On the TODAY show recently, a woman in LA told the story of going to her doctor for stomach pain and severe back pain. She was told there was nothing wrong, not to worry, and that she just needed to lose weight. For four years, she kept going to her providers with the same complaints and was told the same thing. Her symptoms became more severe, she started losing her hair, and still she was told that she “had to learn to live with it”. The woman described how she slowly began to believe it. She thought maybe she was crazy. When she ended up in the ER, she finally learned the truth. She had a 25-lb cancerous ovarian tumor, which luckily the doctors were able to remove.

This woman was a victim of ‘medical gaslighting’. This is what happens when medical professionals dismiss your symptoms or complaints; they don’t take you seriously, they blame your symptoms on something vague like “stress”, they deny tests or treatment, and send you home with the wrong diagnosis. (The term gaslighting comes from a 1944 Ingrid Bergman film in which the husband psychologically manipulates his wife into thinking she’s going crazy).

Medical gaslighting is much more common in women, minorities, and people with obesity. Over 25% of women responding to a recent survey indicated that a healthcare provider had ignored or dismissed their symptoms. People who have experienced this state that they are more likely to distrust doctors.

Let’s go back to the issue of weight. In a study of 4700 medical students in the US, 67% showed explicit weight bias, which means they were consciously aware that they had negative feelings about overweight and obese people. This is true of doctors currently in practice also, not just medical students. And because of this, overweight people are more likely to have their complaints and symptoms automatically attributed to their weight. They are more likely to be told to go home, eat better, and lose weight than to have the proper diagnostic tests run to evaluate the problem at hand. Because of this, patients who have been a victim of a doctor’s weight bias may not seek medical care when they need it. And that’s dangerous.

So, when we are victims of medical gaslighting, we end up hearing suggestions such as these: “you’re just too stressed”, “maybe you should take some time off to relax a little, maybe try some meditation” (in other words, it’s all in your head), “cut back on your caffeine”, “go to sleep earlier”, “it’s just gas”, and of course, “lose some weight”. How do we combat this? What do we do when a doctor tries to gaslight us? Don’t get me wrong, there are many times when the advice to lose weight, lower the stress level, and get more sleep is exactly the right advice. All of them are important for one’s health. But what about when a doctor dismisses a legitimate health concern?

First, let’s talk about what NOT to do. It’s easy, but counterproductive, to fall victim to these thoughts:

• I don’t want to disappoint my doctor
• I don’t want to make my doctor angry
• Who am I to question my doctor? He/She is the one with the medical degree
• I hate confrontation, I just want them to like me

What you DO need to realize is this. Good medicine is based on teamwork. You are an important member of that team. You know your body better than any medical professional. You know what is normal for you. Remind your doctor, respectfully, that while you appreciate their expertise, you are the expert when it comes to your body, what’s normal and what’s not. And you are in the doctor’s office at that moment because you feel something is not right and you want to find the cause of it and you need their help. Insist on having the appropriate diagnostic tests run, and ask what those would be. If you’ve been written off with a suggestion such as “lose weight” or “get more sleep”, and you believe there is more going on, say so. Tell your doctor that you think there is more to your problem than what he/she has suggested, and again, ask what other things could be considered as the cause.

If your symptoms are affecting your quality of life, say so, and insist on being worked up. If your doctor still resists, seek a second opinion, and if necessary, a third. Don’t stop pursuing answers until you are satisfied, until you have the answers you need. Ultimately, this is an issue of communication but it is also an issue of trust. You should be able to trust your doctor, but if he dismisses your valid concerns, you have to be able to trust yourself. Remember that you know your body the best, and if something is not normal, you should trust your own intuition. If you’re not being listened to, get another opinion. Don’t be afraid of hurt feelings. A good doctor doesn’t get their feelings hurt when a patient seeks a second opinion. You deserve to be taken seriously.

There was an episode of the long-running television series The Golden Girls years ago that beautifully illustrates this issue. The character Dorothy is not feeling well for months, sees a doctor who tells her its “all in her head”, she’s just getting older and he suggests that she color her hair to make herself feel better. She gets another opinion and is told she actually has chronic fatigue syndrome. Later, she sees the first doctor in a restaurant, approaches him and tells him off for not listening to her. For victims of medical gaslighting, the scene is wonderfully cathartic.

Ultimately, we need a medical system in which people never feel hesitant to seek help and in which good communication is more highly valued. Until that day, we need to advocate for ourselves and to feel empowered in doing so.