Overweight? No Excuse for Avoiding the Gynecologist!

Are you one of those full-figured women who skips your annual gynecology exam since suffering from some awful gynecologic problem seems infinitely more appealing than being forced to get on a scale, put on a skimpy gown, or get lectured about your weight? You’re not alone. The fact is, women who are significantly overweight tend to avoid the doctor until they are so sick they have no choice.

Posted on | Lauren Streicher, MD | Comments ()

Are you one of those full-figured women who skips your annual gynecology exam since suffering from some awful gynecologic problem seems infinitely more appealing than being forced to get on a scale, put on a skimpy gown, or get lectured about your weight? You’re not alone. The fact is, women who are significantly overweight tend to avoid the doctor until they are so sick they have no choice.

Here are my tips to make a visit to the gynecologist a lot less stressful if you are on the larger side.

Problem: “Every time the medical assistant hands me that flimsy gown and smirks as she leaves the room knowing full well that there’s no way it will fit, I want to die. I dread attempting to wrap myself in one of those paper things that barely cover my breasts and leaves a gap across my belly. By the time the doctor walks in, I am usually clutching multiple scraps of tattered soggy paper in a futile attempt to cover various body parts. It’s humiliating.”  

Solution: It would be nice if every office provided roomy cloth gowns. But there’s no rule that says you can’t provide your own exam gown. Call prior to your appointment and inquire if your doctor prefers gowns that open in the front or the back. Keep in mind that your gown may get stained, especially if you are having a procedure. Bring something that you won’t care if it gets ruined. A wrap around robe or loose dress with a front zipper is fine.

Problem: “It’s all about being naked. I know that at some point I am going to have to bare my body in a brightly lit room. There’s no hiding my stomach, butt, thighs, etc., and I just find the whole experience so embarrassing that I would rather die from some dreadful disease than expose myself."

 

Solution: It would be nice if we could do our exam in the dark! I had one overweight woman drop a cloth over her face during the exam and mumble, “If I can’t see you, you’re not here, and this isn’t really happening.” As a patient, you can mention, “I’m on the modest side and I would appreciate if you kept me covered as much as possible.” Massage therapists use an extra cloth to cover the nonessential parts, and there is no reason that your doctor can’t also.

If your doctor seems oblivious to your need for coverage, it’s probably because we are. You may be mortified, but we spend our entire day around naked bodies and it’s the rare patient that looks like she is ready for the centerfold of Playboy.

Problem: “I know I should go to the doctor, but I keep putting it off. I’m sure I’m going to get yelled at about my weight. Last time I went to the gynecologist I really wanted to discuss the fact that my libido was essentially gone. All my gyncologist seemed to want to talk about was my weight. By the time he told me that I was at risk for dropping dead from a heart attack, unless diabetes got me first, it just didn’t seem appropriate to bring up my lack of libido.”

 

Solution: One patient said to me, after her fifth year at the same weight, “I just know you are going to yell at me because I haven’t lost the weight.” When I reminded her that I had NEVER yelled at her but had simply acknowledged that her weight had not changed and suggested we talk about strategies to deal with it, she admitted that her annual visit was really a time that she was forced to acknowledge that an entire year had gone by without a major change, and that she was actually yelling at her self.

It is frustrating to have a doctor so focused on your weight that none of your other concerns are addressed. Your best bet to avoid a discussion about your weight is to start by saying, “I know I need to lose weight, but since we have a limited amount of time I would prefer to discuss other health concerns today. Then whip out your list and go for it … my libido is gone, my bladder is leaking …  whatever it is. That way, the things that are important to you will be addressed as priorities.

Problem: "I haven’t been to my doctor in 5 years because I know they will force me to get on the scale and I just don’t want to know.”

Solution: It’s not the army. No one is going to force you to do anything.  It’s much better to get everything you need done other than your weight rather than to not come at all. If someone declines to be weighed, I will generally ask for a ballpark figure. You also have the option of getting weighed “backwards.” We will know, but you won’t. Exceptions to taking a pass on your weight? Pregnancy, certain medications and surgery require an accurate weight.

… And you do want to get the right amount of anesthesia, don’t you?

Blog written by Lauren Streicher, MD
Dr. Lauren Streicher is an Assistant Clinical Professor of Obstetrics and Gynecology at Northwestern University’s medical...