Posted by My OB said WHAT?!?.
Aug
17
Posted by My OB said WHAT?!?.
“You Are Too Fat…”
“You are too fat. You need to stop eating so much and you need to exercise more.” -Physician’s Assistant to mother at a prenatal appointment.
There are 46 comments to this post.
“I’m concerned about your weight. During pregnancy, it’s best to eat an exceptionally nutritious diet and do moderate exercise. Would you like to go over some guidelines with the doctor?”
There, was that so hard?
This isn’t even the *doctor* speaking! It’s the physician’s assistant. I forget: are PAs allowed to make a medical diagnosis? Or are they just supposed to write down the numbers on the chart and hand the chart to the doctor?
[Reply]
KDB Reply:
August 17th, 2010 at 5:53 am (Quote)
^^^ That.
My first job was delivering pizzas when I was in high school. My boss stressed customer service and made it very clear that poor attitude and rudeness to a customer would get you fired on the spot.
I find it very sad that you can get treated better ordering a pizza than having a baby. :-/
[Reply]
Jane Reply:
August 17th, 2010 at 5:58 am (Quote)
Could I order pizza while having a baby? Then maybe the medical staff would have the delivery driver’s good example to emulate. Plus I’d have pizza.
[Reply]
Heather Reply:
August 17th, 2010 at 10:24 am (Quote)
Hehehe. Oh, THAT would be a sight! The pizza guy comes in, the laboring woman takes her pizza, paying and the nurses’ heads explode because she’s eating during labor.
[Reply]
CCindy Reply:
August 17th, 2010 at 6:55 am (Quote)
I see a PA (RPA-C) for my general care. She is the equivalent of a CNM as far as education. She knows all the basics and can consult any one of the 4 doctors in the group if she sees something funky/over her head. I prefer her to the doctors since my favorite doctor retired. She listens.
Can I have pizza at 10 am?
[Reply]
Jane Reply:
August 17th, 2010 at 8:00 am (Quote)
you want mushrooms on it?
Thanks for clarifying. The nurses at my children’s practice tell me they can’t even screen my children to tell me they need a doctor (ie, you look in his ear with the scope and tell me whether I should pay the doctor should take a look) and I thought a PA had the same or less training than that.
[Reply]
Selia Reply:
August 17th, 2010 at 1:23 pm (Quote)
PA’s fall into a category closer to an ARNP, they can write prescriptions, but not for controlled substances like narcotics, and they can’t perform surgeries. They can work without a supervising doctor, make a diagnosis, prescribe antibiotics, give vaccinations, etc. Complicated I know!
[Reply]
You’re too stupid. Get your medical degree and become a doctor.
Wait, that’s mean. Why don’t we try phrasing things a little more nicely? Not that Mom didn’t need the information, it may have been important.. but its not the PA’s place to make the diagnosis and the way it was said was just downright rude. No matter how its said, its bound to hit a nerve, best to choose your words wisely.
[Reply]
Sometimes I wonder if doctors and other care providers really think that fat women don’t know they’re fat. Do they really think the woman is going to say, “Really? I had NO IDEA!” Just one more example of the fat shaming that going on in doctor’s offices every day. Focusing on good nutrition and healthy movement is ok. Repeating “fatty fatty mcfatterson!” isn’t going to get anything done.
[Reply]
Daughter of a PA had this to say,
Aug 17, 2010 @ 7:02 am (Quote)
This PA’s bedside manner needs improvement, no question about that.
However, PAs are trained to and expected to: perform complete physical exams, perform diagnostic tests, make diagnoses, formulate treatment plans, and prescribe medications.
Maybe the readers of this site who are so often incredulous that their OB/RN/CNM/PA, etc, didn’t do their homework should do some of their own before going off half cocked and disparaging a whole segment of the health care community.
[Reply]
Jane Reply:
August 17th, 2010 at 1:56 pm (Quote)
I had mixed up a PA and a medical assistant or something else, which was why I asked whether they were allowed to make diagnoses etc.
Everything in medicine is so bizarre these days, with no one but certain individuals being allowed to make diagnoses (or even suggest them) under penalty of malpractice, so I was not sure whether it was the PA’s place to make medical suggestions or a diagnosis to the patient, even if it had been done politely.
[Reply]
THIS. My dad’s a PA, too, and yet somehow managed to be the head of employee health at a major hospital. This person is incompetent because s/he has a lousy bedside manner, not because s/he’s a PA.
[Reply]
Honeybee Reply:
August 17th, 2010 at 3:51 pm (Quote)
Remember: We bash all medical branches on this site. We aren’t saying that PA’s are all bad. Just this one. And some of us do/did need clarification on what they can and can’t do. I had one with prescription privileges when I saw her for counseling,and she was the best. When I saw a “real psychiatrist” almost eight months later, HE was the problem pill pusher.
[Reply]
Oh, PA’s daughter – we would be more inclined to do more research before making comments if we were, say, getting paid to make the comments. Or if we had to go through years of schooling before commenting on a blog. That’s not really the case. And you’ll see the ladies here generally correct each other without getting too very snarky. Please do remember that the duties of particular PAs depends on the practice within which they practice and the state in which they practice – different states and practices vary wildly in what the PAs are legally and traditionally allowed to do. I’ve had doctor’s offices where the PA was allowed to take samples, blood pressure and weights – another office I’m not sure I ever saw anybody BUT the PA.
Maybe just hold on there before you think everyone is disparaging your parent’s choice of career.
[Reply]
Cmat Reply:
August 17th, 2010 at 9:28 am (Quote)
Ditto. My OB has a PA in his office and she’s a lovely lady. All she does is walk me back, weigh me, take my blood pressure and chit chat with me for a few minutes (we have sons close in age) then lets the doc know I’m there. On the flip side when I had my son in another state the PA did everything but check the heartbeat of the baby.
I’m well aware my comment was not nice, but I don’t bundle all people of that profession into that statement. Just like when we comment about nurses, we aren’t bundling all nurses into the “you suck” category.
[Reply]
Daughter of a PA Reply:
August 17th, 2010 at 9:55 am (Quote)
Just flipping the coin on this website. Just about EVERY post on this website bundles all OBs into the “cut to cure/manage to death/uninformed-with-a-degree” variety.
I’m a little discouraged by the fact that Thoughtful Thursday postings get two or three responses, and all the other postings get tons. I should probably just stop reading here because it gets me so upset. Sometimes what the post is about, but most often the fact that we are so unwilling to give our medical professionals the benefit of the doubt. It’s no wonder to me that they manage so heavily and sometimes say insensitive things. If you had their insurance premiums, debt load, lack of quality of life, and daily threat of spurious litigation you might be a little short with your patients, too.
[Reply]
Dee Reply:
August 17th, 2010 at 12:30 pm (Quote)
A PA did a lot of my pre-op and post-op care when I had cervical diskectomy and fusion. He was great.
I also have (currently) a great GYN.
However, I had a doctor who didn’t see eye to eye with me on anything for the birth of my son. It was a miserable experience.
Nurses–a mixed bag–some awesome, some average, some poor quality.
My point: ANY profession has its ups and downs, its excellent members and its less than stellar ones. I’m a college professor, for example, and year after year, students tell me I’m a good one. But I know a number of college profs who do a poor job. Do I get upset at students who have to “vent” a bit about their less able professors? No. Do I get upset when I look at sites where students rate their professors? No. Do I complain about working some crazy hours during the first and last weeks of a semester (usually)? No. That’s what I knew I’d be getting when I chose this career. When you go into a profession, you should know what you are getting into.
I can’t understand why it’s such a problem when women vent to one another about poor treatment they’ve had. Just because 1 member of a profession is wonderful (or terrible) doesn’t mean everyone can be that way. It’s just the way it is.
[Reply]
CCindy Reply:
August 17th, 2010 at 12:39 pm (Quote)
I beleive what some of the ladies were thinking of is medical assistant. Plus remember that there are LPN’s, RN’s, RN’s with a BSN, CNM, NUse Practioners and most of the time they are all called nurses. I believe the PA is a recent thing, I could be wrong, but it will probably be a while until the emphasis moves off the Assistant part of the title. Perhaps they need to put some emphasis on the Registered part of that title.
Plus please remember that this is a site to vent about how the medical professionals we trusted stabbed us in the back when we were the most vulernable. Not evey negative comment has the same disasterous effects, but every one of them can be learned from. Thoughtful Thursdays are short, but how many times can you say “I wish that was my doctor.” “Way to go” or “This one is golden”?
[Reply]
The Deranged Housewife had this to say,
Aug 17, 2010 @ 10:01 am (Quote)
I hate it when the idea of food restriction comes up in overweight pregnant patients.
That said, I think sometimes doctors dance around the subject of weight. Several close relatives are overweight, and the subject seems to rarely come up (at least from their point of view) when another contributing health problem is addressed. A close relative has an eating disorder, but from what I can tell, her doctor never brings it up and weight is rarely discussed. My sister has arthritis and bad knees which, no doubt, are caused by years of being overweight – but losing weight never seems to be a viable option.
I was just thinking today about my stepdad’s cardiologist – who would often go down the “you need to lose weight because of your heart” spiel and yet, he himself was heavy. He ended up having a serious heart attack, which I think totally changed his life and made him realize he needed to practice what he preached.
But again, it’s an uncomfortable subject but one that needs to be addressed, albeit with tact and dignity.
[Reply]
That’s what a friend was told re: her VBAC a couple months ago. She got a new care provider and had her VBAC and she’s bigger than I was before I lost 13lbs with my first (I was 242 when I had my first baby, 213 when I had my VBAC).
Not only was this rude beyond measure, but it could have been complete s**t, too. I can tell you that not eating enough was a large reason I was so overweight. Comments like that a**hole made caused me to stop eating for weeks at a time, during which, I’d gain weight. Thankfully, I realized the pattern, started eating when I was hungry and lo and behold, the weight started coming off. Unfortunately, losing my gallbladder killed my newfound metabolism and I’m again working out how to get back down to a healthier weight.
Did any commenter bother to note that my weight was from coming off childhood medication in my teen years and then from birth control as a young adult? Of course not. It’s because of eating. That’s the only reason anyone is ever overweight. Certainly not genetics or climate or medications or thyroid issues or hormone imbalances… Just like anyone under 125 must be throwing up after every meal. Or not ever eating.
Effing idiots.
[Reply]
This wasn’t mine, but my OB said this to me when attempting to find the heartbeat during my 10 week appointmnet. My children are less than 13 months apart, and I definitely had some residual pregnancy weight. I reported her for this (not sure what good it did, but I definitely left that practice the same day).
[Reply]
My pregnancies were just 7 months apart, and I was big to begin with, so my weight affected basic measurements like fundal height and finding the heartbeat on the doppler. My caregivers never hid the fact that my weight would impact these measurements but never once called me fat. “Your fundal height is a little off because of the weight you are carrying” is way better than “You’re so fat your messing up the measurement” or what have you. That PA was an ass.
[Reply]
I’ll probably get flamed for this but I wouldn’t be surprised to learn that the PA was not born and raised in the US and likely of an Asian culture.
I have found that many cultures just ‘tell it like it is’ and really see no reason to do things any other way. Not an excuse for this behavior but a reason.
[Reply]
Alyson Miers Reply:
August 17th, 2010 at 7:00 pm (Quote)
I know of some cultures (and lived in one) where they think nothing of remarking on someone’s weight, but “fat” isn’t necessarily a negative in these cultures. It’s just a neutral observation. In the country where I lived for a couple years, “fat” doesn’t even mean overweight, necessarily, just well-fed and sturdy. I was occasionally told I was fat, but it wasn’t meant as a criticism, it was just, “oh, look, you have pudgy hips! *patpat*”
That, however, is a separate issue from telling someone she’s too fat and needs to eat less. It crosses the line from “cultural differences” to “bad manners.” :p
[Reply]
When I was pg with my first, I was told by the PA that I was overweight. I am 5 ft 3 was 120 and 16 weeks pregnant. I am still trying to figure how that was even remotely overweight!
[Reply]
Mary S Reply:
August 17th, 2010 at 5:39 pm (Quote)
That is crazy! Maybe that’s “fat” compared to a supermodel, but that would be a BMI of 21.3, well withing the normal range for a non-pregnant person. It’s bad enough that professionals can be insensitive about weight when it really is an issue, but when they say it’s a problem when it’s not, that can cause a problem. My aunt, who has been overweight most of her adult life, says she was never overweight until she was told by her doctor she needed to lose weight at a check up in her early twenties. She weighed 117 pounds then. But she started dieting, and the weight yo-yo was set in motion.
[Reply]
Jennifer B. had this to say,
Aug 17, 2010 @ 6:15 pm (Quote)
I can’t count the number of people who said this to me…
[Reply]
My mother had a beastly doctor with her first three kids. Bear in mind, this started in 1961. She was told how fat she was. This guy was brutal. My mom at the time had a Marilyn Monroe at her prime figure. She was, and is a beautiful lady.
This beast-doctor put her on cottage cheese. And nothing but. None of that ‘eating for two’ stuff.
My sister was a stick figure when she was born. My mother gained a tiny bit more weight with her 2nd child. And beast-doctor argued with her. More weight with the 3rd child. He’d YELL at her.
Finally I was born across the globe from this jackass, and I was a ‘normal birth weight’. My mother also recovered her figure in short order, so that should tell you something about where the weight she did gain came from.
I can’t BELIEVE this crap is still out there. Eating *right* and getting some exercise sure, but holy ####.
[Reply]
Maybe I was lucky, but when I got pregnant with my 1st (I was average weight, 145lbs, 5’6), and gained 70lbs, no one even batted an eye… I wonder if I just carried it well… lol. Even when I had edema and my feet swelled up like giant cantelopes, they (nurses and CNM, I didn’t really see the OB’s much at the end) just said it was good to put on weight, there was nothing to be concerned about because I wasn’t showing signs of PE, and to just keep eating balanced meals, and I would lose it all with breastfeeding, so don’t worry.
I did lose it all, in fact I lost 80 lbs (almost down to what I weighed when I met my DH), and the same thing happened with DS2, except I didn’t gain as much weight, maybe 40 lbs, but lost 50. This time I have a new OB, and at 24 weeks, I think I’ve already gained almost 30 lbs (yikes, lol), but they still haven’t said anything.
[Reply]
mrs. gamgee had this to say,
Aug 18, 2010 @ 10:46 am (Quote)
I am a morbidly obese pregnant woman and I am sick to death of being told that I need to eat less and exercise more, and to watch my weight gain. I am 25 weeks pregnant and am 1.5 pounds over my prepregnancy weight. That’s it! If I were an ‘average’ sized person, my doctors would be freaking out because of how little I’ve gained. I just hate it when medical professionals treat plus-sized patients like idiots who can’t stop stuffing their faces!
[Reply]
Oh and imagine if you came in and had actually lost some weight while pregnant! You’d get the lectures on “starving your baby.” I was overweight through my last pregnancy, gained around 30 pounds total, but was back to pre-pregnancy by around 8 wks post partum (nothing like breastfeeding a hosptialized baby to make you drop weight from exhaustion and stress) now if I could just lose the baby weight from my first child LOL
[Reply]
Thanks for all the kind words ladies! Actually I was on strick bedrest and having a very high-risk pregnancy. When the PA told me this I was about 24 weeks pregnant and had only gained about 20 pounds. I was around 140 when I saw the PA. I was furious! She hadn’t even read my chart!
[Reply]
StaudtCJ Reply:
August 23rd, 2010 at 8:01 am (Quote)
Some providers need to wake up and pay attention. Telling a bedrest mommy who’s not overweight something like that is both ignorant of what overweight is, and making it obvious that you don’t pay attention to anything about any individual woman. I bet that provider assumes that gaining weight is bad, and only saw the 20 pound difference.
[Reply]
Kat Reply:
August 23rd, 2010 at 8:34 am (Quote)
Wow, that’s not even significantly overweight. Heck I weighed over 140 at the start of my last pregnancy, and my midwife didn’t fuss at me about my weight even once.
And what did she expect you to do? You’re on BEDREST and can’t exercise for your baby’s safety. You need to eat to keep your baby growing…
UGH. I am sorry this person put unnecessary stress on you during an already stressful time.
[Reply]
Melissa Reply:
August 23rd, 2010 at 8:39 am (Quote)
So basically, you were a model of health, given that you were on strict bedrest. You know, when your doc says, “don’t even sit up! Don’t shower! Must stay in bed! And whatever you do, DON’T EXERCISE!” And a 20lbs weight gain in 24 weeks on a woman who (by my calculations) only weighed a measly 120 when she got pregnant! That’s exactly what you SHOULD weigh at that point! Because unless you are barely 5ft. tall, 120 is towards the very bottom of a healthy weight or underweight. That means your body’s going to want some more food stores for your pregnancy since you have almost no fat on you. So you “should” gain 25-35lbs, even by “their” numbers. And when will they understand that what you eat matters more than what you weigh? Guess the scale goes on the long list of magic diagnostic machines that go “ping!”
What a horrible thing to say. And what an idiot. I hope you “explained” things to her…in no uncertain terms.
Can you tell us the end of the story? I sure hope you had a happy ending, and that you got good, helpful, attentive care all the way along with only this one glaring exception.
[Reply]
Call it pregnancy hormones and stress but I totally laid into the PA and pretty much told her to f-off. So after that visit I saw my regular OB the next time and told her what happened. She was pretty mad and told me to never schedule another appointment with her, I told her no problem. I gained another 20 pounds and gave birth by emergency c/s at 33 weeks. Baby was in NICU for 3 weeks and is doing great at almost 2 years now. I will never see that PA again but I do know other women who use the practice that love her.
[Reply]
Add Your Comment.
Previous Post
« “…Going To 42 Weeks Is Really Passé.” Next Post
“Stop Checking Your Cervix So Much.” »
« “…Going To 42 Weeks Is Really Passé.” Next Post
“Stop Checking Your Cervix So Much.” »
I’m pregnant. Or did you not know that? It’s in my chart.
Yet another example of a possibly valid concern/recommendation, said so rudely it numbs the brain and tongue.
[Reply]