An Open Letter to A Friend

Dear _____,

You are a very good friend to me in the short time we've known each other. I know if I asked you at the very last minute, you would take care of my cats and help me out in any way. I hope I would do the same for you .

But this letter is about something you do that drives me totally batshit crazy.

You spend way too much worrying about how your daughters look and how fat your sister is becoming and what you need to do to achieve some sort of physical nirvana. You also spend way too much time telling me how your daughters and sister are fat and what they should be doing to fix that.

First of all, I truly do appreciate your ability to concentrate and spend two hours either running and/or being at the gym doing weights. You've come a long way from when I first met you and you were afraid to go into the main part of the gym. You were so afraid to leave the "ladies" section and I'm proud of you for taking that step. I wish I could be that devoted but honestly, I get bored in ten minutes at the gym. I give you a lot of credit for that kind of energy and willpower.

I've met your daughters. I've met the one you said "was piling on the pounds" and I honestly couldn't see it. I suppose she is like a lot of people and have an extra ten or fifteen pounds but I didn't see Piggy McHogg standing in front of me. I saw a normal looking, attractive woman. I don't think she even had a belly and if she did, she hid it.

The other daughter -- honestly, I can't even see the ten extra pounds. She's skinny to me. I know she works out because she teaches physical exercise for a living. And yes, I know it's not an aerobic exercise but my point is she is moving.

It wasn't until recently that I discovered your eldest daughter had a college degree in a very hard field. All I knew about her was that she moved away and she was gaining weight in her new home. That's kind of sad.

As for your sister, I did met her that one time and even then you thought she was gaining weight again. (If that's the case, why did we all meet at Olive Garden? You thought you were fat then too and I know I'm fat....) But I didn't see it. Maybe I'm too charitable or maybe I'm indifferent, but I didn't see morbid obesity. And now you spent your lunch hour IMing me about how much weight she's gained -- she's now 150 pounds? It's easy to be overweight when you are short like she and your daughters are but I'm not sure she is overweight.

In any event, let me tell you this. When you're overweight, you know it. You might deny just HOW much overweight you are, but unless you live in a house with mirrors or wear clothes without any size tags, you do know what size you are to the world. I'm not sure what the point was for you to spend your trip telling your sister that she needed to lose weight but I can assure you this: she already knows what she needs to do. She's been to Weight Watchers and has lost weight and she knows how it works. You telling her all of this just makes something that's already hard even harder. It's not like all of us fat people are sitting around wondering, "How do we stop being fat? Oh wait. Less calories and moving more? Damn, why didn't I think of it? I'm so glad you told me this secret!" She knows. Honestly, she knows.

I'm sure your sister's problems may have something to do with her weight but guess what? It might not either. I pointed out to you that the problems with my knees were more about how my legs were formed and not so much about the weight. (Although the weight doesn't help, the doctors and I agreed.) I said, "Maybe some of her problems have to do with OTHER things. It's not always about the weight, you know." In any case, there's something going with your sister that makes it hard for her to get up and move. Riding her ass about it isn't going to make her move.

It's just weird that you spend so much time harping about your daughters' appearance and then you and your daughter spend time being so scandalized by your sister's weight gain. Is that all there is for you all?

Of course, I can't talk. I spend too much time obsessing about what I'm going to eat, how much of it and my struggles with my weight. I'm sure you may say to me that I'm going to the gym so I'm "better" than your sister but I'm sure you're keeping track of whether or not I'm at the training sessions on Saturdays and how much I've gained this past spring. I don't like it either to be honest and I either need to do something about or just accept it and suck it up and get on with my life.

I'm not perfect. I hate that sometimes I'll see really morbidly obese woman barely able to walk and thank god that "I'm not like that" (yet). Sometimes it makes me try harder to eat better and more more. Other times, I just get depressed. I worry that I will end up like that. I know I was like that and it scares the hell out of me that I could end up on two different blood pressure medicines. So I can understand where you're coming from to a degree. You don't want your kids to be unhealthy and you want your sister around. On the other hand, I really try not to blame people. I know from first hand experience how hard it is to be overweight, have people look at you and judge you.

I've been the person who gets into exercise and wishes others would join me and I've been the person who knows what I need to do but not doing it. (Actually, I'm more at that end of the spectrum than doing anything.) But I also know that sometimes when we conquer some demons, we tend to underestimate how hard it was and think that "if I can do it, anyone can do it." I've done that with my swimming lessons and minimized how hard it was for me. You should remember that when you tell someone to watch what they eat and to move more.

Maybe you think that if we control our weight, we will have control over our lives. What I don't understand is how you think constant nagging is going to change anyone's else life. I am grateful that you doesn't nag at me but I do wonder if you tell your daughters about what a loser I am for not showing up for Saturday's training.

I know that we all need a kick in the pants from time to time but all of us have mirrors and can check the size tag on our clothes to get an idea of what's going on with our bodies. I know from growing up that the constant reminders that I "should" be doing "something" just annoyed me and made me eat more. Maybe I am a loser but I hope I don't go around making everyone feel bad about what they're doing in life. If I do, please let me know.

I'm still your friend but honestly, let it go about what your daughters and your sister are/aren't doing weight wise. They are more than the size of their ass.

Inspiration, Fat Friend, or Both

I joined Weight Watchers 6 years ago and lost over 100 lbs in two years. The next year at my national conference, one of my professional colleagues and I talked about my weight loss success and about how WW worked for me. She was wistful.

This year I got an email from her asking about getting together at this year's conference. The tables have turned: she's lost some 60 lbs and kept it off for a year and a half, turning into an "almost vegetarian" and exercise fiend. She said I had inspired her. But she was also totally honest and said that reading my day-to-day issues with food and weight in my blog over the last year has made her nervous about seeing me again. She didn't want her success to be painful for me.

I don't want it to be painful for me, either, and I also don't want to be lashing out in my well-practiced Fat Friend mode, just because her success makes me aware of my relapse into failure and that I've let go of something that mattered. That I used to be that successful, happy, aware, healthy person and now I'm not. I'm happy for her and her success and I know what commitment and willpower it took to make those significant changes in her life and lifestyle.

It's not anyone's fault but my own for not having the strength and self-respect to keep going even when things got hard. And by letting go of it all, it's now harder because there is so much to undo. I know I'm a good person and have a pretty face and good skin and kind nature and all of that. But I'm still fat and it makes me sad. I wish it just made me mad and inspired me to actually do something about it but right now I'm just tired. My knee hurts a lot and so does the arthritis across the top of my other foot, which makes me walk with a distinct limp and considerable discomfort. Walking the mile from the car to work is just not possible and the lack of exercise feeds (if you will excuse the term) into the whole cycle.

I think that things are piling up to a point that I have to do something because I'm not only uncomfortable in my head, I'm not comfortable in my body either. I don't want to go into a Fat Acceptance thing because it's not okay to me that I'm the size I am in the shape I am.

Inspire me. Tell me a story about what motivated you to take the step of making actual change.

Weight Bias in Health Care Settings

Having read Lori's last post and knowing my own reaction as an obese woman to visiting doctors, I was intrigued to read about a new web-based Continuing Medical Education course developed by Yale University's Rudd Center for Food Policy and Obesity. It's designed to increase awareness of weight bias in health care settings and hopefully improve care for overweight and obese patients. Assuming, of course, that the medical people are remotely interested in doing so.

I took the whole course including the quiz at the end, and not surprisingly, I passed with flying colors. Well duh, I'm an overweight person and have first hand knowledge of the topic. The research quoted matched my own experiences but I'm willing to bet that it will come as a surprise to a lot of medical people.

The Rudd Center is a resource that you should know about. Why? It's a "non-profit research and public policy organization devoted to improving the world’s diet, preventing obesity, and reducing weight stigma." I've been impressed by their balanced policy-focused approach to educate and change attitudes about weight issues. They have a good website with an informative blog and resource links for areas such as weight bias, nutrition, and economics. There are also podcasts and an email newsletter with news and links to more extensive articles. Well worth your time :)

And, who knows? Maybe some of Us could give our doctors the checklists from the online course along with the URL for them to take it themselves. Changing awareness happens one small step at a time. We can complain or we can be part of the solution.

Passing

Last week, I had a very important doctor's appointment about my knee. I had to pull strings and ask for a physician friend to refer me to the best doctor in town. The night before, I obsessed a bit about what I was going to wear and how I would look.

My mother once refused to see an orthopedist because she said he would chide her for being overweight. I pointed out that unless she walked on her hands, the problems with her wrist probably had nothing to do with her weight. But I understood where she was coming from. And I think all of us have had a lot of history of hearing how our weight is responsible for everything under the sun that's wrong with us.

I worked for many years on the medical side of my institution. I worked with residents, interns, fellows, and attending physicians. Medicine (and nursing) are not very glamorous professions. When you add the paperwork, time restraints (especially people in health care management groups), there's not a lot of time to actually TALK to your doctor or even SEE your doctor. (In fact, my mom gets to see her physician once a year. She is bounced to a physician's assistant unless there is some crisis.)

So I dressed up and made sure I didn't smell bad and looked like I did try to take care of myself so when I met my doctor for the first time, I could maybe avoid some bad first impression that would give me less than optimal care.

This isn't nice. I'm basically telling you all that I didn't want him to assume that I was some fat woman who messed up her knee over the years by being chronically overweight and not exercising. No, I'm not one of THEM. I fell down. Don't judge me.

I was hoping that maybe I could camouflage myself and not been seen as one THOSE women. I wasn't going to lie to him, I know my weight has contributed to my knee problem but I also wanted him to see that I did fall down and tear my meniscus, PCL and a few other things in my knee and that might be the reason for my pain.

But the truth is I am one of those women. I have been overweight all of my life and I know that it is true I have contributed to my own problems in addition to falling down and generally really screwing up my already damaged knee.

I was waiting for him to tell me to lose weight, move more (sensibly, of course) and to stop taking up time from patients who were active, athletes, people who had a reason to get up and run, jump and move.

OK, that's what I THOUGHT would happen.

But it didn't. My problems with my knees (plural) is because I have oddly shaped legs and have always put pressure on my knees since I could walk. Sure, being overweight definitely added to the pressure and sure, losing some weight will help but really, this was bound to happen. It just happened sooner because of the weight. My one knee is hurting faster quicker because I did fall down. My knee went even more backwards as a result of the accident and it's accelerating the pressure.

He spent more time explaining my weird leg structures and my knee and my PCL and how nothing was really going to help it at this point except a cortisone shot. Eventually I would need a total knee replacement but for now, it was a shot, strength exercises, and moving. Losing weight would be great too.

I was surprised. I was waiting to be told I was damaged and it was all my fault and what a fat idiot I was in general. I wasn't expecting to hear that I had congenital leg issues.

How much of this is because a physician friend referred me to the doctor? (Don't dismiss this; I've typed enough patient notes that say, "She is a friend of Dr. So and So" or "Her mother works as a secretary for Dr. So and So.")

Did I clean up enough and look like I cared about myself to dress appropriately? Did I talk about my injury in a way that I presented well?

Have I lost enough weight to somehow "pass" as "just" severely overweight and not morbidly obese?

Or, maybe, just maybe, I had a good doctor who didn't immediately hand me the Fat Excuse for my problems?

I'm not congratulating myself on "passing." I know I was lucky and it would have been totally normal to hear that I did this to myself and not hear about the leg/knee structure.

I know we all have horror stories about seeing the doctor. Besides dressing up, making sure we don't smell, and looking like we have half a brain, is there anything else we can do to get beyond our weight when we have a medical problem and get past any stereotypes? I also realize I'm stereotyping physicians too; they might want to spend more time to examine us and see us beyond first appearances.

Are You My Type?

When I was a child my mother used to create occasional prayer lists for me to take to my bedroom and personalize before I went to bed. They were kind of like Jesus Mad Libs, except I can't remember ever thinking they were fun, and I definitely didn't bring them up during grade school slumber parties. Over the course of five or so years, I had accumulated quite a pile of scrap paper, usually old grocery lists or reconstituted Post-It notes, with names, issues, and platitudes written out in my mother's impossibly perfect cursive. I learned the Child's Prayer, the Lord's Prayer...I said prayers for my family, my teachers, my friends at school, the Kansas City Royals, Ronald Reagan.

When left to my own devices, though, I got a little bit selfish. Sometimes, even with my prayer to-do list in hand, I'd turn to God and ask for the most heinously shallow things, requests that the Lord would convince my mother to allow me to change my name to something undeniably fabulous, like Shasta or Denym. That I'd get a phone call from Marc Sommers himself requesting my immediate appearance on Double Dare. That I would, finally, FINALLY wake up with enough money to afford the stonewashed, neon paint splattered mini-skirt that had been taunting me for weeks in the window of the JC Penney. And my deepest darkest desire, something that even now shames me to admit, that I'd contract some sort of chronic condition that would force me to lose weight.

Admitting to a friend a few months ago that I used to secretly wish for a case of juvenile diabetes, or a very curable cancer simply because they force me to get healthier was not one of my proudest moments, until she confessed she used to pine for the very same thing. We both confided to each other that the idea of getting thinner because fate dealt us some sort of tragic hand used to seem so noble, so...RIGHT. I used to imagine scenes where I'd turn down Rice Krispie Treats or brownies at school birthday parties, not because the waistband of my Jordache jeans was cutting into that baby fat that seemed to linger around my hips and waist long after the other kids had shed theirs, and not because my PE teacher had pinched an inch and told me to start running the mile every day and to stop eating so much ice cream, but because the process of curing my Very Serious Illness meant I had to give up sugar. It seemed like such a satisfyingly self-righteous tactic for shunning the temptation I wasn't normally able to resist.

I've never contracted anything more serious than a really nasty case of strep throat in my life, so my plan of wasting away delicately never came to fruition, and instead I continued to balloon up rather ungracefully throughout my entire adolescence and early adulthood. But throughout the course of being fat, and an Angry Fat Girl, and a rabid dieter, and then a reformed dieter, I still always looked for some sort of reason to help me focus on this process of getting healthy and in control of my body and my energy. Last weekend, I was doing some sort of research for my own blog when I came across this article about somatotypes. I had read a little bit about them before but had always considered the body types as symptoms of how we take care of our bodies, rather than actual causes for how we eat, move, and think about our health.

I knew right away I was an endomorph, which is portrayed in that article as a balding man with a pot belly, so basically I'm George Costanza. I'm sure most of us reading this right now are also probably endomorphs, or else you wouldn't have had the true fat chick experiences to qualify as an Angry Fat Girl. And we know our type--pear shaped, pudgy thighs, smooth round faces, little hands and feet that make a striking contrast to the rest of our wide bodies. We're soft, unassuming, comfortable. I guess I figured that's all I ever really needed to know about being an endomorph, that I would always have curves to spare, and I'd probably never really have the upper body strength of our mesomorph sisters, nor the lanky, endless legs of an ectomorph. I was fine with that...a little wistful, but fine.

Then I read on, and started to get excited. The information I read about endomorphs was probably stuff I should've figured out already, but for some reason hadn't really internalized. Endomorphs pack on fat way faster than meso or ectomorphs, because the fat pockets in our bodies are larger and can accommodate so much more. Our temperaments aren't really aligned to exercise--the endomorph would much rather curl up with a book or a bowl of pretzels, which means finding motivation to exercise is hard. Our metabolisms are slower, and we gain weight faster than our athletic counterparts. We're sensitive to processed carbs and fats, and we have a pretty lethal sweet tooth to contend with. Our best options are to be extremely careful about restricting calories and getting plenty of moderate intensity cardio. In short, we've been pretty screwed, genetically, and we have to fight and fight and fight to stay on top of our health. It's an immense relief to me that the weight wasn't falling off like I expected it would because I was some sort of freak destined to weight 200+ pounds for the rest of my life, I just wasn't trying hard enough. When I tell my friends that I can easily gain one or two pounds from just a single unwise dinner splurge in a week, I'm not exaggerating, and now I know it's because my body is wired to keep all that fat. Endomorphs seriously have to push themselves, nutritionally and physically, to get thin, and then be hypervigilant about maintaining that level of health for the rest of their lives. It's like the situation I always dreamed of, except without the pain of actually having something truly wrong with me. I have a condition that will force me to be disciplined, conscious, and careful of the foods I put in my mouth and the way I move my body. If I do, there's a chance I'll be a Sophie Dahl, or...dare to dream...a Jennifer Lopez. If I'm not careful, though, it's a straight path to John Goodman and elastic waist hell.

So my question to you is, do you buy into the whole somatotyping idea? If you do, have any of you overcome your body type and what worked for you? Is there hope for someone like me, who still occasionally bows my head and turns to God for just one tiny childhood disease, and maybe a pony in the backyard if He's not too busy?

Flying by the Pound

Local TV stations used it as a teaser this week: "Will airlines start charging passengers based on their weight? Story at 11pm."

I don't know about you, but every time I heard or read that, my stomach clenched. It wasn't helped by seeing the website for Derrie-Air. Reading the fine print it's clear that it's not real - but the sentiments expressed are being repeated more loudly and more often than ever.

Let's talk about it. Fuel costs are going up and up and I do understand that airlines are squeezed at every turn, and they need to recoup costs. I also understand that the heavier the plane, the more fuel it takes to move it from point A to point B, and that weight includes people, luggage, the actual plane itself and the fuel it's carrying. Airlines are now charging more for additional luggage and I really do think it's only a matter of time before someone seriously floats the idea of charging passengers by weight.

But how to decide that? The average man weighs more than the average woman, so a single base weight of, say, 200 lbs isn't going to be equally fair for both genders. How much would they charge per pound of overage? Do they mean buying a seat and then charging by the pound, or simply charging by the pound in the first place? Related to all of this is the issue of the space we fat people take up. If I'm to pay by my weight, then I want to have adequate reasonably comfortable space on the plane.

I currently buy two tickets when I fly for my own comfort and safety and that of the people around me. One seat won't quite cut it. But two seats are very expensive these days and if an airline were to charge me by my weight after also requiring that I buy two seats, I would not be happy. And I probably wouldn't fly much if I could help it - which is, I think, the whole idea.

I'm not stupid. I know that I'm fat and that my weight has consequences. I pay more for my clothes because they use more fabric; even while it annoys me, I understand what's going on. And I think I would be reluctantly willing to pay more for flying, though not if they want me to stand on a scale at the ticket counter with the weight broadcast to the folks in line. In exchange for the higher price, I want to be treated fairly and with respect, and to sit comfortably on the plane that I'm paying so much to board.

Wile E. Coyote Day

I would have liked to have had a better B.M.

I would have liked to have felt hungry.

I would have liked to have been completely naked.

I would have liked to have had a week of normal dog walks adding up to five hours a day.

Still, I thought I had a shot. I had group sex with food for a couple of days last week but in general, I've been getting more serious about the foods I will not eat and in specific, I've been weighing and measuring since Sunday. It could happen, I hoped. And so, half-clothed, not yet hungry, after a big cup of coffee, I dragged my dusty scale out, made sure it was exactly set, and took my leap of faith.

Only to get a lesson in gravity.

Nada. In fact, for a moment some time recently I weighed that number and then lost two pounds. Not today. Nope. No way.

I've been having a hard time getting dressed lately. The weather is tricky even on a bright day, and We're out of coats and into windbreakers or nothing at all, thus forcing Us to show the world what our bodies really look like and what our clothing management actually is. Clothes that fit last year are tight enough to make me self-conscious this year. I feel uncomfortable and heave-ho-ish lots of the time. And while I try to shower after I've taken the dogs to the park, I can't put on the nice clothes that don't challenge my courage because I still have dogs to walk.

There I was, at 7 a.m., staring at numbers I didn't like, in free fall. Later, as I fluffed the potato I baked for breakfast and got my 0% cottage cheese out, I heard myself muttering, over and over, "Please, God, let me have an abstinent day."

My faith place, subconscious, recognized that if the needle wasn't doing what I wanted it to, I could use it as an excuse of pointlessness.

I had two things I had to consider.

1. The point isn't just to lose weight, it's to have a clean brain and reachable energy, both of which sugar and overeating destroys. I didn't lose the ten pounds I stupidly fantasized about, or even the four...but I wasn't worried, as I ate my spud and looked forward to my pear, that my eyes would be heavy when one of my dogs spotted an enemy coming its way.

Despite the needle, I had what I needed to handle my life rationally and energetically and responsibly for the day.

2. What is more important than how much I weigh -- or what size my clothes are, for that matter? Lots of things, I answered quickly, scrambling for answers. Obviously, given what I've just said, my abstinence is more important -- it greatly enhances my chemical make-up that gives me myself. Giving my dogs the care they need is more important than the needle and they don't care what number is under the needle. Working on my novel is more important. It's even more fun. The books I'm currently reading are w-a-y more important. The friend and family member I would be in the day ahead is more important, even if some one of my friends and/or family might find me appalling right now.

It's not that losing weight is unimportant. I miss my other bodies, the various ones that moved more easily and could wear better clothes and that I didn't have to quarrel with over how I look or fit in public spaces. But I either have to trust that Wile E. Coyote will rise from the dust, shake himself back into three dimensions again and go back to plotting, or that he -- and I -- are roadkill because we failed to catch our goal.

The fact is that if I eat what I ate yesterday, next Thursday's weigh in will be different. In the mean time, I'll keep my dogs and all passersby safe and amused. I will try very hard to write two pages of my novel each day. I will call my parents and touch base with friends. I'll continue to marvel at the economy with which Emma is written. Come Saturday, I'll have a manicure, put on the beautiful dress that I know fits me and meet an ex-boyfriend for dinner and South Pacific. It's my job to look as nice as I can, and then it's my job to forget about not looking as nice as I wish I did.

I mean, isn't seeing a sold-out show in limited run that's gotten fabulous reviews -- on Date Night, no less -- more important than what I weigh? And won't I laugh harder at Bloody Mary and cry more at Lieutenant Cable's death if I'm not thinking about stopping at the deli on the way home?

This coyote is going to think very hard about what is important in the next week.