Living with a chronic illness while facing fat phobia from healthcare providers can be a daunting experience, especially for individuals living in larger bodies and especially for individuals in recovery from an eating disorder. As a therapist with my own lived experience with these issues, I get it!

It is so challenging and defeating when you are seeking good, quality care to address your genuine and valid health concerns and are met with unhelpful recommendations of weight loss. At the end of the day, regardless of your size, you deserve adequate healthcare and evidenced based medicine. I am going to be bold here when I say that weight loss recommendations are lazy medicine! In fact, research over the last 20 years indicates that intentional weight loss has more consequences to your health than it does benefit your health (Harrison 2023).

In this blog post, I aim to shed light on how to navigate the fatphobic medical system. The system 100% needs to change and is full of systems of oppression. So going into this, I want you to have your eyes wide open that this is the reality of the system. I aim to help you navigate this system for our own physical well-being as we all continue to move towards changing and improving the broken system.

Please keep in mind that the information in this blog post is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment as that is well beyond my scope as a mental health therapist. I am providing information based on my own lived experience as well as my own clinical experience addressing advocacy with my clients. Take from this post what is helpful to you and leave behind whatever is not helpful. My goal is to empower you so you go into your next healthcare experience feeling confident and feeling capable of self-advocacy. You can do this!

When navigating chronic illness in a fatphobic medical system, it is imperative that you do your own research and know and understand your condition.

I say this and I know exactly where your mind is going. I am not telling you to go down a rabbit hole on the internet here especially if this is an anxiety provoking task for you. What I am telling you is to get curious and be open to it all. Read articles and blog posts on the condition. Look into podcasts or people on social media sharing their lived experience. If you have any friends or family you trust in the medical field that are nurses or doctors that can provide resources or information to you, reach out to them and ask! If you have a therapist or a dietitian, bring this up in your sessions and do some research together.

*HUGE AND SUPER IMPORTANT DISCLAIMER / HARD TRUTH:

If you have a medical condition that is stereotyped to be an issue “only fat people have” (which correlation does not mean causation but wellness culture and diet culture surely don’t acknowledge this golden rule of statistics but another rant for another time) you will inevitably come across research and information with treatment options including weight loss recommendations or maybe even specific restrictive diets. This is good though, because now we can roll our eyes and be fully aware of the likely bs recommendations that we COULD be told when we are at the appointment and won’t be blindsided. This also means we can start the second portion of the work which is figuring out how to challenge it when or if it comes up at the appointment. Then, we can work through our feelings and emotions about this information. Because let’s be real, it is annoying, frustrating, disappointing, defeating, infuriating, and all the feelings.

The goal here is to empower you with as much knowledge as you can access. My goal for you here is to take it all in but with a grain of salt. Try and decipher between opinion and fact and seek out additional findings on things that seem factual. What are the cited sources? Look into those as well. Your own experience with a chronic illness will be unique to someone else’s and your body will respond differently to some interventions than others. Medicine still attempts to put people in boxes with “one size fits most” recommendations. Be aware and cautious of this. You won’t know everything but you will know enough that you can ask a doctor 1:1 follow up questions and for more information when they offer specific recommendations to you. This will also help with making you feel more empowered to challenge them on any fatphobic responses you may receive.

Please make sure you are checking in with yourself and your anxiety as health concerns and researching them are going to bring up anxiety. If you need support, do the research with your therapist! If you don’t have a therapist, seek one out! Navigating this stuff is stressful and I have learned in my own journey that stress makes many chronic illnesses worse. Talk about that mind-body connection! I want to validate this is part of the process and it is okay to be anxious. It’s unfortunate you have to educate yourself first, I know. But not educating yourself leaves you vulnerable to falling into immediately taking on recommendations that are stewed in weight stigma.

*ANOTHER SUPER IMPORTANT DISCLAIMER!

It is so important that you know as a patient that most doctors and other health professions outside of registered dietitians have minimal to no training on nutrition science unless they have special training that they themselves seek out in addition to their general education. If you are looking for nutrition advice, you need to seek out a registered dietitian who works from a weight neutral lens (not a nutritionist or personal trainer as they do not have the adequate education for this).

Like I mentioned above, I highly recommend seeking a therapist if you don’t already have one who can also support you with navigating chronic illness, fatphobia, and self-advocacy as it can be mentally taxing and difficult to navigate on your own!

In addition, seek support from friends, family, or online communities who understand your experiences. Having a supportive network can bolster your confidence and provide valuable advice for navigating challenging medical interactions, especially when combating fatphobia from healthcare providers.

I want to acknowledge this is hard for a lot of my clients especially those who are not used to advocating for their needs in any capacity. This is okay! We all start somewhere and again therapy can be a great place to do this work so you feel more and more confident over time. When you are ready, clearly communicate your concerns, symptoms, and treatment preferences to your healthcare providers. Express how weight bias affects your care and articulate the kind of support you need to manage your condition effectively.

Before going to an appointment, practice what you would like to say or how you would like to respond when or if weight is brought up in your appointment. Do what feels best for you and it won’t be perfect! Sometimes you won’t have the energy or capacity to speak up or challenge it and that’s ok! You don’t have to take the recommendation given to you.

Some examples of things you could say when advocating for yourself in an appointment:

• “I prefer not to focus on my weight during this appointment and would like to discuss other aspects of my health.”
• “It’s important to me that we approach my treatment without making assumptions based on my size. Can we work together to ensure my care is comprehensive and unbiased?”
• “I’d like to explore treatment options that are not solely focused on weight loss.”
• “What would your treatment plan look like for someone with my condition who is in a smaller body?”
• “Can we discuss non-weight-focused approaches to managing my condition?”

You have the right to be treated with dignity and respect regardless of your body size and regardless of your health concerns. If you encounter fatphobia from a healthcare provider, consider seeking care from professionals who prioritize compassionate, unbiased treatment. Look for healthcare professionals who demonstrate cultural competence and respect for diverse body sizes by researching the provider ahead of time. In fact, feel free to call their office and ask the front desk about the provider and see what information they can offer. In some cases, they can ask the provider on your behalf and get back to you. Sometimes you may even be able to speak with the doctor directly if it’s a small practice! Also, read reviews on google or yelp if they exist or other platforms of patient experiences.

Navigating chronic illness while combating fatphobia from healthcare providers is undeniably challenging. As a therapist, I am committed to supporting my clients in their journey to advocate for themselves and access equitable healthcare, irrespective of their body size.

Harrison, C. (2023). The wellness trap: break free from diet culture, disinformation, and dubious diagnoses, and find your true well-being (First edition). New York, NY: Little, Brown Spark.

Association for Size Diversity and Health (2023). Health at every size principles. https://asdah.org/health-at-every-size-haes-approach/