I have not been feeling well for months. -low energy, aches and pains everywhere, chills, and chronic fatigue. I’m so exhausted that I can barely make it from my bed to the couch downstairs without feeling drained. At first I thought maybe it was depression, but as the months went on, I started to get this feeling that there is something deeper going on with me aside from depression. I have a history of thyroid issues in my family, and I’ve been told by a few doctors that I should keep an eye on my thyroid levels, as they have historically been on the lower end of the spectrum.
Thus, after months of feeling like total crap, I picked up the phone and made an appointment with an endocrinologist, hopeful that this doctor will give me the answers I am looking for. I scheduled my appointment for the end of December – and what did I do immediately after I hang up the phone?
I agonized over the appointment. Every day that it got closer to me having to go to the doctor, I felt my anxiety increasing. I loathe going to the doctor. In fact, I’m petrified. And here is a little glimpse as to why doctors appointments, for myself and many others, are often traumatic:
My recent appointment with the endocrinologist went as follows:
I arrived, checked myself in for my appointment, got my temperature taken, and was called back by one of the techs.
“Step on the scale please,” she says. I respond “Oh, no, I am in recovery from an eating disorder and I cant – ” She cuts of me off. “Ma’am, we really do need your weight if you’re going to be a patient here.” I feel myself starting to shut down. “Ok dont be a big baby, just get on the scale” I think to myself. As I step on the scale, I say to her “Okay but it’s triggering to weigh myself so can you please not tell me what my weight -” She cuts me off again to say my weight out loud in front of multiple other people in the office so that someone else can write it down.
And then the shame starts. I start sweating. “Oh my god oh my god that bitch yelled my weight out to the whole office everyone is going to know my weight oh god I cant breathe.” I walk into the room to wait for the doctor. Soon enough the doctor barges in the door and says hello without making eye contact. She sits down at her computer and asks me deeply personal questions without looking back at me one single time.
“You wrote down that you have PTSD?”
My heart sinks right into my gut. I stammer on my words as I try to give a 15 second elevator speech about my trauma to a woman who isn’t even looking at me. As I finish speaking I start to cry into my mask. “Why couldn’t I just tell her I wasn’t comfortable discussing it?” I think to myself. But I cant help it. I’m with an “authority figure”. I’m playing out my trauma – giving my all to a person who promises to help me but doesn’t actually care about me.
She types on the computer in complete silence for what feels like 15 minutes. She gets up, touches my hands, my ankles, my neck, my chest, and says “There doesn’t seem to be anything wrong.”
I finally start to get angry. “That can’t be right. I’m telling you, I don’t feel well. I know when something is wrong with my body. I am in recovery from my eating disorder and eat better now than I ever have in my life and somehow have put on an excessive amount of weight in the last few months that has me extremely concerned about my health.”
She says “Well, I’ll send you for more bloodwork but in the meantime, you should exercise, 20 minutes a day. Sound good?”
NO THIS DOES NOT SOUND GOOD, DOC. If exercise was the f&%$*@! answer, I wouldn’t be here talking to you, now would I? The problem is that I do exercise, perhaps not as much as I would like because I’m so exhausted I can barely function but I do my damn best. I’m not here because I needed you to tell me to exercise. I’m not here to talk about how to lose weight – I’m here because everything in my body is screaming “SOMETHING IS WRONG.”
But I dont say any of that to her. Instead, I nod through my tears “Yes, I’ll exercise.” and I am sent to the front desk to check out. The woman hands me a piece of paper with the summary of my appointment, in which it says that the doctor discussed BMI with me and I agreed that I was going to exercise every day for 20 minutes.
And I sobbed. The discharge summary said nothing other than that I am overweight and need to exercise. I threw it in the garbage because IT IS garbage. Why why why can we be so obsessed with someone’s weight but be completely oblivious about the trauma that is often behind the number on the scale? Why are we still even talking about BMI? There is a plethora of research negating its validity as a tool for determining health.
How differently could that appointment have gone if she had asked me what is going on in my life aside from exercising? If she had looked me in the eye when she walked in the door and made me feel seen and heard? Would I have been so horribly triggered if they had respected my right not to step on the scale? I guess I’ll never know, but I do know one thing:
This sort of stuff happens in doctors appointments over and over and over again. Folks who are struggling with eating disorders are often masking trauma. When you get to the root of the trauma, you mitigate the eating disordered symptoms. The person then learns how to listen to their bodies and eat intuitively, and their weight becomes whatever it is meant to be.
WEIGHT WILL TAKE CARE OF ITSELF. It is not necessary for doctors to be discussing BMI when 90% of the time, we don’t show up to the doctors to discuss BMI. Weight isn’t, despite what so many people think in this fat-phobic society, the root of all evil. Unprocessed emotions, underlying autoimmune diseases, irregular metabolic functioning, and suppressed trauma, are just a few of the many, many things that are more important than BMI.
I wasn’t given the time of day by this doctor, as has been the case with dozens of other doctors. Instead of leaving with answers for what is going on with me when I know something is wrong, I left full of shame and rage that no one will listen to me when I am doing everything short of screaming at the top of my lungs “SOMETHING FEELS OFF WITH MY BODY PLEASE HELP.”
I’ve been in recovery from my eating disorder for awhile now. I’m more in tune with my body than ever before, but because my BMI labels me as being overweight, everyone jumps to the conclusion that it must be my diet and exercise that are off.
We need to do better. We need to get rid of the BMI are start assessing people’s ACE scores (see https://alyssascolari.com/understanding-adverse-childhood-experiences/ for more info on ACE scores) because this is ultimately what’s going to kill people, not their BMI. You can put someone on the biggest, best diet in the whole world and they will still continue to have health issues until you get to the core of their wounds.
“Trauma-informed” is not just some training that we need to get in order to check off another box on our “to-do” list. It’s a crucial part of the work that all healthcare professionals do. When we start to shift our focus towards a truly trauma-informed practice, I can guarantee that we’ll start saving more lives than the BMI chart ever has.