Elizabeth*, 38, started puberty early, getting her period in the fourth grade. Her pediatrician criticized her for weighing more than the average nine-year-old, despite the fact that she was already five-foot-three. “I can easily say that experience triggered twenty years of body dysmorphia and disordered eating,” she says. “Shortly after that, I used to just not eat for days at a time and then go on the scale, and then eat. I never lost a ton of weight, but it became a game. I thought I was really large when I was a size four as an adult.”

As a “healthy and fit” 11-year-old who started puberty early, Sarah Bregel, 32, also heard from her doctor that she needed to lose weight. Her next doctor criticized her weight at every visit because her BMI was above the number deemed “ideal,” even though it wasn’t in the overweight range. “It really made me question whether or not I was normal,” she remembers. “Other girls were still 80 pounds and flat-chested. I knew I looked different, but I don’t think it bothered me until a doctor said, ‘you should be concerned about this.'” She struggled with body image for years and is still uncomfortable going to doctors.

In a world that judges women for their looks, many rely on doctors for objective, unbiased assessments of their health. Unfortunately, some receive the exact opposite. Sixty-nine percent of overweight and obese women have experienced weight-related stigma from a doctor, according to a study in Obesity.

This can have long-term physical and emotional consequences, according to a recent review of studies. Obese people are more likely than others to have undiagnosed medical conditions, largely because doctors attribute everything to their weight. Instead of suggesting CAT scans, physical therapy, blood work, and other treatments they recommend to other patients, they’ll simply prescribe weight loss.

Ashley Warren, 28, knows this all too well. A doctor told her she was “morbidly obese” (she did not meet the diagnostic criteria) and attributed her allergies, asthma, and chronic migraines to her weight. Years later, her insurance company randomly assigned her a doctor who was more understanding. She’s since learned her allergies and asthma are conditions she’s had since childhood that have nothing to do with her weight, and her migraines are hormonal. She’s now on meds for these conditions.

Many people fat-shamed by doctors end up avoiding doctor’s offices out of fear that they’ll continue to experience this kind of discrimination. Julia*, 37, once waited a week to go to the doctor after noticing symptoms of strep throat. “I didn’t want to be told I was fat,” she says. “Every time I go to the doctor and they weigh me, I know there is going to be some kind of talk about being overweight. It’s one of the reasons I don’t like to go: because so many times, they can’t do anything, and then I’m paying a $30 co-pay for someone to call me fat.”

In addition to postponing treatment for physical health problems, fat-shaming is detrimental to people’s mental health, and patients may especially take it to heart when it comes from professionals. Teresa Altomare, 36, was told by an ob-gyn that she was too fat for her cervix to be visible and that she needed to lose weight to get a better pelvic exam. But two weeks later, a Planned Parenthood nurse gave her exam without any trouble, without Altomare changing anything about her body.

Still, the damage had been done. “That experience threw me head-long into a cycle of dieting and self-hatred that lasted almost three years, and that spiraled so out of control that I had to seek therapy to stop obsessing about food and weight,” she says. “In that moment, I felt like I was so disgusting and sub-human that I wasn’t even worthy of medical care. It also affected me sexually. For a few years, after that visit, when I was with a new partner for the first time, I worried that my genitals were too fat to deserve sexual pleasure.”

Another disturbing trend? Women getting criticized by doctors for their weight gain during pregnancy. Melissa, 37, was called out by her ob-gyn for gaining 20 pounds during her first 12 weeks. She’d lost a lot of weight on a trip right before her pregnancy, so the weight gain was partially just returning her to her normal weight. “Even after the weighr gain, I was not considered overweight, so it was confusing. She didn’t really ask me about my history or explore my relationship to food or exercise. I’m a super healthy eater,” she says. “I shamefully admitted that I’d maybe been indulging—I was pregnant after all—but for me, indulging is like having mayo or full fat cheese on an otherwise healthy sandwich. She told me that I needed to resist cravings and exercise more.” Melissa ended up gaining 30 pounds total during her pregnancy, which is considered within the healthy range. “I’m sorry I wasted weeks at the beginning worrying about weight gain rather than just enjoying the experience,” she says.

After her two very different experiences, Warren hopes more doctors come to view weight as just one factor in health. “Not every single ailment is related to weight, and I think it’s short-sighted for doctors to act like it is. Weight is such a hard subject for many people—myself included—that it should be treated with compassion and understanding by medical professionals.”

“Doctors have power,” echoes Altomare. “They’re basically the gatekeepers of what’s right and wrong with our bodies. Their words matter. I would implore them to remember that there are people in those bodies.”

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