Thoughts on Doctor Visits as An Overweight Person

Almost my whole life, I have dreaded visiting the doctor, and frankly avoided it at all costs.  I have gone a handful of times for routine visits, but unless I'm really, really concerned or sick, I don't voluntarily go.  It's a weight issue for me, and has caused me an incredible amount of angst over the years.  I feared the doctor scale, the blood pressure reading, and the suspense of whether or not the doctor would comment on my weight.  The doctor's office was the one place I carried the most shame about being obese.  I knew that my health was being compromised.  On the wall, I saw the creepy poster of the fat and thin persons through x-ray - the admonishments about what I was doing to my health by eating too much and not exercising enough.  I would leave the office feeling terrible about my inability to get a grip on my health and weight.  Look at what I was doing to my body!


At my book group meeting this past Saturday, one of my dearest friends, who is also a nurse practitioner at an Optifast clinic (not mine, though), brought up this issue as she heard the sad stories from her bariatric patients.  Her eyes were opened to how the established medical community is failing to help obese patients.  I shared with the group my own experiences with this.

As I reflected on my feelings, what came to light was the absence of hope.  Six months ago, I never dreamed I could lose weight.  The task was just too daunting and I had tried and failed so many times that I never felt confident that I could do it.   I knew that I should do it, but didn't feel that I could do it.   When I think about the public messages at the doctor's offices, what they really lack is compassion and hope.  I didn't need to be scared and shamed any more than I already felt.  What I really wanted was for someone to send me a positive message of hope and help.  You know those signs in the women's restroom that aim to help abused women?  "Are you suffering in an abusive relationship?  We are here to help you.  Call -----."  What if the waiting rooms in doctor's office and clinics had beautiful compassionate posters that said "Are you overweight and overwhelmed?  We have several programs to help you every step of the way on your journey back to good health.  You can do it and we can help!  Call us at ------."

The commercial weight loss industry does this pretty well.  We've flocked to their programs with the "before and after" posters, dreaming that we would one day be one of those people.  The medical establishment could learn a thing or two from their approach.  They are big on naysaying commercial programs (talk about mixed messages!), but what alternatives are they providing us?  In our most vulnerable moments, are we going to reach out and ask for help while we have to face a giant poster with an x-ray of a fat person or when we feel the wagging finger of the medical establishment?  Not me.

I'm lucky that my current medical provider has this special weight loss clinic with a number of programs (some of which are free).  I didn't learn about them through a visit to the doctor's office, though.  I found them online when I was grasping at any solution to my weight problem.  I was also lucky to have a friend who I felt comfortable confiding in, and who worked in a weight loss clinic.  In the end, it was my friend in the medical community who compassionately led me to my current program.  Did I know that Optifast was going to work for me?  No.  But just that little bit of encouragement helped me take the next step.

I'm not saying that Optifast is the right choice for everyone.  At my clinic there are a number of real-food support groups to help people who want to lose weight.  I think that support is one of the most important success factors.

Every day for the past 6 months I've been thankful that I started this journey back to health.  It hasn't been easy, but I am giving it my best and really trying to make changes in my relationship with food.  I still have many months to go as I finish my fast, transition to food, and attend maintenance support groups, so I'm a work in progress.  I'm just trying to soak in every bit of this experience.

If you are reading this and are searching for hope, please know that you are not alone and that there are many great people who have started a long weight loss journey and are maintaining a healthy weight.  You can do it too.  Don't be afraid to research and reach out for help, whether it's in person or online.  Even if you have had a lifetime of being overweight, it is never too late to discover the healthy person that is inside of you right now.

Weekend Readings and Links

Well, thankfully the fires have been conquered!

In between loads of laundry and schlepping kids to and fro, I've had the chance to do some fun reading on diet and fitness this weekend.  It seems that everyone has an opinion on how to measure healthiness and what to eat to maintain optimal weight and health.  These are two subjects that are on my mind right now, and that I'm exploring.

The first subject is the reliability of the BMI (Body Mass Index).  For me, it's the scary, judgmental measure of "ideal body weight" a person needs to maintain to be healthy.  I started my journey in the terrifying "morbidly obese" range.  But this well-used measure is controversial.  When you look at the population as a whole, studies have shown this old measure to be a statistically reliable predictor of the relationship between body weight and health risks.  However, when applied to individuals, it doesn't work quite as well.  If you are athletic, have large or dense bones, or are muscular - you may be perfectly thin and healthy while at a higher weight and BMI.  This may cause undue stress or financial penalties (in the case of insurance).    Here is a great little OpEd article, The Top 10 Reasons Why the BMI is Bogus, that explains this well.  I enjoyed reading the comments section even more.

I started reading about the BMI while thinking about my goal weight.  I haven't been anywhere near my normal BMI since I was in high school (30 years ago).  It's a foggy memory.  So when I listed my goal weight for Optifast, I aimed for the upper limit of "normal" on the BMI scale, because the lower level seemed like I would have been very very thin.  Reading MyFitnessPal posts and the like, I have noticed that many people struggle with the question of goal weight, and the answers and thoughts on the issue that resonated with me were of people who said that they let their clothing size and physical appearance decide for them.  That makes sense to me, so I'm keeping an open mind.

I've written a bunch about my explorations of the best way for me to eat to maintain my weight loss. My husband, sister and brother-in-law are all eating a low carb high fat diet for weight loss.  Hubby loves this, and based on what I see him eating, I'm thinking this is a contender for our new "lifestyle".  He has been very successful so far and I think his diet can be easily adjusted for maintenance.  I recently came across a blog that was really interesting.  It is written by a dietitian who also cites peer-reviewed journal articles at the end of her blog posts.  Here is the link to The Low Carb Dietitian.  Since she is a Registered Dietitian and a diabetes educator, I feel comfortable with her thoughts on eating based on recent medical studies.  The tide is always shifting when it comes to dietary conventional wisdom. Over my adult dieting years, many different "truths" have been shared, but yet they keep changing (especially the viewpoints on eggs, carbs and fat.)  If I were to listen to my body, I'd have to say that lower carb is probably better for me in the long run given my strong cravings.

I love getting the chance to read information on health.  This weight loss transformation is an amazing experience, and I'm highly motivated to keep myself here.  I can't even imagine myself at 140 lbs.  A few months ago, I would never have dreamed that I'd be able to lose this much weight and be able to function in long-term ketosis.  It has been a dream come true so far.  But keeping it off in the long run will require equal focus.  Optifastmom wrote a great post on this topic called Weekend Woes.  For many of us who work hard to lose significant amounts of weight, developing and sustaining a healthy Way of Eating (WOE) can certainly be a woe sometimes and will require lifelong vigilance.