Dear Dinah,

I haven’t always been fat. Sure, I’ve always been a larger gal with bigger shoulders, wider hips, bigger boobs. But I entered my fat era maybe in my late 20s, and have only more fully engaged it as I’ve flown through my 30s.

My ex made me feel terrible about my body at every turn for almost a decade. My grandmother used to comment on things not fitting properly—including a prom dress that I was in love with. Trainers will often recommend “lifestyle changes” even though I’m working with them to get strong, not to lose weight.

No matter what they all might think, I am dedicated to taking care of my body. My mother taught me the importance of preventative care, annual physicals, and having a good relationship with your primary care physician (PCP). Yet my adult life has been a series of disappointing interactions with doctors and healthcare professionals who would suggest weight loss for an earache or sciatica, rather than observing my actual symptoms and treating them. Fat was the problem, and weight loss the answer—always. I’ve been on so many diets, from WW to FODMAP elimination, and even some weight loss meds back in the day. Many of these were doctor-recommended, either explicitly (with a prescription) or suggested as a way to lose pounds.

When my last PCP referred me to a gynecologist for polycystic ovary syndrome even though I had no symptoms besides some missed periods and being what the BMI deems “overweight,” I knew I had to find a new healthcare provider. So I asked a family friend who’s an amazing nurse practitioner if she could suggest someone who might be a better fit.

Even with her recommendation, entering your office was another exercise in anxiety—which was, thankfully, immediately put to rest.

Dinah, everything about my visits with you are based on how I feel, what my concerns are, and how to address them. There is no shame or blame. You treat my symptoms and look for underlying causes. Weight loss is not the cure-all. In fact, we don’t talk about weight unless I want to. You have made sure to refer me to specialists who will treat me similarly, or warn me if I should expect they aren’t weight-neutral.

It is hard for fat people to seek medical care because we know we often will be ridiculed or pathologized just for being in the bodies we have. But in your office we talk about my GI issues as a point of information, not an indicator of an unhealthy lifestyle. I told you about my love of running and you suggested podcasts to help merge my need for mindfulness with my training schedule. You have shown up for me as a healthcare provider in the way we all deserve, putting my needs and concerns at the center, with a laser focus on my health—not my weight.

I am so lucky to have found you (and my therapist Sarina, and psychiatric nurse Rebecca, and nutritionist Anita) to help me learn that I deserve and demand respect from my healthcare providers. I am so grateful for you. And Dinah/Sarina/Rebecca/Anita, I hope everyone in your profession looks to you as exemplars of what helping is. It is human-centered, it is compassionate, it is weight-neutral, it is full of joy and, most of all, care.

Love,Emilia