She didn’t ask me what I ate, or if my diet was markedly different than my parents’ (I was eating tofu and ground turkey in the 80s when they just made fun of me). Or anything else about my life.

and it happened again today. she’s telling me what my bmi was, and i just said, “you know, i’m fully aware that i need to lose weight, and i want to lose weight, and i’ve tried every diet that exists.” there was no need for her to take my bmi. i’m fat, i know it, okay?

they just don’t believe you.

But I don’t think my sister will listen to anything I have to say. She has been fat since childhood. My brother and I have tended to be more average weight, although since hitting menopause and taking various medications for severe depression (meds that are helpful, if not life-saving), I’m carrying about 25 pounds of unhealthy belly fat. This annoys me.

But mostly I can camouflage the belly fat, and it hasn’t seriously hampered my activity. My sister has been obese since childhood. There are a lot of family dynamics involved, but …wait, I have no business talking about this aspect. Gah.

Let me move on to a conversation I had with my sister a few years ago. I’d just had a breast lump removed (benign benign benign! Yay!, so medical stuff was on my mind. I asked her about her mammograms, and she said she’d never had one. She grudgingly told me that she’s never had a pelvic exam or a PAP test in her entire life. At this time, she was 49 years old.

My family is not close, and the intervening years haven’t mended that. My sister doesn’t like to talk to me about these things, or anything (actually, she doesn’t much like me) but she opened up enough back then to tell me this.

I was the one who had to tell her that she’s the consumer, the doctors and nurses are hired by her to provide medical care, for which care they are paid, and to urge her to believe that she has the right to get a PAP test without additional commentary. And that the world wouldn’t end if she said straight out, “Look, I’m here for a PAP test. That’s what I want. I am fully aware of my size and weight and do not want counseling from you on that subject.”

Since then, I’ve worried about her, and I’ve been uncomfortable with having said stuff like that to her. I don’t think I said anything wrong, but I’m not sure I conveyed my assumption of her intrinsic value, or my recognition that her situation kinda sucks. You know? She comes from a family in which the parental dialog was “We’d love you more if there were less of you to love”, so obviously it’s not gonna be easy for her to go into a doctor’s office and demand to be treated with respect.

What’s her leverage, anyway? Fat people continue to be targets, and there’s very little public pressure for that to end. Fat peoples’ very flesh is assumed to be public property for comments, criticism, observations, contempt, pity….

My sister is not as healthy as she could be even without losing a pound. You know one of the reasons why? Maybe twenty years ago, during one of the times she was living with our parents, she fell and injured her ankle. (She probably broke it.) She never went to the doctor (habitual shame); our parents never insisted that she go (so expensive when it’ll probably heal on its own), and ever since then, she’s had increasing pain and restriction when walking or weight-bearing of any but the most minimal kind.

She can’t go for walks, or hikes. She has to miss the fresh air and seasonal changes and bone benefits and heart benefits, and all the soul-healing benefits that the outdoors has to offer, regardless of whether she ever lost one damn pound of weight.

You’d think I could do something about this, but believe me when I assure you that I can’t.

Everyone is a human being, and thus deserves the same respectful medical treatment that any other human being would receive.

I swear to you though, every time I go home she is on some other god damned diet. Every time she goes to the doctor he harasses her about her weight. I know their are concerns like high blood pressure, but the woman goes to the gym for half a day three times a week and barely eats anything. She’s much healthier than my Dad who is on her case constantly. She was on Nutri System, the california diet, some weird thing my dad found, I’m sure they’ll be “cutting carbs” again when I go home for the fourth.

For a while there she was eating cottage cheese for breakfast every morning because it was “low carb” and then she went to the doc and her cholesterol was thorugh the roof. SHOCKER. I mean this woman has serious medical problems, but they aren’t just because of her weight, high blood pressure, cholesterol, everything runs in the family.

Why can’t they give her a break? Like it isn’t depressing enough to not be able to drive, she’s not allowed to eat either. Raaaah.

And the funeral story? GAAAAH. Even if the person who died was the most self-destructive person who ever existed — even if she was a frigging crack whore who turned unprotected tricks to get fixes — it’s in jawdropping bad taste to mention it at the funeral. And being fat =/= crack whore, not even close.

Six months later I went back to my regular exam and suddenly there was this diet that it was HIGHLY URGENT that I go on. She went on it and lost 40 pounds in 2 months for her high school reunion.

Now I am a big believer in Chi Gong and Chinese medicine and there may be something to the accupressure part of this. But here’s why people lose weight on this diet: It’s because the diet consists of the following:

Day 1: 20 oz. of full-fat milk. That’s it.
Day 2: 1-1/2 lbs. of vegetables. That’s it.

Continue until you lose the weight.

In 1983 I went on Cambridge Diet and went from 118 to 105. The minute I went off it I started gaining — and never stopped.

I don’t eat fast food. I don’t eat sweets excessively. I do yoga, I walk. And I am now a size 16. And I have a doctor telling me to go on a crash diet after years of telling me not to worry about it.

According to her staff, she was a bitch on wheels while on this diet….sort of like I was when I was on Cambridge because I WAS HUNGRY ALL THE TIME.

But this is the medical profession for you.

I don’t even have a problem with a doctor who wants me to lose weight — if he or she is willing to provide constructive help and understanding that for some of us, calorie in/calorie out doesn’t always apply.

This highly encouraging event has led me to consider finding a new general practitioner and gyno. But I’ve been sitting on the optimism for 6 months because, quite frankly, I still absolutely dread it and don’t know quite how to summon the energy.

The allergist office weighs me but they make it clear it is to determine proper dosage. They take my blood pressure (which is perfect, I’m told), and check other general things to make sure that giving me allergy tests or allergy shots is not going to make me more sick. The only time weight loss came up is when the doctor said the body being unable to process foods to which it is allergic can cause weight gain and so, if I am avoiding the foods on my allergy list, weight loss might be a side effect. She mentioned it as one of a host of things that might happen.

It was amazing. Because for once, the goal of a doctor was to help me breathe instead of to shame me for my weight.

So, yeah, this resonates very personally for me

La Di Da, you nailed it:

If they’re not willing to consider that it might not actually be tragically unhealthy to be fat, or that weight loss doesn’t work, what other knowledge are they lacking?

That is right fuckin’ on.

Made me flippin’ MAD.