Talking About Eating, RA, and Weight
Content Note: This article discusses disordered eating.
At another regularly scheduled endocrinology appointment, I'm sitting in pent-up anxiety wondering what is wrong with my body. Here we go again.
I've felt this familiar feeling before with RA before I was actually diagnosed. The only thing making this different is that I do have RA now, and there's nothing I can do about it. It's intersected every aspect of my life at this point, especially with the amount of weight gain I've had that I can't explain or comprehend.
My endocrinologist suggests a heavily restricted diet
This appointment is different. It feels tense. I feel not listened to again. The endocrinologist tells me that I'm clinically normal; there's nothing wrong in my blood. She tells me that at this point, I should try a heavily restricted diet. She walks me through what an 800-calorie diet could look like for me, the benefits of going on it, and telling me that I will lose weight if I stick to an 800-calorie diet.
Eight hundred calories? Eight hundred calories is, according to my endocrinologist, 4 egg whites with mixed vegetables, 1 small blanched chicken breast, steamed vegetables, and 1 small protein smoothie. That is supposed to sustain me, as a 25-year-old, 6'1'-tall man. She tells me that I can throw in another chicken breast if I'm extra hungry to make it a 1000-calorie diet.
A long struggle with weight loss and gain
You start thinking about all the times when you were younger and you would sneak junk food and candy wrappers into the lining of the couch. You start looking at yourself in the mirror and pull and poke at the extra weight on your body and wish it could go away. You start thinking about how an 800-calorie diet does not fit into a normal person's plan, let alone someone who has rheumatoid arthritis, who needs to eat for his medications, who has tried disordered eating like 800 calories before and did lose weight but then instantly gained it all back plus some.
I rise from my chair and leave the appointment. I don't really consider how awful this appointment has been, how someone with a medical license could proffer such advice to someone struggling with their weight. I ponder what to do, but the only thing I can do in this moment is write about it.
I can't give up, but I don't know what to do
The biological function of losing weight is about being in a calorie deficit, yes. But only eating 800 calories seems beyond excessive and could potentially teeter into the unhealthy. I would have been more receptive to a conversation about reducing calories to maybe 1600, but 800?
All of this came about in the first place given my struggle with weight and Humira. Humira seems to either cause me to gain weight or have an inability to lose weight. But I need Humira in order to physically function; given my rheumatology numbers, it really is working to help me continue functioning. I can’t give it up; I could try to switch to a different drug, but my rheumatologist suggested that all the other drugs would likely remain the same.
I feel frustrated and confused. I don’t know what to do, and I don’t know how to combat what my endocrinologist is saying.