Fat, Female, and Over-Fifty – Being Dismissed by Your Doctor

On our forum the other day one woman expressed that her Doctor was not taking her chronic pain seriously. Multiple women chimed in, having experienced the same dismissive attitude from their healthcare teams. At one point another female community member asked “Are you FFF? FFF stands for Fat, Female, and over-Fifty, and no one takes us seriously.” I’ve been on these forums for over two years now, and I consistently hear that women who go to their Doctors are told “if you would just lose a few pounds...” or “the pain can’t be that bad...” or “a bit of pain is normal at your age...”. It needs to change.

I debated whether to write this article because it’s a sensitive subject, but in the end, my frustration with these physicians I had never met won out. This article is for those accused of being just another aging, hysterical, overweight woman who's exaggerating her symptoms... because F that.

Dealing with weight bias

If you ever got the impression that those extra pounds you were carrying around were blamed as the source of all your problems, you’re not alone. Maybe you were told the pain/swelling in your knees, ankles, and back would go away if you lost 10 pounds. Maybe your fatigue is not actually from your autoimmune disease, maybe you just need to eat better and be more active. Your diabetes, hypertension, and high blood pressure are not in any way affected by your chronic inflammation, it’s entirely the lifestyle choices you’re making.

Dismissing symptoms due to gender

“Hysteria” was previously a common medical diagnosis, applied to women who were deemed as being emotionally volatile, over-dramatic and attention-seeking. Characterized as a psychological illness, physical symptoms like pain were dismissed as “psychosomatic.” Although this diagnosis was dropped in the 1950s the societal belief remains that women over-exaggerate and sensationalize. We have drama queens but not drama kings. Perhaps you’ve been brushed aside, told you were overreacting. Maybe your Doctor noted that you seemed friendly and polite, so how much pain could you really be in? Worse still, perhaps all your bloodwork and diagnostic tests came back clear and you were told “it’s all in your head.”

Over-Fifty: Ageism in healthcare

We may read a lot about ageism in the workplace, but ageism in healthcare settings is pervasive, and it can hinder your ability to get diagnosed or to get treated. A 2011 study on Doctors’ attitudes demonstrated that when it comes to aging many Doctors feel aches and pains are normal, becoming forgetful is normal, having less energy and being fatigued is normal, that older people should not expect to be as healthy as when they were young, and that the body’s “wearing out” simply can’t be helped.¹ Now, view this through the lens of psoriatic arthritis, and it’s easy to see why we’d be frustrated. Swollen joints, stiffness, and achiness are just “part of getting old.” That ‘brain fog’ you think you have is just “part of getting old.” Once again, you're overreacting, or worse, overreaching - expecting a level of wellness that can't be achieved.

Dealing with the trifecta

Given all three of these situations put together, it’s easy to see why that community member was hitting the nail on the head when she said FFF is the “ultimate trifecta.” If your Doctor is walking around with any of these three preconceived notions, they have three excuses at the ready to dismiss your symptoms. Don’t let them. It’s your life, and you are entitled to live it as best you can. Know that gender discrimination, weight bias, and ageism have been shown in multiple studies to be an obstacle to care. I’m sorry that we must work so hard to advocate for ourselves, but it’s crucial that we do.

Wishing you health today.