Sunday, November 2, 2014

Fat Doctors, Fat Counselors


Recently, the topic of whether a fat counselor or doctor is "valid" has been brought up in the comments of my last two posts, when I mentioned that my new "eating disorder" counselor is obese. Yes, it surprised me when I first met her and noticed her size. Why? What was I expecting? What would be "preferred"?

A thin woman who has never had an eating disorder and has never struggled with food issues?
A fat woman who eats what she wants and is happy with her weight?
An obese woman who has already lost 100 pounds, and has 100 left to go?
A thin woman who has suffered from anorexia and recovered?
A fat woman who is working through her own binge eating issues?

Would you rather have an ED counselor who has never had an eating disorder? Or one who has? And if you'd rather have one who *has* struggled, would you prefer for her to be still struggling with her ED or would you want someone who has been able to "overcome" it and has reached an outcome that you, yourself want to reach? Do you want someone who is modeling what you want to achieve?

I think when we talk to people, there are those we relate to on certain topics and some we don't. Sure, I have friends of all sizes, and each friendship is based on something we have in common: a shared interest, children who are the same age, kids in the same sport, working in the same field... something. But with a counselor, you're not looking for a friendship. You don't *need* a common bond to get something from the counseling. But for me, I *do* need to feel like my counselor can relate to my own struggles.

About 17 years ago, I started seeing a counselor because I was newly divorced and felt overwhelmed with all the changes. Parenting alone was a challenge, and so was providing for all of my family's physical and emotional needs. I felt such a weight on my shoulders as the sole provider for four young kids. The counselor I was assigned to within the clinic I chose was a women about 15 years older than I was. Great! Someone with a little more life experience who could guide me and help me through this. But during our first meeting, it was obvious she did not relate, at all, to the things I was sharing with her. She had no children, and had never been married. She worked and provided for herself alone. Yes, I'm sure there are single, childless people out there who can relate because they have, in some capacity, loved and provided for others (and I have child-free friends who are a great support to me). But this counselor seemed so detached from what I was saying. I needed someone who could understand the heartaches, difficulties, joys, and challenges of parenting young children... and she just could not. After two appointments I asked for a different counselor and that one, who had grown children, was much a much better match for me. I related to her because she truly understood.. from experience... my struggles. She'd been through it. Her feedback was insightful and meaningful to me. She had lived through raising kids and had seen the end result, and had great advice for me.

I have a doctor... a specialist I see. He is obese... probably morbidly obese. But he is one of the most intelligent, insightful, compassionate doctors I have ever had. Did I wonder about his weight when I first met him? Yes, yes I did. Because I kind of expected a health professional to be, you know, healthy. He's not an athlete or anything, just a very busy doctor who carries a lot of extra weight. I am pretty sure carrying an extra 100+ pounds on your frame is not healthy. Would you respect and trust a doctor who is morbidly obese? Honestly, would you? They have the same medical training as a thinner, fit doctor. Does the obesity mean anything about their ability to treat you? For me, I still trust him. I still go to him and follow his advice. But I do not ask him for advice on weight loss. I just don't. Maybe because I figure if he had great weight loss advice, he wouldn't be fat. I could be wrong about that. But since I've known him for so many years I know he is not losing weight, he hasn't just lost 100 pounds. But he is an excellent doctor who I respect, and I trust him with my life.

I guess it matters to me what a person's specialty is, too. I've gone to fat counselors before and never thought about their weight at all. But when someone is an eating disorder specialist and is obese, it does bring up questions. A fat dentist wouldn't bring a second thought; a fat personal trainer? I'd want to know more. I'd be interested in whether they are working on getting healthier and have made progress with that or not. Really, if you were going to a gym and saw a personal trainer there and for YEARS this trainer remained obese, would you seek them out for fitness advice? Would you PAY them for that advice? Would you? If you signed up for a Weight Loss Clinic that advertised as being taught by a weight loss specialist who will teach you how to get control of your eating and lose weight, and when you showed up, the doctor running the Clinic was severely obese and didn't mention anything about his weight, would you still want to attend? How about if you were paying $400 to attend this Clinic? Would it matter then?

Would you go to:

A dentist with bad teeth?
A marriage counselor whose relationships have never worked?
A beautician whose hair is unflattering and who isn't wearing any makeup?
A nutritionist that was either quite obese or skeletally thin?
A dog trainer whose dog steals food off the counters and jumps on your child, knocking them over?
A fashion designer wearing frumpy clothes to meetings?
A ballet teacher who doesn't dance?

These are some examples that were brought up in the comments of the last two posts. Don't you think an "expert" whose job it is to deal with a specific issue or field, should have experience AND knowledge in that field? Shouldn't they, as one commenter put it, "walk the walk"?

When my mother went to AA, all of the leaders were recovering alcoholics.
When a college friend went to drug rehab, the drug counselors were recovered addicts.
A friend went to counseling for panic disorder and her counselor told her he is on medication for anxiety.
Aren't Weight Watchers leaders always people who have lost weight through Weight Watchers?

Maybe it is best to have ED counselors who have some firsthand knowledge of eating disorders. Does it matter whether or not they have succeeded at stabilizing their weight in the range of a healthy BMI?

There are good... excellent counselors who deal with things like domestic violence and child abuse without ever having lived through those ordeals. They are driven by compassion for their fellow human beings. They see suffering and want to help. I have known counselors and social workers who have never personally dealt with family violence, but are wonderful in their jobs working with families and children of abuse. Sometimes, perhaps, training and education and compassion might be enough.

A school teacher doesn't have to have her own children to connect with her students and teach them well.
A foster mom doesn't have to have kids of her own to parent and care for her fosters effectively.
But a grief and loss counselor who has never lost a loved one may not be as relatable and effective as one who has.

Sometimes weight has nothing to do with a person's ability to perform a certain function. One can weigh 500 pounds and still be an excellent friend, parent, accountant, computer programmer, artist, author, or chef... but you might think twice before hiring them to lead you on a trek down the Grand Canyon. I haven't seen many morbidly obese firefighters or paramedics, either. Have you ever seen a 400-pound flight attendant on an airplane? It's not discrimination; it's that some jobs require a certain level of fitness or a certain measure of smallness to be able to do them effectively.

I am not questioning the validity, goodness, or morality of any of these people. I think that we, as consumers, do have a right to question the expertise of someone we are paying for treatment. That includes their education, training, and background in the field in which they work. Does it include an explanation of their personal life? Of their mental health, marital issues, parenting experience, or weight? I don't think we are *entitled* to know personal details about those we hire, but we do have to make a choice about whether we believe someone can effectively provide the services we are seeking. For you, that may mean paying for three personal training sessions with an obese trainer and then deciding whether or not they meet your needs. Or it may mean you judge the book by its cover because you don't want to take a chance on throwing your money down the drain on a possibly ineffective trainer... and going with someone who looks fit and healthy instead. But you could be very wrong about the first trainer. For example, an aerobics teacher can be heavier than average *and* fit, and very able to lead you through a great workout. Deciding who to see, and what you want or need, is as personal as deciding what type of pet you own or how many children to have. There is no right answer to that. I like dogs, you prefer cats. I have five children, maybe you want one or ten. I have an ED counselor who is fat; maybe you wouldn't. And I believe that because we are each paying for those services, we have the absolute right to choose based on whatever criteria we feel comfortable with. You'd be missing out on a great doctor if you decided not to see my morbidly obese specialist based on his weight. But you are not obligated to ignore something like weight, which may be significant, when you are PAYING someone for a specific purpose. Judging a person's character or morality or whether they'd be a good friend for you based on their weight is discriminatory and wrong. But making a judgement about where you want to spend your money is different.

I'm sticking with this counselor, for now. I'm not sure if she has the skills to help me with my eating issues or not, but the only way I can find out is to give her a chance.


22 comments:

Deb Willbefree said...

Extraordinarily well said, Lyn. Thank you for this post.

I have been baffled by some of the comments that were so indignant over the concerns and questions raised re: an overweight eating disorders counselor. You laid out the reason for that discussion well.

As far as whether one wants a counselor who has or has not battled a particular issue, it's a mixed bag. Some clients want a counselor Who's been there, others want someone who's never fought addiction. Pros and cons both ways & it is absolutely the client's call. No wrong choice either way.

An interesting note about that issue as related to the past few posts--Whether or not a counselor is more effective if they've experienced addiction is an issue of continual debate in D&A agencies. As far as I know, that issue has never...never...been settled one way or the other--except for one unanimously agreed upon factor--> If previously addicted, the counselor must be clean and stable in recovery to counsel. Period.

But that's drug and alcohol. ED could be different, I suppose.

Again, thanks for this clear-eyed post. :)

Deb

LovelyDreams said...

My therapist has a history of bulimia. (Which she told me about when I began discussing my own disordered eating.) I like that about her. I assume it means she can relate to me AND that she's done her own therapy surrounding it AND probably pays special attention to food and body image issues, articles, books, new ideas, etc.

I would not trust her less if I discovered she binged and purged last night. I don't think not being able to perfectly act on all the knowledge you have makes you unworthy of sharing that knowledge.

Anonymous said...

Interesting indeed. Sounds like you're already thinking of a reason not to listen to her advice. Why not try out some of the suggested she's given you and meet with her for a few weeks to see if it's a fit or not? What does I really still don't get what her weight has to do with it. Anybody could tell you advice. There are 1 million books out there with advice. There's always a reason why they won't work. It would be very sad for youto miss out on her advice and help should you decide to discount her based on her weight.

FogDog said...

I don't think there's a correlation between how effective someone is at their profession and whether or not they actually "lived it". some people are much better at helping others than they are at helping themselves. There are numerous examples of pro sports coaches who were terrible players but great developers of talent. The same can be said in business, I know some great leaders who can organize their team but not themselves. "been there" is not a prerequisite to being good.

mog said...

This has come up for me in the past and my answer remains the same.

I am MUCH more interested in the results they get in OTHERS than in themselves, because they are not charging for their ability to role model, but their ability to create change in the client.

People have differing priorities and in any professional that I am going to pay to provide me with advice, I don't care if their personal priorities lead them to look like they walk the walk that MY priorities and MY filters think should go with a certain appearance.

I DO care about whether they are GOOD at helping their clients achieve the results they are coming for.

Obviously this is not always easy to find out, and maybe seeing if they 'look the part' is what you use to judge in the absence of anything better, but I will always prefer to find someone who GETS THE RESULT I am paying for, rather than just looking the part.

timothy said...

I AGREE YOU SHOULD SEE THIS THROUGH IF THAT'S WHAT WORKS FOR YOU! I KNOW I'M OPINIONATED AND I'M ONE WHO SAID A FEW OF THE EXAMPLES, FOR ME IT'S NOT THAT THEY DONT HAVE THE KNOWLEDGE AND COMPASSION IT'S SIMPLY THAT UNLESS THEY'VE BEEN THERE AND SUCCEDDED THEN IT'S ALL THORETICAL, WHICH CAN ABSOLUTELY WORK AND DOES FOR MANY I'M JUST AN OLD HANDS ON DINOSAUR! LOLOL

kim ellis said...

i did a program called metabolix....like u i was struggling with weight...i worked out to death and thought if i stuck to unprocessed foods and cut out sugar i could get under 190....well nothing worked...so there i was at 211 when i did meta bolix....

i ate the same foods but....

1.sea salt and dried herbs were my seasonsings....when you switch to seasalt your blood pressure issues go away

2. the type of carbs i ate and when i ate them had to change...my muscle mass was too low to support high dense carbs....so only oats or whole wheat crackers (5 crackers max) with my eggwhites for breakfast. ate alot of apples and oranges and grapefruit and strawberries during the day, but those other fruits i could only have occasionally.. no more rice, potato,or those high dense crabs until i could get my muscle mass up

3. because i can’t calorie restrict forever or i would hit starvation mode, i had to do those muscle building exercises....soooo every other day i did some weight training...and the secret to building muscle was that i had to eat some protein 5 minutes after my session...so i would make my meal, work out and then eat

4. a typical day of eating for me goes like this ( when i work out)

bfast 7:30= 3 eggwhites and some low sugar fruit flavored quacker oats and 1 cup green tea ( stevia sweetened)

Lunch 11 = spinach and two tilapia ( seasoned with sea salt and dried italian herbs)

snack 2:30 = apple + 100 calories of any nut i like

weight train for 30 mins
Dinner 6 = lettuce+ tomato and chicken

snack 9pm = another apple

the issue is your muscle mass....your metab will stay low if you don’t build muscle and your body will go into starvation mode if you calorie restrict for too long. You don’t have to kill yourself with weights either. Once you feel the burn you are tearing that muscle and once you get in that protein soon after that will help build up the muscle. Cardio is okay but the muscle is more important....i hope my story provides some insight.

kim ellis said...

oh i am 185.8lbs this moring....i will post again what i weight next week.

Ellen said...

Another thoughtful well reasoned blog post. What you say is just common sense. I think it's reasonable to seek out professionals who inspire us, those who have coped and successfully overcome many of our own problems and challenges. It doesn't mean they have to be perfect.

Winner at a Losing Game said...

Well thought out and very non judgmental post. I don't know the answer to the question of "does someone need to look the part" but I do know that what I see in front of me really affects my ability to determine how open I am to their skill set when considering an eating disorder (at least without explanation).

Anonymous said...

I agree that I would hesitate to consult an obese DIET consultant. Chloe, however, is an ED consultant. You seek help from an ED counselor for help with an eating disorder, not to lose weight. Why are some people assuming that Chloe is obese due to an eating disorder? And that she needs to address whether she has 'fixed' herself? Are we really saying that anyone who is obese automatically has a form of mental illness? Maybe she simply enjoys food, overeats, and is okay with that. Perhaps she is a HAES advocate. Perhaps she is a recovering bulimic. Who knows? But it is grossly irresponsible to speculate on someone's mental health based on a description in a blog - and then extrapolate that speculation to question the person's professional competency and efficacy.
CB.

Lyn said...

Anonymous (CB)~

yes, exactly... I think that is what everyone is saying, including myself. Not assuming she HAS an ED, but acknowledging that we don't *know* why she is fat or how effective she may or may not be at this counseling.

Anonymous said...

You really seem to be getting off on describing someone else as "fat." How fat is Chloe, in your best carnival-worker estimate? 200 pounds? 250? 300? Top heavy or bottom heavy? If it's really this important to you to have written two LONG, BORING posts about it, why don't you ask her? Seriously? Just be all, "Hey, I gotta ask you: you don't look like someone who's in control of her own eating and that is making me question how you can help me get in control of my own. What's up with your weight?" It's her choice to be honest or to tell you that she doesn't discuss her personal life with clients, in which case you have your answer. Go for it. Dare you!

Josie said...

I have zero interest in Chloe's weight, but I do have interest in yours. What's your plan?

Anonymous said...

Not a lot of time to respond, but several times in your post your equate slimness with health.This is far from the truth.

When I have more time, I'll try to go into more detail.

Anonymous said...

Do you even realize how insulting you are to continually call her fat?

Lyn said...

Anonymous~

not "getting off", just describing with the same words I use to describe myself.

Josie~

my plan is to stay gluten free and focus on health through AIP and exercise.

next Anonymous~

I welcome your thoughts. I agree thin does not equal healthy, but I also have a hard time thinking 100+ pounds of extra fat can be healthy.

last Anonymous~

no. Do you prefer "fluffy"?

Anonymous said...

Use whatever words you want to describe your size/weight and your counselor's;doesn't matter to me. You're just HARPING on it, though; like you feel so validated that the counselor isn't physically perfect so you have permission to doubt her. It's gnawing at you that she is visibly overweight (again, HOW overweight is she? Were you expecting a fitness model and you got a more "average American" 170 pounder, or is she someone who has to put the seat in her car all the way back to fit behind the wheel?) -- you are salivating with curiosity. Again, I say out with it: Chloe, you don't look like a person who is in control of your eating habits. Do you practice what you preach?

Lyn said...

Anonymous~

She's about as fat as I am, maybe 20 pounds heavier.

It's just a blog post topic... not my every waking thought. She is still my counselor unless it becomes obvious that her counseling is not helping me anymore.

I'll be posting about my visits with her again, so if that will upset you, you may want to protect yourself and avoid reading. Fair warning!

Josie said...

Hi! Thanks for answering! I started reading your blog a few months ago and as of this morning, I've lost 30 lbs. I am ecstatic. Though I have no sugar/diabetes issues I've been eating a low sugar diet, watching and monitoring it carefully. After two weeks I felt so much better. I did this because of reading your blog, so thank you.

Low carb/low sugar is like the polar opposite of my appetite so I have been using your recipes. :) Loved the crock pot chicken and the ground beef/cabbage/veggie soup.

Let's freaking do this LYN!!! In September I lost 13 lbs. In October I lost 15 lbs. Thus far in November, 2 lbs. I am doing a challenge on My Fitness Pal to lose 10 lbs in November and I challenge you to do the same.

Let's. Do. This. You *CAN* do it obviously, as you've done it before.

Come with me on my November challege! It's only 4 weeks and baby, it ain't even about the weight. It's your mind set. You'll be happier if you do.

Lyn said...

Josie~

your attitude is empowering! It sounds like you are feeling wonderful and doing great... and I want to get my energy/positivity back too. I agree, low sugar is definitely a better feeling. I'll work hard to clean up my diet in November, too. I tend to struggle the most with the sugar but I know I will feel so much better. Thanks!

Anonymous said...

My problem with this is that not everyone in the world cares if they are "fat." Not everyone thinks that being fat is unhealthy. Just because you do, you are projecting it to your counselor. Most really good Ed therapists know the success of dieting, know that people can be fat and healthy and know that some people are meant to be fat. They also know that most times it is outside factors that result in weight gain, not food. Because you don't want to be fat, you think your Ed therapist can't or shouldn't be fat. I Feel like you are justifying this by saying you have a morbidly obese doctor and you trust him, but you wouldn't ask him for weight loss advice. Well, really, no doctor should give weight loss advice, because the success rate is bad for long term weight loss. Anyway, and Ed therapist isn't about helping you lose weight. So, she shouldn't be judged on her weight at all, and her weight shouldn't even be an issue.