There’s a lot of talk about how much difficulty fat people can have in getting proper medical treatment for issues because a lot of medical professionals want to assign “weight loss” as the treatment for things that may not actually have anything to do with weight. This tends to also delay diagnosis for various issues and create a poor relationship between doctor and patient. Most fat people have at least one story about how a doctor was more focused on their weight than any thing else, and this means that fat person is less likely to go to the doctor when they’re sick, which means they’re less likely to get treatment for things that have nothing to do with weight.
But what I want to talk about today is weight gain and mental health.
I’ve gained over 40% of my original weight total over the past 5 years. That’s a big gain and so it flags me constantly because weight gain is often listed as a symptom of various mental health problem including depression. The problem is, I am depressed. And I did gain weight. But for me? The two are completely unrelated. I gained weight because I stopped obsessing about how many miles I was running as compared to how much I was eating. But jeezus if I don’t have to remind all of my care team of that on a regular basis.
“It looks like you’ve gained a bit of weight. That’s also a sign of depression.”
“Yes. But really what happened is I dealt with some body dysmorphia, compulsive tendencies and binge eating so truthfully that weight gain is a sign of mental health.”
“But…you’re here because you’re more depressed.”
“Yes.”
“And you’ve gained weight.”
“Yes. But those things are unrelated.”
“I’ll be the judge of that.”
Now, thankfully this is not a constant battle. Once my care team looks at my charts or talks to me to get my history they are reminded: Oh yeah, she used to run 50+ miles a week and measure out the ketchup she’d put on her fries to stay under her calorie limit and then when she faltered she’d hide in her car and binge and eat 12 donuts in one sitting. She doesn’t do that stuff anymore.
But it is SO HARD for anyone to see that because so many assumptions are made about weight gain and mental health. “Oh, she’s put on a bunch of weight. It’s because she’s been struggling with her mental health and hasn’t been running as much.”
Maybe that’s true for some people, but assuming that about someone is just as bad as assuming they are diabetic or have hypertension. You should not assume anything based on someone’s weight. We’ve all been programmed with the image of fat sad people eating ice cream by the gallon to self-medicate and so we see fatness and we think: SAD.
The frustrating part is I AM VERY SAD ALL OF THE TIME. So it’s really hard to get someone to look past the weight. And the reason why I need them to look past the weight is because I don’t see SKINNY KIM as a sign of MENTALLY WELL KIM. As a matter of fact, SKINNY KIM had a lot more she was fighting with. She had a Binge Eating disorder and extreme Body Dysmorphia. But if too much value is put on my weight as an indicator, then too much will be put on it as a sign I’m better and I don’t need that shit. When I’m getting a follow-up I don’t need a psychiatrist to say: “You are still at X weight though, are you sure you’re feeling better?” I don’t need someone to include “more exercise” or “better diet” on my recommendations when I AM CLOSING MY RINGS EVERY DAY THANK YOU VERY MUCH.
I guess I’m just trying my best to have a VERY casual relationship with my body and it is impossible to do that if mental health professionals keep needing to be reminded that my weight gain is not part of my mental health disorder. I’m just barely past the “obsessing” and “disordered eating” part of my relationship with food and fitness (like you can ever move past that…) and I don’t want to suddenly have to start thinking about that again. I love “close the rings” as a very loose and non-numerical goal. I mean, my watch has numbers associated with it and if I don’t naturally meet those numbers it will remind me…but for the most part I’m just looking at rings and trying to move enough and the right kind of way to close them. This is a VERY healthy relationship with fitness and I don’t want to complicate it anymore.
But jeezus if every psychiatrist and therapist still brings it up. They don’t hound me about it, but it is always something I need to remind them about. REMEMBER ME? THE GIRL WHO HAD BODY DYSMORPHIA AND A BINGE EATING DISORDER? THAT IS MANAGED NOW SO WE CAN WE QUIT TALKING ABOUT THE WEIGHT I’VE GAINED IN THE PROCESS?
They don’t bother looking at my chart regarding my weight gain and possible causes, they just see that I’ve gotten fatter so that must be a problem.
(I’m looking for new therapists by the way. For many other reasons including financial.)
I don’t know. I feel like this is rambling and maybe it’s just frustrating because really my weight gain is a sign of IMPROVEMENT in many areas and yet…YET…I have to constantly remind people or prove that to people. Like…REMEMBER WHEN I COULDN’T GO TO SLEEP UNLESS I HAD BINGED BEFORE BED? THAT DOESN’T HAPPEN ANYMORE! And the prospect of having to talk to new therapists about this journey because they’ll probably see Fat Kim and make judgements is very VERY discouraging.
Yes! I'm so much better mentally and physically than I was at nineteen, yet every time I see the doctor it was always, "You need to eat healthier, exercise more, and lose weight". I've stopped going, to be honest, sadly. But I'm eating so much healthier now (no more disordered eating, lots of vegetables, TWO meals a day instead of half of one) and exercising every other day (and enjoying it!) And yet. It's something I've spoken about a little with my psychologist, but I don't want to find out what her thoughts really are because we have a great relationship and I'm doing really well with her and I don't want to spoil it, but, like...that shouldn't even be a concern!
Anyway, sorry for the rambling, but thanks so much for this, it really hit me hard. Best of luck to you in the future taking on the fatphobia medical system!
You are so right! I've been about 30 pounds lighter than I am right now and when I was that healthy weight, I was dangerously, severely, depressed. I know I need to lose weight right now for other reasons, but I don't have any of the depression and anxiety that I once did. Medical fat bias is real. Trust yourself over the "experts". You're making a lot of sense here and you know your own journey better than anyone else.