The Doctor

**Trigger Warning for discussion of weight losses and gains and bmi, binge eating disorder, and gynecological examinations**

I went to the gynecologist today for the first time in two years (I’d been busy and just kind of lost track of the time), and I was nervous about it from a weight-perspective.  So nervous, in fact, that I had a lot of trouble falling asleep last night and didn’t actually fall asleep until after 4am.  I’m going to go into my recent history with doctors before returning to today’s visit…

The last time I had been to any doctors was last summer when I booked an appointment thinking I had binge eating disorder (I had lost about 40 lbs before entering grad school the year before, and had gained it all back in one year).  I met with a general physician and then saw a therapist and a nutritionist for a while after that.  I found the nutritionist worse than useless–not because she wasn’t a good nutritionist (she may have been, and she was perfectly nice), but because I would tell her about my eating habits and she would say “that sounds great, maybe drink a little more water”.  Basically, she was saying that according to my eating habits, there was no explanation for why I was binge eating.  I actually found meeting with her and having to report on my eating habits stressful and triggering (and obviously not helpful), so after only three meetings, I stopped booking appointments.  The therapist was a little more helpful, because she got me thinking about my life and talking about things that I’d never talked about.  I think I have trouble accessing my feelings when I don’t put them into words, and that’s actually part of why I think this blog has been really good for me.  I can figure out what’s bothering me (or making me happy), and then I can let it sit in its place here and move on.  But when I talked with my therapist about what I was going to “do” about my binges, I got stressed out.

I think the ONLY thing that directly helped me basically stop having binge eating disorder was finding the fat acceptance community.  I found a link into some part of the fatosphere from an eating disorders website, and then lurked around.  Shapely Prose and The Fat Nutritionist (see sidebar for links) were both key sites that helped change my attitude about food, health, and my body.  Once I stopped viewing my body (and myself) as dangerous and shameful, my binges petered out.  Today, my eating feels much more “normal”, at least in that I don’t feel like I’m eating even when I don’t want to eat anymore, and in that I don’t generally feel sick after eating.  I also now have a neutral attitude about what I’m eating and how much I’m eating.  I still think I eat quite a lot, but who can really know, and I don’t have a problem with it–maybe “a lot” is the right amount for me, or maybe other people are eating too little.   Anyway, since last summer, I’ve gained about 25 lbs–after not weighing myself in a long time, I weighed myself a few days ago in anticipation of being weighed at the doctor’s appointment, just to take a little of the unknown out of the experience.  It’d be nice if my weight were to level off, but I’m not sure if I’m going to gain more weight before that happens or not, or even if it will happen for me, although unlike when I started this blog, I have more confidence now that it will likely level off.  Anyway, I’m writing about this just to say that my current weight gives me a bmi of 34 (213 lbs at 5′-6″), well into the “obesity” range.  Before going to the doctors last year specifically for binge eating disorder, my highest weight had only ever been at the top end of the “overweight” category.  As an adult, I don’t remember ever having a doctor discuss my weight with me, and  going to the doctor for routine check-ups never made me nervous.  Back to today…

I just wasn’t sure if my weight would be mentioned at all, or how it would go today.  Overall, I’m pleased with how I acted, and I liked the doctor (she was a new-to-me gyno).  It wasn’t perfect, though, and my weight did get mentioned.  The doctor could see in my records that I’d been seeing a doctor, nutritionist and therapist for binge eating disorder, so she asked me how it was going.  I said something along the lines that I was comfortable with my eating habits.  My blood pressure was high, as it was a year ago when I saw my general physician, and the gyno recommended that I check back in with the regular physician to see if it’s something we should do something about.  She did say “if you lost weight, it would come down”, but I immediately said that I would not be losing weight intentionally, and then she said something like “that’s fine, we’ll work with you in whatever way we need to”.  I was a little ruffled that she would suggest weight loss to someone with an eating disorder in their history, but it was not done in a particularly offensive way, and she seemed perfectly happy to change direction when I made it clear that intentional weight-loss was off the table.  The thing about this high blood pressure issue is that I’m really under-convinced that it is a permanent state for me.  Last year when I was tested I was about to discuss an eating disorder I’d never discussed before, so I was extremely nervous, and as I said at the top of the post, I was really nervous about the doctor’s visit today, so these might be nervousness-related high readings.  They also might not be, because I do have a family history of high blood pressure, but I also have a family history of false-highs; my grandmother always tests high in a doctor’s office, so my grandparents actually bought a blood-pressure cuff so that they could test her blood pressure at home, and it’s always been normal.  I’d never had high blood pressure until last year, even though my weight had been that high before.  It’s possible the high blood pressure is linked to my current high weight, but I’m not sure.  I certainly wouldn’t want to “do” anything about it until I was convinced that it was an on-going thing.

The doctor also asked about sleep and exercise, and I didn’t have particularly “good” things to report on either of those issues, and honestly, I’m just not sure that those are appropriate questions at a general check-up where I haven’t brought up any specific complaints.  I’m not there because I want her to tell me what she thinks I should do–I’m just there to check to see if I have any problems.  I understand that prevention is a concern, but it’s not like I don’t know about the benefits of sleep and exercise.  I’ve written a few times on this blog about how I’m trying to disentangle exercise from dieting, so it’s just not something I want to be pressured about, however slightly.  The doctor really didn’t push it, but she did end the appointment by talking about how she likes to advocate “one small change”, whether it be taking calcium supplements or attending yoga once a month (which…I don’t think the way I described my exercise habits excluded the possibility that I already do yoga at least once a month; that is actually probably close to what I do, but whatever, I may have down-played my exercise).   She also mentioned the “take the stairs instead of the elevator” gem of advice (earlier, while the speculum was inside of me, so I really didn’t feel like having a conversation about it at that point).  The appointment just left me feeling…not that great, I don’t know…  I guess I’m just saying that in this past year my mental health has been my primary focus, and I don’t really want a doctor to tell me that I should be trying to change anything about my lifestyle unless it relates specifically to a medical condition they have confirmed that I have.  I don’t want them assuming anything about my goals or trying to tell me what my goals should be.  In conclusion, I liked this doctor, but the appointment justified my being nervous, and in the future I think I should make it clear that I only want to talk about specific medical conditions.  The doctor said she’s good about email, and because she seemed willing to work with whatever my standards were, perhaps I should send an email before the next visit.  I wish it didn’t have to be this way, because if I weren’t at such a pro-active and skeptical point in my life I might just let these things bother me without doing anything, and obviously they still bother me even if I am going to do something about them.  I just wish going to the doctor was the non-issue that it used to be for me, but unfortunately these uncomfortable situations seem to come with the territory of fat acceptance.

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