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Reflections on 20lbs: The scale is not your enemy...but a bad doctor can be

Friday, October 04, 2013

It's seems oddly fitting that I hit the 20lbs lost mark almost exactly a year after I started on Sparkpeople. On one hand, if you'd told me a year ago that it would take this long to hit that milestone I probably would have cried...or hit something. On the other hand, it wasn't that long ago that I thought I'd never reach this point. I've still got a LONG ways to go and I'm sure there will be bumps in the road...but I can't fathom anything will be as difficult as these first 20lbs. I don't expect people to be interested in this struggle, but for my own sake, I'd like to document the challenges of getting to this point and the lessons I've learned, if only so I don't repeat past mistakes.

Today's entry...psychological lessons.

While I can now saw with certainty that I've lost 20lbs, the truth is I don't actually know how much I've lost or where I started from. This is largely due to a fear of the scale - which is part of how things spiraled out of control in the first place. Little history: my family is nutso about the scale. There's a history of poor metabolism on both sides, which has resulted in a sister, mother and grandmother who have all struggled with some form of diagnosed or diagnosed but obvious eating disorders. I struggled with this some in college, where the scale ruled my life. I lost a lot of weight, but not in the healthiest of ways. For a while after college, I was able to basically maintain and could lose weight if I set my mind to it - but I also got tired of being a slave to the scale, to tracking, to it all. None of my other friends were so obsessed. While dealing with a variety of other psycological issues, I made the decision to focus on myself and not the scale. I also got into a serious relationship, made the decision to leave my job and move to a new city - health was not a focus at all.

It's not a new story. One day, I woke up and couldn't believe the person I saw in the mirror. But I was still in denial about how bad it had gotten. For a good year, I kept thinking I could just work out and the weight would go back to normal - but I still avoided the scale. I don't think I was ready to see the number. Even once I decided to get more serious and join Sparkpeople, I estimated my weight, putting it at the highest it had been (which turned out to be at least 30lbs off!).

I told myself that I wasn't doing this for a number on the scale. I told myself I didn't want to go back to being a slave to the scale. This was for my health, about feeling better about myself. I don't think those reasons were wrong...but deep down, the big reason for avoiding the scale came down to the fact that I was not psychologically ready to see how bad it had gotten. Deep down, I blamed myself for that number and wasn't sure I could handle the "failure" of the truth.

This "no scale" policy may have worked in the past...but this time around, the weight wasn't dropping. I tracked everything, I went from no workouts to 5-6 cardio sessions a week, yet I wasn't seeing a difference. Not after one month, not after three, not after six. Although I wasn't tracking pounds, I WAS tracking inches, if only because I had to be measured for a bridesmaid dress. Three months after ordering the dress, those inches were exactly the same. To say it was frustrating would be an understatement.

I finally decided to bite the bullet with my 30th birthday looming and insurance finally kicking in (I'd worked as a freelancer during the time all the weight was put on, meaning no doctor's visits, which didn't health matters). Before I upped my fitness/diet plan (at this point I was consuming 1500 calories a day), I knew it was important to make sure there wasn't a medical reason behind the weight gain or my inability to lose. It was the first time in years that I'd stepped on a scale, but after 8 months of struggle, I was mentally prepared for the high number staring me in the face. The internist I saw was very understanding and impressed by the tracking I'd been doing, noting it was exactly what they teach people in a weight loss clinic. She agreed that there was something suspect and ran a bunch of bloodwork to rule out thyroid, metabolic or diabetes related concerns...she also mentioned a test of my adrenal gland, but the lab didn't have the capabilities for that test. A month later showed that the bloodwork was normal and I had not lost a single pound.

She referred me to a partner of hers, who was more experienced with weight loss and metabolic disorders, noting that she still thought something was wrong medically but it wasn't her area of expertise. This is where things got bad. I understand that not all doctor's have a warm bedside manner...but this guy went beyond a cold demeanor. After all of 5 minutes of reviewing my bloodwork, weight and history, he saw that I'd had psycological issues and immediately labeled me an "emotional eater" (ignoring my family history and the fact that I was tracking all my foods). He spent maybe 30 seconds going through nutrition worksheets that looked like they were from the 1970's, then handed me paperwork to fill out. Without ever asking me or discussing options, he was having me sign up for a meal replacement program...a meal replacement program that wasn't covered by insurance, cost thousands of dollars and one he happened to run. When I expressed concern about dropping my calorie intake to under 800/day, especially when my current diet wasn't working at all (suggesting something might be wrong, in which case drastic calorie cutting might not be so effective either), he brushed me off saying "I'm sure this will work." He then brought up that he was also starting a weight loss clinic and that I should join - the same clinic his partner said wasn't a good fit for me because I'd already done that work myself. By that point, I felt like a fat cow he was leading to slaughter. The rest of the visit was a blur...all I knew was that I had to get out of there and I was never going back.

It was the low point. Despite the lack of success for months, I had not given up. I had not let myself give into the frustration. The less than 30 minutes I spent with this doctor broke that dam wide open. I sobbed. I was ready to give up. If doctors saw me as a hopeless case, why even bother?

I have to think that the months I'd spent working towards a healthier self gave me the strength to pull myself out of this hole. By the end of the day, I'd spoken with my insurance company about other options and had set up an appointment with a nutritionist and an endocrinologist to have my adrenal checked. Within a week, I'd seen the nutritionist, endocrinologist and a personal trainer...all of whom were aghast at this doctor's plan.

Trusting my instincts in this matter may have been the best thing I've ever done for myself. You never want something to be wrong, but it was confirmed that I had a minor case of something called adrenal fatigue syndrome - because of my past psycological issues, my adrenal gland went out of whack trying to keep my stress levels normal, resulting in an abundance of cortisol in my system. It may not have caused the weight gain, but it certainly wasn't helping my weight loss efforts. Armed with this knowledge (and a little but of medication), I was able to tweak my diet and workout regimen and finally began seeing success.

July 15th is when I saw the doctor from hell. If I'd followed his plan, I may have dropped more than 20lbs by this point...but I'd be out thousands of dollars, wouldn't have any idea of the underlying adrenal issue and I have to believe that weight would creep right back on as soon as I started eating more than 800 calories a day. Instead, I hit the 20lb mark exactly when I should have: 10 weeks in (2lbs a week loss). More importantly, I hit it while eating and exercising in ways that I see sustainable in the long term.

I've gone on for some time now...much longer than I'd anticipated. But here's my main theory on all this rambling: If I hadn't taken 8 months to make peace with the scale, I may sought help sooner...but at the same time, I think I needed that time to work on myself, believe in myself and accept that a higher number on the scale did not make me an unworthy person. By time I was dealing with that miserable excuse of a doctor, I'd put in the work, I had confidence in myself and what I was doing and was thus able to trust my instinct that his "treatment" was NOT the right thing for me.

As for the scale, there is one that now resides in my bathroom and I am on it a lot more than I probably should be (but hey, it's entertaining to see how your weight changes during the course of the day!). But I'm happy to report that the panic is not setting in when I see a number higher than I'd like or I seem stuck on the same figure for a few days. Scale-y and I may be more frenemies than friends...but I no longer feel enslaved by her power and suspect she'll be a part of my life from here on out.
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