How to Navigate Medical Follow-ups While in Treatment for an Eating Disorder

Written by CCTC Staff Writer

Medical appointments are an essential, albeit sometimes uncomfortable, part of treatment for an eating disorder.  Too often my clients come to me after a medical follow-up confused, ashamed, or angered – sometimes it’s a combination of all three.  They may have finally felt comfortable enough to open up about their disordered eating or exercise behaviors only to leave feeling invalidated and unheard, possibly from the inappropriate praise of “healthy attention to diet and exercise.”  They may have been told their weight, a number they have been working so, so hard to detach value from, or have been offered unsolicited weight loss or dietary advice.  They may have had their newly found permission to eat shattered by suggestions of “cutting out” this food or “watching portions” of that food group.  The list goes on and on.  

If you’ve had an experience anything like what’s listed above or have been avoiding the doctor’s office for fear of being shamed, embarrassed, or overlooked, I want you to know you have a right for respectful care.  You have the right to advocate for yourself.  Perhaps the best way to do this is to seek out a provider who practices from the Health At Every Size (HAES) model.  The HAES community offers an online registry that allows you to search for providers by discipline or geographic area. Find it here: https://haescommunity.com/search/. You can also ask your treatment team for referrals. 

If you cannot find a HAES provider in your area, or perhaps your insurance coverage limits the providers you have the option to see, don’t worry.  You can still access HAES oriented care…This is where the self-advocacy comes in.  Keep reading for guidance on how to advocate for yourself at the doctor’s office. 

Educate

If you are comfortable doing so, explain your understanding of HAES to your provider.  Download this letter for help.  It can be emailed, faxed, or snail-mailed to your provider before your appointment.  You could also bring a printed copy with you.

Set Boundaries

Before your visit (if possible) let your provider know you are in treatment for an eating disorder.  At the appointment, politely explain that you would like to have a blind weight taken and not to have the number discussed.  If your weight is being monitored by your treatment center or you and your treatment team have agreed to not monitor weight, you can decline to be weighed all together.  This may be the better option if you are likely to sneak a peek at the scale or have had your weight shown to you or told to you in the past.

It is also acceptable to let your doctor know you are not interested in being counseled on diet and/or exercise.  A simple statement such as, “I have been working with a Registered Dietitian to create a meal plan to meet my nutrition needs,” or “I am following the exercise guidelines approved by my treatment team” should be sufficient. 

Ask Questions

If your doctor (or any care provider) says anything that you don’t fully understand, you have the right to ask clarifying questions.  This is especially true if you are given advice that is contrary to what you have learned at your treatment center.  For example, if intentional weight loss is prescribed to resolve condition-xyz you have the right to ask for an alternative treatment. Plain and simple.  If a specific diet or eating pattern is recommended, you have the right to ask for the scientific evidence that supports it.  You have the right to ask about your blood work and vitals, and what they indicate about your health – regardless of your weight or BMI.

Debrief with Your Treatment Team

Sometimes despite our best efforts and strongest boundaries, visits to the doctor’s office are still uncomfortable.  You might still leave feeling confused or ashamed.  Remember, you are not alone.  You are not the only person to feel this way.  Bring your concerns with you to your next therapy appointment and discuss them with your team.  Depending on your experience, your therapist or dietitian may suggest writing a letter to the care provider explaining what happened and how it impacted you.  Even if it is never sent, this can be an empowering exercise.