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Memo to medical professionals: the 'weight' issue

I have a bone to pick with the medical community, although it's probably well hidden beneath layers of fat. Yes, I'm talking about the way that doctors and medical professionals deal with weight.

A few months ago, I asked my friend if she liked her 'lady doctor,' because I needed to go in for my annual check-up and I don't have a doctor in SF. Her response was something along the lines of "yeah, I like her because she doesn't talk a lot. I mean, except to tell me to lose weight." At this point, she shrugged, as if this is par for the course. For the record, this friend, while not slender, weighs less than I do.

So I went online to Yelp (otherwise known as the bible), and I chose a doctor who gets rave reviews. He's a man, unfortunately, but I figured I should just suck it up and give him a try. And I liked him, mostly. The only thing he did that bothered me was that he talked a little too much. Oh yeah, and that he kept slipping in comments about my weight: "your blood pressure is a smidge high– it's probably nerves about a new doctor, but it could be your weight. When you move back to London, make sure you get birth control with a 30-35% [some hormone] because anything lower is too little for someone of your weight."

This was the first time since the surgery that a doctor has commented that I'm too heavy (and I use the term literally) and need to lose weight. I think once the medical history is out there, it's pretty clear that I'm doing what I can. I've already had major surgery, and now I eat small, healthy meals and work out for an hour and a half, three times a week. I'm so sorry that I still weigh too much; believe me, nobody is sorrier than I! I'm doing my best to lose more weight, but that's not even the issue. The issue is that weight, as in the number on the scale, has damn near nothing to do with health in any way. It doesn't take into account height, bone mass, muscle mass, water weight, or a million other tiny factors that can make that number five pounds bigger or smaller in the course of a day, in my case at least.

When are doctors going to stop using the term 'lose weight' as a substitute for 'get healthy?' I'm so sick of weight being an indicator of health. I'd bet dollars to donuts (and yes, that was intentional and not just a Fattian slip) that I'm significantly fitter, healthier, and generally more able than a girl my age who weighs 120 and never exercises. I'm as heavy as I am for multiple reasons, which include extra fat, of course, but also the fact that carrying around 300 pounds on my frame literally thickened my already-dense bones (I was told this by the surgeon who performed my GB), and that I have legs of steel (under the flub) from climbing Telegraph Hill every day.

I'm not suggesting that doctors need to be more sensitive, but that they need to be smarter. More specific. Target the problem, you lazy fuckers! Stop using 'weight' as a catch-all term for what ails the patient! If I need to be less fat, tell me I need to cut down on my body-fat percentage. If I need to eat more vegetables / fewer carbs / less red meat, or exercises more, or drink more water, or have a frickin' colonic once a month, then TELL ME THAT. I am over the scapegoating of pounds (or kilos, or stone, or whatever).

The bottom line is that naturally thin people, people who've never gained weight for any reason besides laziness or too much MacDonalds, don't have any fucking clue what makes a fat person fat. Every fat person is different; we all have different genetic factors and different environmental factors. I really like sweets, but that's not why I was obese. It was probably a contributing factor, but given that my mom is a health nut, there's no way my eating habits were solely to blame for my weight (by the time I was 10 I weighed 100 pounds, and the closest I got to chocolate was carob). No, I was obese, and I'm still 'heavy' today, because of the genes that my father gave me, direct from my grandmother, complete with slanted femurs, knock knees, wide hips, and small boobs. I'm a pear, and I always will be, but I am NOT unhealthy and I'm tired of one number convincing people that they know anything about me.

Pardon the swearing in this post, but this is something I feel really strongly about. Everybody (and every body) is different, and people in the medical profession should know this better than anyone. To fall back on numbers and surveys and journal articles about weight, instead of talking to your patient about her lifestyle, measuring her body-fat percentage, and testing her overall health, is lazy and borderline unethical, and I won't have it. Can anyone recommend a good 'lady doctor' who takes the time to do things right?

Comments

Anonymous said…
You're a great writer. This makes for an very enjoyable, informative read.
Please keep writing!
Anne said…
Aw, shucks! In all honesty, I really need to hear that sometimes, so thank you.
Sara said…
Very well-put and exactly on point. I have had similar experiences, and it's refreshing to read that I am not alone. There is much more to good health than BMI and body fat percentage, and we need more people to address this problem.
Anne said…
Thanks, Sara!

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