This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing! Today I was using cooking spray (for non-diet ease of use purposes!) and I had a flashback to a doctor’s appointment before I learned the truth about the failure rate of weight loss.
Omg memory unlocked! I remember being shamed for Pam before! That’s about when it started to crack for me… that doctors weren’t as smart and all knowing as they wanted us to believe. If half a second of extra Pam is what’s making me fat, then maybe, just maybe, I’m always gonna be fat. (This was after I would have little contests in my head to see how long I could go without eating, and didn’t understand why I didn’t get thinner. If that half a second of extra Pam for roasting zucchini is too much then, well… maybe my body isn’t the problem here.)
The absolute distrust (and sometimes gaslighting) doctors inflict on us is definitely my biggest source of medical trauma and a ptsd trigger. I was a sick kid and I went through a lot of medical trauma, but it was the distrust that really traumatized me. How am I supposed to trust them with my life if they can’t trust me when I tell them what I ate for breakfast?
Before I figured out I had celiac disease, one my my most debilitating symptoms was upper right side abdominal pain and an inability to eat fatty foods without making it worse and causing GI symptoms. Classic gall bladder. (Fried foods or anything with added oil would make me so miserable— hence the Pam.) I’d been restricting my fat intake to manage my gut pain for years before it got bad enough to finally ask for help. My doctor was understandably convinced it was my gall bladder (spoiler: luckily all tests were normal and no one pushed me to amputate a functioning organ— and now that I’m not eating gluten, I can eat oil in food again!) and he would of course shame me for being fat. Then a few months into all this, the doctor himself needed emergency gall bladder surgery, and he was telling me how great he felt, and how he was eating pizza the same day he had it out, so we should try to get mine out too. But then quickly switched gears and told me I needed to keep trying to lose weight, and that if I added dill pickles to every meal, the “acidity” would kick start my weight loss.
DILL PICKLES. I love pickles, so I was already eating them all the time.
And THAT is when I realized doctors don’t have a clue how to make people thin, and they will say ANYTHING to avoid treating fat people and get us out of their exam rooms as soon as possible.
OH! There was a fad diet in the '60s or '70s, I forget, where to "increase your metabolism so you lose weight," you had to eat ridiculous super low calorie meals, and with each, eat a handful of raisins that had been soaked in vinegar. Same BS, allegedly the "acidity" would do all the work!
SO many fad diets, even going back 50+ years, were utterly gross. The grapefruit diet, where you ate a half a grapefruit for two meals a day, then ate dinner? The '70s-era diet company (Jenny Craig? Cambridge? I forget) diets where you had to buy meals from them, and they had NO fat in them so they were tasteless... and eventually started putting people in the hospital (& some died!) because your body requires some dietary fats or your gallbladder gets very, very angry. The cotton ball diet - seriously, people were supposed to "feel full" by eating cotton balls. The "sleep cure" diet popularized in the (in)famous book, "Valley of the Dolls," was real - you slept through most of the day via drugs and were woken up to drink some limited calories. And then there are ones that are so completely disgusting that you can find if you search but I don't want to completely gross anyone out.
I had lost a significant amount of weight (but still fat) and was seeking fertility treatment. The doctor said losing weight would help and that when I’m hungry I should drink water. This same doctor also found that I had a cancerous tumor in my uterus. The first oncologist I saw gave me a bariatric surgery pamphlet and said this was what I needed for treatment. Weight is linked to cancer, of course. Particularly estrogen related cancer. I went to a different doctor who assured me it wasn’t my weight and he treated me with medication and an IUD. 15 years later and still at a higher BMI, I’m cancer free. It’s the IUD, dummy. He suggested a dangerous and invasive surgery rather than a simple medical device that was standard for lower weight patients.
Shorter story: When I was in my late teens, I was naive and still believed doctors were an authority. I got a bad lung infection and the doctor told me that to get better I had to take antibiotics and ONLY eat once a day, a meal of plain cooked chicken, rice, and some steamed vegetables. And I was so sick and miserable that I believed him. I got better (because antibiotics somehow won despite malnutrition) and I lost a lot of weight. I regained it eventually, of course.
Longer story: When I was first diagnosed with diabetes, almost 30 years ago, I was miserable. Although I was still fat, I'd lost A LOT of weight, very rapidly, and was quite sick. My then-doctor did a finger stick test and it was over 500. I hadn't eaten yet that day, but I didn't yet know what she should have done - promptly popped me in the hospital. Instead she lectured me on how I needed to lose more weight, how I had to stop eating any sugar, how I had to learn to test my blood sugars, and gave me a prescription for an older medication for people with Type 2 diabetes. She also told me "Insulin is only for bad diabetics. You don't want insulin, DO YOU?" as if taking insulin was like taking poison. When that medication didn't work, she switched it to another, then another, all while telling me that I had to be not following the "diabetes diet," because my blood sugars were far too high. I was obviously cheating and eating lots of sugar. Only explanation!
After a few more weeks with this BS, I realized I was going to die with this doctor, and got another one - quickly. New doctor promptly put me on insulin, after which my blood sugars went down and fully stabilized in about 6 weeks. New doctor had their own flaws - I quit them after they refused to treat an infection until I agreed to talk to a WLS surgeon - but at least they got me started down the right path.
Over the years, I've learned things like, no, you don't have to stop eating sugar. Or carbs. What most doctors know about nutrition is minimal and what they know about diabetes & nutrition is nearly non-existent and stuff that's been passed along during residencies like a bad game of Telephone. And insulin is for any diabetic who needs it. Some people learn how to use insulin for when they're sick, because illness itself can raise your blood sugars higher than many medications can handle.
And never, ever, ever, ever NEVER NEVER let any doctor try to tell you that what you eat causes diabetes. It doesn't. Not any kind of diabetes. It just isn't that simple.
I had a doctor once tell me that if he locked me in the exam room we were talking in for 21 days without food I would survive and lose weight because there was a sink and I would be fine with just the water. Not surprisingly, he adhered to the CICO school of thought. When I asked him about the 95% failure rate of weight loss, he gave Penn Jillete as an example of someone had successfully maintained his weight loss for 5 years by sustaining himself on oat milk or something ridiculous (I don't fully remember). I was recommended this doctor because he was supposedly LGBTQ friendly, so if possible this fat hatred felt even worse than under normal circumstances. 😔
Sure, you can lose weight via starvation. I have a link somewhere to when a research group tested out ultra-low-calorie diets on people in the 1970s. People DIED from malnutrition, from heart attacks, and more. I always think of them when there's new publicity over a "mice fed almost no calories live forever!" study. What they never tell you is that when they give the same (relative) amount of calories to primates, they all die.
I love it when people use rich people as examples of "you can keep weight loss off." Sure, when you can afford to live in an area with very little pollution and your biggest stress is suffering through the latest woo nonsense to keep you from eating, then you, too, might be able to keep weight off. For now.
I saw a new midwife in the practice, and she informed me right off the bat that I "really needed to watch" what I was eating, and that I should "avoid white foods."
That was it! Just "avoid white foods." All I could do was just stare at her. If I hadn't been so gobsmacked, I would have asked her if that meant I should stick with things like doro wat and aloo muttar.
What makes it even worse was that I had been so sick with "morning sickness" all day, every day through my pregnancy, that I was barely eating anything, and in fact had been losing weight through the entire pregnancy.
I did put a note in my file that she was never again to provide me with any care, though. From the reaction of the nurse who made the note, I wasn't the only one. The midwife left the practice shortly after.
When I had a 9 month old baby and I was still 15 lbs heavier than when I got pregnant, the PA I saw asked me to describe my day of eating. When she heard I ate sandwiches for lunch, her advice was to stop eating bread and cheese. And get up at 6 am to work out when I said my baby woke up at 7 am.
I did neither one of those things, I continued to work out a few times a week when my husband could take our baby with him to go downtown to drop off shipping and I went to the gym to be around people since I was isolated as a SAHM.
My favorite example, which makes me laugh now but was terribly upsetting at the time, is the doctor who recommended HIIT. For context, I am a superfat person with limited mobility. Walking to the mailbox and back is a workout for me. So HIIT? Seriously? It was so ridiculous.
I definitely feel that pain! Over the last six decades I've been given a lot of worst possible doctor advice. Diet pills (amphetamines) with a side of shaming in my teens and “do not gain a pound” my first pregnancy. A few years later, on a 500-calorie a day regimen I fainted while jogging. I ended up bruised and scratched after I bounced off a seawall and hit the pavement. I regained my senses as runners loped past me and walked back to my vehicle, thankful I didn't fall over the wall. My MD insisted fainting/losing consciousness were "perfectly normal, so don't give up the diet or exercise!" By 2005, I hit a plateau after 4 months and continued to feel hungry 24/7 another 4 months even though I obsessively weighed/documented every bite/activity. The group's weigh-in demons and my PCP insisted I wasn't weighing/measuring properly or fudged my food log. It was a win-win for me because I do not gracefully accept being called an idiot or a liar, so parted ways with both. I went in search of info. A kind young clerk in a bookstore handed me a copy of “The Diet Myth” by Paul Campos. No going back after that.4\
I have always had heavy legs, even when I was very thin every where else. After my last baby, my weight began to creep up. After trying a few fad diets where I would lose weight and then regain it without ever going off the diet, I met a doctor who convinced me my weight was literally killing me. As a result, we took money we didn’t have, I the doctor enrolled me into a hospital weight loss program where o drank a protein drink four times a day, plus plain water. I was very scared and I adhered to it strictly. I initially lost weight but then I had two check-ins in a row where I not only didn’t lose, I gained weight. I was so sick from living off these chemicals for weeks, yet the doctor was screaming at me (literally) that I was a dishonest cheat and liar. She claimed I was hiding food from my family and consuming it secretly and actually convinced my husband of this for awhile. It was the worst part of my life. She kicked me out of her little program so my failure didn’t pollute her data because I was a cheat. I felt like I was going to die. I got another doctor who marveled at my great BP, lipids, and exercise routine. Said the only problem I had was number on a scale. Later, another doctor put me on Redux, saying my cardiac health was in peril if I didn’t lose weight. Redux gave me leaking heart valves, which I was paid $16,000 in a settlement for. After a car crash in 2001, I was told I had lupus. At that point, I was 40 years old and had been on a diet of one sort or another for 24 years and I had gained weight every single year of my adult life and I said well now I have lupus so I don’t care if I’m fat too. From age 43 to today, I have stopped dieting and I have never gained another pound. In fact, I weight 10% less than I did in 2003. I also found out I had other connective tissue diseases that cause weight gain unrelated to diet or exercise. If doctors had looked past their assumption that I was lying and asked the simple question “if she is telling the truth, what other factors might be causing the weight gain?”, I may have stopped it earlier and gotten earlier treatment for my connective tissue disorder. Instead, my actual health was ignored and the entire focus was on getting that weight down. Now, I have kidney disease related to one of the connective tissue disease problems and 5 hospital nearby have denied me a kidney transplant based solely on BMI! Even though my son has volunteered and he is a match for me, the surgeons don’t want a “high-risk” patient messing up their numbers.
Omg memory unlocked! I remember being shamed for Pam before! That’s about when it started to crack for me… that doctors weren’t as smart and all knowing as they wanted us to believe. If half a second of extra Pam is what’s making me fat, then maybe, just maybe, I’m always gonna be fat. (This was after I would have little contests in my head to see how long I could go without eating, and didn’t understand why I didn’t get thinner. If that half a second of extra Pam for roasting zucchini is too much then, well… maybe my body isn’t the problem here.)
The absolute distrust (and sometimes gaslighting) doctors inflict on us is definitely my biggest source of medical trauma and a ptsd trigger. I was a sick kid and I went through a lot of medical trauma, but it was the distrust that really traumatized me. How am I supposed to trust them with my life if they can’t trust me when I tell them what I ate for breakfast?
Before I figured out I had celiac disease, one my my most debilitating symptoms was upper right side abdominal pain and an inability to eat fatty foods without making it worse and causing GI symptoms. Classic gall bladder. (Fried foods or anything with added oil would make me so miserable— hence the Pam.) I’d been restricting my fat intake to manage my gut pain for years before it got bad enough to finally ask for help. My doctor was understandably convinced it was my gall bladder (spoiler: luckily all tests were normal and no one pushed me to amputate a functioning organ— and now that I’m not eating gluten, I can eat oil in food again!) and he would of course shame me for being fat. Then a few months into all this, the doctor himself needed emergency gall bladder surgery, and he was telling me how great he felt, and how he was eating pizza the same day he had it out, so we should try to get mine out too. But then quickly switched gears and told me I needed to keep trying to lose weight, and that if I added dill pickles to every meal, the “acidity” would kick start my weight loss.
DILL PICKLES. I love pickles, so I was already eating them all the time.
And THAT is when I realized doctors don’t have a clue how to make people thin, and they will say ANYTHING to avoid treating fat people and get us out of their exam rooms as soon as possible.
OH! There was a fad diet in the '60s or '70s, I forget, where to "increase your metabolism so you lose weight," you had to eat ridiculous super low calorie meals, and with each, eat a handful of raisins that had been soaked in vinegar. Same BS, allegedly the "acidity" would do all the work!
Raisins in vinegar sounds REVOLTING.
SO many fad diets, even going back 50+ years, were utterly gross. The grapefruit diet, where you ate a half a grapefruit for two meals a day, then ate dinner? The '70s-era diet company (Jenny Craig? Cambridge? I forget) diets where you had to buy meals from them, and they had NO fat in them so they were tasteless... and eventually started putting people in the hospital (& some died!) because your body requires some dietary fats or your gallbladder gets very, very angry. The cotton ball diet - seriously, people were supposed to "feel full" by eating cotton balls. The "sleep cure" diet popularized in the (in)famous book, "Valley of the Dolls," was real - you slept through most of the day via drugs and were woken up to drink some limited calories. And then there are ones that are so completely disgusting that you can find if you search but I don't want to completely gross anyone out.
I had lost a significant amount of weight (but still fat) and was seeking fertility treatment. The doctor said losing weight would help and that when I’m hungry I should drink water. This same doctor also found that I had a cancerous tumor in my uterus. The first oncologist I saw gave me a bariatric surgery pamphlet and said this was what I needed for treatment. Weight is linked to cancer, of course. Particularly estrogen related cancer. I went to a different doctor who assured me it wasn’t my weight and he treated me with medication and an IUD. 15 years later and still at a higher BMI, I’m cancer free. It’s the IUD, dummy. He suggested a dangerous and invasive surgery rather than a simple medical device that was standard for lower weight patients.
First: AUGH.
Shorter story: When I was in my late teens, I was naive and still believed doctors were an authority. I got a bad lung infection and the doctor told me that to get better I had to take antibiotics and ONLY eat once a day, a meal of plain cooked chicken, rice, and some steamed vegetables. And I was so sick and miserable that I believed him. I got better (because antibiotics somehow won despite malnutrition) and I lost a lot of weight. I regained it eventually, of course.
Longer story: When I was first diagnosed with diabetes, almost 30 years ago, I was miserable. Although I was still fat, I'd lost A LOT of weight, very rapidly, and was quite sick. My then-doctor did a finger stick test and it was over 500. I hadn't eaten yet that day, but I didn't yet know what she should have done - promptly popped me in the hospital. Instead she lectured me on how I needed to lose more weight, how I had to stop eating any sugar, how I had to learn to test my blood sugars, and gave me a prescription for an older medication for people with Type 2 diabetes. She also told me "Insulin is only for bad diabetics. You don't want insulin, DO YOU?" as if taking insulin was like taking poison. When that medication didn't work, she switched it to another, then another, all while telling me that I had to be not following the "diabetes diet," because my blood sugars were far too high. I was obviously cheating and eating lots of sugar. Only explanation!
After a few more weeks with this BS, I realized I was going to die with this doctor, and got another one - quickly. New doctor promptly put me on insulin, after which my blood sugars went down and fully stabilized in about 6 weeks. New doctor had their own flaws - I quit them after they refused to treat an infection until I agreed to talk to a WLS surgeon - but at least they got me started down the right path.
Over the years, I've learned things like, no, you don't have to stop eating sugar. Or carbs. What most doctors know about nutrition is minimal and what they know about diabetes & nutrition is nearly non-existent and stuff that's been passed along during residencies like a bad game of Telephone. And insulin is for any diabetic who needs it. Some people learn how to use insulin for when they're sick, because illness itself can raise your blood sugars higher than many medications can handle.
And never, ever, ever, ever NEVER NEVER let any doctor try to tell you that what you eat causes diabetes. It doesn't. Not any kind of diabetes. It just isn't that simple.
I had a doctor once tell me that if he locked me in the exam room we were talking in for 21 days without food I would survive and lose weight because there was a sink and I would be fine with just the water. Not surprisingly, he adhered to the CICO school of thought. When I asked him about the 95% failure rate of weight loss, he gave Penn Jillete as an example of someone had successfully maintained his weight loss for 5 years by sustaining himself on oat milk or something ridiculous (I don't fully remember). I was recommended this doctor because he was supposedly LGBTQ friendly, so if possible this fat hatred felt even worse than under normal circumstances. 😔
Sure, you can lose weight via starvation. I have a link somewhere to when a research group tested out ultra-low-calorie diets on people in the 1970s. People DIED from malnutrition, from heart attacks, and more. I always think of them when there's new publicity over a "mice fed almost no calories live forever!" study. What they never tell you is that when they give the same (relative) amount of calories to primates, they all die.
I love it when people use rich people as examples of "you can keep weight loss off." Sure, when you can afford to live in an area with very little pollution and your biggest stress is suffering through the latest woo nonsense to keep you from eating, then you, too, might be able to keep weight off. For now.
This was while I was pregnant.
I saw a new midwife in the practice, and she informed me right off the bat that I "really needed to watch" what I was eating, and that I should "avoid white foods."
That was it! Just "avoid white foods." All I could do was just stare at her. If I hadn't been so gobsmacked, I would have asked her if that meant I should stick with things like doro wat and aloo muttar.
What makes it even worse was that I had been so sick with "morning sickness" all day, every day through my pregnancy, that I was barely eating anything, and in fact had been losing weight through the entire pregnancy.
I did put a note in my file that she was never again to provide me with any care, though. From the reaction of the nurse who made the note, I wasn't the only one. The midwife left the practice shortly after.
When I had a 9 month old baby and I was still 15 lbs heavier than when I got pregnant, the PA I saw asked me to describe my day of eating. When she heard I ate sandwiches for lunch, her advice was to stop eating bread and cheese. And get up at 6 am to work out when I said my baby woke up at 7 am.
I did neither one of those things, I continued to work out a few times a week when my husband could take our baby with him to go downtown to drop off shipping and I went to the gym to be around people since I was isolated as a SAHM.
My favorite example, which makes me laugh now but was terribly upsetting at the time, is the doctor who recommended HIIT. For context, I am a superfat person with limited mobility. Walking to the mailbox and back is a workout for me. So HIIT? Seriously? It was so ridiculous.
I definitely feel that pain! Over the last six decades I've been given a lot of worst possible doctor advice. Diet pills (amphetamines) with a side of shaming in my teens and “do not gain a pound” my first pregnancy. A few years later, on a 500-calorie a day regimen I fainted while jogging. I ended up bruised and scratched after I bounced off a seawall and hit the pavement. I regained my senses as runners loped past me and walked back to my vehicle, thankful I didn't fall over the wall. My MD insisted fainting/losing consciousness were "perfectly normal, so don't give up the diet or exercise!" By 2005, I hit a plateau after 4 months and continued to feel hungry 24/7 another 4 months even though I obsessively weighed/documented every bite/activity. The group's weigh-in demons and my PCP insisted I wasn't weighing/measuring properly or fudged my food log. It was a win-win for me because I do not gracefully accept being called an idiot or a liar, so parted ways with both. I went in search of info. A kind young clerk in a bookstore handed me a copy of “The Diet Myth” by Paul Campos. No going back after that.4\
I have always had heavy legs, even when I was very thin every where else. After my last baby, my weight began to creep up. After trying a few fad diets where I would lose weight and then regain it without ever going off the diet, I met a doctor who convinced me my weight was literally killing me. As a result, we took money we didn’t have, I the doctor enrolled me into a hospital weight loss program where o drank a protein drink four times a day, plus plain water. I was very scared and I adhered to it strictly. I initially lost weight but then I had two check-ins in a row where I not only didn’t lose, I gained weight. I was so sick from living off these chemicals for weeks, yet the doctor was screaming at me (literally) that I was a dishonest cheat and liar. She claimed I was hiding food from my family and consuming it secretly and actually convinced my husband of this for awhile. It was the worst part of my life. She kicked me out of her little program so my failure didn’t pollute her data because I was a cheat. I felt like I was going to die. I got another doctor who marveled at my great BP, lipids, and exercise routine. Said the only problem I had was number on a scale. Later, another doctor put me on Redux, saying my cardiac health was in peril if I didn’t lose weight. Redux gave me leaking heart valves, which I was paid $16,000 in a settlement for. After a car crash in 2001, I was told I had lupus. At that point, I was 40 years old and had been on a diet of one sort or another for 24 years and I had gained weight every single year of my adult life and I said well now I have lupus so I don’t care if I’m fat too. From age 43 to today, I have stopped dieting and I have never gained another pound. In fact, I weight 10% less than I did in 2003. I also found out I had other connective tissue diseases that cause weight gain unrelated to diet or exercise. If doctors had looked past their assumption that I was lying and asked the simple question “if she is telling the truth, what other factors might be causing the weight gain?”, I may have stopped it earlier and gotten earlier treatment for my connective tissue disorder. Instead, my actual health was ignored and the entire focus was on getting that weight down. Now, I have kidney disease related to one of the connective tissue disease problems and 5 hospital nearby have denied me a kidney transplant based solely on BMI! Even though my son has volunteered and he is a match for me, the surgeons don’t want a “high-risk” patient messing up their numbers.