Staff Rx: A weighty issue

April 1, 2001
Last week, the doctor called me into his office to say that a patient had complained about me and did not want to see me anymore. The reason? I am overweight.

Dear Dianne,

Right now, I am so hurt and humiliated I can hardly write this letter. Last week, the doctor called me into his office to say that a patient had complained about me and did not want to see me anymore. The reason? I am overweight. The doctor stated that he simply could not have patients reacting like this. He further stated that it is his practice, and he strongly advises that I lose weight.

I guess my weight bothers the doctor, because he has brought it up in the past. This time, however, it felt like a warning.

I have been loyal to this doctor for five years; the last thing I need is to be reminded that I am overweight. This is the only practice I have ever worked in, and I have developed close bonds with many of my patients and co-workers. But I'm so wounded by the doctor's insensitivity that I don't know if I can go back.

Can you advise me on how to deal with this situation?

Wounded in Washington

Dear Wounded,

By siding with the patient, the doctor is displaying disloyalty to you as a staff member. If your being overweight is the only reason the patient does not want to see you again, her complaint certainly seems unreasonable.

I also wonder if the doctor is using this as leverage against you. Could it be that he feels your size reflects negatively on his practice? The term "overweight" could mean many things. Are you slightly overweight, moderately overweight - or grossly obese?

At any rate, the doctor's admonitions about your weight could be considered discriminatory. Few laws prohibiting size discrimination exist, but there have been many successful court cases against employers who discriminate against large-size employees. Several states have enacted legislation outlining discrimination based on "race, color, religion, national origin, age, sex, height, weight, or marital status." (State of Michigan: Elliot Larsen Civil Rights Act, Act 453 of 1976, Sec. 209 Mich. Comp. Laws Ann. SS 37.2102, 1985 & Supp. 1993.)

The position of the Council on Size and Weight ( states that people who are larger than average encounter discriminatory attitudes and are denied equal opportunity in many areas of their lives. Prospective employers refuse to hire large-size people, especially in fields where employees do physical work or interact with the public. Large people are subject to harassment about their weight by their employers, are kept in jobs beneath their abilities, and are often demoted or fired because of stated or unstated size prejudice.

Physicians and other health-care professionals often advise fat patients to lose weight when a normal-sized person with the same condition would be given medicine or other medical treatment. Hospitals and other health care facilities and equipment (such as CAT scans and MRIs) are often inaccessible to large people.

Large people are systematically denied health insurance and life insurance, or they are forced to pay higher premiums than those of average weight.

College applicants are frequently turned down by educational institutions because of their size. In a famous discrimination case heard by the Supreme Court, a college made a nursing student sign a contract promising to lose weight or be expelled (the Court invalidated the contract).

Landlords, housing agencies, and real estate agents often deny larger people apartments, or show them only inferior locations to prevent them from moving into the neighborhood.

The numerous cases on file at NAAFA, Inc. (National Association to Advance Fat Acceptance, prove that employment discrimination due to body size is rampant throughout the United States. Such discrimination has also been substantiated by employment surveys conducted by independent researchers. Discrimination against fat people may be direct, but it is also frequently overt, unspoken, or even subconscious.

According to an article in The New England Journal of Medicine (Jerome P. Kassirer, M.D. and Marcia Angell, M.D. "Losing Weight - An Ill-Fated New Year's Resolution" January 1, 1998 - Vol. 338, No. 1), many people can't lose weight no matter how hard they try and usually regain whatever they do lose. The vast amounts spent on diet clubs, special foods, and over-the-counter remedies - estimated to be $30 billion to $50 billion yearly - is often wasted. More important, failed attempts to lose weight often bring guilt and self-hatred. Overweight people are likely to share common prejudices about themselves as lazy, undisciplined, and self-indulgent.

In your situation, the doctor's insensitive remarks have created a gaping wound in your self-esteem. Wounds heal over time, but scars remain. To clear the air, you should have a private talk with the doctor. Here's what I suggest: "Dr. XYZ, I have worked with you for five years. Is there anything about my work that does not meet your expectations?" Wait for his answer. Then continue: "I have been loyal to you and your patients, and I always strive to provide excellent preventive care. However, your recent remarks about my weight hurt me deeply. Please understand that I am acutely aware of my problem. I do not enjoy being overweight. But it is my problem. If and when I decide to do something about it, it must be my decision. I hope my value to you and this practice is not based on my physical size. From now on, I would appreciate it if you would refrain from making any further remarks about my weight." Then excuse yourself and leave.

If you think you have been discriminated against at work because of your size, there are certain actions you should take:

  • Start a file. Gather together all of your employment records, especially your job evaluations.
  • Take notes. If a colleague, supervisor, or employer speaks to you about your job performance or about your weight or appearance, write down the date, time, names of people present, and what was said to the best of your recollection. The sooner you write it down, the more likely it is to be accurate.
  • Address the issue. Make an appointment with the appropriate person to talk about the problem. Act polite, but be assertive. Do not act defensive. Do not be confrontational. Describe the events, trends, statements, evaluations, or actions that are making you feel there is a problem. Ask the other person whether your perception is accurate. If that person says it is, then ask what can be done to solve the problem.

If your complaint is still not resolved, contact your local Equal Employment Opportunity Commission office at (800) 669-3362.

Firing, hiring, and promotional decisions should be based upon the applicant's or employee's qualifications, competence, and abilities. If your weight does not hinder your ability to do your job, your employer has no right to make discriminatory remarks to you. However, if you are grossly overweight, it could be possible that your weight is a negative factor in your job performance.

Evaluate the situation honestly. Are you an exemplary employee? Are there any problems related to your job performance? Do you arrive for work early to prepare for the day? Are you rested, well groomed, and professional in appearance? Do you keep your operatory clean and organized? Do you help other team members when you have the opportunity? Has the doctor ever had to reprimand you in the past?

The most admirable human traits are definitely more than skin deep. Some of the most unpleasant people I have ever known came packaged in beautiful bodies. Some of the most wonderful, gracious, and kind people I have ever known came packaged in bodies that some would not consider beautiful. Beauty is in the eye of the beholder, and has nothing to do with human worth.

In an ideal world, no book would be judged by its cover. But ours is not an ideal world! I urge you to hold your head high, and refuse to allow the insensitive remarks of others to destroy your sense of self-worth and dignity.


Dianne Glasscoe, RDH, BS, is an adjunct instructor in clinical hygiene at Guilford Technical Community College. She holds a bachelor's degree in human resource management and is a practice-management consultant, writer, and speaker. She may be contacted by e-mail at [email protected], phone (336) 472-3515, or fax (336) 472-5567. Visit her Web site at http://www.professionalden