I'm as bad as most other guys when it comes to going to the doctor, but maybe for different reasons

This is how I picture Amber, my primary care provider, when I reschedule my annual check-up for the third time in the last three months.

In two weeks, I'm scheduled for an annual physical with Amber, my nurse practitioner/primary care provider at the Cleveland Clinic.

Amber is great. I like her a lot. She's smart, friendly and takes the time to engage with me and answer my questions.

You would think, then, that I would look forward to seeing her for my check-up. And usually that's true.

But sometimes, specifically when I know I haven't been eating well and my weight is above what it should be, I avoid seeing Amber.

Take this upcoming appointment, for example. It was originally supposed to happen last spring, I think, and I have moved it back three times.

This repeated rescheduling has not happened because I've suddenly had calendar conflicts. It has happened because, other than a two-month stretch over the summer when I first started strength training, I have spent most of 2024 not eating particularly well.

And thus the number on the scale hasn't been great.

The fact is, I only want to see Amber when I know my numbers will be good. And by "numbers," I mean not just weight, but also cholesterol, blood sugar, etc. I go to the doctor not to ensure everything is working OK, but to gain validation that I'm doing great and am...I don't know, a good person?

I don't have to explain how messed up this approach is. It's like waiting until your car seems to be running well before going to a mechanic.

Making this even worse is that my weight isn't that bad, and it's not like Amber is going to yell at me or anything.

Yet I still don't want to hear that my BMI (that most useless of all health metrics) isn't in the normal/good range, or that I need to watch my carb and sugar intake.

I know all these things, and I beat myself up about them often enough without anyone else having to get on me about them.

And again, my bloodwork numbers can't be that bad. In fact, they may all be just fine, I don't even know. It's just the possibility of getting scolded over them, even mildly, that makes me go to the MyChart website and take advantage of that "Reschedule Appointment" link again and again.

Still, I don't think there's any getting out of this physical in two weeks. Like many corporate wellness programs, the one I have at work offers monetary incentives (lower health insurance premiums) just for going to the doctor and for meeting certain biometric targets.

There's hundreds of dollars at stake here. I can't ditch this one.

So I'm going to go. And I'm going to tell Amber the good news first: I'm finally lifting weights!

Then will come the not-as-good news: I'm also lifting a lot of cookies into my mouth!

She will laugh, we'll talk a bit about the mental game of portion control, and it will be fine.

That's what I keep telling myself: It will be fine.

Having your cake and eating it, too: The hard-to-control mental aspect of weight gain and loss

My relationship with the bathroom scale isn't especially complicated, nor is it especially healthy.

I pay lots of attention to the scale when my weight is down. I step on it nearly every day to bask in the glow of the number I apparently believe to be some reflection of my own worth.

But during those times when I know the number is going to be above what I want it to be, I actively avoid the scale.

Right now I am in one of those phases where the scale and I are not friends. This is unfair to the scale in that the number it reports is entirely a product of my own negligence and lack of discipline, rather than anything the scale itself has done.

A few weeks ago I weighed myself and discovered I had gained quite a bit of weight over the previous nine months. And it's not the first time this has happened.

I reported a similar significant gain in June 2015. In fact, if you search for the word "weight" here, you will find I've written a lot about the subject over the years.

I never thought much about my weight until I graduated from high school, when I gained far more than the standard "Freshman 15" (try the "Freshman 40"). I ballooned up in a hurry in my early 20s once my metabolism and genetics caught up with my admittedly sub-par eating habits.

Over the years I have gained and lost different amounts of weight. In fact, I associate certain years with particularly memorable weight fluctuations.

There was The Great Gain of 2012, The Big Loss of 2013, The Sneaky Blow-Up of 2015, The Even Bigger Loss of 2016, The "How Did That Happen?" Gain of 2018-19, The "This Is The Last Time I'll Go Through This" Loss of 2022, and now I guess The "I'm Not Very Good at This Weight Maintenance Thing" Pound-Packing of 2023.

Here's what I don't get: Once I make up my mind to lose weight, it's never particularly hard. And the initial phase of maintaining a healthy weight doesn't feel that difficult, either.

But then, without even noticing it, I lose interest. Other things attract my attention and, before I know it, the weight I lost becomes the weight I found.

I have already begun losing weight (again) since that disappointing trip to the bathroom scale in October, and I don't doubt I'll get back to where I should be, health-wise.

But then what? There's a mental/emotional aspect to food that repeatedly trips me up. I'm not even sure what it is, which makes overcoming it that much more difficult. How do you master something you can't even identify?

When I'm eating healthy, I love eating healthy. When I'm not eating healthy, I love not eating healthy.

Much of it goes back to my all-or-nothing personality. If I can't be perfect, then I revert to being perfectly imperfect. I slip up a few times and decide I might as well eat whatever I want, because I'm clearly incapable of maintaining a sound diet and a reasonable weight.

I can do the physical part of weight loss. It's my brain – prone to extremes as it is – I need to get under control.

With the pounds already dropping off (again), the scale and I will very likely rekindle our friendship by this spring. But I need to start working on my mental approach now because the time is coming when I'm going to be confronted by the same old challenges.

I have yet to conquer them, but I keep trying.

I know very well that striving for perfection inevitably leads to failure, but I do it anyway.

I know something has to change in my head if I'm going to keep the rest of my body in good working condition, but I'm not quite sure what it is.

What's that old saying about being your own worst enemy?