Ignorant Doctor Comments
Cammy wrote a post about an experience that I (and probably many individuals with eating disorders) have been able to relate to on many occasions–an appointment with an ED-ignorant physician. It happens all the time, and sometimes the professionals are VERY nice… they just don’t know anything about eating disorders. So, rather than commandeer her comments with my own experiences, I thought I’d dedicate a post to some of the more frustrating remarks that I’ve received from doctors (and nurses–not dietitians, therapists, psychiatrists, etc. I’ll save those for another day).
- The nurse practitioner that I saw in college insisted that I NOT see a gynecologist. This was after I had lost my period for several years, gained back to a normal weight, and still not gotten it back. She insisted that there was nothing any professional could tell me and that if my body decided to menstruate again, it would.
- I took an ED medical clearance form to my doctor, and on it there were two blanks for blood pressure–one for sitting and one for standing. The nurse looked at it and said “Now that’s a silly question–I don’t see why they wouldn’t be the same.” She took my blood pressure once and wrote the number down twice.
- I was planning on starting accutane for acne when we learned that there was a high incidence of depression/suicide and accutane treatment. When we mentioned this to my dermatologist (since I was already struggling with depression), she said “Oh, that statistic MUST be wrong. When people have clearer skin they are happier!!” (for the record, accutane did worsen my depression–even though it did really help my skin).
- My cholesterol registered as high on a blood test (even though the bad cholesterol was low and my good cholesterol was really high… and this is common with anorexia) and my doctor sent me a letter instructing me to watch my diet and exercise more.
I feel like I could go on and on, but I will stop there. Back in the day I took a lot of things personally (like being told that “if you lose 5-10 lbs then we’ll start monitoring you” or “all your labs came back fine so you are A-OK”) and as an indication that I didn’t have a problem and was asking for help when I didn’t need it… but really, once you’ve seen enough doctors, you start to realize that most of them just don’t know. And the ones who do get it? It’s usually because either they themselves or their loved ones have struggled with an eating disorder in the past.
It is just frightening how clueless they can be sometimes. Some of the slightly ignorant things I think I could bypass. A bit like psych meds, unless it’s your specilaist area, then it’s impossible to know the whole picture. However, some are just common sense.
I always get told by my trusty GP to “eat more”. My favourite was after I had first relapsed back into AN again. I went to get a script for my anti-depressants, and she said (knowing of my diagnosis)
“You must eat more, because you are too thin. But not McDonalds food, because it’s full of fat.”
I was so gobsmacked, I couldn’t actually think of a good response. The fact that in ten years I hadn’t so much as been in the same room as a McDonalds, let alone dreamt of eating one, never occured to her. I am wondering if she actually read my file at all…
Lola,
How maddening–as if you need to be told not to eat something. I had a psychiatrist tell me that too much of my weight gain would be fat if I ate white flour and sugar. I specifically remember the comment, “I don’t want you putting crap like poptarts in your body.” Like you and McDonalds, I couldn’t even remember the last time I ate a poptart… but it definitely did not help my hang-up with “bad foods” and “good foods.”
Maybe in medical school, everyone should just be handed a top ten list of “things not to say to eating disordered patients.”
It’s interesting that you mention Accutane, because I remain convinced that a course of that is what caused a bout of depression that quickly developed into an ED when I was 13. Something else may have triggered it eventually anyway, but it does seem like a doctor might have mentioned the depression risks to someone with such a strong family history of depression, alcoholism, and eating disorders.
I’m sorry that you’ve had experiences like this, I agree with you, I think it’s all too common for ED sufferers to have to deal with well-intentioned doctors with little or no insight/experience with EDs. It doesn’t help that some people can be very deep in an ED and still have largely normal bloodwork results, I think some doctors try to breeze through appointments and pay more attention to pages and chart than the person sitting in the exam room. I didn’t mention this in my post, but earlier this year my physician also tried to put me on meds for underactive thyroid without even acknowledging that my ultra-low weight at the time was a likely factor, and that the way the drugs work usually doesn’t prove effective at all in anorexics. Just a bit of weight gain took care of the problem, but he never discussed that aspect of it with me.
Cammy,
I got the thyroid meds, too- and I’m really thankful I had the good sense not to take them.
Some doctors are impatient, but many are just plain ignorant. I think the focus has gotten so much on obesity, that doctors tend not to freak out about minimal eating and low weight. Or they don’t really understand the seriousness of EDs.
Cammy & Carrie,
Interesting–a friend of mine (with anorexia) was just prescribed a thyroid med for depression… and she’s residential. I wonder what the psychiatrist is thinking?
I agree that everyone is so concerned about obesity that doctors don’t take calories restriction and low weight seriously. Maybe if you saw 100 cases of cardiovascular disease, then low blood pressure would seem really healthy (even if it were too low).
I also think that physicians are much more familiar with the ramifications of obesity than with starvation. Not only are heart disease, high cholesterol, cardiac arrest, diabetes (etc.) more common than say… hypokalemia and early-onset osteoporosis, but they are more easily identified.
Not that any of this justifies your doctor not understanding or being uneducated about eating disorders…
woww.. i feel like there should be a whole book on stupid things doctors have said. those definitely top the list. holy crap. that’s really ridiculous.
I agree about the Accutane thing. I actually did twe courses of it but got pulled off the second time due to high liver enzymes. No one really factored in the depression which probably only worsened, though my folks insist that it was the Accutane that made me suicidal.
As for dumb things said to me, I remember calling to check on my labs in college. There was some nurse on the other line. She said all my labs were okay, except for my potassium. Her answer for this was to eat more broccoli and bananas, never acknowledging that purging made those lab values low.
“Just eat more”. Then I was prescribed Remeron to help me sleep, help with the mood, and gain weight. All it did was led me to binge, which then started a horrific cycle of purging. And don’t even get me started on Neurontin. I came very close to committing suicide.
“But that’s a very unusal side effect,” I was told. Now I read askapatient.com before starting any new med. A pill meant to give me an appetite just made me feel even more out of control. It’s sad, because we are slipping through cracks and I think it can be a huge trigger (look what I can get away with!).
Tiptoe–
How long ago were you on Accutane? It was 5 – 6 years ago for me… I think that the depression and increase in suicidal thinking has caused dermatologists to be more cautious when prescribing it. I heard of someone who’s dermatologist required everyone to see a psychiatrist while on it–my dermatologist was not that on top of things. I wonder if her prescribing methods have changed.
eshoe–
I’m sorry you had such an awful experience on Remeron. I had a bad experience with Geodon–constant tiredness (seriously was taking THREE naps a day) and consistent weight gain. When I told my psychiatrist all of this his response was, “Well, at least you’re not anxious and you need to gain the weight.” Grr. Of course I am not anxious when sleeping and the medication didn’t help with healthy eating at all.
I completely agree that “slipping through the cracks” can be a huge trigger. Even now, when I know that there are so many doctors unfamiliar with EDs out there, it’s hard to not take “you’re fine” as truth when realistically I know that I am not.
ugh. doctors can be ridiculous. When I was getting my bone scan for being underweight the nurse was complimenting me like crazy for having “lean limbs” etc. so ignorant. I hope you’re able to let their ignorance not fuel your ED.
How about this one-
A dietician I once had – and her only area of work was with patients with eating disorders – once tried to make me “give up” being anorexic by saying, “You have to realize that this eating disorder isn’t doing anything for you. Think about it- you’ve been coming to me for a couple months and you haven’t lost much weight!”
Ugh.
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