Sunday, December 24, 2023

If I Told You What It Was Like to Be Fat and Sick, Would You Believe Me?

Hello Invisible Audience,


I got in to see an ear, nose and throat doctor a week ago; I’ve had a sinus infection for nearly two months. I was relieved at how well the appointment went, although when I thought about it later, I really only had one set of criteria that I based that on: the doctor didn’t tell me that my sinus infection would go away if I lost weight.


That may sound absolutely ridiculous, Invisible Audience, but unfortunately, it’s perhaps a much more likely to occur than you know, depending on your body size. A couple years ago I went to a urologist because I had frequent UTI-like symptoms, but none of the urinalyses that my doctor had done showed anything. The urologist told me that it was likely my issues were caused by recent weight gain and the only thing she could offer was a referral to a pelvic floor physical therapist. When another doctor performed a PCR test of my urine, it revealed bacteria that shouldn’t have been there; as soon as that was treated, my symptoms went away.


Unfortunately, that’s not my only experience with fat bias within the medical system, and I have to tell you something, Invisible Audience. As someone who has frequent doctor appointments and a lot of health issues, bracing myself for this sort of response every time I see a new doctor makes healing infinitely harder.


This morning I woke up and had the same struggle I do on any day that I don’t have concrete plans: do I try to do some work? Do I do some writing? Do I attempt to do some things around the house? Or do I try to exercise?


If I choose exercise, I am gambling on whether it will make me feel better or worse. I’m gambling whether or not I’ll have the ability to focus on work afterward. I’m gambling on whether I’ll have the energy to also do the dishes later, or the laundry. If I don’t exercise—and if I haven’t had a really busy week—it’s likely I’ll be able to maybe do a couple hours of work and some housework. I’ll also probably need a nap. If I choose exercise, it goes one of several ways: I get home afterward and need to lay down and am down for the count for the rest of the day (and maybe the next day, too); I get home and feel ok for a couple hours, then my energy slowly fades to nothing within a couple hours; or I feel completely fine and can tackle some other things, but probably not things like vacuuming or moving furniture around or shoveling snow.


I had a sinus infection last summer that got misdiagnosed. When I told my then-chiropractor that I was so tired I was easily taking two naps a day, he told me I should take the first nap and exercise instead of taking the second nap. Maybe this works for healthy people; I don’t know. What I do know is that I finally stopped seeing him when it became clear that he was always going to advocate for more exercise instead of listening to my body. I had to choose to listen to my body instead of listening to him.


Do you believe me, Invisible Audience? Because there’s a part of me that feels like any time I try to talk about what this is like for me, it sounds like I’m making excuses; that if I just shut the fuck up and worked harder, I’d get better. That it’s all in my head. And if you feel that way—even a little—I’d like you think about something my therapist pointed out to me when I was trying to do that to myself a couple weeks ago: those ideas are ableist.


It is a trap to try to argue with you that I wouldn’t be as fat if I could exercise as much as I want. That may not be true. It’s even a trap to tell you that there many known causes of weight gain that have nothing to do with what a person eats or how much they exercise. Because it shouldn’t matter: I should be able to go to the doctor, the same as any thin person, and get treatment for what ails me. I shouldn’t be told that the reason I’m sick is because of my weight, before they’ve established whether I could possibly have gained weight because I am sick. And I shouldn’t have to base my impression of a doctor on whether or not they managed to look at my symptoms instead of my weight when they decided how to treat me—“treat” referring both to how they alleviate my symptoms, and how they interact with me in the exam room.


Before you decide to write back and tell me how I have no idea what I’m talking about—that I really should lose weight to be healthier—please read some of the resources below. But even if you don’t, here’s what I want you to know: I am one of your fat friends, but I’m sure you have others. If you no longer believe in shaming your children or your friends into acting differently, why would it be ok to try to shame us into looking differently? This feels apropos during the holiday season, when many of my friends dread seeing friends and family who will likely comment on their weight. If I broke my leg and my injury were apparent, obvious, and not hard to diagnose or treat, would you feel the same way about deciding that I would get better if I just stopped making excuses? What about if I were thin?


Love and big fat kisses,



·      Fit and fat: Not all agree obesity should be labelled a disease
·      Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals
·      It’s the Diets that Fail, Not the Patients They Are Prescribed To
·      Size acceptance and intuitive eating improve health for obese, female chronic dieters
 ·      The BMI is Junk Science
·      The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss
·      Weighed Down by Stigma: How Weight-Based Social Identity Threat Contributes to Weight Gain and Poor Health
·      Weight Science: Evaluating the Evidence for a Paradigm Shift 

More Resources



Sunday, December 3, 2023

The KNOWing


Hello Invisible Audience,


My therapist said something to me that stuck with me during one of our recent sessions. I’m paraphrasing, but basically she said,


“All that anyone else ever says—your doctors, your chiropractor, your friends, me—is only their opinion. It’s your job to choose whether or not to use it, or even take it in, for that matter.”


This is not new. The last post I wrote to you was basically the same thing. Hell, if you’ve been following me for a while now, you know that I struggle with this TO THE Nth DEGREE. But when she said it, it made me realize something that I never had before.


I thought I had to find someone to validate how I felt before I could let myself feel it.


Do you ever have one of those moments, Invisible Audience, where you feel like you’ve logically known something for a long time, but suddenly it feels like a huge vault door twists itself through its combination and suddenly unlocks? Like maybe you knew something before, but now you KNOW it with all the cells in your body, not just your puny little mind?


Well, that’s what happened.


I have always known that I was supposed to be able to take what I like and leave the rest. What I never realized was that I would just pivot from one person to the next. If someone’s opinion of the situation wasn’t true for me, I would look somewhere else to find someone else to hold onto who did agree with me. I never stopped and worked on figuring out if I KNEW the thing for myself.


There was a second part of the discussion with my therapist that I think made all the difference, Invisible Audience, It’s a larger theme, too; one she and I talk about a lot but is really new to me.


When I say I KNOW something, I don’t mean that I am 100 percent sure. I mean that I KNOW, in my bones, that I am going to do the best that I can with what I have. I do not have to be 100 percent sure that I KNOW in order to make a decision that’s best for me. All I have to KNOW is that I am doing the best that I can with what I have. I am ultimately the one in charge of my life, and sometimes my choices are going to be the ones I make between a rock and a hard place.


I have never differentiated it that way before, Invisible Audience. I never realized that I needed to separate myself out from others and not just borrow someone else’s support of my decision. To borrow their belief that I am making the right choice. That I could actually just live in the gray space and say, “Here’s all the information I have. Here’s how all of this makes me feel. Here’s what I’m going to decide to do. Here’s my confidence that I’m doing the best I can, and if I need to make a change later, I’m allowed to do that.”


This feels HUGE.


I still don’t know what’s coming next, but it’s become clear that I’m the one who needs to decide. It may not be what I ultimately need. It may be that I need something else. But I don’t need to have it all figured out. I just need to KNOW that I’m doing the best I can with the information that I have.


Love and KNOWing kisses,



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