Do No Harm: Part 2

I asked not to see or discuss my weight when I went to the doctor this week.

This is a normal – even expected – request for someone in recovery from an eating disorder.

In case you’re new to the world of eating disorders, let me give you a little introduction.

We’re weird. (Yes, we’re a lot of things…smart, talented, funny, blah, blah, blah…) But, we’re also weird.

We’re weird about food. We’re weird about rules and rituals and routines. We’re weird about numbers.

Yeah, we’re really weird about numbers.

Most of the time in eating disorder recovery, we do what’s called blind weights. Which is exactly what it sounds like: We are weighed blindly, without ever seeing the number.

In treatment, the scale we used didn’t even display a number…it went straight to the nurse’s app. At the doctor’s office, we stand on the scale backwards.

The scale and I have a long and sordid history. I used to step on the scale upwards of 10-12 times a day. I lived by that number…and, as it turns out, I was dying by it, too.

While I was in residential treatment, my dietitian called my mom and asked her to get rid of my scale, so it wouldn’t be a temptation for me when I got home.

I’ve now been home for nearly 6 months, and I still do not have a scale in my possession.

This is the longest I’ve not had a scale since I was 10.

And to be completely honest, I thought I would die if I didn’t know the number. I know it sounds dramatic and ridiculous. But, remember when I said we’re weird about numbers? This is what I mean.

I’d put off this appointment for 3 months because I was afraid to be weighed. (And because I put it off for so long, now I get to go to a dermatologist so they can surgically remove the cysts from my leg. But that’s beside the point.)

I was anxious in the week leading up to this appointment. And, considering my past experiences with doctors, I think it was only natural for me to feel that way.

I wasn’t worried about my leg. (Except for the part where I was convinced I had cancer and was dying. But that’s fairly normal for me. Heyyyyy anxiety! 💁🏻‍♀️)

I was worried about being weighed. I was worried about arguing with the nurse and doctor about why I don’t want to see or discuss my weight. I was worried about inevitably being handed the visit summary on my way out the door, or seeing it in the app moments later.

My therapist wrote a letter, explaining that under no circumstances am I to see my weight or BMI, as it would be detrimental to my eating disorder recovery. I gave this note to the nurse, who (supposedly) relayed the message to the doctor.

And here’s the thing…my actual visit was great. I didn’t feel pressured or put on the spot or judged. It was arguably one of the best doctor visits I’ve ever had.

When I left, I was not given a printed copy of the visit summary, which displays weight, BMI and vitals on the front page.

I walked out and breathed a sigh of relief…

And then before I even got to my car, I had a notification on my phone that a new message was available from my doctor.

I opened it, and BAM. This is what I saw.

Now, you’ll notice I’ve circled in green what I actually saw the doctor about. That is the smallest portion of this visit summary.

Next, you’ll notice giant red boxes around all the things we literally never talked about.

Now, if he had said those things, I would have quickly informed him that I see a dietitian regularly, and it is literally her job to help me navigate food, exercise, and things of that nature.

The fact that it says he prescribed a specific diet and exercise tells me he is not informed about eating disorders.

If he had said those things, I would have told him that some days I struggle to eat even half of that. I would have told him I have the calorie counts of most food items ingrained in my brain, and don’t worry, doc, there’s no way I’ll go over 1500.

I would have told him I’m currently on a break from exercise, because I struggle with compulsive exercise. I would have told him if you tell me to exercise for 30 minutes a day, 3-4 days a week, within a couple of weeks, that would become 3 hours a day, 6-7 days a week. I would have told him that the exercise would have driven my restriction, which would have driven my exercise, which would have created a vicious cycle that most likely would put me back into residential treatment.

I would have told him I do not wish to discuss this today.

And then, of course, there’s the parts marked out in black. That is all the information I (and my therapist) specifically asked NOT to know or be shown in any way, as it would be unhelpful problematic harmful damaging devastating to my anorexia recovery.

Maybe it’s a system error, where it automatically populates that information in every patient’s file. Maybe it’s an insurance thing, where they have to report that they’ve discussed this information with any patient with a BMI within a certain range, in order to get paid. Maybe the doctor, nurse, or receptionist is simply uninformed regarding the nuances of eating disorders.

I don’t care about the reason.

But what I do care about is the fact that it’s wrong. It’s problematic. It’s harmful.

Doctor, you’ve done harm.
Nurse, you’ve done harm.
Receptionist, you’ve done harm.
Insurance, you’ve done harm.
System, you’ve done harm.

I was not in a place where I could discuss these errors with my doctor’s office that day.

But now, I am. I’m ready to fight. I’m ready to speak up. I’m ready to be heard.

The harm has been done. But I’m just getting started.