Dear Health Care Provider,
Health At Every Size says that there is so much we can do to maximize health, and none of these have to do with a number on a scale. There’s no evidence that the majority of fat people can permanently become not-fat people, and lots of evidence that say that trying to make them be so is bad for their health. (I don’t care if you’re one of the 5% who could and did lose significant weight and keep it off for more than five years; I am one of the 95%, and I’m perfectly happy to be so, thanks.) So let’s work on the parts of health we can affect; let’s move with joy, and nourish with love, and address things like blood pressure and blood sugars and respiration as needed, rather than letting weight — so poorly correlated with health — dictate everything.
Intuitive eating, a related idea, says that when we listen to our bodies, they’re actually quite good at guiding our food choices. Intuitive eating helps us eat when we are hungry, and stop when we are full. It says to “Eat food. Stuff you like. As much as you want.” It acknowledges the first rule of nutrition (“Eat or die.”). It recognizes that there are more important things than optimal nutrition (no, really, there are), and tells us it’s ok to honor those as well.
These are not only healthy ways of thinking and living (so why would you want me to stop them?), I think they are the only ways for me to be healthy, body and soul, when it comes to food and weight. They are non-negotiable for me, and you need to accept that if we are to have a therapeutic relationship.
You say you might not be the provider for me if I’m not willing to let you do your job.
But here’s what you can do:
You can help my intuition be clearer. You can support my own trust in my body and its signals. You can ask about how well I feel I’ve been in tune with my intuition recently. You can query about whether I’ve had access to fresh, yummy foods recently, and you can offer assistance in increasing that access.
You can help me figure out whether there are any foods in particular that are adversely affecting my health; if there are, you can help me keep in touch with my intuition while replacing that food in my diet. You can help me see the abundance of what I am able to eat and enjoy and nourish myself with rather than feel deprived.
You can help me figure out ways to incorporate the movement I long for into my life. You can trust that I will do that as I am able. You can recognize that laziness is not what is keeping me away from the gym or the track — and you can ask about what is, if you are open to hearing the honest answers. You can offer to brainstorm solutions with me, or alternatives, or simply commiserate my factual, hopefully temporary, inability.
You can help monitor my vital stats: keep track of my blood pressure, and my heart rate, and my respiration, and all the gazillions of lab results you are sent when I visit the vampires. You can talk about what those say about my health, and offer suggestions to improve them, within the context of my life (see above).
You can make sure that there aren’t any obstacles in my way (other than, y’know, my life) to eating intuitively and living healthfully: you can optimize my thyroid replacement dose; you can help monitor my mood and stability; you can investigate other illnesses I might have; you can help me manage my anemia. You can help me get to a place where I have the energy and the body-trust to do my own work.
Saying that I will not “diet” and I will not seek to lose weight is not saying that I do not care about my health, and it is not saying I see you only as a med-dispensing unit. It is not saying anything except that I will not diet, and I will not seek to lose weight. You can still do so many things to earn your title as health care provider. The only thing you cannot do is harass me about my size.
I don’t see why my assertion of this boundary would possibly mean you cannot do your job — unless you see yourself exclusively as a diet pusher and weight loss promoter. No? We should be fine then.