Why you should not comment on a person's appearance

mrsconn23

Dear Prudence,
I’m a middle-age woman who has struggled with anorexia my whole life. I’ve been in recovery for about 10 years but have recently relapsed. I am seeing my doctor and therapist regularly and taking good care of myself—my health right now is not the problem. The problem is I’ve lost some weight and people keep complimenting me on it. I want to remind your readers that sudden weight loss is not always a sign of health: I could be sick, or depressed, or any number of things. My question is how do I respond to these compliments? I don’t want to say “thank you” because this can lead to further disordered thinking. I’d like to say, “Thanks, but I have an eating disorder, so I’m hoping this is temporary,” but obviously I don’t want to tell everyone about my illness. My close friends know what’s going on, but how do I respond to “compliments” from acquaintances and strangers?

—Public Commentary

MissKittyDanger

"this was not intentional, and not a good thing to lose weight" - leaves it open for people to ask follow up questions if they want

charlotte989875

"I've been having some health problems lately, and I'm hoping I'll return to my normal weight soon."

Heffalump

I think the LW needs to discuss this with her therapist.  Assuming the therapist specializes in treating eating disorders, he or she should have some helpful strategies for deflecting or acknowledging these comments without jeopardizing her health. 

Not to minimize her situation, but I think people just say things sometimes.  I have been known to compliment someone's earrings or shoes even if I don't love them, just for something to say.  She brings up a good point, but mostly I think it's on her to deal. 

baconsmom

Complimenting clothes is not commenting on bodies. 

Honestly, when people do this to me, I break every rule of etiquette and tell them - gently, but still - that it's rude. "I know what you're trying to say, and thank you for thinking I look good. But commenting on someone's body is never, ever appropriate. Please in the future just tell people they have a great outfit or they look happy." 

If they want more conversation, I'll tell them it's because sudden weight loss is often a sign of illness, but also that talking weight with someone can be triggering. And again, I do my utmost to be kind, because I know they're not trying to be awful. 

kimmiinthemitten

I think it's important to be sensitive to other peoples feelings and lives and needs.  If someone tells you something you directly stated bothers them, you should respect that (lightweight example if I say please call me Kimberly, it's rude to call me anything else).

However, if you're not comfortable or ready to approach that conversation, then you need to be aware of your triggers and be working with a professional to address them.  

I'd thank the person and journal how it made me feel to discuss with a therapist until I was ready to broach the problem head on with other people.  Any other response will simply engage them in a conversation they clearly are not ready to have.

short+sassy

My story of weight loss as a very bad sign (sorry, long):

As someone who has always tended to run "plump", plus I have a round face with round cheeks, I didn't think there was such a thing as too thin (for me).

Back in college, even at a 110 pounds and wearing a size 1 or 3...that I had to maintain by exercising 1 hour 5/7 days a week and eating only 900 calories/day...I was thin, but still round and filled out.

Then I started feeling tired.  REALLY tired.  I pretty much stopped exercising for a month.  Yet, for the first and only time in my life, I'd look in the mirror and my normally round-plumpy cheeks were gaunt.

I finally went to the doctor because of my exhaustion.  Of course, one of the first things the nurse did was have me step on a scale.  I remember I joked to her that I didn't want to get on the scale because I'd stopped my exercise routine.

I was 102 pounds.  My stomach dropped and chills ran through my body.  I knew there was something really wrong with me.  I'd lost 8 pounds in two weeks, almost 10% of my body weight.  I'd always had to fight hard to lose even one pound.

I was diagnosed with Type I Diabetes the next day.  My body was starving because I wasn't producing nearly enough insulin to process even the scant 900 calories/day I was eating.

Despite living it, it's so odd to be starving, but not hungry.  Because those words are usually synonyms.  My stomach was full, because I was eating, so I wasn't hungry.  But my body was only getting (roughly) 25% of the calories I was eating. 

sparklepants41

Hugs for you, @short+sassy! Thank you for sharing your story with us. 

kimmiinthemitten

Wow @short+sassy, the upside to your story is that it pays to know and listen to your own body.

MissKittyDanger

Wow @short+sassy  glad you paid attention and got help. That must have been scary. Hugs!

*Barbie*

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

short+sassy

*Barbie* said:

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

That's horrifying.  Perhaps I'm wrong, but I suspect if a man in his early 20s said he wanted a vasectomy to improve a health condition, it would have been "snip, snip away".

I'm glad your friend is in better health now.

*Barbie*

short+sassy said:

That's horrifying.  Perhaps I'm wrong, but I suspect if a man in his early 20s said he wanted a vasectomy to improve a health condition, it would have been "snip, snip away".

I'm glad your friend is in better health now.

Yeah, a college friend had testicular cancer and had to have one of his balls removed - i'm sure his doctors weren't all "wait and see, because radiation/chemo/partial castration may harm your chances of having a biological child someday."

The hysterectomy was what made the final difference. She's been good the last 5 or so years. The whole situation was scary for her and really impacted her life quite a bit. She would have been my MOH, but told me that given her health wasn't sure if she would be able to travel the 2 hours for the wedding. (She didn't end up making it - was in the hospital ~2 days prior and called to let me know - and was still going to try and carpool with some friends, and I'm all "don't worry about it, just get yourself better.")

kerbohl

This whole thing about keeping women "fertile" despite their wishes is so bizarre.  I had a friend who was in Scandinavian and caught wind of the fact that women can choose to get sterilized at 25.  She didn't have the option when returning to North America.  Because of course, us women don't deserve to have control over our own bodies and whether we will/will not have babies. 

The only thing that would scare me about the hysterectomy so young would be going through menopause early. A woman at my work had that happen to her (a hysterectomy at a young age and then the body's side effects to it), and it wrecked havoc on her.  She told me some horror stories.  Of course, the alternative would have been much much worse.  This was also like thirty years ago, so maybe having a hysterectomy younger is not as damaging anymore?

SP29

short+sassy said:

*Barbie* said:

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

That's horrifying.  Perhaps I'm wrong, but I suspect if a man in his early 20s said he wanted a vasectomy to improve a health condition, it would have been "snip, snip away".

I'm glad your friend is in better health now.

Yup. I know someone who was in a car accident very young which resulted in a broken hip that did not heal properly. She developed arthritis and chronic pain. She had several surgeons tell her she needed a hip replacement, but they wouldn't do it because she was a woman of child bearing age and they worried about how her pelvis after the replacement would be affected by child birth. If she were a male, it would have been done ASAP. She told her doctors she didn't want children and would happily get a hysterectomy first- which no doctor would agree to do either because she was too young! She eventually did get a hip replacement, but she had to fight for it near 10 years. Geez. Talk about quality of life....

Anywho.... this has been a good discussion. I'm glad it was brought up.

MesmrEwe

*Barbie* said:

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

Yep - won't even go into the problems I had getting Hypothyroid diagnosed!  Let's just say 8 doctors, two years, and 16 - yes, that's 16, DIABETES tests that showed I clearly do not have diabetes! (and I was training in the gym heavy 5x/wk)  If you're of size, it's always "eat too much exercise too little" instead of the possibility there's a true hormonal imbalance or symptom of a medical condition at play.  

The LW is great in knowing the mechanism going on, which is half the battle to all things eating disorders.  Ultimately she has to gauge who she's talking with because if people don't know, they can't be supportive like you want them to be.   Not that everyone will be, but they're far more likely to be if they know.

ernursej

*Barbie* said:

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

I've requested a hysterectomy for the last 10 years and I'm still being told that can't happen. I've even gone through counselling to discuss my wishes and my expectations but that didn't change anything. No one will do it and they tell me it is due to dangers of unnecessary surgery and what if I change my mind. I've stopped pointing out that people get plastic surgery without issue and some of those surgeries carry more risk that hysterectomies without oophorectomies. Me and my Mirena will just have to be besties forever. 

Edit for spelling

LadyCatherineDB

My friend's mother lost 70 pounds in a few months. A lot of people would say, "You look great. What's your secret?" It was always awkward when she had to respond with "I have cancer."

short+sassy

MesmrEwe said:

*Barbie* said:

I have a friend who was in a similar situation - in regards to significant weight loss due to an illness. In her case it ended up being a positive thing (the weight loss) - she was just shy of qualifying for bariatric surgery, and ended up having a lot of health issues (not weight related). It took her ~5 years to get her health in check, but ended up going from a 22/24 to a 6/8. It was pretty drastic since it was over a ~2 year period. She's able to joke about it - the only positive of the issues was that she lost the weight and avoided having to go through the bariatric surgery. 

The negative of the situation was how she was treated by doctors - one of the things that would help her the most was getting a hysterectomy, but since she was in her early 20s when she started having problems, they refused to do it. She always said that she never wanted to have kids and wanted the surgery, but they made her wait almost 5 years to get it because "what if you change your mind?" ("I won't, but if I ever wanted kids I would adopt." wasn't a sufficient answer for them. )

Yep - won't even go into the problems I had getting Hypothyroid diagnosed!  Let's just say 8 doctors, two years, and 16 - yes, that's 16, DIABETES tests that showed I clearly do not have diabetes! (and I was training in the gym heavy 5x/wk)  If you're of size, it's always "eat too much exercise too little" instead of the possibility there's a true hormonal imbalance or symptom of a medical condition at play.  

The LW is great in knowing the mechanism going on, which is half the battle to all things eating disorders.  Ultimately she has to gauge who she's talking with because if people don't know, they can't be supportive like you want them to be.   Not that everyone will be, but they're far more likely to be if they know.

I had the worst doctor ever on that.  I have almost no thyroid function without medication.  Unfortunately, I went through a period of time where I was unemployed just long enough between jobs that, at my new job, the insurance wouldn't cover a pre-existing condition for the first year (over 10 years ago, pre-ACA).

My last thyroid prescription time ran out, but I couldn't afford the doctor visit and lab tests for a doctor to write a new prescription.  So I just did without.  Once my year was up,  I visited a new doctor under my insurance.  I talked to him about my problem thyroid and my Type I Diabetes.  And the one year I'd had to wait before I could see a doctor and knew I REALLY needed to get the labwork done so I could get back on my prescription.

I could tell he looked down on me because of my weight.  The first thing he said was that thyroid pills weren't a weight loss drug and that he couldn't just write a prescription.  I said, "Right, totally understand you have to do labwork.  THAT'S what I'm asking for."  Started lecturing me about diet and exercise.  I acknowledged I could make improvements there, but also pointed out to him that all the diet and exercise in the world wouldn't help much if my thyroid was barely functioning.

He also told me he suspected I had been misdiagnosed with my diabetes and that I actually had Type II Diabetes, not Type I Diabetes.  Obesity is related to Type II Diabetes (not Type I).  And, for the most part, nobody under the age of 40ish develops Type II Diabetes unless they are extremely overweight.  Keep in mind, this appointment was 10 years...and a variety of doctors over the years who'd never questioned my thyroid or type of diabetes...AFTER I'd been diagnosed with both conditions.

In a really snarky tone, that I don't think he picked up on, I told him, "Well, when I was diagnosed with TYPE I DIABETES, at the AGE of 20.  I only weighed 102 pounds.  Soooooo, I don't think I was misdiagnosed (heavy sarcasm)."  Not to mention, Type I and Type II Diabetes are treated quite differently.  And just insulin with no pills of any kind (Type I treatment) had been working just fine and dandy for me for a decade.

Despite my labwork for him coming back as, duh, a super low thyroid function.  He refused to call in my prescription.  He didn't tell me that, per se.  But he never called it in after I made repeated calls to his office.

Fast forward about 6 months.  Hurricane Katrina hits NOLA.  I evacuate to Miami.  I go to a public health clinic there.  The doctor walks into my room, takes one look at me, and says with alarm as she checks her chart, "We're checking your thyroid level, right?  Good, we are.  I can tell just by looking at you your thyroid level is way too low."  (A low thyroid can give someone a yellowish cast to their skin and enlarge a portion of their throat).

For me, it was one of those moments in a movie where the heavens open up with a golden glow and an angelical musical theme of, "LAAAHHH," plays.

Alaska_RockGirl

I had 7 years of borderline thyroid tests. Went to a doctor who said to me "If you were pregnant, we'd treat this because it could affect the baby, but since you're not, it's fine." I was shocked because it seemed to me if it was worth treating if I was pregnant, it should be worth treating even if I'm not. Doctor was female.

It wasn't fine. Found a new doctor, who like your doctor in Miami, took one look at the test values, discussed my symptoms, and started me on synthroid. I still see my current doctor- she's great!!

short+sassy

Alaska_RockGirl said:

I had 7 years of borderline thyroid tests. Went to a doctor who said to me "If you were pregnant, we'd treat this because it could affect the baby, but since you're not, it's fine." I was shocked because it seemed to me if it was worth treating if I was pregnant, it should be worth treating even if I'm not. Doctor was female.

It wasn't fine. Found a new doctor, who like your doctor in Miami, took one look at the test values, discussed my symptoms, and started me on synthroid. I still see my current doctor- she's great!!

Thyroid levels have a decent sized range of "normal".  It's ridiculous a doctor wouldn't give you a low dose to bump you from "borderline" to normal?  I'm so glad you have a much better one now.

Until that experience, I'd been one of those people who trusted a doctor's advice as gospel.  Because they went to medical school and I didn't.  I lost my faith that day and do my own research now, when a doctor gives me advice and/or something to bring up if I come across a medication/treatment that I think might be helpful. 

It still KILLS me (now with laughter) that the first words out of his mouth was, "Thyroid medication isn't a weight loss drug."  Ummm...yeah, dude...I know.  I wish I could snap my fingers and show you the 50+ lab reports I've had over the years where my thyroid was super low or at a normal range because I'd been taking daily, high dose, Synthroid pills.

cowgirl8238

SP29 said:

Yup. I know someone who was in a car accident very young which resulted in a broken hip that did not heal properly. She developed arthritis and chronic pain. She had several surgeons tell her she needed a hip replacement, but they wouldn't do it because she was a woman of child bearing age and they worried about how her pelvis after the replacement would be affected by child birth. If she were a male, it would have been done ASAP. She told her doctors she didn't want children and would happily get a hysterectomy first- which no doctor would agree to do either because she was too young! She eventually did get a hip replacement, but she had to fight for it near 10 years. Geez. Talk about quality of life....

Anywho.... this has been a good discussion. I'm glad it was brought up.

short+sassy said:

That's horrifying.  Perhaps I'm wrong, but I suspect if a man in his early 20s said he wanted a vasectomy to improve a health condition, it would have been "snip, snip away".

I'm glad your friend is in better health now.

Doesn't need to be for good health, my cousin had a vasectomy at 25 because he was, "just done with having kids already."  He had 2 girls about a year apart, so apparently that and a counseling session were enough to allow him to be snipped, but if I, or anyone else wanted (hell needed) to have it done it would be about as difficult as jumping through 25 rotating flaming hoops while completing the entire American Ninja Warrior Course on top of Mt Everest in a bikini!

Alaska_RockGirl said:

I had 7 years of borderline thyroid tests. Went to a doctor who said to me "If you were pregnant, we'd treat this because it could affect the baby, but since you're not, it's fine." I was shocked because it seemed to me if it was worth treating if I was pregnant, it should be worth treating even if I'm not. Doctor was female.

It wasn't fine. Found a new doctor, who like your doctor in Miami, took one look at the test values, discussed my symptoms, and started me on synthroid. I still see my current doctor- she's great!!

No joke, just went through this about 2 weeks ago.  I had some blood work done because I have been having some minor health issues and (big surprise) since I am overweight and "already insulin resistant" (thanks genetics!) the doctor didn't want to check my thyroid levels at first...despite my results being on the "upper end of normal" two years ago.  So after I point this out to the doctor they agree to do the blood work and the results show that my thyroid is indeed underactive.  So I go in to discuss the results and follow-up with the aforementioned previous issue and the doc feeds me the same line. So I tell him "but I am TTC" and he goes, "oh in that case, here is the script take it every morning at least a half hour before you eat." 

Like why is everything such a fight to have done if it involves your reproductive organs and how you choose to use them (or not)?!

CMGragain

I just have to chime in on this one!

"Ooooh, CMGraigain, you have lost so much weight!  You look fabulous!  How did you do it?"

"Gee, thanks!  I have cancer."  (Smile, and walk away while speaker tries to sink into a hole in the floor.)

Really, this doesn't happen often.  Sometimes I have an evil CMGraigain sitting on my shoulder and whispering into my ear.