I sat in Dr. Long’s office waiting for my one o’clock appointment, alone except for the elfin nurse, not quite hidden behind a counter. By 1:45 I’d already flipped through Alberta Report, and the delicious flush of outrage the magazine always inspired in me had long faded. I moved on to Maclean’s, but the outrage was not nearly as satisfying. I tried to exchange indignant and impatient glares with the nurse, but she was too expert at averting her eyes.
Being a doctor’s daughter, I am schooled in patient patience. I understand that things come up: important calls, emergencies, hysterical patients, late lunches. But after a string of humiliating yearly check- ups, each with a new doctor, I was irritable. The latest was Dr. Long, my parents’ general practitioner, and he wasn’t making a good first impression. If it weren’t for the guilt trip my mother laid on me about getting my Pap done, I’d have picked myself up huffily and left.
At 2 p.m., he arrived, grunted hello and disappeared. Fifteen minutes later, the nurse called out my name to the otherwise empty room.
She led me first to the weigh-scales. When I didn’t hop on right away, she arched a tweezed eyebrow and said, “Step onto the scale, please.”
“Uh…no.”
“No?”
Her little lips curled as tightly as her perm while she looked me up and down. “Step onto the scale, please.”
“I won’t.” Defiant, like a six-year-old, lip trembling.
“The doctor needs your height and weight.”
“Why?”
“This is your yearly check-up?”
I nodded. She gestured for me to step onto the scale.
“I’m five-seven,’’ I volunteered.
Her tiny stature was becoming tighter and more condensed.
“Really, just write down that I’m fat, okay? Write that the patient is obese, morbidly obese if you want. But I’m not stepping on that scale. No way. It’s my body. My life.”
This step-right-onto-the-scale routine was a little too familiar—a humiliation I had endured during my transformation from a lithe long-limbed child to an adolescent with swelling hips and breasts. After Sunday dinners, my father would weigh me and record my weight on a graph that was stuck to the fridge. We watched the line arc slowly upward.
Like always, I lost. The nurse looked at me steadily with an air of gentle disappointment until I stepped onto the scale. But I didn’t see the number. I kept my eyes tightly shut, sick with shame.
I have been a thin woman, a fat woman and every kind of woman in between. At age 20, I was a svelte 127 pounds. Over the past 10 years I have come close to doubling my weight. At age 34, I am now an obese woman.
I hate that my “addiction” is apparent to anyone who looks at me. I hate that people who do look at me think I am weak. I hate that because other people think I am weak, I continually call into question my strength.
I hate that I no longer have the power that comes with attractiveness. I hate that no matter what extraordinary things I may achieve in my life, they will be diminished by my failure to be thin.
The pervasive cultural pressure placed on women to be attractive is strangling me. A silent pressure, mostly, but as sure and as strong as a python’s coil. It’s also private—unless several bottles of red wine have been uncorked among my sisterhood of friends. Given enough wine and time our conversation will cover politics, people and then drift deeper until we reach the heaviest topic of all: our bodies. My beautiful, gorgeous girlfriends obsess about their weight exactly as I do. The difference is they are thin, and I have grown fat. And yet our damage is the same.
Weight. We believe the scale not only measures our weight, but also is the most important and accurate indication of our societal worth, our attractiveness. The tricky thing is that our belief—as mistaken as it is—is true. On one hand, we’ve been told there is no correlation between our attractiveness and our worth, or our weight and attractiveness. Since childhood we’ve ingested a litany of Pollyanna-esque proverbs: it’s what’s inside that counts; don’t judge a book by its cover; beauty is only skin deep; big is beautiful. On the other hand, we see images of women in magazines, in movies, in advertisements, images that extol the virtue and value of attractiveness, and we want it. We want that intoxicating power, that radiant confidence, that still perfection, because it’s missing from our lives. Never mind that it exists only outside of life, that behind the images are women, women who suffer as we suffer. We want it so bad we pay for cosmetics, self-help books, diet aids, not to buy something real, but to keep the illusion alive. Eat more and still lose 40 pounds in three weeks—get that man, that job, that life you always wanted.
The pervasive cultural pressure placed on women to be attractive is strangling me.
Who wants to admit to the truth of our post-modern age? The appearance of an object is more valuable than its function; form more valuable than its content. It’s an ugly reality: the correlation between weight, attractiveness and societal worth. I know this because I have seen the performance of my own stock rise and fall, mirroring the fluctuations in my weight.
Dr. Long was a gruff old man with an Albert Einstein hairdo and matching eyebrows. With no preliminary chit-chat, he launched into the check-up routine.
Blood pressure: good. Pulse: good. Lungs: clear.
I was glad that everything was going swell, because my heart was drumming, my breath was shallow, my skin was blushing. His hands were on me and I tried not to cringe; bared flesh, round belly, stretch marks, spilling fat. Not attractive. But besides a grunt here and there, he didn’t say anything, and I warmed to him.
Glands: normal. Breasts: no lumps.
Belly: no obstructions.
“You want the nurse?” he asked as he pulled out the speculum. I shook my head, grateful that that woman wouldn’t be looking up my gaping vagina. A shock of cold steel and scraped tissue, and it was over.
Not too bad, I thought, as I pulled on my clothes and waited for him to return. I even smiled at him when he came back with an armful of folders. He put those aside, grabbed the blood test form and checked box after box. He mumbled in Latin as he went along.
Recognizing the word thyroid, I gaily interrupted. “Don’t bother with that one. It’s been tested lots and it’s normal. Totally fine.”
He paused, pushed his glasses up his nose to look at me closely. “You shouldn’t be fat. No reason for you to be. Mother is underweight. Father is normal. Brother is normal. No family history.”
I giggled. I don’t know why. “I eat too much, right?”
“Is there anyone in your extended family that’s fat?”
“No. Just me. I’m quite the source of fascination at family gatherings.”
“There must be a reason.” He pushed his glasses up again and peered at me, the anomaly.
All I’ve said about the emotional or the cultural forces surrounding fat can be extracted, leaving behind only the math. I am overweight because of a simple equation: I consume too many calories and burn too few; I eat too much and exercise too little. Let’s assign x as the amount of calories I consume each day to function and maintain my body weight. x is the sum of y (the amount of calories I consume daily) minus z (the amount of calories I burn daily). If the sum of y and z is greater than x, then I will gain weight. Conversely, if the sum is less than x, I will lose weight.
Beautiful, isn’t it? Reducing an overwhelmingly complex issue into two factors? It appeals to my tendency toward black and white thinking. In any case, this is what my mother taught me: I am fat because I can’t do the math.
I not only have a math problem, but also a disease. Have you noticed that fat is no longer a description, but a disease? Overweight is no longer just an adjective, but also a noun. It’s one of two nouns with which health agencies have constructed an epidemic called “obese and overweight.”
I see the steady collection of data as the aggregation of ammunition. I see the writing on the covers of magazines. Gather your doughnuts while you can, because I feel the wind of change upon my cheek. The war on fat is about to begin.
“New research indicates…”—the television shows stock fatties footage: fat people scarfing fatty foods in shopping malls. Shots span the neck and below, leaving them headless, faceless, name- less. Grotesque and inhuman. (I’m sure I’m going to see myself one day. That’s why I am extremely careful never to wear shorts.) Nearly half of Canadian adults from 20 to 64 are overweight or obese according to their Body Mass Index (the international standardizing equation of who’s fat and who’s not). In Alberta, according to Statistics Canada, 57 per cent of adult males and 40 per cent of females are overweight or obese. And yes, obesity decreases life expectancy. Considering the aging baby boomers, Health Canada expects obesity to replace smoking as the number one cause of preventable death.
In fact, fat is the new smoking. As Dr. Anthony Graham of the Heart and Stroke Foundation says, “The prevalence of this serious health risk is almost exactly what we faced with tobacco use 30 years ago, when half of Canadians smoked.”
The bottom line is that the obese and overweight are costing taxpayers health- care dollars. The most conservative esti- mate was $2.1-billion in 2000, according to the Canadian Medical Association Journal. The Centre for Science in the Public Interest pegged the cost at $5.3-billion for the same year.
I am not only fat, but also diseased. But I don’t understand. How is obesity a disease? Fat is a specialized connective tissue, and a necessary part of our bodies, providing heat insulation, organ cushioning, and, most importantly, energy storage. Fat stores excess energy when energy is abundant and releases energy when it’s scarce. Storing excess calories as fat is an adaptive trait that has, historically, increased our chance of survival.
How can tissue, functioning as it always has, be diseased? As far as I know, the biological and chemical processes of the fat cell have not changed. What has changed is the environment that surrounds our bodies: agricultural, cultural and economic. Obesity is the result of constant presence of feast and the absence of famine.
Achieving a “normal” weight through lifestyle changes—decreasing calories, eating healthily and increasing physical exercise—is not a realistic expectation of obese people. According to Health Canada, one-third to two-thirds of weight lost is gained back within a year; within five years almost all weight lost is gained back. According to the National Institutes of Health, within five years 98 per cent of dieters gain the weight they lost, and 90 per cent gain back more than they lost.
If fat becomes more and more prevalent as a public policy issue, like smoking, will it be legislated? What will happen if fat people cannot be legislated into thin people?
The dam of Pollyanna-politeness has broken. My worst fears have been acknowledged: our society is afraid of and dis- gusted by fat.
Last year, I picked up my brother’s Men’s Health magazine. It was an issue geared to scaring fat guys into losing weight. One article was a series of readers’ responses to the question, “How do you feel about fat people?”
“I’m sometimes disgusted by obese people, but most of the time I feel sorry for them. Many are caught in a rut of poor eating habits, or genetics have robbed them of any chance of losing weight. Instead of being shunned, they should be helped.”
Okay, dude, fair enough. I disgust myself too. But I don’t need help.
Another Men’s Health reader: “They can be burdensome to others, but usually the discomfort we feel around them does not come close to the discomfort they feel with themselves.”
Wow. Astute. I apologize for discomforting anyone. For me, it’s not discomfort; it’s shame. Some mornings, to push myself out the door and into the world takes all of my will. My closet empties its entirety onto my bedroom floor, and still I can’t find a single article of clothing that is sufficient to hide my fat. Of course, I know my clothes can’t actually make me thin, but sometimes I wake up without my denial in place. Without denial, I am sure to drown in the rising pool of clothes and panic, which seems a better fate than to go outside and risk scorn and derision.
Men’s Health readers would be surprised, I think, to learn that on these mornings, I am not so much ashamed of my outer self as I am of my inner self, which must be weak and damaged if I can’t control my appetite. And beneath the crust of shame, bubbles my anger that my size even matters, that my value as a human being is so diminished.
I learnt something about my value a short time ago. I had a lusty affair with an entirely unsuitable man. A deeply fascinating man, but also a felon with more than two years of jail time, a high school dropout, unemployed with no prospects and homeless except for his van.
Gather your doughnuts while you can, because I feel the wind of change upon my cheek. The war on fat is about to begin.
In the soft and warm cushioning haze that comes after a particularly good screw, he got lost in some future vision:
“So, do you think you’ll ever lose weight?”
In the same cushioning haze, I discovered I was glad to be asked. I didn’t know anymore and welcomed the opportunity to figure it out. So off I went, happily down the trail of self-discovery.
I told him I’d always assumed that when I found some peace with the past and with myself, the weight would slide off me, like a snake shedding its skin. Maybe that was still true, but I didn’t think so. I went on about how I felt almost fully realized (“I know who I am pretty much, and I know how to deal with my shit”) and the periods of peace that I was sporadically feeling were periods of weight gain—“which is totally crazy, buttotally true. If I ever really feel whole, I’m scared I’ll be, like, 400 pounds!”
I didn’t get to tell him that I lost weight in periods of time when I felt lost, and despairing, because saying the words “400 the pounds” elicited such a strong physical twitch in my partner I was jolted from any further philosophizing.
“That’s too bad,” he sighed. “I like you more than anyone I’ve met.”
Lying on my back, I could almost see the weight of humiliation about to unload, hovering above my chest. Eyes wide open, I mumbled something inane like, “That’s so sweet… wow, I’m sure ready for a good night’s sleep.”
Making matters worse, he rolled over so he lay on top of me, pinning me to the bed. “I can’t believe I’m gonna say this, ’cause I like you so goddamn much,” he started. “I just know we have no future.”
That was my line! Holy soap opera, Batman! He’s gonna cry.
“It’s just like you were talking about before. About a woman accessorizing a man? Being an extension of his presence in the world?”
I didn’t say anything as stupid as that, did I?
“Well, when I look into the future, I know that your size will bug me. I can’t be with you. I’m sorry.”
I started to cry and couldn’t stop. He held and rocked me for a long time. But he couldn’t close the hole. He was worth more to the world than I ever would be.
Hungry. That’s how I felt.
Dr. Long shuffled his papers. Not looking at too much.” me, he said, “You are ruining your life.”
“Excuse me?” I said, shocked at surge of emotion in his voice.
“You will ruin your life if you don’t lose weight.”
Ruin? My life is a ruin. Is it?
“Let me be blunt here.” He paused, waiting for my permission. I thought we were way past blunt.
“Our society, especially for women… For your career… For marriage… you’re an intelligent woman, and if you don’t do something, your weight will get in the way.”
Finally someone had said what I had always known to be true but had been accused of negativity or avoidance if I dared voice it. Fat people were treated differently.
I also wanted to smack him. Me and my fat, we were scrappers, we were survivors, and nothing would keep us down. It keeps me buoyant, you stupid man! “I am healthy, right?”
“Yes, but that’s not the point.” “It’s not?”
“I want you to consider surgery.” “Surgery?” What, no lecture about diet and exercise?
“Either stomach stapling or intestinal bypass.”
“Intestinal bypass?” My new life as a parrot.
“They remove a substantial section of the large intestine. That way, fat isn’t absorbed into your system.”
I stared at him, mouth open, jaw slack. This was the solution? “I just think I eat too much”
Food was scarce in my childhood home. So was nurturing. Not because of poverty—we were an upper-middle-class family—but because my mother was a food fascist and nurturing-challenged. My mother herself had no reason to fear fat: at 5’10”, she has weighed 118 pounds since I’ve been around.
She tried very hard to have a thin daughter, and here she was successful until I moved a province away from her reach.
As much as I used to blame her for my weight gain as an adult, I was thankful for having a skinny girl’s childhood. Now, however, I think my mother had little to do with my food addiction. I think she saw my propensity toward using food as a way of coping and did her best to prevent the worst thing she could imagine happening to a person she loved: becoming fat.
Her preventive measures were bizarre—my mother criminalized eating food between meals. The three-meal regime resulted in the gnawing and gnashing of empty stomachs, particularly after school. My brother and I would sneak pieces of bread and devour it in a ritual we devised: first, peeling off the crust and wolfing it down; second, kneading the airy bread into dough; and third, twisting pieces off into dough-balls and eating them. Sometimes, like squirrels, we’d stuff dough-balls in secretive places, just in case. We’d forget about them, and inevitably, my mother would find them.
“Do you want me to call the police?” she’d start. “Because if you don’t stop stealing, I’m going to have to report you.”
I’d sit silently until the timbre of her voice went soft.
“Taking bread without my permission is stealing. Why can’t you understand that?”
I did understand. I hated hurting my mother, but my fear of starvation was stronger than my fear of either the police or my mother.
My fear of starvation is still my deepest fear, and like an invisible maestro clothed in heavy robes, it directs much of my day-to-day behaviour. I can’t stand feeling hungry; hunger is a child’s feeling of loss, of something missing. At some point, I mixed up the need for nurturing with the need for nutrients, and now my psychic hunger for love and affection, for assurance and comfort, is barely distinguishable from my physical hunger for food. Eating is a pleasure that is mine solely; no one can take such pure, simple gratification away from me. And when I am full, my stomach satiated, I have the space within myself to be creative and productive.
Right now, that’s the trade-off I’m making: being fat means I’m less physically healthy and I have to suffer the societal disgust, but being fat also means I’m productive, creative and more emotionally healthy. I’m no longer sure if being thin is a physical possibility. I know I am too tired to diet, to allow food to take possession of all my thoughts, to be constantly anxious, to win and lose every day. Life is slipping through my fingers and I have too many things to do.
Extremes of any activity—gambling, eating, drinking, jogging, shopping—seem to me to be addictions. After all, what is an addiction but a method of coping, a distraction from the tedium of day-to-day living, a dulling of ever-expanding loss?
“These surgeries are cosmetic, right?” Dr. Long nodded as he assembled his tools to remove a mole that dangled grotesquely under my arm. He offered to slice it off right there in the cubicle.
“I couldn’t afford to have it done.” He looked at me sharply.
“Your parents would pay.”
Too true. At last, my mother could be proud of me. With my arm resting on top of my head, he wiped the mole with iodine.
“Ready?” he asked, scalpel in hand. I nodded and he worked the knife, slicing the mole and its root from my body. I pressed the gauze he handed me against the wound, while he prepared to cauterize it.
“It’s going to hurt. Badly,” he warned.
“Okay.”
I thought about being thin. Thin because I had a staple in my stomach, or butchered intestines. The sickly-sweet smell of burnt skin stuck in my nostrils.
“Unbelievable,” Dr. Long snorted. “You didn’t even flinch. You and your mother have the highest pain thresholds I have ever witnessed.”
SOPHIE LEES is an Edmonton writer. Her feature “Conundrum of Kites,” in the Nov/Dec 2003 issue of AlbertaViews, won a gold award at the 2003 National Magazine Awards.
