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?”
Me: “Yes.”
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!
I'm glad to hear of some change in attitude. I've been complaining to our school nurses since I started working there about their bogus use of BMI scores and how they negatively impact healthy children... and give a pass to some very unhealthy lifestyles just because a kid "scores well".
ReplyDeleteIt's great that you are trying to better the system for the kids you work with! We used to be given letter grades for our health and I was always scored as a C-. After putting in all the work I do, getting such a sub-par grade was so disheartening (even to me as an adult!) It caused me to wonder, "why do I bother trying so hard? I can't win." And that thought process encouraged me to give up. Grading, weighing, and measuring people of all ages like this is just hurtful to them, never helpful or encouraging.
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