Table 5.
Themes and Illustrative Quotes of Weight Stigma Post-Treatment (Relapse Prevention)
| Weight Stigma Post-Treatment in Relapse Prevention |
| Providers Not Acknowledging ED |
| Candy: I was just like, “well I’ve been anorexic…” He said… “You weren’t anorexic. You have Binge ED.” |
| Elizabeth: I don’t look emaciated, [so] either it’s not even been on people’s radars or it’s… something that’s so in the past. It’s not even on my problem list... It’s been ignored... not seen as real. |
| Uki: I see this doc... “So, tell me about this ED thing, obviously, it’s not happening right now.” [I] was like, “No, I’m not currently using behaviors, but I’ve only been out of treatment for six months.” ...Just like, “I doubt your story and I just think that this thing in your medical record is completely useless.” |
| Weight- and Weight-Loss Focused Healthcare |
| Candy: I always told them, “I have an ED, like, prior history. I cannot diet...” And I would frequently--doctors be like, “Well you could diet.” ...Like only if you want to get better. |
| Abby: I’ve been told by other providers that I need to lose weight... they didn’t care about the fact that I had ED on my chart. It just didn’t matter to them. |
| Riley: I have had continuously through my life had doctors tell me to lose weight… including the last almost three years while I’ve been in recovery… |
| Aftercare Triggering Increased ED Cognitions or Relapse |
| Amanda: [I’m] terrified of maybe a full-blown relapse because I’m avoiding going to doctor because of the immediate uncomfortableness in the room, one-on-one. |
| Joanna: [The doctor] was a challenge to some of the new beliefs I was trying to adopt [in treatment]. It made me even more scared of sugar than I already was, and made me doubt the treatment approach |
| Abby: I had a conversation with that doctor [to see] whether or not they could leave out my weight information on… the summary page that they print out… A notation of “obesity” was just super, super triggering. |
| Overt Discriminatory Medical Care |
| Carly: I’ve had quite literal disdain from providers based on the size of my body. |
| Sisu: I had an acupuncturist make comments about my body and like how my arms look swollen, really they’re just fat. |
| Josephine: the one who would not touch me even to take my pulse or listen to my heart… he was very uncomfortable with my body size. |
| Systemic Issues in Healthcare |
| Rosalie: I don’t get health care anymore… My health insurance is shit… You only have a select amount of providers. [I don’t want] a fat-shamer or someone who is going to promote weight loss on you. It’s a nightmare. |
| Lexi: In ED treatment facilities, it’s... much more common to see people in thinner bodies [as] providers and that just kind of fucks with your head... |
| Grace: We’re [ED patients] struggling hard… because we’re just pushed through the system. We’re not actually helped. |