Monday, October 24, 2016

Musings of an “obese” doctor

November 20, 2009 by  
Filed under Fat Acceptance

Our guest post today is from Dr. Rebekah Adams who sent in this piece with the following comment;
I just wish I had a big bottle of self-love I could prescribe for my patients and my bet would be their weight issues would suddenly start to resolve themselves.
I believe the fat acceptance activists here will appreciate Dr. Adams words, since most obese women express that they have continually faced unfair, shockingly cruel, commentary from their physicians about their weight…..which many times leads to avoidance of necessary physical exams.
What has happened to the Hippocratic Oath “first, do no harm?”
I have been wanting to put some of my thoughts together about the debates that are raging on the comments streams of We Are the Real Deal for a while.
I applaud having a forum for people to debate from all sides of a complex, difficult issue. My thoughts are from the perspective of a woman who has struggled with weight issues all of my life, who let some of my best years dissolve in self loathing due to the number on my jeans tag. I have donated a large portion of my precious resources to various “programs” in the multi million dollar weight loss industry. I have since discovered love, motherhood, triathlon, running and happiness. I am very much a work in progress but I have finally learnt that I am much more than my dress size. As a doctor I aim to help people achieve health and spend a long time pondering what this means.
I have worked with very sick skinny people who’s arteries have been trashed by bad food and exercise decisions. I have worked with healthy, happy large people who are in good health and, yes,  I have seen people who have a raft of health problems stemming from a problem with obesity. The lasting effect my patients have on me has very little to do with their weight or their size.
It is such a small part of  a person.
The stories my patients tell me stay with me forever, the spark in their eye, the visits from their family. I have seen so many different bodies, some missing legs or fingers, some with extra bits, some with wobbly bellies, some with buff pecks. But their spirit and their energy, and their overall health IS NOT defined by what they look like.
Sadly, there is a lot of weight discrimination in the health system.
Many of my (usually thin) colleagues think that fat people must be stupid, they should simply eat less and move more. It is a hard pill for me to swallow when they spew their closed-minded opinions in my “curvy” direction. My face reddens and my heart sinks as I think silently “What must they think of me?”  But, in past times, doctors used to take blood from people who had arterial bleeding (which spurts out) to reduce the pressure in their system (stop the spurting) and try and save their lives. With our modern-day knowledge it is bleedingly (pardon the pun) obvious that this intervention simply hastened the patients death.
We WILL look back on this era and shake our heads at our poor understanding of the factors that contribute to weight.
We WILL understand it one day and the BMI scale will be a blemish on our “Evidence Based Medicine” record.
We WILL understand that there are many, many intelligent people ( I include myself here) who have worked out that it is not that simple (while their fit, buff personal trainers at the gym are “obese” on the BMI scale, but confident enough in their health to ignore it).
I think the answer lies somewhere in understanding health and what it means for YOU, for each individual. I know that I am healthy, even when I am “overweight” or even “obese” on the BMI scale. Even wearing a size 14-16. Last year I completed 5 triathlon and a 12km run. I ate good food most of the time and indulged in ice cream and chocolate sometimes. I had a bounce in my step. I ate less and exercised more than my 68kg husband and realized that in order to lose more weight I would have to adopt a more sedentary life, lose some muscle and in my view become less healthy. I realized I was healthy and I learned to celebrate my health and my body- just as it was. I stopped longing to fit into my 10-year-old size 12 outfits. I wasn’t healthy when I wore those clothes.
But now I am ecstatically pregnant, growing my second baby and have long since burst out of my size 14-16 clothes (this is partly thanks to prolonged and difficult morning sickness which was worse when I ate fruit and veggies, and momentarily went away with hot chips). Also as a full-time, working, vomiting mother of a gorgeous toddler exercise became near impossible.  I don’t feel I am at my maximal health at the moment and realize that to get to “my” best health again I will need to work on my choices for the rest of the pregnancy and after I meet my newest little wonder.
I think self acceptance is paramount to a healthy life.
I work on accepting me for me…NOW.
Loving my body today for what it can do.
Working on goals about what I would like to do in the future.
In that way I am a huge supporter of fat acceptance. I am fat, I accept myself, I love myself, I let my husband love me (that took me a long time to accept…when I was filled with self loathing). But I think no matter what your size, no matter what your challenges we should always work towards good health so that we can enjoy the marvellous things in our lives to their fullest. No matter how close your body is to some physical ideal, there is nothing healthy about self loathing. I meet far too many people who let their hatred of themselves and their 5 extra kg or their dress size take them away from the business of living. On the flip side I have met amazing, vibrant absolutely gorgeous people who don’t fulfill today’s ideal of beauty.
If I could only prescribe one thing for the rest of my career I would choose to prescribe a bottle of self-love to patients (if only we could crack the formula on that). Love yourself for who you are now but always strive for good health. Just as with each parenting decision we make we try to be the best parents we can be, or with each assignment or presentation we complete we aim for excellence. Celebrating a result, like a finishing time for a fun run, or celebrating our bodies as they are TODAY, doesn’t mean we should never try to finish in faster time!
Choose Health!


18 Responses to “Musings of an “obese” doctor”
  1. Cait says:

    No matter how close your body is to some physical ideal, there is nothing healthy about self loathing.

    This is beautiful, and so true.

  2. Stephanie vincent says:

    My thoughts exactley…it is so refreshing to hear i’m not alone in discovering the power of self love!!!! If u get the chance check out my blog at.

    • Bek says:

      Hey Stephanie,
      I checked out your blog, Lovely to read about someone who is busy living and loving! We’re generally ok at loving others but thats a pretty tough gig if you can’t love yourself. I’ll be visiting your blog again!
      Happy days

  3. Forestroad says:

    [em]Love yourself for who you are now but always strive for good health.[/em]

    If more people recognized that you can accept yourself and love yourself, and still recognize that there is room for improvement in your life and that you’ve made mistakes and want to work to correct them, there would be fewer people hollering that FA is just an excuse for fat people to be lazy.

  4. bri says:

    Forestroad: I guess one of the problems with that is what exactly is ‘good health’? Who gets to define what good health is? Is someone who has chronic depression but is otherwise within ‘acceptable’ ranges for everything else physical, in good health? Is someone who has well managed diabetes and is otherwise in ‘acceptable’ ranges, in good health? If a fat person has nothing identifiably ‘wrong’ with them other than their weight, are they in ‘good health’? Health is such a complex and loaded term and it varies from person to person. I think it is difficult to use a phrase like ‘strive for good health’ without taking into a consideration a myriad of other issues that contribute to the physical, emotional and menthal health of an individual. It is kinda complicated! : )

    • Meems says:

      I was just talking about this with my mother. I think that “good health” varies person to person. What is “good health” for my body may be unattainable for someone else. Ultimately, some people, regardless of weight or diet, may have high cholesterol or diabetes or any number of other diseases and health problems. What we can strive for is balancing the best health for our individual bodies and selves with enjoying life, which includes sometimes eating foods with little nutritional value or skipping a workout.

      • Bek says:

        Exactly Meems. And you are so right about cholesterol. Diet and exercise CAN help but sometimes it is just a matter of genetics and blaming the patient is so unfair and unhelpful. Thats why I think medical care needs to be individualised .Good health is so individual!
        This is a discussion which really needs to be had more, there are far too many lists and catergories in the world that make people feel like they are ‘failing’.

  5. julie says:

    Why would this be? Is this because you’d have less muscle, or because you’d eat less if you didn’t exercise?

    “and realized that in order to lose more weight I would have to adopt a more sedentary life, lose some muscle and in my view become less healthy.”

    • Bek says:

      Hi Julie ,

      I think I have a high muscle mass when I am fit and have only achieved “normal” BMI by being rather unfit and losing muscle mass as well as fat. I have thought about getting a body composition scan when I reach my ultimate fitness just to test my theory but am coming to trust my instinct about it. It is the same reason that any athletes and personal trainers are “obese”
      One of my greatest gripes with the BMI

      • Gina says:

        Bek – you already know the answer. Don’t worry about your BMI! 🙂

        • Bek says:

          Absolutely! The thoughts of a body composition scan were when I was worried about being veiwed as unhealthy because of my BMI. Now I am sure that the best health for me and for my patients is not dependant on BMI.

  6. Meems says:

    Thank you, Dr. Adams, for writing this, and mamaV for posting.

    [I] let some of my best years dissolve in self loathing due to the number on my jeans tag

    This is why I’m so glad I’m learning to accept myself now, in my 20s, instead of continuing to lose and gain weight over and over again. I’m healthy the way I am, I’m happy with my life, and I know how to dress my body in clothing that helps me feel good about myself.

    • Bek says:

      It is refreshing to hear that there are people out there accepting themselves and getting off the yo yo diet rollercoaster. Our society is not set up to support this common sense approach!

      • Meems says:

        I’ve yo-yo’d since I was probably around 12 (over 10 years now) and I’m sure my metabolism is already kind of messed up and my set range heavier than it might have been otherwise. Now that I’m an adult and believe in FA/HAES, I really wonder why no doctor ever questioned my quest to lose weight, despite the fact that I’ve always had low blood pressure, decent cholesterol (there’s a family history of high cholesterol in thin, active members of my family), and no health problems whatsoever. I wish I hadn’t been allowed – encouraged, even – into doing so much damage to my body.

        I’m very glad to have found a doctor and nutritionist who both support HAES and don’t encourage me to make weight-loss a goal, instead of healthy eating and living an active life.

        Thanks again for posting. 🙂

  7. Tempe Wick says:

    This is great. Thank you, Dr. Adams!

  8. vitty10 says:

    “I work on accepting me for me…NOW.”

    This is awesome! I always try to encourage my friends to do exactly this.

  9. Marsha says:

    Congrats on that new baby growing in your belly and the toddler you’re chasing after as you throw up. 🙂 And for being a role model in your profession for understanding the individual nature of body size and the critical factor of self acceptance.

  10. McLauren84 says:

    If only more doctors embraced this perspective! Great guest post!

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