The Conundrum of Being Told to Diet and Exercise When You Have RA

If you're heavy-set (overweight, obese, fat β€” whatever label you want to put on it or have been called before), you have likely heard the following statement from every single doctor. You've been told: "Well, at the end of the day, you need to remember to eat a healthy diet and exercise more."

Constant diet and exercise advice

They say this even when you come in for an appointment for your recently broken leg, if your sinuses are acting up, a broken and ridged toenail, or anything else that isn't remotely related to your weight or diet.

Before going further, it's important to say this here. The statement of dieting and exercising isn't bad; it's the context in which the statement is said because diet and exercise doesn't solve every health problem β€” especially rheumatoid arthritis (RA).

Assumptions that I'm not doing enough

I've had a lot more health problems lately that have been giving me trouble.

From feeling fatigued and bloated all the time to gaining weight astronomically, my hormones are out of whack, according to my primary care doctor.

I am dieting and exercising

When I go - and, yes they have to ask because I've been gaining weight - they say the same thing: "Diet and exercise, diet and exercise."

I have the data to prove that I am dieting and exercising. My calorie count is below 1800 every day and I exercise for 51 minutes per day (averaged over the past 6 months).

And yet, even when presented with this data, most of my doctors still insist that I'm not dieting or exercising enough.

Erasure of what I do to improve my health

This is an active erasure of my experience and what I've done to alleviate some of the health problems I'm experiencing.

I have to constantly advocate for myself to be heard and understood, which shouldn't happen in a medical setting. I wouldn't be at the doctor if something wasn't wrong, and sometimes I feel that medical professionals forget that most individuals don't want to be at the doctor in the first place.

So, why would people lie about dieting or exercising when they have been? I'm saying this in a vein of understanding the difficulty of advocating for ourselves.

Having to advocate for ourselves

Advocating for oneself becomes particularly difficult when you have chronic illnesses, too, because you then have to piece together the puzzle of your life and your experience each time you go to a new doctor or when a new symptom or problem arises.

And often, the problems that arise with a chronic illness like RA can mirror other conditions. And, therefore, trying to determine which condition is causing the symptom becomes more challenging - both for you and your doctor.

RA often gets in the way of exercise

The other problem of being told to diet and exercise when you have RA and/or are overweight is that RA can often inhibit your ability to exercise!

In addition to muscle weakness and general feelings of fatigue, joint pain and stiffness are not conducive to active mobility and forms of exercise that can quickly burn calories.

Low-impact physical activity

For me, I can't really go to the gym and build muscle, I can't try heavy equipment or things that stress my knees, or anything else like that. Really, I'm relegated to walking and swimming.

And, while these are low-impact on the joints, they still require energy, a relatively scarce resource for those of us with chronic illnesses.

Even when you tell doctors all of this, they often sympathize on the surface but expect you to figure something out. What happens when you try to do that but your body is physically holding you back?

Diet and exercise are important but not a panacea

Clearly, being told to diet and exercise is just a blanket statement for alleviating medical problems.

Yes, it is the case that diet and exercise are important to overall health, but they aren't the panacea to all medical woes. And having to constantly advocate for yourself is overwhelming and exhausting.

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