This is a sponsored post. I was compensated by Med-IQ through an educational grant from Novo Nordisk, Inc. to write about the realities of obesity as a chronic disease. All opinions are my own.
It sounds strange, even with all I’ve learned over the last few years, to call obesity a chronic disease. When you hear those words, you probably think more of things like diabetes or a heart condition. What’s even stranger is that obesity can and does cause those conditions. But obesity is just as difficult to treat, no matter how many times you hear people tell you it’s as simple as “eat less, move more.”
A Tale of Two Doctors
I remember the first time I went to a doctor to discuss my weight. It was when I first realized that diet and exercise weren’t helping me as well as I would have hoped. My body wasn’t responding in the same way that I thought it should be, and I wanted to find out if there was some underlying cause.
I trusted my doctor. He had always been easy to talk to, and he’d never given me reason to doubt him. So when I brought it up, I was pretty stunned by his answer – “What do you want me to do?”
I was pretty discouraged. After all, I wanted him to help. I didn’t know what I needed, and I was hoping he could give me some options to think about. Instead, he gave me the same tired lecture that the next ten years’ worth of doctors would go on to give me – eat less, move more.
In fact, I remember quite clearly the language he used after he heard me tell him that I was eating nothing but salads each day and still hadn’t lost any weight. He said, “If you are eating two lettuce leaves and not losing weight, then you have to cut it down to one lettuce leaf. That’s just how it works.”
The next several years were a constant battle of wills between me and my health – both mental and physical. Suffice it to say that even when I found out that I had metabolic syndrome due to PCOS, making it much easier for me to gain and hold on to weight, and much harder for me to lose weight, I still felt that I was the problem. No one ever explained to me that I wasn’t fat; I had fat. I had obesity.
I ended up making a drastic decision. I had bariatric surgery. I didn’t feel I could lose weight on my own, and I didn’t have the support I needed nor an understanding of how my body worked. So with no other option, I went with the one I knew. And it worked! I lost all the weight, and all of my health conditions improved or went away completely.
Even my infertility that I had been trying to overcome for years went away, and I went on to have four children! It was like a miracle.
Of course, with that miracle came a certain amount of weight gain. After all, I have obesity, and it’s not something that just goes away and never comes back. It’s something you have to manage forever. I tried diet and exercise, but once again, I found that it was difficult to see meaningful results.
My most recent foray into the doctor’s office to discuss my weight was last year. Once again I went in to speak with a doctor I’ve seen multiple times and who has always done well by me. But this time I was extremely nervous. I worried what he would say and think when I brought up my difficulty losing weight.
My obesity was having a harmful effect on my life, adding to crippling back pain and exacerbating my asthma. I couldn’t easily exercise, and I was battling constant hunger, even though I don’t eat unhealthily.
When I finished explaining everything, he looked at me and said, “What do you want me to do?”
I was floored. I almost burst into tears, and I was so disappointed to once again be back at that place where I felt abandoned by a medical professional who just “didn’t get it.” But by some miracle, before I had a chance to react, he reached out his arm to touch my shoulder and said, “No, Katie. I mean, what do you need from me? I will help in any way I can, but I want to know your thoughts first.”
At that point, I did burst into tears, but this time they were tears of relief. Over the next while, he spoke to me about options. He knew my history, and he laid out for me a lot of information to consider. He spoke about medications I could take, nutritionists I could speak to, physical therapy, behavioral therapy, courses that might help, and even surgical options.
He also went through my numbers with me to help me see the details of my health in an objective way. He gave me clear goals, which helped me to realize that I didn’t have to lose 60 pounds to feel better and to be healthy. It wasn’t important to lose every extra pound I carried. Losing even a small percentage of my weight would make a huge difference to my health and happiness.
When I left his office, I had a solid plan in place, as well as access to my doctor through my patient portal. He asked me to check in with him weekly to let him know of any struggles I may be having and to give feedback on what was working and what wasn’t. He didn’t want me to have to come in for appointments unless it was necessary, saving me time and money so that I could really focus on my health.
Can you imagine what might have been different if the original doctor I saw so many years ago had reacted this way?
I might never have had to have such a drastic surgery if I’d had a true partnership with my doctor. I would have been more confident in asking for help and trying different options. I might have found success in other ways. I may have learned more about obesity as a disease instead of being told over and over again that I was the problem.
Obesity is a complex disease that can have many contributing factors. Hormones, genes, metabolism, and other biological factors play a role in whether we may have obesity or not. Our activity levels and diet can definitely help to manage it, but they are not always going to be effective on their own.
Changing the Way You Think
The best thing I have learned since truly understanding obesity as a disease is how to separate my self from my condition. I no longer refer to myself as obese, and I have started to correct other people (including doctors) who use the term. After all, we do not refer to someone with cancer as “cancerous.”
Separating who you are from what you have is an incredibly liberating experience and makes way for more self-love and self-respect, which can be lacking in those of us with difficulties managing our weight. My heart has been hurt many times in my life by hearing mean comments from others who equate size with beauty.
I have also learned that size is not a reliable indicator of health, and it has helped me to see beyond what someone looks like and look at what she can do. I have met several amazing women who weigh more than I do who do triathlons or have distance running trophies.
I don’t let my weight hold me back anymore. In the past, I wouldn’t even attempt certain things, sure that being “too big” would mean I was automatically incapable or precluded from trying. Now, I don’t worry about my obesity, making decisions based on whether or not I actually want to try the thing or not.
In my last post where I discussed Maintenance as Its Own Goal, we asked for readers to fill out a survey about your experiences with obesity and your care team. The initial data we have seen is enlightening.
From the people who believe their current weight is impacting their health, 77% of respondents do not feel heard by their doctors. They feel that their primary care provider had not explored their history of weight gain/loss.
Further, 1/3 of respondents were reluctant to even start a conversation with their providers. 41% said they were too embarrassed, and 26% said they just didn’t know how.
44% of respondents said that they felt a fear of being judged by their provider, which stopped them from even seeing their doctor about their concerns.
Interestingly enough, research has shown that many providers are actually nervous to bring up weight discussions with their patients because they are worried about hurting them or failing them. This is such an interesting idea to me to think that both sides are too embarrassed to discuss a disease! Can you imagine any other disease that a doctor would be too worried to discuss with you?
We’re still collecting survey answers, and it would be great if you could add yours to help with research.
Med-IQ is conducting an anonymous survey and would appreciate your input. The survey, which includes additional education on this topic, will take less than 15 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with obesity and your care team, which will help us develop future educational initiatives. Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize and to send a follow-up survey as part of this same initiative.