I want to tell you that I like my new doctor, I really do. I actually recommended her to someone looking for a doctor, because, for the most part, I really like her. She's a lovely tall ex-athlete with a soothing voice who's very invested in preventative care and whole-body treatment, who manages not to make cramped appointments imposed by corporate overlords feels rushed, who pays attention to what I am saying.
But the thing is, well, the thing is, well, the fat shaming.
It started when I stepped on the scale during check in and noticed that I had finally slipped (barely) over the 200 line -- I'd gone from the high 180s in July, when I was last forcibly weighed, to 201. I flinched. I couldn't help it. I'm acculturated to hate myself for being fat, and there's something about 200 that makes it a particular Fatness Milestone. It's ridiculous, and I'd bristle with fury at anyone saying as much, but it's not always possible to internally live what you fervently believe for society.
200 is just a number, until it happens to me, is what I'm saying.
So I suspected my weight might come up in our appointment, because this was our first meeting, and doctors tend to like to hassle me about my weight on first encountering me. We all know that fat-shaming is big in the medical community, right?
At first things went well. I felt like I was developing a rapport with my doctor, a familiar ease. We went through my personal and family medical history, though, and that's when things started to shift. I mentioned my father's heart attack, and she frowned when I told her he had four vessel disease. She frowned even more when I mentioned that both of my paternal grandparents had also died of heart disease.
"How tall are you," she asked, eyeing me where I was perched on the edge of the exam table, hands loosely folded into each other.
"Er, about five feet," I said.
She strode behind me, forcing me to twist myself in a kind of gross caricature of Ardha Matsyendrasana, and stabbed her finger at a chart on the wall. On the left-hand side, a series of boxes were shaded light blue, darkening to almost navy on the right. I hadn't noticed the chart when I walked in, but I knew it instantly when I saw it: the dreaded BMI chart.
"You're here," she said, placing her finger well into the ominous navy zone. "We'd like you more over here."
She dragged her finger across the chart and into the sky-blue range, stopping short of the pallid "underweight" blues. My eyes followed her finger up to read the target weight range there and I could feel something in me contract as I involuntarily calculated what percentage of my body weight I would have to lose to get to 120 pounds.
I remember what I was like at 120 pounds. I don't seem to have any photos, because it was a long time ago and I avoided the camera like the plague then, convinced that I was fat and disgusting, but I was thin: I was a size four, and I had a pronounced collarbone, and I was mean as a snake, because I was hungry and irritated all the time. I exercised constantly and practiced extreme caloric restriction to stay at that weight, and the result was a person who, while thin, wasn't very nice to be around.
"You should really be watching your weight," she said, which created a momentary vision in my mind of being asked to watch a friend's luggage at the airport while she darts to the bathroom to take a pee, but I know that's not what she meant.
"Watch your weight" is code for "get less fat."
The thing is, I know that the science behind "fat=unhealthy" is bad. I've read numerous studies on the subject and I've written about it. I could have countered her on purely medical grounds with discussions about set points and health as a complex issue, and how fat hatred and the diet industry drive mainstream medical approaches to weight. And I could have said, too, that people have a right to be treated like human beings regardless as to their weight and health risks.
But I couldn't. I couldn't because I was transfixed by the white coat and the air of authority, and because I was struggling with the aftermath of the revelation that I'd gained over ten pounds since July, and my mind was spinning on a hamster wheel, imagining gaining ten pounds every six months for the rest of my life. Thinking of myself as some kind of giant snowball that would never stop getting fatter.
So instead of telling her to stuff it, the words that came out of my mouth were: "I've found that I can only lose weight with pretty extreme caloric restriction and excessive exercise," which is a polite way of saying "I can only lose weight by starving myself and engaging in a degree of exercise that doctors would deem medically unhealthy."
She didn't seem to catch the coded meaning there, though, instead telling me about what she ate, and how by cutting out "all sugars," she'd lost 30 pounds, and I was horrified that my first reaction to that wasn't irritation, but the thought that I could be 170 pounds if I did it too. My second reaction was to wonder how long it took, and if I could ask her that or if it would be impertinent. It wasn't until I got 'round to my third reaction that I started to feel angry, started to feel upset that I was being shamed for being fat -- but I wasn't being provided with a referral to a nutritionist, if my doctor thought my diet was of real concern.
The thing is, I went to the doctor last week, and I'm still stewing over this. I really do like her except for the fat-shaming thing, and I know that if I switch doctors, I'm going to encounter the same attitude, because this is the predominant attitude in medical settings. But at the same time, I'm afraid to go back to the doctor, because I don't want to be hassled about my weight again, and being afraid of doctors is not a good thing for people with chronic health conditions who need regular medical attention.
What bothers me is not just that I was fat-shamed, but that it kind of worked. It's not that I think losing weight would make me healthier, or would reduce health risks, because I don't -- there's a lot of science arguing the contrary.
It's that I look at my body and I hate it, and that I am afraid to return to the doctor's office without proof of having tried to lose weight. I am afraid to step on the scale again and have it read 211, and I nurse a secret dream of stepping onto it and having it read 120 -- even though I know that even if I lose those 81 pounds (~40% of my body weight!), I'm still going to have loose skin, stretchmarks, and other legacies of my past. Even though I know that diets don't work, that starving myself and overexercising will just make me miserable and angry. Even knowing all of that, a part of me still wants to be thin again, and it's been a long time since I heard from that part of me.
And I hate myself for that. And that makes me angry all over again.