I have written and re-written this post many times. It is that difficult to write about this topic. Whatever I wrote, I felt I could write so much more. There are so many nuances to this conversation. There are so many areas of trauma that could be addressed. This writing cannot and will not include the full depth of dealing with traumatic experiences in one’s life – it is just a tiny aspect of the problem.
My trauma is triggered at the doctor’s office. Therefore, I will focus here on the usual “treatment” I receive as a visibly fat person during any health-related visits. Despite improved blood test results in all areas, a still slightly elevated cholesterol (genetic reality in my family) causes the doctor to throw “vague future health risks” threats at me. When I try to seek help for a pain in my belly, I get a referral to a dietician, because: “You are probably in pain because of the fat”. When I get an ultrasound scan, I hear: “Your fat is not allowing me to see your organs well, you should lose weight.” Followed by the unsolicited recommendation of the keto-diet for the best weight-loss results.
Does the doctor ask me about my health behaviours? Of course not. She assumes that I must be sedentary and eat too much since I am fat. Does she ask me about my history with dieting and possible eating disorders? Of course not. She has likely received little or no education on how to check and treat patients with a traumatic history – whether that history includes life-threatening eating disorders or “only” an incessant fat-shaming.
Advocating for oneself is not easy when you are triggered. Somehow, despite hearing these fat-phobic messages all your life, it still shocks you. You may simply become speechless in the presence of the doctor’s authority. So, every visit is re-traumatizing you and you might even stop seeking help unless the medical issue is so serious you cannot avoid it. Is it that strange that statistics show the correlation of serious life-threatening health conditions and higher weights? As fat people, we rarely receive medical attention while these health conditions may still be manageable. Alternatively, we only receive the “dieting” intervention when, in fact, we should have received medications. Moreover, the stress induced by traumatic doctor’s visits should also be taken into the account when thinking about these statistical correlations.
Where is your trauma triggered the most?
If you happen to live in a fat body, like I do, you are likely to get shamed and mis-treated in a broad range of environments. You may look and behave like others do – go to school or work, meet with friends, take care of your family, and have a generally fulfilling and meaningful live. No one will ask you about the trauma. No one knows. Until it is triggered.
Trauma seems to be “in fashion” these days. It may, therefore, be easy to dismiss if it’s not very serious, obvious, or disabling. We might assume that we always take trauma into consideration since we know about post-traumatic stress disorder (PTSD) and offer psychological support to victims of serious traumatic events. But sadly, we sill tend to trivialize the smaller “traumas” of micro-aggressions, shaming, poverty, racism or a myriad of other painful experiences. We still often label the victims of those as being “too sensitive” and “weak”.
Until everyone (especially those engaged in any helping profession) receives education about trauma and harm reduction, we need to advocate for ourselves. Your doctor, psychotherapist, meditation teacher or a fitness coach might never ask you if you have experienced an eating disorder, bullying, shaming or discrimination until you bring it up yourself. It is not easy and it is not fair that we should have the responsibility to educate these professionals. But we can and we should insist on receiving trauma informed care.
In my latest yearly health-check visit I finally gathered sufficient courage to explain my traumatic history with eating disorders to my friendly doctor. I told her why I believe her repeated dietician referrals, comments that the fat is the cause of the pain or focus on one health-marker while all others are perfectly OK may be harmful for her patient(s). I asked her to at least check the patient’s history and evaluate actual health behaviours before jumping to conclusions and giving a (fatphobic) advice. Finally, I explained that my improved health markers are likely the consequence of my “healthy” behaviours:
- Intuitive Eating (as I discovered that I loved veggies in my IE journey)
- Mindful movement (and the re-discovered joy of swimming), and
- Reduced stress due to a regular meditation practice and reduced work hours.
So, perhaps, fat tissue alone is not the only health marker the doctor should be concerned about.
I am lucky that my doctor listened and apologized for not knowing about my eating disorder history. She said that she just wanted to help – and I do believe that’s true. I think most people are just trying to help while still causing harm. I am also lucky because I am relatively privileged – I might have experienced “only” the fat shaming trauma my entire life. I still received psychological help to process it and I would highly recommend a trauma specialist to anyone dealing with any traumatic experiences. At the very least, consider finding a supportive community (see some suggestions below) or talk to a weight-neutral coach or other professional who can guide you on this rocky path.
As a wrap up to this post, I would like to share some of the resources that could be useful:
- Read about Adverse Childhood Experiences (ACE) study – a very convincing research claiming that traumatic experiences are more common than we realize
- If you are looking for help what to say at the doctor’s office, here are some good suggestions:
- In this paper you can read about the evidence behind the weight-inclusive approach to health-care
- Facebook groups that as a fat feminist I find very supportive:
AGGA Coaching 
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