Fat people often experience discrimination and stigmatization when they seek medical treatment. It’s a big problem that leads to metabolic issues, increased inflammation, avoiding medical care, and increased mortality risk. It can be a challenge, but verbally advocating for yourself at doctor’s appointments could reduce some of the negative impact of weight stigma.

Researchers say that feeling stigmatized or stereotyped at a medical appointment can actually make it harder for you to think and communicate effectively. If that rings true to your own experiences at the doctor, you might want to go into your next appointment with a cheat sheet of phrases recently shared by speaker, writer, and researcher Ragen Chastain, in her Weight and Healthcare Newsletter, where she writes about the intersection of weight science, weight stigma, and healthcare.

“Of course, there are tons of techniques to navigate weight stigma, but when I think of the top three phrases, I think about options that will help us get the care we want and need, even in a healthcare system that often tries to reduce the entirety of our healthcare to ‘diagnosis fat, prescription weight loss,’” Chastain wrote.

“How would you treat a thin person with this symptom/condition?”

How to prepare

Write this question out on a notecard to treat like an actual script when you are in the doctor’s office. Speaking up can be so intimidating, especially when we feel marginalized and devalued. Try saying the phrase out loud to yourself at home before your appointment so you're not totally winging it when you get there. It’s ok to check your notes and ask this very frank question.

When to deploy

If your care provider gives you a diagnosis and starts straight away to tell you about weight loss options, remember: whatever condition or symptom you have, people in smaller bodies experience the same symptom or condition. They are not prescribed weight loss for their allergies or sprained ankles. There are other options for you, too.

Your doctor, Chastain wrote, may even be relieved to skip the weight loss lecture to talk about more evidence-based treatments.

A good follow-up

It can feel confrontational to question weight bias and push a provider to see you as more than your BMI, especially when you have a history of feeling demeaned or disempowered in medical settings. If you leave an appointment feeling like you didn’t get weight-neutral treatment, follow up with a message on the portal asking the doctor how they would treat a thin person with your condition or symptoms. The next time, it may even be easier for you to advocate for yourself in person.

“I’m exercising my right of informed refusal.”

How to prepare

Take your notepad! Remember you don’t have to decide on every treatment option at the moment it is suggested. If your doctor’s proposed treatment sounds like part of an intentional weight loss agenda, you can make a note to do more research or ask questions at the appointment. 

When to deploy

This phrase can be useful if you want to bypass the scale at medical appointments where your weight is not medically relevant. 

You may also use this phrase if your provider suggests diets, weight loss surgery, weight loss medication, or any other treatment that you have already researched and decided is not a good option for you (for any reason), and they don’t take “no, thank you” as your final answer. You always have the right to refuse treatment. 

“This type of stigma can be implicit, and the provider may not be aware that they are engaging in it which, of course, doesn’t negate the harm,” Chastain wrote.

A good follow-up

Maybe you were caught up in the moment and for a second, prescribed weight loss sounded like it might just work this time. If you left the appointment and later reconsidered, it’s not too late to send the doctor a message telling them just that. Follow up by asking what treatment options they would suggest for a thin person.

“Thank you, but today I would like to focus on…”

How to prepare

When you walk into an appointment, you likely know what your concerns are. If you don’t already have a diagnosis, you know what symptoms have caused enough discomfort to make you call the doctor. Make a note of your symptoms/concerns before the appointment so you can check each one off as you discuss it. 

When to deploy

When your appointment (or provider) goes off track. Some doctors are so eager to “save” patients with weight loss interventions, your initial reason for seeking treatment gets overlooked. This phrase politely pulls the focus back to your concern.

“The phrase ‘I’d like to focus on…’ can be invaluable when you went to a healthcare provider for something specific (sprained ankle, strep throat, prescription refill, severed limb, etc.) but the practitioner’s weight distraction is getting in the way of the ethical, evidence-based, patient-centered care you deserve,” Chastain wrote.

A good follow-up

Check out more of Chastain’s suggested questions and research for navigating weight stigma in medical situations.

“If the result isn’t what you hoped for, please remember that while that may become your problem, it’s absolutely not your fault—we shouldn’t have to study for a doctor’s appointment in the first place!” Chastain wrote.

For more scripts for talking to healthcare providers while fat, check out writer Meg Ellison’s suggestions. 

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