Dealing with doctors

[Plant Walks]

Hi everyone. I'm new here and grateful for this web site and to read your postings.

I just had an upsetting visit with a doctor yesterday. This was someone I'd never seen before, a cardiologist. I have limited health coverage, so I had little say over who I saw. I see another cardiologist at the same office in two weeks, so with hope and a lot of communication with the office, maybe it won't go so badly.

I've had serious medical issues this past year, exposing me to a lot of doctors. I have been giving them Linda Bacon's sample letter to doctors requesting they focus on my health, not size, and an accompanying fact sheet she wrote. Sometimes I bring them a whole binder of info to flip through. Generally, the doctors have been respectful and interested to learn more about HAES, with a few exceptions.

Yesterday's doctor was an exception.

(I have also taken to telling doctors I have disordered eating, and to please not discuss weight/weight loss, because this is upsetting and results in more severe undereating followed by more severe overeating or unhealthy eating/bingeing (when I'm more hungry), for weeks after an appointment. Warning them this way seems to make them more respectful and careful.)

Well, I didn't tell that to Dr. Smith, nor did I add my usual notes to Linda Bacon's doctor letter, explaining HAES and what I'm trying to do in simple terms.

(I usually add that I ascribe to the philosophy of HAES:
- eat nutritiously (most of the time), according to hunger and satiety signals,
- exercise for fun and to feel good, not for weight loss, and
- let my size fall where it may.)

Well, Dr. Smith said he'd seen Linda Bacon's fact sheet many times (probably from a lot of ticked off clients!) and said, basically, "diets don't work" only when people aren't willing to stick with them (the willpower argument, which she refutes in the fact sheet); that I needed to lose weight to lower my cholesterol and improve my out-of-range lipids, and that my near-vegan eating, which I started ~7 weeks ago to thin my blood and reduce clotting after getting a DVT in one leg, was of no value for blood thinning and that I should give up tasteless vegan eating and go on the South Beach diet.

(I'm taking Coumadin to thin my blood for the DVT, I get my blood clotting level checked weekly, and the veganism keeps thinning my blood to the point that my weekly Coumadin dose has now been cut in half so far! But this cardiologist, like most doctors, has never heard of such a thing, and he wasn't interested in reading the articles by vegan doctors about it.)

Well, when he started in with all of the weight loss and diet comments, I just talked over him and tried to block out everything he was saying, because I won't allow/don't want to hear the diet talk from doctors, because it affects me so severely, the criticism, and affects my eating for weeks after a doctor makes any such comment.

I started writing him a letter today, and then called the RN who's the director of that office. I told her how upset I was, that it was physically abusive to tell someone undereating is medically necessary, especially after the person had provided a letter saying they do not want to diet, and that it's psychologically abusive to tell someone that they just don't have willpower when they can't stay on a physically unsustainable undereating plan.

The RN was kind and willing to listen; we debated a bit, but she seemed to understand more as we talked; and had a pretty good conversation. She said she'd google HAES and sounded interested. She said she'd talk to the doc and would await my letter. I told her I wanted to be a client there and needed their services, but really needed the doctors to respect my wishes to focus on dealing with my cardiology issues nutritionally (the next doc I see there is vegetarian by religion), but do not want to be told to diet or lose weight. I told her how the under/overeating worsens after comments like his. (I'm eating a Milky Way right now, my 2nd candy bar today, after eating almost no sweets or dairy since surgery 2 1/2 months ago. Yesterday, 3 candy bars. Not exactly a binge, but frustrating to be starving, then reaching for candy.) I told her that after yesterday's appointment, I had thought about giving up on going to doctors, like so many other plus-size people do, but then reconsidered, because I need health care and have a right to respectful care.

I've been through medical h*** for several months now, and my nerves are frayed dealing with this issue on top of everything else.

I hate going through this, because it is traumatic, painful, keeps me distracted from schoolwork, is time-consuming, and the criticism hurts to the point where my undereating/overeating is really affected. Just when it's settling down again (or before it does!), it's time to see another doctor.

So, may I ask, how does anyone else here deal with doctors?
Is anyone else's eating affected by doctors' comments about your weight, such as undereating afterward, followed by overeating/bingeing/less healthy eating once famished?

Trying to stop the under/overeating has been a many years' struggle. Because of my medical problems, I'm really trying to stop skipping meals and stop undereating so I'm not craving sweets, etc., and especially meat/cholesterol now. Of course, I'm so big, the doctors would never guess I ever undereat, or that I eat anything healthy.

Thanks for reading all of this.

[Vivienne]

I have only had one health care provider make a snide comment to me about my weight but I cannot remember a single instance of rude comments.

I did have one doctor who did not look at me, did not make eye contact, and did not answer direct questions--AT ALL! My husband reported that he was warm and gracious to him.

I do live in the Midwest in a farm/industrial small city--60K people. Is being fat more acceptable here?

Vivienne

[Plant Walks]

Thanks for replying, Vivienne. I'm glad you have not gotten more harassment from docs than that. And I'm sorry that doctor treated you that way. That's a very interesting insight you have that maybe fat is more acceptable where you are. Maybe we should all move there :)

I've had two doctors recommend weight loss surgery - both after only talking to/meeting me for the first time for 5 minutes - (or less) about other medical issues I was seeing them for.

Do you ever have doctors telling you to lose weight?

That is enough to upset me, their assumption that someone my size has never tried--every day of my life, since first put on a diet, because of all the strain of trying to lose weight all these years, or to even stop the undereating/overeating rollercoaster.

What doctors don't realize, though I try to warn them, is that just recommending I lose weight is enough to make my usual undereating/overeating pattern increase to starve/binge mode for several weeks after the appointment.

I think I need to write my own form letter to hand to doctors, explaining/warning them of this, so that the appointments go better.

It especially upsets me if they then dismiss what I'm trying to tell them my experience has been or what the research shows (docs who are closed-minded to HAES.)

Thanks again for your reply, Vivienne.


Vivienne said:

I have only had one health care provider make a snide comment to me about my weight but I cannot remember a single instance of rude comments.

I did have one doctor who did not look at me, did not make eye contact, and did not answer direct questions--AT ALL! My husband reported that he was warm and gracious to him.

I do live in the Midwest in a farm/industrial small city--60K people. Is being fat more acceptable here?

Vivienne

[Vivienne]

I am sorry to say that I have deep and abiding prejudices against doctors and health care institutions. It is really odd, but I don't remember any doctor telling me to go on a diet. But, I also don't take my doctors very seriously, either. They have been mostly idiots.

I got paranoid once and thought that maybe my doctor and my family thought I should have WLS, but were afraid to tell me. I asked my doctor and did not feel that the surgery was worth the risks. My family were appalled that I would even need to ask them.

Take good care of yourself!

[Barbara]

Isn't it amazing that doctors can be such jerks. Wait. Maybe not amazing. After dealing for years with doctors (and the Nurses who worked in the office) thinking everything had to do with my weight, I finally found a doctor who "got it". She was petit, so had to deal with different prejudices, but I remember when she checked my Cholesteral (sp). It is not quite "borderline high" when both readings are added up. BUT it is at the number it is, because my "good" type is extremely high. All the other doctors said "you have to get your weight down to a "normal" level because of your "numbers. Until this last doc. not one of them even bothered to see that my bad number was way low. Now, this does not make me good, or bad. It is just the way it is. Only my most recent doc said "Well, the good stuff is high, and the bad stuff is low, so you really haven't anything to worry about on that front" And now she has left the practice, so I will have to start all over again to find someone who actually thinks, rather than checks off boxes to decide what I "am"

So yes, I have dealt with many idiot docs and staff who assume that because I am heavy I am lying about how I eat, and how much I exercise (I don't lie). throw in some meds that cause rapid weight gain, and you have me. A unique person. Not a number, statistic or example. I am so sick of it.

[Plant Walks]

I'm so sorry to hear doctors have treated you lousily, too, and glad you had one who gave you a different and affirming experience. At least you can know that the others are full of it, and perhaps tell them and catch them as they try to lie or "interpret" labs according to their biases.

I'm sick of it, too. I'm looking for a new doc (the last one was very good about size, darn it, but lousy in other regards.)

While talking with the medical director of the clinic about who to go to next, I finally realized, I just want to go to a fat doctor, or at least someone with enough extra pounds on her that she has likely dieted and knows what diet-and-exercise-for-weight-loss-hell is like. Some of the slim ones get it, but I tend to find much more empathy from those who've been through enough to realize that weight loss advice, or at least the calorie-deficit advice the medical profession advocates, is incorrect, and worse than worthless. It does harm.

Thanks for sharing your experiences. It helps me to know I'm not the only one dealing with jerk doctors.