I withdrew from my family, avoiding gatherings for special occasions because I couldn’t stand to see the looks on their faces, disappointed as they realized I was as heavy as ever. I remember one Christmas, before I had kids and couldn’t shirk family duties, actually being ecstatic because Michael had to work the holiday. It allowed me to spend the day at home, alone, instead of being forced to attend another family event. I spent Christmas all by myself, hiding from the world and eating whatever I wanted. I was really happy and relieved, and that’s what ultimately scared me the most. Who is happy when she spends the holidays alone? Someone who is not well, I was sure.
I wasn’t able to avoid all family gatherings, and such was the case with that family beach trip in 2002, the one that started with such good intentions but evolved into me sneaking out at night to make a McDonald’s run. Seven whole days of facing my in-laws, with a backdrop of sand and surf, bathing suits and suntan lotion. Could I be more miserable? I didn’t think so, although the gods did smile upon me somewhat: It rained almost every single day, severely limiting our time by the ocean. Let me tell you: Rain at the beach is a fat girl’s friend!
There was at least one sunny day, and it was the day I reached a critical point, personally. We’d spent all morning at the beach, watching our nieces and nephew dance in the surf. I tried to tell myself I didn’t stand out in the crowd at all, dressed in my black T-shirt (black at the beach!) and longish khaki cropped pants (long pants! at the beach!). I was relieved when someone suggested we pack up and head back to the bungalows to fix lunch. I was loaded down, carrying a beach umbrella on a pole in one hand and a folded-up beach chair in the other (a chair that, by the way, I refused to sit on because I was afraid it would collapse under me). My butt was numb, having spent the whole morning sitting on a towel on the hard sand. We had a long way back to the cottage, and the sand was deep, my steps quite heavy. I was sweating like a pig, beads of perspiration flowing down my spine like a river. Even though I’d started out in the lead, every single family member passed me as my steps grew slower and slower.
Eventually I reached the steep staircase that led back up to street level. Taking a deep breath I started the slow journey, carrying more than three hundred pounds of flesh and various unused items of beach paraphernalia. I slowly trudged up the wooden slats, and when I finally reached the top, I made an abrupt stop. The bright sunlight started to dim, as though a huge rain cloud was passing through. But this was a cloudless day, and I knew something was wrong. I tried to steady my breath, and found that I had very little to work with. The sky above me started to spin a little, and I opened my mouth to call out to my group. Michael had already reached and crossed the street—I could see him walking way ahead with his brother, swinging our niece’s hand. All of their backs were to me: my mother and father-in-law, Michael’s grandmother, Michael’s sister, and her kids. I tried to call to them, but no sound came out of my mouth—there was no breath to make any words. The sunlight was really dimming now, and I could feel my legs start to buckle. Please turn around, I thought to myself. The voice inside my head sounded as weak as I felt.
And just like that, my sister-in-law, Molly, turned back to look at me. It was a casual movement, as if she were going to ask me what I wanted for lunch, or what I’d thought of that season of Survivor. It was an insignificant move to her, but it meant everything to me.
My breath was back. I drew in sharply as Molly made her way toward me. “It’s hot!” she exclaimed. “You okay?”
No, but I was getting there. Suddenly the sky wasn’t as dim, my head wasn’t as swimmy. I didn’t yet trust my voice to work, so I just nodded and let her talk. I was able to get my breathing under control as we slowly walked, Molly happily chatting about her family, her kids, her life. I listened in silence, grateful for a sister-in-law who liked to talk and didn’t seem to notice my lack of contribution.
We got back to the bungalow, and Michael followed me when he noticed I went straight to our bedroom. I lay on the bed and burst into tears, telling him what had happened. I also confessed the awful bingeing that had started a couple of days before. Worry clouded his face, but no anger. No judgment. Just love and concern, and it made me cry even harder.
The episode on the beach scared me into action. I didn’t know exactly what had happened, but I felt it was a warning. I had to do something. The day we returned home, I called a doctor I had heard about from my coworkers, one who specifically dealt with bariatric patients. I made an appointment for the following week. I also called a therapist who had been recommended to me a couple of years earlier. I lined her up for the next week as well.
I was frightened enough to try to do something—again. Did it stop me from overeating until the appointments? No. But why would it? I knew I had a plan, that I was going to take action, so I felt I had a license to eat until then.
I had heard great things about the bariatric doctor I was going to see. It intrigued me that she was someone who devoted her practice to overweight patients—it made me feel as though my problems were legitimate and medically based. And surely she’d know what to do. This could be the answer I was looking for!
And it was. I soon learned that her weapon of choice was diet drugs. Turns out only part of fen-phen was yanked from the market; phentermine was still available, and this doctor had seen great results in her patients. I was more than a little skeptical. Did I really want to go down this road again? My feelings were still hurt from the last time, even though five or more years had passed. I just felt so cheated, so wronged. Again, I was never worried about the possible heart damage. My only concern was that losing the drugs stopped my weight loss dead in its tracks—and eventually I’d gained it all back.
My other worry was whether or not it would be effective. I’d had such great success with the combination of drugs, would just one of them do the trick? And how did I know this medication wouldn’t soon be taken off the shelves as well?
The doctor explained that phentermine worked as the appetite suppressant, and she thought that was ideal for my problem. I couldn’t really argue with that—it seemed to me that if you took away the overwhelming hunger, you took away most of my issues. Plus, the doctor said, in order for her to prescribe the drug to me, I would have to commit to seeing her every two weeks so that she could monitor my blood pressure and other vitals. She would perform an EKG before giving me the pills, just to make sure my heart was fine. And she would quiz me extensively about my eating and exercising plans. Taking this medicine was not a long-term solution, she stressed. I was going to have to develop habits that would take me through the rest of my life. It would not be easy, but she felt I would find success.
Really, what alternative did I have? Nothing else was working, and besides, I liked the things she proposed. Eating plan? Exercise plan? Regular check-ins with her in which I would be held accountable? I loved plans! I loved goals and charts and appointments. Since I was obsessing about it all the time anyway, this was perfect!
I enthusiastically signed up, and then almost immediately suffered from sticker shock. I knew the pills would not be covered by insurance—I’d learned that during my fen-phen days. And man, were they expensive! Seventy-five dollars a month. Plus my doctor wanted me to try Xenical, a drug designed to remove fat from food before its digested. Some people experienced pretty nasty side effects (read: accidents!), but I was game. Even on my best diet days, I still had plenty of fat in my diet. I figured this drug could only help. But again, Xenical was not covered by insurance. Another seventy dollars a month! Not to mention the doctor’s visits every two weeks, which, you guess it, were not covered. Another two hundred dollars a month!
I’ll never understand the rationale of insurance companies. Most will not pay for you to see a nutritionist, to join a gym, or to take an appetite suppressant. But they will pay tens of thousands of dollars for weight-loss surgery. In fact that’s the only weight-loss tool they will pay for. Does that make any sense? No wonder so many people are t
urning to that alternative—it truly is their only (affordable) option!
The cost was rough, but I figured I had to do it. Michael and I were both working, and we didn’t have kids at the time, so I felt we could make the financials work. Thankfully the weekly visits to the therapist were covered by insurance, and my first visit to her occurred before I started taking the diet pills.
I had been down this road before. As a teenager I’d suffered a pretty major breakdown and my parents, at my request, placed me in a mental health treatment center. I was so tired of fighting the abusive boyfriend and so sick of feeling helpless to do anything about it. I figured taking such drastic measures would be a major step toward curing me. Only, it wasn’t. I checked in on a Friday and didn’t see a doctor the entire weekend. I was told I would start seeing a therapist on Monday, but by that time I’d talked myself out of the need for inpatient care. Truth be told, I missed the boyfriend so much, I was already over the whole idea. So I convinced my mom to check me out, and I never went back. Thousands of dollars in bills and the legacy of having entered a mental facility, and nothing to show for it.
As I became an adult, I had a few appointments here and there with therapists, always a part of my latest plan to “get well” and “fix my problems.” I never made it past the first meeting with these folks, though, because they almost immediately brought up the possibility of antidepressants. How could they know I needed something like that before they even knew me? I wasn’t opposed to medication, really; I just felt that we should do some exploring first and if we reached that conclusion, then okay. I was turned off by the fact that they were suggested right off the bat, and I subsequently didn’t go back to the counselors who were offering them.
I was a little less incensed when my medical doctors suggested antidepressants over the years. At least they knew me and had a great deal of information about what my problems were doing to me physically. I even agreed when my ob-gyn suggested I try a particular drug. She explained that it was used to treat mild forms of depression and one of the side effects was weight loss. Sounded like a win-win to me! I still wasn’t crazy about the notion, but I agreed to try. Five days into taking the pills, Michael demanded that I cease and desist. I cried nonstop. I couldn’t even function. Maybe I should have given the drugs more time. Perhaps I should have consulted with my doctor about the dosage. But I didn’t, and that was my one and only experience with antidepressant medication.
I hadn’t had the best of luck with mental health professionals. But for some reason I was optimistic about this latest appointment. Maybe it was because I knew I was getting medical help, and I just figured therapy would be icing on the cake. Whatever it was, I went into that meeting with a positive outlook—and I wasn’t disappointed. The therapist acted genuinely interested in me and helping me find a solution. She asked great questions, and from her follow-ups, I could tell she was truly listening. And she never once mentioned antidepressants. I was feeling good about the prospects.
When I finally got the phentermine, I was ready for action. The night before, I ate to my heart’s content: three plates of spaghetti, topped high with meat sauce, and garlic bread. Chocolate ice cream for dessert. And tons of Mountain Dew. I knew the next day would mark a new era, so I figured I better get it in while I could. Some crazy ways of thinking never change.
I ate a big breakfast and waited a couple of hours before taking the phentermine, when I arrived at work. In about fifteen minutes, I knew I would be just fine. The pill put me on such a high, I was knocked out, but in a good way. I found myself smiling uncontrollably, despite myself, as though I had some sort of secret. I called Michael and told him I felt GRRRREAT! And I didn’t eat a thing for the rest of the day. It was glorious!
This was a new experience for me. Each day I felt my mood alter when I took my medication. It sort of “evened me out”—I just felt steady all day long. The stress of my job didn’t affect me as much, and because my eating was in control, I felt more than fine. It wasn’t long before some of the weight came off and people began to notice. I was getting compliments, and I was feeling in control. Life, once again, felt good. I was full of promise.
After several months on this new regimen, I’d lost sixty-five pounds. Again, I felt as though the drugs were my saving grace, exactly what I needed to get going with my weight loss. When I went to see my ob-gyn for my annual checkup, she was thrilled to see I’d lost weight, and she asked how I’d done it. I happily told her I was seeing a weight doctor who put me on phentermine. She stopped short, looking at me with a cocked head. “Is that working for you?” she asked, somewhat skeptically. Obviously, yes—the scales didn’t lie! I explained to her that I felt in control, my moods were great, and I was no longer obsessed with hunger all the time. She nodded thoughtfully but didn’t really have much to say. I could tell she was a bit wary. I was puzzled, but I didn’t press it.
What I did want to talk to her about was getting pregnant. I was approaching thirty, and I felt as though time was running out. Michael and I would soon celebrate our tenth wedding anniversary, and our families were starting to wonder if we would ever have kids. At my heaviest, I was told I probably couldn’t get pregnant, that a morbidly obese woman rarely ovulates. Now that I was losing weight, my mind inevitably turned to when I would be able to have children.
I expected this doctor to say once I completed my weight loss, I should be good to go to get pregnant. But she didn’t. She asked me why I was waiting. “I’ve seen women much heavier than you have perfectly healthy babies,” she said. “Why would you deprive yourself?”
This floored me. It went against what every other doctor had told me. Yes, I’d lost sixty-five pounds, but I still had a long, long way to go before I was considered healthy. Didn’t I need to finish that mission first?
But then the other side of the argument started to make sense: How long would it take for me to lose all the weight? Another year? I wasn’t getting any younger, and besides, why would I want to lose all of my weight just to turn around and gain a bunch with a pregnancy?
I so wanted to have a baby; I had wanted to be a mother almost from the moment I’d married Michael. I felt more than ready, and I knew Michael would make a terrific father. He was scared to death even at the thought, but he allowed me to take the lead on this one. I figured I would go ahead and stop birth control pills, thinking it would take several months to get pregnant. In the meantime I could still continue the medication and continue with my weight loss. You know where this is going.
Yep. First try.
And so that ended my second round of diet drugs. Lots of success, only to be stopped abruptly before I was finished losing the weight. This time, though, I had only myself to blame.
My pregnancy also stopped my going to therapy. Even though it was going well, I viewed having to visit a shrink in direct correlation with needing to lose weight. Since I was no longer trying to shed pounds, I reasoned that I could put therapy on hold. I promised myself I would go back once I gave birth and started back on track to getting healthier.
I had a beautiful baby girl and didn’t gain a whole lot of weight. When Emma turned one, I was pregnant with her brother. After I had Eli, the twelve-pound newborn who suffered because I couldn’t get my eating under control, I knew I was done having children and ready to finally put the weight battle to rest. My health was starting to be a major concern, and I now had two small children to consider.
This time I didn’t waste efforts on other plans. I went to my new ob-gyn and asked for phentermine. She was a little wary, saying in her experience it wasn’t that effective, and she wondered about the long-term risks. I convinced her that I’d done really well with it, and that I was desperate for something, anything, to work. I was more than three hundred pounds, and once again found myself at that hopeless stage. The doctor gave me a month’s prescription, saying she had to see me in four weeks. I’d better show progress, she warned, or I wouldn’t get the pills again from her. Relieved, I fi
lled the script and readied to take it the next day—which of course means I ate my brains out that night!
That old, euphoric feeling came back as soon as I took the pill the next morning, and again, all felt right with the world. Once more I was struck at the mood-stabilizing effect the drug had on me, and it made me wonder if I did indeed need some sort of antidepressant. It just kind of took the edge off. After taking the medication for about two weeks, though, I noticed it wasn’t lasting me all day like it used to. I at first brushed it off, thinking I was imagining things, but I secretly began to wonder if the medication was losing its effect. Still, I lost twelve pounds that first month, and my doctor was thrilled, praising my success. She happily wrote me a new prescription and told me to be back in a month.
One week into the new prescription, it was undeniable: The pills weren’t working. I’d have a couple of hours of good feeling/no hunger, but then that wore off, and I was starving. Without much resistance I would binge eat, justifying my overeating by vowing to change the way I took the medication the next day. Surely I could adjust it and do better, right? I played this game for the rest of the month, torturing myself daily with should-I-or-should-I-not-eat arguments that always landed me at the drive-thru. I wound up gaining back five pounds.
My doctor nodded patiently as I explained (lied) to her that it had been a tough month. I told her I forgot to take my medicine a lot, and I was sure it would work again once I got my act together. She showed no emotion whatsoever as she told me she was not giving me a new prescription and that I would have to get my act together on my own. I tried not to look so desperate, but I dissolved into tears. She seemed pretty unmoved, and I felt as though I’d been punched in the gut.
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