First, this article is not to discredit or compare to anyone. This article is not to take away the celebrations of those whose behavioral changes have made them feel more healthy and fulfilled in their lives — though I will challenge the emphasis on the number on the scale as an outcome measurement to use for such celebrations. This article is to shine a light on a less commonly discussed, less celebrated perspective. While I discourage emphasis on the number on the scale, I will say this … as it’s just a number … I gained 30 pounds over the course of the last year. More importantly — with it, I gained life.
Why does this perspective need to be heard?
Our culture is obsessed with weight loss. In medicine. In society.
Why?
For me, weight loss was a way to make myself so small that I could disappear.
Not eating was my way of numbing myself through the pain of trauma, anxiety, depression and lack of control.
Over-exercising was my way to make the physical pain distract me from the emotional pain.
Throughout my life, the belief that I must always strive to “eat less” and “exercise more” led me to a place where my body was shutting down — a level of exhaustion that penetrated my mental health, psychological health, spirit and life.
I recently listened to a podcast that started with a person claiming that they wished that they “didn’t eat” when emotionally distressed since the discussion was on emotional eating. Let’s pause here, friends. Both under and overeating can be extremely distressing. The grass is not greener on the side of restriction. For more on that, please check out, “Stop prescribing one eating disorder to treat another: Why under and overeating are not ‘opposite problems.'”
Last year, I got sick of being sick, and I decided to jump off the hamster wheel. I leaned into self-compassion, nourished my mind and body, and rested more. I observed how guilty I felt for doing all of these things as societal pressure often prioritizes productivity and the grind, and I did them anyway. I observed my body as it changed, gaining weight in the process of gaining life.
During this time, I dove into writing instead of using food restriction and over-exercise to cope. In writing my articles for KevinMD on eating disorders, burnout, “high-functioning depression” and suicidal ideation, I have released tremendous guilt and shame that I have been carrying for years. I named it. I admitted it. And I owned it. If you are hiding, please come out. The world needs your voice.
As I continued to read and hear the hyperfocus on weight, I thought: the world needs more perspectives to fight against these long-held beliefs and weight stigmas. We need to keep talking.
So why not take a moment to own one more truth — I live with anorexia and I gained 30 pounds over the last year. I am living in a body that functions. My heart beats. My weight is higher than I am used to, and my body is doing what it needs to do to recover. My body survived the abuse of diet culture, restriction and over-exercising. It survived the tremendous stress we have all been facing in the world. Wow, body — you are pretty darn amazing.
Some may stop and say, well, of course, you can celebrate weight gain. You probably “needed it.” Let’s address this. I feel no need to tell you my starting weight to tell you if your perceptions of that theory are true. The urge to show “before” pictures of a severely undernourished body or to tell you a starting BMI substantiates biases and misconceptions about restrictive eating disorders that are doing great harm for those suffering in all body sizes. Check out the other articles for more on those topics: “Eating disorders thrive in secrecy, so let’s talk about it. Starting with BMI” and “Eating disorders are mental health illnesses that don’t have a certain ‘look.'”
So, where do we go from here? What may it look like to stop blaming our bodies and stop measuring our values with a scale? To relieve ourselves of the shame that weight-stigma creates?
First, I challenge you to stop hyper-focusing on weight and start asking patients about “relationships” with food, exercise and themselves, and then to truly listen to their replies — not only to what is said but to what is not said. I am grateful to know Dr. Kara Pepper, an internal medicine physician, who is sharing her recommendations for the use of these types of questions as screening tools for eating disorders and disordered eating. Dr. Pepper’s article “Why you should not use BMI for your New Year’s resolution” is another great read as we examine the flaws in our current health outcome measurements.
When we stop to think about it, we place so much shame and criticism on our bodies and how we eat. I am also fortunate to know Dr. Trina Dorrah, an internal medicine physician who shares her story and perspectives in “The silent burden of shame.”
Let’s try another approach. I prescribe self-compassion for all because self-compassion has been essential for me to start healing from anorexia, start healing from the guilt of leaving a residency, being medically discharged from the military and feeling inadequate — and start healing from the grief of the losses along the way. Self-compassion is what has helped me to nourish myself. Proper nourishment did lead to weight gain for me. That is a fact. And with that weight gain, I gained life. I choose to focus on the latter.
In medicine, we’ve been taught a lot about weight — some of which we must now unlearn. So, let’s forgive ourselves for doing our best with the information we were taught at the time.
As Maya Angelou once said, “Do the best you can until you know better. Then when you know better, do better.”
Stop weight stigma. It’s time to do better.
Jillian Rigert is an oral medicine specialist and radiation oncology research fellow.
Image credit: Shutterstock.com
