Open Letter to Healthcare Workers – how not to behave with someone with an eating disorder

Going to the doctors is very hard for most people with an eating disorder.  The NUMBER ONE reason I don’t want to go is because I don’t want to get on THE SCALE.  It is like a giant scorecard to remind me to listen to all those stupid voices in my head telling me what a worthless piece of $HXT I am and I avoid it like the plague.  However, since being abstinent and having some health issues, I have learned to be upfront with my eating disorder and tell the nurse that I do not want to see nor know my weight.  Generally, this goes somewhat okay.  They don’t understand and often leave my chart laying face up in front of me with my weight in big numbers on it so it defeats the whole effort I made of telling them not to tell me but sometimes it actually works.

Why not tell me?  Because it will never be the right number.  If I weigh 300 lbs I am a fat cow and worthless. If I weigh 250 that’s still not a normal weight and I can’t even participate in most activities because I’m too fat.  If I weigh 150 lbs, it must be off because I couldn’t weigh so little….whatever……the bottom line is the number is never good enough and knowing it just feeds “the voices” and I will feel the need to EAT over it.  It doesn’t make sense to eat over being fat but this disease is cunning and baffling so it does not make sense.

I’m not the only one.  I have a program friend that was so large he had to have a CATSCAN done at the zoo….yes, where they do CATSCANs for elephants…..knowing what that must have been like for him, I asked him, “where did you go to eat afterwards?”…he said, “I remember it very clearly…I went to an all-you-can-eat buffet”.  You see, I didn’t need to comment on the CATSCAN, I knew how insane this disease is and how ridiculous we react to confirmation that we are OBESE….we EAT!!!!

Today I had a follow-up appointment with a cardiologist.  I don’t have any heart issues but I originally went to the cardiologist because my primary care physician referred me due to swelling in my lower extremities.  A few months ago I went through a battery of tests and determined that there was nothing wrong with my heart but my significant weight gain was probably causing the swelling.  Naturally, I had to have the “talk” with the cardiologist about my battles with compulsive overeating and how I had relapsed but was back with Overeaters Anonymous.  It took me to visits with him and frank discussion to get him to begin to comprehend that this is a disease and that I was doing what was working for me to get healthy again.

He was surprised at how upfront I was with acknowledging my weight gain and ownership with the problem.  He suggested I consider going “downstairs” for a consultation with a weight loss surgery clinic.  I told him how many people I have met in OA meetings POST-surgery because they never solved the underlying problem and they found ways to “trick” their surgically manipulated bodies.  I felt pressure but I also firmly voiced my opinion.  He checked my weight on the last three appointments and told me there was a downward trend so he was happy.  I expected to be commended today on my continued weight loss and to go on my merry way.

Well, the first inkling that today would be different was when I saw the Medical Assistant swimming in her pants.  They were falling off her and all she could do AS SHE WAS WEIGHING me was talk about how much weight she has lost and how her pants were falling down.  I told her I wasn’t going to look at the scale and to please not tell me my weight.  Now, sometimes I tell them I have an eating disorder and I’m not “supposed” to know my weight but for whatever reason, I didn’t do that today.

We go into the exam room and she continues to talk about her tremendous weight loss.  She then says, “did we refer you to Carlie”?  What?  Carly Simon?  Who the H is Carlie?  Then she said the dreaded words, “you know, ‘downstairs'” .  Oh, yet another plug for the weight loss surgery…….at this point I’m tired of this woman because I know she desperately wants to tell me about her weight loss success.  I have an EATING DISORDER……if you know anything about that, it isn’t about the FOOD!  That is a symptom of the eating disorder.  I told her that I had an eating disorder and that I go to OA….”oh, I always thought about going there”.  I wish she would.  I know we have pamphlets for the “Professional” but I always think about those as being for nursing students who visit our meetings….HOWEVER, in the future I am taking them with me to these appointments because quite frankly, healthcare workers do not get it.

Well, the cardiologist was delayed at the hospital and since nothing is wrong with me except for being F-A-T, I agreed to see the nurse practitioner.  She starts in on all the cardiology related questions, “shortness of breath? family history of heart disease? do you feel winded?”  I had to explain to her what should already be in my record….I have NOTHING wrong with my heart….I’m FAT so I take diuretics to reduce swelling until I lose weight.  I get that they are going to ask me cardiology questions…I mean, what can I expect?  I’m at the cardiologist’s office!  BUT, I explained to her that I have an eating disorder and that I have been losing weight but I don’t know how much, nor do I want to know but I’ve already discussed that with the doctor.  She proceeds to look through my file and said, “you’re stable”.  WHAT THE HELL is that supposed to mean?  I haven’t moved down in weight??????

CONTRAST THAT appointment with the one I had with my general practitioner yesterday.  I reminded her that I don’t want to know my weight and I don’t want to know how much I have lost and you know what she said?  “You have done great….you have gone down each time I’ve seen you this year and you should walk out of here feeling really good about yourself”.  Ahhhhhhhhhh, yesterday I was on a cloud….today I’m on a “binge-eating” kind of day.

Today I read page 417 of the Big Book because my sponsee needed to hear it…that often happens and I realize that I am the one that needs to hear the message even more than my sponsee…its all about accepting life on life’s terms.

“And acceptance is the answer to all my problems today.  When I am disturbed, it is because I find some person, place, thing, situation — some fact of my life — unacceptable to me.  And I can find no serenity until I accept that person, place, thing, or situation as being exactly the way it is supposed to be at this moment.  Nothing, absolutely nothing happens in God’s world by mistake. Until I could accept my alcoholism (we change that to compulsive overeating), I could not stay sober (abstinent); Unless I accept life completely on life’s terms, I cannot be happy.  I need to concentrate not so much on what needs to be changed in the world as on what needs to be changed in me and in my attitudes.” (Big Book, v. 4, page 417)

As a program friend told me, “bless them, change me”.  Truer words were never spoken.




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