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 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.
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.
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.
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?
rachelmankowitz 