Imperfect Wellness Series: If not dieting, then what? Creating healthy habits, without moralization of those habits, has been harder than I thought.
I'm sitting on an examination table, feet in stirrups, thin paper sheet covering me from the waist down, and an ultrasound wand in my goods. My doctor is performing an ultrasound to check out my uterine lining because of my complaints of a heavy period. "Yep, it looks like your lining is slightly thick, but I'm more concerned about your high BMI ." I nod my head confirming I had heard both pieces of info. While continuing to take pictures of my uterus, my doctor elaborates on the health benefits of losing weight, suggesting I go back to my primary doctor and request a referral for weight loss surgery and really focus on weight loss. "Are things really bad in my uterus," I ask. "No, everything looks really healthy. You're lining is slightly thick and we can address that with 10 days of progesterone."
So let me get this straight, the only information my obgyn doctor knows about me are my BMI, blood pressure, and the health of my uterus. At this time, he has no blood work on me, hasn't looked at my family history (because he asked me if anyone had endometriosis and/or cancer in my family), failed to ask if I had had any previous surgeries (which if he had he would know I did have LapBand surgery at one point in my life), or ask if I was currently making any lifestyle changes that would affect my health.
My entire obgyn appointment lasted 20 minutes, and 90% of it was focused on how fat I was.
It's hard not to instantly believe a doctor is incompetent when he/she focuses on my BMI, and not the reason I am there for the appointment. I don't doubt that this obgyn doctor was, and is, good at what he does. He came highly recommended, and his reviews online were all really good. My issue is that the focus on the size of my ass seems to magically blind the medial profession from providing good health care. My fat seems to take over an appointment, and instead of addressing the sore throat, endometriosis, or other issue I may be having, doctors become obsessed with making sure I'm aware I'm fat and Lord Jesus I better do something about it!
A couple questions I have for the fat-focused doctors are: 1. If the U.S. looks more like me, then is recommending dieting and weight loss surgery working? 2. If you are so concerned about how fat I am, have you looked into recent research on how well people maintain their weight loss long term? 3. Do you know how weight cycling affects long term health? 4. Do you know what the long term success rate is of someone who has had weight loss surgery, and would you still recommend it as a preventative measure?
In the past I would haul medical journal articles with me to my doctor's appointment and try to educate my provider, but now... I just try to find a new doctor.
Is It Really About the Doctor?
I really don't know what the answer is to the fat-focused doctor issue. I will still continue to seek out medical help when I need it, but it might take me a bit longer to find a competent doctor.
I think the bigger issue is how these fat phobic appointments affect me afterwards. Unfortunately, I still do take these appointments personally, and feel more shame temporarily about my body. When taking a step back from this situation, shame is really the bad guy in all of this. My doctor was simply the catalyst for my shame shit storm in today's appointment. What's ironic about this whole situation is that in my doctor's efforts to "encourage" me to focus on my health errrr weight loss, he actually produced the opposite affect of creating a ripe environment of body shame. Body shame has negative consequences on our health, and personally sets me up to sabotage the positive health changes I am currently making in my life.
Being ashamed of my size is not a new struggle for me. Me and body shame go waaaaaay back, but as I get older I don't tend to sit in body shame as much as I used to. Yeah it sucks having to hear the broken record of different fat-phobic doctors, but now I see it more as incompetence on the doctor's part. I don't believe this is an individual doctor issue, but more of a medical community issue. Want to produce better health care providers? Address weight bias. My weight should not determine my quality of care.
After my super fun appointment, I did want to come home and pour myself a stiff drink and follow that with a nice cold beer. What's interesting about this whole appointment debacle is that I do want to push all feelings aside with food and drink. I don't think this is bad or unusual (who likes dealing with crappy emotions?); however, the point of trying to live a healthier life is to try and create new habits, and ways, of handling everyday stressors. So yes, I'm still dry and I didn't stop by the alcohol joint and buy a nice cold six-pack of Hefeweisen, but I wanted to soooooooo badddddd.
A couple of interesting developments since starting these habit changes: 1. I have no acid reflux at all. It's completely gone. 2. On the days I complete my walk/run (love Jeff Galloway's method) exercise and yoga, I feel waaaay more positive about life. 3. Since adding more exercise in, I'm drinking a ton more water than I was before and I think its making my skin clear up. 4. I'm still not getting a whole lot of sleep despite making changes to my schedule and environment. 5. Logging my food, sleep and period is still annoying but I've learned I don't really like lunch. I love a big breakfast and dinner but lunch tends to get lost in the shuffle. Not sure what to do about that or if I should even care.
Here is a list of my initial habits and I've tweeked them to what I'm currently doing below.
1. Adding fruits and veggies to every meal.
2. Cut meat out completely (except broth) for 90 days (started Apr 8th 2019). Revisit meat consumption post 90 days.
3. Keep a food, sleep and period journal to gather data on my patterns and habits.
4. Walk 3x's a week after my kids are done with school.
5. Practice yoga 2x's a week after my kids are done with school.
6. Incorporate some kettlebell swings and lifts 2x's a week. (not working out, will revisit later)
7. Ten minutes of silent meditation daily.
8. Dry up for 90 days (started Apr 8th 2019). Give alcohol a rest.
9. Utilize a therapist to help me process everything that's kicked up in this process.
10. Ask for help or find someone outside of the family to support my exercise and food habits. (ack! haven't done yet!)
If your wellness is lookin' as imperfect as mine, I'd love to hear from you (firstname.lastname@example.org). Send me a message! Let me know how you're doing!
May you find your imperfect wellness,