Whilst we hope all healthcare professionals will provide evidenced based, impartial advice, sadly this often isn’t the case. This then impacts on testing and treatment offered (or not offered), which has an impact on the end result and our mental health in the meantime.
It certainly affected mine when I was sent away to lose 6 stone, despite being fit and healthy and with a diagnosis of low AMH and Perimenopause. A crazy recommendation given I had no medical conditions and time was not on my side to lose weight, but we all know that this was down to the funding or not in my case of an NHS cycle. I wish I had challenged the recommendation to lose weight, but I put my trust in the Doctor and system. I know it wouldn't have changed the result in terms getting funded treatment, but I would have realised that the recommendation was purely about funding and not wasted two years of my fertility journey losing weight when that was not impacting on my fertility.
Even celebrities with all their wealth and power are not immune from experiencing fat bias in healthcare. Take Rebel Wilson for example, who has talked openly about efforts to freeze her eggs.
Rebel has discussed receiving advice to lose weight and being told by medical professionals that this would have an impact on egg quality, which is total BS. As you may know we are born with all our eggs and our bodies use our best eggs first every month during our cycle. Yes, we can sometimes improve egg quality with nutrition and/or acupuncture and I have seen first hand this happen for people. However, there is no evidence that losing weight will improve egg quality. How can we be receiving wrong advice like this from some health professionals? We need the right evidenced based information to make informed decisions about our bodies and healthcare and for personal bias not to affect clinical rationale.
Despite Rebel losing lots of weight she later received a diagnosis of PCOS, which was maybe missed due to assumptions being made about why she was overweight. Rebel admits to feeling "offended" as she felt she was "healthy" and this was ignored while she was overweight.
Like with any bias assumptions are made about people who are overweight (and underweight) and this happens a lot in the fertility industry. Now don't get me wrong if weight is having an impact on our health and fertility then we need to know so we can choose to make changes, or not. However, a holistic approach to BMI is required, much like the approach followed by lots of clinics in Europe, rather than working strictly to the outdated 'bull shit mass indicator', with at times some personal judgement and bias thrown in too for good measure.
In some areas of the UK people are being refused fertility testing to find out if there is an issue and if so what it is, unless their BMI is within the pre-determined range for their postcode. This is outrageous and discriminatory.
Weight bias is a systemic problem, so deep that even celebrities with all their wealth and power are not immune. Please do not be afraid to challenge medical professionals and ask for evidence to support their claims. Having the right information will help you make informed decisions, more quickly about what is best for you and fat, thin or somewhere in between infertility is a disease and this is NOT your fault.
Love Emma xxx