Binging? Purging? Vomiting blood? Try dieting…

Katydid writes…

Two years ago, I landed myself in the ER at around 2 AM. I’d been puking my guts up multiple times per day, every day, for months—binges, meals, mere snacks all found themselves subject to the perverse First Law of Bulimia: what goes down must come up. The night of my ER trip, as I paid homage to the porcelain goddess yet again, I found that along with my stomach contents, the toilet was filled with blood.

The doc in the ER was compassionate and thorough, if somewhat clueless about eating disorders. Aside from being somewhat anemic and dehydrated, all my tests were clear, and as I coincidentally already had an appointment with a new internist in the morning the doc apprised my internist’s office of my situation and released me.

Three hours later (approximately one of which was spent sleeping) I made my way into my new doc’s office. I explained that recently I had lost about a bunch of weight starving and puking nonstop and that now I was restricting much less but still bingeing and throwing up constantly; I told her that I’d had an active eating disorder for about four-five years and I filled in the details of the previous night’s ER episode. She asked about my highest and lowest weights—despite several times losing dramatic amounts of weight quickly and unhealthily, I’ve never been “thin,” and when I told her my highest weight, she said it was “great” that I’d lost the weight, even though I told her I’d only lost it restricting and purging.

Then she put me on the scale. I told her I didn’t want to know my weight, and that she at least respected, but then I got off and she said to me, “well, you’re overweight, but I’m sure you knew that. What are you, like five-two?” (I’m five-four, but telling her that didn’t seem to give her pause at all though it would most definitely change the point at which “overweight” came into play. I’d also now been sitting in her office waiting for about three hours, mainlining water—as per the ER doc’s stern instructions—to the point where I thought my bladder would explode and she decides to weigh me fully clothed including my SHOES and then acts like the number she has is real.)

She goes on to tell me that what she wants to do is put me on a modified Weight Watchers plan and have me come back in a month and weigh me again. (I am 5’4” and 145 pounds—which is 30 pounds less than I weighed six months ago, though I lost the bulk of it in six weeks—and I am so sick with an eating disorder I am barfing up blood and she’s talking about a DIET?!)

I tell her that I’m really not interested as I’m already working with a nutritionist. She then asks me, in a hostile tone, what exactly I want from her; I’m at a loss for words since I figure it’s pretty self-evident that, um, she’s a doctor and I want her to…monitor my health?

She takes my stupefaction as a sign that perhaps I’m looking for an amateur psychologist, as she then asks why I have an eating disorder—“were you raped or abused or something, or is this just kind of a going-off-to-college/growing up thing?”

She did not do a physical exam other than weight and blood pressure; she did not discuss the ER incident. She did not bring up the possibility that, given that I was puking blood, more tests might be necessary, nor did she discuss that though I seemed fine I was fairly anemic and had just barely avoided spending the previous night hooked to IVs. I’m not sure what level of insensitivity or stupidity you have to reach to actually think that the most important thing you can tell a 21 year old with an eating disorder is that she should lose weight. Clearly those few extra pounds I was carrying were FAR more threatening to my health than whatever other damage I was inflicting on my body.

The medical community needs a serious wake-up call: not only can there be health at a range of sizes, there can also be illness at a range of sizes. WEIGHT IS JUST A NUMBER!!!

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41 Comments

  1. That’s outrageous! You’re throwing up to the point of bringing up blood, and she doesn’t want to run any tests to see if you’ve possibly caused serious damage to your body? How does telling a bulimic to go on a diet going to help them get over their eating disorder? I really hope you’ve gotten some real professional help now and are on the road to recovery! God bless!

    Reply
  2. Angie

     /  February 6, 2008

    I can’t understand why she thought 145lbs. at 5’4″ was overweight. That aside, you wonder what they actually teach these people in med school. What a nightmare for you. I hope things have gotten better.

    Reply
  3. fillyjonk

     /  February 6, 2008

    Holy shinola, this is unconscionable.

    Reply
  4. Unconscionable, yes. Unbelievable, sadly no.

    Reply
  5. fever2tell

     /  February 6, 2008

    Yeah, that’s really what somebody with an eating disorder needs, ANOTHER DIET! I really hope you are Ok now and that you found the help you needed beyond this crazy bitch who has no business being in medicine. The least that doctor could have done for you was refer you to a specialist, either in gastrointestinal issues or eating dissorders, you probably needed both.

    Telling people they need to lose weight is what doctors do in these situations when they have no clue what to tell you. A friend of mine is about your size and she was having constant stomach problems, severe cramps, puking up undigested food, the works. She was worried so she went to the doctor and after telling him that she’s been surviving on dry toast and veggies because that’s about all she can keep down, HE TOLD HER TO STOP EATING CANDY BARS AND GREASY FOOD. That’s a direct quote. Then he gave her fiber to put in her morning OJ. If Metemucil had been all she needed, she would have gone to the drug store.

    Reply
  6. Phledge

     /  February 6, 2008

    Angie, having been blessed with a morning of listening to what I will only politely refer to as an “eating disorder lecture” I can tell you that what these people in med school are learning is outdated, insensitive, presumptive bullshit. I am so incredibly sorry that you were subjected to what was nothing less than torture in that person’s office.

    Reply
  7. Holy Mother of God. That is just . . . horrifying.

    Reply
  8. I am just . . . flabbergasted. I hope you’re doing better now and were able to find some decent help. Thank you for sharing your story. I often feel too fat to have an eating disorder.

    Reply
  9. she then asks why I have an eating disorder—“were you raped or abused or something, or is this just kind of a going-off-to-college/growing up thing?”

    The whole post is a jaw dropper, but that especially made my blood boil. “So, what made decide to get yourself one of them eating disorders? Childhood trauma, or is it just a whim?”

    Are they selling medical degrees at gas stations now? The hell?

    Reply
  10. Rose

     /  February 6, 2008

    What a horrible story! It sounds like you could have a malpractice case there since vomiting blood is very serious and you’re lucky that you survived. If it ever happens to you again, find another doctor that same night. I say this because my mother had a friend many years ago who went to the emergency room with the same issue. They sent her home with a pain killer and she died of a bleeding ulcer during the night. Anyway, I’m not trying to scare you, but I don’t want that to ever happen to anyone again.

    It’s also terrible to think that a person the size you described yourself as would be related to as overweight, when even by the ridiculous standards of overweight, you weren’t even there!

    Reply
  11. Good lord. How do these medical “professionals” live with themselves?

    Reply
  12. not only can there be health at a range of sizes, there can also be illness at a range of sizes.

    Thank you, Katydid, for sharing your story. The whole thing is just infuriating, and I’d love to drop-kick that stethoscope-wielding dumbass into next week, but your last point is what really leapt out at me. It’s sort of the crux of a bunch of stories we’ve heard here recently, where people have serious, profound, severe eating disorders, but doctors are more interested in how much they weigh than in what is actually being done to people’s bodies.

    Honestly, that kind of “medical care” we could get from Waldo the Magnificent, who spends his days guessing people’s weights at the carnival, fer fuck’s sake!

    What the hell is the point of seeing a doctor, with all that expensive medical training, if the only thing they’re going to look at is how much we weigh?!

    Reply
  13. sweetmachine

     /  February 6, 2008

    The whole post is a jaw dropper, but that especially made my blood boil.

    God, me too. The nerve. Katydid, I’m so sorry this happened to you, and I hope you have found some real help with your eating disorder since this incident.

    Reply
  14. Patsy Nevins

     /  February 6, 2008

    I am also so very sorry this happened & glad that you survived. I am afraid that this story does nothing to suggest to me that I am wrong to so dislike & distrust the medical community. I am crossing my fingers for all of us for whenever we seriously NEED medical attention. I wish you well, Katydid, as I do everyone who posts on these blogs. Since, contrary to popular opinion, I have never had an eating disorder (I know, EVERY fat woman eats compulsively, right?), I cannot address that subject, but I do know stupidity, blindness, & incompetence when I see them. I think we would all be better off with Doogie Howser most of the time.

    Reply
  15. Phledge

     /  February 6, 2008

    I gotta repeat this, because it bears repeating: YOUR DOCTORS ARE LEARNING THIS BEHAVIOR IN MEDICAL SCHOOL. The people who teach are the people who do the biased research and friends of the people who write the biased journal articles. I wouldn’t go so far as to call it a conspiracy, but medicine is definitely a culture of the status quo, and it takes a lot to turn this Titanic. That’s why, when I ask a question or make a comment, I feel like I’m just rearranging the deck chairs…

    Reply
  16. “What do I want from you? I want you to treat me exactly the same as you would if I was as thin as you and came in vomiting blood because I’m a fucking bulimic. Or would you feel better just leaving me to die and having my family sue you out the yingyang?” They may not understand fairness to the fatties, but they sure do understand lawsuits.

    Why does this stuff remind me so much of the lesbian doctor-horror stories I remember reading in Our Bodies, Our Selves in the 1970s, like that one doctor who told one gay woman with endometriosis that her pain was caused by hatred of men?

    Reply
  17. What the hell??? That’s absolutely insane. I couldn’t help but comment… what a nutcase of a doctor!!!! I feel your pain… I’ve had my share of those. Even a similar incident with weight loss related to restricting/purging. Reported symptoms multiple times ignored by GI doc = ended months later in emergency surgery & organ removal. Second time around, same story ended in similar bloody incident… other end. I really hate insensitive, idiot doctors. WHY on earth did they pick that profession if that is how they view people and helping them??? WTF. I’m sooooo sorry you had to go through that. Good luck with everything…

    Reply
  18. littlem

     /  February 7, 2008

    Phledge - this is why I keep asking, and I’ll keep asking until you tell us —

    1) When are you graduating?
    2) Where will you be practicing?

    Reply
  19. This doctor bullshit has *got* to stop.

    People could *die* due to their SERIOUS ignorance about the reality of weight.

    What the hell, as we know from this wonderfully expository, heart-breaking blog, people *have* died.

    I’m *so* pissed off right now…I’m so, so sorry this happened to you. :(

    Reply
  20. Katydid

     /  February 7, 2008

    Wow, all these responses…are just amazing. You’re all incredibly validating. Thank you.

    I was ultimately really really fortunate–when I saw this woman I was actually in an outpatient eating disorders program, in therapy AND seeing a nutritionist and, though I was pretty resistant to seeing a new doc yet again (my earlier experiences with doctors hadn’t been all that great either…after all, I’d been a couple pounds away from the cutoff for “at risk of overweight” as a kid so being told I was fat at every yearly checkup or flu-related visit was clearly justified) they sent me to see someone who actually dealt with eating disorders.

    ANYWAY…my new doc was TERRIFIC, made NO comments on my weight (other than referring to it as “none of your business, sweetie”) except when I was clearly restricting and losing–though my weight never dropped below “normal.” She did not minimize my ED regardless of my weight, she kept really good track of my health–endless rounds of blood work, a couple EKGs, an endoscopy…and even though they always came out fine, she never took me anything but seriously. Unfortunately she recently left her practice and most likely medicine altogether.

    I’m not well yet–but I’m better. I still struggle, but I’m undeniably both mentally and physically healthier than I was. Even so, the idea of seeing a new doctor and being hassled about my weight or having my problems minimized (even at an undeniably normal weight) scares the crap out of me. I second Littlem–I’m in need of a good doc who won’t make me feel awful about myself. We all are!!!

    (Sorry, I’m incapable of brevity. Clearly. :-))

    Reply
  21. Phledge,

    Have you ever thought about writing a blog about your medical school experiences? I read one written by a Christian medical resident which is very interesting (especially seeing as I am pagan) and I think yours would be even more fascinating!

    Fat Gal

    Reply
  22. Phledge

     /  February 7, 2008

    Okay, OKAY. :) I graduate in 2010, and I’ll be practicing on the West Coast, probably in my native state of Nevada. I’m trying at this point to network with my classmates who don’t agree with the way obesity is being taught so that I can refer people to them (because, obviously, I can’t be EVERY FAT PERSON’S DOCTOR!) but it’s tough.

    I have thrown the idea of a fat medical student blog around in my head since I discovered fat acceptance. At first I was really reluctant because of the time element, but I’m wondering if I wouldn’t be happier sharing my experiences instead of ranting at my husband who still has his own fat prejudices…a blog could definitely be therapeutic. It’s closer to becoming a reality, for sure.

    Reply
  23. Vic

     /  February 7, 2008

    Katydid,

    I am so glad that you managed to get a good doctor and good quality care. Your experiences have been awful, but it is reassuring to know that there are some good doctors out there who care about the health of their patients.

    Reply
  24. *headdesk*

    That doc missed the point by a long shot.

    Reply
  25. girlgriot

     /  February 9, 2008

    This is utterly horrifying! I’m so sorry this happened to you, and so glad you’ve found a good doctor. I dread thinking of all the other patients this woman has damaged.

    Reply
  26. hotsauce

     /  February 9, 2008

    holy.

    shit.

    my jaw literally dropped when i read “were you raped or abused or something, or is this just kind of a going-off-to-college/growing up thing?”

    because eating disorders are just part of growing up. a little bump-in-the-road-style milestone. red badge of courage if you will. and asking you to lose weight?? i am truly speechless. i wish i could contribute some scathing commentary on that moron, but right now … oh … my head hurts ….

    Reply
  27. ya_ta_hey

     /  February 10, 2008

    Ridiculous from any angle…

    OF COURSE the “were you raped or abused or something, or is this just kind of a going-off-to-college/growing up thing?” comment was off the wall for this person in this consultation.

    But what’s more, it was totally inappropriate – even more so – if she HAD been raped or was having a college adjustment problem. Fat thin or Martian.

    We could laugh at these insecure, insufficient medics if they weren’t so darn powerful – and oh btw, if it weren’t our literal lives they were toying with.

    Reply
  28. littlem

     /  February 11, 2008

    “I graduate in 2010, and I’ll be practicing on the West Coast, probably in my native state of Nevada. I’m trying at this point to network with my classmates who don’t agree with the way obesity is being taught so that I can refer people to them (because, obviously, I can’t be EVERY FAT PERSON’S DOCTOR!) but it’s tough.”

    I call first place in your new patient line for GP care.

    You may want to write to Dr. Weil about your approach. He has his new CAM Institute in AZ and has always seemed a little ahead of the mainstream “medical industry” curve. (I’m sure not everyone believes in his line of vitamins, but it seems like there aren’t a lot of cracks in his theory.)

    Reply
  29. This is absolutely appalling. I had a doctor tell me at 14 that I was fat. She made me strip to underwear and then proceeded to make me jump up and down to watch my fat jiggle around my body. I was 5’4″ and 139lbs. She was a tall, thin, evil woman. I felt so horrible and still remember that to this day. It is a shame that we can’t know and get rid of these horrible doctors before we spend the money to see them. Once you see an idiot, you’re insurance has little interest to pay for another opinion.

    I wish you the best of luck with your ED. I hope you can find someone who will really be of good use to you and your body.

    Reply
  30. Aislinn

     /  February 28, 2008

    Oy! This is just, oy! Uggh, I need to bleach my eyes, so much stupidity.

    Just tell me that this wasn’t in Florida.

    Reply
  31. WHAT THE FUCK!

    Excuse my language. But excuse me? I honestly do not want to BELIEVE that this happened…although I know it did. I told MY doctor at my ED clinic that I was sleeping 16 hours a day from the zoloft. That I had no energy to do my studies. That I literally was exhausted from eating an APPLE and at this point I wasn’t even binging and purging at the normal rate. She was so READY to give me anti-depressants and I hesitated for a while…but decided to give it a try. So I figured clearly she could do something about the fact that I could not drive twenty minutes without feeling absolutely exhausted.

    her recommendation: three meals & two snacks a day. that’d give me energy, I’d sleep better AND I’d be able to finish out the semester. I wasn’t outraged actually…it was at that moment that I felt completely defeated. because if your doctor who specializes in EDs can be that insensitive…and recommend THAT…there was no hope.

    Fortunately, I know now there is hope. I just need to find some. Good luck to you. And like, I would totally report that doctor to someone! It’s not just disrespectful, it’s really bad medicine.

    Reply
  32. Katydid, I am coming to this post late but I need to say this. What happened to you should never have happened. Period. I am a doctor. And I’m fat. And you should know that what she did to you is NOT what is being taught at every medical school. That regardless of what she believed was the science behind her words, the first rule of medicine is primum non nocere. First, do no harm. And if she had taken five seconds to think about your illness, to pay attention to you and your hurt/shame/bloody vomit/etc she would have known that her words could only do harm. Shame on her.

    Be well.

    Reply
  33. Julie

     /  May 7, 2008

    I am so sorry this happened to you. Physician ignorance about mental health issues is something that repeatedly baffles and stuns me. Most of them seem to be getting their info from glorified media portrayals of the diseases, it harms more than it helps. I hope whatever help you may be getting is working for you.

    Just as a general warning about GPs prescribing depression meds, don’t trust them. My GP prescribed me Wellbutrin for depression without even inquiring if I had an eating disorder. I read the warning label and it turns out Wellbutrin can cause seizures for people who purge.

    Reply
  34. Me too. I’m so sorry. I hope you find recovery. It’s hard but it’s worth it.

    Reply
  35. nomischief

     /  May 10, 2008

    Hi. I know I am very late reading this post, but I am so sorry that this happened to you. I’m pretty damn speechless at the ignorance exhibited by this ‘doctor’. Grr.

    Reply
  36. Anon

     /  May 18, 2008

    I’m sure this is so late as to be completely useless but I had to say it just in case:

    To fever2tell – what your friend has sounds a lot like gastroparesis, which I was diagnosed with after a long battle a couple of months back. Food doesn’t digest, you have stomach cramps, you never feel hungry, you may also throw up or (in my case) go into shock. Hopefully it’s already been resolved, but if it hasn’t or it comes back, make sure she knows to keep an eye on that as a possibility – it’s a serious problem and you wind up very malnourished.

    And to Katydid: argh – there are no words for how disgusting this woman’s attitude towards your situation was. It’s good to know from your comment that you at least did succeed in finding a doctor (eventually) with a better idea of her job – like, oh, I don’t know, actually addressing the problem!

    Reply
  37. Jessica

     /  May 20, 2008

    I haven’t been to a doctor in almost two years because I was tired of the response to everything being, “You should lose weight. You’ll feel better.”
    I wear a size 14, and my job is far from sedentary (I am a waitress and barista). I walk everywhere, don’t own a car, and eat better and have much better cholesterol than my skinny boyfriend, who suffers from high cholesterol and high blood pressure. I may be 180 pounds, but I don’t think the reason I didn’t have my period for three months and was not pregnant was because I’m too fat.
    I know I SHOULD go to the doctor, because that is pretty scary and serious, but I’m finding it hard to motivate myself to do so, since every doctor since my childhood one (and believe me, if he wasn’t retired, I’d go see him) has been a weight-obsessed moron.

    Reply
  38. yamilyn

     /  April 7, 2009

    i’m a very late comer via junkfood science, i hope treatment for your ED is going well and that you found a different doctor that is more understanding of your situation. it’s quite disgusting when you go to a doctor to try and get help and they treat you like absolute crap. the sad thing is that it happens even if you don’t have an ed and your trying to figure out what the hell is wrong.

    Reply
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