About a year ago, I was at the school health clinic, and the doctor who I saw seemed if not fat-positive, then relatively fat-neutral, enough that I felt safe and at ease. I had mentioned that a medication of mine seemed to go through my body kind of fast, and she said that it might be because of my size, but immediately followed up by saying she has the same thing happen to her, and she's thin, so who knew? This was also the doctor who, after several hiccups and follow-ups about my blood pressure being slightly elevated, finally measured me with the large-sized cuff and declared it perfectly fine.
So I picked the same doctor when I went this year to get myself examined.
It was going basically well at first. Then she noticed that, yet again today, my blood pressure reading was high. And it wasn't until after a whole speech, asking me if I was watching my salt intake and giving me tips on how to do so, and bringing my weight up, only after all that did she think to ask if they'd used the right cuff. They hadn't, of course, and I get nervous enough in examinations that I forgot to insist to the nurse that she use the right size. The doctor took my pressure again, and it was fine, and we continued.
Except, my weight wasn't off the table for discussion.
"You really do need to think about your weight, would you like to see the nutritionist?"
I don't think a lot of doctors understand what they're saying when they say things like that, in the same breath, as the same question.
You are overweight, therefore, you should talk to the nutritionist.
You are overweight, because you eat too much/ the wrong things.
You are overweight, because you've somehow managed to live ten years as a fat person without anyone ever telling you how to eat "properly".
If you only weren't so ignorant and knew how to eat "properly"/ too lazy or unhealthy to follow through with eating "properly", you wouldn't be fat.
I told her that I was eating well, more vegetables than I used to, that I have too many emotional issues with dieting to willingly take on a weight-loss plan right now. But that I am focused on exercising more (easier living in NYC) and eating more nutritionally. I even mentioned the fact that, finally, I've gotten to the point of craving fruits and vegetables and nice filling starches rather than sweets and cake and candy, and explained that it was because by actively NOT dieting, there wasn't anything off-limits that I wanted and nothing that I forced myself to eat, and it took the power away from the formerly-seductive "bad" foods. And she seemed okay with it.....until I clarified that by "eating more vegetables", I didn't mean "eating less meat/cheese/sweets". At which point she kind of laughed, mumbled "that's not healthy," and finally dropped it.
It's not a horrible experience. It left me a little rattled, but I remembered to eat dinner and didn't make myself feel bad later at night when I wanted more food. I'll stick to the permission that I gave myself to eat what I feel like. This story certainly doesn't rival anything at First, Do No Harm.
But it did kind of suck to have an initial good experience turn back into a normal-level iffy one.
as a doctor who in my previous (unenlightened) life might have said similar (OK, I did,and I'm sorry) I wonder if a letter might explain it? Write down what you said, perhaps copy and highlight an article or two about Health at Every Size. Just a thought... I've helped folks craft letters to pediatricians about their healthy children who are "overweight." If I can help, feel free to email me. I think there are good docs who are literally never exposed to the HAES message. Maybe we can all help expose them? Thoughts? Am I way off base? You could use me as a reference... Sucks, but they don't get it, they are taught that BMI is a reliable measure of health, and the only important measure. I think they also assume fat people lie when they say they eat well...
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