Thank you again for doing such a good job of changing the world!
(FK from Norway)

And, also IMO obviously, I don’t say to patients that they eat “crap” – but this comments page is not a professional consult so I don’t feel the need to be PC, and I certainly DO see patients who live on a diet that I consider nutritionally inadequate and calorie dense.

I apparently haven’t given a very good impression in my first post here, but as a medical professional I have a lot of repeat and happy customers, and I’ve been told I’m a better listener than most. However, I also know my limits, and I don’t deal with eating disorders – that’s a whole ‘nother basket of eggs, and I’ve worked with enough ED patients to know that this is not my cup of tea. If I come across a real/suspected ED, I refer them to a specialist – this needs a special level of care (and psych input) which I can’t provide and I’m not going to do them the injustice to muddle through on my own.

Technically BMI wise i am in the overweight category (can sometimes go into the obese category). I am often told “you can’t be that fat!” when I tell ppl I am obese (at the times when i am)… I hope that made sense.

Regarding gym class. I was always very good at sports. In the top hockey team. I was the goally and i could run laps around my team mates in all that padding!!!

I guess most of the issues i have around my weight come from my mother. She was an elite ballet dancer and had the view for a long time that I should also be like her. We had really massive arguments about my weight and when i started throwing up most meals, she actually was happy, because I could, “use it to lose weight”.

So I think that this is a great blog and I am glad you are speaking out about the fat discrimination.

My doctor now is awesome, though. She ignores the BMI, uses one of those electronic body-fat-percentage-calculating things, and is much more interested in my cholesterol (low), blood pressure (low), and fasting glucose levels (yep, still low) than in the readouts from the body-fat gadget or the scale. It’s interesting: the most fat-phobic AND the most fat-friendly doctors I’ve seen have both been fairly thin women. Anybody else have similar experiences?

Anyway, has anyone else noticed how the only people who look good in corsets are considered obese or morbidly obese by the BMI? A lot of older fashions seem geared toward people who are not thin, and they look super sexy. I think as far as fashion consciousness goes, if there were more options that were actually meant to accentuate curves and fit real people, instead of ‘hiding the flaws,’ a lot fewer people would feel bad about their body image.

And a note about health care – I have low blood pressure. I have been told that, were I to live in another country, I would be given treatment for it. Here, however, we are only concerned with high blood pressure, and people tell me that I’m so lucky. There isn’t anything lucky about having a low pulse and very little energy. If I had low blood pressure and was also overweight, people would tell me that I just need to exercise! more! and then I wouldn’t feel tired.

Kind of like how if I became blind, my bad memory and ineptness at finding my way would be blamed on my blindness, not on the fact that I am just silly and forget things.

Or how, when talking to people about being transsexual, my changing understanding of my own sexuality is always met with, “Oh, that makes sense. Because you’re body is female, of course you like women,” or “Oh, of course, because you view yourself as male, of course you like men.”

In any of these cases, it’s all about what is acceptable, and so acceptance movements are important for that – remove the arbitrary standards of acceptance, and then we all get to move beyond this stupid superficiality. Yay!

Anyway, I’m going to show this blog to so many people. It needs to be seen!

I can LOOK at them and tell if they are healthier/been exercising/eating well/taking care of themselves. When they stop eating CRAP their skin and hair looks better, when they cut the cigs they breathe better – it isn’t all about the number on the scales!

Really? You have magical powers which allow you to tell all you need to know, without actually even asking them?? You might want to step back and think about that, especially as you’re a health professional. Being a professional medic does not make you have magical invincible powers to discern all this information as you describe — it just doesn’t, and the assumptions you’re making can lead to a lot of heartache for patients, not to mention harm .

How many fat patients have been half-listened to, or not listened to at all at the hands of a health professional who has prejudged them on their appearance?! It’s not just about not being rude to patients who ‘look unhealthy’ (according to you). It’s not even only about not making numbers the sole focus (although it’s nice to hear you at least say numbers aren’t the things to live and diagnose by)… it’s about *not judging on appearances alone*. And about *listening* and actively trying to *watch out for your own biases*.

My mum is ‘obese’ and you’d probably decide from looking at her that she eats ‘CRAP’. This is because she doesn’t always look so healthy — she often looks tired and stressed, gets bad skin and has inherited early rheumatoid arthritis (makes exercise hard, huh?!), had a hernia from over-exerting herself when she was trying to exercise on a doctor’s instructions (again, hard for her to exercise after that), and is constantly worrying about money because their finances aren’t great in this recession and she’s in pain. From the way you write that ‘CRAP’ in capitals, I’m guessing you don’t think much of people who eat what you deem to be CRAP, so if you think you can tell from looking at them that they’re still eating CRAP then I’m guessing it’s not a huge leap to infer that you tell them to stop eating the CRAP. Even though this is not the sure-fire way to helping someone open up and tell you about their problems… If they in fact do have an issue with food, then diving right on in there with assumptions that you a) know what sort of thing they eat and b) know that this is to blame for whatever they’ve come in for will most likely be harmful. Listening and talking about these things in a respectful way (I don’t find the word CRAP very respectful, especially when it’s an assumption about the kind of food a person eats) might work a little better. And you know what? The thing they’ve come in about might not be to do with their diet or their visible physical features, even — EVEN — if these things are affected in some indirect way.

The central problem could be something else entirely, and I don’t think I’d feel too secure going to a doctor who professes to be able to tell whether or not I eat what s/he deems as CRAP from looking at me. I actually speak from the position of having been very anorexic, but not ‘thin enough’ for the doctor who saw me to take me seriously. Apparently, with my tiny legs and no fat on me at all, my bones were still big enough that it meant I was magically not ill! Even though I wasn’t eating, and when I ate, I purged and/or overexercised straight afterwards, and told the doctor this. Evidently, she knew better from looking at me!?!