Advice re: Dr. Appointment

[stato]

I don't post much, but wanted advice on whether I'm overreacting to how an issue was handled at my annual ob/gyn appointment last week. This is going to be long, so thank you in advance if you read it.

Background on me: I have struggled with an eating disorder (mostly restricting/overexercising) for the past several years, to varying degrees. I am and have been in therapy, and right now would describe myself as eating disordered in thought (ie, I am having an insanely, insanely hard time being anywhere near ok with how I look) but less so in action (ie, I eat restrictively and have food issues/phobias but I eat [as confirmed by a dietician] enough and nutritionally soundly, and I exercise very regularly [5/6 times/wk] but not obsessively/excessively). I am 5ft 2in, 120 lbs (on my scale -- which I know is accurate b/c I
weighed a hand weight to test its accuracy-- as of this morning). I had not, before this morning, weighed myself in 2.5 yrs (I blind weigh at doctor appointments). I knew I had gained weight (but not exactly how much) from my low weight, the vast, vast majority (I thought) in 2010.

This past Thursday, I had my annual ob/gyn appointment. My last one had been about 1.5 yrs ago. I go to a large practice, and generally just see a PA or Nurse Practitioner b/c I'm just there for a checkup/pap. I've gone to this practice for several years, and have talked about my ED history (whether it is in my chart, I don't know). When the nurse weighed me, I asked (as I always do) to weigh backwards and told her I didn't want to know my weight.

During my exam, the Nurse Practitioner, while asking the standard meds/recent health issues/etc. questions asked "how is your diet?" I told her that I have generally been eating very healthily. She said, "really? Because you've gained 15 lbs." I said, "I have? Since when?" She said, "Since your last appointment in November 2011. You weighed 111 then and today you weighed 126." I told her that was surprising. She then -- without asking any further questions as to what I eat, how much I exercise, what's been going on in my life -- launched into a lecture about my weight and how I really need to watch my weight and I need to be more careful in what I eat and I need to exercise. I was a) in shock and b) trying not to cry (again, I have HUGE issues about my weight gain), so -- although I know I should have spoken up and said something about my ED history -- I said nothing. The emotional fallout since then has been really hard for me. I already felt awful about my body/weight, and her "lecture" makes that a lot worse. I didn't want to know my weight, the number itself freaks me out (compared to what I used to weigh), and I feel like she's judging/criticizing my size and weight.

First, I don't think I've gained 15 lbs in that time frame (I have gained 15 lbs, but I'm pretty sure for various reasons including that my clothes fit no differently that it hasn't been in the last 1.5 yrs). I think that, at my last appointment, my weight was recorded incorrectly and was actually 121 instead of 111. I happen to have an appointment this week with another dr I see every six months, and am going to ask him whether I've actually gained that much weight in that time frame.

If you've read this far, thank you so much -- I'm finally to my questions. I feel like her bringing up my weight in the manner she did was inappropriate. First, I am not, medically speaking, overweight. Second, she asked nothing about my history or what's been happening in my life, nor did she look at my chart to see weight history going back years (and, if it's in the chart, which I would imagine it it, my ED history) before lecturing my about my weight and diet and activity level.

Am I overreacting? If not, would it be out of line to call the practice and just let them know what happened and that they may want to be careful in how they approach that type of thing? I'm not angry at the NP and my intention is not to "report" her, but I'd like them to know the kind of damage this kind of thing can cause if said to the wrong person/in the wrong way.

[kams]

You're not overreacting. That is innapropriate of her without a doubt, and I'm very sorry that it happened. I think it would be beneficial to report what happened if you're comfortable doing so.

I would venture to guess that, because unhealthy weight gain is something she probably addresses regularly, she was speaking out of more routine than out of concern for you specifically. That in no way excuses it, though.

[smiley]

Is this a new nurse practitioner at your particular practice? If so, I would probably let them know of the situation so they can address the proper way to handle things with her in that regard. She should have looked farther into your chart before comment on your weight. 126 for your height is still a good weight to be at so she shouldn't be judging too much!

Is it possible that you gained muscle?

[preppy]

You are not over reacting. At all. That was horribly inappropriate for her to lecture you about regardless of the ED. You are still at a very healthy weight so it seems bizarre that she would do that. As someone who also had an ED for years in HS/college and still struggles with body image I can imagine that this has been really tough. I would absolutely be calling the practice to speak with someone about the experience you had, and if it was me I might be checking in with my therapist to talk things through.

I am so sorry you are dealing with this. You have every right to be upset, but know that she was wrong. You are at a very healthy weight and as you said have been doing really well, so keep it up!

[Deleted]

She was out-of-line and you should let your doctor know. That is a healthy weight for you and I agree with PPs that it is weird she chose to "lecture" you over a healthy weight.

[sadlebred]

I agree with kams that she was probably giving her "routine speech" about weight gain. I would speak up next time and let her know your background. Having said that, you are NOT overreacting! You are working on your problems and are in a healthy place. (which is AWESOME!!). I'd definitely mention it to your therapist at your next appointment, so the incident can be addressed and your mind put at ease.

[katinthehat]

routine speech, but an unnecessary one in your case, given that you might have even been considered underweight at 115 (based on your build, which I don't know.)

I would have a hard time making a phone call like that, but I would certainly send a letter or an email to the office manager to let them know.

[stato]

Thanks, guys. I agree it was likely a routine speech, which is why I was wondering whether I'm overreacting. I just wish it had been handled better and she'd looked more closely at my medical history and/or asked better questions than "how's your diet?" before launching into a lecture. If I do call, it won't be because I'm angry with her, but because I want them to consider how damaging this type of thing can be. It's been a really tough weekend, and I don't want other people to have the same experience.

Smiley -- I went from almost 100% cardio to adding Bodypump and working with a trainer about 6 months ago, so SOME of it could be muscle. I would say that could explain the difference between 121 (which is what I think I actually weighed last time) and 126, but not the whole 15 lbs (if I actually did gain that much).

preppyhousewife and sadlebred -- I will absolutely discuss this with my therapist. I emailed him as soon as I left the appointment (I was completely freaking out) and I have an appointment tomorrow.