Open Letter to our doctors

I’ve been under the care of a lot of doctors in my time – primary care, emergency care, dermatology, neurology, rheumatology, psychiatry and more.  And there is always one thread, one theme that runs through all the appointments and care episodes.
The attitude to education about the benefits of losing weight.

See, I get it. I’m a big girl. I am in dire need of losing weight.
But I’m not blind to it. I buy my own clothes and I have seen the numbers on the labels get bigger, or the amount of X’s before the L’s multiply like rabbits on Viagra.
I’ve lost weight, I’ve gained weight. I’ve been on that elevator ride up and down so often I may as well have a red satin rope at the entrance.
Some of it has roots that I cannot change and are out of my control. But some of it purely is because cake tastes better than sweetcorn. Though to be honest bat guano tastes better than sweetcorn. But I digress.

So I dread so many doctors appointments because of the ‘weight chat’.
You see, I understand your quandary. You have health education thrust at you like the business end of a hammer, and you have less time per patient than it takes someone to find a toilet after ten sennakot tablets. So you have fit it quickly into your time slot. 
But from a patient perspective, there have been so many occasions where I have walked into an appointment feeling buoyant because I have lost ten pounds (for instance), and am bluntly told I need to lose weight to improve my health symptoms.
And of course I do. My back wouldn’t hurt half as much if it wasn’t sandwiched between my lard arse and my heavily padded tits. And knees are not designed to take the strain I put on them. They cannae do it Jim, they just don’t have the power.
But the point is that I am already trying hard.  And when that isn’t actually part of the conversation, the positives aren’t acknowledged, and instead the conversation focuses on my shortcomings, it is a huge blow to my confidence and self esteem.
And a lot of people like myself have problems around emotional eating. So that chat often has the opposite effect on me to what was intended. I get into “whats the point” mode.

I am actually far more likely to slip into old and dysfunctional eating habits after one of these appointments.

This blog, this open letter, it’s a plea to you to take this into consideration the next time someone waddles into your consulting room. Open the conversation differently. Maybe ask whether they have given any thought to losing weight, or have started any kind of weight loss plan.  It gives that person the opening to tell you the plan they am using (which may also need a conversation of it’s own if its not manageable long term) and how they am managing on it.
Because “that’s great, well done, keep it up, because losing more weight will improve your health even more” is such a boost. Personally it makes me walk out with fresh determination. Leading with “you could do with losing some weight” is such a smack in the face when you are already trying hard. And I have to be fair and acknowledge I have seen doctors who have led with this opener. This letter is not me taking a shot at doctors who are already doing their best with zero resources, and working too many hours.
But to point out that somebody is on the right road far more likely to continue towards where they are already heading  and all it takes is a simple choice of phrase change. It might also have the effect that they might open up to you and ask for help instead of feeling resentful.

It took me a long time to admit I couldn’t do it on my own. I couldn’t lose weight and deal with my complex medical history, mental health issues and disordered eating alone. And I did the hardest thing of all. I phoned my GP and asked for help.  I am a day away from my first appointment with a bariatric consultant. And honestly? I am TERRIFIED. But I am excited that I can take a step towards confronting and resolving my issues head on. Its going to be hard work, but the fact I was able to face up to what I needed to do and admit I was tired and needed help was a crucial step for me.  But it’s a step I honestly believe could have come sooner if one person had taken the time to discuss weight with a more positive slant with me. 
I’ve been to appointments where I have not only bluntly been told my weight is making my issues worse, but when I agreed and told them I had lost a stone it was not acknowledged, and the haranguing continued until I lost my temper. I wrote a poem that day that I rarely perform because of the multiple use of the word Fuck.  I also stopped at the garage on the way home, took two steps out of the car and fell into the loving arms of a bar of Cadbury’s Dairy Milk. I ate until the anger was gone and was replaced by shame for letting myself undo my hard work.

That was a fairly extreme example and I mostly meet kind and compassionate doctors, who I don’t feel the need to use obscene language about afterwards. But with our spiralling obesity crisis a conversation around thoughtful language that will encourage, not discourage, weight loss and give people a chance to ask for help, is needed more than ever before.  And I really hope it happens.

And if any of this has resonated with you then thankyou


A Fatty

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