adopting healthy behaviors” — not simply dieting. Several sites provide databases of professionals who abide by the HAES ethos. If there isn’t an HAES provider in your area, oftentimes an HAES office can provide a referral, or you can point your doctor to the HAES resources for health care providers.
2. Write a script and practice it beforehand
These experiences can result in a lot of anxiety about going to the doctor.
Meredith Noble, a food and body peace coach, suggests thinking “about what would make a particular encounter with a doctor feel more safe for you. For example, think about whether there are any boundaries you want to put in place.”
3. Bring some moral support
All the coaches I talked to suggested bringing a friend, partner, or family member to your appointment for support and to advocate for you if you get tongue-tied. I have personally found this strategy extremely helpful!
4. Ask not to be weighed
For me and others who have a history of disordered eating or body image issues, being weighed at the doctor’s office is a triggering experience. If it’s not relevant to your visit and will be stressful for you, consider opting out, or asking to be weighed facing away from the scale.
5. Keep the focus on you
Dr. Dang says, “If you’re feeling uncomfortable or concerned about your doctor’s approach to your concerns — talk to them about it.” Don’t be afraid to redirect the conversation to keep the doctor’s focus on your symptoms and questions.
For example, if your doctor says, “Have you considered going on a diet?” You could say, “I’d like to keep the focus on my rosacea, and not on my weight.”
Chastain recommends asking, “Do thin people get this health problem? What do you recommend for them?”
6. Never forget you have options
You always have the option of a second opinion. If a provider doesn’t have a BP cuff big enough, a gown large enough, or the skills to draw your blood? Remember that it is their job to provide health care to all their patients. It’s not your fault they aren’t prepared to provide that service.
Finding doctors who talk about nutrition and joyful movement, who respect me and my body, and who are comfortable in dialogue with body positivity has vastly improved my health in the past year.
Learning to advocate for yourself is a process; it might feel hard or strange when starting out. Christy Harrison, an anti-diet registered dietitian and host of the Food Psych Podcast, reminds us, “Remember that you have the right to request your medical care is done in the way that you want.”
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