The Newest Form of Discrimination

What Makes me Angry?

Someone asked me this the other day. It’s an interesting question because I do spend a lot of my time with a smile on my face… I really couldn’t think of anything at that moment.

Well, it didn’t take long. (I knew there had to be something!) My happy mood changes when people discriminate against my patients. Especially because they do so without truly knowing or understanding them. I think it’s their way of being sympathetic to my position, but usually it just makes me mad. I love my patients. I don’t think about them as “lazy people who brought this all on themselves.”

healthcare discrimination


As a dietitian and diabetes educator, I typically work with persons who have diabetes and persons who are overweight and trying to lose weight. Sometimes, I work with other health conditions like stroke patients or cardiac rehab patients.

Among these groups, I would say 80% of my patients are persons with type 2 diabetes. Something about my patient population causes people to make certain assumptions about their character. It’s funny, most people are very understanding if you have Type 1 Diabetes (Okay, we won’t give you such a hard time. YOU couldn’t help it); but when it comes to Type 2 Diabetes, we have all kinds of judgement for THOSE people.

Do you think it’s a good idea to point your finger at THOSE people when statistics say that one out of every three people by 2030 will have type 2 diabetes? You think you’re safe?

Or what about when people discriminate against people who are overweight or obese? What about when you look at their body and instantly make assumptions about their character when you fail to do this about your own.

I don’t like this. It’s mass discrimination in its newest form.


The prejudicial or distinguishing treatment of an individual based on their actual or perceived membership in a certain group or category. Historically, categories could be any of the following: race, gender, sexual orientation, ethnicity, national origin, or religion. [I think we can add a few new categories – perceived health and body size.] It involves restricting members of one group from opportunities or privileges that are available to another group, leading to the exclusion of the individual or entities based on logical or irrational decision-making. 

Sometimes, I feel like I’m a woman working with black people in the 1950s. I like my patients, but everyone else says, “Oh… you work THERE. With THOSE people. I’m sorry about that. They deserve everything they get.” I thought we were past this?

Why do we do that? Those people = Us people

I’ll prove it. If you have a tendency to think of THOSE people, then allow me to remind you of how THOSE people are similar to US people. Differences are all relative.

First problem: Their issues and coping mechanisms present visually. They’re public, not private.

We’ve all got problems. Some of them are more public than others. Let’s say one man struggles with gluttony and the other man struggles with pornography. They’re both things that started out okay – eating and sex, but they’ve been manipulated into something ugly and destructive. Which one are we likely to notice?

Let’s say two women have low self-esteem. One of them eats to recover her feelings of self-worth and the other woman shops for clothes to recover these same feelings. One woman has excess weight and the other woman has thousands of dollars in credit card debt. Which woman is worse? Which coping mechanism is more public? Do you think the shopper is going to show you her bank account?

Second Problem: No appreciation for the effort it takes to change behavior.

My patients have a hard time changing. Guess what? That’s not so unusual. We all do.

Small changes are big changes to some people.

  1. Drink something different when you’re thirsty. I have people throw a fit when I suggest they drink water instead of their typical flavored/sweetened beverage. “But, I don’t like water.” I struggle to resist saying, “Get over it. Do it anyways.” We never like what’s different.
  2. Get rid of one of your possessions. I encounter so much resistance when I suggest that a person with habitual night snacking and insomnia get rid of the TV. This is the clear solution to their problems, but the idea is abhorrent.
  3. Replace your old activities with new ones. I have a set routine of my own. If someone asked me to start doing something new that would be hard. I’m already filling 24 hours of my day with tasks that I like or feel are necessary. In order to add something new, something old would have to go. (FYI, this is why you’ve seen a shortage of blogs lately. I’m prioritizing other things right now because my life is simply too full.)

What if I ask you to stop eating fast food, but the rest of your family refuses to follow suit? That person has to encounter negative situations all because of their decision to “be healthier.” Furthermore, their decision to eat better may start to cause other people around them to feel “judged” or “guilty.” This could lead to family stress. Stress could make them want to give up and go back to old habits.

Third Problem: You don’t know them. Not really.

The difference between your interactions with obese persons and my interactions is that they talk to me. They trust me. I’m in a healthcare setting. I’m paid to care.

The truth is: I’d care even if I weren’t paid to do so. I care because I know too much to objectify these people who struggle maintaining a healthy weight. I know often their behavior with food is a cover/replacement for other problems in their life. Problems that seem irreparable. Problems that require an overwhelming amount of change and responsibility. Responsible actions that they haven’t been taught or that they haven’t been practicing.

Everything is overwhelming.

What usually happens when you’re overwhelmed? Instead of getting something done, nothing gets done.

Can you try to see people as people? We’re all different shapes and sizes, but we’re all the same basically. We have these two parts of a whole. A body and a spirit. Sometimes they can compete instead of working together. Which ever one is broken, we have to fix it.

We need to be whole people because whole people aren’t limited like half a person might be. Whole people are happy inside their life’s situation. Whole people cope better than people who are only working with half of what they need.

There is a choice to be whole. This choice is not as easy as you think. It takes some hard work. It takes moving against the current.

You’re capable of making this choice. I know you can do it and I’m happy to help.

Love, Sarah

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