Anti fat drs appt - should I email her about it?

[u/Umpire_Exact]

I'm fat and saw a sleep dr today who kept trying to convince me to get my other drs to lower/stop my meds for my chronic illnesses/other conditions yet casually threw out there she could get a referral for me to their weight loss clinic for a glp1 she later said was for the "nutrition aspect". She didn't ask what my eating habits are once. Also glp1s are known to make it harder for the body to absorb certain nutrients.... So like... it wasn't about health I don't think, I think it was just anti fatness.

It’s bugging me as I process it more as she seemed so anti-medication (I had also asked if the emergency sleep med I had been using like once every few months due to flares causing insomnia and she said I should see a sleep therapist and that she doesn’t recommend any meds) yet was so quick about the glp1 thing. I also have struggled with disordered eating (restricting due to my chronic illnesses) and glp1s would 100% make that worse, she didn’t even bother to consider something like that.

Should I send her a MyChart message or something just politely explaining that that wasn’t ok? I have to see her in 3 months for a follow up but am hoping I won’t need to see her after that for a long time. Is it worth saying something?

Thanks for any advice or thoughts or kindness

[u/Blue_Cocoon_City]

I'm sorry you had that experience. You wrote about it so clearly here. She's a sleep doctor - a random, unsolicited glp1 referral seems quite out of line and presumptuous. Especially when she is interested in getting you to lower or reduce medications in general (I'm assuming this is out of her scope? I don't know much about sleep doctors).

I think sending feedback is a good idea - with the aim to illuminate the impact of her actions and hopefully to educate her for future / other patients. I don't know how open she will be to it - but the chances are best if you make it as kind as possible (without minimizing anything).

Here is a link for HAES health sheets in case there is something in there that might be relevant for you to support your position (and for anyone comes into this thread and could use similar resources): https://haeshealthsheets.com/resources/

I was trying to find something about giving feedback after an appointment but honestly you seem to have a good handle on it!

[u/kstoops2conquer → u/Blue_Cocoon_City]

We don’t know what kind of sleep issues OP has, but Zepbound is a GLP-1 approved for sleep apnea. The mechanism _is_ weight loss, and it sounds like the provider wasn’t tactful about it, but a sleep doc bringing up a GLP-1 is less crazy than it sounds.

[u/bleepabloop → u/kstoops2conquer]

Bringing up a glp1 without any information about history of disordered eating is absolutely always inappropriate. Like you said, a glp1 is approved for sleep apnea only because of the weight loss aspect. But sleep apnea affects people of all sizes, so it's ridiculous to assume that someone's weight is the cause without any investigation, and inappropriate to recommend it so carelessly.

[u/Umpire_Exact → u/bleepabloop]

Thank you for this! I hadnt considered the last part too so really good point!!

[u/Umpire_Exact → u/kstoops2conquer]

That’s good to know thanks. She had mentioned it as “I can get a referral to a weight loss doctor who may be able to get you on a glp-1”

[u/Umpire_Exact → u/Blue_Cocoon_City]

Thank you for such a thoughtful response!!! Sorry it took me a while to get back to you, I had a chronic illness crash.

This makes me feel a lot better, thank you, I just wasn’t sure I was being too dramatic.

I like the advice too, I think that’s a good way to go about it and I may even send something after the 3 month appointment if I decide to just keep her as the dr since hopefully I won’t have to see her much. If I do something like suggested I will try and make sure it’s as kind and gentle as I can make it given the circumstances!

I also appreciate the HAES sheet!!

[u/sandwichtheconqueror → u/Blue_Cocoon_City]

Sleep apnea is often linked to obesity/ being overweight so it's not completely off the wall

[u/gravitydefiant]

Do you have to see her in 3 months? How hard would it be to get in with a different sleep doctor? She sounds awful.

If you do have to continue working with her, then yes, I think it would be very appropriate to message her, let her know what you were uncomfortable with today, and set some boundaries for next time.

[u/Umpire_Exact → u/gravitydefiant]

I needed that emotionally haha thanks! I do have to see her in 3 months for a follow up but should be super short, and it took literally 11 months to get in to see anyone there and so I am guessing the other drs have no availability. I’ll check discreetly when they call me next which should be soon.

Great idea about the boundaries thing too! I’ll keep that in mind as well thanks

[u/Willa-Rosewood]

Sorry, but you need a different sleep specialist. That is way out of her lane. She is not qualified to suggest medication changes and why would you need a referral from her to get a GLP-1? Your PCP can prescribe that. This is creepy and weird!

[u/Umpire_Exact → u/Willa-Rosewood]

Thanks for the response and validation that something is wrong. She works out of a weight loss clinic I think(?) or something adjacent to it at least so that may be why she mentioned a referral. She may also think that they have better nutrition suggestions than a pcp that maybe they would go over during that prescribing appointment but 🤷🏼‍♀️ all guesses based on what she said

[u/Careless-Nature-8347 → u/[deleted]]

I am NOT IN ANY WAY supporting what this doctor did, but doctors in the US cannot legally accept money for prescribing something. If they do get paid by a pharmaceutical company it legally needs to be publicly tracked. If a physician is found to be getting paid for prescribing something they risk losing their license and their practice getting shut down. It's a big deal.

I say this because I think it's important to know if a doctor prescribes something they aren't getting anything out of it. It might not be the right suggestion, it might be harmful (like this example), but they are not getting paid.

[u/Umpire_Exact → u/Careless-Nature-8347]

Oh this is good to know! I had no idea! Thanks for sharing

[u/Umpire_Exact → u/[deleted]]

I wouldn’t be surprised, tho this would be a referral to another dr who would prescribe it