I've had time to think since I walked out on my doctor on the 10th, and I composed a letter to her today. I'll be sending it to her on Friday. I don't expect a response from her, but I want her to know why I won't be coming back to see her anymore. The letter follows:
Re: Office visit Nov 10, 2010
I've had some time to think since I saw you on November 10th, and there are some things I think you need to hear. Since you don't seem to listen to me when I'm talking to you in person, maybe you'll listen to what I have to say when I'm putting it down in black and white and you can't interrupt me with your preconceived lipophobic ideas.
First of all, I have been fat for over 30 years of my life, and every doctor I've ever seen has told me that, like I'm stupid and can't tell that I'm fat.
Second – I've dieted and lost weight, that's not the hard part. The hard part is maintaining that weight loss, and that's where medical science, doctors, diets, drugs, and surgery have failed me (note: I'm not the one who failed here, I tried, it was the methods used that failed, not I that failed). In the end, all those methods of weight loss did nothing for me but make me fatter and worsen my health and well-being in the long run.
Third – You tell me that it's just a matter of eating less and moving more. Fine. I want to know how I'm supposed to exercise when I'm in excruciating pain after standing for less than 5 minutes or walking for less than 1 minute when you refuse to prescribe anything for pain that's stronger than relafen (which doesn't even begin to touch the pain I have).
Fourth – You say I probably have fibromyalgia, but you aren't willing to do anything to try and treat it. I asked for a referral to a rheumatologist, and you told me there was a 6-month wait, and I got no referral and I'm still in pain. You haven't suggested a pain clinic or anything but weight loss.
Fifth – You said you would send me to an in-patient weight loss clinic. You act like I don't have a life, that I can just up and leave my husband, my house, and my pets for a couple of months. My husband has type 2 diabetes and I'm the one who plans the meals and the grocery list to control his diabetes. I give him his insulin shots and I'm the one who knows how much he needs of each insulin. I also do the budget and pay all the bills for the household – my husband doesn't have a clue how to do any of that. I balance the checkbook online. If I'm gone for a month or more, there is no one to do any of that for him, but you seem to think that's fine, as long as I lose weight. No thank you, I'm not up for another failed diet attempt, been there done that too many times.
Sixth – Did you even realize the congnitive dissonance in your statement that you know that weight loss surgery doesn't work for everyone but you think that putting me on another diet will work? What part of “I had a VBG, lost weight, and gained back more than I lost”, which is definitely a plan with calorie deficit in mind, do you not understand? Why do you think that another diet will work when weight loss surgery didn't? Do you just keep pushing “calories in/out, eat less/move more” because you don't have any other ideas? Look up the study that Stunkard and McLaren-Hume did back in 1959 about the efficacy of weight loss diets. Look up the studies done by Kramer, et al, Stalonas, et al, and Graham, et al. Every one of those studies shows that diets don't work for at least 95% of people in the long term. The Stunkard study has been around for more than 50 years, probably longer than you've been alive, and you're still recommending something that doesn't work, along with most of the other doctors out there. Talk about insanity. If you don't have a solution that works better than a diet, then I suggest you don't push diets and focus more on what can be done to improve your patients' health. Are they eating a wide variety of foods, do they move their bodies in ways that they enjoy, are their numbers good? If the answers to all those questions are yes, then they don't need to lose weight, and you need to look for the real cause of whatever problem they're presenting to you instead of blaming it on their fat.
The definition of insanity is doing the same thing over and over and expecting a different result every time. Sorry, I've stopped the insanity of dieting. Every time I've dieted, no matter what method I've used, it's failed. Why should I keep trying the same thing over and over again, when I have more than enough experience to know that, in the long run, it won't work? Have you ever had to diet to lose weight? And I'm not talking 5 or 10 pounds here, I'm talking 50 pounds or more. If you haven't had to lose that much weight and try to keep it off forever, you don't know what you're talking about when you say it's calories in/calories out, eat less/exercise more. I don't care that you're a doctor and went to medical school, you haven't lived it so you don't know what it's like to be called a liar and told that your experiences don't matter or aren't real.
When this is what one hears from doctors one's entire life, is it any wonder that one gets fed up and says “No more, I've had enough!” and walks out? This is why I hadn't been to a doctor for so many years when I first came to see you, and it's why I won't be back to see you again. I'm tired of being discounted and told that if I would just lose weight, all my problems would magically disappear.
Been there done that, and guess what? I was still in pain.
ETA: I added some information about studies to item 6 in the letter, and changed it from probably won't be back to see her to won't be back to see her before I printed and sent the letter to my ex-doctor.