Women who are overweight and obese can find accessing healthcare difficult and stressful, according to research in the latest UK-based Journal of Advanced Nursing.
Researchers from Texas, USA, carried out in-depth interviews with women aged between 20 and 61, after recruiting them through local advertisements placed in community agencies and a regional newspaper.
"The participants in our study described the experience of seeking healthcare as a constant battle and struggle and were upset by the reactions of healthcare staff" says lead author Professor Emily Merrill from Texas Tech University Health Sciences Center.
"They told us that they felt even more uncomfortable with specialists than with their own family doctors and nurse practitioners."
Four themes emerged: struggling to fit in, feeling not quite human, being dismissed and refusing to give up.
Women talked about feeling shame and embarrassment because they did not fit into the normal healthcare environment because of their size and needed larger gowns, blood pressure cuffs, scales and chairs.
Elena told researchers that she had to wait half an hour to have her blood pressure taken, because the right equipment wasn't available. She related how embarrassed she was while the nurse was running round the office saying: "We need the bigger cuff. She can't fit the other."
And Tammy's bad experiences have made her plan ahead when she goes to a healthcare appointment. "I am to the point now where I will pretty much demand a larger fitting gown before the nurse even walks out of the room" she says.
Women also reported feeling less than human because of their size.
For example, the doctor delivering Doris' son upset her with a tactless remark at a time when she feeling particularly vulnerable because of her size. "He said 'Just relax and just envision yourself on a beach like a big ole whale beached.' That hurt me so much because already I felt big."
Tammy added that healthcare professionals didn't seem to see her as a person. "When you look at me, see me as you would look at any other normal person with a condition" she said. "Don't look at me as some huge overweight woman who needs your help."
The women who took part in the study had all dieted and felt defeated by their weight and their failed attempts to control it.
Stella said that being overweight was the "worst thing in my life" and she longed to be a normal size. "It's not something I think about one or two times a day. It's something that is always, always there, from getting out of bed…" she told researchers.
Elena was cross that the doctors didn't listen to what she said, that she didn't eat fast food and drink sodas. "They don't care. It's like they are too busy to stop and listen" she said.
The women also talked about being dismissed by healthcare professionals.
Lynette was refused treatment for her arthritis by a chiropractor because of her weight. She told the researchers he "took one look at me and said 'All you need to do is lose weight and that would solve all your problems'… He didn't bother with X-rays or an examination or anything, so it was amazing to me that he could know that from just reading over the questionnaire and looking at me."