Anatomy Lesson: A Medical Student Contemplates Her Life-long Struggle with Her Weight—and How it May Make Her a More Sensitive Clinician

Alice Zhao ’22. Credit: John Abbott

When I sit in the doctor’s office, I wonder what she thinks of me. When she walks in, there’s the initial glance: young female, pleasant appearance. Then there’s the quick logging into the chart, the swift downward scroll through my vitals. Pulse, 75. Oxygen saturation, 99 percent. Height, five foot six; weight, 175 pounds. Here, she might pause—just briefly. We exchange the usual pleasantries. How are you; I’m fine, thank you; what brings you in today; I’m just here for my annual check-up. She listens to my heart and lungs. I lay down as she palpates my stomach, which is warm and a bit too fleshy. I imagine looking at her face—her serious face that betrays no opinion—when she tells me that my weight is not where they want it to be.

I will apologize, just a little, for being too busy to properly take care of myself. She will stress—in that calm, advising tone—that diet and exercise are important and being overweight can predispose you to high blood pressure, high cholesterol and diabetes. (I know this; I’ve known this for a while.) She will give a gentle, reassuring smile and say she wants to draw blood just to check. Our interaction will end with a few more genial phrases, maybe a comment about Weight Watchers. The door will close behind her, and I will get up to leave.

From the average patient’s point of view, we had a perfectly normal interaction. But as a medical student, I have to wonder how much went unsaid. Does my physician judge me for my extra pounds, since I am—must be—well aware of the health dangers of being overweight? How is this girl who can’t even keep her own body in check going to lecture patients on how to take care of themselves?

With my white coat on, it’s easy to think about solutions. If you smoke, stop. If you drink too much, give up alcohol. And if you’re eating too much, just eat less. If you can’t? Well, you must lack discipline.

It all feels so frustratingly routine. I am 20 pounds overweight. I have a family history of high blood pressure, high cholesterol and high blood sugar. I leave the office with a sheaf of pamphlets in my fist, as though a few slips of paper will magically change everything.

In the examination room, there’s no context for me to explain a relationship to food that stretches back before I was born, before my parents even moved to this country. My mother and father grew up in Beijing—and while they weren’t poor, they were by no means wealthy. My mother often went to bed hungry; my father’s morning dumpling was considered a luxury. When they moved to America, a whole world unfolded before them: what a strange, excessive place this country must have seemed, where there was so much food—so many different kinds that you could spend your life eating and never taste it all! My parents love food in that way you love anything you might lose.

For me, I suppose that love is both a blessing and a curse. I don’t think my parents ever told me that they loved me—at least not out loud. I guess speaking of their affection, their pride, was too intimate. Even now, I think if they said anything close to “I love you” or “I’m so proud of you,” I would squirm and change the subject. But whenever I come home, my mother always takes me to eat my favorite Chinese casserole. And whenever my father visits me in New York, we go out for a massive slab of prime rib with that perfect, juicy trim of fat.

God, I love food. I am sitting at Big Wong’s in Chinatown with my medical school friends; our chopsticks dip into crispy noodles drenched in seafood stir-fry, snag pieces of perfectly roasted duck with glistening skin. I am sitting with my mother and father at home, that first bite of too hot xian bing spurting into my mouth, pork and chives and soy sauce coating my tongue. And, even farther back, dimmer in memory but still sharp: it is noon in my grandparents’ small apartment in Beijing, the air conditioning is on, and we are eating noodles over a small fold-out table. The cucumbers crunch between my teeth, the sesame paste is smeared around my lips.

How can I think of discipline when these are the associations I have with food? How can I count calories when these moments of joy and closeness are immeasurable?

I want to tell the doctor I have tried—that I knew the consequences even before I was handed an ID badge with “Medical Student Class of 2022” under my name. I was diagnosed pre-diabetic twice, once in high school and once in college. The first time I swore off bread and dessert and lost 20 pounds; the second time I trained for a 5K in the middle of an Arizona summer. I have discipline, believe me. But it is so hard to keep that kind of energy going. And when you love food the way I do—the way you love something so integral to yourself it is a piece of your identity—it is exhausting.

It’s taken me a long time to realize all of this, to realize that my weight shouldn’t be this source of shame, this mark of failure always stinging and hot. Like most things in life, it’s complicated: a product of genetics, culture, the world I live in, the person I am. Trying to categorize the fluctuating numbers on my scale into something as simple as success or failure would be a mistake.

Here’s what I imagine, instead.

In the future, I am an endocrinologist. When I walk into the examination room, I see my patient sitting in a chair. Young female, pleasant appearance. Vitals are good, but the BMI is high. She doesn’t yet have diabetes, but she’s close—just on the cusp.

I want to know what her job is. I want to know what her family is like. I want to learn more about her relationship with food and exercise, how many meals she eats per day, if her neighborhood is safe to walk in. And I’ll understand that it will be hard for her—because I’ve gone through the same thing. There will be times when her numbers will be better and times when they will be worse, and there will be times when she feels frustrated and wants to give up entirely.

But I’ll be there to listen to her. I want her to know that she’s not alone.

— Alice Zhao ’22

 This story first appeared in Weill Cornell Medicine, Winter 2020

Weill Cornell Medicine
Office of External Affairs
1300 York Avenue
Box 314
New York, NY 10065 Phone: (646) 962-9476