Fat-shaming happens, even if you aren’t “fat”

EB writes:

I have never been anything that anybody could reasonably call fat. At 5’5.5″ I stayed around 125 from the ages of fourteen through 26. At 27 I weighed myself (usually a bi-yearly event or so) and discovered my weight had crept up to 135. This didn’t bother me because I was getting fat (because I wasn’t) but I thought maybe I was consuming more calories than I needed. I hadn’t noticed because at this time I wore mostly drawstring-waist clothes and hadn’t seen a change in the way they fit. I kept a cursory eye on what I ate, keeping in mind that I was clearly getting as many calories as I needed and maybe a few more. With no further effort on my part my weight came down to 130.

Then I found out I was pregnant.

And then I got hungry. Constantly, crushingly, insistently hungry. This was not the normal First World hungry or even the “I’ve been hammering boards together all day and boy am I famished” kind of First World hungry. This was something different. And I had to feed it. So I adapted my diet as best I could, in the interests of staying a functional human being.

I went for my ten-week checkup and was scheduled with a nurse practitioner who I had not seen before that day. She walked in, stood by the door, didn’t bother to introduce herself, and asked me how I was feeling. I didn’t feel much like discussing how I was feeling, since I’d discussed it to death with everybody, including having discussed it five minutes prior with the woman who took my blood pressure, but I answered dutifully with a response along the lines of “I’m making it”. She queried me more closely and I told her that I was constantly hungry, eating all the time, and kind of fatigued.

She told me this was normal for pregnancy. Which I already knew, which was why I didn’t want to discuss it because what was she going to do to fix it? I told her I wasn’t really feeling nauseous but mostly it was just that I got sick of certain foods because of eating them when I had no desire to eat them. She didn’t seem to understand this concept and I said “You know how sometimes you’re like ‘Man, a sandwich would be really tasty?’ Well, it’s the opposite now. It’s more like ‘Man, I really don’t want a sandwich, but I’m starving and I have to eat SOMETHING.'”

She asked me how often I ate and I told her honestly that I would eat five times a day and snack in between.

She then proceeded to jump to conclusions about how MUCH I ate at each of these meals, telling me I’d gained 10 pounds since before I was pregnant and that during the first trimester I was only supposed to gain about a pound a month. [Let's not discuss here how much of that might be breast tissue; I’d also gained a couple of cup sizes by that point.] Wait. WHAT? I challenged this and she said that my record said I had weighed 125 before I was pregnant.

Now let’s discuss the poor data-gathering I observed at this office. At the first prenatal appointment the provider asks how much you think you weighed prior to getting pregnant. You answer and that, apparently, gets added to your record. If you happened to be wrong about that, then how are you going to know? My guess would be I said my pre-pregnancy weight was 125, 130 or so, and she wrote down 125. They would then weigh you at each visit and the medical assistant taking the weight seemed not to care if you leave your shoes on or take them off or if you’re wearing your coat or who knows what all else. So you have to figure any reported weight could be off by 2-3 pounds. Add in the effects of, say, wet hair, a full bladder, having your wallet in your pocket, or having just eaten breakfast. That’s another 2-3 pounds that you could be off. Therefore, if you are the provider and looking at this number, you need to bear in mind that it is a ballpark figure.

But what the heck. Look at a garbagey number, compare it to an equally garbagey number, and criticize a starving pregnant woman and tell her to eat less.

Anyway, she said that I’d weighed 129 at my last appointment a month previously. So if I was supposed to gain a pound a month, I was 5 pounds over and apparently deserving of this lecture? I was distinctly irritated by this point and commented about full bladders, and she dropped the mention of specific numbers but then said something about how if I was eating five meals a day and snacking in between that was probably too much, as if she knew how big of meals I was eating. Then she started to say something about how maybe if I wanted a sandwich I could just eat a really small sandwich, which I cut off by saying “I know about portion control.”

Then she shifted gears to talking about exercise. I admitted that I didn’t exercise much because I felt lousy most of the time. She asked, in the same sort of perky voice that she had been using through the entire conversation, what I liked to do. I said walking and she said I should shoot for walking 30 minutes a day. I pointed out for the second time in two minutes that I feel lousy, fatigued, not up to it, and she pointed out that exercise produces endorphins that make you feel better (which I knew, but I so did not need this lecture on this particular day). I cut off this conversation too and said that this wasn’t even what I wanted to talk about and I had other questions, and she mercifully dropped the subject.

So, short version, I got criticized for supposedly gaining too much weight, for almost no reason whatsoever, after I’d just told her I was hungry constantly.

I ended up switching practices. I never reported this lady, though I wish I had. I ended up gaining almost 50 lbs before delivering my daughter, and the new providers I saw never said word number one about it—at each visit they told me my weight was fine. My daughter was an average weight, neither of us had any complications, and I was back to 125 by six months postpartum. Apparently whatever horrible thing was supposedly a risk because of those extra 5 lbs never materialized. I wonder if it is worth reporting this provider as this was 2 1/2 years ago. I shudder to think of the effect of this conversation on someone who actually had an eating disorder or even food issues (since aside from food aversions in pregnancy I have the least food issues of anyone I know.)

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3 Comments

  1. I think we need to pass a law that says scales can measure adults only in 20-pound increments. That level of change might be medically significant for dozens of reasons, but fussing over anything less than that is just obsession and bigotry.

    Reply
  2. What do you think about writing the nurse practitioner a letter about your experience and how it made you feel? I think that could end up being more productive than reporting her.
    I am a nurse practitioner, and I’m horrified to read about your experience, truly.
    But I also know that patient feedback–both good and bad–means a lot to me. You might be able to spark a bit more self-awareness and reflection from her if you explain what that visit was like for you.

    Reply
  3. starkiller99

     /  June 28, 2013

    My sister’s OB practice had 2 scales. Just by accident my sister had always been weighed on the same one, until one week. They said she had gained 5 pounds and started in on her about eating too much. She argued that the scale was wrong because she had always used the other one. They claimed both scales had been calibrated and were known to be accurate. They continued to lecture her about her diet, she continued to insist that she did NOT gain 5 pounds in only a week, not the way she’d been eating. They lectured, she bitched, on and on. My sister is one of the most stubborn people I know, so they finally weighed her on the other scale just to prove her wrong. She had only gained the one pound they wanted.

    Reply

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