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Re: Should I be concerned? regarding my weight? Kath

Posted by CareBear04 on April 11, 2008, at 23:27:14

In reply to Should I be concerned? regarding my weight?, posted by Kath on April 6, 2008, at 18:49:28

hi kath,

definitely relate to your problems. i'm about your height and very underweight. i don't think i'm fat, but i don't think i accurately see how small i really am. a few weeks ago, i was with my mom at a cocktail party-type event people watching, and somehow we ended up pointing out the girls who we thought had the same figure as me. i picked out someone who was thin but not in an unhealthy way. my mom, on the other hand, picked out this stick-thin, frail, pre-adolescent girl with that look common at that age-- like they've grown way too fast and their weight hasn't caught up.

my pdoc, too, seems to suspect an ED, but for whatever reason, it's never really been a focus of any session. sometimes when he's seen me he's commented that i don't look like i'm eating very well, but he's never engaged me directly on the subject of my eating. a couple of weeks ago, we were rescheduling an appointment and it came up that i had an appt that afternoon with my pcp. he asked me what about, and i told him the truth-- that it was a 1-month follow-up weight check. my pcp, too, hasn't said to me, anyway, any concerns about an ED. he's only asked me to drink ensure plus between meals and other practical suggestions. in the fall, my labs showed very low iron, low B12, and low vit. D. i'm not really sure why the levels are low-- i eat meat, don't have any blood loss, and got plenty of sun during the summer.

anyway, my pdoc didn't dwell on the subject at that time, but at my next appointment, we did talk about it. he seemed a little upset that i hadn't told him that i was being monitored by my pcp, and i guess i downplayed its importance in response. that seemed to strike him as a reckless attitude towards my weight, which caused him to want to make me concerned. he asked me how many menstrual periods i've missed, and i replied that i'm on continuous ocp and don't have periods. he mentioned the nutritional deficiencies as evidence of malnutrition. at one point, he pulled out his pocket DSM and flipped to the anorexia criteria to resolve a disagreement we had about whether a subjective intent is necessary. he conceded that i wasn't refusing to maintain a minimally healthy weight at a concscious level but left open the question of whether there are subconscious factors at work.

anyway, that discussion surprised me for several reasons. first, his question about my periods indicated that he views me as really unhealthily skinny-- i think of amennorhea as a really serious complication, and i don't think i'm so underweight that i would be missing periods if i weren't on birth control. second, if he thinks i should be more concerned, why hasn't he addressed the issue before or, for that mater, since?

as far as whether you should be concerned-- i don't think there's an easy answer. i think the fact that you're asking, though, shows that you are concerned (or at least think you should be), which is an important insight. i wonder if my utter indifference as to my weight is a sign of intentionality?

did you say that you were going to bring it up with your dr? let me know how it goes!

cb


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