“Just Lose Weight” Isn’t Medicine — It’s Medical Gaslighting

I had a client come in recently deeply frustrated after an appointment with a specialist — in this case, a pain doctor. She went in looking for help with chronic pain, chronic illness, hormonal chaos, digestive issues, and severe executive dysfunction.

The doctor’s entire plan?
“You just need to lose weight.”

No guidance.
No context.
No considerations for her actual lived experience.
Just… weight loss. And then he walked out.

This Isn’t Medicine. It’s Harm.

My client already knows that extra weight isn’t helping her pain. Most women do. We do not need a medical degree to understand gravity and joints.

But telling a woman to “just eat less” — especially when:

• She’s not overeating

• She is in chronic pain

• She has hormonal imbalances

• She has digestive dysfunction

• She’s so exhausted or dysregulated she can’t get out of bed some days

— is not only useless advice… it’s harmful.

Women’s metabolism does not respond to weight loss in the same linear way men’s does. And most women are not gaining weight because they’re overeating. I see this every day in clinic: the weight is a symptom, not the cause.

The Other Side of the Spectrum

I also have many clients come to me saying, “My main goal is weight loss.” And I often end up disagreeing — not because weight doesn’t matter, but because it’s not the root issue most of the time.

Truthfully?

Most women do just fine being 5–10 lbs above the chart recommendations.

BMI is a deeply flawed system. What is helpful is understanding where the weight is sitting:

• On your organs? Not great.

• On your hips and thighs? Actually protective as you age.

And yes, you will gain a little weight through perimenopause and menopause. It’s normal. It’s adaptive. It’s your body protecting you.

What becomes difficult is when someone enters perimenopause already 20+ lbs above where they feel best, and then the hormonal shift adds another 5–10. That’s where we focus on metabolic resilience before the transition.

Medical Gaslighting: The Other Epidemic

Another pattern I’m seeing constantly:

A woman goes into her doctor at 40–50 years old saying she feels like she’s losing her mind. Her periods are irregular, her mood is unpredictable, she can’t sleep, she’s exhausted, she has pain, her libido is gone — basically she feels like a stranger in her own body.

And the doctor responds with:
“You’re just perimenopausal.”

And offers… nothing.
No support.
No roadmap.
No help.

Just a label. And dismissal.

This shows up in so many forms:

• Severe menstrual pain dismissed as “normal”

• PMDD brushed off as “PMS”

• Digestive dysfunction labeled as “stress”

• Chronic pain minimized because “your labs look fine”

These conditions impact a woman’s ability to function, work, maintain relationships, parent, and simply live. And yet too many are told to “deal with it.”

Here’s Where I Stand

I am not here to ignore weight.
I am not here to hyper-focus on it either.

When you walk into my office, I’m looking at your whole picture — because that’s the only way healing works.

If you tell me your symptoms and say, “I feel crazy,”
I will say:
I believe you.

If your hormones are a mess, we address that.
If your gut is inflamed, we address that.
If your blood sugar is unstable, we address that.
If executive dysfunction and pain make basic tasks feel impossible, we address that too.

And guess what?
When we treat the real issues, the weight often comes off as a side effect of balance.

I don’t use weight as a moral marker, a character judgment, or a measurement of your worth.
I use it as one small window into a much bigger system.

What I Can Promise

I can’t promise I can fix everything.
I can’t promise you’ll never need conventional treatment.
I can’t promise fast results.

But I can promise this:

• You will be heard.

• You will be believed.

• You will not be dismissed or shamed.

• We will work with your whole body, not against it.

• You will leave my office feeling supported, not defeated.

Women — and also people of color, LGBTQ+ individuals, neurodivergent folks, and anyone outside the “default patient profile” — experience disproportionate medical gaslighting. It’s not fair, and I will not participate in it.

I am here to help you navigate the system, reclaim your health, and feel safe in your body again.