Category Archives: Eating and Weight

At the Core

unknown

I said I was going to work on unpacking some of my core beliefs about weight and body image, and I’ve been doing this. I have not been enjoying the process.

“Core beliefs” is a term I picked up from cognitive-behavioral therapy. It refers to deep, underlying convictions that we’ve picked up from somewhere. Usually we don’t realize the extent of the role they play in our lives and thoughts.

So, enough intellectualizing on my part. What do I believe about my weight and its meaning, and can I look at it honestly and see how messed up some of it is?

Core belief #1: I am not really “me” unless I am below a certain weight. 

This is one of the deepest, and I know I am not alone in it. Many who are overweight see their bodies and selves as a work in progress, aided by a culture that encourages us to see our lives as something that will be completed by a better body–or a house, or a job, or a partner, or any other kind of “carrot.”

The weight at which I am “myself” has become more reasonable than it used to be. It’s thirty or forty pounds less than where I am, as opposed to eighty. The problem is that the line exists at all; that a high weight has consequences not only for my health but my very sense of self.

Core belief #2: There is no point in exercising, or doing other things that are good for my body, unless I am currently losing weight or maintaining a very low weight.

This inner tape has done me an incredible amount of damage. It’s often caused me to miss out on not only the health benefits of exercise, but the elevation of mood and self-esteem moving my body brings. If I have a period of healthful eating and some exercise, breaking the streak of the first behavior requires me to give up the second one as well. Never mind that moving my body would help my mood and make me able to return to better eating sooner–nope, it’s all or nothing.

Core belief #3: Being fat and/or eating more than a certain amount is not spiritual. My spiritual self is thin, abstinent, and free from all compulsions. Contact with the Divine as I know it is something I have to earn by not eating.

This belief started to form in my twenties, when I was first exploring my spirituality in the context of a recovery program for compulsive eating. If I was eating in a way that wasn’t on my (very restrictive at the time) plan, I was resisting God’s will. Being on the diet equalled being surrendered to my God’s will. When suffering a relapse into my self-destructive bingeing, and wanting to pray for help, I felt that I had no right to pray until I cleaned up my act. It was a vicious circle.

This belief gets reinforced today by some aspects of my bipolar disorder. Starting a diet tends to make me hypomanic, and hypomania can bring heightened mystical feelings as well as heightened creativity. Similarly, overeating or eating too many starches and sweets has a sedating and depressing effect, making me feel less in touch with the mystical aspects of myself.

Core belief #4: I cease to be a sexual or romantic being when my weight exceeds a certain amount.

It’s natural for me to wrestle with my sexuality as I age; most of us do in this culture. Even when I was younger, though, this pattern was there. I was always thinner in my fantasies: good sex was only for people with good bodies. Times spent in the lower parts of my weight range were the times I took sexual and romantic risks. Somewhere, within a relative narrow weight range, I change from a sensual and sexually awakened woman to one who sees herself as sexually invisible and dormant. I don’t ask for sex, physical intimacy or romantic attention.

Core belief #5: Someday I will conquer my eating disorder for good and never again suffer a relapse. I will achieve “normality” in this realm and maintain it for the rest of my life. This, more than anything else, will mark me as a success in life. 

I don’t need to go into how unrealistic this is. It’s as ridiculous as the idea that I’ll make myself not be an addict any more. I’ve got this issue, and I’m going to have it for the rest of this lifetime even if my health improves. I have to ask myself how much of my life I want to devote to this one area of struggle.

I’m sure there are more of these core beliefs, as well as the many surface thoughts that come up when I deal with doctors and other people. I have no intention of giving up on my health–but what would happen if I stopped defining myself by my weight?

Doctor, Doctor

I must go to the doctor again. This particular appointment is with the endocrinologist, but I realize that the feelings I’m having are not specific to her. They are part of a pattern existing throughout my adult life: a visit to the doctor is a visit to the land of judgment, silence and apologies.

There was a span of years when I was making this worse because of my active addiction to painkillers. Some doctor visits were preceded by anxious reviewing of my desperate exaggerations or even outright lies, combined with the ever-present shame. One of the blessings of recovery is freedom from these dishonest machinations.

There are also times when my apologies are about not taking my meds properly, as during a severe depressive episode, or failing to carry out some other assignment designed to help me.

However, for most of my adult life, the dragon I face in the doctor’s office has been the same one: being fat. Fat, whether to a greater or a lesser degree, in a medical climate that places almost any ill at the door of one’s weight regardless of other health parameters (and it must be admitted that, although I believe in the Health at Every Size philosophy, it is usually clear that my body would be happier near the lower end of my weight range.)

No doctor, be they primary care or otherwise, has ever failed to inform me that I should lose weight, with the exception of the rare few I only met while at the extreme low end. They tell me this as if I do not know it; as if I have somehow managed to reach middle age without being aware that I am overweight.

Any explanation I might give about why losing weight is not working out at the time, or about regaining it following a loss, sounds like excuses. And I don’t want to make excuses, anyway. I’d really prefer it to be taken as read that I’m aware of the issue and doing my best, even if my best is not what they would like. Still, not an appointment passes–no matter what the presenting problem or how unrelated it might seem–without me having to answer for the size of my body.

This problem is neither new nor unique to me, and I know many awesome people who could give me advice on how to stand up for myself more effectively. I realized lately that much of the problem resides in myself: I don’t present my situation unapologetically because I have not come to terms with it. I haven’t unpacked and dealt with a lifetime of internalized fat prejudice I didn’t realize I was carrying.

The doctor I’m going to see, who wanted me to have lost weight since our last appointment, is one for whom my weight really is a relevant parameter: we are dealing with blood sugars, hormone levels, and other things that are affected by it. I can’t present her with the results she hoped to see. I have to show up as I am and ask her to treat the patient she has, not the patient she wants. I have to be honest with her, and ask her to ally with me in treating my conditions on the assumption that my weight is not going to go down right now.

I would like her to give me advice about focusing on fitness, with the understanding that I may or may not be able to do as much as she wants. I’d like her to pleased with what I do accomplish, even if it’s only managing to take my meds properly and go on a few walks.

Yeah, and I’d also like a pony.

Some of what I want isn’t going to happen. My longing to be understood and respected by those in the medical profession could be a classic example of going back to that dry well. Even as I long for it, I identify with the doctors themselves and the frustration they must experience when patient after patient sickens or dies for lack of following  a few “simple” instructions. I feel unworthy of their time. I feel unworthy of the medical care I’m privileged to have available. (The fact that they are providing a service for which I’m paying gets lost in this self-recrimination.)

There’s one thing, however, over which I do have power. That’s the baggage I mentioned above. It’s time for some major unpacking, and the more I think about the topic the clearer and more extreme some of the buried core beliefs are becoming.

Why I Cannot See You Again

I miss you too, whoever you are. Maybe you’re an old classmate that I haven’t seen in years, or maybe it’s only been a month since we took a walk together. But you see, it is not possible for me to see you again. More precisely, it is not possible to let you see me. It is not possible for me to let you see me because of my weight.

Never mind that, if you’ve known me for a while, you have seen me at this weight before. You’ve probably seen me at higher weights–but you may have recently seen me at lower weights too, and that’s what I can’t stand.

Ever since I was 13 years old, I have been defined by my weight. Much of this definition happens in my own mind, although it is helped by some aspects of our culture. Going to college, working at jobs, having a child–all of it was secondary. The mark of my success or failure as a human being was a number on the scale.

The weight gain of the past year, capped off by yet another weight gain in the last couple of months, has me convinced that if I see you, what I will see is a look of horror and disgust on your face as you compare me to the last version of me that you saw.

Every desperate attempt at dieting during the past year has been “rewarded” with a weight gain rather than a weight loss. On the advice of my new psychiatrist, I am switching to a very basic mindful eating plan designed to prevent the extremely destructive binge eating episodes. This means that I have no idea what will happen to my weight–and therefore, I have no idea when I will be able to see you again.

Intellectually, I know that if you consider me a friend of yours, weight fluctuations are nothing new to you. In your mind, it’s probably a part of how you view me. You have seen me everywhere on the spectrum of weight, and you have seen me be inconsistent in how I deal with food. To you, it is probably just a personal characteristic of mine. And, if we’ve been friends for a while, this characteristic of mine is not a dealbreaker for you. You have your reasons for valuing me, and those reasons don’t have to do with me winning some kind of permanent victory against my eating disorder. I know this, intellectually.

Nevertheless, some sort of line has been crossed in the last couple of months. I just cannot see you again until I have somehow met the requirements. It doesn’t matter how many poems I’ve written recently. It doesn’t matter what else I might have done that is interesting. It doesn’t matter that you might enjoy having me listen to you about your life, or that we could laugh and play together.

Now, you know me well enough not to believe 100% of what you just read. You know that I don’t always let that voice win, and that I am capable of facing it down to make contact with another person. I will keep trying, because you matter to me.

News Flash (Not)

Unknown

I have come to the conclusion that life is not fair.

You would think I already know that to my bones. I’ve written about the concept of fairness, and how expecting fairness can get us into trouble in recovery or any other parts of life. I know we are promised nothing.

But there are some courses in life we never really complete…there’s always a new layer or dimension to cover. A new way for the lesson to be presented, a new way we need to integrate it into ourselves. So I’m feeling it, learning it; trying to accept it in two new ways lately–one more self-centered than the other.

The self-centered one has to do with what I’ve already talked about…the problem I’m continuing to have with my metabolism. I sought a higher level of support around my sensible eating plan, and it’s been going really well for a couple of weeks now–until I step on the scale and have an experience I can best describe as baffled terror. The math just doesn’t work out right. Even the endocrinologist is puzzled; at our last appointment I presented her with a list of what I’d eaten for the last ten days and she agreed that I shouldn’t cut any more calories.

Abstaining from compulsive eating has always brought me some degree of physical recovery in the past, and it’s hard for me to accept that I must, for the indefinite future, abstain without getting any of those rewards. I know, intellectually, that I am getting rewards in the form of not making things even worse, but it’s hard to feel it when I am scared and ashamed and in pain.

The other way I’ve been exposed to the lesson recently is that my relative, who has been ill for a while, has transitioned into hospice care. I am watching this process, and the effects it has upon my loved ones.

I think death is simultaneously the most fair and the most unfair thing there is. It’s fair because it comes for everyone, but it’s unfair about when and why and how. It’s not merit-based. And when you get right down to it, down into the nuts and bolts of the process of dying a “natural” death, it’s hard not to think that there ought to be a better system for this kind of thing. It’s not fair. It’s not going to be fair.

We all, on some level, think that life should be fair. Hard work and good deeds should be rewarded, evil should have consequences, and our efforts in life should influence the outcome. Even when confronted with countless examples to the contrary, even when we watch others grieve or be persecuted, even when we ourselves suffer, a part of us wants to believe it’s going to be different.

I’m in no hurry to stop believing some parts of that, really. We have to, in order to keep going. I have to think my fight matters. I have to believe my efforts influence the outcome…what I have to let go of is the belief that I can control how they influence it and what the end result will be.

I could die tomorrow, or next year–countless poems unwritten and all of my recovery efforts spent for just a few more years. It wouldn’t be fair. It’s also not fair that I’m alive at all when many of my fellows didn’t survive their active drug addiction.

Positive Feedback

What has happened to me in the past year, and especially in the past few months, is really not hard to understand from an engineering point of view. It’s a classic positive feedback loop.

If you’re in marketing, positive feedback means people like what you are doing. In engineering, not so much. “Positive” just means that the output of a system is feeding back into it in such a way as to produce more of that same result.

More snow on mountaintops melts as a result of global warming. The snowmelt exposes more dark material where snow would have been. More dark material absorbs more sunlight, causing more warmth, causing more snow to melt, and so on. Science is full of examples of such positive feedback loops.

My recent visit to the endocrinologist (who had a cancellation and saw me within a week, much to my surprise) has me trying to think about where I am in a more logical and solution-oriented way. My metabolism developed a serious problem, we don’t know exactly when. I put on weight, which raised my blood sugars, which affected everything from mood to immune system to energy levels. The thyroid issues got worse, which led to more weight gain and more blood sugar issues. The sicker I got, the crazier I got. The more tired and dumb I felt, the more I neglected my self-care and got sicker. Sometime in the past three months the process sped up.

It is painfully obvious that if I’m going to have a chance to survive this phase of my recovery, I have to accept where I am and try to set aside baggage about how I got here. The endocrinologist has given me meds that will address my issues, but it’s up to me to take them. She has told me my sensible food plan should be adequate once the meds have had some time to work, but it’s up to me to practice patience and not go back to self-destructive eating.

I have to take an active part in healing this body, the one I have at this moment. I can’t wait until 10 or 20 or 40 pounds of it is gone. I need to take this body for walks, and feed it well, and give it its medicine.

I don’t talk much about it on this site, but I used to be a scientist. My first degrees were in the field of biological science, and I used to work in labs. I was trained to think like a scientist…and I have to try.

Shame Status Report

Shame is trying to kill me.

It has help, from my addiction and my bipolar disorder…but shame is leading the vanguard right now, shrieking battle cries.

Depending on which study you read, up to 98% of people who lose a really large amount of weight gain it back…and these are time-limited studies, in which keeping most the weight off for a mere year or two years counted as success.

I finished my big weight loss in August of 2013. A recent weight gain has brought me to the point of having gained back more than half of what I lost…and I’m feeling crushed with shame. For a year, I’ve been fighting to reverse the gains of the year before. Driven by shame, I wanted it gone now, yesterday, no matter what I had to do. My body disagreed with my plans. My psyche fell deeper and deeper into the hideous rituals of compulsive binge eating.

What I’ve experienced is not a surprise. All along, I knew it was likely. Even as I was losing the weight, I knew the odds were terrible. I was always open about the fact that the medical diet I went on had an incredibly high risk of regain, and I was doing it only because my strange autoimmune condition required swift action. And it has been a success, in that sense. The problem hasn’t returned.

I never claimed to know what I was doing; quite the contrary. And I never, never implied that someone else should do what I did.

So why do I feel so ashamed?

Now, after finding a bit of sanity and staying the same for two months on a food plan that should have resulted in a modest loss, I’m reeling from this recent gain. Ten pounds, from falling to discouragement for only two weeks.

On the bright side, I know now that there is something weird going on with my body. I spent the last couple of weeks being pretty scared because, when I saw my doctor for advice about why my food plan wasn’t working, he examined me and found that my thyroid is swollen. I’m less scared now, because the ultrasound I was sent for showed no masses or nodules in it. I’m being put on an additional thyroid supplement and extra iodine.

So it should be all good…the gain is regrettable, but I have a plan. Well, it’s not all good. I’m frightened about what the new meds will do to me, I’m constantly hungry and I’m even more aware of how crazy I’ve become with food in the last year.

But the shame is the worst–I want to hide, disappear, live in a stasis pod until some of this weight comes off. I can’t write. I’m isolating even more than usual. I’m withdrawn from all physical affection, convinced I don’t deserve a loving or sexual touch for at least 30 pounds.

I blame myself for all of it, no matter the meds changes last year that catalyzed some or the current (possibly long-standing) thyroid issue. Even though the gain would have been less without these things, I’m still a compulsive eater who has been struggling and I can’t forgive myself for that. I can’t forgive myself, or let go of the grief when I think of the lighter, healthier body I had a couple of years ago and how it’s gone and I might never have it again. Any ache or pain I get feels like an accusation, trial and sentence.

My insanity trying to get me to use food to punish myself more. Only two days into this new treatment, it tells me that there’s no point in sticking to my moderate plan, that I’m doomed, that I don’t deserve to care for myself. Depression pipes up from the peanut gallery and tells me none of this matters anyway.

The ongoing and dangerous trend of giving myself little or no credit for staying off drugs continues.

I have no quirky metaphors at my command in this piece. This is a status report and an exercise in honesty. As always, know that it isn’t the whole picture of who or what I am. There are other stories I could be writing today, if I didn’t need to get this off my chest. I could spin a metaphor about a silly game I’ve been playing lately. I could tell you an old story about a bowl of grated apples that nearly inspired an orgy. I could tell you about my most recent victory and the beauty that was my reward…yes, I will tell about all of these things in time. Until then, let this remind any like me that they are not alone.

Goldilocks

I have come to the conclusion that Goldilocks is not an addict.

It’s not a difficult conclusion, really. It’s not that she is without issues, most notably a lack of personal boundaries or respect for those of others. But her behavior is clearly abnormal when observed from an addict’s perspective.

Come on–she samples two bowls of porridge and and finds the third one to be “just right.” She eats it. Satisfied, she goes and finds a nice place to take a nap.

What’s wrong with her? Why isn’t she rummaging through the bears’ kitchen, trying to find more of that perfect stuff? Or trying to mix the hot and cold porridge to capture that “just right” again? Or just gulping down the hot and cold porridge, because it’s better than nothing? How is it possible that she is moving on?

As I write this, I’m several weeks into a food plan I’ve been resisting with the mental equivalent of kicking and screaming for many months. You see, in the past year I’ve alternated my very low-calorie weight loss plan with episodes of uncontrolled binge eating…and, after a lot of suffering, I weigh almost exactly what I weighed last January.

I have longed for sanity…but I wanted it on my terms. I wanted to take off some of the weight I had gained in the previous year, and then eat sanely. In early December, I admitted it wasn’t working. No matter what I want, I have to hear what my body is saying to me: I demand to be accepted and dealt with exactly as I am, and every time you starve me I will torture you with cravings until they bring on a balancing binge.

So I gave in. I wrote down a plan every day, involving specific amounts of healthful food. Real food, not weight loss shakes and artificially sweetened protein bars. I ate what I wrote down, no more and definitely no less.

In a week, I was virtually free of cravings. I felt stronger, calmer, my body ached less, and I seldom thought about food in between my planned meals. I had found the circle of grace…and it has lasted for nearly a month now. My body and mind have continued to send me messages amounting to “About time, dumbass!”

Great news, right? There’s just one problem–I am nothing like Goldilocks. The concept of moderation, of just right, of enough…my addict brain squirms in discomfort.

No quick gratification from fast weight loss? No resolutions to starve virtuously after the latest episode of overeating? No “tomorrow will be different?”

Weird.

I’m not new to this idea. I’ve written often about how foreign consistency feels to any addict, let alone one with bipolar disorder thrown into the mix. Acting too normal for too long; struggling to keep my self-care away from any concept of virtue or vice…yeah, that’s my strong suit.

Embracing, again, the severity of my eating disorder and my need for structure and surrender without discounting or sabotaging my other recovery…yeah, I’m great at balancing acts. My brain doesn’t ever whisper that food would be less of an issue if I took painkillers again, or that I wouldn’t be hungry at night if I took sleeping pills.

Accepting that this process will never end, and loving myself anyway? Sure, I don’t have any critical voices shouting that I should have done this years ago and stuck with it.

Being willing to write honestly about this aspect of me, no matter how much I am sick of dealing with it and no matter how much I fear being boring or repetitive? Sure, I don’t have any egotistical qualities urging me to make my struggles look cool or edgy.

Who am I kidding? There’s no way I can do this alone.
Oh, wait, I remember now…I’m not alone.