A tip for your next doctor’s visit

Because numbers don’t always serve you

Reader warning: This post includes descriptions of an abusive relationship and disordered eating. Please take care when reading or skip if you are not in a space to process this subject matter. Also, if you would like to hear an audio version of this post, hit play in the player below:

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In my experience, Koreans are blunt.

It could be a language thing. I’m on a 321-day Korean Duolingo streak and have yet to encounter words that soften or convey subtlety.

Even so, growing up, it was common to hear judgments such as, “You’re overweight!”—often coupled with the (confounding) directive, “Clean your plate!”

As a kid of naturally medium build who enjoyed eating, these directives did not apply to me. I didn’t think about my weight at all until the summer after my freshman year of college. 

The spring of freshman year, my parents told me they needed to shift their financial priorities. I was on my own financially from that point forward and as such, started working long hours. During college breaks, I temped 9am to 5pm at office jobs in Boston, after which I took the train and bus to work an evening job at an ice cream store until 11pm. I watched my bank balance with a steady thrum of anxiety and fear because every minute counted wherever I was punching in, in terms of earning enough to cover my next semester’s tuition. As a result, I tried to squeeze in working minutes at every turn, tightening my commuting route and eventually skipping mealtimes.

Had I been in a normal connection dynamic with friends and family, I think I would have course corrected on this behavior, but at the time I was a year into a relationship rife with manipulation and toxicity that involved isolating me from loved ones. As the pounds started to fall off my frame, he said, “You’re starting to look good.”

These words are less blunt than “You’re overweight!” but just as sharp. In retrospect, I see the intentionality of the comment. Criticizing me was almost like a hobby for him; I was berated for everything from the pace at which I walked, to the speed with which I depressed the gas pedal when driving his car, to what I wore (he loathed the leggings I had grown to love freshman year), to the length of my hair. He made blistering comments about my family and friends to plant seeds of doubt and drive isolation. He ridiculed the names in my college’s Commencement program for being waspy and privileged to make me feel bad about the place where I was finally finding my feet. There didn’t seem to be anything about me that he couldn’t weaponize. And so, even though his comment about my unintentional weight loss was pointed and mean, it felt like a compliment; something to grasp onto.

I grasped on. And so commenced a summer of restriction and (unsuccessful) attempts at purging when I lapsed and ate something other than produce. The scale that I had never paid attention to in my parent’s bathroom now became a daily fixation—often multiple times a day. In my mind there was a direct correlation between losing weight and being less abused.

Which of course was not the case, but I was 18 years old and didn’t know any better.

As the summer wore on, I earned tiny breadcrumbs of praise as I continued to shed pounds. It felt like such a relief that I just kept going.

I dropped from a size 10-12 to a size 4 that summer.

And then I got lucky. The seasons turned and I headed back to college for sophomore year. A couple of friends expressed their worry and encouraged me back to being the person they knew—someone who laughed and could be lighthearted, someone who could take a break every now and then, someone who delighted in eating with friends and trying anything on the menu. What a gift it is, to have friends who will issue the loving straight talk. And what a blessing it was to return to campus at that time; it was almost as if the college perimeter served as an enveloping forcefield.

(It turned out the campus perimeter did prove to have some protective power. There were only two occasions where this person crossed the line and stepped onto campus and his discomfort was clear. He instead took to parking his car and watching me from the main access road.)

It would take another year and half to break off this relationship, during which time I worked to distance myself in the campus protective forcefield and gained back some weight—earning me the title “Porky Pig” (seriously, what an asshole). After I graduated and moved on to the adulting phase of my life, I vowed never to own a scale. I simply wanted to feel comfortable and happy in my clothes.

And this tactic has worked great. I highly recommend it!

Fast forward to my 30s, sometime after carrying two babies and experiencing the typical metabolism changes associated with aging. Every time I went in for a routine medical visit, despite being a reasonably fit person of medium build—fit enough to even run a few half marathons—my BMI always came back with the label overweight. Sometimes the staff would tell me this fact and also say something along the lines of, "Don't take that number seriously. Obviously, you are not overweight."

They said this lightly, and yet, I found myself perplexed. If this number didn’t need to be taken seriously, why was it being reported to me? 

And so, every visit since, I ask the staff not to read out my weight and BMI. It has no bearing on my everyday life other than conjuring judgment with a label that does not square up with my physique and health condition.

It pains me a little to say this—as a former scientist who loves numbers—but numbers don’t always serve you.

This past Friday, I had my annual checkup and, as usual, I told the physician’s assistant I didn’t need to know my weight, but that I wanted to know my height since this metric is a matter of cheerful dispute in my household. I stood with my back facing the digital read. I wondered if the PA made a quick note in my chart because I appreciated that later, when my PCP ran through my chart with me, there was a brief pause at one point, and she said something like, “Your numbers look good, and you are in good health.”

After I got home, I did have a moment of curiosity, especially as I thought about writing this post. I decided that later that morning, after I caught up on work emails and if I still felt like knowing, I would look at the printed post-visit summary I was provided. 

I did look, and the second metric reported (after blood pressure) is BMI. Per usual, I am overweight.

I smiled, shrugged, and moved on with my day, grateful for my excellent health, my unconditionally loving and supportive partner, and the existence of elastic waistband jeans, a wonderfully flexible companion for someone who lives in a climate with four seasons and whose shape shifts accordingly.

And so, my advice is this. If you are in good health yet find hearing readouts of things like weight and BMI annoying or triggering, just ask your medical staff not to share them with you. I have always found staff to be respectful and accommodating of this simple request. Related, if you decide you do want to know the information, consider the data later when you are not, say, in the disempowered position of being almost naked in a space that can feel very vulnerable. 

You only have one body. Give it all the respect and love and grace it deserves.

I took this photo on Friday, February 2, the day of my well visit and overweight BMI read.

P.S. This NBC News article, “BMI is a flawed way to measure obesity, experts say. What else works?” offers a recent primer and summary about BMI, including reference to the American Medical Association’s positioning about BMI.

P.P.S. Though I definitely had a few moments of, “OMG why do we humans cause so many problems for ourselves?!” I appreciated this Chasing Life podcast episode for its evolutionary perspective on how fat was a protective measure for hunter/gatherers, and how fat percentage differs greatly for humans compared to far less complex mammals (totally fascinating). This conversation reinforced my feelings that we need to stop fighting our bodies with diet culture and focus on treating ourselves well with basic things like hydration, good food, and movement that serves us and—if you are like me—works to counterbalance time spent at a desk. In a nutshell, yes, we humans cause a lot of problems for ourselves, and that means we also have the capacity to treat ourselves well.