'I'm a GP. Medical professionals do NOT need to talk about your weight.'

As a specialist GP working in Melbourne, I read Claire Murphy’s article about being fat shamed last week and instantly felt sad, but not surprised.

I read her words slowly – twice over in fact - and listened to her tell her story on the podcast. Then I took a deep breath and walked away from my laptop to collect my thoughts, and acknowledge the emotions swirling in my head and my heart.

“I know medical professionals need to talk about weight.”

Those are Claire’s words – and they were ringing in my ears.

But as a GP who has had the privilege to care for patients of all shapes, and sizes, and as an individual in a larger body myself who has been fat-shamed by colleagues - I do not agree.

Medical professionals do NOT need to talk about your weight.

Medical professionals need to talk about ways to improve your overall health and wellbeing.

Your health and wellbeing are NOT THE SAME THING as your weight.

Weight-loss is not necessary to improve physical health.

Weight-loss is not necessary to improve emotional and psychological wellbeing.

Watch: The More Than My Body campaign. Post continues below.

I have seen endless patients who have been harmed – deeply harmed – by the intense fatphobia and diet culture that underpins traditional medical education and practice.

I have truly lost count of the patients I have met over the years with variations of Claire’s story. Patients presenting to health professionals for help, but leaving consultations traumatised. The reasons for seeking help are as endless as the patients; headaches, back pain, broken bones, red eyes, coughs, abdominal pain, abnormal bleeding – whatever presenting issue you can imagine, weight-loss is prescribed for it.

I remember a young woman who had seen a handful of doctors for her back and chest pain. She had been told over and over again to lose weight and her pains would settle.  She needed a chest x-ray and a new bed to resolve her pain - a plan we arrived at after two or three sessions.

It is rare that I meet a patient – regardless of their size – who does not tell me that they are thinking of, planning to, needing to, wanting to or working towards making their body smaller.

They could be a dress size 24, or a dress size 10. 

It seems to be a universal goal.

This is especially true at times when women are incredibly vulnerable - when trying to get pregnant or just after having a baby for example.

Fat-shaming was part and parcel of both my pregnancies whenever I saw a health professional who was not part of my core team.  I remember a medical professional simply refusing to believe that my food diary was truthful, and that my recorded blood sugar levels were accurate as they simply could not be true for someone in a body that looked like mine. I was lucky to have a core team who looked after my overall health, with an obstetrician and psychologist who practised from Health At Every Size (HAES) principles.

My eldest child is now six years old, but the pain from being fat-shamed in my first pregnancy lives on. And I suspect it will always be there.

HAES is an approach to health and wellbeing that uses the knowledge or evidence we have from studying the science behind weight, wellbeing and mortality.  

Listen to Claire Murphy discuss the time she was fat shamed by her GP. Post continues below.

That evidence makes clear the behaviours that will actually improve quality of life and reduce all-cause mortality (or your overall risk of death from disease) are:

1. Eating more than five serves of fruit and vegetables per day

2.  Joyful movement / leisure time physical activity more than 12 times a month

3.  Not Smoking

4. Zero to one alcoholic drink per day for women /No more than two alcoholic drinks per day for men

Weight-loss is NOT one of the behaviours that has been shown to reduce your overall risk of death. You can do all of the above behaviours and never lose any weight – but you will still improve your health.

Studies show that following the four lifestyle behaviours listed above consistently is what determines your overall risk of disease and or dying – not which weight category your body fits into.

Your risk of death when fit (walking 3-4 hours per week as the definition of fit) is essentially unchanged across the weight categories.

Weight and health are consistently conflated into being the same thing.

We live in a culture that is deeply fatphobic and diet culture permeates through countless moments day to day.

Weight-loss being the ‘cure of all that ails us’ is a deeply held belief across society – a truth universally accepted without critique or challenge. A medical student said to me recently: weight-loss just makes sense.

This belief is difficult to shake.

The problem is that it is NOT a truth.

Dr Lynda-Rose Chapeyama. Image: Supplied.

Weight-loss will not automatically improve your health and wellbeing, but a relentless focus on weight-loss will very often cause significant issues in your emotional and psychological wellbeing.

Anxiety, low mood and poor sleep often occur within the diet cycles that end with most people weighing more than they did before they started. 

Disordered eating and increasing rates of eating disorders abound.

It is difficult to put into words the long-term, traumatic consequences of being fat-shamed and having your concerns about your health ignored. I want to thank Claire and others who share their wounds with deep bravery and vulnerability. May all of us health professionals truly hear these voices, and take responsibility for improving our own knowledge so that once we know better, we can do better.

In the pursuit of health, I would suggest that radical self-acceptance, self-compassion and the lifestyle behaviours I mentioned  above – fruit and veg, movement, not smoking and limiting alcohol are the pivotal steps to take to start a journey to true health and wellbeing.

Support for your mental health, plenty of water and enough sleep are perfect additions.

These behaviours will not automatically result in weight-loss. That’s not the goal. Your health and wellbeing are the goal.

This is the start of a conversation – the nuances of your own circumstances are best addressed one on one with a compassionate, skilled health professional who practises from a HAES framework.

This can be a GP, a dietitian, a personal trainer, a physiotherapist. Someone who will listen to your goals for your health and support you as needed.

Oh – and in the example of Claire’s case  - your chosen doctor would deal with a potential ankle fracture by managing your pain, organising an x-ray and giving the advice to Rest, Ice, apply Compression and Elevate (RICE). 

NOT by telling you to lose weight.

Some further resources for health professionals in particular to start their journey towards removing weight from the centre of their idea of health are: www.unpackingweightscience.com and www.healthnotdiets.com Study links available through these resources.

Dr Lynda-Rose Chapeyama (she/her) is a Specialist General Practitioner, Psychological Medicine Practitioner and University of Melbourne MD1 Tutor.

She aims to practice trauma-informed and respectful inclusive medicine. Weight stigma and its traumatic impact on her patients of all sizes, genders and backgrounds is a near constant theme in her clinical practice. 

Dr Chapeyama lives and works on the land of the Wurundjeri people of the Kulin Nation and acknowledges that sovereignty was never ceded. She pays respect to the Elders past, present and emerging of the land she has made her home.

Follow her on Instagram @drlyndarose or find out more on her website.

 Feature Image: Supplied.