Illustration: © Anastasia / Adobe Stock.
When a clinician brushes aside your symptoms, it can be hard to find the words to push back. Pain, fatigue and the fear of being labelled difficult can make that conversation harder still.
If you feel medically gaslighted, ask for your concern to be addressed, the reasoning behind the assessment, and a clear plan for what happens next. You can request that unresolved symptoms are recorded, seek another opinion, or ask someone you trust to help you communicate. You do not have to prove that a clinician intended to dismiss you before asking for better care.
This page brings together practical guidance from URevolution’s editorial team and Miriam Swallow Adler’s original account of weight-related dismissal. Her story describes her circumstances when she first wrote it; it is not an update on her current health.
Content note: the personal account discusses disordered eating and purging.
What is medical gaslighting?
People use “medical gaslighting” to describe healthcare encounters in which their symptoms or concerns are dismissed or minimised, sometimes leaving them doubting their own experience. The term can name something patients have struggled to explain: leaving an appointment feeling that the problem is their credibility rather than their health.
That does not tell us what a particular clinician intended. A missed diagnosis, disagreement about a test, or discussion of mental health does not by itself establish gaslighting. A clinician can reasonably be uncertain, recommend against a test, or consider psychological factors while still listening and explaining their assessment.
The useful question is whether your concerns have been considered and whether you understand the next steps. You can ask for both even if you are unsure what to call the encounter.
How to respond to medical gaslighting in the appointment
The following phrases are suggested wording, not quotations from patients or clinicians. Choose what feels usable. Reading from your phone, handing over a note or asking a supporter to speak with your permission are all ways to take part.
Say which concern has been left unanswered
“I’m worried we haven’t addressed the pain I came in about. Can we return to that before we finish?”
If explaining everything feels impossible, name one concrete effect: a symptom is waking you at night, preventing you from working, or making an ordinary task difficult. You should not have to perform distress to be believed. The point is to make the unresolved concern clear.
Ask how the clinician reached their assessment
“What makes you think this explains my symptoms? What other possibilities have you considered?”
If a test or referral is declined, try: “Could you explain why it wouldn’t be useful now, and what would change that decision?”
This asks for clinical reasoning without assuming that every requested investigation is necessary. You can disagree and still ask for an explanation you understand.
Bring the conversation back from weight or mental health to the symptom
“I’m willing to discuss my weight, but I also need this symptom assessed. What is the plan for it?”
Or: “Can we discuss how you reached the conclusion that anxiety explains this, and what follow-up is needed if it continues?”
Weight and mental health may be relevant to care. Their mention should not end the conversation about the concern you brought. Miriam’s account below shows what it felt like when weight became the repeated answer to very different problems.
Ask for the unresolved concern and plan to be recorded
“Please include this symptom, its effect on my daily life, and the next steps in my notes.”
You can also ask how to get a copy of the consultation record or letter. Asking for documentation is a way to support continuity of care. It is not a guarantee that a particular test will be ordered.
Leave with a follow-up plan
“If this doesn’t improve, when should I come back? What changes mean I should seek urgent help, and who should I contact?”
A plan can include monitoring, treatment, further investigation or another appointment. What matters is understanding it. The NHS appointment checklist includes questions about next steps and who to contact if things get worse.
If you have severe or rapidly worsening symptoms, seek urgent medical assessment rather than waiting to resolve a disagreement or complaint.
What if you freeze, cry or cannot challenge the doctor?
You have not failed. An appointment can involve a large power imbalance, especially when you depend on that service for ongoing care.
You can return to the issue later. A short message might say:
At my appointment on [date], I raised [symptom]. I’m still concerned because [effect or change]. Please could you clarify the assessment and arrange appropriate follow-up? I would also like the unresolved concern included in my record.
Ask the service what communication support it can provide. You might need an interpreter, written information, time to process a question, or someone beside you to take notes. A supporter should help you express your wishes rather than take over the conversation.
Preparation can help, but respectful care must not depend on a patient being organised, articulate or calm. For broader preparation, read Helene M. Epstein’s guide to getting a doctor to take your concerns seriously.
What to do after a dismissive appointment
Write down what happened while it is fresh: the date, your concern, the response and any agreed next steps. Keep your own account separate from the clinician’s record so that you can identify an omission or misunderstanding.
If trust has broken down, ask whether another clinician can review the concern. Access to a second opinion or a different service depends on your healthcare system, referrals, insurance and availability. Changing doctors is not always a quick or affordable option.
You can also ask the practice or hospital how to raise a concern. Explain what happened and what you want addressed, such as an explanation, review of an unresolved symptom, or correction of an inaccurate record. In England, Patient Advice and Liaison Services (PALS) can help with NHS concerns and explain complaint routes. Elsewhere, ask about the local patient liaison or complaints service.
A complaint and getting care are separate tasks. Continue seeking appropriate assessment while a complaint is considered.
When “lose weight” became the answer to everything
Miriam Swallow Adler’s personal account, edited for clarity from the original essay.
I suspect I had been dealing with an eating disorder throughout my teenage years and into adulthood. Being dismissed by healthcare professionals made it harder to get help.
During one of my psychiatric assessments, I noticed the psychiatrist scrawling down “ED???” in big letters and circling it repeatedly. These assessments were already traumatic. Every time I spoke, I felt as though I was regressing in my recovery and reliving past traumas.
We discussed my sleeping and eating habits. I mustered the courage to admit that there were times when I would forget to eat for several days and sometimes make myself regurgitate meals. I thought this was just a student thing. I did not realise it could indicate a problem with my eating that needed attention.
At the time I wrote this, I had never received a formal eating disorder diagnosis. I wondered whether my weight played a role: my BMI placed me in the category described as obese. But my weight should not have invalidated my struggles or the harm I was causing myself.
I had low self-esteem about my body. My eating patterns worried me. I would miss meals and sometimes purge after eating at a restaurant because I felt too full. I worried that my relationship with food would deteriorate further.
To my disappointment, the medical professionals in my life did not seem too concerned, despite knowing about the purging. They kept pressuring me to lose weight. That emphasis overshadowed my concerns about disordered eating and other health problems. It felt like medical gaslighting: my concerns were dismissed, and everything was attributed to my weight.
I was also experiencing chronic pain and recurring injuries that went undiagnosed for an extended period. Whenever I sought help for the pain, the response was consistently, “Lose weight, and you’ll feel better.”
It was infuriating. I felt that the injuries and pain I was describing were being overlooked. Weight loss seemed to be the only advice I received, regardless of its psychological, emotional or physical cost.
I demanded that my disordered eating be recognised as a problem, but it fell on deaf ears. How far did I have to go before they took notice? Was there a cutoff point, and did it depend on kilograms lost?
When would they recognise that my self-loathing needed attention rather than treating it as something expected or normal? Why were missed meals and crash diets not met with concern?
I want us to stop assuming that weight loss is always good news. Ask people how they are doing. Give them room to answer. There may be something happening that you cannot see.
Eating concerns deserve attention at any body size
Miriam’s account is a personal testimony, not a retrospective clinical diagnosis. Her uncertainty about a diagnosis does not make the concerns she reported unimportant.
NICE’s eating disorder guidance, recommendation 1.2.8, says that BMI or illness duration alone should not determine whether someone is offered treatment. If you are worried about your eating, restriction or purging, seek professional assessment; you do not need to wait for your body to look a particular way before asking for help.
For related reporting on weight-focused dismissal, read women’s health issues and the trouble with “just lose weight”.
Do you have to tell the doctor they are gaslighting you?
No. You can use the term if it helps express what happened, but you can also say, “I don’t feel my concern has been heard,” and ask for an explanation or follow-up. Choose the approach that feels safe and workable for you. No phrase can guarantee a good response.
You deserve care that takes your account seriously, including when the cause of your symptoms is still uncertain.
Sources and editorial credit
The practical sections were prepared by URevolution’s editorial team; Miriam Swallow Adler remains the author of the personal account. Suggested scripts are editorial examples. This page has not received a clinical review.
- Harvard Health: What to do about medical gaslighting.
- NHS: What to ask your doctor or other healthcare professional.
- NHS: What is PALS?.
- NICE NG69: Eating disorders, recognition and treatment, recommendation 1.2.8.
Originally published 11 August 2018. Revised 3 October 2026.
