9 Things I Wish I Told the Doctor Who 'Prescribed' Me Weight Loss

I waited three weeks to get an appointment with my doctor to discuss the severe fatigue that I’ve been experiencing for the past eight months. Honestly, I’ve been exhausted for the past five years, but with two small children, working, interning, and pursuing a graduate degree – that’s to be expected. Now that I’m done with internships, school work and the needs of itty bitty babies, I assumed my energy levels would increase. Yes, I’m still parenting, working full time and managing chronic depression, but I didn’t expect my need for ten shots of espresso a day to increase as my life became less busy.

This exhaustion has significantly impacted my daily life and my interpersonal relationships. From falling asleep at work to being too tired to play with my kids, my fatigue has become more than a slight annoyance. I reasoned it would be good self-care to get it checked out with a medical professional. Unfortunately, my doctor took one look at me and gave me a prescription for weight loss stating, “You’ll feel a whole lot better if you lose X amount of weight.” Not only was my exhaustion not addressed, but she was gone before I could explain to her my view on the topic.

Here’s what I would’ve told her if I’d had the chance:

1. Weight loss doesn’t usually work.

If a person is able to successfully suppress their weight, it is usually only a matter of time before they gain it back. The only consistent outcome we know about weight loss attempts is that it is a predictor of future weight gain and metabolic suppression. If a person is in the small (less than 5 percent) portion of the population who is able to successfully suppress their weight for greater than three to five years, there is a good chance that person has a disordered relationship with food, exercise, or both.

2. Weight suppression can be harmful to the body.

Trying to control your weight often requires ignoring your body’s natural signals and can instill an innate distrust in oneself. When we diet, we might endorse that our desires and needs are not to be trusted, regardless of the danger we may be submitting ourselves to. As hard as we work to force our bodies into submission, our bodies will usually work just as hard to protect us from perceived famine. It’s what we’re biologically built to do.

When we don’t get the results we want, it is highly likely that we will reach for even more dangerous means to attempt to control our weight such as extreme calorie deprivation, purging, weight loss surgery, compulsive exercising, diet pills, diuretics, laxatives, legal and illegal drugs – the list goes on. All of this is infinitely more harmful to the body than staying at one’s current weight. 

3. If this were really about physical health, then we wouldn’t be talking about my weight at all.

We should be discussing how to incorporate more healthful behaviors given my time restraints, resources, environment, wants and needs — not the number on the scale. Perhaps the most healthful action I can incorporate into my life right now is taking a multi-vitamin and that’s OK.

4. We cannot address my physical health without also addressing my mental health.

If you’ve never dealt with depression, then I don’t expect you to understand. There are days when it’s all I can do to get out of bed. On these days, cooking myself a healthy, organic, well balanced meal or completing a workout is way outside of my capabilities. 

Furthermore, what if eating emotionally is actually a healthful behavior for me? Emotional eating is one of multiple coping mechanisms that allow me to deal with difficult emotions instead of turning to self-harm. Perhaps my most immediate health concern is not my nutritional status, but instead my desire to harm myself. In this context, eating emotionally is actually a harm reduction technique that allows me to self-soothe rather than endanger my life.

5. I have no moral responsibility to be “healthy.”

Physical health may or may not be a value of mine and that does not detract from my worthiness as a human being. Even if I have no desire to be physically healthy (irrespective of my weight), that is my prerogative. I am not morally required to pursue “health” and suggesting otherwise is oppressive in nature. 

6. Shame is not an effective means of promoting change.

Trying to force a person into changing their behavior by way of coercion, social stigma, guilt or shame has yet to prove as an effective motivator for longterm change. In fact, basic psychology suggests that using these tactics only makes people want to rebel against the suggested behavior change with more gumption than before. Humans do not like to be told what to do. Research suggests that we need to be intrinsically motivated for longterm sustained behavior change. Fat shaming is ineffective. 

7. I’m actively working to disengage from diet culture.

If you had bothered to listen, you would have learned that I’m working with a body positive health coach – not on losing weight, but on healing my relationship with food after a lifetime of food controlling my life and self-worth. If we’re going to talk about health, then my mental, emotional and spiritual health must be included in this conversation. Yes, I gained weight when I let go of restriction and stopped attaching worth to my food choices. Like the majority of people who restrict food for any period of time, the pendulum had to swing back in the other direction. I’ve been the size that culture deems socially superior and it didn’t make my life all unicorns and rainbows. Thin is not the “cure all” that it’s prophesied to be. When I was at my thinnest, I was obsessed with food and exercise and actively self-harming because I could never get it “right.” Not having my life revolve around food and exercise is worth more to me than thin privilege.

8. You are reinforcing patriarchy by telling me to conform my body to arbitrary standards such as the Body Mass Index (BMI).

You are telling me that it is more important for me to put my time, energy and money into becoming smaller than it is for me to accept and appreciate my body the way it is right now. You are telling me that my head space should be filled with numbers: calories in, calories out, weight, BMI, measurements, minutes spent exercising, etc. Do you know what happens when my brain is busy with all of these numbers? I can’t focus on important issues like body sovereignty. This distraction and complacency is exactly what feeds the system of patriarchy. 

9. The conversation we are having is inherently classist (and racist, and sexist and ablest…but one thing at a time).

I have an immense amount of privilege in this society because I’m white, heterosexual, educated, (visibly) able-bodied, English speaking, employed, etc. I will not pretend that I know what it is like to be a person who is judged by their weight while also facing institutional oppression for other physical characteristics. That said, I do not have the luxury of endless money and time to spend on the pursuit of thinness even if it were something I valued.

When I explained to you that I get up at four every morning and go non-stop for 17 hours and then literally collapse into bed too tired to even wash my face, I’m not sure where you thought I might fit in that extra cardio session you suggested. If I had infinite resources, I would outsource my grocery shopping, meal prep, cooking, cleaning, laundry; but my financial situation does not allow for that. Most days are just about getting my family’s basic needs met. It is a luxury to have the time, energy and money to pursue body modification.

I still don’t have an explanation for my chronic fatigue, but I am certain of one thing: putting up with discrimination and oppression certainly isn’t helping anyone’s energy levels. I have the luxury of being able to choose a different doctor, but we often don’t get to choose whether or not we are subjected to body shaming. The reality is that fat-phobia is rampant. This is especially true as the difference between our bodies and that of the societal ideal increases. This oppression only intensifies with the more minority statuses that a person identifies/is perceived of identifying with. I don’t know what the experience of discrimination is like for anyone but myself, but what I do know is everyone deserves to feel safe in their body – especially when they are asking for help.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

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