I struggle with my weight. It’s been a lifelong drama, with many supporting players: relatives, doctors, well-meaning (and not-so-well-meaning) friends and boyfriends, teammates on the many sports teams I’ve played for, nutritionists, therapists, you name it. Sometimes there’s relative peace—when I’m active, social, well-rested, not too-too busy in my work life, and my relationships are on an even keel—life is calmer and I worry less about it.
Lately, as menopause has announced its presence in my life (I’m sorry, but who thought this was a good idea? evolution, you’ve got some ‘splaining to do) the struggle has resurfaced. My sleep is interrupted, and I have less energy (but more mood swings—yay) and my cravings for sugar and carbs are at an all-time high. Add to this a heavier-than-usual workload this semester and 108 inches of snow in Boston (and by the way, it’s snowing again now—argh) and it’s no surprise that my average baked good consumption is up, and I’ve gained weight.
Samantha, Tracy, Nat and the guest bloggers have written loads about the failures and perils of diets—they don’t work in the long-term and contribute to lowered self-esteem and increased weight. I know this, too—my research areas are obesity, eating, and health behavior change. And yet I keep flirting with the idea of dieting again. For me, diets are like bad ex-boyfriends—I’ve forgotten the pain and suffering they imposed, how the relationships failed or even backfired. I just remember how good-looking or charming they were, full of seductive promises that “this time, it’ll be different”.
So what am I to do about being back in a state of weight-panic THIS time? Here are three things I’ve done this week. I’ll report back later on to let you know what’s happening—what is working, what I’ve jettisoned, what other responses I’ve adopted, and how I’m feeling.
1. I bought a book.
For an academic, nothing is more reassuring than book purchases, especially when one is confused, frightened, stalled, or in need of comfort. Just the thought of reading books, especially in a comfy study or library, is reassuring.
The book I bought is Gretchen Rubin’s “Better than Before: Mastering the Habits of our Everyday Lives”. The New York Times Well Book Club is running an online discussion, which caught my eye this week. Partly out of academic curiosity, and partly out of need to do something, I got the book and checked out the online discussion.
There are loads of books with loads of theories about behavior change, and of course this blog has talked about many of them. When I actually get around to reading this book I will fill you in. For now, all I’ve done is taken the quiz to set the stage for where I fit in Rubin’s behavior-change taxonomy. From there she has lots of suggestions for tailored strategies to optimize effectiveness.
Now, I have no particular expectation that this book is better or more effective than others; I will report back on my experiences later on. But for now, just owning this book feels like it’s helping me regain a little more perspective, which is good.
2. I’ve stopped eating sugary foods (at least for now).
While talking with a therapist about my energy levels, cravings, menopausal moods and general dissatisfaction with life on planet Earth these days, she suggested that maybe stopping eating processed sugar for a while might result in improvement of my overall mood and well-being. Just to be clear, I’m not talking about stopping eating these:
but rather, stopping eating these:
For now.
I’m on day 3 of the no-baked-goods-and-other-sugary-stuff plan, and will report back on what I’ve done and learned.
3. I’ve changed primary care doctors.
This was a very big move—I’d been with the same doctor since 1998, and value familiarity, loyalty, and the deep knowledge base she has. But I never felt comfortable talking about my weight with her, and dreaded what she had to say, which never felt supportive. We squabbled about calcium and vitamin D supplements, and frequency of mammograms (she disagreed with the USPSTF recommendations which I wanted to follow). I would delay physicals in order to avoid being weighed. Again, even though I know how bad the effects of weight stigma are on women in healthcare settings, it still took me a long time to act.
The first meeting with my new provider was eye-opening: she spent an hour with me (unprecedented in my experience), and we talked about weight, activity, menopause, sex, etc. in ways that felt positive and centered on my goals and needs. I told her that I was willing to be weighed for my yearly physical and also when there was a medical need for complete accuracy (say, if this was a surgery pre-op visit). Otherwise, I said I really didn’t want to be weighed, that it was a deterrent to my seeing her She agreed, and we moved on smoothly.
Here’s how I handled the scale issue with the nurse (who I saw before the provider came in). She introduced herself and said, “I need to get your weight and height”. I responded right away with “I’m not going to get on the scale, but I’m happy to tell you my weight; I weighed myself this week.” She said okay. When we got to the scale, she said, “you’re not going to get on the scale?” I said no, but then told her my weight. Then she asked, “are you willing to have your height measured?” We both laughed, and I said yes indeed. It turns out I’m the same height as the last time I was measured.
The issue of primary care office visits and weighing of patients is controversial and far from settled. For what it’s worth, in a US National Institutes of Health document about treating obese patients, one of its recommendations is to weigh them during visits only when it’s medically appropriate. I’m not here to speak authoritatively about this issue, but I did want to include how I handled my experiences and fears of weight stigma in this environment.
I’m very lucky not to be on any prescription meds, so I don’t see healthcare providers often. But I’m hopeful about my prospects moving forward with this new practice.
I’ll report later on progress, shifts, and lessons learned. For now, thanks for reading.
