TW for lots of fatphobia and weight loss talk, but I have some thoughts that just won’t leave me alone. This is long.
More so observations about my interactions with doctors (as a Pt) after a moderate amount of weight loss. Two interactions on opposite ends of the spectrum have taught me one thing:
You can’t win for losing.
The first interaction is with my favorite doctor. This is the guy that’s literally saved my life multiple times, and the first person to figure out some my rather unusual issues. He’s always blunt with me, which I’ve always appreciated. He’s never been one to pretend that weight loss would cure my issues, but he wasted no time in telling me that it would help control some of the symptoms.
But he waited until I asked the question first.
At first he was interested in a general trend: up or down? After a while he gave me a simple goal: lose 20 pounds by the time I saw him next. The next time I saw him, I’d actually lost 30 pounds, and I think it made his day.
But there was one thing that look me aback a little: he assumed that since I had done so well with my weight loss, that all of my other symptoms were under control. Think about that for a second. So many of us are told that all of our symptoms will get better when we lose weight, that we’re ignored when we’re fat. We assume that if symptoms persist once we’ve lost weight they’ll take us seriously. But what if they just look at us like we’re crazy when we tell them that weight loss didn’t make us feel better?
At the same time I couldn’t bear to burst his bubble. I mean he literally showed me off to some of the staff that visit declaring how well I was doing. He’d paid attention to other issues, and I’ve had other issues since that visit that they’ve been very responsive to, but I was a little surprised by the whole thing.
The other doctor is one I see because he’s literally the only specialist of his type in town. He was outwardly fatphobic as fuck, but adequate at what he did so I dealt with it.
He would ask me the following questions about my health, even though they had nothing to do with his specialty and he had never run any tests relating to them:
Every time without fail: “How is your diabetes?” I’m not diabetic. “How is your pre diabetes?” I’m not pre diabetic. “How is your insulin resistance?” My last NON fasting blood sugar was literally 79. “Have you looked into gastric bypass surgery?” My BMI does not meet the minimum criteria. “How is your high blood pressure?” I have low blood pressure.
I put up with it, and eventually he’d get back to the topic I was actually there to see him about.
Mind you, I’d between my first and second visit I’d lost 20 pounds.
Which brings me to my latest visit. Between my second to last and most recent visit I’d lost an additional 23 pounds. (That’s 43 pounds total for anyone keeping track) My blood pressure was 94/48. The nurse was actually concerned about me.
When the doctor came in, it was like I was seeing a totally different provider. He listened to me, he was attentive. He took my symptoms at face value, and offered treatment. He didn’t bring up any of his usual baseless questions. In fact he didn’t bring up weight at all. I mean great, but a little disturbing as well. This is how I should have been treated all along.
It left me a little perturbed, until I got my care summary a few days later. My vitals were at the top, with BMI at the top line: 30.2. Obviously still quite heavy, but also a drastic improvement. For the first time in years I have a BMI that’s nearly in the overweight range, and I’m nowhere near done losing weight yet.
Then I see the first thing on my problem list: E66.01: Morbid (severe) obesity due to excess calories.
For those not in the know, that’s a diagnostic code for a BMI of 40 or higher. Which I have never been, not even at my highest weight. He then went on to say that I have been non compliant with weight loss despite extensive counselling.
Reminder: He never once brought up weight in any way during the visit. My current BMI is 30.2, which is noted on this very same note. That’s 9.8 points below the minimum BMI needed to be accurate for that diagnosis. I HAVE LOST 43 POUNDS IN THE LAST YEAR.
But, as an individual I was treated much better, at least to my face.
I know I need to let go of these things, but they keep rattling around in my head. I know there are SO many people out there that are bigger than I am and don’t have the knowledge and experience I do in navigating the healthcare minefield- as a patient and a professional.
So like I said earlier, there’s only one conclusion I’ve been able to come up with:
You literally cannot win for losing.
