So over the past 24 hours, I've had a catastrophically yucky initial meeting with my (potential, violently rejected) new primary care physician, followed by (admittedly mild, but I'm sensitive to this sort of thing) Facebook drama. I posted on Facebook shortly after I left the office, because I was upset and distressed by the horrific 5 minutes I'd spent with the doctor. Unfortunately, in addition to several supportive comments, one friend (whose partner is a WLS "success story") posted a finger-wagging comment basically scolding me for overreacting, saying that it was probably appropriate for the doc to act as she did. Then, some other rad fatties and allies posted vehemently anti-WLS comments. Which felt good to read, but they in turn prompted the pro-WLS friend to spring to the defense of WLS. All of this in comments that started to feel like a flame war on my FB. It was to the point by this morning where each FB notification was making me feel sick, because I dreaded what it was going to be...
Finally, I decided to respond. But I'd been doing so much thinking that it became far more blog-length than comment-length. So I'm posting it here instead. I'm sure some rad fatties and anti-WLS people will think my position is not strong enough. While on the other hand, my friends and acquaintances who have positive ideas about WLS will probably feel I'm being unreasonable in my resistance. I can't please you all. I can only try to think this through and navigate it the best I can. I am torn, caught in the middle between the hordes and masses of society who think my body is an abomination, a disease to be "cured" by any means necessary, and by the small, quiet voices of fat acceptance and HAES and the tentative reaching instincts of my own body and soul, which tell me that fat is part of my biology and my identity and it's the world that needs to change, to stop treating me badly and seeing me as a problem and an intrusion.
There's so much to respond to in what everyone said on my FB. I agree with the strong negative feelings that many of you have about these surgeries. On the other hand, I understand where my friend who said the distressing stuff was coming from (even though the way he said it really hurt!). I know several "success stories" for whom the surgery was really wonderful and they are feeling great / much improved / it was all worth it / etc. Which only serves to confuse me because I feel even more pressure to accept the pressure of medical professionals. However, I simply must stick to my own gut feeling/intuition/confidence that this is NOT the right path for me - at least right now. I won't say never, cause who knows?
What truly pisses me off about this doc is that, as I said in my initial FB status post, she had met me LITERALLY 5 minutes before stating that bariatric surgery was really my only option. She had not had me fill out any new patient paperwork. It's almost certain that had not reviewed my medical record extensively, if at all, given how overworked clinicians are these days and the fact that I had not scheduled a full physical, just a 15 minute appt. When she walked in, she asked, "What can I do for you today?" I stated that I am looking for a new primary care physician, and she repeated, "But what do you want today," or something. She didn't ask me any questions or move to initiate the getting-to-know-you conversation I was hoping for. So I said that I am looking for a team captain, that I see a variety of specialists for different concerns, including a naturopath, chiropractor, psychologist, occasionally podiatrist. I went on to express that I was seeing her because I am looking for a new primary care doc who will NOT insist on constantly recommending HMR (my medical group's in-house version of Weight Watchers) or bariatric surgery, as those recommendations aggravate my eating disorder and depression. I explained that I believe in focusing on changing behaviors, not focusing on weight (working my way into explaining HAES). But before I could elaborate, she said that that was just it, we can't change behaviors, and that for someone in my "category" the only viable option is bariatric surgery.
Really? You don't want to hear more about the eating disorder I just mentioned? But of course fat women don't have eating disorders, do they? If you have an eating disorder, it makes you skinny. After all, the same thing we diagnose as an eating disorder if you're below a certain weight (severely limiting calories, obsessively planning meals and reading nutrition labels, working out to excess, etc.), we prescribe to fat people, don't we! You don't want to know if I exercise or not, or what I eat, before making such a sweeping statement? But of course not; you know exactly how I eat (poorly) and whether I exercise (obviously not even a little) from looking at me, right? It may be - it probably is true - that I will never eat or exercise "perfectly." But you don't even ask the questions??? It was blatantly clear that this woman thought she knew everything relevant about me just by looking me up and down. And so I told her, "ok, well that's what I needed to know. We're done here." She protested, "But don't you want a flu shot or a whooping cough booster?" "No, I don't want anything from you." Not exactly the ringing, persuasive speech I might craft if I were a character in my own movie... but I didn't cry. I didn't give her that. At least, not til I got to my car.
I have done a lot of thinking on this in the last 24 hours and I've come to believe that my feelings on WLS and abortion are somewhat parallel. In both cases, I believe that everyone has the right to choose to go through that procedure, but it is emotionally complex and has long-lasting physical and emotional consequences and should not be taken up lightly. In both cases I would not personally choose that procedure but respect others' right to make their own personal decisions about what is best for their bodies and their lives. And just as I would be offended by a doctor who recommended abortion just because I was visibly pregnant and single, I am offended by a doc who recommends bariatric surgery just because I'm fat.
Pro-choice folks have the slogan, "Keep your laws off my body." While there is no law that one must have bariatric surgery (though it's getting scarier and scarier in terms of de facto weight loss requirements embedded in ability/non ability to access health care in this country), there is a TON of pressure out there, especially for folks like me who are in the very far right (not politics, math - on a graph, bigger numbers are to the right!) portion of the weight bell curve. So it may not be as catchy, but I say it with gusto:
KEEP YOUR ASSUMPTIONS OFF MY BODY. Yes, I mean you, Dr. And you, well-meaning friend. My body is mine. In this day when fatness increasingly IS a choice (if you believe bariatric surgery is a viable option, which so many seem to), it becomes increasingly difficult to stand up and say, "I am fat. I don't believe thinness is a choice for me. So I am going to live in this fat body" without getting some pretty forceful push-back.
Ok, now I have all sorts of interesting thoughts percolating about how just when we thought people might accept that diets don't work, and therefore fatness really is biological and not a "choice"... in walks bariatric surgery, and in just a few short years goes from experimental to frighteningly mainstream. Coincidence?
But that's a subject for another day... This post is already exceedingly long. Kudos and thanks, if you're reading this. You've made it to the END OF THE POST. Leave me a (positive, no meanies allowed!) comment and you get a gold star. :)