Category Archives: Weight Loss
Patient Rights Note
I lead a discussion on Twitter yesterday and learned that many people are unaware of their rights as a patient, and that some people avoid going to the doctor due to being put on a scale.
You have the right to refuse to be weighed at your doctor’s office.
You can also ask to be weighed without looking at the scale and ask not to know your weight.
Personally, because I am usually wearing heavier clothes, and I am required (for medical reasons) to weigh myself daily, I tell the medical assistant my weight. If they argue, I tell them they are making me uncomfortable, and they stop.
Generally, I am coming to see my doctor about an acute illness, not my weight. My doctor does not need to know my weight to order a blood test or many medications.
Times when your doctor may insist on a weight and you should probably comply:
- If you are at a hospital, about to have surgery or need antibiotics – proper weight = proper dose
- If you are at a hospital and are not eating or are on medications, they may want to weigh you daily to check effectiveness.
- If you are coming in to specifically talk about weight loss or gain.
- If you are coming in for a physical (although still, you can refuse, but I would suggest weighing yourself at home).
- If you have had weight loss surgery, you can expect to be weighed at each appointment before and after.
Your doctor can refuse treatment if you refuse to be weighed. You can fire your doctor. You can call your insurance, report your complaint and find a different doctor. You have rights, and I want you to know what they are.
Nurses: Remember it is our job to advocate for our patients. If a patient is not coming in for a weight related problem, we may not need to know their weight. Ask yourself if insisting on a weight is going to cause the patient stress.
Food Anxiety Chat
Today at 5 PM EST on Twitter, I will be hosting a chat on food anxiety and the different forms it takes. Please join! If you want to send questions anonymously, please email me questions to GrimalkinRN@gmail.com
We will be discussing what forms food anxiety takes, how it develops, how we cope, and what happens when we can’t cope.
Please share this post if you have a moment!
I’ve been on steroids and sick since the beginning of February and it’s added 10 pounds to me. I am at my highest weight ever.
250 pounds. I’m going to have to buy some new, bigger clothes at this rate. I already bought scrub pants, but my bras are tight and everything is tight. I tell myself I can lose weight, but I really don’t think I can do it fast enough. I have an interview today and I’m just praying my jeans won’t be too small. I’ve been living in yoga pants since I got over 230.
I feel so ashamed of myself. I tell myself I couldn’t help getting bronchitis. I can’t help that I got pleurisy and I have tried to exercise but it’s also difficult to go out when I have asthma and it’s cold. I tell myself steroids make you gain weight, and I needed the steroids to breathe. This is all true.
But there’s another problem.
I have an eating disorder. I binge eat. I particularly binge eat when I lose any weight at all. Seeing the scale drop makes me want to eat. Seeing my clothes get looser makes me want to eat. I see a doctor about this but haven’t had much success with the anxiety that comes with weight loss.
I grew up very poor, and we didn’t always have food. My mother always praised us when we gained weight. She was probably relieved that we weren’t starving. We didn’t always have food when we were growing up. This lasted from the time we moved to Nashville, Tennessee, until the time she met my first step-father, Merritt, when I was about 7 or 8. After we met him, we were abused, we were hit and emotionally tormented, but we were fed.
We also had plenty of food in the Summer when I visited my grandparents. There were snacks and my grandparents always made sure we had plenty of them. I wasn’t hungry for most of my childhood, just a small part, but it has stuck with me.
I remember once, I was hungry and there wasn’t much food in the house. My mom was at work. I found a can of tuna and ate it. When she got home, she was furious. She said “that could have fed us for a week!”
Of course it couldn’t, but I remember that. I remember her yelling at me whenever I ate something that wasn’t specifically for mealtime. Snacks weren’t really something we had around the house, even after we were better off financially, and oh my God, I felt hungry all the time.
I won a scholarship to Germany my senior year of high school and it was the first time I really was offered enough to eat for a long period of time. I didn’t react appropriately. I started buying food at the local market and hiding it in my room. My host mother really didn’t understand and I know her feelings were hurt. But the sight of the food in my bedroom cupboard was comforting. I didn’t know it, but I had started to hoard food. I didn’t know it was a psychological condition at the time.
Then I got home. Shortly after arriving back in the States, my mother and step-father kicked me out. Then I really didn’t have enough food. I literally would count change to buy a can of soup or ravioli. When I got paid, I would go to the store and buy as much food as I could. I would buy so much food that I could barely make rent. The food hoarding got out of control. I put food on credit cards. I would buy and buy and buy food and not eat it. I’d stock my pantry and fridge and then go get fast food. None of it made sense.
When I moved to Colorado, I tried to change. Several times, I took my load of food to a food bank, only to buy another hoard with my next paycheck, putting myself at risk of homelessness again. I didn’t have a great job, but I had a job that paid enough for an apartment, bills, and a reasonable amount of food. But I had to have more. I had to have cans and cans and cans of food. To preserve the hoard, I’d still go to restaurants and get fast food, so I wouldn’t have to touch my hoard.
Eventually, I got into therapy, but I never really talked about food hoarding. As my anxiety lessened, I was able to give away food a little bit at a time and now while I do have more food on hand than my husband and I need, I don’t have so much food that I regularly throw it out. I have started making recipes out of the things I keep in the fridge. I keep food in the freezer, but I eat it. And when I went gluten free, I went through my cabinet and donated things I could no longer eat.
But what I can’t seem to do is stop eating. Whenever I lose any weight, I feel a compulsion to eat. I have to eat. I can’t not eat. I eat until my stomach hurts, and then as soon as the pain lets up, I eat some more.
I gave up soda, I gained weight because I replaced the soda with other food. I gave up gluten, I gained weight because I found lots of substitutes. Last year, I tried to become a vegetarian and gained weight so fast it was alarming.
My doctor doesn’t really get it. I used to take Wellbutrin and that was very helpful for appetite control. Then I started having hand tremors from Wellbutrin and I’m on a different medication for depression that is really not helping my anxiety. I honestly don’t know what to do. When I think about looking for a support group, I feel so embarrassed. When I think about dieting, I want to eat. When I think about exercising, I want to eat.
I really can’t throw all of this blame on my mother. She was a single mom, and we were incredibly poor. My father didn’t pay child support until she managed to have it removed from his paycheck. But things happened when I was a child, and these things make me prone to hoarding food. I’ve managed to stop hoarding food in cabinets, but instead, I now hoard weight on my body.
If I can’t stop doing this, I’m going to get diabetes. I’m going to get joint issues, I’m going to get high blood pressure. I already have slightly elevated blood pressure. My asthma is getting worse. My clothes don’t fit. They are painful, and I really can’t afford to buy new ones right now.
This isn’t about accepting my body as fat and loving it. I don’t feel good at this weight. I feel awful.
I’m not asking people for solutions, I’m just getting this out, writing it down. I’m going to try to find help for my specific problem.
I don’t blame my mother for being hungry but I do blame my childhood for these habits I have now. I hope that by writing it down, admitting to the world I have a problem, I will be able to start changing my habits and my body.
I want to emphasize here: I do not want dieting advice. I do not want to hear about Paleo or veganism or anything like that. I have learned that restricting my diet triggers me to binge eat. I am going to work at exercising more and learning not to go eat when the scale goes down. That’s going to be my first step.
Thanks for listening.
A Fitness and Diet Post
Over the last year, I’ve gained about 50 pounds due to developing painful tumors between my toes and steroid treatment for them. Prior to that, I’d lost 30 pounds with diet and exercise, but the tumors were so painful, all I could really manage was work.
My husband has also been gaining weight. I’m putting down our weight loss and exercise plan here because I want to keep it simple and document what we are doing.
1) Exercise 3-4 times a week, at least twice in the gym with weights.
2) Smaller portion sizes with more vegetables. Vegetarian/vegan meals 3-4 nights a week.
3) Better snacking. Rice cakes and almond butter. Veggies and Hummus. Veggies and salsa
4) Less alcohol. If we want more than one beer or glass of wine an evening, we have to walk to a bar.
5) If we want a splurge meal, we go to the gym, walk or bike to it.
6) Take a 30 minutes walk after dinner every night.
Most of my plan is activity oriented. I’m getting really good at planning meals as well. I wanted to put this down because I don’t believe in diet fads, but I know where John and I could be doing better to lose weight.
Along with this, I am working to be more accepting of my body. I’m never going to be a size 8 again, but I can get stronger and more comfortable in my skin. I am still in much better shape than when I started exercising 2 years ago. That’s really important. I also need to be accepting that I have Meniere’s Disease, which causes me vertigo, so I cannot always exercise, and I should not make myself feel guilty about it. This diet and fitness plan is not just about changing my body, but about accepting my body.
Sauteed Salad with Honey Ginger Balsamic Vinagrette with Gluten Free Garlic Bread (Vegetarian)
Without the garlic bread (for which I used Against the Grain’s Gluten Free French Loaf and butter), this meal is vegan. I’m cutting out dairy but didn’t want to throw away half a loaf of awesome bread.
So vegetarian and gluten free. Vegan if you have vegan bread. You can use olive oil, garlic and basil to make a nice topping for garlic bread. Broil on high for about 3-5 minutes, watching closely for your kitchen to catch on fire. Such is the life of someone who doesn’t broil very often. BUT I DID NOT BURN MY BREAD TODAY.
Sauteed Salad with Honey Ginger Balsamic Vinagrette (Vegan)
You will need:
Salad (I used a mesclun salad, but any base will do)
Cold veggies – any you like, I used carrots, celery, radishes, cherry tomatoes, cumber and an avocado
Veggies for sauteeing: I used snap peas, baby bella mushrooms, a yellow bell pepper, and an orange bell pepper. This would also be great with asparagus.
Extra firm Tofu
3 cloves Crushed Garlic
Salt and Pepper to taste
Optional: Daiya “cheese”
In a tofu press, press the tofu until as much water as possible has been drained. Then pour in a small bit of olive oil and 2-3 tablespoons of balsamic vinaigrette. Marinate for at least an hour.
Wash your salad and vegetables thoroughly. Chop veggies, setting cold veggies in one bowl and hot veggies in another bowl. Set out plates with your base salad and the cold veggies so you have them ready for later.
Chop about 1 tablespoon of ginger root into very small pieces (or grind).
Crush or grind at least 3 cloves garlic.
In a large skillet, heat olive oil, several tablespoons of balsamic vinaigrette, and 2-3 tablespoons of honey. When water begins to evaporate from vinegar, add garlic and ginger root. Cook until fragrant. Add hot vegetables.
While the ginger and garlic are cooking, take out tofu and cut into small squares. Toss squares with remaining marinade. Add to oil/vinaigrette mixture. Cook for 1-2 minutes, until squares are thoroughly saturated. Add veggies to be sauteed. Saute veggies until tender and fragrant.
Add hot veggie/tofu mixture to salad, making sure to pour any extra oil/vinaigrette mixture onto salads. Salt and pepper to taste.
The daiya cheese tasted good, but honestly the salad didn’t need it. I won’t add it when I make it again, but I will add asparagus.
This salad was unexpectedly satisfying and flavorful. The honey and balsamic vinegar compliment one another nicely, and the olive oil & avocado are healthy fats. This meal is high in fiber and nutrients. It is NOT a cheap salad to make unfortunately, but it is delicious. I will be making this salad for a future episode of #cookingwithjoanne on Twitter.
Gaining and Losing
Last year I lost 30 pounds.
For a year, I worked out on a regular basis, saw a personal trainer, but the real way I lost weight was by decreasing eating to once a day, with maybe a snack or two unless I was at work.
Since then I’ve gained 40 back.
First, I got diagnosed with Morton’s Neuromas. They are fibrotic growths in between your toes. I have them on both feet. They cause searing nerve pain through your feet. Because I’ve been warned to avoid surgery at all costs due to benign hypermobility syndrome, so I ended up getting 3 rounds of injections into each foot, between my third and fourth toes.
Drug users don’t even go in between the toes, you guys.
So I had to stop working out. The pain was too much. I got depressed again, I started eating too much again.
Then I agreed to have some corns removed from my left foot. This was before my primary care diagnosed the hypermobility syndrome. The corns took 3 months to heal. Working was excruciating and I still get nerve pain where they were removed. Never again.
A few weeks ago I started trying to walk more to drop weight and hopefully not starve myself. I had to walk 15,000 steps a day, work out for an hour every other day, but I finally started to lose weight.
Then my foot gave out. I’ve been getting steroid shots into the arch of my foot and once again I’m under instructions to walk as little as possible.
I hear people talking about fat acceptance and learning to love your body, but I truly hate my body. I’m already covered in scars, and while I got thinner for a little while, now I’m fat again, too. I like my body better when it’s thinner. I feel like I’m never going to be able to lose weight. My metabolism is so slow. I literally have to barely eat and workout daily as well as take an hour or two hour walk daily on the days I don’t work to lose weight.
To add to it, I have anxiety related to dieting. Even though I’m more comfortable in my body when it’s thin, when I start losing weight, I start to have huge amounts of anxiety and I want to eat. I mean, I want to eat until I feel like I’m going to explode. It’s not that I don’t have the ability stop feeling hungry, I just feel the need to constantly be eating. I wish it made sense.
This fight with weight and depression. I see a shrink. I take my meds. They help more than they hurt.
I don’t have to go to school full time, I have 3 part time semesters left. Hopefully not having as much school work will mean I can dig out of this awful place I am, get some weight off, and get it to stay off. I think it could, if I didn’t feel so anxious when I feel the slightest bit hungry.
I really, truly, wish I understood my brain. I know that part of my food anxiety probably comes from not always having enough to eat when I was young, and when I was out on my own. Knowing why something exists doesn’t really make it go away.