Reader question: BBC Horizons, Junk Food, and the GB

Last night, after I posted about the BBC Horizons program on obesity, I got an email from a reader who needed help understanding the gastric bypass surgery and what it might be able to do for her.  She had been emotionally overeating for thirteen years, since suffering a devastating loss, and she wanted to know if the GB could really change her desires for junk food, as the BBC program suggested.  In case anyone else wants a more detailed response on this, I've posted my response here:

Hi,

I've found that the gastric bypass has altered my desire for crap food, but I would say it mostly has to do with behavioral conditioning – every time I eat something very rich or sweet, I get really sick, and after a while I started feeling sick just smelling certain things.  Kind of like when someone gets really drunk on rum and never touches it again.  So it's effective, but not very nice, and I have to admit there are always going to be times when your desire for a food is stronger than your knowledge that it will make you sick (my dad is sick all the time as a result of this – he had the surgery too).

As for the emotional eating, I think this is one area where a surgery like gastric bypass has the potential to harm rather than help.  They told us when we went in for the operation that some people had to have it reversed because they couldn't handle the fact that their bodies wouldn't let them eat everything they wanted, and they were really hurting themselves.  I would say, go to your GP and tell her everything you've told me: that you want the surgery to help you stop gaining weight and lose the weight you've already gained, but that much of your overeating is linked to emotional problems.  I think if you do have the surgery, you should make absolutely sure that you stay in therapy for the emotional eating after the operation.  It could really hurt you to stuff yourself for emotional reasons when your body is altered to be unstuffable – you might even do serious damage to your insides.

I totally understand your feelings about losing your grip on reality.  There is so much information out there, and so much of it is conflicting.  From my experience with gastric bypass, I'll tell you this: the surgery was a serious kick in the pants to start eating better, because it severely limited my intake and made sure that fats/sugars made me sick.  But once my body healed and I started gaining back a bit of control over my eating habits, I found I was able to overeat sometimes, or eat sugar without getting sick – I found ways around the restrictions.  This is one reason (alongside my concern over your emotional eating causing physical damage post-surgery) that I strongly suggest staying in therapy even if you do decide to have the gastric bypass.

I hope this has helped clear things up for you a bit, and I'm happy to answer any more questions you might have. 

All best,
Anne

Please note that I'm always happy to receive emails with questions or concerns, even very personal ones.  Where the concern is something that seems broadly applicable, I might post my response on the blog, but I will never identify you or post your email without your consent.  If you'd like to make sure I don't even post my own response, please let me know in the original email.  I know that the decision to have weight loss surgery can be fraught with fears and concerns and excitement, and that sometimes it feels like all the information out there just leads to more questions.  I'm here to answer questions, yes, but also just to be a support for people who feel totally alone in their decision-making process (or even the recovery process).  It's what I wished I'd had: a friend who'd been through it all.  That's what I want to be for anyone who needs it.

'The Truth About Fat' on BBC Horizons

A friend of mine emailed me last night, suggesting I watch the latest episode of BBC 2's 'Horizon', because it dealt with the issue of Gastric Bypass.  But when I started watching it this evening, I realized that really, it deals mostly with obesity – how and why it exists, and what we should do about it – and Gastric Bypass plays a large part in the last third of the program.

In all honesty, as I started watching, my immediate reaction was rage and righteous indignation.  Gabriel Weston, the thin, blond, female surgeon who hosts the show announces at the very beginning that for her entire life (including the ten years in which she's been practicing medicine) she has operated under the 'assumption [...] that I am the size I am because of my character'.  Now, not only is that a particularly smug way of putting it, there is a serious problem with the underlying message: that fat people are fat simply because they are lazy and eat too much.  They don't have the strength of character to change their bodies.

Of course, the program isn't just about this one extremely irritating person spewing her views about fat slobs – it's also about finding out why fat people are fat, and investigating the causes of and possible solutions to this 'epidemic' that's sweeping the western world.  And on that front, the show (and maybe Wilson, if she wasn't just there as a figure-bobblehead) does a very good job.

One of the first people Wilson talks to is a doctor whose own personal experience with attempting to control his weight led him to study the reasons that our bodies seem so stubborn when it comes to weight.  Interestingly, this doctor is a former athlete, who was trying and failing to gain weight, despite being, as he said, very motivated and a very driven person.  He is now studying the ways in which hormones affect our weight and, specifically, our appetites – Wilson is, of course, skeptical of the idea that hormones are the reason she's not fat (easy to be skeptical when you're thin).

The hormone studies are really interesting.  I don't want this post to be a super-long summary of the show (if you're in the UK you should watch it on iPlayer), but the gist of it is that every body contains a 'hunger' hormone and a 'fullness' hormone.  In normal people, these peak and trough as you'd expect: hunger is very high when you're hungry, and fullness is high when you've just eaten.  In obese people, though, the hunger hormone never really peaks, but it also never goes away completely.  It just stays dimly present all the time, like a lightbulb that's on very low.  This means that, unless they're truly starved for a long period of time, obese people never really get hungry, but they also never really aren't hungry – they could always eat  (this is particularly interesting to me because it's totally how I feel post-GB, and I suspect it's how I felt when I was heavier as well, although of course I don't remember).

The other studies Wilson learns about involve genes – specifically, a study involving twins with different body types and another that tracks genes from when the patient is a fetus in the womb into childhood, to determine whether or not a pregnant mother's diet has anything to do with her child becoming obese later in life.  Both studies were really interesting, and both came up with yet more reasons for people getting fat.  The twins study found that both twins had the 'fat gene', but only one of them had a life experience that 'switched it on' (this was usually stress-related).  The other study found an astounding 25% chance that poor diet during pregnancy (specifically deprivation but also poor food choices) would lead to the child being obese later in life.

The last thing Wilson examined was a potential solution to the problem: Gastric Bypass.  Interestingly, though, she examined the surgery from a different angle than I'm used to: how it changes the patient's brain, through changing his stomach.  Wilson spoke with a psychologist who is studying the ways the unconscious mind reacts to photos of rich vs healthy foods, and she has found that patients whose brains essentially drooled over photos of fatty, sweet foods before surgery have a much more muted reaction after the GB.  The surgery is presented as a way to change appetite, not just lose weight.

I wasn't sure I agreed with the premise at first – I still love me some sweets – but as I examined my own habits more closely I had to admit that even though, ten years after the GB, I do eat sweets, the kinds of sweets I'm drawn to now are much less rich and sticky-sweet than what I would have chosen before.  And I can barely look at greasy, creamy, rich foods without feeling like I might throw up.  And that's a huge deal.  As the surgeon who performs the GB on camera says: 'they want something to change their lives, and that's what it does' – I agree 100%  Nonetheless, it was presented a bit more black-and-white than it is; interviewed 6 weeks after surgery, the patient says she dislikes fat and sweet immensely.  In fairness, she's still swollen inside and throwing up regularly – I'm not sure she'll feel quite so strongly once she's healed.

Overall, though, the program is well-researched and presents multiple interesting angles on a very complex problem.  They examine the different kinds of fat our bodies store, pointing out that visceral fat, the internal kind, is what causes things like diabetes and other diseases; they investigate different causes for why people get fat; and they even take a new and different look at why one solution is better than others because it changes not only the body but also the brain.

And, to her credit, Weston does eventually change her mind about fat people through her investigations, even admitting that 'it is all too easy to take the moral high ground'.  Still, it's depressing to think about just how much it took to get her to open her mind.  As the BBC's own program description puts it: "Gabriel is shocked to find out that when it comes to being overweight, it is not always your fault you are fat."  This is extremely troubling; not only is she kind of an asshole for thinking this way, she's also a bad doctor – for ten years, she has been willfully misunderstanding her patients as a result of her own sense of superiority.

To me, an attitude like hers shows how closed-minded and judgmental doctors are trained to be when it comes to fat.  This is a problem on a basic human decency level, of course, but more importantly it's a problem because it keeps doctors from viewing the issue of obesity as a medical puzzle to which there may be multiple, different, ever-changing answers, which I'm pretty sure is how they're trained to view the rest of the body's afflictions.  As far as I'm concerned, doctors should always be open to new ideas and new information, because that's how we cure diseases; really all scientists (in my opinion all people) should be open-minded, otherwise they not only risk being assholes, but they also risk being straight-up bad at their jobs.  Which, in a doctor's case, can mean really dangerous consequences for her patients.

Despite Weston's newly opened mind and the show's interesting and balanced look at the problem of obesity, I came away from watching it feeling a bit sick.  How many doctors out there in the UK and America – and how many laypeople, who don't even have a good reason to know better – feel the same way about obesity that she did before investigating further?  I can tell you simply from my own experience that there are plenty.  And I find that depressing, and exhausting.  While it's great that this one doctor changed her mind (after months of BBC-sponsored education), I can't help feeling sorry for all those patients who had to endure her useless, judgmental attitude for ten years, and it's hard not to wonder when the rest of the world will stop wallowing happily in the filth of their society-accepted fattism and sit up and start paying attention to the reality of this problem.

It seems obvious to me, based entirely on observation and a curious mind rather than personally conducted scientific studies, that fat people are fat for different reasons: emotional, hormonal, genetic, situational, and a hundred others.  I can only hope that programs like this one start the long, slow process of getting the rest of the world to realize that as well, and to figure out that we won't solve anything until we stop judging and start trying to understand.

Say Yes to plus-sized brides being treated like brides (period)

 If you follow me on Twitter, you'll already know how obsessed I've been recently with a show called Say Yes to the Dress, which is a reality show that follows brides-to-be who are looking for the perfect dress at Kleinfeld's bridal salon in NYC.  I got into the show when I was living with my parents in San Francisco a few years ago, and spending a lot of my free time Tivo-ing reruns of What Not to Wear and other TLC shows (like I Didn't Know I Was Pregnant – NOT recommended for anyone even slightly suggestible).  I'm already a bit dress-obsessed, in general, and I have a weakness for reality TV (the NYTimes says that's okay!), so one episode was all it took to hook me.  I love seeing the different styles of dresses, comparing how they look on different body types, gasping at the incredibly poor taste some brides have and the stunning dresses others choose.  I love tearing up when the dads start to cry and yelling at the entourages when they opine too strongly despite the way the bride clearly feels and clapping and grinning when super-gay, super-adorable stylist Randy finds a girl the perfect dress – I just adore it all.

And I've missed it, since moving back here to the land of copyright issues.  It's hard to find my favorite shows online (it's impossible to find them legally), and anyway I've always been a bit squeamish about illegal uploads (classic goody two shoes, always thinking I'll be the one to get caught).  So I've just done without.  I had a book to work on in my free time, anyway, and I had enough trouble catching up on Come Dine With Me and my other fave UK reality shows. 

But then I finished my big edit, and sent the MS to my editor, and... didn't have much to do.  I mean, there's plenty to be done (visa stuff, job hunting, and always dishes and laundry), but I also found myself with a lot of free time on my hands and very little entertainment.  So I bit the bullet – I bought two seasons of Say Yes on iTunes (let's not talk about how much that cost, okay?), and I devoured them in a week (hey, they're short!).  And then, because I was panicking a bit about running out, I bought another season, of a spinoff series called Big Bliss.

Yup, it's about plus-sized brides.  And I was wary, I must admit.  I hate the title (it's kind of rude and condescending and I just dislike the use of the word 'big' because it makes me think of mountains in wedding dresses), and I agree with my friend Rachel that they shouldn't have their own spinoff at all (her exact words were: "why do they need their own show?  They're people too!"  Word, Rachel, word).  But I loved the idea of seeing women in wedding dresses who, even if they didn't represent me, represented something I still relate to, and (this is important) something other than the 'ideal image' of a woman.

And guess what?  I LOVE IT.  I love the dresses and the bickering and the taste levels and all the same things I love about the original series, but I also think it's probably the first show I've ever seen about 'plus sized' women that treats them like normal people.  The stylists don't seem to care at all that they're putting women into size 28 dresses (sometimes those women are size 30, and the stylists just rubber-band those motherfuckers and ask the girls what they think of the dress without blinking) – they just want their clients to feel beautiful.  There's no judgement on whether or not that woman is beautiful in any sort of 'objective', society-approved way.  These women have fiancés who love them, who obviously think they're gorgeous, and they deserve dresses that make them feel gorgeous.

The interesting thing is that almost all of them, even the most outwardly confident 'volumptuous' women, arrive in the salon nervous about what they'll find.  They're scared they'll look like sausages, or that people will think they look 'undignified', or just that nothing will fit at all.  And the stylists handle these fragile women with just enough grace and sensitivity to make them feel at ease, without calling attention to the fact that they're fragile (in fairness, many brides, of all sizes, are fragile about how they look).  Randy is especially caring, in a completely genuine way, and I just want to squeeze him and send him roses and chocolate and thank him for making these girls feel like not only are they beautiful, but they deserve to feel beautiful.  I love it.

It's not just the stylists, either.  One of my problems with Biggest Loser was always the camera work – slow motion clips of heavy people running, their faces red and sweaty, their bellies bouncing.  IT pisses me off.  It's voyeuristic and exploitative and offensive.  And Say Yes doesn't do it.  They don't hide the brides' bodies (not even when they're not in dresses), but they don't focus on things like back rolls or red faces (and you know they're there, after all that getting in and out of tight dresses).  They focus on the dresses, the detailing and the shapes and the flattering/unflattering aspects of them.  And, most importantly, they focus on the faces – the frowns, the tears, and the eventual YES glow. 

So if you're looking for a reality show that feels truly real, without exploiting people or subtly mocking them or patronizing them, I highly recommend Say Yes to the Dress, Big Bliss.  Heck, I recommend the skinny version too (lord knows there are plenty of body image issues there as well), but if you're specifically in the market for something to make you feel like the world isn't such a judgmental crapfest after all, then Big Bliss is where it's at. 

Now if only they would show the brides' sizes / measurements so I'd know where I stand, my life would be complete...

New year, new attitudes about weight and health?

Happy New Year!  I've had a lot going on these past couple of months, and I'm currently getting down to business on the first big set of edits for my book, but I just had to pop in to share my thoughts on a couple of articles that have been stirring my blood lately.

First, this article from the New York Times, about a new study proving that our bodies actually conspire against us to hold onto fat we desperately want to lose, and that people who have lost weight before actually burn fewer calories doing the exact same activity as they would have burned had they never been overweight (sorry if that didn't make sense, just read the article).  I read it while I was on holiday in Rome, stuffing my face and telling myself that all the walking on cobblestones would work off the carbonara and the lasagne and the fried artichokes, and I must say I found it both fascinating and seriously depressing.  The description of the lifestyle a person needs to lead just to keep off a significant weight loss is so severe, I basically wanted to give up right then and drown myself in tiramisu.

But then I posted it on Facebook, and got a couple of really thoughtful responses, which allowed me the chance to change my mind a bit (click to enlarge, and please excuse the messy blurring of people's names/faces):

Then one of my good friends added to the conversation, posting a link to this response to the NYT article, which I found really interesting and which, as I said to her, is exactly the kind of response I hadn't even allowed myself to consider, because as a self-titled fat person I didn't feel like it would be taken seriously coming from me.

But now I was starting to shift my view of this new study.  Maybe it wasn't depressing, maybe it was liberating: could it be that our bodies resist losing weight precisely because our 'weight goals' are below where our bodies prefer us to level out?  Sure, we're probably evolutionarily programmed to hold on to fat in case of famine, and we probably don't need that gene anymore.  But could there also be something to be said for being fit at any weight, and trusting our bodies to know what's best for us?

A sort of answer came a couple of days later, when my former teacher sent me a link to another article, this one about why women need fat, from Salon.com.  This time, rather than just telling readers that their bodies will resist losing weight more than they expected, the scientists interviewed in the article actually defend extra weight in women!  The part I found most interesting:

"Many M.D.s have bought this fallacious line that the optimal weight for women in terms of their health is what M.D.s call normal weight, a BMI between 18.5 and 25. And they have thought this to be true because women with higher BMIs exhibit a series of physiological measures that are indeed risk factors for disease in men. But they are not systematically risk factors for disease in women. If you actually look at the data from the National Health and Nutrition Examination Survey and data from studies done in other countries, the optimal weight for women who have had a kid is what doctors currently call “overweight.” I’m not saying that obesity is optimal, but all the findings show that overweight women survive better than normal weight women. We walk a fine line in the book because we argue that being overweight is not nearly as bad as your doctor has been telling you, but on the other hand, Americans are heavier than they need to be. There are diseases that still correlate with heavier weights, like diabetes. But if we ate a more natural diet, by that I simply mean the diet that we evolved to eat, we would all weigh less."

Whaaaaat?!  I've been saying BMI is bollocks for years, and here it is in black and white: not only is it true that diet and fitness levels are more important indicators for health than weight, but BMI, according to these guys, is a completely skewed indicator for women as a whole! 

I was pretty blown away by this.  I mean, I've always thought (and said) that we should focus less on the number on the scale and more on real indicators of health, like lifestyle and blood pressure and lung capacity, but I sort of never expected to be backed up so wholeheartedly by scientists. 

It's nice to feel like the scientific world is finally starting to get it.  And although the aforementioned NYT article does still promote weight loss, even for people who are otherwise super healthy, I feel like maybe it's a step in the right direction.  If nothing else, as the comments on that article suggested, people who are naturally thin might look less disdainfully upon heavy people who struggle to lose weight.  And lord knows that's a start.  Compassion leads to greater understanding, and if we can understand weight and fat better, maybe we can start to change our views on them.  And maybe then we won't need the skinnies to have compassion for us, because we'll just be different, rather than worse, or lesser, or contemptible. 

Hey, it's a new year – a girl can hope for change, right?

I should be happy...

Things have been crazy lately.  I’ve finished my MA, started looking for a full-time job, and gotten an agent and a book deal, all in quick succession.  It’s all happening really fast, and it’s almost all good news; as my friend pointed out on Facebook when I announced that I had a publisher, I’m finally profiting from my all-consuming neuroses.  They’ve always been the source of my self-deprecating humor, these nerves of mine, but they were never much good for anything else until now.  Suddenly, I have an audience for my particular brand of crazy, and everyone around me seems to be thrilled on my behalf.  I should be thrilled too, and I am, I keep insisting… well, my logical brain is thrilled.

The thing is, in my heart I’m terrified.  Publishing a book about my body anxiety publicizes it, and while I’ve always been one for publicizing my issues on a conversational level, I’ve never really had to deal with a large audience before.  Even this blog only has a few cherished followers and a smattering of googlers.  So I’m anxious about what happens next, and especially about the pressures associated with my particular choice of topic: will people expect me to be constantly dieting and working out, and if I’m not (which is most of the time), will I get hate mail from people who think I’m a lazy slob who complains about her body without trying hard enough to change it?  Will I get reviews saying I’m charmingly neurotic, a new sort of everywoman, or will they label me a whiner who’s trying to profit from having been fat and taking the easy way out?

And it’s not just about what other people think – I’m judging myself much more harshly in the light of future publication.  I’m worried I don’t work out enough (though I’ve become more disciplined lately), concerned about every sugary bite that goes into my mouth.  I’m also up nights fretting over what should be in the book and isn’t because it didn’t flow correctly, worrying that I haven’t given my readers enough information.  And perhaps worst of all, I still feel shitty about my body, and now I’m beating myself up over than even harder than usual.

Lately I’ve been feeling like the fattest girl in every room.  I’ve always had slim friends – kind of extraordinarily slim, too, often smaller than a size 10 – but for some reason it seems like the more friends I make, the smaller the average size gets.  Maybe it’s a sort of aspirational technique – my parents always used to say that one reason I did better in school than my brother, despite our equal IQs, was that I surrounded myself with the best and brightest and aimed for the top, while he surrounded himself with the mediocre and aimed for the middle.  And maybe it’s that way with my body, maybe I gather the slim gals around me in the same way that dieters tape photos of models to their refrigerators, as inspiration.  But if so, it doesn’t seem to be working.  All it does is make me feel like the elephant in the room.

And then I beat myself up for feeling that way.  The point of my book was to work through my issues, and also to show them to the world and myself as issues that most women deal with, no matter their size/diet/surgical history.  And the aim I had for myself, which is also laid out in the last chapter of the book, was to stop focusing so much on my body and try to work on my mindset – if my boyfriend loves my body, and I know it’s healthy, and most of the world doesn’t think it’s revolting, then why do I have to hate it so much?

But I’m failing at that aim these days.  I don’t know if it’s the book deal or just the beginning of winter doldrums, but lately all I see when I look down at my body is rolls, flab, and excess skin.  I work out and I’m feeling great and kicking my own ass and then, mid-plank, I look down at my legs and see the skin hanging off the thighs like an upside-down mountain range and I drop down onto my mat and feel like crying.  Of course I make myself get back up and keep going, but it’s gotten bad enough that I’m thinking about surgery again.  And that was so not the point of trying to change my mindset.

I don’t know… hopefully I’m just in a bit of a depression and I’ll come out of it soon.  And as for the book, I’m just crossing my fingers that the excited part of me will take over some time soon, and the terrified part can go sit in the corner until it’s all over.

For now, all I can do is keep at it: working out, editing the book, and pretending everything’s fine in my heart.  Because one day it will be fine again, and until then there’s no point upsetting the people around me.  Especially my editor.

Exercising with the BF – A Validation Tale

I have something to confess: I haven't worked out in a while.   And by a while, I mean at least a couple of months.  And by worked out, I mean anything besides walking around at a leisurely pace (that includes super low-key yoga/pilates).

Amazingly, I'm smaller/lighter right now than I was back in the spring, when I was much better about exercising (well, I say it's surprising, but I guess it's been the case 90% of the last ten years, so I don't know why I continue to be surprised), but nonetheless I've been feeling sluggish and soft lately, and last week I decided to get back on the horse.

A friend of mine on facebook has been doing a Jillian Michaels* workout, and she's been posting a lot about how exhausted it makes her and how much it hurts – my kind of workout, when I really want to get stuck in.  I messaged her and we chatted back and forth about the video, and based on her review ("it kills, but it's only half an hour and it isn't boring") I bought it on itunes and tried it out the very same day.

Oh. My. Lord.

This video (the 6-week ab shred) is no joke.  There were moves I couldn't even do, much less keep up with.  But I got through it, and I felt proud of myself.  And then came the next day – oh god I could barely move.  My abs felt okay, but my thighs and back were killing me.  I moaned and patted myself on the back about it to the BF, and he was duly sympathetic and also a bit interested.  So I invited him to join me in doing the video this morning.  And he actually agreed, and followed through!

It was awesome.  Five minutes in, my already-sore muscles burning but my resolve strong, I looked over to see the BF, red in the face and looking stunned at the strength and agility expected of him.  I chuckled and said "no joke, huh?"  The rest of the workout was just as satisfying.  He performed admirably: there were moves that I couldn't face with my sore body, which he managed to do, and there were moves which he sat down on the mat and watched, while I gave it a shot.  The different weight and strength distributions of our bodies probably had something to do with that (plank moves are really extra hard when all your muscles and all your weight are in your hips/thighs).

When we finished, he collapsed and stared over at me, his eyes wide and rolling like an overworked horse.  I felt so validated.  Smug, even, which is unfair because the BF had never said anything to indicate that he thought my workouts were easy.  But that didn't matter – I felt validated on behalf of all women, in the face of all men.

I've always felt like there was an attitude in the fitness world that women don't work as hard.  That the vast majority of women get on the eliptical for 20 minutes, watch The Real World and get their heart rates up a bit, and then go do 50 crunches on the mat, grab a smoothie, and go about their day.  Or they do yoga for an hour and go to lunch in their spandex.  Even the cardio classes have a reputation for being dance-based, flounce-around excuses for exercise.  Women just work out so they can eat without feeling guilty and shop for cute leggings and sports bras.

On the other hand, men's fitness routines are thought of as harder-core: running on a treadmill followed by heavy weight-lifting.  Lots of sweat, lots of grunting, lots of old, stained, holey T-shirts.  Men work out for fitness, and women just do it because they feel like they should.

Which is probably true, in a lot of cases.  But one of the reasons they feel like they should work out is often because of the pressure they get to look a certain way.  And, in general, it takes a LOT of work to look as good as we're told we should.  It's hard, sweaty, exhausting stuff, trying to get thin and flabless.  Most men, on the other hand, can run a few miles a day, be proud of their general physique and resting heart rate, and go on about their lives.  No. Fair.

But looking good is only sort of why I do it, personally.  I watch Jillian and her lackeys and I'm fully aware that there's no way in hell that I can ever wear spandex and not have a hint of muffin top.  Those women are like 4% body fat, and that'll never happen to me – I'm convinced that even when I die and decompose, I'll still have rolls – but I also know that I can be stronger.  Firmer.  My arms can be more defined, and my ribcage can be less squishy.  My collarbone can be more pronounced.  I may never look great, but I can look better.

But it's a whole lot of work.  And I'm willing to put it in (half the time) because it makes me feel better about myself.  But I won't say it's not extra satisfying to know that my naturally strong, fit boyfriend feels the burn at least as much as I do (more, on some moves).  Bless that boy and his sweaty, red, stunned face.  He stuck with it, and I think I will too.

* I'm not a huge fan of Jillian Michaels, generally – the whole yelling at fat people who are trying their best thing really turns me off – but she's pretty good in this video.  A bit annoying, but not so condescending or trying so hard to be a tough bitch.

PS You've read the pros of exercising with the BF, validation and companionship and all that, but the one big con is that he's there in the room with me when air bubbles escape during crunches.  AWK.

The Isolating Side-Effect of GB

Weight loss surgery is controversial.  This isn't news.  But what you may not realize is that it's not just controversial among thin or 'normal' people, but in the fat community as well.

Whenever I visit any sort of 'fat acceptance' website, I'm always startled by the attitude toward GB and surgeries like it (WLS, in short form).  Today, I came across this interesting article on being a 'Smaller Fat' – the strange limbo that those of us who are BMI-defined as obese but who look 'normal' enough to pass – and I was all set to write a post about the main article.  But then I read the comments.

One commenter talked about the strong support system she had at her workplace in the medical profession, where people understand that BMI isn't everything and fat people should be understood instead of tormented.  Lovely, right?  But then, in a parenthetical aside, she mentions that one of her supporters is a doctor who "had to autopsy a bunch of WLS victims" once, and therefore (it is assumed) is on the side of understanding fat rather than attempting to fight it.

The one that really got me, though, was the last sentence of a long and interesting comment on what the numbers really mean and how judged people feel as a result of their weight/BMI.  The commenter made multiple valid points about the media and the overdramatization of the fat 'epidemic', and then she ended with this: "WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*"

It's kind of weird for me to read stuff like that.  When I was considering the surgery, I never once considered that I might be betraying the fat community.  I guess I never really felt like part of that community, to be fair, but somehow I still feel like they view me as a traitor.

After surgery, though, I find myself isolated twice: not just hovering in limbo between 'normal' and 'obese', but also feeling like I'm neither an accepted part of the thin world nor welcomed in the fat world.

I think that's a little bit ridiculous.  Surely I feel a lot of the same injustices and anxieties as people in both camps.  Women (and men) all over the world have issues with their bodies, and whether they resort to WLS, or go on the cabbage soup diet for a month, or just spend tons of time and energy and money on their appearance, I'd be willing to bet that nearly all of those people who weren't born with natural confidence have tried something to make them feel like they belong in their bodies.

The vilification of WLS in the fat community is counter-intuitive, to me.  I get that they don't want to be pressured into it, but does that mean that everybody who has it is inherently weak or stupid?  Willing to risk our lives for a chance at what we thought might be normalcy?  It seems unnecessarily stubborn to me to refuse an opportunity to change what you can't accept about yourself, if only so that you can self-righteously fly the flag of self-acceptance in the face of those who took that chance.

I don't know.  I'm not sure how to structure my thoughts on this issue, but I do sense another chapter forming in my mind.  I'm not sure I can send my manuscript out without any comment on this strange limbo that some of us occupy.  But if I can't even formulate a blog post coherently because I'm so mixed up, how on earth am I going to get a cohesive, 4000-word chapter out of it?