This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing! I have permission to share the story of a patient I advocate for. She is fat and has Type 2 Diabetes (T2D). Her latest A1C test was 7.1%. This is .1% over her goal and up from her previous test. Her doctor told her that she didn’t need to adjust meds but should “do her best to eat less sweets and carbohydrates.”
My husband's blood glucose goes up in response to fatty meat, which every expert says is impossible. I want to tell them to come to my house and watch it happen.
Also, that .1 nonsense for the A1C is so annoying. I go back and forth between 5.6 ("Everything's fine!") and 5.7 ("BWEEEP! BWEEEP! RED ALERT!! PRE-DIABETIC!!"). Given the amount that physicians like to bloviate about how important their extensive education is, they could maybe apply a split-second of rational thought to the situation and see that there is no dramatic metaphysical discontinuity between 5.6 and 5.7. "Oh, but it's evidence-based." Yeah, bite me.
I told my provider recently to please not give any restrictive eating advice, but instead to tell me what she would like me to eat more of, because any restriction advice can make it harder for someone with disordered eating to eat anything, and thus is a set-up for a binge, especially of sweets and fats.
She acted annoyed to that, responding as if this was something particular for me.
Next appointment, I'm going to tell her this is advice from the eating disorder recovery community to providers, not just for people with EDs, but for all patients, as ED prevention. I will explain to her, or write up, a two-column list about the differences between what I call a restrictive approach to eating vs an abundance approach to eating, a la Ellyn Satter: the many benefits of scheduled eating of meals and snacks, with each of the major food groups represented, in quantities one's body asks for, and always providing enough food at each meal and snack, such that there are leftovers, as that is the only way, Satter wisely points out, to ensure that everyone has gotten enough to eat.
It's incredible how often HCPs make this flippant remark in response to any increase (even without a defined trend) in blood glucose or A1C. This is almost always without regard to an individual's holistic health picture or as mentioned, the various acute (or chronic) factors that could impact one's blood sugar. It is challenging for individuals to avoid internalizing this as restrictive diet messaging with a side of self-blame and shame to boot. Provider's words really matter- they must take caution and care with what and how they say it, and ensure that it is evidence based!
My husband's blood glucose goes up in response to fatty meat, which every expert says is impossible. I want to tell them to come to my house and watch it happen.
Also, that .1 nonsense for the A1C is so annoying. I go back and forth between 5.6 ("Everything's fine!") and 5.7 ("BWEEEP! BWEEEP! RED ALERT!! PRE-DIABETIC!!"). Given the amount that physicians like to bloviate about how important their extensive education is, they could maybe apply a split-second of rational thought to the situation and see that there is no dramatic metaphysical discontinuity between 5.6 and 5.7. "Oh, but it's evidence-based." Yeah, bite me.
Thank you!
I told my provider recently to please not give any restrictive eating advice, but instead to tell me what she would like me to eat more of, because any restriction advice can make it harder for someone with disordered eating to eat anything, and thus is a set-up for a binge, especially of sweets and fats.
She acted annoyed to that, responding as if this was something particular for me.
Next appointment, I'm going to tell her this is advice from the eating disorder recovery community to providers, not just for people with EDs, but for all patients, as ED prevention. I will explain to her, or write up, a two-column list about the differences between what I call a restrictive approach to eating vs an abundance approach to eating, a la Ellyn Satter: the many benefits of scheduled eating of meals and snacks, with each of the major food groups represented, in quantities one's body asks for, and always providing enough food at each meal and snack, such that there are leftovers, as that is the only way, Satter wisely points out, to ensure that everyone has gotten enough to eat.
Thanks again.
It's incredible how often HCPs make this flippant remark in response to any increase (even without a defined trend) in blood glucose or A1C. This is almost always without regard to an individual's holistic health picture or as mentioned, the various acute (or chronic) factors that could impact one's blood sugar. It is challenging for individuals to avoid internalizing this as restrictive diet messaging with a side of self-blame and shame to boot. Provider's words really matter- they must take caution and care with what and how they say it, and ensure that it is evidence based!
Thank you!!