In Which Jo Gets Extremely Crabby.

I'm not a big follower of Fat Acceptance or Health At Every Size. Pretty much all I've read is Kate Harding's Shapely Prose and Melissa McEwan's blogs on the subject, although I did snag a few copies of the original "FAT! SO?" back when it was a 'zine. (Doesn't that bring back memories of the 1990's? Imagine, children: we used to have to self-publish things on paper before Blogger!)

Part of this is because I'm not "really" fat. I'm what's usually called a "tweener"--sometimes wearing a 12, sometimes a 14, sometimes a 16 if it's a top and it's fitted. People looking at me wouldn't automatically call me "obese", though that's what my BMI says I am. I feel sort of like I'd be co-opting a valuable movement if I horned in on Fat Rights without really having experienced any discrimination in, say, insurance coverage or hiring on account of my weight.

Another part of it is because the hospital where I work, which I call Sunnydale General (shout-out to Buffy!) does a lot of complex bariatric surgery. I'm talking super-bariatrics, the sort of surgeries done on people who weigh 500 pounds or more, or who weigh 300 pounds and have so many co-morbidities that nobody else will touch them. I've seen the health effects of super-obesity up close, and that makes me (probably unwarrantedly) skeptical about some branches of the FA movement. "Health At Every Size" is a fantastic idea, and it's reality for a lot of fat folks, but it's *not* reality for the people I run across.

That said, I think I might have to get more active. I had a little run-in with my doctor the other day, and am now looking for a primary-care physician.
I went in with a week-long history of right upper quadrant pain that started after I ate one of my bimonthly cheeseburgers (nom nom nom nom). I came in hypertensive, as I always am when I visit the doctor, and fifteen pounds lighter than the last time I visited him.

He did not focus on the hypertension. I got the usual quick lecture about cardiomyopathy and aneurysms before reminding him that my own trending of my blood pressure (at work, away from anything that could cause white-coat syndrome, and yes, I'm aware of how ironic that is) showed that I have perfectly fine, not-concerning blood pressure. My worry was the possibility of a gallbladder problem, and I said as much.

"Well," he returned, "You do have the five risk factors for gallbladder disease." Then, because I am a nurse and he likes to quiz nurses, he asked, "Can you name the five risk factors?"

"Fair, fertile, forty, female, and fat" I returned.

"Yes, especially fat" he replied. "You are far, far too fat."

I am five-foot-two and weigh 173.8 lbs. My body fat is somewhere between okay and too-high, though it's improved since I weighed 188 lbs. I work out three times a week with Atilla and have an active job. I eat mostly whole grains, lean proteins, vegetables (in fact, I have a mostly-vegetarian diet), and stay away from sweets. My two big vices are caffeine and beer. I can outlift, out-cross-train, and outlast nearly everybody else I know. The one thing I can't do is run long distances, though I can maintain an aerobic heartrate for two to three hours at a time without falling over.

I told him all this. I pointed out that my muscle mass is approximately half again what you'd expect for a forty-year-old woman, that my bone density is the shizznit, that all my trends are positive.

Yet he came back again to the same point: "You are far too fat. You must lose more weight."

Dude. I know I'm fat. Why do you think I joined Weight Watchers? Do you think I don't own a mirror? The *point* here is that, although I might be producing and storing more estrogen than is normal (because of that added body fat), I am a healthy individual, aside from some right-upper-quadrant pain and some white-coat hypertension.

The last medical person who expressed concern about my weight fell silent when she removed the drape from my upper body and saw my back. "Never mind," she said, "I see you carry....some muscle."

Not my doctor. He kept harping and haranguing, and I left his office feeling, quite frankly, like shit. I have a training routine that makes even personal trainers turn pale, I eat well, I've lost and kept off more weight than most people can ever manage to do, and yet I felt like shit.

The one good point of the visit was when he took a look at my upper legs as part of the full physical. I have some bruises-turned-scars there (that's the "fair" part), and he asked what they were from.

"Oh," I said, airily, "those are from when I put my neighbor's washing machine into his truck for him."

"Washing machine?" he asked.

"Yep," I replied, "he couldn't get it into the truck bed by himself, so I grabbed the strap and lifted it up there for him."

There was dead silence in the room for a moment. Then he said, "You still need to lose weight. You are far too fat."

I am looking for a new physician once this possible-gallbladder, maybe-it's-a-toomah crisis is resolved. And I might just have to go buy Health At Every Size, just so I have better comebacks for doctors like him.

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