Article Date: 4/1/2010

Did You Just Call Me Fat?
Patient's Perspective

Did You Just Call Me Fat?

One optometrist dares to go there — and gets his patient a potentially life-saving diagnosis.

By Renee Bates, as told to Erin Murphy, Associate Editor

When I moved from Massachusetts to South Carolina, the shrimp, grits and local barbecue joints helped cushion the painful loss of my beloved clam chowder and Portuguese bakeries. But the transition wasn't entirely smooth. The movers scratched my grandmother's side-board, the cat hid fora week and I realized I needed new glasses.

I'd always been farsighted, and I'd gotten a new prescription just 6 months before, so it was strange that I needed another one already. My new optometrist had me fill out more paperwork than my old one, with more details about my health and family history. Unfortunately, a woman weighed me and took my height as well. (The scale is not my friend.)

In the exam room, the doctor looked over my chart. “It says here that your mother has diabetes. At what age was she diagnosed?” the doctor asked. “Fifty-two,” I answered.

As he looked at my eyes, I asked, “Could the stress of moving affect my vision?”

“It's unusual for a prescription to change this significantly in this short a time period,” the doctor told me. “Before we get you new eyeglasses, I'm going to refer you to your family doctor for some tests. I know you're only 39, but you have some risk factors for diabetes, and it's best to get you tested just to rule it out. Diabetes can cause sudden vision changes.”

Well, this was not what I wanted to hear. I just wanted to get my new glasses and get out. “I feel fine,” I told him. “I think maybe it's all the driving and paper-work I've been doing….”

“It may not be diabetes,” the doctor told me again. “But you have some risk factors. Your mother had diabetes, African Americans have a higher incidence of diabetes, and your BMI is high.”

“What's my BMI?” I asked.

“It's 38.3,” he answered.

“No, I mean, what does BMI mean?”

“It's your body mass index,” he explained. “Yours is well into the obese range — Obese Class II — and that's a risk factor for diabetes.”

Yes, he said it. My ears did not deceive me. He just came right out and called me fat — Obese Class II, in fact. I know nobody is confusing me with Halle Berry, but I'm not inclined to listen to some stranger point out my weight problem instead of just giving me new glasses.

“Renee,” he continued. “We don't know anything for sure at this point, but this is a really unusual change in vision. I want to be sure nothing is wrong instead of just giving you a new prescription. If there's an issue with your blood sugar, then correcting it could actually correct your vision problem. I've been tested before –it's a simple test, no big deal.”

It felt like a big deal. I went to the doctor, just as The Man Who Called Me Fat to My Face recommended, and the result was positive. I have mild type II diabetes. My doctor prescribed medication, and I've cut back on the shrimp and grits and a lot of other things.

I returned to the optometrist after a few weeks, and my vision was fine again, just as the optometrist had predicted. His words definitely stung, but I'm glad he's thorough. No one had ever recommended diabetes testing for me before … maybe because no one wanted to point out my weight problem. Many people have diabetes and don't know it, and that's dangerous — even more dangerous than telling a lady she's fat. nOD

Editor's note: Periodically, new OD will explore eye care from the patient's perspective. Whether you have a special interest in contact lenses, low vision or pediatric care, you'll find out from real patients what attracts them to a practice and keeps them coming back.

Optometric Management, Issue: April 2010