Fellow dense person here. I was 175 lbs in high school, wearing 28-inch waist jeans. Every new doctor is perplexed when they weigh me. I can't count the number of times a doctor has weighed me, had me step off the scale, weighed me again, had me step off the scale again, weigh themselves, then weigh me again. They then shake their head, and write down the number, and tell me that the obesity charts and measurements do not apply to me. I'm currently 230, and am mistaken for <200 usually. I can wear the same pants that my sub-200 friends wear (38-inch waist). A lot of people try to transmogrify their fat into "heavy bone density", or some such bullshit. The reality is that some of us weigh more. Some less. Welcome to the club.
I wouldn't care so much except for the fact that every time I see a doctor for anything they weigh me, calculate BMI and then go "have you considered losing some weight?" We literally had to have blood tests to get the loan on the business because our bank required life insurance to cover it in case me or my wife died. So some fat slob burnout Russian smelling of old cigarettes came by and said "you are fat. You lose weight." I was 187 at the time, a good 50lbs lighter than I am now. Same pants, by the way. At one point I went to the goddamn doctor and said "if you guys are going to raise my rates because you think I'm fat you're fuckin' duty bound to help me lose weight." So they sent me to a nutritionist who told me to double my caloric input to 4000 calories a day. I got down to 135 in high school through a grueling and uncompromising application of starvation and exercise bulimia. I looked like a concentration camp victim. But then, that was when I had the best self-image. Which is where you begin to recognize that you have an unhealthy relationship with food. And then you go try to talk to a psychologist about it and they hear "eating disorder" and explain that there isn't a mental health professional in the land that will treat you outpatient for insurance reasons. Want to feel better about sharing a BMI with Dennis Rodman? Yeah, that'll be a 28-day stay with teenaged girls.
I have heard a nutritionist lament that her employer did not have such facilities on-site or in-plan and inform me that if I wished to spend $250 out-of-pocket she could make inquiries. This would not, of course, have any impact on the "I see that you're fat. Do you feel properly ashamed?" dialogue that opens all health discussions. I went to the Bastyr clinic once with foot pain when running. The student, an earnest young lady, took down a bunch of notes about exercise and diet. Her supervisor, an instructor, walked in a half hour later, glanced at my chart and said "Huh. You're about 50lbs overweight. Try diet and exercise" and walked out without so much as looking me in the eye. The next time I came in I brought the pedal I had broken off the exercise bike at the health club (RIP Mieko's you cheap piece of shit) to ask if she had any other suggestions. She refused to see me and insisted I transfer care. Bummer for the student.