I’m just adding that I hate BMI as a standard of health, always have. It sets up unrealistic goals for people. Even more pissed now since DD2’s last well check appt now has her listed as obese because of her BMI. She’s 7.
My goal is to teach both my girls that strength and how they feel is the proper measure of health. Not a number on a scale.
I felt a moment of rage at my daughter's pedi* when she commented during her last checkup "we won't worry about weight until two years old". Yes she's only 60th percentile for height and 70th for weight but she's also 90th percentile for head size. I mean, it's not like there's a huge mismatch with height and weight. If anything it's her giant head skewing her numbers. Ugh.
*we normally see the other doctor in the practice but he was on vacation and I will absolutely make sure we only see him from now on unless it's an emergency
Thankfully her pediatrician is amazing and she didn’t say anything about it. It was on the print out though.
I also hate the "good for you" comments. I had a severe mental health crisis back in May. I lost a total of 14 pounds in 10 days. I had gone to seen another provider in my regular doctor's office because he wasn't available (he's awesome!). I was concerned about my mental health. I was concerned about the constant feelings of panic I was having. I was upset about not being able to eat, that I was actually terrified to eat. I had so many fucking things wrong. I was *thisclose* to having DH check me into a psychiatric facility. Just typing all this out right now brings back so many horrible feelings.
Her comment? "Honestly, good for you on the weight loss. It's 14 pounds and for someone who is already very overweight, that's not a bad thing." WHAT?!
... Anyway my brother is an obese doctor (since they were mentioned upthread lol) and it is interesting to talk to him, because he cant keep up with what is healthy and what isn't, or what is the best way to lose weight - the information is always changing. I don't think he ever mentions weight to his patients, but he still has to sometimes verify that he did "discuss obesity" or something for some insurance companies (maybe its Medicare? BCBS?) so he usually just checks the box. But it comes down from the insurance company that obesity needs to be discussed regardless of the reason for the visit, which I know he finds super annoying.
I was surprised to read something along these lines in the article:
Lesley Williams, a family medicine doctor in Phoenix, tells me she gets an alert from her electronic health records software every time she’s about to see a patient who is above the “overweight” threshold. The reason for this is that physicians are often required, in writing, to prove to hospital administrators and insurance providers that they have brought up their patient’s weight and formulated a plan to bring it down—regardless of whether that patient came in with arthritis or a broken arm or a bad sunburn. Failing to do that could result in poor performance reviews, low ratings from insurance companies or being denied reimbursement if they refer patients to specialized care.
I'm sorry to all who have been victimized by their doctors, whether because of this requirement or because their doctors are jerks or whatever other reason.
I also want to say that I like the way the author and photographer let the people decide how they want to be photographed. You can really see their strengths and personalities in their photos. They're not just some cliche.
OMFG. I am glad you complained. My mouth literally dropped open at that comment.
ETA: Well, I was talking about the one from the PA about your husband, but then I read your second comment about losing weight during a mental health crisis and I'm even more WTF.
I remember one time during my physical, my (thin) doctor asked me to touch my toes and do a few other flexibility maneuvers. She said something like "wow, you are pretty flexible for a..." and then stopped.
Flexible for a what, bitch? A fat person?
She never finished her sentence, but I think that was actually the last time I saw her. That combined with her dismissal of my sleep problems (lose weight and it will help!) made me decide she was not the right provider. And I know those are pretty minor comments compared to many of the stories here.
I agree with whoever said upthread that her chubby doctor was more responsive. My last 2 physicals have been with an overweight NP and she's great. Sadly I just moved out of state, so I'm back to square 1 with all my providers. I am not looking forward to navigating finding new ones.
And we know how hard weight loss is to maintain, so....what's the answer to that?
I found this article frustrating, because it really doesn't give any answers.
I usually don't reply to threads unless I've read through them, but I have to quote this first now that I've had a chance to read the full article. What *is* the answer? Because in my own experience, being obese now has been affecting my health, so if WW won't work because I'll just gain it all back, what do I do? As far as I'm aware, we haven't invented the magic pill that allows us to keep the weight loss off and trick the body into thinking we're supposed to be at that goal weight and not going into starvation mode.
Honestly, I think we need to think in terms of obesity management, not obesity cures. Sure, obesity might make certain other health conditions worse or increase your risk of certain things. But you can say the same thing about high blood pressure or cholesterol, type 1 diabetes, celiac, Crohn's, and literally 900 other chronic conditions that people live with and manage. People who have these things have ups and downs. Sometimes their downs are caused by their own diet and sometimes they aren't. Most of these people however aren't judged in the same way a person who regains weight back.
There are no cures for chronic conditions, and we accept that they get treated through management. If we know obesity is a chronic condition, why is the only solution being offered to cure it? It can't. Even if you lose the weight and keep it off, it's a lifelong struggle. That's not to say that people shouldn't be given resources and support to help them lose weight if they want them. But for those who can't or don't want to, we should be focusing on smaller components of the puzzle, e.g., having them focus on a couple little changes to help blood pressure if that's high too, instead of declaring the only solution to be to lose 100 pounds.
Post by Velar Fricative on Sept 20, 2018 15:06:50 GMT -5
ESF, thinking of obesity as any other condition that can be managed is key and I never thought about it in that respect. I don't judge people with high cholesterol, and people appear to say they have high cholesterol without feeling shame (because it's not and shouldn't be a shameful thing). We don't tell people with celiac that it's their fault.
I'm so sorry the medical community let you down, Queen Mamadala . Were you able to show your former blood tests (the ones you paid OOP for before) to your OB so they can help you with it?
I'm sorry you had to go through all of that.
Yep. I went back with current research on optimal ft4 and ft3 range and my test results and got the "those numbers aren't too worrisome. You'll feel better if you lose the weight." So...yeah, discouraging. And I have shitty insurance with limited options for providers. I ended up seeing a ND that deals with a lot of patients with less than optimal thyroid function. Great reviews. But I immediately felt out of place. Super fit attractive doctor. After spending 45 minutes explaining my history and spilling my guts, he tries to be gentle and addresses my weight, but in the "You are obviously very smart, diligent and educated. I can tell you know what's going on and what to do. But I really think if you work on losing weight..." followed by "You have such a beautiful face and you have five kids that need you" and ended with "I don't know if you have past trauma of a certain kind you need to work through. I know it's not uncommon to struggle with heavier weight as a protective barrier or shield." Um, WTF!? No. It's called a pregnancy + major PPH + whatever shit happened to my body post-hemorrhage + depression. Ugh.
Meanwhile, I'm holding back tears, because I was not being heard. Despite the test results. Just that my weight could be contributing to the low thyroid function, despite my saying I gained the bulk of this weight after symptoms started.
So I decided to pay OOP to see another ND, but a Black woman, and I finally felt heard.
I'm so sorry the medical community let you down, Queen Mamadala . Were you able to show your former blood tests (the ones you paid OOP for before) to your OB so they can help you with it?
I'm sorry you had to go through all of that.
Yep. I went back with current research on optimal ft4 and ft3 range and my test results and got the "those numbers aren't too worrisome. You'll feel better if you lose the weight." So...yeah, discouraging. And I have shitty insurance with limited options for providers. I ended up seeing a ND that deals with a lot of patients with less than optimal thyroid function. Great reviews. But I immediately felt out of place. Super fit attractive doctor. After spending 45 minutes explaining my history and spilling my guts, he tries to be gentle and addresses my weight, but in the "You are obviously very smart, diligent and educated. I can tell you know what's going on and what to do. But I really think if you work on losing weight..." followed by "You have such a beautiful face and you have five kids that need you" and ended with "I don't know if you have past trauma of a certain kind you need to work through. I know it's not uncommon to struggle with heavier weight as a protective barrier or shield." Um, WTF!? No. It's called a pregnancy + major PPH + whatever shit happened to my body post-hemorrhage + depression. Ugh.
Meanwhile, I'm holding back tears, because I was not being heard. Despite the test results. Just that my weight could be contributing to the low thyroid function, despite my saying I gained the bulk of this weight after symptoms started.
So I decided to pay OOP to see another ND, but a Black woman, and I finally felt heard.
Obesity will never be treated like high blood pressure or Celiac Disease until societal definitions of beauty and desirability change.
Well sure, if you want to be defeatist about it, that's one way of looking at it. The other way however is to think about it that way from an individual level, and use that to be a better advocate for ourselves when dealing with the medical community and set better, more realistic expectations and goals.
Everyone needs to read this article, but who should be sharing it so more people read it? A PP understandably said that she didn’t want to share because it feels like it could be taken as making excuses. A thin person probably doesn’t feel comfortable sharing it because she doesn’t want to feel like she’s trying to convince people of something she doesn’t fully understand...nor feel like she’s calling out overweight friends. Then there is me...I’m currently overweight, but I fit the traditional assumptions that people make. My weight IS because of eating too much and not moving enough. I don’t have compounding medical, emotional, or physical issues. I’m “average” sized for where I live, so I don’t have to deal with the judgement like so many have experienced. I still get the fat talk from my doctor and my “goals for losing weight” including specifics that I need to come up with at the office make me feel shamed. I wouldn’t doubt it one bit if it’s an insurance requirement because she tries to be very encouraging and positive about it. But it still sucks.
So, the article doesn’t get shared. And again, honest and open conversations about this topic are few and far between. And the misinformation continues and there is no change in society’s acceptance of ALL people.
I think we need a lot more research into health and weight. There are probably a million reasons why a person is overweight, and sometimes the weight isn’t even problematic at all. If we try to research it and manage it as one thing, I don’t think we will ever get anywhere. We really can’t expect doctors to know a lot about everything...but we should be able to expect that they “do no harm” by their lack of knowledge in an area. That should include all of the emotional damage they cause when they say things like PPs have mentioned.
Post by seeyalater52 on Sept 20, 2018 20:55:22 GMT -5
I’m so sorry for everyone here who has experienced the psychological and physical violence of the health system’s approach to weight. It’s messed up.
I’m super late to getting through this article and the thread partly because I’m having a week and partly because there’s a lot of @ content in here that meant I needed to take some breaks and breathers. As my own thoughts are @ heavy so ******TW******
I have a super complicated relationship with my weight right now and while I would consider myself a pretty average size (pant 6-8) at 5’0’’ BMI is a total joke so I’m solidly into the overweight category. Over a year of failed infertility treatments and especially IVF have skyrocketed my weight, along with the various accompanying restrictions on exercise and of course eating my feelings during failure after failure and miscarrying our first baby after 2 years of trying which sent me into an even deeper depression and caused more sad eating.
I spend an unreasonable amount of time obsessing about my weight and all the studies that correlate lower success with treatments with overweight and obsess BMI and I feel helpless to change it and also like my inability to change it means I dont deserve to be and won’t ever get to be a mother.
I’m deeply depressed and anxious and can’t being myself to go back on an antidepressant because my only option is Zoloft and the last time I took it I gained 40 lbs in 6 months (and that amount on a 5 foot frame is a lot) and I’m afraid that I will literally never get pregnant if I gain that much weight.
And while my RE sees me as a thin person and hasn’t ever brought up my weight as a barrier to treatment or success, my PCP/gyno basically refused to prescribe me an antidepressant because of my history of weight gain while on them because she thinks it will make it more difficult for me to get pregnant. She planted this seed in my mind that I can’t get out.
Knowing how horrible all of this feels and also knowing that it’s only a small sliver of the experiences that many overweight people, but especially women, go through internally and with their health care providers makes me deeply sad and a little scared. It’s so damaging and pervasive and awful.
Post by bronxgirl on Sept 20, 2018 21:06:29 GMT -5
big hugs, seeyalater52. When I first started going to an RE I was relieved to see so many thin women in the waiting room because I was worried it was my fault due to weight. I usually hate being the only fat person in a room, but I had the opposite feeling at the RE's. The doctor never told me that my weight was an issue in regards to IF, but I will always wonder of things would have worked out differently if I had lost the weight. Finally I am in a mental place that is allowing me to lose weight, but I am likely too old to get PG. You are in my thoughts, seeyalater52,and I wish you the best.
lilac05, I ended up sharing the article on Facebook with a short statement about how fat-shaming is cruel and ineffective, and obesity is often a chronic condition that requires real (medical) care not tough love. Because that's the biggest takeaway I'd like for people to have, that there is a real problem that requires a real solution.
Post by badgergrl on Sept 21, 2018 16:37:03 GMT -5
I broke my leg and moved. When I saw my new orthopedic dr in the new city he asked if I was still having pain in my still fractured leg. I said yes and pointed to the areas. He then said “if you lose 75 pounds that won’t hurt anymore”
Uh. Thanks. I’ll get right on that. But it’s hard to move since my fucking leg is broken.
After having DS, I was down to my lowest weight in years. Then I got Mirena. I ballooned up 30 pounds. No one suggested it could possibly be that, because there was no 'evidence' or 'research'. Well, go on any message board and you'll see hundreds of women talking about how they gained (and struggled to lose) so much weight after getting Mirena.
Only liking your post out of commiseration. I got my Mirena out and greatly reduced the stress in my life and quickly lost a bunch of weight. Can I pinpoint the cause of the gain to the Mirena? It was either that or the ADs or massive stress. No doctor I had would EVER recognize that a Mirena, ADs, or stress caused my weight gain. It had to be MY fault.
I gained 40kbs after I got my Mirena placed. I got it 6 weeks after my second pregnancy, when I had already lost a good portion of the 25lbs I had gained while pregnant. When I mentioned to my doctor that I was concerned the Mirena caused it he said “birth control doesn’t make you fat. Overeating does.” And when I mentioned I was pretty aware of what I ate and that the 40lb gain in about 5 months didn’t make sense he told me that maybe I needed to “be more self aware.” And when I asked for blood tests to check hormone levels, because I was about 8 months pp and nursing, he absolutely refused to do it. It’s been 2.5 years and I still haven’t had blood tests done to check if my hormones are out of whack.
Only liking your post out of commiseration. I got my Mirena out and greatly reduced the stress in my life and quickly lost a bunch of weight. Can I pinpoint the cause of the gain to the Mirena? It was either that or the ADs or massive stress. No doctor I had would EVER recognize that a Mirena, ADs, or stress caused my weight gain. It had to be MY fault.
I gained 40kbs after I got my Mirena placed. I got it 6 weeks after my second pregnancy, when I had already lost a good portion of the 25lbs I had gained while pregnant. When I mentioned to my doctor that I was concerned the Mirena caused it he said “birth control doesn’t make you fat. Overeating does.” And when I mentioned I was pretty aware of what I ate and that the 40lb gain in about 5 months didn’t make sense he told me that maybe I needed to “be more self aware.” And when I asked for blood tests to check hormone levels, because I was about 8 months pp and nursing, he absolutely refused to do it. It’s been 2.5 years and I still haven’t had blood tests done to check if my hormones are out of whack.
Hormones and weight gain in women should be studied but probably never will since women's medical issues mean jack shit to the men making decisions. Men tweak their diets and lose weight. Women very rarely experience the same. It must be a moral failing not any legitimate, scientific reason. I know how significantly hormones affect my weight. I don't know how to treat it but I know if my hormones are out of whack, my weight responds.
It's far easier to shame women about their weight and keep them focused on counting their 1200 calories a day. It's more effective to keep women in our places if we're focused on our pant size. Fuck, we're hungry most of the time.
And all the fucking money we spend on diet and exercise stuff that will NEVER work??
If we weren't hungry and wasting all our time and money, imagine what we could have done by now.