Gaining

I went to see my OB for a checkup last Wednesday, and it's taken me until now to write about it. Because I have mixed feelings, but the primary feeling in the mix is crappy. No, no, no - the baby is fine. Everything's dandy there - my OB heard a heartbeat (I didn't hear it, but she heard it, so that's okay) and all else looks good with my little 5 cm. progeny. It's me. Or, as she put it as she clucked her tongue and shook her head at me from her seat in the examining room, it's my weight. She said that she was concerned that I had gained 44 lbs. during my last pregnancy, and that I hadn't lost it all before getting pregnant again. She said that for my height (about 5'2"), I should really be getting down to less than 120 lbs. after this pregnancy, and that she didn't want to see me gain more than 30 lbs. this time around.

I keep going around and around with this in my head. You see, it would be one thing if I was an overweight person to begin with. But I am not. I will be the first to admit that I gained too much weight during my last pregnancy, and that I certainly learned my lesson the hard way (those last 10-12 lbs. never did get off). I was already planning to be more vigilant about what I was eating during this pregnancy (i.e., forego the daily Ben & Jerry's chocolate milkshake and frequent stops at Jack in the Box for cheeseburgers in favor of tuna fish sandwiches or salads and glasses of water or milk). I now know that pregnancy is not a license for me to eat indiscriminately - nothing really is - and that eventually I will have to pay. But so far in this pregnancy - that is to say, in my first twelve weeks or so - in spite of my Lorna Doone frolics, I have gained around 3-4 lbs. (as opposed to 15 lbs. in my first trimester last time around), and I was feeling pretty good about myself. But no - I was shot down by my teensy-weensy, marathon-running doc who is treating me like I am a fatty. I felt like I was in the fifties or something!

It is a very fine line we women walk, I realize, when we begin arguing with our doctors about our weight (or telling our husbands or friends or our blog audience about all the things we wish we could have said to that bitch). Inevitably, we sound hyper-defensive and whiny and like we're about to make a gazillion excuses. But I'm feeling pissed off, and I think rightfully so. You see, I follow the BMI guidelines for weight versus height, because I feel that this is the most objective and simple way to determine a healthy weight for height. The other reason I follow this is because this is what doctors supposedly refer to in order to determine if a person needs to take extra steps to manage their weight. According to the BMI chart, I have managed to stay pretty much within a "healthy" or "normal" weight range for my height. And now I am pregnant, and I was planning to try really hard to gain within the "recommended" 25-35 pounds for a woman of normal weight. The point is, I had studied all of this - I had made a concerted effort to prepare myself for the changes in my body in this pregnancy - and I felt like my doctor treated me like I had no idea what was going on and I was just going into this pregnancy carelessly. She never asked me once what I was doing for exercise, what kinds of foods I was eating, etc. She just got bent out of shape about the number on the scale.

My doctor also didn't ask me, before launching into her speech about my weight and how much I was gaining, if I had ever had an eating disorder before, which I found most alarming. I actually haven't, and I am fortunate to have gained a fairly healthy attitude about eating and weight and food in my life, but I have encountered many, many women who do have a wide range of issues with eating. I also know that pregnancy and the inevitable weight gain that accompanies it can be quite a trial for someone who has gone to extreme measures to control her weight in the past. Add to this a doctor telling you that you are headed toward FAT if you don't exercise more control, and in some women this might trigger an all-out recurrence of their disordered eating behavior, leading to innumerable risks for the growing baby (not to mention the mama). Of course I checked, on the initial questionnaire, that I do not have an eating disorder, and the doctor may have reviewed this before talking to me, but I imagine that many women who do have a problem would also check "no" in order to avoid another confrontation/counseling session with a professional.

The point is, I felt that all of this that happened was very irresponsible on my doctor's part, and I am pissed off at her and wondering if I should go to the trouble of switching doctors at this point. I realize, however, that no matter what I do, what she said is now going to stick with me and needle at me throughout this pregnancy and beyond. Even if I do succeed at gaining 30 lbs. or less, I will be haunted as I try to take the weight off that maybe I won't be able to get it all off again, and then even if I do, that I won't be able to get down to 120 - the magic number that my doctor spewed. I have not weighed 120 since the 7th grade! That number seems unrelated to any BMI chart or anything I have ever seen. It sounds, again, like some ideal that girls learned, in whispers, in the 1950's - "You musn't let your weight get above 120, or your husband will stray, darling." There is the side of me that knows that what she said is at some level irrational and extreme and not exactly for me, and that's what I try to focus on. But there is another side of me that freaks out every once in a while that what she said was actually the gospel truth, and that I must trust her judgment and her comments as she is a highly-educated, experienced medical professional. After all, why would she just want to make me feel bad? She has an interest, doesn't she, in retaining me as a patient?

I think the term "eating disorder" is interesting. It conjures up images of Karen Carpenter or Paula Abdul or, for me, perfectly-tanned, blonde Connecticut girls in pearls and cashmere sweater sets eating their salads with lemon juice and a cup of tea day after day in the dining hall at my prestigious New England college. And I all-too readily said, just above, that I do not have an eating disorder. But I am inordinately concerned with my doctor's comments, made almost a week ago now, about my weight. In fact, my husband might say I am "obsessing," and he would probably be right. Though I do feel that my attitude about food and weight is generally healthy, I know that I can get caught up in other people's determinations about what a "good" or "healthy" body looks like or measures up to (or down to). I think that women in this society are severely patronized about this issue. We are told not to worry about our weight so much, and everyone knows that supermodels are freakishly tall and thin and we should just love ourselves, etc., etc., but isn't it a shame about Judy, who's had three kids and she used to have such a nice figure and now she's really gained a lot of weight. Or Allison, who would probably feel better about herself and get some dates if she could just drop a few pounds. Or back to my last post, where a woman who is beautiful and slender to boot "probably has an eating disorder." It's like this great farce. Do we or don't we feel that women should just be themselves and be healthy? And what does healthy really mean to each one of us?

I will say that my doctor's comments have freaked me out to the extent that I am giving much extra thought to what I put in my body now. And I am surely eating more healthfully as a result, even as I gain. I will try not to worry, I say. I will focus on having the healthiest baby possible and nothing else matters. But I will put out there that it is almost impossible even for the most confident of women to hear a negative comment about their bodies, their weight, and not carry that comment around in their sack of woes, of "can'ts," for a long time after. My sack was really lightening of late, but now I am huffing and puffing from the extra weight.