Help me deal with this doctor's comments about my weight.
March 8, 2017 11:39 PM
Today I saw a doctor who suggested I lose weight.
I have a history of an eating disorder and my BMI is healthy. However, I've got an apple shape and tend to carry weight around my middle, which led to the doctor's comments.
I saw my dietitian last week, who said my exercise / eating habits were good, and that my BMI was in the middle of the healthy range. Both my dietitian and psychiatrist don't think I need (or should) lose weight.
I've had a pretty awful past couple of months and I'm feeling very emotional at the moment.
So: how do I best deal with these comments and avoid relapsing?
What I don't want please: Diet or weight loss suggestions.
I saw my dietitian last week, who said my exercise / eating habits were good, and that my BMI was in the middle of the healthy range. Both my dietitian and psychiatrist don't think I need (or should) lose weight.
I've had a pretty awful past couple of months and I'm feeling very emotional at the moment.
So: how do I best deal with these comments and avoid relapsing?
What I don't want please: Diet or weight loss suggestions.
Get a good night's sleep, do your self-care. Treat it the way you would treat a minor fender bender - if your other doctors say you are fine, remember it is not about you but about them (the doctor). And if you feel like you're going to relapse, maybe it's time to schedule a therapy appointment!
posted by benadryl at 11:57 PM on March 8, 2017
posted by benadryl at 11:57 PM on March 8, 2017
Find a new doctor. You are under the informed care of a nutrition professional and a psychiatrist, both of whom are familiar with your health status and history. Trust them. They're giving you good information based on knowing your situation.
This doctor you saw today is being careless and you should dismiss their comments. Find someone who you can trust who will make a proper diagnosis and not give advice based on shapes and loose generalities that don't even apply to you. Like any other profession, there are good doctors and not-so-good doctors. Find one who takes the time to look at your specific situation and who engenders trust.
It's always rotten to have a bad experience with a medical professional. It's often a stressful experience where we're extra vulnerable and having a negative interaction on top of that sucks. I'm sorry it happened to you. It sounds like you're making great progress with your dietician and psychiatrist. Concentrate on that and don't let this incident diminish that.
posted by quince at 12:16 AM on March 9, 2017
This doctor you saw today is being careless and you should dismiss their comments. Find someone who you can trust who will make a proper diagnosis and not give advice based on shapes and loose generalities that don't even apply to you. Like any other profession, there are good doctors and not-so-good doctors. Find one who takes the time to look at your specific situation and who engenders trust.
It's always rotten to have a bad experience with a medical professional. It's often a stressful experience where we're extra vulnerable and having a negative interaction on top of that sucks. I'm sorry it happened to you. It sounds like you're making great progress with your dietician and psychiatrist. Concentrate on that and don't let this incident diminish that.
posted by quince at 12:16 AM on March 9, 2017
FWIW, I once had an eating disorder, and was at one point so undernourished that my periods stopped. But my GP thought I could loose a bit of weight because my stomach protruded. It turned out that protruding stomach was another sign of undernourishment, and that the GP had her own food issues.
When I finally won over the anorexia, I became overweight, because other stuff also happened. My current doctor is adamant that we have to solve that "other stuff" before I even attempt at loosing weight.
So my advice to you would be to find a doctor who sees you as a whole human being and is able to prioritize which issues to tackle first. Ask around among friends and family.
posted by mumimor at 1:01 AM on March 9, 2017
When I finally won over the anorexia, I became overweight, because other stuff also happened. My current doctor is adamant that we have to solve that "other stuff" before I even attempt at loosing weight.
So my advice to you would be to find a doctor who sees you as a whole human being and is able to prioritize which issues to tackle first. Ask around among friends and family.
posted by mumimor at 1:01 AM on March 9, 2017
Can you get additional time with your therapist asap? Your mention of relapse re your eating disorder is so worrisome. I'm afraid that our best intentions may fall seriously short of your needs.
In the meantime, keep reminding yourself of your progress to date. You are seeing a psychiatrist and working with a professional who is helping you change your eating habits, i.e., you are proactively addressing/making progress regarding a notoriously difficult health issue. (And congratulations on that, btw.) And remember, the doctor who knows you better (your psychiatrist) isn't worried about your weight.
I am very surprised that your dietitian uses BMI as a reference point. It was originally intended to serve as a measure of obesity in the general population—never meant to be applied to individuals. And it has been thoroughly discredited regarding the original purpose. Not something you need to address tonight, of course, but come back to this once the crisis has passed and make sure that those monitoring your health are using valid measures.
posted by she's not there at 1:25 AM on March 9, 2017
In the meantime, keep reminding yourself of your progress to date. You are seeing a psychiatrist and working with a professional who is helping you change your eating habits, i.e., you are proactively addressing/making progress regarding a notoriously difficult health issue. (And congratulations on that, btw.) And remember, the doctor who knows you better (your psychiatrist) isn't worried about your weight.
I am very surprised that your dietitian uses BMI as a reference point. It was originally intended to serve as a measure of obesity in the general population—never meant to be applied to individuals. And it has been thoroughly discredited regarding the original purpose. Not something you need to address tonight, of course, but come back to this once the crisis has passed and make sure that those monitoring your health are using valid measures.
posted by she's not there at 1:25 AM on March 9, 2017
Aw man, I'm so sorry, I had a similar experience with a nurse, who told me my blood pressure was sure to be through the roof - this while taking my blood pressure, which then turned out to be normal. Then she said I probably needed to see a psychiatrist because I must have mental health issues because no one 'normal' could be this fat. (I do actually have anxiety issues, but she didn't say it as though she actually understood mental health issues). It made me feel really terrible, especially as I was just recovering from a horrible chest infection and I felt fragile and sad anyway. I just wanted to offer you my sympathy and empathy.
I like parmanparman's advice for sensible follow-up. Then self-care, self-care, self-care. Be kind to yourself. And if it helps, know you're not alone.
posted by Ziggy500 at 2:33 AM on March 9, 2017
I like parmanparman's advice for sensible follow-up. Then self-care, self-care, self-care. Be kind to yourself. And if it helps, know you're not alone.
posted by Ziggy500 at 2:33 AM on March 9, 2017
I would probably have a good cry, then try to shake off the doctor's comment. They do not know your history as well as your specialists do.
If you need to see the doctor again soon, maybe you could start the session by saying something like "Before we begin, I would like you do be aware that I have a history of an eating disorder. I am currently receiving excellent care and guidance from a psychiatrist and a dietician. My dietician has said that my eating habits, exercise habits and BMI are all healthy. Neither my dietician or psychiatrist have recommended that I try to lose any weight. Another doctor recently suggested that I need to lose weight, which is not a helpful suggestion at this time. I would like to request that we not discuss my weight today."
posted by kinddieserzeit at 3:02 AM on March 9, 2017
If you need to see the doctor again soon, maybe you could start the session by saying something like "Before we begin, I would like you do be aware that I have a history of an eating disorder. I am currently receiving excellent care and guidance from a psychiatrist and a dietician. My dietician has said that my eating habits, exercise habits and BMI are all healthy. Neither my dietician or psychiatrist have recommended that I try to lose any weight. Another doctor recently suggested that I need to lose weight, which is not a helpful suggestion at this time. I would like to request that we not discuss my weight today."
posted by kinddieserzeit at 3:02 AM on March 9, 2017
how do I best deal with these comments and avoid relapsing?
By treating that doctor's opinion as just that - an opinion - and giving due consideration to the extent to which that doctor's familiarity with your body and your history compares with that of the other specialists you're seeing when you're deciding how much importance to attach to that opinion.
Most doctors are good at what they do, but that doesn't make them omniscient. Sometimes they, like everybody else, are just wrong.
If you encounter a general pattern of doctors with opinions you think are just flat wrong, but those opinions are pretty much in line with each other, it would probably be a good idea to start questioning your own opinion and seeking further information to get an understanding of why that army of doctors holds their shared opinion. But that is not this. This is one general practitioner's opinion, and it disagrees with that of two other medical professionals who presumably know you rather better than that GP does.
If I were in your shoes, I would simply file those comments under "most likely ill-informed" and choose not to act on them in any way.
posted by flabdablet at 3:23 AM on March 9, 2017
By treating that doctor's opinion as just that - an opinion - and giving due consideration to the extent to which that doctor's familiarity with your body and your history compares with that of the other specialists you're seeing when you're deciding how much importance to attach to that opinion.
Most doctors are good at what they do, but that doesn't make them omniscient. Sometimes they, like everybody else, are just wrong.
If you encounter a general pattern of doctors with opinions you think are just flat wrong, but those opinions are pretty much in line with each other, it would probably be a good idea to start questioning your own opinion and seeking further information to get an understanding of why that army of doctors holds their shared opinion. But that is not this. This is one general practitioner's opinion, and it disagrees with that of two other medical professionals who presumably know you rather better than that GP does.
If I were in your shoes, I would simply file those comments under "most likely ill-informed" and choose not to act on them in any way.
posted by flabdablet at 3:23 AM on March 9, 2017
I always have to reframe conversations like this as "this is so much more about society's stance on weight than it is about my health". I'm a fat person with a significant history of disordered eating and I've had a ton of unhelpful comments from doctors in the past (guy who asked me to come in three hours ahead of schedule on the bus in the snow writing to my GP saying I looked fat in my GIANT FUCKING SNOW DAY SWEATER, asking nurses not to tell me the number on the scale and then the doctor sending me a letter with my weight and BMI in it anyway, why even bother, etc.), to the point where I've found I just have to brush off as being Not Really About Me At All.
My post-recovery post-lots-of-psychiatric-medication post-fucking-my-metabolism-for-years weight is higher than a lot of people would say is technically healthy, but it's healthier for me than engaging in eating disorder behaviours. I also find it helpful to think in terms of, "well, this conversation made me feel shitty, but not as shitty as [being cold and exhausted all the time because I'm not eating enough/other unpleasant ED-related stuff]". The way I am now is honestly healthier for me, but not everyone I meet in the medical profession is going to instantly get/agree with that because society has a lot of really fucked up ideas about bodies and food and weight. It is on me to keep myself safe and to know what's right for me, more so than any doctor can, and that means being judicious about how much relevance I assign to any one person's opinion about my body or my size.
Letting myself go on this journey has been the difference between panic-reengaging with unhealthy behaviours every time anyone implies anything less than perfect about my body, any my current state, where it's still uncomfortable but I can let it wash over me a lot more. When I got the letter with my weight and BMI in it recently, it felt shitty but I was able to go "eh, still better than starving all the time" and put it out of my mind, rather than sending myself into an instant loop of shame and disgust.
You know what's right for you. Stick with it, and don't let asshole medical providers sway you just because they're technically in a position of health authority. It's very important to remember that people working in health still often have weird ideas about what health actually is (and don't always take into account the fact that it's different for everyone for a lot of very complicated reasons), and they're not always going to be acting or speaking in your best interests.
posted by terretu at 4:14 AM on March 9, 2017
My post-recovery post-lots-of-psychiatric-medication post-fucking-my-metabolism-for-years weight is higher than a lot of people would say is technically healthy, but it's healthier for me than engaging in eating disorder behaviours. I also find it helpful to think in terms of, "well, this conversation made me feel shitty, but not as shitty as [being cold and exhausted all the time because I'm not eating enough/other unpleasant ED-related stuff]". The way I am now is honestly healthier for me, but not everyone I meet in the medical profession is going to instantly get/agree with that because society has a lot of really fucked up ideas about bodies and food and weight. It is on me to keep myself safe and to know what's right for me, more so than any doctor can, and that means being judicious about how much relevance I assign to any one person's opinion about my body or my size.
Letting myself go on this journey has been the difference between panic-reengaging with unhealthy behaviours every time anyone implies anything less than perfect about my body, any my current state, where it's still uncomfortable but I can let it wash over me a lot more. When I got the letter with my weight and BMI in it recently, it felt shitty but I was able to go "eh, still better than starving all the time" and put it out of my mind, rather than sending myself into an instant loop of shame and disgust.
You know what's right for you. Stick with it, and don't let asshole medical providers sway you just because they're technically in a position of health authority. It's very important to remember that people working in health still often have weird ideas about what health actually is (and don't always take into account the fact that it's different for everyone for a lot of very complicated reasons), and they're not always going to be acting or speaking in your best interests.
posted by terretu at 4:14 AM on March 9, 2017
You might want to ask the health professionals whose opinions you trust for suggestions for a new GP. You could also take a list of doctors on your plan to your next appointments with them, and just ask them to look through it for yeas and nays.
However, I've got an apple shape and tend to carry weight around my middle, which led to the doctor's comments.
A study about body shape and health made pretty superficial rounds on morning talk shows last week. Honestly, I think it's more likely that your doctor's comments came from watching a weak three minutes on Good Morning America.
posted by gnomeloaf at 4:28 AM on March 9, 2017
However, I've got an apple shape and tend to carry weight around my middle, which led to the doctor's comments.
A study about body shape and health made pretty superficial rounds on morning talk shows last week. Honestly, I think it's more likely that your doctor's comments came from watching a weak three minutes on Good Morning America.
posted by gnomeloaf at 4:28 AM on March 9, 2017
Ugh, I am so sorry this happened.. Fuck this. You are beautiful & healthy. I would go really easy on yourself, like just very gentle with your feelings, and do as many things that help you feel whole, healthy, beautiful, and loved. (friends, good food, movement, TV, bath... whatever allows you to feel good.) Wear the clothes and things that make you feel happy. Let yourself off the hook. Eat some gelato and sit in the sunshine.
Honestly, I don't even let myself get weighed at the doctors anymore - not since being pregnant- just fuck it, we can talk about my health in different ways, for this exact reason. It's just too stressful. I don't go to the doc that much, but it hasn't been an issue and we've been easily been able to discuss my health without needing a number or my BMI. Just something to consider,.
posted by Rocket26 at 5:57 AM on March 9, 2017
Honestly, I don't even let myself get weighed at the doctors anymore - not since being pregnant- just fuck it, we can talk about my health in different ways, for this exact reason. It's just too stressful. I don't go to the doc that much, but it hasn't been an issue and we've been easily been able to discuss my health without needing a number or my BMI. Just something to consider,.
posted by Rocket26 at 5:57 AM on March 9, 2017
Nthing the comments to get a new doctor. This one's an idiot.
It's sort of tangentially related, but I came across this set of scripts for talking to medical professionals that may be useful to you.
posted by Tamanna at 6:15 AM on March 9, 2017
It's sort of tangentially related, but I came across this set of scripts for talking to medical professionals that may be useful to you.
posted by Tamanna at 6:15 AM on March 9, 2017
That is so insanely irresponsible of the doctor. If you keep feeling bad, don't look away from that but try looking at it differently. It feels like hurt, but it's actually anger and anger directed right can make the world better--as we've just seen, actually: just look at all the people here who feel solidarity with you and recognize this for what it is because it has happened to them. Speaking out about it and seeking help and community as you've done is brave and strong. Please make a deliberate, concerted effort to turn your absolutely justified anger about this clueless bullying out and away from your dear self and at the doctor who has more than earned it.
posted by Don Pepino at 6:49 AM on March 9, 2017
posted by Don Pepino at 6:49 AM on March 9, 2017
When shopping around for a new GP (and I would after the experience you've just had), it might be beneficial to see about trying to find a doctor who's a DO rather than an MD. Nothing against MDs, but DO medical training tends to focus on a more holistic, quality-of-life view of diagnosis and care. They would probably be more likely to take a detailed medical history, which would include knowing your history with EDs and which specialists you're already seeing, and less likely to make an off-the-cuff, armchair diagnosis based on absolutely no information.
I'm so sorry this happened to you. Take care of yourself. You are healthy and your specialists agree.
posted by helloimjennsco at 7:55 AM on March 9, 2017
I'm so sorry this happened to you. Take care of yourself. You are healthy and your specialists agree.
posted by helloimjennsco at 7:55 AM on March 9, 2017
My hobby is researching health issues so I'm in a lot of groups and discussion boards on various but specific topics of health. I can't tell you how many stories I've heard of people saying that a doctor told them that they needed to lose weight and then completely blew off the patient's actual reasons for the visit.
Weight is commonly a side-symptom of underlying issues, and once those issues are properly addressed, then weight issues get addressed or resolve themselves. In all cases these stories ended with "so I found a new doctor who addressed my actual issues and now I feel better".
Side note: the general public would be appalled to learn how little time is spent covering certain common issues in medical school. Whenever possible try to see a specialist.
posted by vignettist at 8:11 AM on March 9, 2017
Weight is commonly a side-symptom of underlying issues, and once those issues are properly addressed, then weight issues get addressed or resolve themselves. In all cases these stories ended with "so I found a new doctor who addressed my actual issues and now I feel better".
Side note: the general public would be appalled to learn how little time is spent covering certain common issues in medical school. Whenever possible try to see a specialist.
posted by vignettist at 8:11 AM on March 9, 2017
I've stopped viewing doctors' (and other professionals') as the end all be all word of god truth. They have knowledge, sure, but they also have vastly different opinions and seeing different doctors overtime has shown me that. I had one doctor say that my vulva was weird looking. Never went back to her. Fuck them. Find another doctor who will treat you with respect.
posted by monologish at 9:51 AM on March 9, 2017
posted by monologish at 9:51 AM on March 9, 2017
[Couple comments deleted; folks the question isn't, what are some good reasons to lose weight or think a lot about your weight. The OP's in recovery for an eating disorder; question is "how do I deal with this without relapsing".]
posted by LobsterMitten at 12:43 PM on March 9, 2017
posted by LobsterMitten at 12:43 PM on March 9, 2017
What the doctor should have said, to be accurate, would have been "the aggregate data which which I'm familiar shows a correlation between the presence of the kind of abdominal fat you have and elevated rates of certain health problems, which are statistically less common among people who don't have that abdominal fat. I don't actually know anything about you personally, though."
Unfortunately, doctors never really say this with accuracy; they jump from this to "you should lose weight" which is such stupid bullshit. It might be true to suggest "you should get in your time machine and rearrange your own genes and be born as a person who doesn't carry abdominal fat." That is not the same as "you should lose weight"; although it is about as helpful.
posted by fingersandtoes at 6:17 AM on March 10, 2017
Unfortunately, doctors never really say this with accuracy; they jump from this to "you should lose weight" which is such stupid bullshit. It might be true to suggest "you should get in your time machine and rearrange your own genes and be born as a person who doesn't carry abdominal fat." That is not the same as "you should lose weight"; although it is about as helpful.
posted by fingersandtoes at 6:17 AM on March 10, 2017
This thread is closed to new comments.
posted by parmanparman at 11:54 PM on March 8, 2017