Unexplained Weight Gain? – You must be gorging yourself, no other explanation for it.

Hi – I found your blog in the aftermath of a visit to my doctor about my rapid unexplained weight gain that left me shocked and in tears.

I have always been super health and exercise conscious, but over the last year I have gained 25 pounds and no amount of dieting or exercise will shift the scales. I consider myself very nutrition conscious – in fact health and nutrition have always been personal interests of mine. After trying several doctors, who all simply referred me to community dieticians who: 1. told me about calorie intake and the food pyramid 2. Advised me to ‘move more eat less’ 3. gave me a printout of the Paleo Diet from the internet, I decided to visit an eminent and expensive doctor in my area. After explaining that I tried everything, that I was very well informed about exercise and nutrition and was looking to discover if there was another cause of my inability to lose weight, he started a barrage of the most astonishing comments. The worst part was, these comments were not addressed to me, but to a very young, very slim med student who was sitting in on the consultation. I won’t bore you with a blow by blow description, but a selction of his comments included:

“No one ever went into a concentration camp and came out fat”
“Have you ever read the book “Why French Women don’t get Fat”?
“Cut out those chocolate biscuits at morning tea” ( I hate chocolate)
“Don’t you have any other interests, hopes dreams that you could be thinking about instead of food?”
“Have you ever been to Europe where people really respect good food?” (I guess the assumption here was that I live on burgers and fries? In fact I lived in Europe for 20 years and am very interested in cooking and food of different countries)
And my favourite – directed to the student: “What do we call people who make the same mistakes over and over and expect a different outcome?”
To her credit, the young med student looked mortified, but not as mortified as me..My lip was quivering and I could barely speak. I walked out of there with a pathology referral whch was not explained to me, shell shocked and devestated.

I now find myself even more humiliated, feeling worthless and not entitled to having anyone give a damn about helping me resolve my weight issues. And guess what, if this rate of weigh gain continues, I will represent a worse health risk and get treated even worse by the medical profession!

Enlarged thyroid nothing to worry about – Get a 2nd opinion!

Hello, I’m vesta44, I moderate First do No Harm, and this is my story about mismanaged medical care and the 4 years I waited to get it taken care of.
Backstory is that I’ve been fat for 30-some years of my life, my blood pressure, blood sugar, and cholesterol have always been in the normal range (I’m 57 now, soon to be 58). In 1997, I had WLS that made me fatter, made my mobility issues worse, and did nothing to make doctors look past my fat for the real reasons for those mobility issues. I was told they were caused by my fat, follow the Nightmare on ELMM Street (eat less/move more) and I would be magically cured.
So for years, I stayed away from doctors unless I had a sinus infection or a serious cold that needed to be treated. After all, who needs to be constantly told that every ailment they have is caused by their fat and that dieting, which has failed so many times in the past, is the only cure?
Then 5 years ago, I met and married a wonderful man. He said I really should get a physical, see how my health was, make sure everything was ok. I had moved to where he lives, so I found a doctor there and made an appointment. Everything checks out normal, other than my thyroid is enlarged, which Dr W says is nothing to be concerned about. Okay, I believe her, until 2 years later, when I’m at my dad’s house for my mother’s memorial service and we’re talking about family health history. My mother has a history of thyroid problems (hypothyroidism), and my dad’s dad had an enlarged thyroid removed that was cancerous. They couldn’t remove all of it – it was so large by the time they got around to removing it that if they had taken it all, they would have cut the nerves that controlled speech and swallowing – he wouldn’t have been able to talk or swallow. They gave him 3 months to live (he was 87 at the time), and he lived to the age of 90.
So I come back, and at my next appointment with my doctor, I tell her all of this family history, and that I’m concerned about my enlarged thyroid. She still says it’s nothing to worry about, and then says I’m using this as an excuse for being fat. Now she and I have had our words about my weight before, several times. I’ve told her my weight is not a topic for discussion unless I’ve gained or lost a large amount in a short period of time (which has never happened). Still she pushes ELMM, still I tell her diets don’t work, diet drugs don’t work, and WLS doesn’t fucking work, what the hell else am I supposed to do? STFU and give me a referral to an enodocrinologist who knows what they’re talking about when it comes to this kind of thing. Dr W refuses. I get mad and walk out on her, go home and think for a week, find my own endo, then go back and demand that she give me a referral or I’ll find another doctor that will. She reluctantly gives me the referral.
I see the endo, we have an ultrasound done, and yeah, my thyroid is enlarged. Dr A says it’s pretty big and it should come out. I’m not real hip on surgery, but she gives me the name of a surgeon who does thyroidectomies all the time and she’s good. I talk to Dr M, we decide to wait 6 months, do another ultrasound, see if my thyroid is staying the same or growing.
Well, the 2nd ultrasound showed that my thyroid was growing, so we decided it had to come out. Scheduled the surgery, was supposed to be 3 hours, took 4 1/2 hours. My thyroid was so large, it had almost wrapped around my wind pipe, and my esophagus. Dr M said she was surprised I could swallow anything other than liquids, it was compressing my esophagus so much. She also says it should have come out when it was first found that I had an enlarged thyroid.
Just goes to show what you know, Dr W, nothing to worry about, right? I guess I should have just let it keep growing until I couldn’t eat at all, then maybe I’d have lost weight like Dr W thought I should (I am so glad I fired her). So my enlarged thyroid is gone, I’m started on Levoxyl and following up with my endo on that. Everything turned out fine, but only because I finally demanded that my doctor take my concerns seriously and give me the referral to someone who knew more about my condition than she did. (and I’m still avoiding general practitioners, I can’t find one in this area who isn’t fat-phobic and practices HAES).

Lower back/hip pain? Pain specialist says home remedy will cure it, along with losing weight

JG writes:

After a few years of pain in my lower back and hips, and a long history of mobility oddities, health issues, and struggle with weight, I was referred to a Pain specialist, in the hopes he could pinpoint the cause, and suggest treatment and pain management techniques so I could return to being active.
On Monday, I woke up many hours before my appointment, and left plenty of extra time to get to the clinic. This extra time was wasted, as I went to the wrong medical center (multiple clinics in town share the same name). I’ve been to both in recent months, and I became confused. I called right away, and told the 1st receptionist what happened. She said she’d page the doctor to see if he’d still see me, and in the meantime, I headed over. The two clinics are near each other, it was easy to turn around, get back on a bus, and walk the briskest pace I could to make the last several blocks. I showed up 20 minutes late. The 2nd receptionist said “Did you get the reminder phone call about the time for your appointment today?” I had. The 1st receptionist said “This is the woman who just called!” The 2nd receptionist “Oh. It’s your first time here. I see.” I don’t find it entirely implausible that people make this mistake once in a while, I felt rather frustrated by the brusque response.
While I wait for the doctor, I finish up notes on the illustrations I’d made of myself and areas of pain and how the correlate to various activities – I brought them as suggested by my primary care physician.
I lost about 28 minutes of the appointment, so I understand a rushed exam and a lack of patience. What I do not expect is that he asks me questions, and never lets me answer a single one, he cuts me off every single time. He doesn’t have my medical history or records other than the form I filled out as a first time patient. He glances at the illustrations over my shoulder but won’t look at the documentation of pain and what it correlates to (or take them to review later). He pokes exceedingly hard in places he’s examining, and seems surprised that I can’t tell what hurts anymore (The physical therapist I’d seen with her full weight on an elbow never hurt like his prodding did.). He further ignores me repeated statements of “But that is not where it hurts!” It still hurt to touch the areas he pressed hours later.
He said I have “Degenerative Disc Disease” and “Sacroiliac” problems. Now, with him not having looked at the x-rays, or even talking to me about what the problem is with the pain (or where the pain is!), how can he diagnose so quickly? Then he tells me stuff I already knew (based on my PCP and PT doctors, and research), no surgery will fix it, no medication will help, Physical Therapy is the only thing that’ll do it (and apparently, I can do it myself with some stretching, and maybe a home TENS unit, according to this new doctor – So what, how dare I waste his time when a home remedy is all I need?), and says I don’t need an MRI or other exam because there’s no nerve damage (I have no reflexes in my right leg, and both legs will go limp periodically when I walk, my hips experience pins and needles… that’s not nerve related?). He suggests loosing weight, I give a somewhat spotty response since he keeps interrupting me. Then he gets on the phone, dictates over several minutes everything I wrote on the form, his evaluation, and a request to send it back to my doctor.
Then the real trouble starts. He gets off the phone and says I need to loose weight, it’s all about expending more calories than I take in (I would LOVE to expend calories, that’s why I’m here, sir!). I tell him I’ve been to 2 nutritionists, and that eating well is too expensive when I’m out of work. He repeats himself before I finish. I remind him of my history of PCOS – and he says “Oh, well, you could eat a matchstick and gain weight!” and repeats the other part again. I tell him mobility is a better help to me. Then he suggests starvation. I point out that I’ve done that too [1], as a precursor to a specific diet and exercise plan and it resulted in 60lbs. of weight loss, but that mobility was key. I try to explain to him that when I’m mobile, I can and do loose weight. He then says I should consider starving myself to get the weight off.
His expression, his attitude, it’s like he seemed to think I only needed to be confronted about being fat, or like none of the dozens of doctors I’ve seen in my adult life ever told me I was fat and that I should do something about it, or like he’s the first person to tell me my weight is killing me. He acted like I never before heard about weight loss options, and really, if I would just consider not gorging myself I’d be perfectly healthy!
[1]When I was 19, and living with my ex-husband in our first apartment hundreds of miles away from everyone, I ended up starving, and lost 25lbs. It wasn’t on purpose, it wasn’t instant, we had no money, and finally after a week without eating anything but 3 oranges I was eating skin from the sides of my fingernails without even noticing it. In 1999, I discovered the low-carb diet as a treatment for PCOS, and against the advice of everything I’d read, I ate about half of the minimum, starving myself for an ugly month full of hysteria, panic attacks, and extreme fatigue. Since then, having developed difficulties with hypoglycemia, and putting on much more weight than I had back then (recent surgery recovery tells me if I get weak, I’m going to seriously injure myself the first time I fall down, trip, or pass out from dizziness because the weight will get in the way), and the mental side effects (I would probably need a suicide watch at some point, I was quite suicidal during the second starvation episode), I can’t imagine this is even remotely safe to do without immediate medical supervision. It seemed highly inappropriate for him to suggest a dangerous home remedy without having looked at any test or evidence, or consulting my medical history. It also seems inappropriate for him to offer this advice outside of his specialty and experience.
On Tuesday I was in more pain than I’d had in weeks, and on Wed. I was in more pain than I had been in for several MONTHS, I had clear swelling around the spots around my spine and neck where he pressed so hard, and spots that feel like lumps in the tissue. Touching the area is still quite painful. I feel it bears repeating, even with the most severe pressing, exploration and deep tissue work done by my physical therapist, I never left her office injured. I am currently awaiting a response from my PCP, I expect I will file a grievance with the clinic.

Endometriosis diagnosis & treatment nightmare

Sophia writes:

I carry my weight very well. So well, in fact, that nurses often weigh me twice, and most doctors don’t comment on my weight until they sit back and look at my chart. I was a competitive athlete growing up, and although I am certainly overweight now, I still retain much muscle mass especially in my thighs. I am tall for a woman and even at my thinnest have never dipped below a 14/16 (and I was almost unhealthily thin at that point, subsisting on diet coke and cigarettes).
Toward the middle of ’06 I began experience constant pain. Endometriosis had been bandied around as a possible diagnosis since i was 14, and I had been on hormonal birth control almost continuously since then. My mother had endometriosis, and so did many of her female relatives. I searched high and low, and finally found a specialist (a Reproductive Endocrinologist) who supposedly had experience in treating endometriosis in my area. There were not many, and he was the only one who would treat me for the medical condition, not for the infertility aspect.
The initial interview was horrible. Right from the start he told my husband and I we shouldn’t think of children yet, that we were too young and should be out of school (as if that’s his business at all). He took one look at the weight on my chart and said that my pain was probably psychosomatic and/or caused by my weight and that I was more than likely too fat to conceive naturally anyway. After I was nearly in tears, my very typically cool-headed husband told the doctor heatedly that he had lived with me for a good deal of time and that I was in so much pain daily that I could hardly function. Of course I had gained weight, my husband pointed out, I had been hardly able to leave the house for months. Finally the doctor agreed to take an ultrasound. I lay on the table holding my husband’s hand silently gagging from the pain. Only then did the doctor look down and say “does this hurt?” like I was some freak. I hardly croaked out a “yes”. The doctor looked sternly at me, then left the room for me to get dressed.
When we met him in the hallway, he said he was ordering a laparascopic surgery to examine my insides. He was ‘piggy backing’ me onto another surgery, and told me he would ‘order a laser just in case’ but he ‘doubted it would be used’. He told me again I needed to lose weight and see a shrink.
A month later I had the surgery. What should have been a 30 minute procedure stretched 5 times that length, much closer to 2 1/2 hours. My uterus was covered with spots, and the photographs he took looked like someone had taken a lit cigarette to my insides. Upon research, he only made 2 incisions, instead of the typical three, and never checked my other internal organs beside my uterus/ovaries. While I was in the post-op recovery room, the doctor came out to speak with my husband and my mother. He flat out told them the surgery was much more difficult because he had to work through ‘layers of fat’. He told my husband I was severely overweight, and the ‘amount’ of endometriosis he found was not enough to be causing the pain i was in (which goes against all current research on the condition). My husband almost punched him right there in the hospital. It was obvious he was trying to cover up his previous insensitivity and disbelief. It was obvious i had this disease, and he didn’t even have enough time or care to treat me fully.
I have not gone back to this doctor. My GP and my last ob/gyn were and are immensely supportive of my health, overweight or not. They are both convinced my weight struggle is related to a hormone imbalance from my endometriosis, combined with the difficulty I have in staying physically active. I know they would like me to lose some weight, but mostly manage my hypoglycemia and get some cardio worked into my life. They never push or are mean about it. I told them both what the surgeon said, and neither could believe or agree with what he put me through.
The absolute worst part is that this doctor trains Reproductive Endocrinologists at my local medical university. I hope they learn more compassion and better bedside manner than he ever imparted. The best part of all of this? The guy had to be 250 lbs himself, easily.

Eye Problems and lecture about being too fat by eye doctor

Pamela writes:

To begin with, here’s a short back story. I’ve been having problems with my eyes for the last five months or so – I had to stop wearing contacts and use drops every day, but things weren’t getting better and my eye doc was mystified, so she sent me to a specialist.
I went to the specialist, and it was NOT a good experience.
There were two main problems. First, the guy kept insisting that I must be sleeping on my face and aggravating my sore eyelids. I definitely do not sleep on my face. But he seemed to believe that all overweight people were simply incapable of sleeping any other way – he didn’t seem to believe that I could possibly sleep comfortably on my side because I would “choke” on my fat.
The next is the worst part. After telling me that I probably have Floppy Eyelid Syndrome and have to tape shields to my eyes every night so I don’t move my eyelids when I sleep, he proceeded to lecture me for ten minutes about being overweight, including advising me to get gastric bypass surgery and, when I said I wouldn’t do that, he suggested that I go on an extreme diet like MediFast.
Now, I’m sure you don’t know this, but I was on some medicine that made me gain about 75 pounds in less than six months. I was always a big girl (size 16/18) beforehand and quite happy with myself. However, after that weight gain and hormone issues also caused by the medicine, I got severely depressed and went on a lot of crazy diets to try and lose weight and am just now getting to a point where I have decided that rather than go on any more crash diets, I will just eat well and exercise and try to accept myself for the size I currently am (22/24/26, depending). Having my EYE doctor degrade me like that, without knowing my medical history at all, and with HIS DOOR OPEN SO OTHER PATIENTS COULD HEAR just made me feel absolutely horrible.

‘No Hope Hospital’ for patients of size

The BBC reports on a case of size-discrimination in health care from across the pond. Gary Barton is a 6-foot 6-inch father of four who weighs in at about 266 pounds. The former steelworker is registered disabled, suffers from diabetes, arthritis and peripheral neuropathy, which means he has no feeling in his feet or lower legs and walks with a cane. He went for an MRI scan at his local Good Hope Hospital, where he was given headphones during the procedure. The two female radiologists didn’t turn off the intercom and this is what Barton heard:

“I got up onto the table on my own no problems but once I was up there they were getting me to move around a bit. I’m not too bad but I do suffer with arthritis so I wasn’t exactly jumping around,” he explained. “They gave me headphones to relax me but I think they forgot to turn the intercom off because I could still hear them chatting.”

“The nurse said, ‘Oooh, that was a bit of a struggle wasn’t it’, and the radiographer said, ‘Yeah, I thought he was going to break the bed’. I was stunned and immediately shouted, ‘I heard that’.”

Mr Barton said the embarrased radiographer apologised but her colleague “was in fits of laughter”.

He added: “It is outrageous and it isn’t what you expect from medical staff. I won’t lie, I wasn’t too hurt and upset and I can see the funny side of it but I was shocked by how unprofessional and vindictive the staff were. I’m not as big as they made out and even if I was, you expect a certain level of care from medical practitioners, not scorn. That hospital ought to be called No Hope, not Good Hope.”

Barton rightfully complained to the hospital and in a letter to him, the trust said it apologized “unreservedly” for the incident and that “The member of staff involved deeply regrets having made the comments and is fully aware that her behaviour was both totally inappropriate and professionally unacceptable.” The radiographer would have faced disciplinary proceedings but Barton insisted that no further action be taken against her.

Eating ‘yer veggies will cure congenital spinal curvature

Catherine writes…

There is congenital spinal curvature in my family.  Every female member, no matter what her weight, has it.  This includes me.  Mine is “three-way,” meaning that I have an abnormal twist from side-to-side (scoliosis), an abnormal twist from front-to-back (lordosis), and a rotational twist (kyphosis).  This means my back muscles are constantly working much harder than they should.  It naturally follows that I can throw my back out easier than most people, and I’ve had bouts with pain so debilitating I could barely walk.

A few years ago I went to a doctor complaining that the back trouble was worse than usual.  The doctor did not even look at my back but rather told me that the cause was that my extra weight was pulling the spine out of place. He suggested that if I just “ate right” I’d lose the weight and all my problems would go away.  He didn’t even suggest any exercises to help the muscles even after I mentioned that it’d been some time since I’d been in physical therapy.  He only suggested over-the-counter naproxen.

Three weeks later, I was in so much pain that I could not even stand up straight.  At the age of twenty-eight I was walking with a cane and I could not even dress myself.

I went to another doctor who took one look and immediately prescribed strong muscle relaxants, prescription pain relievers.  I was walking normally in three days; once the immediate problem settled he was happy to give me information about strengthening exercises.  It was then and only then he brought up my weight — and it came by way of asking if he could take some blood in order to check my thyroid function.

I stayed with that doctor for years.