I was compensated by Med-IQ through an educational grant from Novo Nordisk to write about the realities of obesity as a chronic disease. All opinions are my own.
As a person who is currently meeting the clinical criteria for obesity, I have seen my share of judgement and negative talk. In fact, much of that negative talk has been internal, as I find myself working in the same mindset that many other folks have been conditioned to. To put it bluntly, it’s really easy to think of those who are obese as lazy, lacking self control and suffering from poor self-image.
We have been conditioned to think of “fat” as a descriptive word – something you are instead of something you have. We equate excess weight with personal failings. We equate it with a lack of attractiveness. We even equate it with a person’s worth. Everything we see in the media reminds us that our weight and shape, no matter our other talents or healthiness, is the most important indicator of how others see us.
When you are an obese person navigating the world, people can treat you very differently than if you were thinner. I should know. I’ve been on both sides.
We have been conditioned to think of “fat” as a descriptive word – something you are instead of something you have.
In 2008, after years in an unhappy marriage, living in a foreign country with no real support system, I was diagnosed with type 2 diabetes. My weight, which had been a struggle since puberty, had skyrocketed to nearly 260 lbs, and I was what doctors described as “morbidly obese.” The shock of those words and my new diagnosis completely floored me. I knew I was fat – I was reminded of it every day. Going into clothing stores to buy new jeans or even underwear was an ordeal. The young shop girls would laugh at me behind their counter, and when I asked for help finding my size, I was often told that I needed to go to a special plus-size store.
My real passion at the time was socks, shoes and purses. These were the items I could buy without worrying whether they would fit me. I began to show my personality through accessories, as it was made abundantly clear to me that fashion was off limits to fat girls.
It was mid-May when I finally was told by my doctor that my weight was now a danger to my health. I was twenty-six years old. For years, I had tried every diet under the sun, and I even succeeded at a few. I would lose a small amount of weight, and I’d be so happy that I’d celebrate with a fast food meal. It was an endless cycle that would always see me putting on more weight than I’d taken off. As a result, the number on the scale went up and up and up.
At some points I would actually cut my calories to dangerously low levels, and I still couldn’t make my weight go down. I remember telling my doctor how hard I was working at it, eating nothing but lettuce salads with a tasteless vinaigrette. He looked at me without pity and said, “If you are only eating lettuce and still gaining weight, try eating half as much lettuce.”
As you can imagine, I was disheartened to say the least. My then-husband was little help, as well. While he tried to be supportive, he believed that my weight was simply due to a lack of willpower and not enough desire to change. His solution was to try and take control of my diet and use shame tactics if I didn’t stick exactly to what he thought I should eat. It was demoralizing and a big factor in our later divorce.
When I finally got my diabetes diagnosis, I knew that I needed to do something to finally get my weight in order. In an act of panic, I booked myself for bariatric surgery – in the Czech Republic. Less than three weeks later, I flew to Brno and had my “last meal” in the town square. I ordered a delicious pizza and told myself that I’d never feel the need to eat such a meal again.
I had my surgery, and over the next year, I lost over 120 pounds. I also lost my husband.
In all honesty, going from being 260 lbs to 140 lbs was a huge change mentally as well as physically. While it was difficult to get used to my new body, I was more shocked by the way I was now treated. As a thin woman, I found that people could not do enough for me. Shop assistants no longer laughed at me. They instead ran around the store finding me clothes they thought would suit me.
Even more surprising was the attention I got from men. My husband had made a habit of leaving me at home when he went out for events, saying he knew I was a “work in progress” and didn’t want me to be meeting people looking like I did. What he really meant was that he was embarrassed that his wife was so fat. He promised that once I hit my goal weight, he would be stoked to introduce me to his friends. Now that I share this, I realize how terrible that really was, but at the time I genuinely felt grateful to him that he was keeping me hidden and free of judgment.
Of course, once I had lost all the weight and looked more socially acceptable, I found I enjoyed the attention I got from others. In the end, I realized that I was no longer in love with my husband, and we parted ways, accepting we were better as friends.
The Weight Rollercoaster
Obesity is not a word that describes who I am. It is something that I have.
Within a few months, I met the man who eventually went on to become my second husband and the father of my children. I was thin and felt beautiful, which gave me an abundance of self-confidence. Within a very short time, I became pregnant with our first son. That was nine years ago.
Since then, we’ve gone on to have four amazing boys, and my body has changed. Pregnancy, illness and depression have contributed to a weight gain of around sixty pounds. I have felt like a failure, but thankfully my husband doesn’t see me that way. He not only thinks I’m beautiful and accepts that my weight fluctuates a lot, but he also sees that I am the person he loves, however I look. He tells me often, “Do you think I’d love you any less if you had cancer? Or if you lost your legs in an accident? None of it would change who you are.”
And that right there is the crux of the matter. Because obesity is not a word that describes who I am. It is something that I have.
Over the last several years, my husband and I have both made a huge effort to take control of our health by making regular exercise and healthier eating part of our lives. We have tried to lead our children in the right direction by being a good example to them, taking them hiking regularly, bringing them to the gym when we go and teaching them how to cook healthy meals for themselves.
Through this adventure, my husband has managed to lose nearly fifty pounds and keep it off. For me, my weight has fluctuated high and low with little middle-ground. At times I feel extremely frustrated with myself. Other times, I accept that I have a chronic condition that needs constant management. I try to show myself grace.
Obesity Is a Chronic Disease
Med-IQ is an accredited medical education company that provides an exceptional educational experience for physicians, nurses, pharmacists and other healthcare professionals. Through discussions with them, I have come to understand that obesity is a chronic disease, and it has nothing to do with a lack of effort or willpower.
While many medical professionals are still behind on understanding obesity and weight management, it is imperative that we raise awareness so that patients and advocates can have a successful relationship with their doctors and caregivers to become more successful in their health goals.
Weight is not simple. The World Health Organization defines obesity as excessive fat accumulation that may harm a person’s health. It is not something you should think about in terms of your BMI or other rigid diagnostic criteria.
People develop obesity for many reasons, including existing genetic risk factors in their DNA that respond to environmental, cultural or behavioral factors. Stress, lack of sleep, certain medications and eating energy-dense but nutrient-poor foods can all contribute.
Finding a positive and supportive healthcare provider and community are incredibly important for successful weight management for those who suffer from obesity. Understanding that every person’s path to successful weight management is as unique as their path to having obesity is crucial.
Trade the Misinformation for Truth
We have to change the narrative when it comes to obesity. When someone has cancer, we don’t refer to them as “cancerous people.” They are people with cancer. The same is true for this. We need to stop saying “obese people,” and instead start referring to them as “people with obesity.”
Dr Donna Ryan, a retired endocrinologist and President of the World Obesity Federation stressed to us that the answer to treating obesity isn’t as cut and dry as losing a specific large amount of weight. While my doctor may say I am 60 lbs overweight, it doesn’t mean I need to strive to lose the entire sixty pounds. Instead, Dr Ryan stresses that losing even five or ten percent of your body weight can have enormous positive health implications. For a person who weighs 200 lbs, that is only ten – twenty pounds, a much more manageable goal than fifty or sixty.
There is so much misinformation out there surrounding obesity – from the general public to healthcare professionals. We must change the way we view this disease and help to end the bias and stigma surrounding it.
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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.
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