People’s bodies are sacred. This is coming from someone who is not religious and is, perhaps, not even spiritual. People’s bodies are sacred, and, excepting the most severe cases of mental illness — like self-harm, eating disorders, or suicidality — commenting on someone’s relationship with their body isn’t helpful. Even in cases of severe mental illness, we must respect a person’s body and the reasons that they are doing what they do, even when seeking professional interventions.
Along similar lines: I started a new exercise plan a couple of months ago. It’s fairly unambitious (to start with), but I hope to one day be able to run a mile in 7:33 like I used to before I got sick.
Why is that a problem? It’s not. However, another goal of this exercise plan is to lose some of the weight that I gained as a result of being sick. In fact, I have already lost 20 pounds.
To many, there is something un-feminist about trying to lose weight; at the very least, a women trying to lose weight is a victim in a system that has told her she is not valuable. The responses I get when people hear I hope to lose weight are varied, but they almost always fall under two categories: but you look so much healthier now that you’ve gained weight! and you’re beautiful just the way you are.
It is true that I am healthier now, at this weight (which isn’t a healthy weight), than I was at a lower weight. But this doesn’t have anything to do with the weight itself. What makes me healthier is now is that, back then, I was very, very sick — missing days of school because of abdominal pain, losing ungodly amount of blood daily, drinking milk- and protein-shakes to reach 2000 calories because I couldn’t hold down solid food. The medicine that kept me functioning for a few months made me gain 50 to 60 pounds of fat. So yes, I am healthier now, but I am not healthier because I gained weight. I am healthier because of the drug that also — coincidentally, unfortunately — made me gain weight.
This is but one example of how chronic diseases can take an amount of bodily autonomy from you. From having difficulty fastening buttons — rheumatoid arthritis — to having your body damage its own organs — lupus — the sanctity of one’s own body doesn’t always matter to nature. For me, losing weight — and regaining abilities I had before I got sick — is a way to claim back some control over my body that I lost.
Of course, as someone who has successfully lost some weight and unsuccessfully lost the rest of the it, I can tell you how hard weight is to lose. As much as I hate it when people tell me that I shouldn’t lose weight because you are beautiful just the way you are, I also refuse to be held up as example of how someone, if they only try hard enough, can succeed in losing weight. After all, losing weight requires calorie restriction. There is no other way, in the history of evolution, that human bodies lost weight in the absence of disease. Calorie restriction, even at healthy, physician-sanctioned levels, is hard. Our bodies are wired against it.
And I can definitely tell you that a doctor simply saying “you need to lose weight” isn’t doing anything to help. People who are overweight, overfat, or obese are told on a daily basis that they are supposed to lose weight. The reasons are varied — for health, for beauty, for status, for purity, for success, for value — but the message is the same. Saying it once more, even when you wear a white coat, isn’t going to change anything.
So, moving forward, there are some important points I and anyone else going into the health care field should remember:
- A person’s body is sacred, but a person’s relationship with their body can be complicated. So when a fat person sits on your exam table — or anyone who has been told their body isn’t acceptable, from a man who’s been told their body makes them a woman to a woman who’s been told her skin is too dark and her hair too curly — we need to be able to recognize and respect both that complexity and that sanctity.
- As future physicians, our responsibility will be to the health of our patients. While losing weight is healthy for some patients, maintaining a healthy relationship with their body and mind is, too. We must carefully navigate this balance to do good by our patients.
- Ultimately, people make decisions about their body. We might not like them, we might voice our disapproval, but empathy requires that we understand that the vast majority of people make decisions that make sense to them in given circumstances. Don’t meet these decisions with sneers; meet them with empathy. If what they are doing is entirely objectionable, explain to them the facts with compassion, not derision. Derision never helps.
- An obese or overweight patient that doesn’t lose weight or change their diet isn’t being non-compliant. The vast majority of people do not have the tools or expertise to lose weight. It is your job to supply them with these tools — and not just to add your “lose weight” to the cacophony of “lose weights” that have been screaming at them from billboards, advertisements, and the playground since they were 8 years old. You’d do just as much good telling a sick patient to “get better.” Okay, thanks, doc — but how?
Ultimately: people’s bodies are sacred. Remember that, always.
Photo credit: Foter.com. Grayscale added by author.