I’ve been honest here that 2022 was a really bad year for my anxiety. After feeling like I had it pretty well under control over the past few years (even during the early days of the pandemic!), something happened last year where my usual mental health tactics were not working.
So I re-started therapy and tried to do other things that are proven to help with anxiety symptoms, like getting regular exercise and drinking less caffeine. But what has helped my anxiety more than anything is medication. I’ve been on the generic form of Lexapro for quite a while now (I think I started it in 2017, and have been on 5mg, 10mg, and 20mg over the course of those years). But it wasn’t until Lisa started to gently prompt me to consider talking to my doctor about changing my meds that something clicked in my brain, so I didn’t need to get any other doctor as there are many type of doctors now a days since getting a doctor degree is not that difficult, you can go online and find phlebotomy training if this is a career you like.
Sometimes I forget how Lexapro has altered my brain chemistry. It’s worked so well for me for so long that I always think there’s something more I could be doing to better manage my anxiety. More therapy! More exercise! More sleep! And while those things do help anxiety symptoms, there comes a point where medication may need to be investigated.
I know some people don’t like being medicated for anxiety. “I don’t want to numb out to life,” they say. But when you have anxiety like mine, when you can’t stop the spiraling thoughts and the nightmare scenarios playing out in your brain over and over again, when the overwhelming feeling of doom takes over, being numb sounds amazing. I want to numb out. I want to stop these thoughts. I want my brain to shut off.
Thanks to Lisa’s prodding, I scheduled an appointment with my doctor. Unfortunately, the GP I have been seeing for many years, whom I adore and who has such a warm, kind bedside manner, is on leave for another two months so I had to see her temporary replacement. I wasn’t thrilled about that, but I made the appointment anyway.
And I had the kind of appointment you dread as a fat person. It was the kind of appointment I had heard about from other fat people but had never experienced myself.
This doctor, a man, comes into the room and we talk about my anxiety for a short period of time. He recommends adding Wellbutrin to what I’m currently taking but doesn’t explain what it is, how it can help, what the dosage is like, how I should start using it… nothing like that.
Instead, he then proceeds to talk to me about my weight. He doesn’t connect this with my anxiety. He doesn’t talk about how eating certain foods or how exercise can help me with my anxiety symptoms. Instead, he couches it all in “concern” about my “weight.” I’ve never had to deal with something like this with my regular GP. She has never, ever brought up my weight like this. The only time we talked about it was when I brought it up. I wasn’t there to talk about my weight. I was there to talk about my anxiety.
I wish I had stopped this discussion in its tracks, but I’m an Enneagram 9 through and through, which means I am non-confrontational to a fault and just wanted to get through this conversation as quickly as possible. We talked about my eating habits and when I mentioned that I drink soda, he perked up. “Oh, there’s an easy change. Just drink diet soda.”
Hold on, what?!
I don’t think I’ve ever had a doctor recommend diet soda as an alternative to regular soda. That’s not a good alternative! Diet soda may not have the same amount of calories and sugar as regular soda, but it has other terrible chemicals and is not an alternative! If he had mentioned trying seltzer water like La Croix or talked to me about how to drink more water, I would have been more apt to listen to him. But telling me to switch from regular soda to diet soda… I quickly realized, this man is a quack.
He also brought up the option of medication for weight loss, which is something I truly, truly do not believe in. For myself, it is just not an avenue I’m willing to explore. And when he told me that his favorite medication to prescribe these days is Ozempic, I was D O N E with this doctor. Ozempic is not a weight-loss drug. It is a drug that diabetic people use to improve their blood sugar. But people have started to realize that you can take Ozempic and lose massive amounts of weight, so more doctors are prescribing it to patients who want to lose weight.
And what has happened because of that? There is a shortage of Ozempic. The people who use this drug for an actual medical reason cannot get it because a bunch of celebrities and influencers decided they wanted to use it to lose weight.
I knew all of this before the doctor brought up this drug. I had heard about it on a podcast and had read up about the shortage. And I wish I had called out the doctor when he brought it up, but yet again, I did not. I just tried to make myself as small as possible and kept my opinions to myself so I could get out of there. I just wanted to get out of there.
Whenever I hear of things like this happening to other people, I get so frustrated. Why didn’t they speak up? Why didn’t they challenge these people who are saying these things? But the truth is, it’s embarrassing to be told you’re too fat and need to lose weight. It’s embarrassing to feel like you’re this out-of-control slob who cannot manage her eating habits. It’s embarrassing to come to the doctor for a legit reason, and have him see me only as a fat person he needed to fix.
He didn’t see me as a patient. He didn’t spend time talking deeper about my anxiety issues and talk to me about my medication options. He didn’t bring up my eating habits because they could be linked to my anxiety symptoms; he brought it up because he saw a fat person. If I had been a thin person in his office, he would not have even thought to talk about my eating habits. And that’s the difference.
I cried in my car after that appointment. I had been so proud of myself for making this appointment and was feeling so hopeful for how this would help my anxiety symptoms going forward. And instead, I was given a quick medication and a lecture on healthy eating habits. It was so demoralizing.
Afterward, I decided not to take this doctor’s medical advice and instead of filling the prescription order, I scheduled an appointment with a psychiatrist. I had that appointment on Friday afternoon and goodness gracious, was it such a different appointment from this one. The psychiatrist, a woman, was kind and warm and informative. She went through my entire history with anxiety, depression, and other mental health issues. She talked to me at length about the different options available to me, and together, we decided to bump up my Lexapro dose. I’ve been on 20mg for a few years now, so we’re going to try 30mg and possibly go up to 40mg if I feel that I need that.
There was such a difference between these two doctors. I felt seen and heard and comforted by my psychiatrist, rather than dismissed and condescended to. For the first time in a long time, I feel hope when it comes to my anxiety disorder. I feel like I have the right team, between my therapist and my psychiatrist, to gain control over my symptoms and finally feel better for the first time in over a year.
I am angry this happened to you and frustrated on your behalf. Doctors are supposed to help their patients, and this doctor did just the opposite. I’m glad you had another doctor who was able to focus on the actual issue you brought up and suggest solutions. Also, thank you for writing about this because many people have not had this experience due to thin privilege, but we all need to be collectively aware of how terrible those in a larger body can be treated. I hope the medication increase helps you this year!
Thank you, Sarah. It was a super demoralizing appointment. If I had brought up my weight and asked to talk about it, that’s one thing. But the fact that I was there for my anxiety and it was really brushed over just shows me what kind of doctor this guy is.
I take medication for anxiety and mental lability and I am SO sorry that you went through this with that doctor. A doctor really makes all the difference in treatment, and not by the medicine they give, but how they treat patients. Seeing a psychiatrist has helped me so much, and so has the medication!
Hoping you feel better soon. <3
Thanks, Lacey. I felt so proud of myself for making that appointment – it was a big step for me! And he just crushed my soul with his focus on my weight, which is not the reason I made the appointment.
First up, it’s so admirable that you reached out for help. I loved that comment when Lisa said that she had to get her medications adjusted for her RA and you might need to do the same for your medications. Getting help for our health conditions should be normalized, regardless of what those health conditions are and I’m so proud of your for taking that step. I know it’s not easy what with phone calls to make appointments and then having to be open and honest in an appointment.
Thanks for sharing this story. Medical practitioners have their own biases and it’s terrible when those biases impact you so directly. I hope there’s a way for you to lodge a complaint about the way your concerns were treated and dismissed.
Thanks, NGS. It’s amazing the work that goes into getting help for mental illness. It’s exhausting enough to make a doctor’s appointment, and then to have the appointment and feel dismissed and belittled is so demoralizing. I’m so glad I was able to find a psychiatrist who was willing to listen and take my true needs into account.
First off, I am so sorry you were treated this way. I was so saddened to get that update from you and hear about how your appointment work because it takes a lot of courage to book an appointment and say that you need help. And then to be treated so horribly? I am glad you had a much much much better experience with the female psychiatrist. I am glad you are working with someone who does this day in and day out and can discuss the risks/benefits/options with you. As you know from our emails, I worked with a psychiatrist for over 5 years and only just transferred my lexapro rx over to my GP this year because my pysch said I was in such a good place that it could be managed by a GP going forward. But I am glad I was under her care for so long as I went through a lot of change – namely, pregnancies and births. We watched extra closely for PP signs after I had my babies and Phil was diligent about making sure my mental health was in a good place, and she could explain the risks of staying on lexapro during pregnancy (ultimately that is what I decided to do – she follows the research and gave me a summary and said what she would do). But I am proud of you for looking for a better solution. You are doing all the right things, and this shouldn’t be viewed any differently than me having to change my RA meds recently.
Also, I kind of get a knee-jerk reaction to people saying anything negative about being on anti-anxiety meds… I so wish I did not need them but I tried to go off them once and it was horrible. So I view them as being as necessary as my RA meds! Maybe if you have really low-level or situational anxiety, they are optional. But being on anti-anxiety meds allows me to live a full life where my brain isn’t interfering with my ability to enjoy life! And just like I can’t control having RA, I can’t control the fact that my brain chemistry is such that I need lexapro. But I know I’m preaching to the choir by saying this!
Thanks for encouraging me to get my meds looked at! It feels so good to be under the care of a psychiatrist who will be able to monitor my moods closely, and make changes when that feels necessary.
I totally agree with what you’re saying about being on meds! It drives me crazy when people consider it a “last resort” because it shouldn’t be a shameful thing to need to be on meds for a mental illness, just like it isn’t shameful to be on meds for a heart condition or autoimmune disease or anything like that!
First off, I’m sorry about that asshole doctor.
But I’m SO glad you saw a psychiatrist. They’re better equip to handle more complex mental health issues and know the appropriate meds for each diagnosis (some react better to others – I got meds from a PCP once and they gave me the entirely wrong type of med for my mental health diagnosis and I was doomed to hit a wall with them which I did). I’m on 40MG of lexapro (and a couple other meds) and it helps immensely. I’m not numb but I can exist day to day which I can not without medicine. I should warn, my insurance refused to cover that high of a dose as it’s not commonly prescribed so I’ve been getting it from an online pharmacy for $9.75 a month out of pocket. You may not have that issue, hopefully your insurance is better, my doctor fought for mine to cover and they refused. So just warning of a possible issue. Keep up with the psychiatrist for your mental health meds. I’m glad she was so helpful!
Thanks, Bri! I think using a psychiatrist is going to be a much better route for me, and I can already feel a difference in just the way we talk about my moods and other things I can be doing to help. Thankfully, I was able to get my new meds with no issues from my insurance company, so fingers crossed that trend continues!
I was able to get 30mg with no issue from my insurance too but they refused 40mg. You may not end up on that dose but I just wanted to throw out a warning in case you do and it’s a similar issue!
I hope you are proud of yourself for advocating for you! I am similar in that I don’t enjoy confrontation but sometimes it really isn’t worth it depending on the situation and person. I like that you still sought out help even after that disappointing doctor appointment. Good for you!
Thank you, Sandra! I am proud of myself for making that appointment, and I know it was the doctor’s own biases that led him to have this conversation and not anything that reflects on me. I’m hoping that a sternly worded email will get through to him that he needs to change his way. (Wishful thinking, probably.)
First of all, I am horrified about how you were treated and you should definitely send a complaint (maybe through the practice online system, if that exists?) about this doctor. Since he was only a temporary replacement for your GP, I am hope you can go back to her soon. Otherwise, I’d have immediately asked to switch GPs (I had to do that once because the doctor I was seeing was just NOT listening to me and dismissed my symptoms/concerns over and over). This is so not acceptable (but I understand why you didn’t speak up).
Having said that, I am glad you’re in good hands with your psychiatrist. I might have told you that Jon also is on Lexapro for his anxiety and it can definitely be adjusted and it has helped him so much.
Sidenote re: weight, I know that you’re working hard on excepting your body as it is and I think that is terrific because I think you can only truly make changes if you’re a) ready for it and b) don’t expect miracles. The doctor was totally out of line to even bring it up (esp. since you were there because of your anxiety, not because of your weight).
As you probably know certain meds can make it harder to lose weight (even if you’re doing all the right things). Jon’s been struggling with this too, but I’d much rather know that he’s doing well with his anxiety and overall well-being than losing a few extra pounds.
I am so glad this was my first experience of this kind, and that my regular GP has never, ever brought up my weight in this way. Whenever we do talk about my weight, it’s because I have brought it up. I am definitely lodging a complaint because I’m sure he’s having similar conversations with other patients! I will be very glad when my GP returns from leave.
And yes, that’s the way I feel too about my weight. I’d much rather be fat and happy than thin and miserable. I know there are changes I need to make to my lifestyle, but the way this doctor went about it was so unprofessional and honestly, dangerous! I’ve been talking about these lifestyle changes with my psychiatrist (she has talked to me how they can be connected to brain health mostly, not in an effort for me to lose weight) and it’s felt like a much better conversation. Less demoralizing and more empowering!
Like everyone I’m so disappointed you had such a horrible experience, but I’m SO proud of you for recognizing the misinformation being presented and moving on. It would have been so easy to default to this doctor’s recommendations or spiral because of his awful advice.
BUT YOU DIDN”T and this is amazing and such a testament to your mental fortitude. And then to go one step further and share it all here where it can benefit others? Thank you!!
Thank you, Elisabeth. This comment made me smile. 🙂 I do hope this helps people who have also been shamed in this way at the doctor’s office and to also help thin-privileged people understand what it can be like for fat people at the doctor’s.
I am so sorry– that’s really horrible.
I am glad you found a doctor who listened to you and gave good advice.
Thank you, Sarah. I am really happy with the psychiatrist I found, so I guess after all of this, I am grateful for that at least. <3
My dad is one of the people having trouble getting Ozempic on time for his diabetes because of the shortages! I had not heard about it being prescribed for weight loss until he told me about it so I thought it was an insurance issue.
I dread doctor appts because of doctors like that and I don’t think I would have been able to speak up either.
Ugh, I am sorry to hear that your father has been impacted by this shortage! It’s so ridiculous that people who need it cannot get it for such a silly reason.
I am so upset for you. That appointment sounds incredibly demoralizing and completely unhelpful. I’m really glad that you were able to meet with a psychiatrist, and that your appointment with her was so much better. And I hope the new dose of medication is exactly what you need to tone down the anxiety.
Thanks, Suzanne. It was not the appointment I was expecting and it was hard to sit there and be shamed about my weight when I just wanted to get help for my anxiety. A sternly worded letter is forthcoming!
Oh Stephany. I am so sorry this happened to you. What a nightmare scenario. Here you are, trying to do something for your health, and this asshole comes in. I mean, honestly, how awful.
However, I am so proud I could cry – you didn’t let it knock you out, you took control and went to a psychiatrist, you didn’t take his (terrible) medical advice or his prescription, YOU TOOK STEPS!!! I’m so proud that you did that and I hope that this new dosage is just what you need. I know you’ve been struggling a lot this year.
SERIOUSLY, THAT DOCTOR. What an absolute shame.
Thanks, Nicole! I am proud of myself, too. It was such a demoralizing appointment, but I am so glad I did not let his comments defeat me because I found a really great psychiatrist afterward and she has been amazing!
OMG Stephany. I am so so sorry you had this experience. So sorry. What a horrible piece of sh*t. And to make it worse by offering stupid suggestions like diet soda and that drug… like what in the AF?
I hope no one is making you feel bad for not speaking up. Even when you are not a 9, it’s hard to think clearly in these situations. My well-intentioned husband has asked me “why didn’t you ask this or that” after dr appointments and I am like, “my brain just shots off cause they are supposed to be an authority, please come with me.” (he means well)
I am so glad the second dr was better and you have a solution. Sending you so much love.
I am on Wellbrutin and I am not in a fog! It’s made me so much less worried about work and less angry. (Not saying YOU should take it, saying I agree with meds)
Yes! We see doctors as authority figures and think they are saying everything that’s right and true, so it’s hard to question them when they say something offputting. It’s easier when there’s a second person in the room to ask follow-up questions. He was such a terrible doctor, and I don’t think he should be giving medical advice to anyone!
Wow, what a terrible doctor!!! Diet soda, really? And I actually have a client who can’t get his diabetes medication right now- I assume it’s Ozempic- for the reasons you mentioned. And Stephany, I’ve totally been there where- someone is being an ignorant a-hole and I just sit there, and later think of all the things I SHOULD have said. I’m sure you were bind-sided by all this, since it wasn’t the conversation you expected to have. Anyway…. I’m glad you had a good experience with the second doctor, and I hope the increased dosage helps.
His diet advice was so terrible! When he told me to exchange regular soda for diet soda, I was ready to walk out, lol. What kind of diet advice IS that?! Truly bonkers.
It’s so easy to imagine what we’d do in these types of situations, but so much harder when we are there and our brains have just shut down. It happens to the best of us!
Oh goodness, I am so behind on reading your blog, I’m sorry I missed this. I am so sorry that that asshole doctor treated you this way. I empathize with you not speaking up to him, that is SO HARD. I am so glad that you are talking to a psychiatrist, and working on your medication.
My mom used to get conversations like this with doctors sometimes, before finally getting a doctor who GOT IT, who she told that every time she lost weight on a diet, she ended up gaining more back, that doctor said, “OK, we know that won’t work for you.” and left her alone about it. I’m glad that your regular doctor is one that understands you. When she would see a doctor about some unrelated issue, and they would suggest that she lose weight, she would say, “Do you have thin patients with this condition?” And they would have to admit that, yes, they did. She would say, “Then let’s discuss the issue that I am here to discuss.” I think she was in her 50s before she came up with this response. I hope you can use it, or something like it, if you are ever in that situation again (and I hope you are not).
My daughter suffers from anxiety that sounds similar to yours. Hers is OCD, without the C. Meaning she has intrusive, obsessive thoughts, but there is no compulsion involved. It is horrible and debilitating. She wanted to try medication, and I was terrified of that, because my mom tried anti-depressants and they confused her badly. She thought she was being kidnapped when I took her from the hospital to the rehab facility. Thought she was being poisoned when I tried to get her to eat. It was horrible. But we relented when the psychiatrist said that it really could help. So she tried a combination of therapy and medication. I won’t say that she has zero anxiety, but she is SO MUCH BETTER now. She tried a couple of different medications before settling on Prozac. I am so thankful to have my darling girl back.
I hope that the combination of a new dose and a psychiatrist is just what you need, and you can get past your anxiety. <3
I am sorry your daughter has been going through her own mental issues. It’s so hard when there aren’t specific symptoms to point to but we know something isn’t going well in our brains. I’m also glad she’s on medication. It’s crazy how differently people can react to medication! It has been a lifesaver for me. <3
Thanks for sharing your story, J!
This is so, so late. But I couldn’t just let this post sit here without sharing my anger at what that ‘doctor’ did to you. I know this is probably not helpful, as it may reawaken the trauma of what he did to you, but you may want to consider sharing this experience with your actual primary when they are back from leave. This is… well, in my opinion, this person should not be allowed to practice medicine.
I am amazed at the strength you showed in making this appointment, showing up, and then doing something that was right for you rather than just following this (redacted) moron’s advice. You did what was right for your mental health and your life. And I am so glad you did.
I hope, by this point, you are feeling positive effects of the increased dose, and that your anxiety is again held at bay. So you can live your life, love your girls, and love your people.
(And thank you, too, for having the courage to share this… I suspect others who don’t know you [yet] may find you because of this post…)
Take care, my friend. <3
Thank you, friend! That is a very good idea to share my thoughts with my primary care doctor when she returns from leave and I think I will do just that! <3