Tag Archives: weight loss

communication, condescending twatbags, healthcare, mental health, overly helpful people, pests, social media

It’s not “bad advice” to tell someone to find a new doctor if they are unhappy with the one they see…

Yesterday, I read an advice column by Carolyn Hax of the Washington Post. The first subject came from a woman who described herself as in her mid 50s and obese. Her question was adapted from an online conversation. Below is what Hax put in her column:

Hi, Carolyn: Will you give me a Pap smear or a pep talk? I am dreading my yearly OB/GYN appointment. My doctor, while very personable, continues to care more about my weight than any other issues. I am in my mid-50s and obese, but I am working out two to three times a week with a professional trainer. Those sessions are quite strenuous.

I am not normally at a loss for words, but my mild pushback during the last physical resulted in an irritated doctor, pushing additional “suggestions” — which usually entail signing up for a commercial weight-loss program, visiting a colleague who is not in my network, tummy tucks, etc. I generally reserve those topics for my yearly visits with my general practitioner and prefer she concentrate on my “woman parts.” Yet I know the first thing out of her mouth during the next visit will be, once again: “You still need to lose weight. Are you still exercising?”

— At a Loss for Words

I agreed with Carolyn Hax’s advice, which was this:

A pep talk, then: Get another doctor. If that’s not practical, then state clearly to this one that you are working with your primary doctor on the weight and will not discuss it in this appointment. It’s your appointment, your care. You say what and when. If you lose your nerve in situations like this, then write it down and hand the note over.

I left a very short comment on the Facebook post for this column. I wrote “Get another doctor or, do what I do and avoid going. ;)”

Now… maybe I shouldn’t have have “joked” about not going to the doctor, since that’s not exactly a health promoting suggestion. I actually wasn’t joking, though, in spite of the winky smilie. I don’t go to doctors unless I’m really sick. I know some people think that’s crazy. In fact, given my educational background, it’s probably very surprising that I don’t visit doctors and get screenings. But if you know my history, it’s a lot less surprising. I had a really bad experience with a gynecologist who traumatized me. I also have kind of a bad attitude about life, most of the time. It’s getting worse by the day.

However… I do think the first part of my comment was sound. I do think that if your doctor isn’t a good fit for you, you should find another one. Doctors aren’t gods. They make mistakes sometimes. And if you’re going to one who upsets and alienates you so much that you don’t want to go see them, that’s a sign that you need to find a new doctor, even if they’re not wrong about advising you to lose weight, or change, or eliminate, some other aspect of your lifestyle.

OB-GYNs, in particular, are examining a very intimate part of the body, and that requires great trust in them. I am a firm believer that any doctor who is putting their hands in orifices where the sun doesn’t shine needs to be very professional and sensitive to their patient’s needs. I feel that way because of that first (and only) OB-GYN doctor I saw, who treated me like a slab of meat, insulted me, and physically hurt me. Then she basically told me to shut up while she continued her exam.

Afterwards, that doctor blamed me for the fact that she wasn’t as thorough as she’d wanted to be, because I wasn’t “relaxed”. As if I, as a virgin on whom she’d just used a large, metal speculum that hurt like hell, could easily relax, under those circumstances. She abused my trust. I left her office in tears, feeling like I had just been sexually assaulted, and knowing that technically, I’d only just had my first pelvic exam. That experience still made me feel extremely violated. Now, I don’t trust most doctors at all. Intellectually, I know it’s irrational to think that all doctors will do what that woman did to me. I’ve even had some good experiences with doctors since that incident. I still find it terrifying to see most physicians… even the ones who don’t require me to get undressed for them.

The doctor in the above scenario sounds like she’s basically competent, but she’s pushing “solutions” that aren’t feasible for the patient and are wasting precious time in an appointment that is probably already too short. So, I don’t think it’s wrong if the patient decides to try another doctor in that case. She may find, after trying another doctor, that she likes the first doctor more, or she may find that the second or third doctor she tries is better for her needs. If she has the flexibility to try different practitioners, I think she should. It’s her body, and her healthcare… and ultimately, it is her LIFE.

I got some likes for my very short comment, on which I didn’t elaborate. One person left me a “sad” smiley. But then, I got a comment from someone calling herself “Winnie Jay”. Winnie Jay decided to blast me and another commenter, then chastised me for “joking” about such a serious matter. She then ended her diatribe by calling me “girl”.

I know it sounds crazy, but Winnie’s comment really infuriated me. Especially, since she called me “girl”, which is a very diminishing and disrespectful thing to do. I mean, she’s not wrong to write that obesity isn’t healthy and is correlated with chronic diseases, and people often lie about what they’re actually doing to protect their health. But does she really expect people to take her seriously when she’s so confrontational and rude? My first instinct, honestly, was to tell her to go fuck herself.

However, instead of firing back at Winnie, who unceremoniously “pooh poohed” on my brief and basically innocuous comment, I wrote “Thanks for your input, girl.” And I left it at that. I didn’t even use a “reaction” or an eye roll smiley. If she has a brain, the fact that I reciprocated by calling her “girl” won’t be lost on her. If you want people to take you seriously and hear what you have to say, you shouldn’t go out of your way to alienate them… which is exactly my point about the doctor described in Carolyn Hax’s column. Fortunately, Winnie didn’t come back, nor did I get any other comments. As of this morning, Winnie is now on my block list; so we won’t run into each other again.

I looked at the responses on the Washington Post’s article itself, as opposed to its Facebook page. Quite a few people were pointing out that the doctor was right to aggressively harp on the woman’s weight at every visit. As a former student of public health, I agree that obesity isn’t healthy, and competent doctors should address it, or at least encourage healthy weight loss. However, physicians should do that with sensitivity and respect, as well as some situational awareness of the patient’s reality. Good people skills are important. Most folks don’t like to be lectured, especially if they’re adults. Chastising adults as if they are children is a good way to get fired.

I realize that asking doctors to have a little sensitivity might be a tall order when you only get about fifteen to twenty minutes for an appointment. But, if the doctor is spending some of that time promoting things like commercial weight loss programs, tummy tucks, or out of network doctors that the patient can’t, or won’t, access, that’s precious time wasted that could be used for coming up with a better, more effective solution, that will fit the patient’s reality and ultimately have more of a chance of success.

Medicine in the United States is a business. People can and do leave reviews for their doctor’s services. I don’t think that is a bad thing, either, because it helps people choose a practitioner who can give them the best care for THEMSELVES and THEIR OWN BODIES. Some people like authoritative doctors who tell them what to do; it gives them a sense of security. Other people prefer a more collaborative approach. Some people like doctors who are very relaxed and calm. Others feel like a doctor that is too calm isn’t doing anything to help them.

Fortunately, there are a lot of physicians in the United States, depending on where you live. Anyone living in the Washington, DC area will have a lot of options for receiving basically good care. So I think Carolyn Hax was right to tell the letter writer to look for another OB-GYN who is more in line with offering her care that is appropriate for her situation and preferences. After all, she’s paying for the doctor’s time and expertise. It might as well be time that is as pleasantly spent as possible, especially since she seems focused on improving her health and hanging around in this hellscape we’re in right now.

As for Winnie… I could have told her off, if I’d felt like it would have done some good. Winnie was likely looking for a fight, and she made some erroneous assumptions about me. She might be surprised to know why I responded the way I did, but instead of being respectful and kind, she decided it was more effective to be hostile and insulting to a stranger.

If I had decided to respond to her, I would tell Winnie that a person could be the BEST trained and most educated doctor in the world, who recommends all of the right treatments and medications and is very highly regarded and respected. None of that will do a single whit of good if a person feels so uncomfortable and alienated that they can’t bring themselves to make an appointment and go in to see the doctor.

Because of what happened to me when I saw a FEMALE OB-GYN, I have a really hard time seeing doctors today. Just the thought of calling one for an appointment fills me with dread and anxiety. I’m smart enough to know that not seeing a doctor is risky, especially at my age. But I also know that I don’t particularly want to grow old, anyway, and spending time talking to someone who is obnoxious, offensive, or oblivious isn’t my idea of a good time. Especially if I’m paying for it.

I also know that I am not the only one who feels this way… I’ve blogged about it before, with links to articles about people who have gone in for a specific medical problem, and the doctor remains hyper-fixated on their weight. That approach really can cause a person to feel like they don’t matter and their actual needs won’t be addressed; and it makes it that much harder for them to ask for medical attention when they really need it.

Again… just my thoughts, y’all. I have an issue that probably should be addressed by a doctor, but my choices here involve either going to a military doc (like the asshole OB-GYN who hurt me), or seeing a German doctor, who may go into lecture mode. Neither option is very appealing.

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complaints, condescending twatbags, healthcare, LDS

Repost: Fat fighting 70s Mormon style…

I am reposting this entry from September 28, 2016, because it relates to the other repost for today. I used the same BYU film for both posts, but they are about different topics.

Yesterday, while screwing around on YouTube, I came across a most bizarre film from 1971.  It was evidently put out by the Church of Jesus Christ of Latter-day Saints.  Behold…

A film for “sweet spirits” who could stand to lose a few… or more.  The music on this is nightmare inducing…   

The LDS church has a long history of producing audio visual learning aids.  If you were around in the 70s and 80s, you probably saw some of their ads on television.  I hesitate to refer to them as PSAs, because they were really put out as a means of attracting people to Mormonism.  As someone who was born in 1972, I vividly recall several different ones that were regularly rotated on daytime TV.

I must admit, watching this video makes me cringe.  I’m embarrassed and humiliated for the women who are in it.  Having never been LDS, I can’t really speak to what this film was really intended to do, other than remind women that they need to be thin and pretty for the Brethren, so they can find a temple worthy husband who will take them to the Celestial Kingdom.

One woman talks about how she still gets “dates” even though she’s fat, so she has no motivation to lose weight.  How sad that is.  The only reason she could possibly have to want to lose weight is to find a man?  What about losing it because you want to?  I also find it very strange that this film makes these women out to be binge and compulsive overeaters.  Yes, it’s true that many people are heavy simply because they eat too much, but that’s not always true.  The truth is, being overweight is a complex problem that can be caused by a variety of factors.  I am myself overweight, but I don’t eat three bowls of ice cream in a sitting, as is depicted in this film.  

As the film continues, the male announcer says…

This is part of our commitment action approach to weight control.  The girls meet weekly in therapy sessions where behavioral change is emphasized.  Overweight people tend to be dishonest, inconsistent, and irresponsible.  How often have we said or heard people say, “I don’t know why I can’t lose weight.  I hardly eat a thing.” or “I was nervous and upset.  I just couldn’t help myself.”  All kinds of alibis and excuses.  Our sessions together tend to debunk these excuses and instead focus on behavioral consistency, control, and commitment with an emphasis on action.

How sad it must have been for the young LDS women who watched this video.  They are automatically considered “dishonest, inconsistent, and irresponsible” simply because of the way they look.  And consider the fact that the church is very food oriented.  Women in the church are encouraged to be excellent homemakers and cooks.  

The very sexist announcer goes on to say…

Group members help Judy improve the consistency between what she says she wants to do and what she actually does.  If Judy wants to be thin, she has to engage in thin activities, such as eating less and exercising more.  Sometimes she sees the problem as impossible to control.  We try to help her refute this.

Notice too, that it’s a man leading this group and he has all the answers.  As if a man really understands why a woman might feel compelled to overeat.  He keeps referring to the women as “girls”, too, and talks about them like they’re all a bunch of simple minded twits.  

The horrible music continues and they show video footage of heavy women swimming, their fat rolls jiggling underwater.  They show twin little girls laughing openly at a heavy woman biking past them.  Nowadays, someone would be calling CPS on the girls’ parents for letting them walk alone in a neighborhood!  They show a fat woman diving into water and when she hits, there’s a sound of gunfire, as if the sheer volume of water displaced has moved the earth somehow.  One woman is doing stretches only to get exasperated and give in to the temptation of potato chips.  It’s as if the filmmakers are saying “Shame on her for being so weak!”

A woman named Dawn says that she was sick all week and had a sore throat.  She ate ice cream to make her throat feel better.  And, don’tcha know, that’s why she’s fat!  She could have used ice cubes, you know… as the announcer tells us.  What a dick.  He says, “We try to help her see herself through the eyes of other group members.  To realize her self deceit.”

The video is rife with closeups of heavy women eating, shoveling fattening foods into their mouths in a way that is supposed to be disgusting.  I could continue to quote from this nasty little film, but I think you get the picture. 

Apparently, the answer to getting thin is to start dating.  A man will fix everything.  Get yourself a good man and you’ll have all the motivation in the world to lose weight.  “Being ‘feminine’ can be fun.'” the announcer says.  It’s a load of nasty bullshit.  

I know this film is 45 years old.  Since I’m 44, it doesn’t seem like it’s that old.  I guess it is, though.  I have my doubts that the attitudes among church members has necessarily changed a lot, although they are almost certainly less “in your face” about it than they are in this offensive film.  

Here’s another film from BYU…  

More fat shaming, though at least this one isn’t leveled strictly at women.

There is certainly nothing wrong with eating right and exercising.  There is nothing wrong with wanting to lose weight.  What I find offensive is the attitude that a person’s character is being judged by what size clothes he or she wears.  It’s offensive that a person’s worth is being measured by how heavy he or she is. I don’t know that a film like this would be made today, but it sure is cringeworthy to see that it was made around the time I was born.  

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book reviews

Repost: my review of Stranger Here: How Weight-Loss Surgery Transformed My Body and Messed with My Head by Jen Larsen

Here’s a repost of a book review I wrote for Epinions in 2013. I am reposting it here as/is.

I am fat.  While I wasn’t really fat as a kid, I’ve always been huskier than a lot of my peers.  I came out of the womb weighing close to ten pounds, and my mom told me I looked like I could walk out of the hospital by myself.  I wondered how my friends stayed skinny and I seemed to gain weight at the drop of a hat.  As a teenager, I fretted about my weight constantly and dieted a lot; though looking back, I wasn’t really fat then, probably because I was very active.  As I got older and learned how to drive, I got bigger.  It did a real number on my self-esteem and was both a symptom and a cause of the major depression I suffered in my mid 20s.  While I don’t generally seek out books written by people who want to write about being heavy, I did run across a very interesting article about Jen Larsen, author of Stranger Here: How Weight-Loss Surgery Transformed My Body and Messed with My Head (2013).  I remember clicking the Amazon link on that article, curious about the book and Jen’s transformation. 

I actually know several people who have had weight loss surgery and most of them have experienced dramatic results, though not without hardship.  It’s definitely not an easy way to shed pounds; at least not at first.  When Larsen decided to go for the surgery, she had just finished a MFA in writing and worked in a university library.  She dreamt of being a writer and obviously had the goods to make it happen. Unfortunately, she felt that being so heavy was weighing her down in more ways than one. So she decided to turn to surgical means to help her slim down and finally embark upon her career dreams.

Jen Larsen had a procedure called the duodenal switch.  She found out about it on a Web site that had lots of dramatic before and after pictures.  As she looked at those photographs on the Web, Larsen weighed in at over 300 pounds.  She had trouble showering.  She had trouble walking and breathing.  Her weight was affecting her mind and her body.  She had trouble finding clothes that fit her.  Even though she was enormous, she was invisible to other people, who treated her like being fat was contagious.  Her boyfriend, Andy, seemed to be more like a platonic drinking and smoking buddy than a lover.  Sex had become a distant memory.

Larsen explains briefly the struggle she endured to get insurance approval to have the surgery.  She also writes about the preparation she had to do before the operation, which ultimately took about five hours.  With Andy’s help, she recovered from the surgery, which reduced the size of her stomach to the size of an egg.  She endured drinking gritty protein shakes and watched some of her hair fall out from the struggle to get enough protein every day.  She lost scads of weight… over 180 pounds.  She also became a very different person.

My thoughts  

I breezed through about half of this book in the first sitting.  Jen Larsen has a very entertaining and engaging writing style.  She writes her story as if she’s a very observant friend, bringing up thoughts that occurred to her throughout this journey.  I must admit, as I read about her feelings about being obese, I realized they were remarkably similar to my own.  I am nowhere near weighing 318 pounds, but I have certainly experienced some of the attitudes Larsen did when she was very heavy.  People can be unkind. 

Larsen is very candid about some of her habits, which makes it somewhat easy to understand how she got to be so large.  For one thing, she drinks…  a lot.  She continues to drink to excess and smoke even after the surgery.  She also doesn’t seem to alter her eating habits much, though she eats much less than she did when she was very heavy.  As she loses weight, she finds herself becoming more self-centered.  She becomes less interested in settling, which is not necessarily a bad thing.  But she started noticing other people’s attitudes about food and eating, too.  She comes to some interesting conclusions about why people are the way they are when it comes to body image, their own and other people’s.

I was somewhat puzzled by Larsen’s feelings about her transformation.  She writes that she doesn’t regret having the surgery.  Indeed, at the end of the book, she supplies her own before and after photos which are very dramatic.  Yet she doesn’t seem to recommend having surgery to lose weight.  At the end of the book, she includes the addresses of many Web sites, many of which promote fat acceptance.  

Larsen concludes that it’s much easier to be skinny than fat, even though she cried when she lost her magnificent boobs along with all the weight.  And yet, she also seems to think that having your “guts rearranged” is extreme.  Ultimately, I sense that Larsen has mixed feelings about what she did to lose the weight and the end results of her actions. 

Some readers have observed that Larsen doesn’t really follow “the rules”.  She doesn’t seem to follow up with doctors or stick to a diet.  I think, in her case, while she was pretty healthy as a very obese woman (in terms of her cholesterol and sugar readings), she didn’t have the surgery to improve her health; she did it to look better.  That’s not an unreasonable thing, I guess.  A person’s mental health and self-esteem are important, too.  But Larsen comes off as being still raw from her experience, maybe to the point of not being all that likable to some readers.  On the other hand, if I met her, I’d probably think she was a hoot. 

Frankly, though I have often fantasized about losing lots of weight and becoming really skinny, I’m not at a point at which I would consider bariatric surgery.  For one thing, I hate going to doctors. For another, the idea of having surgery petrifies me.  I hate throwing up and having bowel issues.  I no longer have the need to attract men, since I have a wonderful husband who loves me for who I am.  And so far, I don’t seem to have any health problems.  Of course, I don’t go to doctors, so what do I know?

Overall

I thought Stranger Here was a good book.  So many people are dealing with weight issues and this is a pretty good account of what it’s like to go from being very large to being very small.  As Larsen points out, that much weight loss so quickly does do a number on your head.  When you lose the weight, your problems don’t go away.  But you can’t blame them on being fat anymore.  This book is a good reminder that there’s no such thing as a magic bullet for fixing your life.

Jen Larsen’s blog (which appears to be defunct).

As an Amazon Associate, I get a small commission from Amazon on sales made through my site.

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