How to help doctors not be dicks

I’m probably breaking some sort of blog rule by not posting for years and then posting so close together. I think the people (you know, THE people) would tell me to wait a week to post this since I just posted yesterday and if you want to increase followers… blah, blah, blah. But I don’t really care about getting more followers and I don’t really care about blog rules or any rules I think are dumb and I’m real excited to share what I did with a client today. This was inspired by a talk given by Shiloh George at the 2018 Association for Size Diversity and Health Conference.

All too often (OK, most of the time. Like, seriously most of the time) providers, especially doctors don’t know what they are doing with my clients. They say triggering things on the regular. They recommend weight loss to clients at heavier weights who have restrictive eating disorders. Remember in my last post when I said I have clients in larger bodies starving themselves? Yeah, it’s a thing. Oh and doctors shouldn’t be prescribing weight loss for anyone because um, if it worked, everyone would be thin  but that’s for another post. Back to my clients with eating disorders. I’d say at least 75% of them have stories of doctors harming more than they are helping. So in addition to me sending starting to send eating disorder crash course letters to providers,  I’m making this option available to clients as well. We come up with what that specific client needs from their provider, they show up with a letter to their first appointment, ask the receptionist to have the doctor read it before they see the client (as Shiloh says, “to not mess with the power dynamic) so when the doctor enters the room they know the client means business. Below, the the first letter composed. I love what we came up with. I love that the client’s personality shows through. We mean business y’all. We mean business.


Dear Dr. —-

I have some complex mental health disorders. The following list is what I need for our time together to be the most helpful and least harmful to me. If you feel you are unable to meet these expectations please inform me so that I can find a new provider.

  • If possible, please have a female nurse in our appointments.
  • Please ask before you touch me in any way.
  • I have an eating disorder. Please don’t ask to weigh me. Do not discuss my weight with me. You can discuss any weight concerns with my dietitian. I have provided her information below. If you try to discuss my weight with me, I will find a new provider.
  • Do not make any comments about my eating habits. Again, if you have concerns, please discuss with my dietitian.
  • I expect to get the same recommendations you would give to a thin person if they had the same health issue as me.
  • If you don’t evaluate me the same way you do with someone in a thin body, I fill find a new PCP.
  • Please educate yourself on Health at Every Size principles if you do not already know them.
  • Shame is bad for my health. I would like for you to first do no harm and provide me with shame-free health care.
  • I have a compulsion to do personal research on my personal health. I need you to give enough information and explanation on my care to help me in avoiding WebMD. For example, I need to be told why labs are being ordered.
  • I have heard you are a badass doctor and this is me being a badass patient.

Thank you so much for your cooperation. Now let’s establish some badass care!


I fucking love what I do. I just love it.

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