Monday, March 23, 2009
Wednesday, March 18, 2009
About a month ago, I was standing in my kitchen talking to Mom on the phone. I told her I'd been working with a hospital wellness program for almost a year, aiming to lose weight through frequent consultation with my doctor, a nutritionist, and a therapist. They were recommending me for weight loss surgery so that in the event of insurance approval, I will have that option.
I was having a bad day, and I needed to cut through the small talk bullshit and tell my mom how I felt. Even after everything I've said here about her issues and toxicity, she does have a mother's heart and can listen to me with sober ears when I tell her I'm hurting. She may not always give the best advice, but she does empathize and share her love.
I might be approved for surgery, and it freaks me out. A year and a half ago, my self-esteem was in such a bad place that I would have jumped at the opportunity; honestly, even the slight possibilities of malnourishment and death would have been better than the life I was not living. But now there are so many factors that come into play.
- Is it fiscally responsible? Our economy is in the toilet, and I want to have surgery to quickly fix what a lifestyle change can improve over time? Corporate insurance plans are higher than ever, and this procedure would put another burden on my own organization. I love my job, and I don't want to negatively impact this group. My doctor told me that the complications from obesity would do more damage to insurance rates – and my body – over time. That's true, but…
- I don't plan on being obese forever. Not only is my weight on a downward slope, but I eat wholesome foods and exercise. I got fat over the last 4 years because I ate right, but I just ate too much of it. I have good blood pressure, no signs of diabetes, a strong heart. I'm healthy, just fat. It's the latter that needs to change.
- Would I be happy with myself if I lost weight this way? Right now I am thrilled by my successes, however small, because they are proof of the good choices I make. Success from weight loss surgery doesn't come from the choices made every day, but from the necessity of consuming small bits of food so that I don't rupture. Plus, I must eat all day to meet protein and nutrient requirements that aren't met with supplements. I can't fathom eating all day, and I can't see how I can work that into a normal social life. It's the gastronomic equivalent of having an iPhone – both useful tools that become mindless habits, keeping you from full participation in a meaningful life full of other people.
- After a few months of rapid weight loss, even with regular exercise, I will have excess skin. I've come to see that as an inevitability, seeing as how my elasticity is shot from so many years of yo-yo dieting. Hell, my thighs didn't have elasticity to begin with; they were always curdled with fat. The point is will I just be trading one body issue for another? I'm afraid it's just going to start an endless cycle of body dysmorphia, and that's how the cat lady got started. If you give a mouse a bypass, she's going to want a brachioplasty.
I started the conversation by telling Mom I was, as usual, upset with my body and myself for gaining back all of the weight I worked so hard to lose in the first place. I told her I was ashamed of myself for falling off track after moving to Chicago. Then I told her about the possibility of surgery and the above reasons for not doing it.
Tuesday, March 17, 2009
Tuesday, March 10, 2009
Tuesday, March 3, 2009
Monday, March 2, 2009
Mom bought a drum of the strawberry powder and put it within my reach on the first shelf in the cabinet to the right of the microwave. To this day, I internally refer to this as the Slim-Fast cabinet. She told me to come here first when I was hungry.
Together we read the directions and mixed my first shake: gritty and grayish pink, salty and metallic, oversweet with a taste faintly echoing strawberry. Mom counted on the elixir to be both kid-friendly and miraculous. I counted the days until she forgot about it.
Until then, I would have to bear with her filling my pink ballet slipper canteen with the stuff and urging me to go play in the heat. To bear her waking me at 4 am before she left for work, reminding me to take a canned shake for school lunch. She'll be counting them to make sure.
It only added to my shyness at school. I was already a subject for scrutiny – in my eyes at least – and to bring a diet shake to school would only further stigmatize me as the hopeless fat girl. I either poured the shake down the sink, burying the can in the trash, or I took it to school only to throw it away as soon as I could. I made damn sure that no one knew my secret shame as a dieter.
I was an anxious kid, shy with very dark thoughts. I remember playing with kids at the park where Dad played softball, standing on the bridge and asking what they would do if I jumped. It was just a ten-foot drop onto soft grass, but still. I remember telling my great aunt Ellie at a family reunion that I didn't think I'd live to see my 11th birthday. I was emo before it had a haircut.
But the part of me that shined through the most was friendly, silly, imaginative. I only let the dark stuff slip through when I was feeling hurt or ignored by other kids. Those feelings were very real; the manifestation of them I can blame on soap operas.
Dieting played a huge role in creating that attitude. After Slim-Fast came Dexatrim, then another over-the-counter appetite suppressant that Mom fed me in the early morning before she started her day. It spawned a ritual of lather, rinse, repeat with a whole new gimmick.
In fifth grade, we went to Jenny Craig. Since I was so young, they required a doctor's note. I took a blood test and got the release, only for Mom to balk at the cost of food at sign-up. We never started the plan.
Mom got a bottle of T-Lite. The pill left a muddy aftertaste, and for three consecutive days I had to follow a strict eating plan, but could eat normally for the remaining four days of the week. The product still exists, and after searching the internet for the menu, I remember that my favorite was the 2nd day:
Breakfast: 1 egg (hard boiled or poached), ½ banana, 1 slice of toast
Lunch: 1 cup of cottage cheese, 5 saltine crackers
Dinner: 1 skinless chicken breast (3ozs. total), 1 cup broccoli, ½ cup carrots, ½ banana, ½ cup lowfat frozen yogurt.
Honestly? After 4 months of this, I came to see the cheese and crackers as a treat. That's how bad this menu was. Lunch was always tuna or egg with dry toast. But I could drink all the coffee and tea I wanted, and you can bet that I packed as much fro-yo into that ½ cup as possible.
When I wasn't showing much progress, Mom had me call their customer service line to ask for tips and support. The guy on the other end just kept saying, "You have to drink a LOT of water. Just keep drinking and those pounds will come off!" And I drank so much water that my electric green pee turned clear by bedtime.
We toyed with making grapefruit my staple diet food. She bought me my own Thermos, and we made batches of "Magic" cabbage soup that I ate at every meal. She brought home what looked like a 'roided up shampoo bottle full of liquid protein and I gagged down two tablespoons prior to each meal to prevent overeating. It was kept under the sink next to detergents, bleach, and cleaning chemicals. I think that's about right.
I read the Atkins book while lounging on my floral print comforter, special-issue Barbies and porcelain dolls watching from their perch on my wicker bookshelf. I learned about carbs and ketosis before I even knew about algebra.
The main event came in junior high, when Mom took me to this new clinic in Newburgh, Indiana – 50 miles from my hometown. In order to make it there before closing, I had the special privilege of leaving school early every Wednesday afternoon.
In all my months of going to this clinic, I never saw the doctor. This place was run by nurses, and every visit was the same: weigh-in, take blood pressure, pick up pills. These "prescriptions" were filled in the office and they came in little white paper boxes with instructions stamped on one side. Who needs Walgreens?
Three pills: a small white tablet, a small orange tablet, and a gray and yellow capsule. The white pill helped me shed water weight, and it was to be taken first each day. The orange pill had to be taken at 10 am, the capsule was to follow at 2 pm and no sooner. I couldn't tell the school nurse about them, so I kept them in my pencil pouch and snuck them when I had the chance. Those two pills suppressed my appetite, and they were called Fen Phen. I took them for nearly a year. I was 13.
At first, this was our thing, our three hours of uninterrupted time together, where I could tell her about school and hint at things I wanted. Mom was impressed with my progress during those first weeks, but of course those losses petered out to 1-2 lbs per week, which was encouraged. It didn't encourage Mom. The number on the scale predicted the tension inside the car during the drive home. If I showed a loss of less than 1 lb, the nurse would congratulate me, Mom would smile, and my face grew hotter as we waited for the pills and Mom signed another check for $90.
Her smile faded on the walk to the car. Inside, she accused me of cheating, not trying hard enough, and wasting her time and money. My tears were already spilling as we walked through the gravel parking lot, and through them I would plead to her, beg her to believe that I was doing my best, and I hadn't had a soft drink in months. Those drives home were the worst hours of my life. I had to look out the window the whole time so she wouldn't see me cry. If I dared to look at her, I would just cry harder; if she saw it, she would command me to stop.
On school outing to Homestead Pizza, I drank Diet Coke and pressed napkins on my slice of pepperoni pizza to soak up the orange grease. A popular girl looked at me like I was crazy, and I told her I didn't need the oil. I didn't tell her that I wished I was her for one day.
It was in Mr. Klein's AP algebra class when I told Tabitha that I didn't feel right. While I was getting ready that morning, I became dizzy and broke out into a full sweat. I was nauseous, my eyesight was spotty and I had to sit down on the toilet for ten minutes just to steady myself. I told Tabby about it because she was new and nice, and she didn't judge; her mom was anorexic and could reportedly eat for a day on one small bag of Doritos. She suggested I tell the nurse and stop taking the pills. I said I'd think about it.
It wasn't long after that when the Fen-Phennery was abuzz with activity. They surprised us one visit by making me take an EKG. They said the drugs aren't normally prescribed to teens under 16, and this test was just a precaution.
The funny thing about precaution is you normally show it before taking action. They acted like they never knew how old I was. It's okay; I looked big for my age – especially when I was wearing men's jeans and "career wear" tops made for the larger woman. It was all that would fit.
The machine spit out a long receipt of erratic peaks and valleys that the nurses nervously examined. They told my mother that our family physician should take another test – just to make sure the outcome wasn't a fluke. They gave the original readout to Mom without making copies for their records. Mom put it in her car's armrest and it remained there, unexamined by our doctor.
Mom was worried about my heart, but she dealt with it the best way she knew how: ignoring it in hopes that it wouldn't exist anymore. That was our last visit to the hawker's office.
It wasn't too long after when we saw the office on the local news. It shut down after questions arose about the "doctor" behind it, its under-the-table practices, and the FDA's growing concerns about the dangerous implications of the fen phen cocktail.
Mom eased up on me after that. The house remained snack free, and birthday cakes were still discouraged. She made comments about my weight and suggestions about my food choices, but there were no more fads. I was left my very own dysfunction, to do with as I pleased.
It would be a cop-out to blame Mom for my relationship with food, to play the victim. I didn't ask to go through all these fads, but I chose to eat in rebellion. I became conscious of it at some point. I'm fat because I was angry, because I wanted control, because I was helpless in the face of high expectations. I played the biggest part in all of this – the ingenue in my own soap opera.
It's time to get a new storyline.
So there's that,