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Diagnosis: Fat. Prescription: Lose weight but don’t exercise!

May 17, 2013

I get so tired of ranting about how I’m treated at the doctor’s office, or how scared I am whenever I meet a new doctor.

So, today, I’ll rant about how my husband was recently treated at the doctor’s office.

A week ago, Conall had a … well, we’re not sure. He had symptoms of a heart attack: extreme chest pain, shoulder pain, shortness of breath. I took him to the urgent care that is right across the street from our apartment. They were great, took care of him as best they could, then had him transferred to the emergency room via ambulance.

They ran all sorts of tests on him and determined that he didn’t have, and wasn’t having, a heart attack, so they released him with instructions to follow up with a primary care physician. They didn’t do anything for his pain, but that’s a different issue. The pain went away on it’s own by Saturday.

So, of course, on Sunday he decided to participate in archery for two hours. Of course.

But I digress.

On Monday, he had an appointment with a new doctor. As much as I didn’t want to have him see a new doctor for whatever this is, he needed a “you may return to work” note, and he hasn’t been to a doctor for three years. This was a doctor that was a “preferred provider” from our insurance. Maybe that should have warned me. She was able to get him in fast though, and so I made the appointment.

When we arrived at the office, we weren’t in the waiting room five minutes when we were called into the office. We didn’t even have a chance to finish all the paperwork. The nurse came into the examination room and asked all the usual questions, including questions like “how active are you?”

Now, I’ve written previously about the “health initiative” his work is engaged in. We know for a fact that Conall walks 35 miles a week because he wears a pedometer, and some weeks he walks even more than that. That’s only the walking part of his job. He also does a lot of lifting, pulling and pushing heavy items, bending, stretching, and so on. In fact, he has a very active job.

Besides that, he is active in his hobbies. I mentioned the archery he did on Sunday because he wasn’t hurting any longer. He shoots both cross bow and long bow (the cross bow has a 75 pound pull, which means it takes 75 pounds to pull the string to full extension, cock the bow and put the arrow in; the long bow has a 35 pound pull). For about two and a half hours, he shot arrows on a range that had staggered targets from twenty yards to forty yards. After he shot six arrows, he’d walk down to the target to retrieve them and do it again.

He also fences regularly. Every Thursday night that he’s not working, he fences for three or more hours.

So, he’s very active.

Oh, did I mention he’s fat? Y’all kind of guessed that, right?

Up until last year, he was only” overweight (at a BMI of 29). But then, he broke his knee at work near the beginning of the year, and our karate dojo imploded. The lack of activity for three months from not being allowed to work or doing any of his hobbies, as well as not being able to get back into karate since then has meant he has really packed on the pounds — all 20 of them.

Those 20 pounds were enough to bring his BMI up three points and put him into “OMG YOU’RE GOING TO DIE TOMORROW!” range.

The doctor came in and, right off the bat, told him that he was “obese,” and needed to lose weight, first and foremost. If he didn’t, dire things would happen, like more events that put him into the ER last Thursday. Then she started talking about the tests that were done on him at the urgent care and hospital. Everything looked okay, except his blood sugar — but she wasn’t too concerned about that, because he had an IV in, and that could cause a false high reading.

His “high reading”? 109 for a NON-fasting test. He’d had milk, a protein shake, and some raisin bran in the four hours preceding the test. According to ABC News, the normal range for a non-fasting blood sugar test is between 100 and 130. But this doctor wasn’t too concerned about how “high” his result was because having an IV is known to mess with the values.

The only reason I didn’t say anything to her was because we needed that all-important piece of paper saying he could go back to work.

And Conall, even though he has read the studies about losing weight, heard my commentary on the UCLA meta-analysis of diets (and how they don’t work for anybody), and even sent me links to studies that were either completely ludicrous (study shows you can catch obesity from your fat friends!) or showed how the obesity epipanic is so overblown …

Even after all that, he told the doctor, “Yes. You’re right and I’ll work harder to lose weight.”

Up until then, losing weight had NEVER been a priority for him. He knew he was healthy because of normal blood pressure, normal readings on all tests (granted, that was three years ago), not eating much fast food or restaurant food, and living a very active life. But now, because this doctor told him to lose weight, it became a priority.

I had to bite my tongue to keep from telling her off. When we got out of the office, I went off about her. She either didn’t read the notes the nurse took about how active his life was, or she took one look at him (and even though he’s tall, big boned, and has a LOT of muscle, he also has some fat on him) and decided he was lying. Either way, she made a decision about his health — that he was in her office after a very terrifying and painful episode that we still don’t know the cause of — because he is fat.

At the end of the visit, she gave him a paper that stated his next steps (as well as the work release). The paper told him that because a heart incident hasn’t been completely ruled out, he needs to not exercise or do anything strenuous until after he gets a stress test. The very next bullet point pointed out that he has a BMI of 32 and therefore needs to change his eating habits, increase his exercise, and lose weight.

Did I mention she never asked what his eating habits are?

This is the first time Conall’s been diagnosed “fat.” Because of his height and muscles, and because his BMI has never officially been “OMG YOU’RE GOING TO DIE!” he’s been able to bypass that part of an examination. At the most, a doctor would tell him, “You might want to think about losing weight at some point, or at least not gaining any more.” But he was never told “if you don’t lose weight you will die.”

It took him a day and a half before common sense kicked in. Until he realized that she just treated him like I’ve usually been treated. Until he realized that he was allowing her to do the same things to him that he’s seen me do to myself after doctor’s visits (before I found Size Acceptance/Fat Acceptance and Health at Every Size®). I also helped by making fun of all the stupid things she said (the “high” blood sugar level, the “don’t exercise, but eat better and increase activity so you lose weight”). At one point, I also said, “If you are going to die tomorrow because your BMI is 32, then at BMI 44 (close enough, I’ve not been weighed in forever but all my clothes fit the same) I should have died yesterday! Oh, wait! I probably am already dead, my body just hasn’t figured out it’s supposed to lay down yet!”

And he agrees with me. We’re only staying with this doctor until the results of the stress test come back. Once that happens — whatever the results are of it — we will be finding a new doctor for him who won’t fat shame him, who won’t diagnose him as fat and tell him all his issues will be fixed if he just eats better and exercises more so he’ll lose weight.

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9 Comments leave one →
  1. vesta44 permalink
    May 17, 2013 10:32 am

    I hope you get good news from his stress test, and that someone can figure out what caused the pain (hopefully, it was a one-time thing and there’s nothing wrong with him).
    I just love (hate) how doctors look at that BMI classification, see it’s in the obese range and automatically assume one is a lazy couch potato who eats nothing but junk food, even when information to the contrary is right there in one’s medical record. I really wonder how some of these doctors even managed to become doctors when reading and comprehension skills are obviously not something they possess. They also automatically assume that one is a liar if one’s BMI is anything over 30. Must be a lot of liars in this world then, with 30+% of us having a BMI over that. *headdesk*

  2. May 17, 2013 12:50 pm

    No surprise to me. I was referred to physio for a genetic joint condition and she told me my pain is due to “being so unfit and overweight”. Never mind I had just told her how I walk for an hour a day, and was doing 1.5 hr iyengar classes, weight training and swimming until the pain and fatigue got too bad and I had to give them up. And never mind I have a diagnosis from a musculoskeletal specialist.

  3. May 17, 2013 8:25 pm

    My Gyno told me I have heavy periods (sorry, I know TMI) because of all my excess belly fat. Nevermind that I’m 47. Nevermind that I have skinny friends who complain of the same thing…..

    • Elizabeth permalink
      May 18, 2013 10:17 am

      Just to let you know, Tracey, that heavy periods are a classic symptom of hypothyroidism. I know I sound like a broken record, but after what I’ve suffered from being undiagnosed/untreated for 40 years, I just want other people to know the symptoms. When my nurse practitioner gave me Dr Broda Barnes’s book Hypothyroidism: The Unsuspected Illness, I told her it read like a journal of my life.

      Your gynecologist, is like most doctors, ignorant. Apparently they get through medical school without learning anything about the body’s organs. I had glaring symptoms for decades, including heavy periods, and was told I “looked fine.” The TSH test (thyroid-stimulating hormone) they use is absolutely useless — many hypothyroid people have “normal” TSH results.

      • May 19, 2013 5:23 pm

        Ditto for me. All my symptoms caused by my weight mysteriously disappeared after finally being prescribed thyroid meds despite not losing a pound.

  4. Dizzyd permalink
    May 17, 2013 9:51 pm

    You guys forgot that people skills seem to be left out of the med school curriculum anymore – and been replaced w/ ‘Spouting Diet Talk like A Brainless Automaton 101′ and ‘Adv. Idiotic Statements’.

  5. June 23, 2013 7:13 am

    Ugh, I hate it when doctors do this. I had some chest pains and went to the doctor. They took my BMI and I was told by a nurse that I was “obese for a petite person” at 120 pounds. They thought my chest pain was heart related because of my “obesity” but it turned out I only had sprained cartilage in my ribs from overexertion from exercise….

  6. bronwenofhindscroft permalink
    June 23, 2013 11:36 pm

    Update on the stress test: It seems there’s nothing wrong with him. At least, not his heart. So, that’s a good thing!

    • June 24, 2013 9:12 am

      Awesome! That’s good news, at least. But having an undiagnosed ailment is stressful and frustrating, though. I hope you guys figure out what’s going on.

      Peace,
      Shannon

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