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Statements such as “A little fat is part of being a woman, you have to live with it” are often a reality in today’s healthcare system. “Medical gaslighting” is a serious phenomenon that occurs when medical professionals ignore or play down the symptoms of their patients. This has been proven by numerous studies, such as the Armstrong K. (2021) study by renowned international institutes (see end of text). Not only are those affected further unsettled, the resulting misdiagnoses can have fatal consequences – for example, if the necessary treatment is started far too late or is not provided at all. Medical gaslighting presents patients with the problem of having to fight for recognition of their complaints.
In this blog post, we look at the causes and background to medical gaslighting, explain which groups of people are particularly affected and what measures you can take. We would like to encourage you to listen to your body’s signals and not allow yourself to be rejected.
Have you ever been to a doctor’s surgery for pain or other ailments and not been taken seriously? Perhaps your complaints were simply talked down, treated as stress or psychosomatic? Did you have the feeling that you were seeing the wrong doctor? Then this could be a case of medical gaslighting. This describes the not-so-rare occurrence when doctors misjudge and trivialize their patients’ symptoms.
In Germany, the term gaslighting became known through the 1960 TV movie “Gaslicht”. In it, a businessman manipulates his wife with psychological tricks to make her appear mentally ill. Among other things, he turns down the gaslight in the apartment and explains that she is only imagining the flickering.
This gave rise to the technical term gaslighting for the deliberate psychological deception of another person. Medical gaslighting is a special form of this manipulation. It occurs when medical professionals downgrade pain as normal or less severe, for example. This effect is particularly common with diseases that have not yet been widely researched or are associated with unspecific general symptoms, as is often the case with Lipedema.
It is important to understand that medical gaslighting is not a deliberate attempt to influence the doctor. Rather, the effect can be caused by a misjudgment on the part of the specialist. The reasons for this are varied and often result from a combination of different causes – with serious consequences for the patient.
In our modern world, time is a limiting factor that influences a careful and clear diagnosis. Due to tight budgets and at the same time many consultations, doctors, especially those with statutory health insurance, usually only have a few minutes to listen to the concerns and needs of their patients and to recognize and correctly classify the symptoms.
Due to the lack of time available for patient care and budget constraints, often only a superficial examination is possible. An intensive search for the cause of the symptoms or adequate care is therefore often not provided. Ambiguous symptoms exacerbate this problem.
Doctors often exude the authority of an expert, which can have such an intimidating effect on patients that they do not question their diagnosis. This weakens the patient’s own symptoms. A lack of self-confidence and sudden doubts about the symptoms lead to a breakdown in the relationship of trust between doctor and patient.
Medical gaslighting is also driven by unconscious bias. This particularly affects people from other cultures, LGBTQ people, overweight and older people and men with mental illnesses. These groups of people often experience different or unequal healthcare. This also applies to women in general. In medical terminology, this is referred to as the “gender health gap”, the imbalance in the medical treatment of women compared to men.
This has arisen because medical research often only takes into account the experiences of male patients. The specific needs of women are often ignored. For example, the symptoms of a heart attack in women differ significantly from those in men. This is described in detail in the study “Gender Aspects in Cardiovascular Pharmacology” by the authors Sabine Oertelt-Prigione and Vera Regitz-Zagrosek. The paper was published in the Journal of Cardiovascular Pharmacology and Therapeutics, 17(1) 2012, pages 40-47.
Little-researched diseases with similar or almost identical symptoms can also cause the medical gaslighting effect. Such differential diagnoses (DD) must also be considered by the doctor as a possible cause of the patient’s symptoms. This means that doctors should consider all possible diagnoses as an alternative explanation for the symptoms or findings.
In general, women are judged on their appearance much more often than men. Obesity or fat shaming is a common reason why they are teased and devalued in their environment. The discrimination ranges from pointed remarks to nasty insults, bullying and exclusion. It takes place both online and in real life.
Doctors are not exempt from these prejudices either. This is demonstrated, for example, by the study “Impact of Weight Bias and Stigma on Quality of Care and Outcomes for Patients with Obesity” by the authors Phelan, Burgess, Yeazel, Hellerstedt, Griffin and van Ryn, published in Obesity Reviews 16(4) 2015, page 319-326.
Medical gaslighting – or the doctor ignoring the complaints – can occur in almost all areas of health. This is also referred to as invisible illnesses. For example, severe weight loss or weight gain that is dismissed as normal menopausal symptoms, but which may actually be a thyroid disorder. Other examples can be found in diseases that have been little researched to date, such as endometriosis. This is an often painful and usually chronic disease of the lining of the uterus. Polycystic ovary syndrome (PCOS), which is based on a complex dysfunction of the ovaries, is also difficult to diagnose. The symptoms associated with these diseases are often classified as psychological and therefore treated inadequately or incorrectly.
A good example of medical gaslighting is unrecognized Lipedema. This is a chronic fat distribution disorder that occurs predominantly on the arms and legs and mostly affects women. The disease is associated with physical, psychological and aesthetic restrictions, which can occur to a considerable extent. In fact, affected patients often struggle to have their symptoms recognized as a serious condition at any stage of Lipedema. If the problems in the early stages are considered to be of minor importance, they can later be wrongly diagnosed as obese. An early diagnosis and a rapid start to treatment can have a positive influence on recovery.
Instead, the fat deposits are classified as normal excess weight, explained away as psychological difficulties or lack of exercise or simply dismissed as a cosmetic problem. A misdiagnosis of Lipedema can quickly lead to social stigmatization, which begins in the personal environment of affected women. Social expectations of female bodies and supposed ideals of beauty are high and convey a false image to the public. The (social) media, which disseminate these unrealistic beauty standards, often contribute to this. This leads to a high level of psychological pressure to conform to these ideals, which exacerbates the complaints of Lipedema patients.
It is therefore not only the doctors’ job to make a reliable diagnosis, but also to relieve their patients of their feelings of guilt. After all, they have no influence on the disease, which can have many causes. Lipedema with abnormally altered fat cells cannot be eradicated by exercise, diet or a healthy lifestyle. Your doctor should take your symptoms seriously and help you to solve the problem. However, the opposite of this, medical gaslighting, is out of place here.
The fight against medical gaslighting starts with your own psyche. You have to realize that this phenomenon exists and you are allowed to doubt the doctor’s word if you disagree. It helps to follow your own intuition and statements such as “it’s just stress or the psyche” or that “pain is part of life and getting older” are not profound diagnoses. Unfortunately, they only serve to unsettle you and make you doubt yourself, but they won’t get you one step further.
So if you feel that your doctor is not taking you seriously, don’t be afraid to get a second opinion from another specialist – especially when it comes to a Lipedema diagnosis. You should also know that you are not alone in your situation and that there are many like-minded people with similar problems. Sharing experiences with others and reading testimonials will help you to assess yourself objectively.
The Lipedema COMMUNITY from LIPOCURA® on Instagram
If you feel that your complaints have not been taken seriously by a doctor or that you have perceived the comments as patronizing or even insulting, you can make an official complaint. The relevant state medical association will accept such complaints. The chambers check that medical professionals comply with the professional code of conduct. The Medical Profession and Chamber Act of the respective federal state applies.
More than almost any other condition, Lipedema is often confused with other health problems, such as normal weight gain. An increase in fatty tissue in certain areas of the body can also occur with lipohypertension. In contrast to Lipedema, however, the increase in subcutaneous fatty tissue is usually painless, which is an important indicator for a correct diagnosis. In addition, other metabolic disorders such as a malfunction of the thyroid gland can also lead to an altered fat distribution in the body.
Clear identification of Lipedema is also made more difficult by the fact that this is a disease that has been little researched to date. Studies are practically only just beginning. There are correspondingly few diagnostic standards available, which are not yet part of medical studies. For these reasons, many general practitioners in particular lack specific knowledge about Lipedema, meaning that it is often not possible to take a comprehensive medical history.
Choosing the right doctor is therefore of crucial importance for affected patients. In the vast majority of cases, only a specialist will be able to make an accurate diagnosis of Lipedema and initiate treatment. Medical specialists with special training in the diagnosis of Lipedema include, for example, lymphologists, phlebologists and specialists in plastic and aesthetic surgery. Medical professionals with experience in Lipedema can differentiate the specific clinical picture from others through a series of specific examinations. These include the pinch test, Stemmer’s sign, palpation, ultrasound and cross-sectional imaging (CT and MRI).
Early diagnosis is crucial for starting treatment to alleviate Lipedema symptoms. Lipedema that is diagnosed late or left untreated at an advanced stage can lead to an increase in symptoms. This can lead to further complications in everyday life, making treatment more difficult.
In order to increase the chances of recovery, it is important that the diagnosis is made as early as possible by an experienced specialist who is able to recognize the typical characteristics of the disease and distinguish it from other clinical pictures. In this context, many patients already have a long history of suffering behind them. They often feel misunderstood and left alone by doctors who have downplayed or misclassified their symptoms.
Are you one of the women who suffer from Lipedema that was not recognized or recognized late? Then you should not despair or think that nothing more can be done. If your doctor has ignored your symptoms, get a second opinion. Because no matter what stage you are at, treatment to alleviate the symptoms or even achieve a pain-free and aesthetic result can be started at any time. All you have to do is take the first step in the right direction.
If you are looking for a reliable and understanding partner for the diagnosis and treatment of Lipedema, then we would like to recommend the competence centers of LIPOCURA®. We have been a leader in the holistic treatment of Lipedema for over 15 years. Every year, our specialists perform around 1,500 liposuctions for Lipedema (minimally invasive liposuction) at our various locations. You can therefore rely on our many years of experience and our extensive expertise.
With each individual treatment, our focus is on improving your overall health and aesthetic situation and thus increasing your quality of life. We treat you with complete impartiality and take you and your complaints seriously. We will be happy to assist you and provide you with detailed consultation.
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Armstrong, K. (2021). Medical Gaslighting: The Intersection of Race and Gender in Healthcare. Journal of Health Disparities Research and Practice, 14(2), 124-139.
Applebaum, A. J., & Breitbart, W. (2013). Care for the cancer caregiver: A systematic review. Palliative & Supportive Care, 11(3), 231-252.
Bonvicini, K. A., & Perlin, M. J. (2016). The Surprising Impact of Communication Skills Training on Health Care Professionals’ Confidence, Patient Satisfaction, and Perceived Quality of Care. Patient Education and Counseling, 99(4), 617-620.
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From Dr. med. Katrin Lossagk
From LIPOCOACH® | Pia
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