Written by Monique Bellefleur, Ed.M, LMHC, MEDA Director of Community Education
I hear time and again from clients that they are afraid to go to the doctor’s office. I don’t blame them when I hear their stories: The doctor told them they were eligible for gastric bypass surgery (even though they had not asked about it and have an active eating disorder); They had a heart rate in the low 40’s and the doctor told them they were perfectly healthy (even though they had a BMI of 17 and an active eating disorder); They went to the doctor’s for a sinus infection and the doctor told them they need to lose weight. The list goes on…
However, it remains important to receive medical care. Although we wish the medical community understood more about eating disorders, we unfortunately have to learn to be our own best advocates until the medical community catches up.
Here are MEDA’s 5 tips for speaking to your doctor about their weight stigma and/or your eating disorder:
- Don’t be intimidated: Remember, doctors are just people who have gone to medical school. Yes, they have spent years studying the human body, but that does not mean that they are perfect, all-knowing beings. Even though eating disorders have the highest mortality rate of any mental illness (Smink et al, 2012), a 2014 national survey found that out of 637 internal medicine, pediatric, family medicine, psychiatry, and child and adolescent psychiatry programs, 514 did not offer any scheduled or elective rotations for eating disorders (Mahr et al, 2015).
- Use your Voice: Doctors are often overbooked, overworked, and rushing to the next appointment. We all know the overwhelming feeling that comes from listening to your doctor rapidly firing off questions while simultaneously directing you to stick out your tongue, say “ahh”, take deep breaths, cough three times, undress, redress, on and on. It may seem impolite to interrupt this process to ask your own questions, but you deserve to be heard, especially when it comes to your health. Speak up and express your questions and concerns about your care and your body until you feel satisfied with the information you have received. It is not your fault that you have an eating disorder. It is a serious mental illness that deserves appropriate care, and you may need to be very upfront with your doctors regarding your ED. Learning to use your voice is an important part of eating disorder recovery- think of it as an opportunity to practice.
- Confidence is Key: It’s a natural response to respect a person of authority’s opinion, but you are the expert on yourself. If something doesn’t feel right, let the doctor know, including when you feel dismissed. For example, if not seeing your weight is helpful for your recovery, tell the doctor and medical staff directly. If they happen to let that information slip (which seems to happen frequently!), bring it to their attention. If you feel like your doctor is dismissing your condition due to your body size or eating disorder diagnosis, tell them. Doctors take the Hippocratic oath to “do no harm”. It may be uncomfortable, but if their comment or behavior harmed you, you can let them know. By educating your doctor on how they made you feel, you may be saving another patient from a similar experience.
- Come Prepared: Have you created a plan with your treatment team for how you will handle your doctor’s appointments? Have you done research of your own on a suspected condition? Bring this information with you. Write your questions and symptoms down in advance. Bring along a friend or loved one if you need support. When you are prepared, you will be less likely to panic and forget your questions. If you have literature to share with your doctor about eating disorders, weight stigma, or any other condition, share it with your doctor and express how important it is to you that they consider the information. They may not have had a chance to learn about these topics in their medical training.
- Connect them to MEDA: MEDA offers free trainings to the medical community on eating disorders and weight stigma. If you feel like your doctor could benefit from a training, connect them to MEDA at firstname.lastname@example.org or at 617-558-1881.
Resources to bring to your doctor’s office on eating disorders and weight stigma:
- MEDA Print out for Doctors: https://www.medainc.org/wp-content/uploads/2018/05/MEDA_doctors_print_8.5-x-11-flat-PROD_11.2.17.pdf
- Ragen Chastain’s Health At Every Size Cards (these are awesome): https://danceswithfat.wordpress.com/2013/04/01/what-to-say-at-the-doctors-office/
- 9 Truth’s about Eating Disorders: https://www.medainc.org/wp-content/uploads/2018/03/Nine-Truths-about-Eating-Disorders.pdf
Mahr, F. , Farahmand, P. , Bixler, E. O., Domen, R. E., Moser, E. M., Nadeem, T. , Levine, R. L. and Halmi, K. A. (2015), A national survey of eating disorder training. Int. J. Eat. Disord., 48: 443-445. doi:10.1002/eat.22335
Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports,14(4), 406-414.