Thursday, February 21, 2013

Weighty Issues—Body Image Awareness

fatThis week is body image awareness week, so I suppose it’s fitting that I spent about 45 minutes on the phone with a friend of my mom’s today. She’s an obese hypochondriac who elected to do lapband surgery a few years ago. When she asked me about it then I told her what every doctor I respect has said: it will NOT eliminate diet and exercise from the equation, and is more or less a surgical procedure designed to force patients to do what they have to do anyway. Removing a risky surgery with life-long after-effects is the only rational choice. I know others feel differently, but I have yet to see anyone convince me otherwise.

She did it anyway. She lost 30 pounds. She has regained the 30, plus another 30. She still overeats, does not exercise, still makes excuses, and must carry spare underpants with her in case she has leakage. She regurgitates constantly while eating meals. Many of her friends mention that it makes them uncomfortable while eating out. I can’t imagine it's pleasant for her.

During the conversation she accused me of not understanding, because I have no trouble dieting.

While her phrasing was rude, there is one truth, there. I have no trouble dieting.  I don’t diet, and never have. I am still overweight, but have steadily lost pounds over the past 15 years. I have never gone back up in size, but don’t obsess over size or weight. My weight loss has been very slow.  My doctors have been very happy with it. What I did was:

1. Get medical treatment for issues that were helping to “make me fat.”  These had nothing to do with my diet, including having a gall bladder removed in the nick of time.  My diet certainly contributed to chronic gall bladder pain, eventual infection, and very nearly my death. But injury contributed, and misdiagnosis from bad physicians (who missed a gall bladder larger than a football for nearly a year and dismissed me as a fat complainer with indigestion) were, too.  I also had PCOS, which has virtually disappeared as I lost weight and got healthier. I was called a “borderline diabetic” for years. I still don’t know if this was simply lazy medical practice because I was very obese, or if I really was “borderline.” My blood sugars have been completely normal for years.

2. Move more. Never avoid moving when I can. Park further from the door. Walk the dog. Get up every day, no matter how much I would rather not. When I was young I moved a LOT, in spite of being heavy. I was active, even athletic. It was astonishing how much my personality, happiness, and physical ability bounced back as I started moving again.

3. Eat less, and eat better. I never stop myself from having chocolate or ice cream. I have a small amount. After a few years I realized I didn’t want more. I can’t remember a time when I “binged.” Even now, overeating for me is not binge-eating. It’s a second helping of something once in a while, and the GOOD news is… I feel it immediately. Your stomach WILL shrink. Emotional eating IS a habit that can be broken. In fact, it melts away on its own if you stick to your better habits.

4. Refrain from excuses. If I feel slightly bloated after eating, I take a walk. I don’t self diagnose with some syndrome that is a lot less likely to be the problem. I ate too much. EVERY person I have ever heard talk about losing weight being incredibly hard, and how difficult it is emotionally, and plateaus… counted calories, pounds, and sizes. Ignore the markers and be healthy… you will be unaware of plateaus and feel no need to make excuses.

I dislike it when people demand a pound count, because it completely tells on them when they insist they are “really just worried about health.” What I can say, only because my medical folks have stressed and confirmed it, is that I am literally half the size I was 15 years ago. Before my gall bladder surgery (the dramatic, emergency, saw-her-in-half kind) I was wearing a size 32 (not a 32” waist… a 5x / 6x). I now wear a 20 to 22, depending. I weighed at least 425 pounds (I was 405 a week after surgery, but refused to be weighed prior to it). My last weigh-in was 215.  I have lost a pant-size since then. (To be honest, I thought I would gain that back, since some of this weight loss was cancer-loss. So far I have not, and it has been a month.) I only have these statistics because of medical professionals and being forced to buy new clothes.

It wasn’t easy. Going without food never bothered me as much as MOVING did, because I was in constant pain. But the more I moved, the less pain I felt. The more I walked, the easier it became. I now only have joint pain in bad weather or after too much exertion, and take nothing but Tylenol on occasion to manage it. I still struggle with long flights of stairs, partially because of my knees, but largely because I am puffing with one lung. Walking steadily and slowly on level ground does not bother me at all. I actually enjoy it. Even in my late 20s and 30s I struggled to walk more than a quarter mile. I’m 47 now and can do 5 miles if the weather is good and I move at my own pace… still… though I am asked by my doctors not to. Plus Max quits on me after a mile. :)

Had I failed to keep moving, I would be dead. I would never have had the energy and physical stability to beat cancer, would not be able to function with one lung, and would not be living with pulmonary fibrosis at all. A 400 pound woman can’t function with one lung, limited heart health and capacity, and oxygen therapy. I could not have survived.

I would also not be capable of being sexually active. While sex drive is not always a problem for larger people (it often is), my heart and lungs, my knees and back, my sheer inability to move—all of these would have made regular, rigorous sex unsafe. Plus size people can, and should, love and be loved. But danger or simple inability to handle sexual exertion is a reality for some, and a concern for anyone considered morbidly obese.

My mom’s friend has no idea how insulting she was in calling it “easy” for me, but she is also someone who will never accept ownership of her body, her responsibility for it, or her own role in who and what she has become.

It’s not about dieting. It’s not about blame. It’s not about excuses. It’s about getting your shit straight, getting over your pity party, getting doctors who LISTEN and don’t consider you a waste of time because of the shape they see in front of them, and getting over it.

The one thing it is NOT is easy.

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