Opinion | Op-eds

Body shaming at Barnard’s Health Services needs to stop

“So it says on your record that you have a history with an eating disorder.”

“Yes,” I sputtered. I know it’s true, but no matter how many times the nurse practitioners read it to me at Barnard Student Health Services, it still feels uncomfortable. 

“All right, well, we have a new policy where we have to weigh you once a year. I know we weighed you in the fall, but let’s just do it again.”

For years, these numbers ruled my world. Every day I would step on the scale, and that determined my worth—which is why in my second year of recovery, I refuse to weigh myself. In the fall, a nurse read the same medical history to me. She told me the same policy, and I stepped on the same scale. I thought I was stronger than the numbers. I’ve recovered, I thought, it won’t bother me. But of course, the number was higher than I thought. Immediately I felt weak and out of control.

[Related: Body positivity looks different for each person]

Unsure of how to address my weight, the nurse escorted me to the front desk and asked the receptionist for the number of the nutritionist, without even looking at me. The receptionist didn’t get the hint. She kept repeating, “But she’s here to talk about birth control. I don’t understand what you’re saying to me.” At the time I brushed it off, unsure of what to make of it.

So this spring, I was resigned. I complied, even though I was unsure as to why I was being weighed twice in one year. I stepped on the scale, and as the nurse tried to tell me the number, I shouted, “LA LA LA,” like a five-year-old, but I still heard the number.

When I stepped off the scale, she said, “Well, good work. You’ve lost 10 pounds from the fall, but your BMI still counts as overweight. We have a new policy that states that if your BMI is overweight, you have to be tested for diabetes.”

All I could think about was the fact that I had lost weight from the fall, so that made being “overweight” OK. At least I wasn’t my previous number. But it wasn’t until I left Health Services that I started to really digest what had happened.

It is understandable that Barnard and Aetna are testing for diabetes—BMI is currently how our health is assessed. But the way in which Health Services is handling the topic of weight prevents students from using Barnard’s resources.

This isn’t specific to me: Health Services should be more well-versed and sensitive when approaching these issues. I talked to several other students, and even students without eating disorders, like Sarah Caputo, BC’ 15, have expressed that they’ve felt stigmatized by Health Services. Caputo exemplified this when she told me that: “Knowing that I will be told I am overweight ... made me so nervous to go to Health Services that I put off getting a flu shot for three months.” 

A Barnard first-year shared with me that she went to Health Services because she was worried she had suffered a concussion playing rugby. It was her first time going, so her temperature, height, and weight were taken. Then, after diagnosing the student with a concussion—a head trauma—the nurse made it a conversation about her weight. 

“Factually, what she was saying was not all wrong, but at that moment I was in pain, scared because I knew I was going to get behind in my school work, and so overwhelmed,” the first-year said. “I’m an adult—I came to the doctor for something both specific and serious and felt almost blindsided by the latter half of the interaction.”

This incident is by no means unprecedented. Another friend, a Barnard senior, went to Health Services to get paperwork signed for a shoulder surgery. After having her BMI measured, she interpreted the nurse’s facial expression as “disgust” as the nurse wrote down the number and asked whether the student exercised. The student informed the nurse that, yes, she exercised. Her upcoming surgery was, after all, to repair a sports-related injury. 

The student told me, “She [the nurse practitioner] scowled and said, ‘OK, well, do you have a healthy diet?’ At this point I was mostly just upset that she made all of these strange assumptions. … Every time I’ve been to Health Services since then, I’ve been super nervous about what the doctor or nurse will say about my weight, even if I go in for something completely unrelated.”

The war on fat is a national one—the concept of health at every size is unfathomable to most. American children are being weighed at school, in front of all of their peers, and their BMIs are being stamped on their report cards. Children are being taught to fear fat and to measure their worth by their weight. In a recent study, the Campaign for Commercial-Free Childhood found that 70 percent of normal-weight high school girls are dieting because they feel overweight, and I can assure you that this sentiment does not disappear the minute they arrive at college.

According to its website, Barnard’s Primary Care Health Service has three goals: “To provide excellent clinical health care in a sensitive, non-judgmental and responsive manner. To promote the health of body, mind and spirit within the student community. To educate students to become knowledgeable and effective users of health care.” 

I think my own experience, and the experiences of so many others, have been counter to Health Services’ very mission. Because of the judgmental and insensitive manner with which nurses have handled weight, students feel discouraged from taking advantage of the health care provided. Staff should have a level of clinical sophistication and sensitivity when addressing eating disorders—a common medical problem—and weight. This institutional body-shaming needs to end, so that everyone at Barnard can feel safe in their bodies at the place that is supposed to heal them.

The author is a Barnard College junior majoring in American studies. She is a co-organizer of Body Positivity Week at Columbia.

To respond to this op-ed, or to submit an op-ed, contact opinion@columbiaspectator.com.

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shame posted on

Enough with the use of the word "shaming" - so cliche. Healthcare providers routinely weigh all patients, not in order to "shame" them, but rather to get a more comprehensive view of their health. And yes, weight is a key factor in health.

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Anonymous posted on

True, but we also know that it's possible to be a "normal" weight and be completely unhealthy, and that people whose BMI classifies them as "overweight" can be totally metabolically healthy. It's well known that BMI is a flawed and incomplete measurement of health. Health Services shouldn't place so much emphasis on it – especially not with patients they know to have a history of eating disorders.

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Marco posted on

While a young person may be over weight and healthy, you are omitting the vastly studied and statistical evidence that over time, over weight people will succumb to joint and disc degeneration, heart disease, diabetes, and a number of degenerative diseases than the general public, and at an earlier age.

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Anonymous posted on

Did you not read this article? When you go in to get birth control or to get checked for head trauma, you shouldn't have to 1) get weighed and 2) then get told you have to get checked for diabetes.

Sure, weight can be a factor in health. But the point is, none of the examples above were of women who visited Health Services SPECIFICALLY to get weighed. They went there for completely unrelated purposes — and yet got weighed, and then got pushed to do other measures.

THAT is shaming. When you go to the doctor for some unrelated reason and yet the doctor makes it all about how you much lose weight/get tested for diabetes. That is shaming.

Again, seriously, learn to fucking read.

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Anonymous posted on

I mean, if you're prescribed medication, you probably should be weighed... but correct in the shaming aspect.

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SEAS '15 posted on

I am totally against shaming, but I completely understand where health services is coming from.

For diabetes: I can only imagine the law suits that could potentially happen if a health clinic is fully aware that a student is overweight and does not check possible illnesses that coincide with being overweight. The liability could be huge, and with so many kids at Columbia with rich, lawyer parents, the university could lose a lot of money.

For weighing students: Um... if you're put on ANY medication, you should be weighed. Period. For instance, Plan B is significantly less effective if you're overweight. Students who are overweight will need to take a different alternative, and most of the alternatives for overweight students require a prescription (because they are potentially more harmful).

Just like when you come to the doctor with a headache and he checks your heart beat and your ears, which seemingly has nothing to do with your headache, it makes sense that health care professionals would monitor weight. It can be an indicator of something going wrong, and it can seriously cover their ass in liability lawsuits.

However, staff should be far more respectful and severely less judgmental. Also, BMI is a joke. Not sure why that's a factor.

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Marco posted on

A responsible healthcare practitioner should always consider weight as a factor in any kind of check-up and in providing pharmaceuticals. And birth control pills/hormones can cause some water weight gain and food cravings. It should definitely be part of the discussion.

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Anonymous posted on

It would take no effort at all to weigh patients blind (facing away from the scale and with the number not read aloud) instead of foisting the information on them. Literally no effort for the medical staff to get the information they need without causing psychological distress to the patient. The fact that they continue to use their current methods *anyway* even though they are more harmful indicates that they are unsettlingly comfortable with doing harm to patients.

So yeah, "shaming" is the right word.

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TRUTH posted on

Thank you so much for writing this article. This type of discrimination due to my history with eating disorders is precisely why I took myself off Barnard's health care plan after freshman year. I felt from day one that my care was compromised simply because of my history. I really hope health services can rectify this.

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Maud R posted on

This is messed up. Paulina, you should definitely organize a protest or a petition or something. Tell me where to sign up.

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thanks posted on

well said

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bnard check ur priorities. posted on

This is awesome. Not only is their shaming/BMI obsession weird and unnecessary, but also very dangerous around people with a history of eating issues. The fact that they read your numbers/ had that discussion with you (in that way) after acknowledging a history of eating disorders is horrifying. For many people not in recovery or not far enough along in recovery that could have very very serious consequences in terms of mental health.

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Anonymous posted on

also there is a typo in the paragraph that begins "this isn't exclusive to me..." in the word "students"

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opinion's picture
opinion posted on

Thanks for bringing it to our attention—the typo has been corrected!

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Anonymous posted on

AMEN!!!!!!

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Spell-Check posted on

"I talked to several other sutdents"

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Anonymous posted on

People that are overweight often contract late onset diabetes. Obesity is an epidemic in the United States, and is a well known fact that diabetes is on the rise. Lets stop making it seem that BMI is bull shit, and that everyone is ok because we do not want to "shame" someone. We are doing their health a disservice by being so Politically correct. Or maybe you know more than our Surgeon General?

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Um posted on

Literally five minutes of research would show you that BMI is from from a bulletproof indicator of medical health. For instance, I've had an underweight BMI my entire life and so have all the women in my family, although we eat plenty of food and my medical check-ups show routinely good results. You have to take a holistic assessment of all of the components that make up individual's health, and the BMI is only one. That also belies the bigger point here, which is that students are not getting the help they need for other health issues because they're afraid of being continually harassed about their weight. That's simply not ok.

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what? posted on

yeah your right, using a few examples, totally disproves BMI, and that obesity and diabetes epidemic in the United States is all made up. I am sure everyone is just "big boned."

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um posted on

I used an example from my personal history (which suggested the complete opposite of your sneering "big-boned" joke), but I also encouraged you to research it on your own. Also, it's quite clear from the people Pinsky has interviewed that it's not just overweight people who are getting harassed here.

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BC posted on

The most shocking thing here is really that she asked the receptionist for the nutritionist's info in front of, presumably, a waiting room full of students. That is a straight up HIPPAA violation, and speaks volumes about Primary Care's ethics.

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Michael Segal posted on

One of the consequences of having health insurance is that someone else has a financial incentive to mange your health. They may do it with grace or clumsiness, but it is part of the package. In a wider sense, having your health insured by the government means that the government will start creating rules governing your personal choices; e.g., whether you can order a large soda in NYC. They are trying to achieve good results, but it can be demeaning if done wrong.

Asking someone about weight in a visit about a concussion, however, sounds very inappropriate. The practice guidelines for concussions are to minimize stress so as to minimize death of neurons in the brain. Asking about high weight could easily worsen the effect of the concussion by stimulating release of stress hormones such as cortisol.

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Anonymous posted on

"One of the consequences of having health insurance is that someone else has a financial incentive to mange your health. "

yeahhh that person is, for most barnard students, Aetna. Nurses at BPHS aren't hired by Aetna, they're hired by Barnard. Your example about the soda laws would only make sense if we were all on Medicaid or Medicare.

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Anonymous posted on

Will they weigh people backward, if asked? Even as someone with a "normal" BMI, I'd prefer to be weighed backward and then asked if I would like to know the number rather than that being the default.

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Anonymous posted on

Barnard Health is the worst service at the college (even worse than housing). The staff is not trained and they use completely inappropriate language and conduct. I have often been spoken to about my illness in the waiting room in front of everyone waiting there. I once went to there for a very severe urinary tract infection and was in so much pain. The nurse was visibly disgusted and verbalized that to me. A friend of mine also went there to get birth control and was told that she likely had chlamydia, without even receiving a test. I am happy that Paulina has shed light on this issue. Health services should be a safe space for students, not a place of embarrassment and shame.

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Anonymous posted on

I've had such mixed service there. I've been there four times and seen four different doctors--two were wonderful women who made me feel very comfortable and safe, moreso than any other healthcare providers I've seen, and two were completely callous and unhelpful. When the birth control I got there made me severely depressed and I had to go off it, I asked about other potential medications and was told to stick it out for a couple more months until the effects wore off (I was skipping classes because I couldn't motivate myself to get out of bed, crying at the drop of a hat, etc). The other time, I showed up extremely sick before they opened (didn't bother to check the hours because I was so addled/alarmed about my symptoms) and the secretary + doctor opening were totally insensitive, let me know how annoyed they were that I showed up early, and refused to offer me any help before they officially opened in 15 or so minutes. I understand that maybe they have to wait... but they were literally yelling at a sick student who was willing to wait for their help.

PS I should be exempt from their health care insurance but have to buy it anyway because they won't recognize mine so #lol

PPS I've never been weighed there, which is weird, and also everything described in this oped is fucked up

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wat posted on

"We have a new policy that states that if your BMI is overweight, you have to be tested for diabetes.”

are you fucking kidding me

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Anonymous posted on

Giving someone facts is not being insensitive. If your are overweight you are overweight. Theres nothing wrong with it in any other sense in that it is a predictor for diseases. If you measure your worth by your weight then you need to learn to deal with it. Like if I was a person who measured myself by money and therefore never did any finances or taxes becuase I was too ashamed of my income then thats my problem not anyone elses

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Anonymous posted on

"If you measure your worth by your weight then you need to learn to deal with it."

Wow. That is exceptionally insensitive, especially considering that the author has admitted to having an eating disorder. Telling a person who is recovering from an eating disorder that she is overweight could cause her to revert back to her disorder—which, in case you forgot, is a LIFE THREATENING DISEASE.

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Anonymous posted on

But then what can and cant you tell people. Like its not as if they are publishing the weight of this person for everyone to read, it is only being seen by the person. There are so many situations where you have to see information that is the truth but is hard to swallow: Rejection letters, salaries, bad grades, death of a family member. All of these have been known to lead to severe depression and suicide but that doesn't stop them from being shown to an individual. Like you cant expect advertising companies to not advertise alcohol cause recovering alcoholics might get tempted to drink again. I am not trying to devalue the seriousness of an eating disorder the same way I would not devalue alcoholism, and I would do everything to support someone who has it and help them out of it. But if a person is overweight they are overweight and they have to come to terms with it in a healthy way and either accept it and realize that it doesn't matter or work towards making it better somehow

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Anonymous posted on

But then what can and cant you tell people. Like its not as if they are publishing the weight of this person for everyone to read, it is only being seen by the person. There are so many situations where you have to see information that is the truth but is hard to swallow: Rejection letters, salaries, bad grades, death of a family member. All of these have been known to lead to severe depression and suicide but that doesn't stop them from being shown to an individual. Like you cant expect advertising companies to not advertise alcohol cause recovering alcoholics might get tempted to drink again. I am not trying to devalue the seriousness of an eating disorder the same way I would not devalue alcoholism, and I would do everything to support someone who has it and help them out of it. But if a person is overweight they are overweight and they have to come to terms with it in a healthy way and either accept it and realize that it doesn't matter or work towards making it better somehow

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Anonymous posted on

But then what can and cant you tell people. Like its not as if they are publishing the weight of this person for everyone to read, it is only being seen by the person. There are so many situations where you have to see information that is the truth but is hard to swallow: Rejection letters, salaries, bad grades, death of a family member. All of these have been known to lead to severe depression and suicide but that doesn't stop them from being shown to an individual. Like you cant expect advertising companies to not advertise alcohol cause recovering alcoholics might get tempted to drink again. I am not trying to devalue the seriousness of an eating disorder the same way I would not devalue alcoholism, and I would do everything to support someone who has it and help them out of it. But if a person is overweight they are overweight and they have to come to terms with it in a healthy way and either accept it and realize that it doesn't matter or work towards making it better somehow

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Barnard '15 posted on

First, I want to say to the larger Barnard community that health services is totally welcome to hearing critiques (maybe not at the time, that could be scary for the student, but after it going directly to MJ whenever one feel comfortable). Regarding weighing: I have a serious history of eating disorders and have never been weighed any of the many times I've been to health services. All of my friends that get weighed ask to not be told the number, and their health care provider has been happy to not tell them/weigh them blind (looking away from the numbers). Finally, all health care provider and any health services is different. If you find one that listens to your requests to not know your weight, or whatever specific request you have, stick with that person. You can make appointments with specific people and (in general) its a good idea to see the same provider as a simulated primary care doctor. There are many services that are open to critique, hearing qualms, critiques, or even praises at Barnard (specifically health related) and I can say that they are HOPING to hear from students. Please talk to those people in the position to help.

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Also BC '15 posted on

Who would those people be? I totes agree that a change in policy would be easy to make, if we organized and knew who to talk to. So let's do it!

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Jabba the Hutt posted on

Yes, these doctors are sooooo evil for wanting to encourage a healthy lifestyle and for their patients to avoid the health risks that are associated with being overweight. It's literally their job to evaluate patients and give them advice on what they can do to improve their health! They aren't trying to hurt anyone. If your friend did have a negative experience with a doctor (which could just as easily been a doctor having a bad day or your friend just misinterpreting her reactions), then that is truly unfortunate.
Honestly, if you are overweight, don't complain when someone says you are overweight. If it REALLY offends you that much, then maybe you should consider a change in diet or an increase in exercise or whatever to avoid the problem altogether. And if you truly believe that you're at a healthy weight and that you don't need to consider a change, then why the fuck do you care if the doctor recommends it? A doctor's job is to objectively treat patients...why do you expect them to sugarcoat it? If my dentist tells me that I need to floss more (we've all been there) I just get over it and consider flossing more...I don't go on tumblr and whine about how the mean dentist hurt my feelings by telling me the truth.

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THANK YOU posted on

for posting this. although i never experienced this with barnard health services, i have experienced insensitive and messed up questioning when i come in with an unrelated health issue. one time i went in with bacterial vaginosis (a super common vaginal infection--not even a sti) and was confronted with a slew of really shaming questions about how many partners i had, who they were, and, flat out, if i had been forced to have sex and if that is why i was there. OBVIOUSLY i was there for 3 fucking pills to make the infection go away but came out triggered and pressured to answer questions about times in my life in which i have experienced sexual violence. i almost considered writing an op-ed about it but didn't. a friend told me that they were supposed to inform me that i was never obligated to answer those questions but never did.

i know this is slightly different, but it feels really relevant to the way in which they can be so insensitive and shameful to students who come in with medical needs.

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Anxious posted on

I have an anxiety disorder, at times have struggled with drug abuse and addiction, and am diagnosed ADHD, so I sympathize with your battles, as what are normal, everyday experiences for an average person can leave us in a state of complete panic and can trigger past behaviors.

Perhaps one of the hardest things for me is to actually take the medications that I need to keep me balanced and healthy, as pill bottles, pills—even little things like the sound of the cap when I open one of the bottles—can be triggering and anxiety-producing. It's tough, taxing, and I wish there was another way, any other way, for my meds to be given to me, but there isn't, and I have to accept that. Foregoing the process altogether, while it is an option, would be a horrific decision for me to make and would almost certainly lead to a medical crisis.

So I sympathize with your struggle and with the feelings you've expressed in this letter, and it absolutely sounds like the nurse in question was rude, insensitive, and a shitty healthcare "professional".

But that being said, it is no more immoral for her to weigh you than it is for my pharmacist to put my meds in a little orange pill bottle. Does it feel oppressive at times? Fuck yes. But this feeling is irrational, not the policy of my pharmacist or of Barnard Health Services. You have to check your weight, and I have to take my meds—these processes may suck for us, but that doesn't mean they're automatically bad, or that the instigators are cruel or insensitive.

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Anonymous posted on

I have an anxiety disorder, at times have struggled with drug abuse and addiction, and am diagnosed ADHD, so I sympathize with your battles, as what are normal, everyday experiences for an average person can leave us in a state of complete panic and can trigger past behaviors.

Perhaps one of the hardest things for me is to actually take the medications that I need to keep me balanced and healthy, as pill bottles, pills—even little things like the sound of the cap when I open one of the bottles—can be triggering and anxiety-producing. It's tough, taxing, and I wish there was another way, any other way, for my meds to be given to me, but there isn't, and I have to accept that. Foregoing the process altogether, while it is an option, would be a horrific decision for me to make and would almost certainly lead to a medical crisis.

So I sympathize with your struggle and with the feelings you've expressed in this letter, and it absolutely sounds like the nurse in question was rude, insensitive, and a shitty healthcare "professional".

But that being said, it is no more immoral for her to weigh you than it is for my pharmacist to put my meds in a little orange pill bottle. Does it feel oppressive at times? Fuck yes. But this feeling is irrational, not the policy of my pharmacist or of Barnard Health Services. You have to check your weight, and I have to take my meds—these processes may suck for us, but that doesn't mean they're automatically bad, or that the instigators are cruel or insensitive.

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PCHS and Furman Counseling posted on

Have both made extensive issues about my minor body image issues. Yes, sometimes I diet. Yes, sometimes I work out 5 days a week. Other days I eat cookies for breakfast and don't work out for 2 weeks. Whatever, I do what I can to be healthyish and they have made my confident self think twice before doing things like running and baking that make me happy because they have extreme concerns about my diet. I didn't honestly worry about it until they made a huge deal about it-and now I feel guilty just thinking about food-as if it isn't healthy to think about my next meal during a boring lecture class.
My therapist forced me to make an appt at PCHS to get a general check up and hounded me about my weight and height and BMI... I will say Marjorie seidenfeld at PCHS did weigh me, she told me to face the other direction and didn't read my weight out to me bc I said I didn't want to know. So take THAT, Furman. The number on the scale doesn't matter if I feel good in my own skin. Which, you know, as a bold and strong Barnard girl I feel hella fine all the time.

Okay rant over. But Paulina- I'm sorry you've had such a shitty experience with PCHS, you're definitely not alone. And girl you knowwwww you look good, so don't let them drag you down that path.

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Anonymous posted on

I went to barnard health services for a study abroad check up/birth control...I was informed that my BMI was "technically overweight" and that I should lose "15 or 20 pounds" to be within "healthy" range. Okay. I tried to explain that I had actually lost a lot of weight a year ago- this is kind of where things have stopped- and that I was perfectly healthy. RN repeated that I should lose 15-20 pounds anyway. Believe me, a huge majority of people who grew up "overweight" have been hearing "healthy diet" "exercise" and some version of "you should lose weight" for their entire lives. I don't need you to bring it up randomly. I'm thinking about my body all the time anyway so thanks

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Anonymous posted on

The point here isn't even about body-shaming specifically--it's about a lack of sensitivity training for health staff. I go to Columbia so I've never used Health Services at Barnard, but when I went to Columbia Health Services because I was sick, my (incidentally male) doctor WOULDN'T BELIEVE ME when I said I wasn't sexually active. He kept insisting I could tell him anything and that activities other than intercourse are considered sexual activity etc. and when I continued to insist I wasn't sexually active, he raised his eyebrow at me. Like gee, thanks a lot for making me feel like a complete loser.

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Sam posted on

This is the kind of crap that f's with your head. Like we don't know we might be overweight. So we need to hear it from you, a professional. Wth. I wish doctors would get a clue and some sensitivity.

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