You’re fat – See a dietician

Kake writes…

I needed to visit my [general practitioner] to get some more birth control pills, but unfortunately she was on holiday so I agreed to see a locum [Editor’s note: a locum is a doctor who fills in for another doctor, a substitute doctor so to speak].

Birth control pills mean you need your blood pressure checked, so the locum put the cuff around my arm, started inflating, etc.  I wasn’t expecting anything unusual, since I’ve always had blood pressure on the low end of normal.

While she was doing this, the locum suddenly blurted out: “so, while you’re here, would you like me to make you an appointment to see the dietician”? Remember, she was in the middle of taking my blood pressure at this point. I _could_ have just said “no, thank you”, which in hindsight might (or might not) have made her shut up, but I did go on to say “I don’t see any need to” – because I didn’t see any need to.  I know plenty about nutrition, I have a very varied diet, and my regular GP has never had any concerns with my physical health.

Locum took this as a cue to start a rather blustering argument with me – a patient with her arm in the blood pressure machine.  (She wasn’t very good at the arguing; she did seem to get quite upset that I was actually scientifically literate.)  Unsurprisingly, the machine correctly noted that my blood pressure was high.  The locum decided this meant I couldn’t have my pills; I told her this wasn’t acceptable, and she caved in and gave me them.

My next few blood pressure readings all went wrong too, though – to the point where the GP/nurse said that it was obvious they were inaccurate. The whole business soured me so much that I didn’t bother registering with a new GP when I moved house several years ago, so I haven’t seen once since.

Luckily, as I said, I’m pretty healthy, so this is no great loss for me, and my partner doesn’t mind using condoms _too_ much.  I can only imagine how much it sucks to be unfashionably unthin and actually _need_ regular contact with a GP.

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  1. I think Kake’s story is a powerful testament to the influence a well-informed and assertive patient has in the determination of their health care. Kake knew her facts and wasn’t afraid to present them – the doctor’s inability to counter Kake’s assertions just goes to show how very little evidence there is to support claims that fat is unhealthy. And when the doctor denied Kake birth control pills, Kake very plainly told her it wasn’t acceptable and got the pills she needed in the end.

    Doctors are intimidating folks, I know, and a fat-phobic doctor can be especially difficult to stand up to. Just remember everyone, YOU are the customer here; the doctor is at YOUR service. Don’t be afraid to stand up to them and don’t be afraid to seek out a second opinion. It’s YOUR health and YOU are your best advocate.

  2. Rachel did this come from you? I don’t know who Kate is but I thank her tremendously for sharing her story. And thank you Rachel for your insightful comments. I always feel happy when I read what you write and I am very thankful every time you participate in the conversation at A Celebration of Curves.

  3. Corinna – I’m just the messenger here. The story above was submitted by Kake. Thanks for the kind words.

  4. DivaJean

     /  January 14, 2008

    I have had very similar circumstances to Kake.

    My usual internist and gynecologist know exactly where I stand on the whole dieting issue- its only when I have the occasional urgent appointment and need to see someone else in their groups that I get the dieting speeches and platitudes. Physicians who actually take the time and know me and my situation- what a luxury!

    They know that I often walk a mile or two before hopping on the bus to work in the morning- and that walking is my usual mode of transportation. Telling me to walk an half hour a few times a week is laughable. They know that my life partner- who has had a gastric bypass- can’t sustain the energy to chase after our 4 kids in the park– but I can. I am the one who can run after my kids on their bikes when they are learning to ride- not the “healthier” one who had the gastric bypass- so don’t even think about mentioning a referral to a “bariatric specialist.” I would just as likely turn on my heels and leave the doctor’s office.

    And certainly- doctors or health professionals should know better than to look at someone and just decide a nutritional consult is in order. It takes a long discussion with a patient to assess eating habits and whether the patient is evening willing to consider changing their eating habits. Otherwise, the referral and time of the nutritionist is wasted.

  5. another corinna

     /  January 29, 2008

    god – I had an shockingly similar visit to a GP regarding birth control, ‘advice’ to lose weight, argument over my knowledge and his, ending in me deciding to go off the pill (it was actually my partner who suggested it saying that he’d use condoms because it wasn’t worth my sanity – and health too really as pills are pretty crappo for you). I now really dread ever having to see a doctor again. I’m healthy too but even healthy people get ailments. I just wait for niggles to go away now. Niggles that might be nothing but might be something and it’s just the crapness of too many recent drs visits (by recent I mean the last three years or so since fat came into every visit), that stops me making sure that’s all they are.

  6. geekgirlsrule

     /  January 30, 2008

    The last time I saw a dietician and did the whole food diary thing, she wound up telling me to eat more, because there was no way I could sustain good health on the amount of calories I was taking in per day.

    The best part, she said I definitely needed carbs more than anything else.


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