Embracing Health and Self-Acceptance – a Dietitian’s Journey

Yesterday, with some encouragement from others, I went to a hairdresser that specializes in cutting “curly hair”. In one sense, it was life-changing to have my hair cut to actually “be” curly, and in another it was another step in my “journey”, a Dietitian’s Journey. My “unruly” hair was not unlike being overweight and in poor health; all were barriers to looking and feeling the way I wanted, but not something I dealt with until recently.

I saw my hair’s texture as a barrier to having the smooth, silky hair I desired and that I saw in the media as being something to be valued.  Growing up, naturally curly or wavy hair was seen as unruly; something that needed to combed or brushed and restrained in some way, in a clip or pin of some kind. Yet older women went for “perms” and these man-made curls were placed where they were desired, in the size that was desired and coloured to the chosen shade.

Growing up in the early 1970s, being overweight was solved with “girdles”; just like unruly hair was solved with combs and hair clips. For those that are unfamiliar with “girdles”, they are essentially torture devices that women squeezed into to arrange their fat in a more acceptable manner, and at least keep it from jiggling where it offended others and embarrassed the individual. Wearing a girdle wasn’t about health; but appearance.

Around this time the “health at every size” movement became popular, but it wasn’t until I was a Dietitian that it came to my awareness. The overweight women around me were not into acceptance, but denial and girdles were their solution.

In the 1990s, I was torn between the reality that being overweight or obese was rarely associated with positive health outcomes, yet at the same time knowing there was a need to be compassionate toward those who themselves were overweight or obese. At this point, I was slim and in good health, so my views were coldly ‘academic’. That said, I was always against “fat-shaming”, but didn’t feel the answer was to “embrace” being fat. I missed the point; it wasn’t about embracing being overweight or obese, but about focusing on health — health at every size.

After having given birth to 3 children in a little over a year (yes, one set of twins and a singleton), I had little or no time to focus on “me”. My weight continued to creep up and along with it, my blood sugar and blood pressure. The photo on the left is what I looked like at this time 16 years ago. I knew my being overweight (obese, actually) was unhealthy, but despite my education, the idea of “eating less and moving more” seemed impossible.

The years passed and in May 2008, when I graduated with my Masters Degree in Human Nutrition, I was obese and pre-diabetic.  I heeded my GP’s advice and followed the (then) Canadian Diabetes Association’s dietary recommendations to eat 60 g of carbohydrate at each meal, plus protein and carbohydrate at each of 3 snacks. I considered I was being so virtuous by eating “whole grain”, which was whole-wheat pasta, brown rice and multigrain brown bread with seeds.  Despite this, within two years I was diagnosed as having type 2 diabetes and in hindsight, eating that many carbohydrates per day; carbohydrates that were really just less refined and not truly “whole, foods”, and eating that many times a day, made becoming diabetic inevitable. The only issue was how long would it take.

When I first saw an endocrinologist in 2014, she told me that if I continued to eat the way I was eating (same as above) I would be on insulin within 5 years.  She encouraged me to eat a maximum of 100 g of carbs per day and mostly as unrefined vegetables, with only a small amount of fruit and unprocessed, whole grain. It took until my health had become a crisis two years later until I had little choice but to change my lifestyle.  That was March 5, 2017 and the rest as they say, is history.

The photo on the left is what I looked like at my Master’s Convocation in May 2008 and the photo on the right is what I looked like this past May 2019. Yes, there’s a big difference — a 55 pound difference and even better, my type 2 diabetes is in remission and I no longer have high blood pressure.

In my health-recovery journey (which you can read in its entirety, here), I didn’t focus as much on weight, as I did on lowering my blood sugar and blood pressure. My focus from the beginning of my journey was on health as I attained a healthy body weight and waist circumference.

Surprisingly, my first experience with ‘fat-shaming’ was in January 2018; ten months into my health-recovery journey. I was told by someone quite well known in low-carb circles on social media that they “wouldn’t trust a fat Dietitian” and that ”once you get in shape then you can dish out advice“.  I was hurt and offended, and my response at the time was to write an article I titled “Competent to Counsel“; where I addressed that what makes me competent or credible is not my own body weight, but my knowledge. I still feel that way now, even thought I’m slim. While it was offensive to be spoken to in this way, it made me acutely aware of the tremendous bias that overweight and obese people face; especially obese clinicians. I think it gave me more compassion towards those that struggle with these issues who have faced this type of disdain for years.

It has been 6 months since I achieved my health and weight loss goals, and both are stable. I’m still below the criteria for type 2 diabetes and have normal blood pressure.

I’m still not used to being ‘slim’. I still think I can’t fit in a space behind a chair, or beside a parked car when I have ample room. I try on clothes that I think are the right size, and they are too big — and then assume the brand must be ‘sized wrong’. I’ve been told it takes a while to adapt.  That said, I am fully aware that as many as 80% of those who lose weight regain it within two years, so being in ‘maintenance mode’ does not mean I do nothing. I continue to monitor my weight weekly and waist circumference every few weeks. While less frequently than before, I continue to test my blood sugar at home and go for my HbA1C test every 3 months and now that I am off blood pressure medication, check my blood pressure frequently. While I am at a good weight and waist circumference and have recovered much of my health, I cannot afford to rest on these accomplishments. When I see my weight creeping up, I take inventory of what I am eating differently and same with changes in blood sugar or blood pressure.

Maintenance isn’t about doing nothing, it is about doing the same thing, over time.

Embracing my health is a bit like embracing my curls. I am no longer the obese Dietitian with type 2 diabetes and high blood pressure and I can share my story with others; to encourage them that I understand, have “been there” and also that I have the knowledge to help. But just like those who embraced their own curls before me and encouraged me to do so too, each person has their own journey. My role is to support people in theirs.

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