Many of you know I’m a rabid fan of My 600lb Life on TLC but you may not know why. Yes, it’s a great ongoing reinforcement for me, but in order to be on the show, patients have to weigh a minimum of 500 lbs. In June 2014, I weighed in at 438. I think that’s the highest I ever weighed, but since I never weighed at home and avoided doctors as much as possible, I’m making an educated guess. I never looked at the scale when I got weighed at the doctor; I had to look up that number in my records. But judging by the way I felt physically, I’m pretty sure that was my highest weight.
When you watch the show, you listen to the patients talking about the pain of standing, walking, moving around; how difficult even the easiest everyday activities are; how hopeless and overwhelming everything feels. My mom (a retired RN) watches the show also and I usually get a text from her during the show saying something to the effect of “just wire her mouth shut!!” usually while the patient is talking about her physical difficulties. My mom has no empathy for these patients and I don’t think she understands why I’ll repeatedly watch the reruns. It’s because they were me and I was them. I was the chubby kid, the pudgy teen, the obese adult. My weight was a slow steady relentless gain throughout my life. I spent most of my twenties in the two hundreds, most of my thirties in the three hundreds and by my forties I was fighting to stay out of the four hundreds: a fight I lost in my late forties. When I was 48, I was the highest weight I had ever been. Most of my adult life I was between 370-385. (If any of you have seen My Big Fat Fabulous Life with Whitney Way Thore, I was her size.) I didn’t like being that big, but it had become “comfortable” and by that I mean, there weren’t a lot of things I wanted to do that I couldn’t do but I had gotten pretty good at judging my limits. I could get around pretty good, but I knew when to stop and how to take shortcuts to “maximize my mobility.” I took several trips to Disneyland (one of my favorite places) and my strategy was to hit the rides I could fit on (that was my reality) and when my friends went on rides I couldn’t get on, I’d wait someplace with all our stuff while they rode the rides. I was a convenient meeting place. They didn’t push me to do more because crossing the park was hard on my knees, back and feet. It was a big effort for me to walk any extended distance: I was carrying 375 lbs.
When Dr. Now’s patients talk about the pain of standing and walking, I know that pain. My weight ruined my knees: I have moderate to severe arthritis in both of them (my right is worse than my left). My large lower abdomen (my panniculus) put quite a strain on my back so just standing hurt my knees, my back and my feet. Maneuvering around the house or office or anywhere was usually a challenge since I was twice the size of a normal sized person. Fitting in chairs with arms or cars was always hit or miss since they’re not made for someone the size of two people. I was often afraid of breaking chairs (toilet seats included) and there were a lot of times I wasn’t able to wear the seatbelt in a friend’s car (they were nice enough to not comment). In college, I was too big for some desks and I had to use the “disabled” desk made for students in wheelchairs. In auditorium classrooms, I had to sit next to an empty seat, since the little foldover desktop would not lay flat enough across my stomach for me to write on it: I had to use the one next to me. Getting up from any chair or seated position was always a strain on my knees, back, and hips, (lifting the equivalent of at least two adults) but staying seated for a long period of time was another source of pain on my low back. My weight even affected my sleep: I had apnea because my weight was essentially beginning to smother me.
Clothing and shoes were another challenge. It’s extremely dispiriting to realize that the blouse that fits you is big enough to double as a king size pillow case or that when your slacks are folded in half, they are the same size at those for normal sized people. It’s even more embarrassing when you’re shopping and people think your slacks (folded on the store hanger) are a skirt. When you lay out your clothes for the day and your shirt is the size of a small throw, it’s pretty demoralizing. I know my nightgowns/ nightshirts were that size. I’m guessing a skirt would be that size but I never wore skirts or dresses because getting the slips, nylons and camisoles were next to impossible in my size. Let’s not even discuss lingerie! Shoes are a lot of fun because while there are some stores that normally carry double-wide shoes, when you need triple E, you almost always have to order them. Getting shoes a size larger doesn’t help much because your foot just gets wider, not longer.
My mom doesn’t mean to be callous when she makes comments about wiring the patient’s jaws shut (I’m giving her the benefit of the doubt here), because she doesn’t understand how insidious the weight gain is. It’s like quicksand: you know you need to get out, but you don’t know how to extricate yourself. Fighting it just seems to make it worse and cause you to sink faster but doing nothing doesn’t get you out either; you just keep slowly sinking. You try making small improvements, but while they may seem to help, it feels like you’re bailing out the Titanic with a teaspoon: it’s working but the improvements are infinitesimal compared to the sheer magnitude of the problem.
I tried diets but dieting seemed to make the problem worse since it was the “fighting the quicksand” scenario: limiting my calories slowed my metabolism so when I gave up the diet (infinitesimal progress), I gained back more weight pretty rapidly. (In all honesty, I didn’t try a lot of diets because I knew they didn’t work, but at the same time, I was desperate to try something! Unfortunately with most of the diets, the more I limited the food, the slower my metabolism became, so I’d have to limit my food even more, á la The Biggest Loser ‘winners.’ I did try some of the “food subscription diets” where you buy the pre-packaged diet foods and eat according to their plans. Generally those plans & foods worked for me, but even while I was losing weight on them, I kept asking myself “so what happens when I stop eating their food?” That was an easy call: I gained weight again because their “meal plans” hadn’t taught me anything. The idea behind most of them seemed to be to eat their food until I reached my goal weight and then they’re going to teach me how to stay there. I never got there because- again- it limited my calories and slowed my metabolism. I simply had too much weight to lose.
One of the first questions Dr. Now asks his patients is “how did you get to this weight?” For most of my adult life, the answer is simple: I ate as much as I wanted of whatever I wanted whenever I wanted. Sometimes I will tease others (and my pets) with the phrase “I want! I want! I want!” I know how that feels: gimme what I want NOW!! It’s easy to ignore the consequences, and frankly that’s what I did for most of those years when I weighed 370+. But it wasn’t like I woke up one morning and “wow! how did I get so big?! yesterday I was only 150!” It’s that insidious weight gain I mentioned earlier. Part of it I can blame on the explosion of cheap processed foods: they are easily metabolized, full of calories and actually designed to make you keep eating more. The fact that most of my generation and those that followed have problems with obesity and type 2 diabetes backs this up. But most of us who grew up eating these cheap processed foods do not get to weigh 400+ lbs, though sadly there are a lot more of us than before. A lot of the blame has to be placed at my door. I didn’t want to be active (I was never good at running or sports) and I spent a lot of my time with sedentary pursuits (reading, writing, watching tv, etc). It was an amazingly awful combination: the more I ate, the bigger I got, the less I wanted to move so the more I sat and hey, how about another bag of cheese puffs? I tend to give myself credit for not hitting the 400s until I was over forty years old, but I was definitely on track to hit the 500s in my fifties (I noticed the numbers were paralleling each other and it was a frightening realization!) It’s along the same lines as giving yourself credit for breaking the chair but not falling through the floor: “well, the disaster could have been a whole lot worse!” Either way there is nothing good about weighing what I weighed.
It’s a hard situation to confront when you are that large and steadily gaining weight. The solution seems simple: just go on a diet! But when those diets are based on calories in vs calories out, they don’t work. All it does is wreck your metabolism and leave you constantly hungry, so you are not only miserably famished all the time, eventually your metabolism settles at your current calorie intake and you stop losing weight. So while you may have lost some weight, you are right on track to gain it all right back, unless you drop your calories further. I read in an article last September that one of The Biggest Loser ‘winners’ has to keep his calories under 800 per day in order not to gain the weight back. To translate that into food, 800 calories is approximately 24 ounces of plain grilled chicken breast or 1.77 Starbucks Grande Mochas with 2% milk and whipped cream. Sounds filling, doesn’t it? So when you weigh over 350 lbs, are still gaining weight no matter what you seem to try, it feels pretty hopeless. Somehow, you walked right into this quicksand and now you can’t get out. You try making healthy changes: eating less and exercising more (again calories in vs calories out) and for a while it works, and then when it seems to stop, you try something else, but again, bailing out the Titanic with a teaspoon. It’s easy to see why people like me, Whitney and Dr. Now’s patients just accept that “I’m the fat one in the family!” Defeat with dignity seems better than the constant failing and disappointment. A phrase from The Simpsons would often pop into my head: “Can’t win- don’t try!” I was just destined to be fat so I might as well accept it.
Except it was killing me in so many painful ways. There was the physical pain that comes with lugging around two full sized adults on a body built for one. There was the constant ‘helpful’ comments from family and the stares and ridicule of strangers always wearing on your spirit. You feel embarrassed, helpless, inadequate and stupid almost every day, always asking yourself “how the hell did this happen to me?!” You are angry at yourself, at everyone in your family who tries to ‘help’ (because although they mean well, all they are really doing is reminding you of what a screw up you are), and you’re angry at all the jerks in the world who make rude comments about ‘fat chicks’ and other overweight people. It’s physically and emotionally draining to fight the weight and it’s physically and emotionally draining just living with it and all the limitations that it carries. I know in my case, the only way I found to fight it is to keep living my life as best I could. It seemed as close to defeat with dignity as I could get. I had resolved to do as much as I could as long as I could, much the way I believe Whitney Thore has come to terms with her weight: try not to let it get in the way.
It’s a hard life, and I wish I could give everyone the keys to the secret passage out of it, but there are no easy solutions. For some, bariatric surgery is the best solution. My mom used to try bribing me to get it done but I have never had any interest in getting my insides remodeled, although if I had reached 500, I think I would have seriously reconsidered. For others, radically changing their eating habits works, or weight loss medications or other devices (they have a permanent stomach pump now). Most- if not all- of these solutions sound a little desperate, but when you weigh in that neighborhood, desperate is exactly what you are! For me, the solution was radically changing my eating habits: I went from a diet that was 80% simple carbs to a diet that is 35% protein, 35% fat and 30% complex carbs. I now eat as few simple carbs as possible (fruit is as simple as it gets most days). It’s not as drastic a change as getting your gastrointestinal tract rearranged, but it sure wasn’t an easy transition to make. I’m just happy and relieved that it worked and that it allows to me to live a lifestyle that is still normal and satisfying, both mentally, physically and spiritually. I have finally found my way to a happy place after a very long and desperate sojourn on the dark side.