Isabelle Lomax-Sawyers: On being a fat medical student, at the start of our metabolism module
Selected Excerpts
“When you talk to a fat patient about their weight, it is not the first time they have thought about it. It probably isn’t even the first time that day. I have been fat all my life to a greater or lesser extent and I don’t believe there has been a day when I have not been aware of it. I dread eating in public and squeezing into the backseat of full cars. I plead claustrophobia and refuse to get into elevators when they are anywhere close to capacity. I always know when I am the fattest person in the room.”
“Bludgeoning fat people with a suggestion we should be less fat every time you see us actually doesn't make us less fat. It makes us avoid going to see a doctor when we need one. But most importantly, it makes us feel awful, and contributes to the already crushing stigma we experience living in our bodies every day.”
Discussion Questions
Reading Isabelle Lomax-Sawyers' essay about being a fat medical student, what stood out to you? How did it resonate with your own experiences of weight and weight bias in healthcare or medical education?
Lomax-Sawyers describes the daily, crushing awareness fat people have of their weight and what people think of them because of it (see first excerpt above). How does this interact with how doctors are taught to think of weight? What effect does this education have on doctors truly seeing their fat patients?
What can this essay teach us about the experience of being a fat person in healthcare? What would healthcare experiences that foster trust and connection, not disdain or bias, look like? How can we all help create such a world?
Reflections from #MedHumChat
“What stood out to me, among many other things, was the conflict between being a medical student and a fat person. It reveals to me this image of an ideal medical student, an ideal patient. What about those of us who don’t fit the mould? I felt the pain of it.”—@Gina_Nicoll
“As a resident physician, it all stood out and all resonates. I've had preceptors insist I include obesity in the problem list and counseling for every single patient they wanted to apply it to, regardless of why they sought care. Most of all though was the acknowledgment towards the end that people in medicine (and tbh, people in general) struggle to fully validate, see, honor, & humanize bodies that don't look like theirs.”–@MGraceOliver
“I think that medics are taught to view fat bodies as failures of maths. As @yrfatfriend describes in the next essay in today's chat, mantras like "eat less, move more" and "calories in, calories out" form the basis for how body weight is discussed by many docs. And because (1) all fat bodies are a problem and (2) the solution is simple maths, then (3) fat people are non-compliant (ugh)/failures/to blame, if they don't or can't become less fat when the doctor suggests they should.”—@izzylomax
“I believe it was Gina who pointed out that the readings show us that HCPs can be victims of weight bias as well as perpetrators. While weight bias is a learned behavior, it starts way earlier than in medical school and one solution could be changing the language we use when talking about food. I remember reading an article recently that advised against labeling certain foods good or bad and avoiding phrases like "cheating" when talking about eating sweets as a way to reduce anxiety around eating.”—@riboflavian
About this #MedHumChat
“On being a fat medical student, at the start of our metabolism module” was paired with “How Health Care Bias Harms Fat Patients” by Your Fat Friend for a #MedHumChat discussion February 5, 2020 exploring Weight Bias in Medicine.
We were honored to be joined by special guest Isabelle Lomax-Sawyers (@izzylomax), a medical student at the University of Otago in New Zealand and the author of this piece.
The pieces for this chat, along with the discussion questions, were selected by Gina Nicoll.
About the Author
Isabelle Lomax-Sawyer (@izzylomax) is a medical student at the University of Otago in New Zealand.