I recently asked my social media followers: "What's the most unhinged condition a healthcare provider has blamed on your weight?" The responses broke my heart and lit a fire under me all at once.
The Stories That Keep Me Up at Night
- A dislocated wrist in someone with Ehlers-Danlos Syndrome. EDS literally affects connective tissue, but sure, blame the weight.
- Mono. Mononucleosis. A viral infection. Blamed on body size.
- Sinus infections. "Here are some antibiotics and you should lose 50 pounds." For. A. Sinus. Infection.
- Pneumonia misdiagnosed as a blood clot "because fat people get clots." Except it was actually pneumonia, which could have been fatal if not properly treated.
- Mental health conditions: Depression, schizophrenia - apparently these brain chemistry disorders are caused by adipose tissue now.
- Genetic conditions: Factor 5 blood clotting disease, fibromyalgia, POTS - all blamed on weight instead of being properly managed.
- And my personal favorite: An infected spider bite that could apparently be "cured with gastric bypass surgery." I cannot make this up.
This Isn't Just Bad Medicine - It's Dangerous Medicine
Here's what happens when we blame everything on weight:
- Actual conditions go undiagnosed while patients are sent away to "lose weight and come back"
- Medical trauma deepens as patients learn their pain isn't worth investigating
- People avoid healthcare entirely rather than face more weight stigma
- We miss opportunities to provide actual, helpful care
What's Really Happening Here
When I see providers blaming broken bones on weight, I'm not seeing malicious intent. I'm seeing:
- Learned bias from a medical system that taught us "obesity causes everything"
- Cognitive shortcuts that feel easier than doing thorough clinical work
- Unconscious prejudice that makes us see fat bodies as inherently problematic
- Lack of training in weight-neutral assessment techniques
The Shift That Changes Everything
In my practice, I stopped asking "How might their weight be involved?" and started asking:
- "What does their clinical presentation tell me?"
- "What are the actual contributing factors here?"
- "How can I provide the same quality care I'd give anyone?"
- "What does this patient need to feel better right now?
This isn't about ignoring health factors. It's about being a better clinician.
What Patients Actually Need From Us
- Based on hundreds of conversations with patients who've experienced weight stigma in healthcare:
- They want us to listen to their actual symptoms, investigate their concerns thoroughly, provide treatment for their current condition, and treat them with the same respect we'd show anyone.
- They don't want weight loss lectures when they came in for strep throat, assumptions about their lifestyle based on their appearance, to be blamed for conditions that have nothing to do with weight, or to leave our office feeling worse about themselves.
The Bottom Line
Every time we blame an unrelated condition on weight, we're practicing bad medicine. We're also perpetuating a system that has failed our larger-bodied patients for decades.
As healthcare providers, we can do better. We must do better.
If you're a provider who wants to learn how to have these conversations without causing harm, I've created 5 specific scripts that help you provide excellent care without weight stigma. Get them here
What's the most frustrating example of weight blame you've encountered? Share in the comments - sometimes we need to see these patterns to believe how widespread they are.
From the age of 14, I knew I was going to be a chiropractor. I loved the concept of healing through touch and was always the kid who was hugging my friends or rubbing someone’s shoulders after a tough day. My future seemed clear: I envisioned myself helping people alleviate their pains and improve their lives without prescribing medicine or performing surgery. But alongside this vision of my professional future, there was another, more personal expectation I believed I needed to meet
—I thought I had to be thin..
As a teen, I was deeply influenced by makeover movies (think Never Been Kissed, She’s All That, The Princess Diaries), where the leading lady undergoes a dramatic physical transformation, usually from fat to thin, ugly to beautiful, or overlooked to admired. I don’t remember thinking I’d be fat my entire life. When I pictured myself as an adult, I was always thin. I was the transformed girl I saw in the movies.
These stories shaped my understanding of personal value and success. This dream of a future thin self was intertwined with my professional aspirations, convincing me that my ability to be a good chiropractor was linked to my ability to become thin. I internalized the idea that to be listened to and respected, I needed to “follow my own advice,” and fit into a physical mold.
The belief that doctors, particularly those at the top of the healthcare hierarchy, need to be thin is pervasive. Looking back, I realized that I had never seen a fat doctor, though there were plenty of higher-weight nurses and assistants. I questioned: Do doctors know something about staying thin that others don’t, or is the medical field riddled with bias that discriminates against higher-weight individuals? It has become increasingly clear that anti-fat bias is ingrained within the system.
Throughout my education, the shadow of this bias was always lurking. From the jokes about fat bodies to the warnings that fatness “caused” all types of diseases, it was hard not to see myself in the joke or feel the pressure to change my body. I spent much of my 20s and 30s trying to find the future me.
However, this "one-day" frame of mind is harmful. It suggests that true happiness and success are just out of reach, contingent upon meeting a specific body weight or image. It discourages individuals from living in the moment and appreciating their current selves. It can delay happiness and make one feel like a failure even when successful in other areas.
Over the years, I've come to recognize the destructiveness of these beliefs. The truth is, being a good chiropractor—or any kind of doctor—has nothing to do with one’s body size. It's about skill, empathy, dedication, and the ability to care for patients effectively. I've learned that the bias within the healthcare system is what needs to change, not the bodies of those who work within it.
The journey to unlearn these biases has not been easy, but it has been worthwhile. It involves challenging long-held societal beliefs and advocating for a more inclusive perspective that values professionals for their skills and compassion, not their body size. This shift in perspective is crucial not only for the well-being of healthcare professionals but also for the patients who benefit from a diverse range of doctors.
Let's begin to dismantle the harmful stereotypes in healthcare and affirm that good doctors come in all sizes. Our ability to care, to empathize, and to heal is not measured by the scales but by the heart and the hands that perform the healing.
The term "Fat" is used as a neutral descriptor, which has been co-opted by the Fat community and does not carry any negative connotations. It is used interchangeably with the term "higher-weight individual".
The words “ov*rweight” and “ob*se” are always censored because they are harmful and stigmatizing terms that incorrectly pathologize and medicalize bodies based solely on their size.
