Doctors refused to treat me, blame all my symptoms on my weight

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DEAR DR. ROACH: I had chest pains, dizziness and shortness of breath on exertion. Chest pain lasts for a few hours. At one point it was so bad that I couldn’t walk a hundred feet, had to use a cane and severely limit my physical activity. I have already been to the doctor about this. They do an EKG, which comes back to normal, so they blame it on anxiety, then tell me I’m fat. (I know I’m fat, but even when I was doing intense martial arts twice a week, I couldn’t lose weight. And my physical therapist told me not to do yoga.)

If it makes any difference, I’m also a type 2 diabetic and suffer from fibromyalgia and PTSD. This is not the only problem that the doctors refused to treat, because they can attribute it all to my weight. My diabetes went out of control for a while because my doctor only wanted to tell me to lose weight instead of ordering blood tests when I complained about symptoms.

When these symptoms appear, my friends tell me to go to the doctor, but they don’t do anything to change the situation. Why would I pay over $1,000 and waste a few hours for an urgent care visit and an EKG only to be told I’m fat and anxious when I can cover my chest with stickers, play on my phone and tell me I’m home fat for free? Who is right, me or my friends? — ST

ANSWER: I’m so sorry to hear how badly you are treated. I’ve heard many people say that doctors don’t take symptoms seriously in overweight or obese people. (There is strong evidence that this is true, and that women and people of color are also consistently treated worse. People with any mental health condition, such as anxiety or PTSD, are often in disbelief.)

While I understand you are frustrated, your symptoms are very concerning. Particularly if you are over 50, they strongly suggest heart disease, especially in someone with diabetes, which increases the risk of heart disease.

Considering your bad experience, the amount you’re paying, and your PTSD, I can totally understand why you’re hesitant to go. However, you deserve to receive good care, and I believe you will be able to find a doctor who can treat you well and not automatically override any complaints about your weight and anxiety. I recommend that you be completely honest about your concerns.

When I have a patient with multiple ER or acute care visits for possible heart disease, I often recommend a more definitive test than an EKG and blood test, which is the usual acute care assessment to check for heart muscle damage. It may be a coronary CT angiography, which is very sensitive and specific. (The weight limit for this test depends on the scanner, but is usually 450 pounds.)

If you have blockages in your heart causing your recurring symptoms, it needs to be treated to prevent a heart attack. If blockages aren’t the cause, EKGs aren’t usually helpful, and you need another type of evaluation to find out where these symptoms are coming from.

Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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