Let me preface this post by saying I have been through quite a few doctors in my life. Every time I switched insurance or moved or had a bad experience with my primary care doctor, I was out looking for a new one. As I progressed along this weight loss journey, I got pickier about my doctor. I wanted someone who would spend time with me, listen to me, actually look in my eyes when I am speaking, hear what I had to say and address my concerns. While I am not a doctor, I do have a science degree and don't like being talked down to. I don't like being treated like I am stupid, and I don't like a doctor brushing me off, staring at his chart or his watch, and rushing out the door. So I was absolutely thrilled when I found my current doctor about 2 years ago.
I must have weighed in the low 200's when I first went in there for a checkup. I know I weighed in the low 230's when I went to him with the Medifast materials and asked him for his opinion. He did a bunch of tests on me, told me it was a good plan but I'd need to come in for checkups every so often, and gave me the thumbs up. He was thrilled when I came back and all of my blood work had improved and I had lost weight. We sat and talked about nutrition and exercise and he gave me a referral for physical therapy for my knees. When I was 175 pounds he was so happy for me. He told me he was excited to see my success because almost everyone who came in there obese was complaining how they only eat salad and chicken and "couldn't" lose weight. He said they never wanted to take his advice, never actually stuck with any plan long enough to see results, always asked for weight loss surgery or magic diet pills and pretty much always stayed fat. He said it was refreshing to see someone actively taking charge of their health and changing their life. "That is rare," he said. He always seemed interested in what I had to say about the subject. He always looked in my eyes and listened intently. He always smiled.
I searched so long to find a doctor like this. I trust him. He has done right by me in every circumstance when I have been sick. So this week when I went in to see him, I was saddened at his change of attitude.
I went in because I had an infection. He prescribed the antibiotics. But I also wanted to ask him about my regained weight, my struggles to get it back off and lose more, and if he had any suggestions... like maybe a dietitian or more PT or maybe he would find something wrong like a thyroid problem and could fix it. It was obvious I'd regained some weight; last time I saw him I was probably 20 pounds lighter. I am the one who brought it up, after he noted my raised blood pressure (140/90).
"I have had a really hard time losing anymore weight," I said. "You know, I lost over 100 pounds and then I got stuck, and I felt like I couldn't stick to my plan very well. And I've gained some weight back and I keep going up and down and I really want to get losing weight again." We talked about Medifast and that it was a good time to stop and make some changes, but I noticed he wasn't looking at me. He was looking at his chart, seemed disinterested a bit. Suddenly as I was sitting there feeling and looking rather fat and complaining that "I am trying, but I have no energy. I am tired most of the time, and get hungry a lot, and get these cravings and want to eat..." and in a split second it was like I was hovering over myself in the room, seeing a very different scene than I had imagined.
It was a fat woman sitting in the room with her thighs spilling out of her chair, whining about not being able to lose weight, and her doctor was busily noting things in her chart, and he was disconnected, checked out, thinking, "I am so tired of these fat people who won't just DO it..."
I don't know if he was thinking that, but he was definitely different. I almost wondered if he was rolling his eyes as he turned away, because I was just like every other fat person who came in there complaining and staying fat. Well, most likely that was all in my head. But I felt it anyway.
And then, instead of a dietitian or a meal plan or a PT referral or a "how about you get off your ass and burn some calories?", I got a suggestion I didn't expect.
Adipex. Adipex? What the heck was that? I had no idea. He said that if my blood work came back okay, and there was no underlying reason for my weight issue, he would be willing to write me a prescription for Adipex. It is only for short term use, he said, and it basically is an appetite suppressant. Okay, then... I said I would think about it.
I came home and looked it up. Adipex is phentermine. You know, the phentermine that is one half of the Fen-Phen debacle of the 90's. Remember that? I do. Because I took it. Yep, I took Fen-Phen back in 1996 because I weighed a whopping 180 pounds and my doctor (different doctor) told me to take it. I lost 6 pounds on it and had some really awful side effects. Of course, it is the *combination* of phentermine and fenfluramine that causes potentially fatal side effects; the FDA says phentermine alone is "safe." Except when it isn't. Surely the side effects must be rare, I suppose, but when I saw irregular heartbeat and heart palpitations on the list, I decided to opt out. I've had issues with these before that have sent me to both the ER and a cardiologist. It turned out to be remedied by, of all things, avoiding sugar (and stress), but who knows if this drug could be a trigger? And the other, "more common" side effect? Increased blood pressure. Nice.
Now, to my doctor's credit, he did have his nurse call me after I got home to tell me that he would want me to come in regularly for walk-in blood pressure checks if I take this drug, and would not prescribe more after 30 days if it was elevated. But still. Hello? WHY?? Why.
It makes me sad. Even the good doctors are jaded. Here, take a drug, maybe this will give the fattie some hope. Maybe this will work, or at least make her stop whining about being fat. That's how I feel. I feel like doctors just sigh and look at us (us, the fat ones) and think we are kind of pathetic. Maybe they don't, I dunno, but he was so excited when I was actually losing weight and keeping it off that I now feel like a great big disappointment. Just another fat person, staying fat.
I won't be staying fat, but I won't be taking Adipex either.
Friday Update and Reality Check
7 hours ago