In 2016 I fell while on vacation. It is believed I tore my right bicep. But MRIs are not built for those of us who are superfat, so I never knew for sure. That prevented proper treatment, which means to this day I live with pain. That muscle will spasm easily and excruciatingly painfully.
Worse, this experience left me terrified enough to have gastric sleeve surgery. I knew all of the risks. I knew it wouldn’t make me thin. I didn’t even want to be thin or care about thinness. I just wanted to be able to get a damn MRI if I ever needed one again. My grandmother was in remission from 3 types of cancer and routinely had to get scans that would never have been available to me. I just felt cornered. And like a cornered animal, I made a choice… one that was drastic, but felt necessary for survival.
I thought I could handle it. I thought I wouldn’t get sucked into the weight loss aspect. I’d done IE/HAES for over a decade. I felt confident. I had great support. I had a therapist, a psychiatrist, a best friend who had been through the same surgery but who also knew not to believe all the BS they tell you about it… and a husband who is so supportive just thinking about his unwavering, steadfastness will make me tear up.
I was wrong. I have spent the past seven months in relapse hell.
All the education, all the preparation, all the logic in the world could not prepare me for the reality of any of this.
And I feel foolish. I feel naive. I feel like I should have known better than to believe I could reason with something that is not rational… an eating disorder.
I amputated 80% of my stomach, not to be thin — or with any illusions I’d be anything even remotely close to thin (or even to the unbelievably overly optimistic and unrealistic expectations the surgeon tried to give me — which was 240 lbs). I did so knowing that it, like any surgery, could theoretically kill me. Not because I believed it, in and of itself, could make me healthier (and in fact, I knew it might make things worse).
I did it JUST because I’d had a horrific injury that never got properly treated because bodies like mine are not accommodated for by the medical professionals who are supposed to care so much about our health. I did it because I was scared of what happened if that was a life threatening injury.
And the bitter irony is, despite doing it, I am still not small enough for a standard MRI. I’m still not going to fit in a lot of machines medicine uses for testing.
My body FREAKED out. My thyroid went ballistic (for which they still have no satisfying explanation). I spent months trying to stabilize it. I went very hypo and then hyper… and I felt every single change. This hormonal change is only one of dozens I’m sure I’ve undergone, and it likely caused my body to stop losing weight faster than is “average.” Because by the end of 4 months, my weight loss basically stopped entirely. By 6 months, I’d had my first gain.
I wisely broke up with the scale again after that, but trust me when I say that not getting weighed is nearly as bad for my mental health now as getting weighed. I cannot win.
I thought if I viewed it through the lens of a medical procedure I’d be safe from the harm of diet culture, of my eating disorders — and let’s face it, there’s little difference between disordered eating and dieting… unless you’re thin. If you’re fat and engaging in an ED, you’re celebrated. I’ve said in the past that bariatric surgery is essentially medically induced/sanctioned anorexia. It’s creating a situation where you are eating so little you are forcibly starving your body. It’s true. Somehow, somewhere along the way, in my fear and panic, I lost sight of this truth.
I forgot how insidious EDs are… how sneaky. I forgot how incredibly pervasive diet culture is, how something that to the vast majority of people can seem like an innocuous comment can make an ED voice go “UH HUH… SEE! THEY GET IT!”
And oh, do I remember now. Now that I am drowning in it, I remember all too well how challenging it is to get away from it. Worse, unlike the last time, this time I already know the answer. Last time, I was discovering it for the first time. It was new and exciting and I was oh-so-ready… I was so done with dieting, so ready to let it all go. It was natural to embrace intuitive eating/HAES principles. I absorbed what I learned… and I lived and breathed it as easily as I do oxygen.
This time… I know the answers. There’s no “discovery” to be had. I know how peace can be found, but I don’t know how to get there again. I have not felt this badly mentally, at least where food and my body are concerned, since I was a 15 year-old in a psychiatric hospital on the eating disorder ward.
And I don’t even want to be thin. I never expected or wanted to be thin. I thought I’d wind up around my body’s prior “set point,” which was probably around 380 lbs. When my surgeon said “I think ‘we’ can get you to about 240 lbs,” I quite literally laughed in his face. I pointed out that I have weighed over 300 lbs since I was 15 years old, and that at 41, I did not expect to see anything even REMOTELY close to that. Interestingly, the day of my surgery, he’d changed that “best case” to 300 lbs with no explanation.
Additionally, no one told us about the research that has alarmingly indicated a much higher rate of self-harm (including suicide) in people who have had bariatric surgery than their counterparts. And even my copious research, done over literally a decade of analyzing surgeries (mostly for purposes of education, not because I was planning to have it for a decade, but to be armed with the facts about it), had not turned that up.
My best friend and I have both experienced this firsthand. She is someone who has never had any issues with severe depression prior to surgery, by the way. Fortunately, she has a supportive partner and no intention or desire to actually harm herself, but she has felt the depression and she has battled the ugly thoughts — and she DID get to a weight most would consider average or slightly below average, if not thin. But like me, she did it not to be thin but because she was told so many times over the years that all of her pain from prior injuries (unrelated to weight) was being caused by or made worse by her weight. Like me, she initially had a brief decrease in pain, only to saw it come back… with a vengeance. In her case, guess what? Her pain, which was for so long was diagnosed as “weight caused” was actually being caused by the death of a bone she’d broken. It is something that likely could’ve been stopped, or at least slowed down… had any single fucking doctor bothered to look beyond the number on the scale. Now? It’s so bad, so far gone that her only viable treatment option is a stem cell transplant… something she’ll be lucky as fuck if her insurance will cover, something she’ll have to go to a neighboring state to have done.
So, if you happen to read this… if you’re considering one of these surgeries, please be very, very careful. Please know that your expectations will be tempered by reality. Yours may not look like mine (or my friend’s). But that doesn’t mean that it will be a pleasant reality, either.
Please consider if sacrificing your mental health is worth a smaller number on the scale — one you may not even consider “ideal,” one that still may never be anywhere near low enough to get you into a “normal” BMI.
