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I Don’t Want To Go To the Doctor

            I got a call on the answering machine (yes, they still exist, as do land lines), cancelling an upcoming appointment with the cardiologist. And I was thrilled! It’s not that I particularly hate my cardiologist, but every time I go to a doctor, whether it’s my primary care doctor, or a rheumatologist, a pulmonologist, an endocrinologist, a cardiologist, etc., they weigh me and then tell me that my real problem is my weight, and proceed to lecture me on how to go on a diet.

“I’m not fat, I’m fluffy.”

            I have been on every diet, and read every diet book, and lost and gained weight multiple times, and now I am working on Intuitive Eating with a Nutritionist and trying to undo all of that damage, but even so, every time I see a doctor they insist that if I just ate less and exercised more it would all be fine – as if my problem is that I’ve never heard of a diet before.

            Or as if my weight is my primary medical issue, which it’s not; the added weight is a symptom of both the psychological trauma of my childhood and the medical disorders I have had to deal with as an adult (and the medications I need to take to manage both). I’ve said this to my doctors over and over and over again, but it doesn’t seem to make a difference.

            When I told my nutritionist about all of this – and about my rage at the doctors, and adults in general, who encouraged my eating disorder when I was a child, and who have continued to push me into disordered eating as an adult, without ever feeling shame or responsibility, let alone bothering to educate themselves about an alternative way to address issues of nutrition and weight in their patients – she said, well then, that should be our next project.

            Huh?

            She said, you need to practice setting boundaries with your doctors around weight, and even try to educate them about the pervasiveness of the Diet Mentality and the endless Mobius strip of weight loss and weight gain that they seem to think of as such a wonderful idea but that has actually been shown to cause more health problems than remaining steadily overweight your whole life.

            But I’ve tried, and they never listen to me, and it’s not fair, and why don’t they have to learn this in school, and why is it my job to teach them and…

            And she agreed with me, and listened to me, and said, we need to work on setting boundaries with your doctors around the subject of weight.

            But, but, but…they never learn, and they keep repeating the same things, and whenever they tell me that I should just stop eating so much I believe them and…

            Oh.

            I had the aha moment at the same time she did: the real problem is that I don’t have confidence in what I already know and have worked so hard to learn, so that when they challenge me, I give in.

“Never give in!”

            I’ve worked so hard this past year to learn how to hold my ground when the “You just need to stop eating,” and “You’re less of a person because you are overweight” messages are said by movie stars, or social influencers, or random people in my life; but when a doctor says it, the ground under my feet still gives way. I sit there feeling small and hopeless and I forget everything I know, and believe everything they tell me – that if I would just stop eating so much I’d never have health problems again.

            Depending on how brittle the doctor is in presenting their message on my weight, it can take me hours, or days, or even weeks to get back to solid ground and remember that, actually, my weight is not the problem. And diets have never been a long lasting solution even to the weight issue, never mind for my health overall.

            So what can I do to fix this? And can it be fixed before my rescheduled appointment with the cardiologist which is coming up way too soon?

            The nutritionist suggested that I remind myself that, on this subject, the doctors don’t know me better than I know myself. She said to tell them – I know you’re going to bring up my weight, but I am working with a nutritionist on Intuitive Eating and I am making progress at my own pace, and, for now, your advice is not helpful on this subject. My weight is the least of my problems, and if we can focus on the physical pain and exhaustion that make life so difficult for me, and the connective tissue and auto-immune disorders that cause the pain and fatigue, and numerous other symptoms, that would be a more productive use of our time together.

            But I’ve said all of that, or at least most of it, to my doctors, and they just talk over me. Though maybe I haven’t said it with confidence. Maybe I’ve said it with my eyes on the floor, afraid of what they would say in response, afraid of their disapproval. Because even when I’ve said “the right things” I’ve only said them once; and when the doctor, inevitably, pooh poohed it, I shut up. Because I freeze in the face of their disapproval. I forget everything I know, and I let them talk down to me and blame me without contradicting them. And, no, it’s not my responsibility to teach them, or change them. But if I could stand up for myself, maybe I wouldn’t be so negatively impacted by each doctor visit.

            But how do I get there? How do I hold onto what I know when I start to feel shaky and small? How do I convince myself that I do know my body better than they do, and that I have done the research and I’m not just believing what I want to believe because it sounds easier?

            The temptation to just cancel appointments, or to go but shut off my brain for the duration, is very deep, because I don’t feel strong enough to stand up for myself effectively.

“Yeah, let’s stay home.”

            I wish I could promise myself that next time will be better, and that I will be different. But I don’t know how to make that happen. I had hoped that writing this essay would give me the confidence to believe that I can stand up for myself, but instead it has made it clear to me how much more work I need to do.

“Oy.”

If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.

            Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?   

                        

           

           

           

           

           

           

          

         

           

           

           

           

           

           

           

           

           

Food Insecurity?

            I was talking to my nutritionist about how I panic when I do the experiment where I have to stop eating mid-meal to check in on my hunger levels, and she said, you are food insecure.

            Huh?

            I thought food insecurity only referred to people who legitimately don’t have access to enough food, because of poverty, or living in a food desert. It felt melodramatic to think of dieting as a cause of food insecurity on that level – but the more I thought about it the more I realized that the nutritionist was right.

            Being on a diet means imposing food insecurity on someone who should not otherwise lack nutrition; imposing scarcity on someone who lives in a world that is full of good food. Why are we willing to do this? Why are doctors willing to encourage this?

“Why?!”

            There is something unnatural, even cruel, in imposing a diet that doesn’t match the food that is readily available (gluten free food for millions of people who have no actual allergy to gluten, anyone?). It’s like saying to someone who lives on the beach, you should never swim. Or to someone who lives in the Alps, you should never ski; and you are a terrible, ugly, gluttonous person for even wanting to ski. And so many diets are based on passing fads and half-finished research, rather than on any real understanding of the role food plays in our lives, so that the rules we have to follow aren’t just cruel, they are also, often, wrong. The fact is, food has never been simply about nutrition. If we forget that, we forget large parts of who we actually are and where the disorders in our eating habits even come from.

            Each time I have regretted taking on the no-diet rule of Intuitive Eating this year, because I’ve been gaining weight instead of losing it, I’ve checked in with myself and realized that I did not want to return to the constant panic and deprivation that comes with diets – whether they are low calorie, low carb, or low anything else. The severe diet I tried over the summer – to deal with stomach pain symptoms – was all the reminder I needed that dieting is no way to live.

“We agree. No diets for us.”

            But thinking about food insecurity as being caused by something other than actual food scarcity made me think about all of the other artificial scarcity situations we create as human beings. Simple things, like forcing ourselves to work sixty hours a week when we don’t need to, or forcing ourselves not to cry because it looks weak, or forcing ourselves to be fiercely independent instead of relying on the people around us when we need help.

            I grew up in a middle class home. We were never poor, and yet, we frequently couldn’t afford the things we wanted, or needed, because my father withheld the money. He had it, he just chose not to spend it on us when he wasn’t in the mood (other times he would spend money on us, but only on things he wanted for us). We also went to school with a lot of people who were upper middle class, and compared to them we were poor. We got small presents for each night of Hanukah, while some of our classmates got presents worth hundreds of dollars each night. But we were not poor. We were abused and neglected by our father, but we were not poor.

            The fact is that abuse and neglect lead to an experience that is so similar to poverty that it can be hard to tell the difference. If you are food insecure, love insecure, and safety insecure, what good does it do to know that your father could afford to pay the bills if he chose to?

            The work I’ve been doing with Intuitive Eating this year has most often been about teaching myself to understand that food is always available, and never off limits, so that I can learn to decide what and when to eat based on actual hunger, rather than on the fear that the food will disappear if I don’t eat it right away. This work has taken much longer than I’d hoped, and, of course, the food represents so much more than just food. My panic at deprivation is so deep that it feels as if I’m being threatened with death, rather than just momentary hunger, when I choose to stop eating a little bit early.

“Hunger is awful.”

            The work of recovery is ongoing, and seems endless at times, but just when I think I’ll never untie a difficult knot, it loosens, and five other knots loosen with it, like magic. So I will keep working on this, and working on reminding myself that I don’t have to live in scarcity, because the things I want are available now. It’s such a hard lesson to learn, though, and food is just the first step.

“We could eat.”

If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.

            Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?

Intuitive Eating and Where I’m Struggling

             One of the basic arguments against dieting, in the Intuitive Eating Workbook is: A diet mentality is the false belief that weight loss leads to happiness. But this has always felt true to me. As a kid, I was unhappy, and I wanted to believe that there was something I could do to fix it: if I could blame all of my unhappiness and loneliness on my weight, then I could at least hope that someday I’d feel better. In reality, I have lost weight over and over again, and it has never resolved the depression or self-hatred or loneliness, and yet I’m still afraid that if I let go of the belief that weight loss will make me happy, I’m letting go of the hope that I will ever be happy.

            And it was reassuring to have a diet plan to follow. I’ve stayed on diets for months, or years, despite losing no weight at all, because the sense that I was doing the right thing made me feel better, even if it didn’t help me reach my goals.

“Two chickens a day would reassure me.”

            I crave a diet plan to tell me what to eat, how much to eat, how to prepare it, and even when to eat it. Diets feel like safe containers for someone, like me, who has learned to believe that food is dangerous and unpredictable; for someone who is overwhelmed with too many choices and who believes, fundamentally, that her body is wrong and must be controlled and limited and made smaller.

            The problem is that the diets themselves perpetuate those beliefs about the dangerousness of food and the dangerousness of my body. The diet tells me that I can’t survive without it; that I will crash and burn, and there is no alternative, except maybe for another diet. That’s why this transition to a no-diet life is so damn hard; because there is no plan, no safe container, just impossible lessons to learn, like: trust yourself, honor your feelings, respect your own body and wisdom.

            I’m no longer on a specific diet plan (Like Weight Watchers or Noom) and I’m not counting calories or avoiding carbohydrates or fats, but I still have the endless voices in my head telling me that I shouldn’t eat this and I shouldn’t eat that, and if only I lost weight I’d finally be happy. And the voices aren’t just in my own head, they’re everywhere.

“I hear them too.”

            The frustrating thing is that the research on diets has been clear: the majority of people who go on diets gain the weight back, and often gain even more than they’d lost in the first place. And it’s not just that diets don’t work, they actually create health problems, because the cycle of weight loss and inevitable weight gain is worse for the body than maintaining a weight above what the charts suggest. But no one I know actually believes the research. So, are we all in a collective delusion? And how do I escape from a belief system that is constantly reinforced?

            Doctors have been some of the worst offenders in creating shame around my weight. They have blamed any and every health issue on my weight, even when it was clearly unrelated, and they have had no interest in hearing that my health has never improved as a result of weight loss.

            I recently had to see the gynecologist for my yearly checkup, and she said that my health is good except for one thing and you know what that is. But I didn’t know, because I could think of a number of issues that are currently impacting my health. But before I could even try to answer her non-question, she said, it’s your weight. And, she said, You just need to eat less. Then she proceeded to show me what a small portion of food would look like, with her hands.

“No doctors!!!!!!”

            Aside from the fact that I probably know more about dieting than she does, and that the size of food doesn’t determine its caloric value, what she’s ignoring is that being on a diet and just eating less has taught me to feel like a bad person for eating anything.

            When I read in the Intuitive Eating Workbook that if I am hungrier on a given day then I should eat more, I was sure that that rule shouldn’t apply to me, because, of course, I would lie to myself about my hunger level, and sneak food past myself.

When the Intuitive Eating Workbook told me to respect my cravings and learn how to eat those foods when I crave them, and then to stop when I am full, I didn’t know what to do, because I was always told to do anything and everything to distract myself from cravings, and to never give in to them. I was supposed to drink water, or take a bath, or go for a run, to avoid eating the food I really wanted to eat, even if I had no interest in doing any of those things. I automatically assume that if I crave something, or even want something with any intensity, then I shouldn’t have it. I’ve read so many articles that say craving a food is a sign that it is bad for me, and that I will crave exactly the foods I am allergic to and that’s how I’ll know I’m allergic.

            But is that true? Are the things I feel most strongly about the things I should avoid? Then what am I left with? How do I decide what to do if wanting to do something is a sign not to do it?

            Who came up with this shit in the first place?

“Um, you said a bad word.”

            During this year of social distancing, a lot of people have experienced cravings for human contact, cravings so strong that they broke safety protocols to go out to parties or bars or restaurants, because the need for human contact was so insistent. Is it the craving for human contact that’s bad or the way they chose to satisfy that craving?

            My students at synagogue school often crave movement by the time they arrive after a full day of school. They crave it so much that if I don’t create a safe and productive way for them to move, they will move in whatever way they can. I can choose to create a safe environment for them to move in, or I can choose to ignore their need and leave them to disrupt the class or drive themselves crazy, but either way, the kids are going to move; not because they are bad kids, but because they are human.

“Like me!”

            Can I accept that in myself too? Can I ever find a way to give myself permission to be guided by what I want, without worrying that I’m taking the road to hell?

In a recent visit with the nutritionist she said that I was confusing taste hunger with physical hunger, because as long as the food still tasted good I still wanted to eat. Ideally, she said, the yummy taste of the food would diminish as I became full, but that has never been my experience. So we planned out a very specific sequence of actions for me to check in with my physical fullness, and my taste hunger, separately, with the commitment that I would rely on my physical feeling of fullness to tell me when to stop eating, even if the taste hunger persisted.

I want to believe that I can learn how to do this and find a healthier and happier way to eat and live, but it still feels like a fairytale; like something I want to believe in that can’t possibly be true. I still live in a world where everyone thinks they need to be on a diet, no matter what they weigh. I still live in a world where we have no realistic idea of healthy sizes for different bodies, and we judge each other based on standards that fit almost no one. How am I supposed to ignore all of that noise and suddenly learn to trust myself?

            I don’t know yet, but I will keep working on it.

“We’ll eat the leftovers. To help you.”

If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.

            Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?

Weight Watchers

 

I went to Weight Watchers as a thirteen year old. A friend of my parents’ was a Weight Watchers leader, and when we spent time at her house she made Weight Watchers recipes, and talked up the meetings, until it became clear that I was her direct target, with my vaguely pudgy body.

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“Rude much?”

 

Unfortunately, that first foray into dieting set me off on the anorexic path: if eating less is better, eating nothing must be perfect. For a year and a half, I ate less and less until I lost my period, and spent a summer fainting. When I started to eat again, and no matter how little I ate, I gained weight. Fast. It turned out that I had burned out my thyroid with my starvation adventures, and I’ve been on synthetic thyroid replacement pills ever since.

In my twenties I did a very simple on-line program, with calorie counting and recipes. And it worked. Except that I, again, reached a point where I thought I should stop eating altogether, and I panicked at every food choice, and lost almost all joy from eating. And then I got very very tired, and short of breath, and no matter how much I exercised, or how little I ate, the weight crept back on. That time, I ended up on pain medication and spent years going to every kind of doctor in the book.

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“I’m starving.”

My current attempt at Weight Watchers came from an offhand suggestion from the cardiologist, when he did a work up for my borderline high blood pressure. I pooh pooh-ed it at first, because there are other reasons for my blood pressure to be high, but when I looked up the new version of Weight Watchers it looked manageable. I figured it couldn’t hurt.

At least for now, the list of unlimited foods makes this plan doable, because I don’t have to worry about getting to the end of the day with no calories left in my budget. I’m still overwhelmed by all of the different point values, though, and I am entirely dependent on the Weight Watchers app to tell me what I can and what I can’t eat, and when; but I’m not starving, and that’s a relief.

Except, weight loss is a dangerous thing. It’s like gambling or video games: you can get addicted to the high of success, and lose track of everything else that matters to you. Like staying alive. Chances are high that losing weight won’t improve my health in any significant way (because my health problems caused the weight gain, rather than the other way around), but there’s some relief in being on a plan, and having clear guidelines to follow, instead of having to trust my own judgement all the time. Food has always been stressful for me, and maybe making it simpler will reduce some of my overall anxiety.

 

I eat a lot of canned peaches (juice drained), and Greek yogurt (plain, nonfat, with Truvia sweetener). I eat a lot of chicken and eggs and veggies and fruit. I’m still trying to get a handle on the Smart points, and how much to budget for things like oatmeal, or whole wheat bread, or sweet potatoes, or, of course, ice cream and cookies.

Cricket thinks the unlimited chicken thing is Nirvana. And she’s sure that I chose this diet plan with her in mind.

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“Chicken!!!!!!!!!!!!!!”

You’re welcome, Cricket.