I recently had a meeting with an endocrinologist I am regularly consulting about my diet. I told her I had a cheat day, which is the only cheat day I've had since I began tracking my calories 3 months ago. I got food at Shake Shack and ate nearly 4000 calories that day. She told me that if I feel like I need a cheat day I must be restricting my calories too much, and I need to be careful about not getting into a cycle of binging and purging. I find this really frustrating because I don't habitually binge eat and have no history of purging.
I'm not slightly overweight, I'm morbidly obese, I have been most of my life and I have not lost any weight in weeks. If I don't restrict my intake of calories/insulinogenic foods further, I will not lose weight. She told me I need to remember I am improving my health even if the number on the scale isn't getting lower, but I cannot possibly be healthy at this size. I have made a lot of positive changes to my diet but there's plenty of room for improvement, I'm not eating a ton of vegetables and I still eat sugary food like cookies. You can see my most recent cronometer entries here.
I often see people on social media making posts about doctors focusing on weight loss instead of their real health problem, but I have personally never experienced this. Even for issues that are obviously weight related, like knee pain, weight loss is rarely mentioned. Rather than over-encouraging weight loss I feel like a lot of doctors I see almost discourage it.
I have seen a lot of doctors about my weight. I also often feel like doctor give me cookie cutter advice that doesn't apply to me in particular. Like when I bring up intermittent fasting they tell me to not eat between 7 pm and 7 am. I'm not eating at that time anyway. Not everyone is waking up at 3 am to eat snacks. And when I say this multiple times it's like they don't hear me. Fasting is also strongly discouraged because they think it will lead to an eating disorder. I only know one endocrinologist who I feel like gives useful advice, and she moved far away. In spite of that I'm going to start seeing her again because I'm tired of advice like this.
Don't get me wrong, anorexia and other eating disorders are serious problems and doctors are right to be concerned, but I feel like this concern is emphasized over weight loss. I'm also frustrated because I became morbidly obese as a child and I wish my doctor had intervened before it got to that point, but their advice was to tell my parents to let me eat anything I want and the only dietary change my doctor suggested was skim milk.
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