Fearing the doctor

ellioc2 · December 2018

I’m due for a doctor checkup in several weeks. The main reason is just to check in about how some new meds are working for me, but I know I will be weighed which causes me a lot of anxiety. I have made some pretty drastic changes this fall to my diet/exercise after this doctor let me know that it’s “time to get serious about hitting the gym and eating cleaner”. I have a history of an eating disorder, so weight has always been particularly sensitive for me - I usually do blind weights and we kind of tiptoe around it, but I’m tired of this anxiety and decided to take it into my hands. I knew I was in the slightly overweight category, so could stand to lose some weight by the way. So I’ve been working out 2-3 times a week and I’ve reduced my caloric intake to 1200-1400 a day. About a month ago I did get a scale that my husband agreed to do blind weights on me every 2 weeks. Since then I’ve lost 10 pounds (5 pounds each time) according to him. I don’t know how much weight I’ve lost before that from September when I started to late October. Anyway, I’m just nervous. I’m nervous she won’t think it’s enough or she’ll think it’s the greatest thing ever and think I should keep it up. I’ve been noticing some GI issues lately (cramping, diarrhea, nausea) that are not my norm that’s a bit concerning. It might be stress related, it also might be due to the high-fiber, bulky foods I’ve been eating. I’ve also noticed that I’ve been more irritable and feeling cold. Some of my hair has been falling out. Not a lot but more than normal. But if I bring that up to her, am I making excuses? This should be easy, right? If I’m seeing results and I have the weight to spare I should keep on doing what I’m doing. I just don’t know how the session is going to go and it’s causing me a lot of anxiety. Since I’m in weight loss mode, I now feel as if I have something to “prove”. I know this all might sound silly but this is where my mind is at right now.

NorthCascades · December 2018

Unless the medicine you're going about requires the doctor to know your weight, tell them you don't want to. You can do that. They'll respect your wishes. You're already working on it and this is clearly provoking anxiety.

Fflpnari · December 2018

Try not to feel nervous, the best thing you can do is have an open and honest conversation with your doctor. She will probably be happy that you are trying to be healthier.
If you have more than 50lbs, losing 2.5 pounds a week is good.
I have a lot of eating issues. I quit weighing myself because it stresses me and can make me lose my good eating habits quickly. Have you tried talking with a counselor? A healthcare team approach might be beneficial for you. Registered dietitian, counselor, and doctor. They can help support you together

Running2Fit · December 2018

Have you sought professional help for your eating disorder?

TavistockToad · December 2018

I would be more concerned at having lost 10lbs in 2 weeks when you say yourself that you're only 'slightly overweight'.

veganbaum · December 2018

ellioc2 wrote: »

Fflpnari wrote: »

Try not to feel nervous, the best thing you can do is have an open and honest conversation with your doctor. She will probably be happy that you are trying to be healthier.
If you have more than 50lbs, losing 2.5 pounds a week is good.
I have a lot of eating issues. I quit weighing myself because it stresses me and can make me lose my good eating habits quickly. Have you tried talking with a counselor? A healthcare team approach might be beneficial for you. Registered dietitian, counselor, and doctor. They can help support you together

Realistically, I have maybe 20-30 pounds left. So not a lot, but not a little either. My husband said that I should get to my goal of 140 in a couple of months if I keep losing at the same rate. I’ve thought about speaking to a registered dietician, but am putting it off for now.... I had a session with a personal trainer who has her degree in exercise science and she told me 1200 is too low especially for my age and height (5’6”, I’m 27 years old). I’ve been playing around with eating closer to 1400 especially on my gym days (where I burn about 500 on the elliptical and then so strength training) but I don’t want to eat too much and hinder my progress. It’s such a constant mental battle and I’be been feeling worse about myself and my body, not better

Your goal should not be to keep up at the same pace, and hopefully your husband doesn't encourage that. With 20-30 pounds to lose, you should set your rate of loss at 1 pound/week and eat those calories. Your progress will not be "hindered," you will make progress at a healthy rate. Your body can only burn so much fat in a day. Additionally, losing at a slower rate could help you build long-term habits for keeping the weight off.

Given your history with ED, I think that losing 2.5 pounds a week when you only have about 20-30 pounds to lose, you saying this should be easy, your husband saying you could reach your goal weight in a couple of months, and your anxiety about what your doctor will tell you is worrisome. What did you set your goal at? Set it to 1 pound/week and eat those calories, and more on the days you work out.

Also, you do not have to "hit the gym and eat clean" in order to lose weight. Of course, exercise and even just regular movement is important for health, and can help many people mentally and emotionally, but it's not necessary for weight loss. Eating an overall healthy diet is important, as well, but you don't have to "eat clean." Saying that you are burning 500 on the elliptical (which is likely inflated at least somewhat) and then doing strength training, although I don't know what that means for you, tells me you might be starting off at a rate that you won't be able to sustain. Maybe not, I don't know you. But, you'll likely be more successful if whatever habits for exercise you build up now are habits you see yourself sustaining for the foreseeable future.

Lounmoun · December 2018

Your doctor should be there to help you be healthy. Does your doctor know your history with an eating disorder and just told you to hit the gym and eat "cleaner" with no guidance? It sounds like your doctor did not actually tell you to lose weight just recommended regular exercise and a better diet. That is probably fine to say to most patients as a generic healthy lifestyle recommendation but maybe not for someone with a history like yours who will interpret it as "I have to lose a bunch of weight NOW!"

It sounds like you have probably lost weight faster than you should be and are possibly malnourished from what you describe. If your doctor does not think there is a problem with that or says you did not do enough then I would look for a different doctor who can work with you better for your health.

Expecting to lose 20-30 lbs in a couple of months at your size is not a healthy plan to continue.
If I were you I would stop trying to lose weight today and just try to maintain your current weight until your appointment. Make sure you are getting enough protein, fats and other nutrients. Maybe cut down your exercise if you have been doing a lot to try to lose weight. Take a break.
http://community.myfitnesspal.com/en/discussion/10569458/why-eating-too-little-calories-is-a-bad-idea/p1
http://community.myfitnesspal.com/en/discussion/10142490/a-list-of-calorie-dense-foods/p1
https://mynutrition.wsu.edu/nutrition-basics/

I think when you see your (or any) doctor you should discuss your eating disorder history, extreme anxiety, not being able to look at a scale yourself, losing at least 10 lbs in 2 weeks, and the physical issues you have been having. I would ask for a referral to a registered dietician to help you set up a balanced plan to lose no more than 1 lb a week if your doctor thinks further weight loss is appropriate for you.

I would consider making it a priority to seek professional counseling for the anxiety and emotional issues you have no matter if your weight loss is fine with your doctor.

emmamcgarity · December 2018

Given that you have had an eating disorder in the past, lost 10 lbs in two weeks, and your hair is falling out, I recommend you up your calories to maintainence and schedule an appointment right away. You can request not to be weighed until after talking to the doctor. Bring a list of concerns to show the doctor and ask for a strategy for the weight loss that is safe and reasonable. Be abosolutely positive to share the past eating disorder first. Once you’ve gone over your list of concerns, just get weighed so that you and your doctor can work as a team to address your concerns and come up with a good approach.

kshama2001 · December 2018

ellioc2 wrote: »

I’m due for a doctor checkup in several weeks. The main reason is just to check in about how some new meds are working for me, but I know I will be weighed which causes me a lot of anxiety. I have made some pretty drastic changes this fall to my diet/exercise after this doctor let me know that it’s “time to get serious about hitting the gym and eating cleaner”. I have a history of an eating disorder, so weight has always been particularly sensitive for me - I usually do blind weights and we kind of tiptoe around it, but I’m tired of this anxiety and decided to take it into my hands. I knew I was in the slightly overweight category, so could stand to lose some weight by the way. So I’ve been working out 2-3 times a week and I’ve reduced my caloric intake to 1200-1400 a day. About a month ago I did get a scale that my husband agreed to do blind weights on me every 2 weeks. Since then I’ve lost 10 pounds (5 pounds each time) according to him. I don’t know how much weight I’ve lost before that from September when I started to late October. Anyway, I’m just nervous. I’m nervous she won’t think it’s enough or she’ll think it’s the greatest thing ever and think I should keep it up. I’ve been noticing some GI issues lately (cramping, diarrhea, nausea) that are not my norm that’s a bit concerning. It might be stress related, it also might be due to the high-fiber, bulky foods I’ve been eating. I’ve also noticed that I’ve been more irritable and feeling cold. Some of my hair has been falling out. Not a lot but more than normal. But if I bring that up to her, am I making excuses? This should be easy, right? If I’m seeing results and I have the weight to spare I should keep on doing what I’m doing. I just don’t know how the session is going to go and it’s causing me a lot of anxiety. Since I’m in weight loss mode, I now feel as if I have something to “prove”. I know this all might sound silly but this is where my mind is at right now.

emmamcgarity wrote: »

Given that you have had an eating disorder in the past, lost 10 lbs in two weeks, and your hair is falling out, I recommend you up your calories to maintainence and schedule an appointment right away. You can request not to be weighed until after talking to the doctor. Bring a list of concerns to show the doctor and ask for a strategy for the weight loss that is safe and reasonable. Be abosolutely positive to share the past eating disorder first. Once you’ve gone over your list of concerns, just get weighed so that you and your doctor can work as a team to address your concerns and come up with a good approach.

@ellioc2 I agree that you are losing weight too fast. With only 20-30 pounds to lose, there's no need to create such an aggressive deficit that is causing you to lose 2.5 pounds per week - that's for someone who has over 100 pounds to lose.

It's also fine to tell the nurse you don't want to be weighed, either at first or at all. Ask your doctor for a referral to an eating disorder specialist.

lynn_glenmont · December 2018

ellioc2 wrote: »

I’m due for a doctor checkup in several weeks. The main reason is just to check in about how some new meds are working for me, but I know I will be weighed which causes me a lot of anxiety. I have made some pretty drastic changes this fall to my diet/exercise after this doctor let me know that it’s “time to get serious about hitting the gym and eating cleaner”. I have a history of an eating disorder, so weight has always been particularly sensitive for me - I usually do blind weights and we kind of tiptoe around it, but I’m tired of this anxiety and decided to take it into my hands. I knew I was in the slightly overweight category, so could stand to lose some weight by the way. So I’ve been working out 2-3 times a week and I’ve reduced my caloric intake to 1200-1400 a day. About a month ago I did get a scale that my husband agreed to do blind weights on me every 2 weeks. Since then I’ve lost 10 pounds (5 pounds each time) according to him. I don’t know how much weight I’ve lost before that from September when I started to late October.

I get that telling you the change in weight isn't the same as telling you your actual weight, but shouldn't he limit the information to whether you could stand to lose a little weight or not? Giving specific numbers doesn't seem like blind weighing.

Anyway, I’m just nervous. I’m nervous she won’t think it’s enough or she’ll think it’s the greatest thing ever and think I should keep it up. I’ve been noticing some GI issues lately (cramping, diarrhea, nausea) that are not my norm that’s a bit concerning. It might be stress related, it also might be due to the high-fiber, bulky foods I’ve been eating. I’ve also noticed that I’ve been more irritable and feeling cold. Some of my hair has been falling out. Not a lot but more than normal. But if I bring that up to her, am I making excuses?

And definitely bring up all your symptoms to your doctor, from the nervousness to the GI issues to the hair loss. A good doctor considers the entire array of symptoms. If your doctor makes you feel that informing her of all your symptoms is inappropriate or "making excuses," I hope you're in a health system or insurance system that will allow you to look for another doctor.

This should be easy, right? If I’m seeing results and I have the weight to spare I should keep on doing what I’m doing. I just don’t know how the session is going to go and it’s causing me a lot of anxiety. Since I’m in weight loss mode, I now feel as if I have something to “prove”. I know this all might sound silly but this is where my mind is at right now.

It's only been a few months since your last appointment, right? If you've had any kind of measurable progress, I would think your doctor would applaud that and say keep on doing what you're doing, unless there was some kind of deadline (for surgery, or starting some kind of chronic-disease management meds) that you haven't mentioned. And since you believe you're still overweight, why would you be nervous that she'll think what you've been doing is "the greatest thing every and think [you] should keep it up"? Wouldn't that be a good thing? Even when you're a healthy weight, you probably should keep up a modified version of whatever you've been doing (maybe eat a little more, maybe cut back on cardio if you're been doing more than is necessary for heart health and overall fitness), so I'm not sure why that should be a cause of nervousness?

Best of luck. The only advice I can come up with is to think about what you would do if your doctor responded in any of the ways you're imagining, so you are prepared, and maybe can see that they're not as awful as you're thinking they will be. Your doctor is a person providing a service that you're paying for. Your doctor is not someone who has actual authority over you, like a police officer or a judge.

lynn_glenmont · December 2018

ellioc2 wrote: »

Fflpnari wrote: »

Try not to feel nervous, the best thing you can do is have an open and honest conversation with your doctor. She will probably be happy that you are trying to be healthier.
If you have more than 50lbs, losing 2.5 pounds a week is good.
I have a lot of eating issues. I quit weighing myself because it stresses me and can make me lose my good eating habits quickly. Have you tried talking with a counselor? A healthcare team approach might be beneficial for you. Registered dietitian, counselor, and doctor. They can help support you together

Realistically, I have maybe 20-30 pounds left. So not a lot, but not a little either. My husband said that I should get to my goal of 140 in a couple of months if I keep losing at the same rate. I’ve thought about speaking to a registered dietician, but am putting it off for now.... I had a session with a personal trainer who has her degree in exercise science and she told me 1200 is too low especially for my age and height (5’6”, I’m 27 years old). I’ve been playing around with eating closer to 1400 especially on my gym days (where I burn about 500 on the elliptical and then so strength training) but I don’t want to eat too much and hinder my progress. It’s such a constant mental battle and I’be been feeling worse about myself and my body, not better

OK, didn't see this before, which means despite asking him to do blind weighing, he's giving you all the info you need to determine your current weight. Is the blind weighing something recommended by your therapist or ED team? Maybe your husband needs some more direction on how to do this.

lynn_glenmont · December 2018

kshama2001 wrote: »

ellioc2 wrote: »

I’m due for a doctor checkup in several weeks. The main reason is just to check in about how some new meds are working for me, but I know I will be weighed which causes me a lot of anxiety. I have made some pretty drastic changes this fall to my diet/exercise after this doctor let me know that it’s “time to get serious about hitting the gym and eating cleaner”. I have a history of an eating disorder, so weight has always been particularly sensitive for me - I usually do blind weights and we kind of tiptoe around it, but I’m tired of this anxiety and decided to take it into my hands. I knew I was in the slightly overweight category, so could stand to lose some weight by the way. So I’ve been working out 2-3 times a week and I’ve reduced my caloric intake to 1200-1400 a day. About a month ago I did get a scale that my husband agreed to do blind weights on me every 2 weeks. Since then I’ve lost 10 pounds (5 pounds each time) according to him. I don’t know how much weight I’ve lost before that from September when I started to late October. Anyway, I’m just nervous. I’m nervous she won’t think it’s enough or she’ll think it’s the greatest thing ever and think I should keep it up. I’ve been noticing some GI issues lately (cramping, diarrhea, nausea) that are not my norm that’s a bit concerning. It might be stress related, it also might be due to the high-fiber, bulky foods I’ve been eating. I’ve also noticed that I’ve been more irritable and feeling cold. Some of my hair has been falling out. Not a lot but more than normal. But if I bring that up to her, am I making excuses? This should be easy, right? If I’m seeing results and I have the weight to spare I should keep on doing what I’m doing. I just don’t know how the session is going to go and it’s causing me a lot of anxiety. Since I’m in weight loss mode, I now feel as if I have something to “prove”. I know this all might sound silly but this is where my mind is at right now.

emmamcgarity wrote: »

Given that you have had an eating disorder in the past, lost 10 lbs in two weeks, and your hair is falling out, I recommend you up your calories to maintainence and schedule an appointment right away. You can request not to be weighed until after talking to the doctor. Bring a list of concerns to show the doctor and ask for a strategy for the weight loss that is safe and reasonable. Be abosolutely positive to share the past eating disorder first. Once you’ve gone over your list of concerns, just get weighed so that you and your doctor can work as a team to address your concerns and come up with a good approach.

@ellioc2 I agree that you are losing weight too fast. With only 20-30 pounds to lose, there's no need to create such an aggressive deficit that is causing you to lose 2.5 pounds per week - that's for someone who has over 100 pounds to lose.

It's also fine to tell the nurse you don't want to be weighed, either at first or at all. Ask your doctor for a referral to an eating disorder specialist.

With all due respect, I don't understand the point of this advice. OP is getting weighed at home by her husband who is giving her all the information she needs to know what her current weight is (current rate of loss + time to goal weight at current rate of loss). So suggesting she refuse to get weighed at the doctor's office is like suggesting she refuse to have her blood pressure measured or her blood drawn if those procedures cause her anxiety. It just denies the doctor pertinent information that the patient in this case already has. (And it sounds like the doctor's office was doing blind weigh-ins a proper manner, not sharing her actual weight with her.)

kshama2001 · December 2018

lynn_glenmont wrote: »

kshama2001 wrote: »

ellioc2 wrote: »

I’m due for a doctor checkup in several weeks. The main reason is just to check in about how some new meds are working for me, but I know I will be weighed which causes me a lot of anxiety. I have made some pretty drastic changes this fall to my diet/exercise after this doctor let me know that it’s “time to get serious about hitting the gym and eating cleaner”. I have a history of an eating disorder, so weight has always been particularly sensitive for me - I usually do blind weights and we kind of tiptoe around it, but I’m tired of this anxiety and decided to take it into my hands. I knew I was in the slightly overweight category, so could stand to lose some weight by the way. So I’ve been working out 2-3 times a week and I’ve reduced my caloric intake to 1200-1400 a day. About a month ago I did get a scale that my husband agreed to do blind weights on me every 2 weeks. Since then I’ve lost 10 pounds (5 pounds each time) according to him. I don’t know how much weight I’ve lost before that from September when I started to late October. Anyway, I’m just nervous. I’m nervous she won’t think it’s enough or she’ll think it’s the greatest thing ever and think I should keep it up. I’ve been noticing some GI issues lately (cramping, diarrhea, nausea) that are not my norm that’s a bit concerning. It might be stress related, it also might be due to the high-fiber, bulky foods I’ve been eating. I’ve also noticed that I’ve been more irritable and feeling cold. Some of my hair has been falling out. Not a lot but more than normal. But if I bring that up to her, am I making excuses? This should be easy, right? If I’m seeing results and I have the weight to spare I should keep on doing what I’m doing. I just don’t know how the session is going to go and it’s causing me a lot of anxiety. Since I’m in weight loss mode, I now feel as if I have something to “prove”. I know this all might sound silly but this is where my mind is at right now.

emmamcgarity wrote: »

Given that you have had an eating disorder in the past, lost 10 lbs in two weeks, and your hair is falling out, I recommend you up your calories to maintainence and schedule an appointment right away. You can request not to be weighed until after talking to the doctor. Bring a list of concerns to show the doctor and ask for a strategy for the weight loss that is safe and reasonable. Be abosolutely positive to share the past eating disorder first. Once you’ve gone over your list of concerns, just get weighed so that you and your doctor can work as a team to address your concerns and come up with a good approach.

@ellioc2 I agree that you are losing weight too fast. With only 20-30 pounds to lose, there's no need to create such an aggressive deficit that is causing you to lose 2.5 pounds per week - that's for someone who has over 100 pounds to lose.

It's also fine to tell the nurse you don't want to be weighed, either at first or at all. Ask your doctor for a referral to an eating disorder specialist.

With all due respect, I don't understand the point of this advice. OP is getting weighed at home by her husband who is giving her all the information she needs to know what her current weight is (current rate of loss + time to goal weight at current rate of loss). So suggesting she refuse to get weighed at the doctor's office is like suggesting she refuse to have her blood pressure measured or her blood drawn if those procedures cause her anxiety. It just denies the doctor pertinent information that the patient in this case already has. (And it sounds like the doctor's office was doing blind weigh-ins a proper manner, not sharing her actual weight with her.)

My point was she could have her weigh-ins done by an eating disorder specialist. Failing that, by the doctor after she talks to him or her. NOT by the nurse.

She went into a tailspin after the last visit to the doctor, for which I give the doctor partial responsibility, and so suggest a specialist.

Fearing the doctor

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