Doctors constantly told me to lose weight and start exercising, especially when I was trying to get pregnant. But they didn't know how hard I tried and how much their words hurt.

By Anna Lee Beyer
July 02, 2019
Yeji Kim

In the last 10 years, I have taken four different weight loss medications, joined Weight Watchers again, followed a doctor supervised diet program, and attempted dozens of other diets. I have trained for a half marathon, practiced yoga weekly, and trained for a second half marathon. I have studied the Health At Every Size approach, turned my back on diet culture, and turned back to diet culture for "one more try" way too many times.

Among those milestones, I have been pregnant twice. In a decade, my weight has never fluctuated more than 0.5 percent—not when I was pregnant and not when I ran almost daily for a year. How remarkably stubborn bodies can be about weight.

I carried two babies with only the faintest uptick on the scale, and my obstetricians patted me on the back for it. I was being a good fatty by not gaining the 20 to 30 pounds or so smaller women are expected to gain. But I wasn't always praised by my doctors.

Before I was ever pregnant, I experienced the stigma of having Type 2 diabetes. It's one of a few diseases that provokes contempt rather than sympathy. And being diabetic and trying to conceive, I became an even bigger magnet for body policing and shaming medical experiences.

I had seen one obstetrician for two months when I asked for a new doctor. After several visits, I was sure he knew nothing about me beyond my weight. Our appointments lasted less than five minutes, and all he told me was to "lose weight and start exercising." At that point, I had been running for a year and was training for a half marathon. The doctor had never asked me if I exercised or what I ate. He made assumptions based on my appearance, and his speculation and disinterested glances at a chart surely wouldn't help me conceive and have a healthy pregnancy.

Studies show there are maternity care providers who feel "high levels of discomfort, intolerance, and feelings of repulsion in caring for obese pregnant women," according to research published in BMC Pregnancy and Childbirth in 2013. Weight stigma in general can lead to "poor psychological functioning, body dissatisfaction, increased episodes of binge-eating, and exercise avoidance." A 2001 study also found doctors are more likely to assume larger patients are not as healthy, not as self-disciplined, and take less care of themselves than thinner patients.

As an "obese" woman, I can confirm I have felt discomfort, intolerance, and repulsion from the medical professionals I have turned to for healing and support. Many larger people experience disdain and dismissal when they seek treatment for ailments from routine to serious. The fat always seems to obscure the human, and many doctors can't see beyond it.

I felt a little comfort hearing author Angela Garbes speak to registered dietitian Christy Harrison in 2018 on her podcast Food Psych about the very same thing I was going through.

"It's ridiculous that there's this barrier to care, and it's coming from just weight-biased interpretations of the research," Harrison said while discussing her book Like a Mother, a personal and science-based exploration of what happens to a woman's body during and after pregnancy. "We don't know the causal relationship between body size and health outcomes. But there is a lot of evidence to suggest that weight stigma is a mediating factor, where weight stigma might actually be causing the health outcomes that we are seeing in people in larger bodies."

Yes, there is evidence to prove that. Weight stigma in pregnant and postpartum women can lead to "increased depressive symptoms, greater weight gain during pregnancy, and weight retention after their baby is born," according to research from Worcester Polytechnic Institute in Worcester, Massachusetts.

Both of my pregnancies were tainted by fear and guilt because I was considered high-risk. I was told extra monitoring, extra tests, and more frequent visits were necessary because of my size, diabetes, and age. Out of fear of harming my babies, I never questioned the requirements. Still, the scheduled birth of my second daughter became a messy tangle of blood transfusions, an emergency hysterectomy, and the NICU. None of the problems we experienced on her birth day were detected by the extra tests and exams. And none of them can be linked to my weight.

It's been three years since I was last pregnant, but I am still the same size and am still impacted by stigma at every medical appointment. I don't know how many times a doctor has told me to try harder to lose weight because "we want you to be around a long time for these babies." Not one has ever recognized how hard I have tried, or that the failure is not mine. I take their pills and drink their protein shakes. I buy new sneakers and exercise books. When none of that works to make me the size and shape they hope for, I challenge their expectations.

And instead of feeling fear and shame, I remind myself what I'm worth when it comes to my care. Certified birth educator Jen McLellen said it best: "You deserve to be treated with dignity!"

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