Doctors, Can We Do Better?

It’s been a little while since I’ve had a checkup. While I have a wonderful doctor (see below), I am somewhat averse to having checkups; I received a lot of judgment and poor information from previous doctors when I had my eating disorder, and now as a clinician I know the way in which information provided can be short-sighted. Let me be clear: I do not dislike or blame doctors. And yet, I think it is essential that those in the medical field learn more about eating disorders and disordered eating.

I have heard from too many clients, friends, colleagues and readers about the comments made by doctors that show lack of awareness around the gravity of eating disorders. I’ve heard first-hand reports of individuals who go to the doctor due to pain in their wrist only to be told to “lose weight” and to find out (eventually) that their wrist is sprained—an issue completely and utterly unrelated to weight. There are doctors who prescribe weight loss without actually reading the research that shows that this is not truly the recommendation for most problems.

Yes, it may be recommended—there are some medical conditions that require an individual to be mindful of eating habits—but this is not the case as often as the recommendation is doled out. And when it is recommended, it can be done in a non-judgmental way, without assumptions or callous tones and without focus on weight itself.

My most recent physical was with a family practice in Manhattan not far from my office. The doctor was thorough and took the time to ask me about not only my physical health but my emotional and mental health: What’s my mood? Am I sleeping? Do I have positive relationships in my life? How do I manage stress?

This doctor took the time and spoke to me about exercise for the sake of moving my body, not weight loss. He knew his stuff and he made eye contact with me, treating me like a person, not a patient. This is how I strive to treat my clients and fellow humans: like individuals, not simply people with problems. I am hopeful that we can all—whether or not you are a medical professional—learn from him.

1. Listen. Make eye contact. Take a moment. We all have difficult days that at times make our jobs harder or cause us to feel hopeless or stressed. But especially in the helping field, we must understand the impact our words, voices and statements can have on others in setting the tone for hope, openness and understanding.

2. Don’t focus on weight. Regardless of whether or not it needs to be part of the conversation, it need not be the focus. Look at the person as a whole, not a number on a scale.

3. Ask if the individual wants to know their weight. This can be triggering or promote a message that the number matters to you. If you insist on weighing patients, then don’t assume the patient wants to know the number. Do research and assess why you need to weigh the individual; is it necessary?

Talk about movement, not weight loss. Studies show that exercise helps us to remain healthy because it keeps our bodies strong. It is not about purging calories, so don’t make it about this.

4. Ask questions if weight loss is actually medically needed. Don’t assume it is. This assumption is a fallacy. And if it is—if informed research shows it is—then be kind and gentle. If a client needed to drink numerous alcoholic beverages as part of a treatment (go with my metaphor for the sake of understanding), they would be asked whether there is a history of substance abuse; are there any concerns; can this be done in a supportive manner? We need to ask these same questions with regard to weight changes.

5. If you notice a weight change, don’t praise it or condone it. Remain curious and objective.

6. Remember, you may be the person that your patient has decided to trust. Do not get in their way by promoting a fat-phobic society or shame around mental illness. Ask, listen, be non-judgmental.

Doctors, nurses and those in the medical field: thank you for all you do. Truly. Just as I ask you not to be closed-minded, I do not pretend that all doctors fail at the above points. I’ve had many positive, warm interactions. But for those who may forget some of the points above, here is a helpful refresher that can truly make a difference in the lives and experiences of your patients.

By Temimah Zucker, LMSW

Temimah Zucker, LMSW, is the assistant clinical director at Monte Nido Manhattan. She speaks nationally and works in private practice. To learn more, visit www.temimah.com.