My pediatrician made my eating disorder worse. And it’s not for the reasons you may think.

 My pediatrician made my eating disorder worse. And it’s not for the reasons you may think.

TW: mention of eating disorders, weight numbers

I first learned what the term “self conscious” meant from my pediatrician. I must have been around 8 or 9 years old when she said it to me as I stood exposed in my underwear. Until then, I didn’t have the awareness or vocabulary that my nervousness around undressing and instinct to cover myself was because I felt “self conscious.” I left the visit feeling like self-consciousness was an unfavorable diagnosis that I had to overcome.

At my next annual visit, I received another negative mark on my record. My pediatrician said, “Mom, we’re a little overweight. Let’s cut down on portion sizes. No more seconds at dinner.” I remember the scale reading 75 pounds. It was the first time I became aware of how much I weighed. It was the first time I felt ashamed of my eating habits, and of my body. This is when I first started to restrict my food intake.

I kept my first food journal when I was in 5th grade. I remember noting down just “pear” for what I ate in one day. I feel so sad for that little girl.

I developed strange behaviors around food when I entered middle school. At that point, I was back to eating regular meals. But I also had the compulsion to eat whatever my friends couldn’t finish on their plates. It got to the point where I would demand some of my friends’ lunches, even if they did want it. I couldn’t control it. And I felt so guilty for asking.

This behavior didn’t completely stop until I entered high school. Going into my freshman year, I was coming off of a summer of sleepless nights. I dreaded going to bed each night because I knew I wouldn’t be able to sleep. When I told my mom about my insomnia, she told me “We’re a family of bad sleepers” and “Did I need to see a therapist?” I didn't want to be a burden, so I declined therapy.

I’ll never forget my annual check up prior to starting high school. I remember learning that I was now 5 feet tall and 116 pounds. My pediatrician still didn’t like my weight, noting that it was on the higher side. I felt like a failure. (Hi! Interjecting from the present here- Just to be crystal clear, being 5 feet tall and 116 pounds is completely normal and healthy. It's not even close to being overweight!)

I finally made a change after a week of winter softball conditioning during my freshman year of high school. I was the slowest on the team. I felt so out of shape, knew my doctor didn’t like how much I weighed, and felt scared for my health.

So I started running. Just a mile a day. But I also started heavily restricting. Although I didn’t have access to a scale, I could feel my clothes starting to fit looser. I knew it was working. In no time, I went from the slowest at softball conditioning, to the fastest.

At my next doctor’s appointment at 15 years old, I actually felt excited. I wanted my doctor to see all the progress I had made. I wanted her approval. At that appointment, I learned that I grew 2 inches (now 5’2) and that I had lost over 10 pounds from the last check up. I was now down to 104 pounds. My doctor praised my figure. She said “You don’t seem like little self conscious Emily anymore.”

Then she asked me about my periods, were they regular? The answer was no, they weren’t. She responded “That’s normal for female athletes like gymnasts and runners. It just means you’re training hard.” Unfortunately, that’s when I first started equating working hard/performing well with losing my period. It took a very very long time for me to challenge and undo that belief.

However, the tone of the visit turned. “You’ve lost a lot of weight and have grown 2 inches. Are you eating enough?” She glanced at my mom. My mom answered hesitantly, “She has been eating a lot less lately.” My doctor then asked me point blank, “Are you anorexic?”

Immediately, panicking, I responded, “No! Of course not! I can eat more! I’m just trying to be healthy!” Which wasn’t untrue. I truly wanted validation from my doctor. I wanted a good score on my check up. But I also didn't want to give up my "new figure" or newfound self confidence.

That response was good enough for my doctor. I left that appointment proud of what I had accomplished, but determined to not be a burden. I began eating peanut butter sandwiches as snacks in between meals to gain some weight. This worked and got my doctor off my back. 

Retrospectively, all this did was teach me that I needed to hide my eating disorder- which I did fairly well from ages 15-19. (Not a flex, just the reality.) Instead of being ashamed of my body, I shifted shame to the mechanism behind my shrinking body, my eating disorder. The shame never disappeared, it simply transformed.

At the end of the day, language matters. You never know what children will latch onto. My pediatrician was just part of what caused me to develop an eating disorder. But I wonder if I had a pediatrician with a more weight-neutral mindset, would I have developed as severe of an eating disorder as I did? I’ll never know the answer. But it’s worth talking about. Professionals working with children need to understand that their words have impact- good and bad.