Lest anyone think I am on the cusp of full, healthy self-acceptance, let me give you a peek at some of the miasmic content of my inner life.

My annual physical was today, except I haven’t been so stellar on the “annual” part. I thought I had, but my official records show that the last time I went in for a well visit was in March of 2018. Whoopsy!

In anticipation of today’ visit, I steeled myself for the “I-have-your-best-interests-at-heart” beat down I was expecting from my primary care doctor when she and I got to the part about my current weight. I imagined her concern about the number on the chart, especially relative to the 2018 number, and rehearsed my response to her prescription for weight loss with some subtle fear/shame drizzled over the top for full effect.

In these mental rehearsals of my doctor’s imaginary scolding, I envisioned that I would stack her comments in a neat crisscross pattern, whip out the Queen of Hearts Zippo lighter given to me by a roommate 15 years ago, and ignite the bonfire of food restriction and punishing exercise I planned to enact immediately.

“Well, I have to do it, you know. For my health. Doctor’s orders.”

Here’s the thing though. She didn’t mention it. Not one syllable about my weight. I have an amazing PCP who is actually not perpetuating weight stigma or diet culture, and there I was, disappointed. We got all the way to the end of the check up and I started to panic. Was I not going to get my hall pass back to orthorexia? How was I going to get the validation I wanted to take extreme measures to shrink my body if my doctor wasn’t going to give it to me?

As the appointment was wrapping up, she asked me if I had any health concerns, and I blurted out “This is the biggest I’ve ever been and I’m kind of freaking out about my weight gain. I don’t feel like my eating habits have changed much. I’m afraid I’m going to gain more weight.”

Do you know what she did? Could you even believe me if I told you?

• She normalized weight gain during a global pandemic. “Many people have put on weight this year. Stress can really contribute to weight gain, even if your diet hasn’t changed.”
• She normalized people’s bodies changing over time. “As women slide through those last ten years leading up to menopause, our metabolism changes dramatically. Our bodies technically need fewer calories as we come out of our child bearing years. Many women notice weight changes in their 40s.”
• She validated my concerns about my health. “We’re going to run blood work, and we’ll look at your thyroid and your blood sugar and other markers. Your previous blood work has always come back fine. If we see something amiss this time, we can make adjustments. If you feel like you want to lose weight, we can talk about that.”
• She carefully advised against dramatic calorie restriction. “Your body needs fewer calories as you age, but it’s difficult to feel satisfied on a restricted diet. Finding exercise or a sport that you enjoy and ramping up your time moving is a more sustainable approach. Eat food you truly enjoy, and try to avoid eating or drinking things out of boredom, or things you don’t actually enjoy eating.”
• She didn’t even breathe the letters “BMI”. She didn’t print out handouts about weight loss. She didn’t remind me of risk factors for diabetes or cancer or heart disease. She did show me the fitness app she uses for body-weight-resistance strength training “You don’t need any special equipment! And weight training is good for your bones!”.

My doctor did all the things I know so many people want and need their doctor to say to them. She focused on my actual overall health (bloodwork, how I am feeling in this body of mine, my mental health in this train wreck of a year) rather than one number. From what I have been reading, I know this is not the norm. I am thankful for my very English, very proper, very weight-neutral doctor. I am also thrown for a loop. If I’m not motivated by fear and body shame, I guess I’ll just have to be motivated by the endorphins of exercise and the pleasure of eating what I truly enjoy? I am honestly not sure I know how to do that.