Tuesday, May 12, 2009

Fat-friendly doctors


I'm writing a magazine piece right now on "women's diseases"-the disorders (often autoimmune) that have historically been pooh-poohed by doctors. I'm talking about diseases like chronic fatigue syndrome, lupus, MS, fibromyalgia, and PCOS. As part of my research, I've talked to many women with these diseases, especially PCOS, or polycystic ovarian syndrome. One of the telltale characteristics of a woman with PCOS is having very high levels of insulin, which wreaks all sorts of havoc on the body. And which, oh yes, makes you gain weight.

One of the women I interviewed talked about gaining 125 pounds in less than a year, without changing her diet or exercise habits--and then being told by a doctor that she had to "get your eating under control!"

Of course, you don't have to have PCOS or another illness to have had a run-in with fatphobic doctors. Many of the stories here speak to the same issues.

So for anyone who's ever had to deal with a doctor who just doesn't get it, here's a link to a fabulous list of fat-friendly health professionals around the world.

The site is maintained by one Stef Maruch. Thanks, Stef. You're doing us all a big favor.

14 comments:

Anonymous said...

Harriet, you might want to also check into the Mirena IUD. There are lots of forums with women experiencing weight gain of 30-50 lbs on the Mirena but being pooh poohed by their doctors and being told that it's a diet and exercise issue. That happened to me and it sort of induced a PCOS-like state. Once I had the thing removed, my body changed dramatically within a week.

Harriet said...

Sounds dreadful. Thanks for the tip, Anon.

Amelia said...

It took me five years to finally find a doctor who understood that I wasn't fat because I was lazy or lacked discipline. I can't tell you how many times I heard "eat less, exercise more". Even more so I can't tell you how many times I had to stop myself from ripping off the head of the person who said it. Pair that with the dysfunctional eating I have developed because of all the "diet pushers" disguised as health professionals and it's been a challenge. I'm incredibly blessed to be working with the care team that I am.

Harriet said...

Amelia, I hoe you'll add your doc to Steph's site, if you haven't already.

Harriet said...

That's hope. With a p. Oy.

Stef said...

Thanks for posting about the site I maintain! And thanks to all the people who send me submissions. You're helping other people find doctors they can trust, which is literally a lifesaver.

Nancy said...

My once willowy daughter has gained lots of weight because of the meds she takes for bipolar disorder. While her current meds have helped her tremendously----she is working full time, has quit using alcohol and cigarettes for almost 3 years and is engaged to a very nice young man---she now has a metabolic disorder because of the side effects of the medications. She is seeing an endocrinologist and is on Metformin to keep the insulin levels low. But she probably also has PCOS and/or endometriosis, too. What a choice---sanity, functionality with heightened CV risk and a slew of other problems with the medications OR suicidal depression, dysphoric mania, addiction/self medication and totally dysfunctional life w/o the meds. The endocrinologist keeps telling her to exercise more (she walks to work and is active but can't afford to join a gym) and he usually forgets that she's on psych meds that put her in this position!! When you're depressed and have little self-worth to start with, you can only imagine how devastating these side effects have been for her since she was a teen, esp in this thin-obsessed culture. To find any doctor or specialist who really "gets it" has been next to impossible. I'm encouraged that the gynecologist she was referred to for possible PCOS/endometriosis is in the same practice of one of the doctors mentioned on Stef's website. I also know that there's a top notch endocrinologist who specializes in neuropsychiatry and women's reproductive health at Stanford University in Palo Alto, CA. If we had the time and the money, I get her an appt there. I emailed the doctor and asked her for names of similar MD's in our area and she didn't know of any. Her prompt and courteous reply made it obvious to us that she truly "gets it." Btw, when/where will your magazine article be published concerning this topic? Thanks for all the resources, info and honest commentary that your blog provides.

Anonymous said...

Hey, if it is within the scope of your article, consider adding vulvodynia to the list. I have had it for three years now, and it took 18 months to finally get a diagnosis and another 6 after that to find a doctor who treats it! It's one of those under-reported conditions that obgyn's by and large do not know about. Many women exhibit the (maddening, painful, and spirit-crushing) symptoms but their physicians can't find an infection so they turn their patients away, telling them everything is fine. But there *are* treatments for the symptoms that can help with the pain, and hopefully as more people become aware of the condition, more research dollars will go towards finding a cure.

Rosalie Y said...

Harriet,

I know this is unrelated to your post, but I was wondering if you had any thoughts about ED-related books and their impact. I saw this interesting NYT blog post that questioned whether ED-memoirs were solving the problem, or perhaps part of the larger problem to begin with. I was wondering what you -- as a parent, journalism professor, writer, and avid reader -- think about the topic!

Here's the story:
http://well.blogs.nytimes.com/2009/05/11/the-troubling-allure-of-eating-disorder-books/

When I was sick, I read through all the ED books I could get my hands on, even those that were recovery-oriented. Marya Hornbacher claims that she wrote wasted to inspire people to recover from EDs, but unfortunately, lots of people with eating disorders claim to trigger themselves by reading/re-reading it. In the treatment program I went to, almost everyone had read the book at some point. I was no exception. I think the problem with ED memoirs (and ED movies/TV shoes/preventative media) is that they tend to go into too much description, almost as if to say, "look where I was once. Let me self-indulge a little by telling my story". It's hard to describe the behaviors without glamorizing them. When I wrote the article for Duke last year, I tried to take care not to go into the behaviors for that reason, but when I re-read what I wrote from the perspective of being fully recovered and one year detached (and one year wiser), I regret mentioning ANY description of being sick, because I do sense a smidgen of glamorization. It's a tough balance for ED memoirists/authors to strike, and the only writers that I've found to have done it well are not memoirists but those who write solely about recovery (Aimee Liu, Jenni Schaefer, etc.). I don't know if it's possible for a memoir on ED to be at once truthful and completely uplifting.

In a similar vein, I only learned about purging because we watched a cautionary video in middle school. It had all these dramatizations and facts that flashed on the screen, but one of the few things I took with me was, "People can voluntarily throw up?! 3% of American women do it! Well, now I know next time I eat too much." The dangers covered by the video didn't even register.

I'd love to know what you and your readers think, especially about how ED memoirs impact readers. Thanks!

Harriet said...

Rosalie,
I'm going to post on this shortly. Thanks for bringing it up. I've been trying to avoid it :) but I think I can't anymore.

Anonymous said...

thank you. what an interesting site. i have a health conscious doctor who sees the whole picture. he expects each patient to become well, sooner or later - no matter the disease. i have lupus, insulin resistance, and osteoporosis, along with several vitamin deficiencies. he is invested in my well-being. other care practitioners i've had, even alternative ones, seem invested in my illness by comparison.

his name is Yew-por Ng, in Moscow, ID. He is an MD in a general practioner office. Total Health Physician Group.

Wanda W said...

My doctor is alway stating you are eating the wrong foods to get the weight off. I state that I eat veggie, carbs etc in the right portiond. But with my thyroid going up and down with my meds being checked regularly. I get fed up listening when she's not.And trying to get at a certain weight that she feels comfortable with. So I just concentrate on whats good for me.

lindsay said...

Seconded on the Mirena...I don't get on scales unless I absolutely have to on general principal, but in the four months that I had a Mirena, I felt a massive, tighter difference. I was lucky in that I had a doctor that wasn't particularly weight obsessed, so she left me alone about it, but after I had it removed, I started dropping weight rather markedly.

Anonymous said...

Thanks for the link! I am so SICK of my current doctor totally blowing off any issue I have as being related to my weight. Asthma that I've had since I was 18 and 125 pounds? No no, just lose weight and it will go away. Fall off a horse and twist my knee? Weight related. Problems sleeping? Must be because I'm fat. Jerk. Hopefully that list will have a Dr near me who will look past my big butt and actually listen to me for a change!