Jude's Story
When Weight Stigma Stands Between You and Sleep Apnea Care
Meet Jude
Jude was a regular-looking kid until puberty hit, and then they started gaining weight. Everyone assumed it was because they ate too much and didn’t exercise enough. But Jude was quite sporty and they weren’t eating any more than their friends. It was a constant source of frustration, but Jude had supportive parents who had b een through something similar during adolsence themselves, and they never failed to cheer Jude up whenever it got a bit too much.
Jude was 22 when they were diagnosed with PCOS. “Lose some weight and come back if you’re having trouble getting pregnant,” their doctor advised. Pregnant? Jude was just starting to get the hang of adulting – they were still living at home and applying for their first job out of university. Parenthood was the furthest thing on their mind!
But that was that. Throughout their 20s and 30s they did everything they could to keep the weight off, but the harder they tried, the fatter they got. Whenever they googled PCOS, they read about insulin resistance and how important it was to stay at a “healthy weight” to avoid getting diabetes. So they stayed away from google, and prepared for the inevitable.
So far, their blood suagar has been normal. But there’s something that has been on their mind for some time now. Something that causes a great deal of embarrassment for them even though they didn’t tend to embarrass easily.
Jude Snores
Now, snoring is one of those classic fat stereotypes that people just love to make fun of. Sure, babies and puppies can get away with it, but when you’re in your twenties, it’s particularly rough because snoring is supposed to be an “old person thing.” Add being fat to that mix, and well… you know how people can be.
It didn’t help that Jude spent most of their twenties in a long term relationship with an extremely toxic partner who really knew which buttons to press. You know the type – the one who dresses up insults as “concern.” Their partner made sure to point out the snoring straight away, turning it into an ongoing joke that wasn’t really a joke. It was just another way to dig at Jude.
Because their partner blamed everything on their weight, and their doctor blamed everything on their weight, and pretty much everyone else blamed everything on their weight, Jude didn’t seek help. In fact, they didn’t talk to anyone about it. Even when they started hearing people talking about sleep apnea and realised that they were experiencing so many of the same symptoms. The shame was just too much to overcome.
Thankfully, Jude eventually realized that their relationship wasn’t serving them and kicked their partner to the curb. But emotional abuse had taken its toll. They were pretty battered and bruised for a while, and went through a period of feeling low. They struggled with stress at work, their mood plummeted, they started having panic attacks, and life just sort of unraveled.
Jude Is Exhausted
Ten years and several months of therapy later, Jude is still absolutely exhausted. Beyond exhausted, really. They now have a couple of kids, a job, bills to pay – you know, a life. But they were just so tired all the time.
At first they assumed it was because of depression, stress, not getting enough sleep, a full-on job, the kids… But they’d been working on a lot of these things and hadn’t noticed any improvement. At the back of their mind, they kept wondering, what if it’s something more?
Finally, Jude worked up the courage to visit their doctor. They knew they were in for a weight loss lecture. They knew they’d once again be told all about how they should exercise more and get some fresh air because that fixes everything, right? But they went anyway.
And sure enough, before they even sat down, they knew they were in for trouble. Their doctor barely looked up from the computer screen, wasn’t interested in listening, and immediately assumed they were tired because they “just don’t do enough exercise”. Translation: you’re tired because you’re fat and lazy. Classic stuff.
Jude Needs A Sleep Study
Right at the end of the consultation – and I mean right at the end whilst Jude was putting their coat on – the doctor finally asked about their sleep. When Jude mentioned they could sleep through the night but woke up feeling like they hadn’t slept at all, the doctor decided on a sleep study referral. It felt like an afterthought and at that point, Jude was desperate to get out the door. So they agreed and left straight away.
Afterwards they sat in the car crying for a good twenty minutes. The whole thing was just too overwhelming. The diagnosis was overwhelming. The fear of what it might mean was overwhelming. Would it impact their ability to drive? Would they end up having all sorts of interventions and tests they couldn’t handle? What even is a sleep study? Would they have to sleep in a hospital? How would that work with the kids?
But deeper than all that practical stuff was the fear that had plagued Juder all of their adult life: “Oh great, another diagnosis they can blame me for.” Jude already had PCOS aand was at risk of developing diabetes. The last thing they needed was another diagnosis that basically screamed “you’re fat and you need to lose weight.”
A different kind of care
What weight inclusive treatment looks like
A Better Way
Imagine a scenario where Jude visits the doctor, but this time it’s different. The moment they walk into the consulting room, exhaustion written all over their face, Dr Ayodele (Dr Ayo for short) puts their computer screen to the side. Because really, how can you connect with someone when you’re staring at a screen? Dr Ayo gives Jude their full attention and simply asks, “Tell me what’s been going on.”
And Jude starts talking about being tired. Not just your normal kind of tired, but that bone-deep exhaustion that makes every day feel like you’re walking through treacle. Dr Ayo listens – really listens – because fatigue like this isn’t something that should be brushed off, no matter what.
When Jude mentions waking up feeling like they haven’t slept at all, Dr Ayo’s interest is piqued. It’s such a classic sleep apnea sign. They start asking more questions about Jude’s sleep. Not in an accusatory way. Not with any assumptions. Just genuine curiosity about their experience.
When Jude mentions the snoring, shame starts creeping into their expression. They’ve been mocked for it so many times before, but the Dr Ayo doesn’t skip a beat. Instead, they share something that often surprises people: sleep apnea isn’t just a “fat person’s condition.” They talk about fascinating population studies where researchers just invited random adults to have sleep studies. The results? Up to half of them had sleep apnea. Half! And these weren’t just Fat people – these were people of all sizes.
Dr Ayo explains how sleep apnea can be caused by all sorts of things – the way your jaw is shaped, your genetics, even just how your throat muscles relax when you sleep. They take the opportunity to praise Jude for seeking help and express profound saddness that Jude has lost thir faith in the medical profession. Dr Ayo is determined to restore that.
When the topic of a sleep study comes up, anxiety flashes across Jude’s face. Dr Ayo notices and takes time to talk it through. They explain exactly what happens during a sleep study, how most of them can be done at home now (no hospital stays required!), and what treatment might look like if they do find something. They discuss CPAP therapy – not as this scary medical thing, but as a tool that could help Jude wake up feeling properly refreshed for the first time in years.
The whole conversation focuses on one thing: helping Jude feel better. Not about their weight, not about what they should or shouldn’t be doing, just about addressing this exhaustion that’s making their life so much harder than it needs to be. Because that’s what healthcare should be about – making life better, not making people feel worse.
How the Medical System Failed Jude
Jude’s doctor immediately blamed their fatigue on their weight rather than trying to get to root cause. Fatigue is a common presenting symtpom, and instead of asking about sleep patterns at the start of their appointment, their doctor spent most of the time lecturing about exercise and diet. This weight-centric approach not only delays proper diagnosis but also reinforces harmful stereotypes that equate fatness with laziness and lack of self-care.
The system’s failure extends beyond that single appointment. Years of medical stigma had taught Jude to expect weight lectures instead of real healthcare, leading them to delay seeking help even as their exhaustion worsened. When sleep apnea is mentioned, it is usually presented as yet another “fat person’s disease” rather than the common condition it is, affecting people of all sizes. This framing adds to a person’s shame and resistance to pursuing a diagnosis.
Most damagingly, their doctor’s reflexive suggestion of weight loss as a solution ignored the evidence about its ineffectiveness for treating sleep apnea. Studies show minimal improvement in apnea episodes with weight loss, while suggesting weight loss can lead to long-term weight gain – potentially worsening the condition. By focusing on weight instead of proven treatments like CPAP therapy, the medical system often denies Fat people access to care that can dramatically improve their quality of life.
Weight Inclusive Care Looks Like...
- A proper physical examination and a referral for a sleep study
- Recognizing that weight loss is not a treatment for sleep apnea, that at best it results in two fewer apneas per hour, and that it is likely to worsen outcomes in the long term.
- A choice of effective treatments (such as CPAP), including the option of no treatment
- Addressing the real harm – weight stigma
- A Focus on quality of life improvements rather than just risk reduction
- Providing comprehensive and ongoing support and adjustments as needed
The key to successful sleep apnea management isn’t weight loss – it’s providing accessible, stigma-free healthcare that focuses on effective treatments and quality of life improvements. When we remove weight stigma from the equation, patients like Jude can get the care they need sooner, leading to better health outcomes for everyone, regardless of their size.
Where To Next
Over the past few years, I’ve been advocating for weight-inclusive medical care, sharing evidence and experiences that demonstrate that there’s a better way to practice medicine. This passion has grown into a book I’m currently writing, where I dive deeper into these transformative approaches to patient care. Check out No Weigh for more information.
If you’re looking for medical care that treats you as a whole person, not just a number on the scale, I’d love to work with you. Book a consultation and experience the difference that weight-inclusive healthcare can make.
Are you feeling tired all the time? There are a number of reasons why this may be the case, which is why I created an on-demand masterclass that focuses on how to diagnose and manage fatigue in a weight inclusive care. I also have a masterclass that focuses on the weight inclusive management of sleep apnea.