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Fat, Health, and Being an Advocate With Your Doctor

by Lana Simmons, NASM-CPT, RYT-200

It’s 2011 and I’m sitting in my Doctor’s office, naked from the waist down with only a thin paper blanket covering me, hoping this OB/GYN visit will be quick, painless and weight-loss-talk free.  Actually I’m hoping for positive feedback, and dare I say “Congratulations,” from my Doctor due to my 100 pound weight loss over the past year.

I have always been a large-bodied woman.  My dieting career started at age 10, when my pediatrician scribbled the words “obese” on his notepad and explained to my mother that I needed to lose weight “before it became a problem.”  He told my mother to remove all sweets from my diet, complete 20 – 50 push-ups and sit-ups every day, and write down every piece of food that went into my mouth.  Let the diet cycling begin…

Over the next 25+ years I would go “on” and “off” diets while losing and gaining 100’s of pounds (even having the dreaded LabBand weight loss surgery).  During this time I would rarely see a Doctor unless it was absolutely necessary, and if I did see a Doctor the visits would usually end up like this:

Doctor: Do you realize how fat you are?  You need to lose weight.  You are on your deathbed even though your blood work looks fantastic.  If you were in a normal BMI range you wouldn’t be in my office for a sore throat, migraines, __________.  Here, take this pamphlet on weight loss surgery.  Oh?  You’ve already had weight loss surgery? Well, maybe you need to try another weight loss surgery.

So after losing the most weight I had ever lost, 100 pounds, I believed I would finally be able to opt out of the weight loss lecture at my OB/GYN appointment.  I was hoping to have a real conversation about my overall health.

My Doctor finally arrived with her head down in my chart.  She didn’t greet me, but stood near the door concentrating on something that seemed very concerning in my chart.  Finally she looked up at me and says, “Do you know where you land on the BMI chart?”  She quickly moved to a HUGE poster of a BMI chart on the wall and pointed to the obese range.  She continued talking when I didn’t answer her, “I think we really need to talk about losing weight to help you improve your over all health.  Have you tried tracking what you eat and exercise?”  At this point, I’m shocked that THIS is how our appointment is starting out despite my intense and all-consuming effort to lose 100lbs.  I’m determined to prove her wrong and respond, “Yes, I’m eating 1400 calories a day, working with a Dietitian and Exercise Physiologist, and also running over two hours a day.”  Her response was to speak with my Dietitian about LOWERING my caloric intake to 1200 calories and ADDING strength training to my routine.

I left the appointment feeling humiliated, yet also realizing it was up to me to educate the health care professionals I interacted with to look beyond my size.  I had no idea how I was going to do this, but I knew that no matter how much weight I lost, I would always receive the weight-loss lecture because of the build, size, and shape of my body.

Over the next couple of years I slowly regained the weight I had lost, and simultaneously attempted graduate school for the third time. One of my grad classes was a research and statistics class where we had to choose a topic to research and form our own opinion on.  I chose the topic of weight loss, hoping I could find a research experiment, or research statistics, on the best method of losing and keeping weight off.  Finding research on ways to help people lose weight wasn’t an issue; finding ways to keep the weight off for more than 5 years was.  Late one night after searching for weight loss maintenance, I stumbled upon Dr. Bacon and Dr. Aphramor’s Journal article “Weight Science Evaluating the Evidence for a Paradigm Shift”.  And this… this is how I found the Health at Every Size® principles and eventually the Association for Size Diversity and Health (ASDAH).  Slowly over the next couple years, my focus went from losing weight to re-defining what health looks like for me no matter what the number on the scale says.

Through the years, I started printing off all the journal articles I could find on the HAES® approach and reading as much as I could about the research behind the HAES® principles and how diets set us up for failure.  Now, when I meet with a Doctor, I bring copies of my journal articles with me.  The conversation usually begins with me needing to lose weight until I give my Doctor copies of articles on how dieting doesn’t work therefore setting patients up to gain weight, and how health does not depend on the number on the scale.  It is a conversation that HAS to happen otherwise my Doctor and I are stuck in the “you need to lose weight” cycle – therefore never truly addressing my health.

Some Doctors have been open to my research and others are not.  I think it’s important that we are all advocates for our own health. I hope some day, there will be a paradigm shift within the medical community, and our medical professionals will consider a holistic model of health rather than one single number on a scale.

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Lana Simmons NASM-CPT, 200hr RYT, is a recovering chronic dieter who does have a long sordid past wit the dieting roller coaster.  In 2012, Lana decided she’d had enough calories, points, low carb, no carb, paleo, food scale drama to last her a lifetime.  She practices a Health at Every Size approach concerning health and fitness.  Stop by and check out her podcast and blog #sizeHUMAN at or, or on Twitter at @LanaBeyondScale.

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