A friend reached out from overseas, wanting to talk. “I tried typing it up, but it didn’t make sense.” When we talk, she is measured and reeling, dizzy from a visit with a new doctor.
Prior to this recent visit, she saw the same trusted doctor for decades, through her young adult life, through childbirth, through raising a now-teenage daughter. When she saw that doctor about a sudden change in her body, an inexplicable gain of 50 pounds, with no substantive changes to her regular diet, the doctor gestured toward a faded BMI chart and a diagram of a plate of food neatly divided into macronutrients. The doctor offered to prescribe Weight Watchers or Slimming World. “Calories in, calories out,” the doctor told her plainly. “Eat less. Move more.”
It was all so tidy, linear in a way that her body had never been. This is arithmetic; her body is algebra.
She checked with her husband, friends, family. Does she eat too much? Does she move too little? Each one reflected, then offered a reasoned and measured “no,” saying her habits mirrored their own.
So, for the first time, she saw a specialist. Within one visit, he solved the riddle of her body: an endocrine disorder that she has likely had for decades, causing her to gain weight at the drop of a hat. He said its onset likely took place in childhood. Despite a lifetime of regular doctor visits, in the space of moments, she suddenly has a diagnosis that makes sense of a lifetime in unruly skin.
“Is this an epidemic? How widespread is this kind of misdiagnosis?”
“He said the symptoms were classic,” she told me on the phone. Her body bears distinctive shapes and markings reserved only for those with this particular diagnosis. The specialist told her this condition rendered it nearly impossible for her to lose weight in the absence of medication and further treatment—the opposite of the Sisyphean task she’d taken on for so many years.
Her primary care doctor’s advice was a simple photograph. The specialist’s was its complex negative, a perfect opposite, bright where the other was dark, illuminated where the other was shadowed.
She struggled to comprehend what the diagnosis meant for her, the different paths she could’ve taken had she known, had she been treated. Later, she described this moment as a slow-motion punch. Even an ocean away, I felt it too.
She wondered if she’s alone. She is concerned about the millions of other timelines out there, woven into the fabric of fat people’s medical experiences. Just how big a problem is this? “Is this an epidemic? How widespread is this kind of misdiagnosis?” she wondered aloud.
I told her I didn’t know, but I’d ask.