Update 2 in OP: Non-CEP, shitty doctors appointment

[VillainV]

Update 2: I got a call yesterday that the nutrition clinic had an opening this morning! I went and OMG this lady is amazing. We talked for 90 minutes (!!!!) about my previous history, disordered eating tendencies, current menus, and then made some tweaks that she thinks will help. She’s big on Intuitive Eating, and immediately gave me permission to stop any form of tracking or counting. She agrees that while there are some benefits to a Keto diet and she likes many keto recipes, eating nothing but meat for 6 weeks is a bad idea based on my history and goals.

So, I have some small things to work on, and I go back in six weeks.

I’m incredibly relieved and energized about this. I feel like she really gets me, and cares about seeing me meet my goals in a physically and mentally healthy way.



Update: I went back to talk about ADHD and he is putting in a referral for behavioral health so I can be assessed. I’ll probably use that opportunity to ask about weight management help as well. I also found a working number for the nutrition clinic but their first appointment isn’t until November….


Trigger warning for people who struggle with weight, body image, eating disorders….

I’m choosing to post this here because this board has had a lot of good discussions about health that separate it from weight, diet, etc. If you’ve struggled with these and are in a bad place right now, you might find this discussion really difficult.

For background, I’m 5’4” and have bounced between 188 and 204 pounds for the last several years. I’m in the military, and we are “supposed” to meet specific weight and body composition standards (mostly based on BMI or body fat%). For most of my career, the Air Force has used an abdominal circumference measurement, which I have been able to pass despite having a high BMI and body fat %. This year they are getting rid of the abdominal circumference and will go back to BMI/body fat. Which means I will likely fail.

I have tried so many “diet” plans, most have focused on balanced eating, calories in vs. out, increasing movement, etc. In my 20s and early 30s I flirted with disordered eating (severe calorie restriction) and compulsive exercise. After my son was born, my weight increased a lot, to its current number, but I’ve been very reluctant to try any kind of “diet plan” that would spiral me back toward disordered eating. Well, the result is I lose 10-12 pounds in maybe 8-10 weeks, my weight plateaus, I stay there for 2-3 more months before “quitting” and gaining the weight back.

Today I went to see the flight doc (happens to be a new guy I’d never met before) to see if he can provide me resources to help with my eating (dietician, counseling, etc) so I can either a) lose the weight or b) show the Air Force that I’m putting in a good-faith effort so that when I don’t make body comp standards I can at least prove that I’m working on it and getting professional help.

So without knowing me or asking me what I’ve done or what I’ve tried, this man immediately says “It amazes me that nobody has put you on a ketogenic diet because this is the only thing that will help you lose the weight.” He goes on to say “my weight will eventually kill me” and “Keto is really hard but if you really want to lose the weight you can do it.”

His suggestion is that I wait until Jan 1 (so I don’t have to worry about sticking to a restrictive plan over the holidays) and then eat NOTHING BUT MEAT (and eggs and cheese) for 42 days. No veggies, no fruit, no grain. Then I can move to a less-restrictive low carb diet.

I told him that if I’m going to try something like this, I’ll need a huge amount of support, hoping again for a referral to a dietician or other resources. He said “just look on the internet” for info, and that “none of the dietitians on base are good enough to help me with this, they’ll just tell me to eat a ‘balanced diet’ which clearly hasn’t been working so far.”

He also talked about different types of exercise I might want to try (again, without asking me what I’ve been doing or why), and managed to make some disparaging comments about “the women he sees on the treadmill every day who haven’t managed to lose a pound.” I mean, I get it — my exercise regiment hasn’t really helped me lose weight either, but that’s also not why I do it.

So while this guy made some good points and very likely might be right, from a medical perspective, he was SUCH A JERK about it. He talked WAY more than he asked or listened, and I spent the whole time feeling incredibly dismissed and offended.

Guys, I went back to my car and cried. I’m still crying. I don’t know what to do. Part of me wants to report this guy via anonymous feedback mechanisms (for…being an asshole? I don’t know what I’d report him for exactly). I don’t want to piss him off because he’s the only flight doc here right now and I will need to still see him to maintain my flight status.

I also still need to talk to him about my ADHD concerns — I made an appointment for Friday but I honestly don’t know that I even want to talk to this guy again. He was so dismissive and mean that I don’t think he’s going to be receptive to talking about my concerns.

I could use some kind words, or even some advice right now. I’m at such a loss.

[pixy0stix]

Fuck that dude. I'm sorry.

[eddy]

He gave you dudebro advice with absolutely no regards to the fact that you are in fact not a dudebro. He and his pals get shredded with Keto and stand around lifting weights. He thinks that equals everyone.

It is shitty advice and he wasn't even considering you as a unique person.

I am so sorry you had a tough experience.

[VillainV]

Sept 21, 2021 12:39:48 GMT -5 eddy said:

He gave you dudebro advice with absolutely no regards to the fact that you are in fact not a dudebro. He and his pals get shredded with Keto and stand around lifting weights. He thinks that equals everyone.

It is shitty advice and he wasn't even considering you as a unique person.

I am so sorry you had a tough experience.

Precisely. I mean, I’m willing to try a low-carb eating plan and changing up my exercise routine. I haven’t really tried it before, and with the proper amount of help and support I think I might be successful at it (or at least find new food or forms of movement that I might enjoy).

But I’m gonna need a hell of a lot more that “do keto, just Google it, you’ll be fine.”

[hbtk]

I don't have much advice, but I am sorry you experienced that. Operating within the military healthcare system, both as the service member and the spouse, can be super infuriating. My husband and I both have had really crappy experiences - him with the flight doc and clinics, me with the various base clinics and the referrals I'm given (or that they won't give). I think part of the problem is that it's a very insular system often run by people who love working out and are generally healthy (or in denial) who just cannot and will not empathize with people who are struggling. Like many (most?) things in the military, they need either a ton more education on these subjects or to refer their service members to people who can ACTUALLY provide the help. I think they are going to be in for a rude awakening when PRTs resume on a regular basis after the last year and a half of high-stress environments both at home and at work so I hope that will push them to do more for dietary, fitness, and mental health resources. The fact that he recommended keto, which does provide good weight loss but comes with its own set of issues, tells me he is probably not well versed on this subject. I would maybe try going to your ADHD appointment and saying "Hey, I did some research on the keto plan that you suggested, and I think it sounds good but would really like to meet with a nutritionist to make sure I am doing it right and also help me with some substitutions for certain dietary limitations. I would like a referral when I leave here." That way you're giving him the ego stroke but also being direct about what you want/need, not leaving it up to him to make the connection. Sorry you have to do that, though, because you shouldn't.

[mskitkat]

Telling someone with a disordered eating background to do keto is blindingly terrible advice. I’m sorry.

Are you interested in a recommendation for a nutritionist? I follow one on tiktok, and I like her advice so much that I am hiring her for personal help.

[bee20]

What a dick.

I put on 15 pounds in the first few months of covid and it took me several tries over the course of a year to get it off. I tried Intermittent Fasting at the insistence of several male friends and OMG did that not work. It was super annoying having them explain to me that they had the one true answer.  (What ended up working for me was keeping carbs under 100g/day and calorie counting check ins with friends. No Bros ever suggested those ideas ). 

I hope you are able to get true support.  If that's not possible and you have to do it yourself, I was surprised for myself how much the accountability helped so maybe there are some other women facing the same measurement change issue that would want to buddy up and do daily text checkins?  The other ladies in my group followed different diet plans and had more and less to lose but we all hit our goals.

Honestly I might wait on the ADHD appointment because it sounds like he won't be helpful and seeing him again so soon will be a mess anyway.  Would it be possible to bring a friend to the next appointment?  Or at least write down your concerns and send them ahead, and then go through them with him?  Sorry he treated you that way, it is terrible for a doctor to be dismissive when you were hopeful of getting help at the appointment.

[Bad Dingo]

I'm sorry, I am currently a bit higher than your higher end and the same height and had a horrible doctor visit yesterday that keeps bringing me to tears.

Hugs and commiseration <3.

[audette]

Guh. Is he the only doc you can see as your primary? I know the rules on that differ for active duty and dependents.

When I have dealt with similarly shitty docs at a military clinic, I managed to file a complaint against them, and get my COM switched to a different doc. But, I don't know that my husband could have done that.

Dudebro Doc needs to figure out the difference between counselling a patient and chatting with his other functional fitness dudebro at the gym.

[VillainV]

Sept 21, 2021 12:56:29 GMT -5 mskitkat said:

Telling someone with a disordered eating background to do keto is blindingly terrible advice. I’m sorry.

Are you interested in a recommendation for a nutritionist? I follow one on tiktok, and I like her advice so much that I am hiring her for personal help.

I might. I’d like to try on-base resources first so that at least I have documentation that I’m following professional advice.

[VillainV]

Sept 21, 2021 13:00:02 GMT -5 audette said:

Guh. Is he the only doc you can see as your primary? I know the rules on that differ for active duty and dependents.

When I have dealt with similarly shitty docs at a military clinic, I managed to file a complaint against them, and get my COM switched to a different doc. But, I don't know that my husband could have done that.

Dudebro Doc needs to figure out the difference between counselling a patient and chatting with his other functional fitness dudebro at the gym.

He’s the only one right now, but I think we’re getting a second doc sometime in the next few months, so maybe I should just wait until he or she gets here and then revisit my concerns.

[eddy]

Also this is more permission than advice, but I find dieting extremely overwhelming and miserable. And I would say I am a pretty healthy person with established habits.

So I just focus on one thing I want to improve at a time. And I am not even talking my whole diet. Just one thing within my diet.

Like right now I am focusing on trying to hit 140 g of protein a day. That is a lot, but I am also lifting heavy so I am seeing how this makes me feel. Anyways I am not worrying about my carbs or my calories. Just protein. That feels so much less overwhelming. And honestly if I am hitting that mark each day I don't have a ton of room for other food because that is a lot of protein.

Anyways we are all so unique. But big wholesale changes are really really hard. Try taking a bite size approach. It will feel more successful.

[audette]

Sept 21, 2021 13:02:33 GMT -5 VillainV said:

Sept 21, 2021 13:00:02 GMT -5 audette said:

Guh. Is he the only doc you can see as your primary? I know the rules on that differ for active duty and dependents.

When I have dealt with similarly shitty docs at a military clinic, I managed to file a complaint against them, and get my COM switched to a different doc. But, I don't know that my husband could have done that.

Dudebro Doc needs to figure out the difference between counselling a patient and chatting with his other functional fitness dudebro at the gym.

He’s the only one right now, but I think we’re getting a second doc sometime in the next few months, so maybe I should just wait until he or she gets here and then revisit my concerns.

I might try the suggestion from hbtk, if you feel up to it, or are worried about the timeline of when the new doc is supposed to arrive. Otherwise, waiting may be a not bad option.

In the meantime, if there is an offpost dietician or nutritionist you would be comfortable seeing on your own dime, it might at least be an option to get started and be able to show the incoming doc that you are trying...

[waverly]

I'm sorry you went through this. I would wait until the second doc. There is no way I would ever talk to that doctor again if I could at all help it.

[ssmjlm]

I would probably see if you can get in somewhere else. He really doesn't understand the body and keto is not the way for most people to maintain healthy living.

I know it's harder as active duty, so I'm not sure if you can file a complaint or ask for a HAES doctor.

[raangoli]

I am so sorry you were treated that way. You are a person who matters and deserve better.

[dcn]

Ugh I’m so sorry. He sounds kind of useless. I would have cried too. Also, as you know doctors don’t have a ton of nutrition training so not sure why he thinks he knows more than a rd would.

My H is Army, but they have dietitians embedded organically with a lot of brigades or battalions now as part of their holistic health and fitness program. If not there is always a way to access one and you don’t need a referral. I’d go to your clinic or mtf website and just call one to see if you can get an appointment set up.

They are also inserting strength and conditioning coaches to help with fitness, not sure if the AF is doing the same? Does your wing (not sure if that’s the correct term) have someone who organizes physical training? There is a big push in the army right now to get people certified as master fitness trainers to help units improve their functional fitness (as part of the new PT test).

The army also has wellness centers where you can go to get health coaching, body fat % measurements and tracking etc.

[VillainV]

Sept 21, 2021 13:22:15 GMT -5 dcn said:

Ugh I’m so sorry. He sounds kind of useless. I would have cried too. Also, as you know doctors don’t have a ton of nutrition training so not sure why he thinks he knows more than a rd would.

My H is Army, but they have dietitians embedded organically with a lot of brigades or battalions now as part of their holistic health and fitness program. If not there is always a way to access one and you don’t need a referral. I’d go to your clinic or mtf website and just call one to see if you can get an appointment set up.

They are also inserting strength and conditioning coaches to help with fitness, not sure if the AF is doing the same? Does your wing (not sure if that’s the correct term) have someone who organizes physical training? There is a big push in the army right now to get people certified as master fitness trainers to help units improve their functional fitness (as part of the new PT test).

The army also has wellness centers where you can go to get health coaching, body fat % measurements and tracking etc.

I’m looking into on-base dietitians. In the last hour I managed to Google a number for a “nutrition clinic” but the number seems out of service. But I’m sure there must be…somebody? We are a small Air Force unit on a Navy Base, so I’m not sure what exists here as far as Strength and Conditioning resources here.

[hbtk]

Sept 21, 2021 13:22:15 GMT -5 dcn said:

Ugh I’m so sorry. He sounds kind of useless. I would have cried too. Also, as you know doctors don’t have a ton of nutrition training so not sure why he thinks he knows more than a rd would.

My H is Army, but they have dietitians embedded organically with a lot of brigades or battalions now as part of their holistic health and fitness program. If not there is always a way to access one and you don’t need a referral. I’d go to your clinic or mtf website and just call one to see if you can get an appointment set up.

They are also inserting strength and conditioning coaches to help with fitness, not sure if the AF is doing the same? Does your wing (not sure if that’s the correct term) have someone who organizes physical training? There is a big push in the army right now to get people certified as master fitness trainers to help units improve their functional fitness (as part of the new PT test).

The army also has wellness centers where you can go to get health coaching, body fat % measurements and tracking etc.

I love this in concept but in practice it will be more of the same, I think. The people who get certified as master fitness trainers will be the workout bros who are completely out of touch with the needs of some of the active duty population - particularly women and those who struggle with health as they age. Now they will just be there to nag and try and make themselves look good to command, which generally will entail unrealistic workouts and snarkiness. It's a talking point for their evals. I would be interested to know who is certifying them and what the program looks like, and if they are being taught to understand the difference between actual health and just working out.

I am saying this because my H is at the Naval Justice School right now, and they just did command PT for the first time since Covid. They got one of these dudes to lead the command PT, and even the senior leadership felt like the workout was incredibly out of touch with the situation and population. Three people were injured. They have not repeated the experience lol. 

[ellipses84]

Some @ in my response. I’m so sorry. I didn’t struggle with weight gain in a major way, aside from permanently gaining a few lbs with each kid, until I had major surgery in my late 30s. The aftermath of hormone issues caused me to gain an extra 50lbs in a short amount of time, mostly in my stomach which was never an area that I gained much weight before. I’m very short so even a few lbs makes a difference. I suddenly started experiencing how shitty doctors can be about weight, either dismissing my concerns or saying super rude comments like I should stop snacking off the food my @kids don’t finish, as if that’s the cause of all my weight gain. I have cried in my car after appts, steeled myself to go back at my next appt and address my concerns before they said anything and eventually switched doctors. I’ve been working my ass off for the past year with intense workouts and eating better, with zero results in inches or weight loss, although I do feel healthier and have more strength / stamina. I can see major results with everyone else in my workout class. It’s so frustrating. I feel like I look ok in the mirror but don’t even recognize photos of myself. I was guilty of thinking it’s not that difficult to lose weight until I experienced it myself.

In my mid-20s, I had one stressful year where I atypically, rapidly lost weight and doctors dismissed me then, too, and told me I should consider myself lucky instead of running tests to see if there was a medical reason.

My only suggestion is to switch doctors or insist on a referral. Is there anyone else you could see for non-urgent care even if they are further away? Are there any virtual options where you could talk to a different Dr? Do you have a messaging system where you could write it all out? Be super direct and state your reasons and say, please provide a referral. You can report someone for poor bedside manner but that could be awkward if you have to see him in the future. Do they ever send out surveys? If so, I’d do that and leave it generic but clear that he needs to listen more, provide referral, have better bedside manner, etc.

[picksthemusic]

Wow. What a terrible provider. I'm sorry you had that experience.

I'm going to link to something my provider gives her patients regularly to help with building your plate and adjust your eating habits so that you may go into a slight calorie deficit without feeling deprived. It's essentially the Mediterranean way of eating, and a lot of our patients like it and do well. It's geared toward diabetics, but it has a lot of good nutrition information. Feel free to ignore if this is not the type of advice you were looking for.

www.novomedlink.com/content/dam/novonordisk/novomedlink/patient-support/disease-education/en/documents/Planning_Healthy_Meals.pdf

ETA: If you see him again, please insist on a referral to a dietician/nutritionist. If he declines or says he won't, tell him you want him to document in your chart that he is declining to refer you to a specialist and why. This should make him at least put in the referral.

[amberlyrose]

First- that dude is a jerk. 110%.

It took me a long time to process how much the military screwed over my body image, fitness, and overall health. I would receive the same advice from my superiors right before PRTs, which led to the same yo-yo effect. Get fit/skinny right before a test, injure myself somehow from overtraining/undereating, gain it back. I would have legit panic attacks at the idea of running because it was my worst score every time. Add in some undiagnosed ADHD and RSD to round it out and it would take me days to mentally recover from fitness related things.

Anyway, I know you want to get that support and guidance from your flight doc, but I'd suggest finding a registered dietician that works with disordered eating. Let the flight Dr. know you "took his advice" by looking on the internet and found someone to support your plan. Have him note it in your records. Your PRT is important for your job, but your health and wellbeing is more important.

And know you are not the only woman to leave a military Dr. to just sit in the car and cry for awhile. I've been there and I'm so sorry you have to deal with it right now. If you want to PM me, I'm here.

[secretagent]

I'm so sorry. I'm about your size based on the stats you posted and frankly would never do Keto as it's not sustainable and would be a disaster for my mental health. What an asshole.

[lilac05]

I’m so sorry. I would have cried, too.

I would not be returning to this guy for an ADHD appointment unless something has drastically changed very recently that has you concerned about your safety or the ability for you to do your job well. If it’s just a situation where you’ve finally come to accept something and are ready to do something about it, I’d hold off. Find some good podcasts to listen to or read an ADHD book. I can guarantee those would be more helpful than this doctor. He’s likely just to say, “Eh. Everyone is a little ADHD these days.”

[sonrisa]

Sept 21, 2021 12:33:45 GMT -5 VillainV said:

 I don’t think he’s going to be receptive to talking about my concerns.

I don't either. I'm sorry you had to deal with such an asshole. 

[aurora]

I'm sorry. I also ended up in tears last year after a doctor's appointment where he refused to listen to my symptoms and relevant history before "diagnosing" me and telling me my cure was to drink more electrolytes.

I hope you are able to see the second provider who is coming in and that they listen to your concerns and treat you like the actual human that you are (who is worthy of respect and kindness).

[cuadrado]

I'm sorry - there's a HUGE discussion right now in the nutrition/medical community around the ethics of these types of weight requirements in the military. F*ck that doctor.

[VillainV]

Sept 21, 2021 14:06:12 GMT -5 cuadrado said:

I'm sorry - there's a HUGE discussion right now in the nutrition/medical community around the ethics of these types of weight requirements in the military. F*ck that doctor.

I’m glad to hear this! The whole institution is incredibly fat-phobic, and it’s about 200 times worse for women. I can understand promoting healthy lifestyles, nutrition, and fitness, but I think the military’s collective understanding of what it means to be “healthy” and “fit” are very very imperfect.

[dcn]

Sept 21, 2021 13:32:12 GMT -5 hbtk said:

Sept 21, 2021 13:22:15 GMT -5 dcn said:

Ugh I’m so sorry. He sounds kind of useless. I would have cried too. Also, as you know doctors don’t have a ton of nutrition training so not sure why he thinks he knows more than a rd would.

My H is Army, but they have dietitians embedded organically with a lot of brigades or battalions now as part of their holistic health and fitness program. If not there is always a way to access one and you don’t need a referral. I’d go to your clinic or mtf website and just call one to see if you can get an appointment set up.

They are also inserting strength and conditioning coaches to help with fitness, not sure if the AF is doing the same? Does your wing (not sure if that’s the correct term) have someone who organizes physical training? There is a big push in the army right now to get people certified as master fitness trainers to help units improve their functional fitness (as part of the new PT test).

The army also has wellness centers where you can go to get health coaching, body fat % measurements and tracking etc.

I love this in concept but in practice it will be more of the same, I think. The people who get certified as master fitness trainers will be the workout bros who are completely out of touch with the needs of some of the active duty population - particularly women and those who struggle with health as they age. Now they will just be there to nag and try and make themselves look good to command, which generally will entail unrealistic workouts and snarkiness. It's a talking point for their evals. I would be interested to know who is certifying them and what the program looks like, and if they are being taught to understand the difference between actual health and just working out.

I am saying this because my H is at the Naval Justice School right now, and they just did command PT for the first time since Covid. They got one of these dudes to lead the command PT, and even the senior leadership felt like the workout was incredibly out of touch with the situation and population. Three people were injured. They have not repeated the experience lol. 

Oh no! I’m sorry he had that experience. I wouldn’t form an opinion and discount an entire program from one guy. I’m sure there are meatheads who go to the course but there’s plenty that aren’t. I don’t want to put my H’s job out there but he’s very involved with the course (and he’s the opposite of a dudebro) so I’m speaking from a knowledgeable place.

That said, this new way of approaching fitness and health in the military is a culture change, and there are definite road bumps and incorrect messaging out there still.

[dcn]

Sept 21, 2021 14:06:12 GMT -5 cuadrado said:

I'm sorry - there's a HUGE discussion right now in the nutrition/medical community around the ethics of these types of weight requirements in the military. F*ck that doctor.

Yes, people inside the military agree! It’s so slow and hard to make changes.