What “Board Certified in Obesity Medicine” Means to Me as a Fat Patient

When a doctor chooses to brag about that particular certification, there are three assumptions I need to make in order to keep myself safe as a fat patient:

1. From the moment I walk into their office as a fat person, they are trained (and certified!) to see my body as a problem to be solved.

The word "obesity" was literally created to pathologize a body size. It's very possible that they won't be able to see past their weight bigotry (including their tendency to blame nearly anything on my size) to give me care for any health issue I may actually be having. By extension they may, without notifying me, suggest treatment options not because they have the greatest efficacy in dealing with my actual health issue, but rather because they believe that they might result in weight loss, or prevent weight gain. Similarly, they might withhold viable treatment options because they have a possible side effect of weight gain.

2. They are willing to risk my life and quality of life to make me thin.

They have willingly joined a branch of medicine which centers around the idea that it is completely acceptable to risk a fat patient's life and quality of life for the smallest chance that we might get a bit thinner, and there is no guarantee that they will feel obligated to be clear about the risks because of the paternalistic nature of their specialty.

3. They either don't understand, or don't care about, research.

They are willing to base their career on embarrassingly poor, shockingly shoddy research - so they either aren't capable of understanding the issues with the research upon which their certification is based, or they don't care. Either way it doesn't bode well for their ability to practice ethical, evidence-based medicine. Not a good look.

So when a doctor tells me that they are board-certified in "obesity medicine" I have every reason to believe that I am sitting across from someone who doesn't understand the basics of research, and who truly believes that it's worth risking my life to make me thin (and who might choose their fatphobia over accessibility.) I have to continuously remind myself that everything they say to me is said through their filter, which includes the belief that my life is less valuable and more risk-able than a thin person's life.

Sadly, since "obesity medicine" also tends toward corruption (see, for cample, the " Obesity Action Coalition ") I also have to wonder (and try to research) if this doctor is in the pocket of a company like Allergan or a pharmaceutical company that manufactures dangerous weightloss drugs, giving them a financial incentive to harm me.

Depending on where I live and what doctors are available to me, I may still need this doctor's help. If that's the case, then I'm going to have to be hypervigilant - researching everything they say and recommends - are they prescribing that medication because it's actually the best thing for my condition? Or is it because weight loss (however small and temporary) may be a side-effect? Is that medication they suggested going to risk my health and life? Are they going to push me toamputate a perfectly healthy organ in a dangerous surgery that, if it doesn't kill me, could leave me with horrific lifelong side effects? Are they going to withhold needed care until I comply with their desire for me to look different? I may have to lie to get the care I need.

The bottom line is that as a fat patient I have to worry about medical fatphobia with almost every healthcare provider (though, happily, the number of weight-neutral, Health at Every Size based practitioners is growing!) but I know that I can never trust a doctor who brags about being certified in "ob*sity medicine" to look out for my actual best interests. That sucks, but at least their certification gives me some warning.

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Hi, I'm Ragen Chastain. Speaker, Writer, Dancer, Choreographer, Marathoner, Soon to be Iron-distance triathlete, Activist, Fat Person. View all posts by Ragen Chastain