My doctor’s office STILL thinks I’m fat, and a troublemaker too


Well, it happened again. Unfortunately, I had to go back there. To the medical office that thinks I’m fat. In case you haven’t heard this story before, the skinny, er fatty is this: the new medical group I’ve been going to has decided that my BMI (ratio of height to weight) qualifies me as overweight, causing them to give me a weight-loss handout (aka fat handout) every time I leave their office.

Against my better judgement, I went back there for a follow-up visit, but this time, determined that I wasn’t going home with the fat handout again. My strategy: if I don’t step on the scale, they won’t record my weight, and won’t be able to give me the fat handout. I went in resolved to avoid the scale at all costs.

“Put down your things and step on the scale,” the medical assistant, whom I’ll call Ethel, says after calling me back into the office. “No, I don’t want to be weighed today,” I answered calmly. I was totally unprepared for the ensuing backlash. “You have to be weighed,” replied Ethel, her voice going up a few decibels. “Um, no I don’t and I don’t care to be weighed today,” I answered, pretty calmly I thought. “But you have to be weighed, it’s our policy,” Ethel replied, putting the same emphasis on the word policy as if she were saying mandate, decree, or law. “Well, no I don’t have to be weighed. I have the right to decline,” I answer back. I’m getting a little worried now about the backlash I’m getting, but I can’t back down now.

Ethel is positively sputtering now. Her voice has gone up well above inside voice level, and I’m a little surprised that she’s carrying on this way in what should be a professional setting. “Well, I’m going to have to get the manager,” she finally sputters back, several times, I might add. She’s positively frantic by now. Apparently, this hasn’t happened before.

The manager? Really? Let’s stop and look at this situation for a minute. The issue that has caused Ethel to go to red alert is that a patient has declined to be weighed. Does she get paid by how many people she weighs every day? Or does she get beaten or fired if she doesn’t weigh every patient? Now granted, there are a few groups who really should be weighed at their health care visits: children; anyone being seen for unexplained weight loss or illness; persons with chronic conditions such as diabetes, heart disease or kidney disease, pregnant women, and people who are ill. But I don’t fall into any of these groups. I was just there a few weeks earlier and was weighed then, so this really shouldn’t be an emergency now.

But, back to reality. Ethel is still sputtering about calling the manager and their policy. She’s positively shrieking now. I would expect the manager to be more upset about her unprofessional behavior than the cranky patient who declined to be weighed. So finally to stop the standoff,  I told her to ask the provider I was seeing, and if she insisted that I be weighed I would do it, but otherwise not. “Well, we’ll just see about that” Ethel answered as she shuttled me back to the exam room.

So back in the exam room, I talked to my provider and told the whole awful story. She’s good-natured and understanding, unlike the others in this office. “I’m just sick of getting the fat handout every time I come here,” I told her. “I’m really not overweight, it’s just that I’m too short. If you could make me a little taller, I’d stop getting the fat handout.  An inch should do it”

So, I finished up the visit and left, not sure if she was willing to go out on a limb to save me from the fat handout. Then, I looked at the papers they handed me at checkout. I know I was 5′ 2″ when I came into the office. But on the way out, I had turned into 5’7″.

© Huffygirl 2012

My doctor’s office thinks I’m fat


Huffygirl: the obesity epidemic starts right here

I visited a consultant at a new health care group recently, and it turns out, that they think I’m fat. And, they’re determined to do something about it. Every single stinkin’ time I go there. Yes, obesity is a huge problem in this country, and my doctor’s office is determined to nip it in the bud, starting with the biggest offender – me.

My first time there, as I left the office, the receptionist  handed me a packet of papers and said somewhat sheepishly, “Here’s some information on healthy eating.” My first thought was, “wow, how wonderful that they care about my health as a whole person,” until I got home and looked it over. Turned out these papers were all about obesity and weight loss, and what I must do to start taking care of my obesity problem, today. Really. To say I was insulted was putting it mildly. But I thought I’d be the bigger person. After all, they think I am. So I put it aside. I refused to let my self be annoyed.

Until the next time I went there. Nothing was different about my weight, so turns out, I’m still fat. When I went to leave, there they were again with the fat handout. Now granted, even if I was fat, and, spurned on by their wonderful diet information, had decided to do something about it, chances are, I’d still be fat when I came back four weeks later. And the next time. And the time after that.

So the next time I complained to the doctor, who I must say, had a good 30 pounds on me. “Your people think I’m fat,” I said, “and I’m getting a little offended by it.” Well, she looked at me, looked at my chart, tut-tutted and said “well yes, your numbers don’t quite meet our guidelines, blah, blah” and then she went on to blame the government. Yes, according to her, the American Recovery and Reinvestment Act requires health care providers to provide, among other things, weight loss information to patients who, according to whatever mystery standards they are using, are fat. Then she went on to a well-rehearsed speech about how they are only doing this because of the government, and if I didn’t want to get a fat handout every time I came there, I needed to contact my congressperson, instead of complaining to her. So there. Instead of the lecture, it might have been nice to hear which obesity guidelines they were using that labeled me as fat, as according to BMI (body mass index) I’m still under the wire. But no. Just you’re fat, the government makes us say so, so there.

And so it’s continued. Every time I go there, or to any other office within that health care group, I get the fat handout. The last time I was there, I balked. “Don’t give me those fat papers again, I already have them,” I said to the receptionist on my way out. She started in with the usual diatribe about the government makes us, we have to give them to you, blah, blah, and handed me the fat papers again. In anger, I ripped them off of the stack of papers she gave me, and flung them down on the check-out desk, it turns out, on top of a huge stack of the same fat handout, left by other angry patients.

I have to confess that I am unfamiliar with the American Recovery and Reinvestment Act, and even after reading about it, still do not see where it says in there that I’m fat. I’d be interested to hear from others if any of you have  had similar experiences. In the meantime, I’ve either got to look for a whole new bunch of doctors, or resign myself to being called fat every time I darken their door.

Huffygirl aka Fatgirl

More from Huffygirl on exercise and weight:

Back off Al Gore, we don’t need no stinkin’ internet (well, maybe just a little bit)


Al Gore's brain child (Courtesy of Google)

I feel – refreshed. I’ve just  found a young person who is not obsessed with the internet.Or Facebook. Or constantly texting and Twittering. For security reasons, I’ll call her  “M.” M is a college student. She uses the internet when she needs to for school or convenience, but she doesn’t have internet access at home. No constant obsession with Facebook. She has  a FB account, but doesn’t really use it much. She can’t shoot off quick status updates or emails to her friends. Instead, she might actually have to call someone, or gasp, talk to them in person. M is not a Luddite; she’s just  a refreshingly practical person who decided that  internet access is low priority compared to all the other places her money needs to go. M is one of my climbing wall buddies. On Wednesday nights while she is scrambling all over the wall like one of the Flying Wallendas, her peers are sitting somewhere drinking high-calorie lattes’ and tapping away at their computers or phones.  M is studying exercise science and outdoor recreation, a focus that could no doubt lead her to a career  someday of getting overweight people to be active and play outside. She shouldn’t have any trouble finding a job, since about 50% of our population is now either overweight or obese

I came home after this conversation feeling renewed and nostalgic, just in time to catch most of Modern Family. Yes, I know here I am expounding about  people sitting around too much and then I come home and watch TV. But I had just been to the gym, so give me a break.

Anyway, in this episode, the mom Claire becomes concerned that her family is spending too much time sitting and using electronic devices. She bans the use of anything electronic for a week  – computer, cell phone, video games, iPad, Pod, Touch, etc and offers a prize to the person who lasts the longest. Of course, in no time at all Claire tries to make an airline reservation by phone instead of online, and quickly caves when she finds out how difficult it is.

Internet, electronic devices – blessing or curse? They’re great for convenience for things like making reservations, instant communication, online banking,

Huffygirl playing outside, pre-internet (© Huffygirl)

shopping and the like. But they can become a curse when they keep us from talking to the person right in front of us, or so occupy us with inactivity that we no longer play outside. I’m concerned when I see a group of people sitting together texting and playing with their phones instead of talking to each other. Or when I see children who are great at video games, but no longer play outside games. And don’t even get me started on our obesity epidemic – that’s another blog all together.  Can we temper our electronic device use to a sensible level like M?  Your comments please. Meanwhile, I’m going for a bike ride.

© Huffygirl

American’s Love Affair With Food: How can we break the cycle?


Courtesy of Google

 Fact: For most people, food is plentiful in our country. It is not always the best food for us, but in general, it’s out there. Except in remote areas, Americans are bombarded with opportunities to buy food through fast food restaurants with drive-up windows, convenience stores, gas stations, grocery stores, restaurants and vending machines.    

Fact: Obesity is a rising problem in America, which brings with it long-term health problems, the most prominent being type-two diabetes mellitus.    

Fact: David Kessler and many others have found that certain foods that are high in fat, sugar and salt, trigger an addictive food cycle, that makes it difficult for people to avoid eating those foods, or to eat them in moderate amounts.    

So what do we do about it? How do we break the cycle that frees us from overeating or eating the wrong kinds of food? We know it’s not easy. David Kessler wrote a whole book about it, after an arduous quest to find his answers. The plethora of other diet and weight loss solutions available through books, videos, weight loss centers and online programs tell us that many are trying but not all are succeeding. With obesity rising towards epidemic proportions in our country, it seems that Americans are losing the battle.   

Where to start? Here’s some tips that may work.   

Identify your food triggers. Kessler did this by diving into the dumpster behind a restaurant to find the ingredient list for the food served there that he found addictive. Hopefully most of us will not have to go to that extreme. Think about what foods you crave when you’re stressed, lonely and depressed, and what restaurants you frequent at those times, what foods you just can’t pass us adding to your grocery cart, and what foods you eat even when you’re not hungry.  This will give you a pretty good start. What’s next – never eat these foods again? Avoid driving by your favorite restaurant (and all the signs advertising it too?) Probably not practical solutions and likely will lead to a sense of deprivation. Try something moderate instead – keep your favorite can’t-resist-food out of sight on a high shelf, and allow yourself one day a week to indulge it. In a restaurant, share the favorite dessert with someone else, or ask the server to remove it after you’ve eaten half. (Seems wasteful I know, but these are desperate times.) Try chewing gum or brushing your teeth after you’ve allowed yourself an indulgent taste of your addictive food. Take one bite and throw the rest away. Only allow yourself to eat your addictive food in the presence of others, which makes it less likely that you’ll over-indulge. All of this takes planning, motivation and some self pep-talks. You may need to start a reward system for yourself, whether it be new shoes, a day off, etc. Find something to replace the pleasurable sensation that you get from your addictive food. The trick is to not replace it with something worse, like alcohol, tobacco, or online gambling.    

If you’re able to exercise and not already doing it, start. Many people find walking a good way to start. Start slow and increase gradually according to your own ability. If you can’t walk but have access to a gym, an alternative is a seated machine called a Nustep – the user sits in a comfortable chair with feet extended onto pedals, and hands on handles, sort of combination stair-climber and recumbent bike motion. Add weight lifting on alternate days, or use resistance bands at home if you can’t get to a gym. (More exercise tips in previous posts in the “exercise and fitness” category.) Exercise, in addition to helping with weight loss and maintaining bone mass, can provide a sense of well-being similar to what one gets from eating pleasurable foods. In fact, some excessive exercisers have found this to be so true that they become “addicted” to exercise. Something to discuss at another time.   

Find a buddy. If you partner with someone else who is working to avoid addictive foods and improve weight, having an ally can be a life-saver. You can encourage each other and hold each other accountable. Can’t find a buddy? Try an online program, attend a class, or meet with a dietician.   

Avoid fast food restaurants – probably the biggest source of addictive foods. This takes planning. Pack a lunch to take to work. If you miss going out with your coworkers, limit yourself to one lunch out per week. Bring food along when you’re traveling. After my recent bad experience eating Subway food while traveling, (see “Do you want a gallon of soda with that?”) my husband and I planned ahead on our next road trip. We knew we’d be on the road at lunch time, so on the way out of town, stopped at a grocery store and picked up salads, snacks and water. No fast-food debacle and about half the cost of a fast-food meal.      

Avoid check-out impulse buys. The latte when you run into the gas station. The gallon of popcorn at a movie. The candy bar in the check out line. The pretzel at the mall. Make a rule for yourself – only buy what you originally went into the store to buy.   

Avoid diet soda. For many people, the artificial sweetener in diet soda triggers an addictive food cycle, that   

Courtesy of Google

 

leads to overeating other foods. If you’re a big consumer of diet soda, you’ll probably have to cut back gradually. The worst idea ever? The invention of Diet Coke. It seems to be the biggest culprit because it has the great Coke taste, few calories, addictive caffeine, and is the drink of choice of celebrities. If you’re old enough, think back to a time before diet soda was invented – aka the 1950’s and 60’s. Do you remember seeing so many overweight people back then?   

Get help. If you find yourself frequently treating feelings of sadness and loneliness by eating pleasurable foods, consult your health care provider.  You may have an underlying depression that would be better treated medically or cognitively (talk therapy).   

What else? Share what works for you.     

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