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Wednesday, May 16, 2012

Which One Really Needs Help? Call the Doctor!


Even Mica was disturbed by this!

I know, I know—I’ve got another 5 days before my expected post is due, but I just can’t wait. I can’t let Laura’s painful experience go unaddressed. If you haven’t read it, please do so now. But brace yourself—you’re gonna get angry.

It’s not unusual for me to hear and read about inappropriate statements and suggestions that medical providers make. Actually, we all can manage to say stupid things—I know I’m no exception.  (Really, no need for those that know me personally to comment on this statement!) But today I heard two doozies—Laura’s tale and a patient’s story.

I don’t know Laura—except, that is, from her blog comments. What I do know about her is that she has made extraordinary progress in her recovery from anorexia. That she can now enjoy pizza! That she gets it—and she follows through with healthy, normal, eating behaviors. That’s she’s worked hard to put all the disordered thoughts aside and use her wise mind to justify doing the right thing. That she, like many others, have needed to use self-talk to move from the myths, the misinformation, about nutrients and foods and weight. Ahh, she’s done so well. I don’t even know her, but I am so proud of the work she’s done, of how far she’s come!

And then someone she respects, her MD, albeit inexperienced with eating disorder, totally sideswipes her. The respectable doctor projects, I suspect, her own mishugaas—about weight control, about carbs, about fats. Our wise Laura knows better—but of course when the white coat-clad MD begins her critique of Laura’s intake it’s simply devastating.

Yes, you can eat the whole panini if you're hungry!
What I read in this comment is not that it triggered her eating disorder; she concludes by stating that this doctor just didn’t work out. (Hooray for Laura! Time to change doctors—or get her to close her mouth and withhold absurd and inaccurate assessments of Laura’s intake!) 

But, I suspect, it’s the profound sense of disappointment in her doctor, and perhaps in our crazy food-and-weight obsessed society, as a whole. Laura appropriately acknowledges that there are absolutely no grounds for this doctor’s comments—she has zero evidence to conclude that Laura is struggling with her weight, or unhappy with her intake or struggling with eating disorder behaviors. 

Perhaps if she had asked more open ended questions—you know, like “How’ve you been feeling about your eating these past weeks?” or “What concerns would you like to address about your recovery?”, she could have prevented this damage. It would make a lot more sense than projecting that there’s a problem, simply because Dr. Dieter has perhaps struggled with her own weight and her eating!

Hats off to you, Laura, for having the sense to air your feelings and get support—and for sharing your reaction with the doctor. Hopefully, she’ll learn from her mistakes. And hopefully, you’ll find an MD that really gets it!

As for the patient story? Nothing too unusual that you haven’t heard before. It’s a case of an MD who looks at a 20-ish patient and tells her that her weight should be about 50 pounds less than it is—which would bring her to a place she has never seen on her growth curve. It would bring her BMI to a percentile lower than ever before, even since grade school! Fortunately, this young woman appeared to have a good sense of self, knowing darn well that this MD’s goal was crazy.

If she is appropriately nourished and growing
along her curve, must we make her weight
an issue?
But what if she took the doctor’s orders to heart and began to fight her body on what was normal? To push activity to an obsessive level and to restrict her intake to a point that was neither healthy nor maintainable? What if she had the genetic predisposition for an eating disorder and all it took was the encouragement of a doctor to set the ball rolling—given her own frustration with her recent weight increase and being told her BMI was in the obese category? This woman was more fit than most people I know and had no health issues. She ate healthily and exercised. And there likely was an underlying medical explanation for her recent unexplained weight gain, yet to be determined.

See the problem? Do they even realize the power of their words?
Do you even realize the power of yours? If you are on the receiving end of poor advice, do share your concerns. Consider another opinion from someone you trust. Or do like Laura did—contact the MD and respond. And if you need to, move on—and reach out for support.

Feel free to share your own horror stories, or simply to express your opinions.



Thanks for reading.

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