Dear Medical Professional,
I want you to imagine, for a moment, that you are treating a new patient.
Upon meeting him, he tells you that he has been an alcoholic for over 24 years, which is more than half his life. He’s been through many levels of treatment, including partial hospitalization three times, as well as intensive outpatient and individual therapy.
He has worked relentlessly to maintain his sobriety. Then he explains that the past two years are the first time he has been in real recovery since he started abusing alcohol at age 17. And he’s coming to you for a well visit.
He procrastinated setting this appointment for months because he is self conscious about telling people about his disease. Worried about the appointment, he even practices what he’s going to say ahead of time.
Now imagine you get this patient’s blood work results back, and while almost all of his results are in the “normal” range, one level is slightly elevated. Let’s say it is something that can possibly be indicative of a heart issue.
You send him a message in his “patient portal” (a new way to “communicate” with patients). It’s an impersonal and obviously standard message that states, “Labs from your recent physical are all normal, except for a slight elevation. This can be naturally corrected by drinking one glass of red wine per day.”
Obviously this would be an absurd message to send to a recovering alcoholic.
Possibly even unethical. I like to think your jaw would drop in disbelief if I told you this actually happened. What if I told you that not only did this happen, but that it happened to me?
Well, it didn’t happen exactly this way- but it was pretty darn close. If you swap out alcoholism for “eating disorder” and glass of wine with “diet”-it is EXACTLY what just happened to me.
And I wish it stopped here with the automated impersonal message that was sent to me.
But the next morning I received a phone call from the doctor’s assistant. She explained again that one of my numbers was slightly elevated but that “it can be corrected with a low carb low sugar diet.”
After a long, uncomfortable pause I said, “I’m in recovery for anorexia. Hearing you recommend I go on a diet is very triggering.”
Her response was less than comforting. She replied with, “I’m not telling you to stop eating. Simply cut out carbs, sugars and cut calories.”
At this point I lost my composure and expressed my frustration with the conversation. She again assured me, “I’m not telling you to lose weight or go on a diet- just to go on a low carb low sugar diet.”
Is it me, or does that make ZERO sense?
When I am able to step back, I understand this professional entered her field in order to help people. I get that doctors also are invested in helping their patients reach optimal health.
But their education and training is steeped in diet culture. And lacking in education and training in mental health. And it is maddening.
But what is ALSO maddening is the fact that I provided my doctor with my background information on my 24+ year struggle with anorexia and bulimia.
It was difficult for me to be vulnerable and share this information. But I did so with the hope that the health care that I received from her would take my situation in to consideration.
When doctors shoot out recommendations that are standard and computerized wit out even bothering to consider the person’s unique situation, it can be triggering, frustrating, and even harmful.
Thankfully I have spent the past two years seriously embracing recovery. I’ve challenged myself by entering treatment, trusting my treatment team, and facing my fears and lifelong beliefs. Plus, I’ve immersed myself into Health at Every Size and intuitive eating communities.
I have educated myself on the science behind diets and understand that the ONLY thing that diets result in are rebound weight gain and eating disorders.
I find it hard to stomach the fact that my doctor is now prescribing for me the very thing that keeps me sick. Although I’m finally secure in my recovery, this encounter was triggering upsetting, and confusing.
The eating disorder thrives off of insecurities and fears. While my wise self understands that in order to be healthy I can NEVER diet again, the eating disorder now gained some ammunition from someone with the letters MD beside her name.
And that can be powerful.
Personally I am using this experience to flex my recovery muscles. To practice the coping skills and come back to all of the reasons it was necessary for me to give up dieting in order to regain my life back.
So, I am writing this letter to all of the medical professionals out there.
Because I am not just a number and I am not that unique. There are thousands (maybe millions) of warriors out there fighting on a daily basis to maintain our recovery from eating disorders. Which, by the way, are the mental health disease with the highest mortality rate.
And we need health professionals to consider the full picture before prescribing a standard and sometimes NOT APPLICABLE recommendation to a patient.
So, before you prescribe a diet to your next patient, simply consider this question: just because research supports drinking one glass wine per day for heart health, could you, in good conscious, prescribe a glass of wine per day to a recovering alcoholic?
If your answer is no, then please be cautious when prescribing diets. Because to a person in recovery from or at risk for developing an eating disorder, prescribing a diet is honestly the same thing. And has a very good chance of causing harm.