Physical Fit: Your Charts Do Not Define My Feelings

While the majority of my entries on this topic have been a collection of anecdotes and observations about a middle aged woman’s efforts to shed some undesired adipose tissue and maybe acquire a healthier lifestyle along the way, there is really more to all of this than exercise. And, no, I’m not talking about dietary changes either (though stay tuned, because that is coming… go ahead and groan). I’m actually talking about other parts of health and wellness that include healthcare professionals.

Yes, I’m going to talk about going to see your doctor. Before you start to close the browser window, just hear me out (or at least continue reading).

Healthcare in the USA is a bit of a trigger point for some emotionally charged political discussions. I am NOT going to be dealing with those issues here¸ other than to say the government is pushing for everyone to have some sort of healthcare coverage. Again, not going to talk about the merits of how they are doing this. The point being there are more people who are complying with the mandate to get insurance, though not enough are financially able to do so as it stands.

Most health plans (I won’t generalize to ALL) actually cover preventative care at 100% or at least at a higher percentage than “sick call”. Preventative care is your yearly check-ups, routine labwork, cholesterol and triglyceride checks, colonoscopies (at certain ages), gynecology checks, and mammograms (again at certain ages). Some even give you incentives to get these things done. Regardless, part of living a healthier life and pursuing any sort of physical fitness means being aware of these factors that impact health and taking the steps to stay healthy and catch anything that might be a sign that something is not right early enough to do something about it.

However, visiting the doctor is not without its “slings and arrows,” as I discovered when I was being appropriately health conscious and having a bit of a check in with my oncologist/hematologist (not all my medical interactions have been preventative, unfortunately). Part of these visits, aside from the vampiric portion of the program (that part where they take what seems to be all of my blood for their own purposes and then tell me that I’m anemic), is to weigh me. I will tell you, that while I am not the epitome of vanity, I dread those damned doctor scales every time.

Unlike the spring or digital version of the friendly (or not so friendly) bathroom scale, these monstrosities compound the insult with injurious placement of little weights at varying degrees to measure and using lever and fulcrum with little leaden weights to accurately determine the amount the body weighs in response to earth’s gravitational pull. Keep in mind; you are being weighed without the psychological benefit of removing shoes and clothing to ditch a few extra ounces. Yes, I know they are more accurate, but seriously? Watching the nurse wait to see if the indicator rises or falls below the midline and trying to imagine myself being light as a feather or holding my breath as if that would possibly make the numbers go in my favor… she reaches out and keeps adjusting… adding more and more weight and sliding those little bastards further towards the end to balance the leverage against my ponderous mass. It is a humiliating experience. Not merely just watching the numbers is agonizing but also because, in this particular case, the scales in question are in the high traffic area right next to the counter where the next appointments are scheduled and the “checking out” ritual occurs. So, everyone passes by and can view my shame… it is very unlikely that they give two rips about my weight, but it is just the perception, you know.

So, while I have not the svelte or willowy physique of a runway model, nor do I have claim to the hourglass figure of Marilyn Monroe, I am a solid specimen and as I have been working out there are fewer bits that jiggle than there used to be. Since embarking on my fitness journey, I have shed a few pounds, but not any drastic offloading of weight, as the scales do attest. I am, however, what is considered tall for a female. I am about six feet of human female, and I have always tended to be more on the athletic, Amazon build than otherwise. I’ll even share with you the actual number that was on the aforementioned apparatus: 194. So, like I said… solid. I will not be blowing away in a good gale nor will I have any problems remaining firmly grounded upon the earth.

Anyhow, after the weighing in process was complete, I waited in my appointed examination room for the appearance of the doctor (or more likely one of his myriad of minions). Sure enough, in walked one of my medical staff with my chart in hand. All in all, the results were in my favor. My values were the best they have been in many years. I basked in the glow of all the positive praise of my good health when I happened to glance down at the chart and my eyes riveted on one diagnosis… OBESITY.

Yep, that is what it said. I will admit that from that moment, no other words or information permeated my brain. I was stuck. I had been labeled as obese. I couldn’t tell you what more was said before I took my little paper to the desk to schedule my next follow up. I mechanically responded to questions and took my appointment card. I wandered in a trance-like state to my vehicle in the parking lot and made my way back to the office. For the rest of the day, I ruminated on this term: Obese. I immediately saw it as a criticism, and I pondered what more I could do. I had changed my lifestyle and been working out. I was tracking every morsel of food that entered my body. My medical provider had labeled me with an unhealthy, primarily self-induced condition that could have devastating impact on the rest of my physical health. I work in the healthcare field. I see this term applied all the time. I know what it means technically, but while as a clinician I know the terms and criteria of the diagnosis, I also cannot rid myself of the emotional connotations of the term in our society.

Think about it. What do we think of when we hear “obese” or “obesity”? Immediately, we have the image in our minds of the lazy, couch potato with rolls of adipose tissue bursting from the straining fabrics and elastics of their clothing while they continue to absorb billions of empty calories and high fats from junk food and sodas. Admit it. That image is there.

Clinically, what that term means is that on a chart somewhere in a text book, on a wall, in a computer program, there is a BMI that corresponds to weight and height and some assigned level of normalcy or healthy. BMI stands for Body Mass Index and involves some mathematical gymnastics using weight and height to give a number by which some medical professional can determine your health risk due to carrying unnecessary poundage… or conversely have concern that the patient may be underweight and suffering from malnutrition due to starvation. There are tons of BMI calculators online. There are also a plethora of charts that show what constitutes a healthy BMI range. Strangely, not all the charts appear to be in agreement. However, while they do not all seem to agree with where I fit in precisely, they all appear to think I weigh more than I should.

I left my oncologist’s office less focused on the positive aspects (namely my blood pressure being 98/60 and my blood values representing me as all but the perfect specimen of hematologic health) and instead, completely obsessed with the “obesity” word. In my mind this word had taken on a character and importance of a proclamation from heaven. It destroyed my whole day. It’s true. I had the pervasive emotional funk wrapped around me like the proverbial cloak, and I’m pretty certain that there was a black cloud hovering over my head that shot lightning bolts at passersby. True story. Ask my staff. Some are still recovering from their burns.

Eventually one brave soul actually asked me what was wrong, and to my extreme shame, I told him… “I am obese…”

This admission and declaration attracted the attention of another friend who stopped in his tracks and the two stood there staring at me as if I had grown a second head or possibly a second ass since my weight was the apparent issue. Their continued appraisal was beginning to make me uncomfortable when they both responded with “What?!?” I repeated the shameful statement, and to my amazement they just started laughing. I did not particularly appreciate the humor in this case, but then they started both talking at once to declare the complete inaccuracy of the diagnosis. I explained to them where I had seen it and how it had been determined. Both of these guys have some knowledge of the fitness realm, and finally they were able to tell me why what I had seen was ridiculous. It seems that these charts to which so many of our medical professions are adherent fail to take into account muscle mass and fat to muscle ratios. My friends recounted various individuals who were the epitome of fitness, weight trainers, and body builders who were by these charts considered obese because the chart compares weight to height… and nothing else.

Finally, they asked me how I felt. And I had to actually consider it. How did I feel if I ignored that word that was still indelibly burned into my temporal lobe (obese…ob-ese…o-b-e-s-e…)? I thought about it. I felt pretty good. I can run three miles without wanting to die or feeling that I am expiring. I go to the gym five or six times a week. I seem to have more energy. I’m eating better. I notice that some of my clothing fits differently than it formerly did. So… yeah, I’d have to say, I feel pretty good. Why did the numbers on a scale have that power over me?

And that… my friends, is the moral of the story. Those numbers and charts and scales are not always the best measure of overall health. Do I suggest you ignore them all together? No. But I do believe that there has been too much emphasis placed on how much a person weighs instead of body composition, muscle and bone density (especially as we get older), and the feeling of wellbeing and fitness. What matters to me is that I continue to run and do my strength training and feel healthier and keep my blood levels and vitals where they should be. Too much attention to the numbers on the scale can lead to eating disorders and vicious cycles of weight loss and gain that is unhealthier than trying to be more active and eat good things.

If you, like me, are struggling with the numbers on a weighing device, try taking a break from it. Try using other body measurements (yes, like with a tape measure). If you have access to body fat calipers, use them. Keep a log of your activities and truly assess how you feel when you are physically expending energy. Make that scale a once in a while thing instead of a daily or even weekly thing. Realize that we are all different in our composition and that the charts are designed based on the averages and sometimes are not even using the most updated best-evidence models of health. I personally still have some pounds to shed. My knees tell me this, not the scales or charts. I focus now primarily on my lifestyle not my weight. I have declared to all that the charts will not define how I feel.

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