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.
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