Has a doctor told you to lose weight?
The first time a doctor told me to lose weight, I was an underweight teenage athlete. Underweight for me anyway.
I had stage 4 osteoarthritis and a follow-up ortho appointment at Alta Orthopedics. A follow-up from what? 3 ACL-related surgeries in the summer of 2006, beginning May 25th and extending through an ICU stay the month of June. During my Cottage Hospital "retreat," I enjoyed intravenous ciprofloxacin & opiates while frustrating the phlebotomists daily. I experienced significant weight loss from my muscular frame. This was not a 'good' kind of weight loss. It was weight loss resulting from the fact that infections increase your metabolism, hospital food is repulsive, and my bedridden 'joie de vivre' waned as the pseudomonas aeruginosa thrived.
Despite the summer of 2006 events, I was happy to be independently crutching my way back into the Pueblo-inspired orthopedic office, with my Razr cell phone falling out of my rear pocket.
Upon arriving at this follow-up ortho appointment, a thoughtful technician approached the front desk to open the door for me. To the right of the front desk was their in-house physical therapy office. However, the technician escorted me to a room on the left before I could sit down. Inside this room was an x-ray machine, height measure, and a scale. New data was collected for my chart. While standing for an X-ray, I made a joke about needing to pay models to pose for pictures. The technician gave me a sympathetic laugh and updated my chart. I weighed less than I had in years, excluding my recent ICU retreat. In fact, I had gained some weight since my ICU weigh-out. After the technician updated my chart, a doctor I had never met came out to talk to me.
This doctor was not my surgeon. He did not know me, the type-A student-athlete with perfectionist tendencies. He was an older man with a delicate frame, holding my chart of numbers in his hands. He barely looked at me and made no small talk. The doctor stared down at the chart he was speaking to while describing how bad my osteoarthritis was. "Stage 4. Yeah, I know," I thought to myself. This doctor continued to tell my chart that my weight gain would wear out my arthritic knee and I'd need a knee replacement 50 years before my peers. I audibly questioned this at this news with a "What?!" loud enough for him to look up. I remember the disconcerted look in his hazel eyes when he gazed upon me and sized up my frame.
Having existed my entire life as an elite child athlete with enough density to comfortably sit on the bottom of a pool, I had never 'looked' my weight. I was accustomed to the shock on others' faces, and this gaze was again when I felt the doctor's confusion over the number on the scale that was unmatched by my physical appearance. However, he continued to tell me that for my 62.5 inches of height (which was not much shorter than his height), my BMI should be less if I wanted to be able to walk in ten years. My new goal should be to use my knee as little as possible. Swimming without kicking was the only approved form of exercise for me, a far deviation from the musical art forms my brain and body grew up with. For me, this was incomprehensibly demoralizing, black-and-white advice. There was frigid apathy towards my mental health. I wasn't seen as a whole person. I was a 2-dimensional outline on a black and white chart that needed to be narrower.
Worse than what was said was what wasn't. This doctor did not talk about me returning to sport (he said I never would). He did not talk about my unique body composition, %SMM, %BF, or explain how muscle weighs more than fat. He did not discuss nutrition, offer safe diet advice, or explain how to achieve his goal of not gaining more weight to me. He did not acknowledge that my 'weight gain' on that day was technically still a weight loss from my initial surgery date on May 25th. He did not mention that gaining muscle could support my arthritic joint and reduce wear and tear. According to the doctor, gaining muscle would further deteriorate my knee. His message was to use my knee/body as little as possible, and while I can't exercise, I also cannot gain weight.
Eat less. Do less. Be less. What antiquated shit advice was that?! <eye roll> <gagging face>
Do all doctors suck this hard? No. I am very pro-doctors and Western medicine. I shared my story to point out that just because someone is a doctor, it does not make them a reputable source for nutrition and/or weight-loss advice. It does not make them a strength and conditioning expert or a sports psychologist. Non-specializing doctors are not trained to recognize or communicate with patients teetering on a tightrope of disordered eating. In fact, some doctors live with disordered eating (gasp!) and give terrible advice outside of their scope of practice. It took me too many years to realize this, and I do not wish my experience on anyone. However, if you have experienced the gut-dropping feeling when a doctor tells you to drop weight, I hope you know you are not alone. I hope you don't feel fat-shamed into the corners of the internet, lured by click-bait headlined "Do These 3 Things to Lose Your Gut!" Your health goal should never solely be to have less gravitational pull on this planet.
Body composition is complex. Nutrition is nuanced. You deserve to have your health viewed holistically.