Once again this year I signed up for the Wellness coaching program at work in order to get a discount on my health insurance costs. Once again they came to the office to weigh, measure, take blood pressure, and sample my plasma for cholesterol, sugar, triglycerides and the like.
Last Tuesday they called me at home to set up coaching sessions.
This company uses the word “stratify” to classify members into health categories – so when they call they will say things like, “you’re stratified as high risk for a heart attack because of your weight so we need to talk about weight loss strategies for you” or, “you’re stratified as high risk for diabetes because of your weight so we need to talk about weight loss strategies for you.” I have, in the past, referred to their monthly call to me as the fat check.
In my head their calls go something like this:
Coach: “Hi Carolyn! Are you still fat?”
Coach: “Oh – well try not to be fat and we’ll talk to you again next month! Do you have any questions?”
Me: “My allergies are really bad, can you help with that at all?”
Coach: “No, not really.”
I’m exaggerating of course, the conversations weren’t quite that awful. Although it is true that my request for how to deal with my allergies did baffle my coach and I had to teach her exactly what binge eating disorder is.
My time as a customer has been marked by discontent on my part. At one point I explained to them at length who invented the BMI, why he invented it, and why it should not ever be used as an indicator of patient health. I told them how unfair and prejudiced it was that they continue to stratify me as unhealthy and high risk despite my great blood work, great blood pressure, four to six workouts per week, my daily goal of a minimum five servings of fruits and vegetables, my low consumption of red meats and saturated fats, my non-smoking status, my extremely low alcohol consumption, and my continued slow weight loss.
My coach was sympathetic but firm: the BMI rules all. The BMI says “obese” so I’m still stratified unhealthy. End of story. She did ask, however, if they could follow up with me on my concerns in order to better their system, and I eagerly agreed.
I got bounced around between coaches a lot after that, and part of my brain wondered if I’d been stratified not only as unhealthy but also as an uppity fatty that nobody wanted to work with. I’m polite, but on this topic I can get pretty passionate.
Then last Tuesday’s call happened, and the conversation went like this:
Coach: “Okay Carolyn, since you’re stratified as healthy you can sign up for whatever you’d like to learn. We offer intuitive eating techniques, general nutrition, general wellness, exercise advice…”
Me: “Wait a second – did you just call me healthy?”
Coach: “Yes, you’re healthy and low risk so your sessions will be about whatever you’re interested in.”
I nearly cried. Very happy tears.
Since I still fall right on the borderline between overweight and obese on the BMI scale, this means the wellness company has changed what “healthy” looks like in their metrics. They have stopped canting the system heavily toward whatever the BMI says and started looking at the overall picture: including eating habits, workouts, blood work, lifestyle, and all the things that really matter.
They have stopped using appearance (and the beauty standard) as a diagnostic tool.
I would like to believe I had some small part in their change, and that now they can actually do some good for people instead of conducting useless monthly fat checks.
I signed up for sessions about intuitive eating, and when I asked if the coach I’d be speaking to was familiar with binge eating disorder the scheduler on the phone replied, “absolutely.”
Keep shouting! We can make things better!