Harper's Story
When Pain and Weight Stigma Colide
Meet Harper
At 33, Harper brings creativity to life through their work as a graphic designer, transforming blank screens into vibrant visual stories. Their desk, adorned with carefully chosen artwork and inspirational quotes, told its own story of someone who found joy in bringing beauty into the world. But lately, that desk had become more prison than sanctuary, as Harper battled an invisible enemy that was slowly reshaping their life.
It started in their mid-twenties – a deep, persistent ache that seemed to seep into every corner of their body. At first, Harper dismissed it as the natural consequence of long hours hunched over their computer, telling themselves they just needed more movement, better posture, perhaps a new chair. But as months turned into years, the pain became an unwelcome companion, joined by a bone-deep fatigue that no amount of sleep seemed to touch.
Harper Faces the Medical System
At 28, after years of hesitation, Harper finally made their first appointment with a doctor. The decision hadn’t come easily. As a fat person, Harper had learned early on that medical offices were rarely safe spaces. Their fears were quickly confirmed when the doctor, barely looking up from their computer screen, dismissed their concerns with a wave of the hand and a printed leaflet about healthy eating.
“Lose weight and exercise more,” came the familiar refrain, delivered with the same casual indifference one might use to recommend an over-the-counter pain reliever. No examination. No blood tests. No questions about Harper’s actual diet or exercise habits. Just another healthcare professional reducing their complex symptoms to a number on the scale.
The Years of Dismissal
Two years later, at 30, Harper tried again. This time, they were more assertive, explaining how they’d already attempted the suggested lifestyle changes without improvement. The doctor ran some basic blood tests, but when they came back normal, the conversation quickly turned to mental health as the offered explanation. “You’re probably just depressed,” the doctor suggested, as if the chronic pain and exhaustion that had reshaped Harper’s life were merely figments of an unhappy mind.
Of course Harper was depressed! They’d been in constant pain and chronically fatigued for over two years. Unsurprisingly, the antidepressants that followed did little to address the pain that continued to dictate the terms of Harper’s existence. Their world grew smaller as the pain grew larger, until even the simplest tasks became mountain-climbing expeditions. Still, the medical establishment remained fixated on their weight, treating it as both cause and consequence of every symptom they reported.
By 32, Harper had seen three different doctors and received countless suggestions about weight loss, but precious little actual help for their pain. When they finally received a referral to a rheumatologist, it took months to get an appointment. The diagnosis came as both validation and abandonment. “You’ve got fibromyalgia,” the specialist announced, before promptly discharging them back to primary care, where the cycle of inadequate care and weight stigma continued.
A different kind of care
What weight inclusive treatment looks like
A Better Way
Everything changed when Harper found Dr. Ravi through an online support group for people with chronic pain. From the moment they entered the clinic, the difference was palpable. The waiting room featured artwork by disabled artists and informational quotes about pain management – not a single weight loss advertisement in sight. The chairs were sturdy and varied in size, a subtle but meaningful acknowledgment that bodies come in different shapes.
Dr. Ravi’s approach was revolutionary in its simplicity: she actually listened. “Tell me about your pain,” she said, maintaining eye contact instead of staring at a computer screen. “And tell me about how it’s affecting your life.” When Harper mentioned their graphic design work, Dr. Ravi’s eyes lit up with genuine interest. “That’s important information,” she said. “Understanding how pain impacts your work helps us create better management strategies.”
For the first time, Harper heard fibromyalgia explained in a way that made sense. Dr. Ravi used a simple analogy: “Think of your nervous system like a sound system where the volume control for pain is stuck on high. This isn’t your fault – it’s a real condition with complex biological mechanisms. Being in a larger body doesn’t cause this, just like being in a smaller body wouldn’t prevent it.”
When discussing treatment options, Dr. Ravi took a comprehensive approach. “Pain management isn’t one-size-fits-all,” she explained. “We need to consider your whole life – your work schedule, your stress levels, your sleep patterns. Weight loss won’t fix fibromyalgia, but finding the right combination of medications, physical therapy, and lifestyle modifications that work for YOUR body can help make it more manageable.”
How the Medical System Failed Harper
Harper’s story illustrates a profound failure in our healthcare system – the tendency to attribute every health issue to weight while ignoring the actual symptoms that bring patients in for care. This weight-centric approach leads to:
- Delayed diagnoses as legitimate symptoms are dismissed
- Inadequate pain management while doctors focus on weight loss
- Accumulated medical trauma that makes patients hesitant to seek care
- Worsening health outcomes as conditions go untreated
- A cycle of shame and avoidance that compounds health issues
The fixation on weight often prevents healthcare providers from seeing their patients as whole people, leading to missed diagnoses and inappropriate treatment recommendations. For conditions like fibromyalgia, where early intervention can significantly impact long-term outcomes, this delay in proper care can have devastating consequences.
Weight Inclusive Care Looks Like...
- Believing patients when they report pain
- Conducting thorough examinations and appropriate tests
- Providing pain management without weight-loss prerequisites
- Understanding that chronic pain conditions affect people of all sizes
- Treating the actual condition rather than focusing on weight
- Creating treatment plans that fit into patients’ real lives
- Acknowledging and addressing medical trauma
- Supporting patients in advocating for better healthcare
A different kind of care
Where To Next?
For too long, fat patients with chronic pain have been caught in a healthcare system that prioritizes weight loss over actual pain management. But there’s a better way. Through weight-inclusive care, we can create a healthcare environment where all patients receive appropriate treatment, regardless of their size.
This is why I’m currently writing a book where I dive deeper into these transformative weight inclusive approaches to patient care. And I want you to be a part of the process. Check out No Weigh for more information.
If you’re struggling with chronic pain and tired of having your symptoms dismissed, know that you’re not alone. Join our community in The Weighting Room, where you’ll find support, resources, and healthcare professionals who understand. Additionally, you can Book a consultation with me.
Want to learn more about fibromyalgia and weight-inclusive approaches to pain management? Check out my comprehensive on-demand masterclass, where we dive deep into the science of chronic pain and explore evidence-based strategies for managing it – no weight loss required.
Remember: Your pain is real. Your experiences matter. And you deserve healthcare that treats you as a whole person, not just a number on a scale.
