New Year’s 2023 Life Review, Health-Centered

EATING, WEIGHT, ETC.

I’ve done more thinking about “body positivity” and healthy weight than I ever have before.

You know what’s super annoying? When I went to my doctor in September because I could not eat, because when I tried to eat I only vomitted due to the GI crisis for which I was at the doctor urgently seeking care, the primary care nurse who checked me in had words for me. What did she say? “Oh great! You’ve lost weight!”

And I said, “But do you remember what I just told you about why I’m here? I can’t eat – I mean, I almost completely cannot eat at all.”

Did that get it to click for her? Nah. She doubled down. “Yeah, but look at this! You’ve lost 14 pounds since May!”

I said, “Man, I’ve lost 14 pounds since 12 days ago, when this crisis began for me. Can you please try to listen to me?”

No, actually, she could not try to listen. Her computer spit out a BMI factoid and she read it and congratulated me. I assure you that I was healthier when I was not starving to death, but she did not consider any of that.

I got myself a smart scale.

After realizing the limitations of the primary care nurse to discern the difference between a healthy weight change and *I might be dead in two months because I cannot eat enough to sustain life*, I acquired a scale that is able to measure the percentage of muscle and fat in my body, bone density, level of dehydration, things like this. I felt this all was more useful information for me.

Basically, what I learned is that those seven weeks of starvation I experienced in September-October of 2022 made me lose a ridiculous amount of muscle mass. It made sense. Having not enough energy for my brain to work right, I sure as heck couldn’t make my body move much, and so atrophy ensued. As the primary care nurse congratulated me on my lower BMI score, my body had become much more ill, not more healthy. Why couldn’t she tell the difference?

I now use my home smart scale mostly to track gains in muscle mass and losses in fat mass. BMI tells me nothing. I think BMI should not be the go-to metric it seems to be for everybody. It was also what the GI doctor asked me for during my quick “phone call visit” with him in October to describe my body.

How bogus is BMI tho?

As of today, New Year’s Day, my BMI is 26.7, which is still overweight. This BMI number actually underrepresents my biggest problems though: the atrophy I experienced from seven weeks of near starvation, and that more of those pounds are fat than what would be a healthy ratio for a woman my age. But BMI will still show me as overweight/unchanged after I make substantial improvements. Check this out.

According to the app that goes with my home smart scale, I still need to regain 15 pounds of muscle mass to enter into the lower end of the range of normal muscle mass for a woman my age and height. That won’t make my healthcare providers happy, since it will result in a higher BMI, but it will indeed be a healthy change. Toward that end, I try to do as much treadmill walking as knee pain permits, in addition to eating my very healthy high protein, low fat and low carb diet capped around 1200 calories/day.

I also need to lose 18 pounds of fat mass to enter into the range of normal fat mass for a woman my age and height. The same diet and exercise is for this goal too.

It’s funny, right? Because, obviously, doing both of those things means I will weigh a net change of three pounds less than I do right now. After that net loss of 3 pounds, I will have a perfectly healthy fat and muscle mass ratio, and I will still be considered “overweight” according to the BMI metric, which would be 26.4. So I say to hell with your BMI. It led my primary care provider’s nurse to celebrate my most gravely ill state of my life, and it will lead these same people to tell me I’m “overweight” after I regain these last 15 pounds of muscle and lose these last 18 pounds of fat. Nah.

SO WHAT HAVE I LEARNED ABOUT MY BODY

forget bmi
Screenshot of weight loss in pounds and BMI over the past three months.

Despite having already lost 35 pounds from September 7, 2022 – January 1, 2023, and now eating 100% healthy foods only, with a religiously faithful GERD-healthy intake of always-small portions, and without even drinking any seltzer anymore, because seltzer is acidic – I drink only water now, despite these changes and even with doubling the omeprazole to its max dosage, I have uncontrolled GERD symptoms. Diet and weight loss have not lessened my symptoms at all (even though I agree they are good/healthy changes).

Unmanaged GERD for me includes reactive airway symptoms (caused by GERD) that means I’m back to using my albuterol inhaler 3x/day, whereas when my GERD was fully managed (prior to May 2022) I was only needing to use albuterol 1-2 times/month). Gastric emptying study also revealed gastroparesis, or delayed gastric emptying, which may be a side effect of all this omeprazole.

I learned that starving for seven weeks can tank a person’s metabolism, certainly someone in menopause.

I learned that I really do want to live a long, healthy life with my beloved. Really. This was a life-changing a-ha in the midst of all this nonsense for me. Even though my GI crises are not something I caused, I still want to do everything within my power to give myself the best chances of health. I’m not “on a diet” or whatever. A switch flipped for me and this is how I’m going to live now, making healthy choices with food and exercise to the extent that I’m able. I’m loving the body I’m in, doing the best that I can to take care of this body so I can try to live this one quick life out well.

My next appointment with the GI doctor whom I’ve never met other than in that one quick phone visit is this week, in person. Hopefully, he can hear my concerns* and hopefully he can take me seriously and help figure out how to manage these symptoms. Fingers crossed.

* concerns = unmanaged GERD with reactive airway, early satiety, hiatal hernia, aperistalsis, and gastroparesis despite maxed out omeprazole, optimal GERD diet and behaviors, and weight loss wherein four months of the perfect GERD diet and weight loss have not improved my GERD symptoms in any way, and doubling omeprazole only improved me from being unable to eat more than 700 calories a day to being able to eat a bit more. What else can we do?!

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About Erika Sanborne

Erika Sanborne has been producing media since 2014, specializing in corporate and higher ed video explainers, portraiture, green screen videography, and other digital media productions. Her latest passion in graphics is data visualization.

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