Weight has always been a big concern for me. I can remember being as young as 8 and being told that I was getting too chubby and that if I ate that cookie I would be fat. Throughout middle school and high school I went through various processes trying to lose weight. I would spend significant time at the gym, and while my body would tone, I could never lose that persistent belly.
I tried the Dr. Bernstein Diet to great success. I slimed down remarkably fast: and ended up with iron deficiency and a few months after going off the diet, ended up in the hospital with idiopathic pancreatitis. (Other members of my family also suffered negative health effects during and for the period shortly after this diet.) I lost weight so fast, that one teacher grew concerned when that fact was taken in conjunction with the needle marks (blood tests) on my arm. I managed to convince him that I was not a heroin user, but thanked him for looking out for me nonetheless. Despite the massive weight-loss however, that little belly paunch still did not disappear. However, after going off the diet, I ballooned almost immediately back to the weight prior to the diet. This, no matter how hard I tried to eat healthy and exercise.
The early symptoms of my arthritis, which appeared in high school, were dismissed as being caused by my weight. No xrays or further investigation was done.
Food became an obsession. Not for me the rebellion of drugs, alcohol, and sex. For me, the biggest act of rebellion was to indulge in a big mac at McDonalds, or to sneak the occasional cookie. Every moment of my life was about food and weight and the never achievable goal of weight-loss and the success of that perfect body. All my anxiety focused on it. If I eat this will I be accused of being fat again? Eating was equal parts pleasure and guilt. In many ways it was like sex and religion; that endless cycle of pleasure seeking followed by remorse and guilt.
I never delved into the classic displays of bulimia or anorexia. I never ventured so far as to purge or became obsessed with exercise. I have no doubt in my mind though, that if I spent time with a therapist, I would easily be diagnosed with body dysmorphic disorder and anxiety. That it never reached the level of being life threatening seems almost a miracle. That obsession with weight is not something I struggled with at all. Many of those close to me were similarly obsessed, and their watchful eyes and barbed comments only made the situation worse.
That I never dated in high school, only reinforced the idea that I was fat and thus unworthy of love. I believed truly that unless I was a size four, no man would ever find me attractive and I would be doomed to spinsterhood. Despite that feeling though, I actually still considered myself attractive. I had a cute face, nice eyes, great curves, tits to die for, and an exotic enough appearance with pale skin and dark features. It was as if I simultaneously existed in two different spheres: the attractive but chubby Ania and the fat and disgusting Ania. In my own mind, I could not wed those two ideas into a closer approximation of the truth.
When I left home and moved to Ottawa for university, something strange happened. Leaving the environment of weight obsession let me forget about it for some time. It no longer hounded my thoughts at every moment. Instead of thinking about whether my parents would find out about that chocolate I ate, or that occasional hamburger I indulged in, I was able to forget about it entirely. Those of you familiar with residence eating are probably not surprised to hear that my diet was worse than ever. At that time, the healthy options at the uni cafeteria were near non-existent and the cooking facilities were little better. Despite this however, I started losing weight naturally. Rather than gaining the freshman 15, I lost close to 20 pounds; this, without any conscious effort on my part. The only time when those effects started to disappear however, was right before visits home. The return to those same people who were obsessed with my weight put me right back into that same headspace and once again food would become this unholy rebellion. I would sneak candy at an alarming rate, going through insane acrobatics to try and not get caught, often, with little to no success.
The lever of obsession with weight that still existed in my mind however was such, that when I was assaulted by a doctor at the clinic, it took me two years to even realize I had been assaulted. I was more upset and preoccupied at the inappropriate comments she had made about my weight.
The next few years were like a yoyo: there was the relatively though occasionally still messed up time I was in Ottawa, and the food obsessed binge eating person I became prior to and immediately after visiting home. The fact that my weight always came up at a visit, despite even requests not to bring it up only made it worse. There were times when I would spend visits home with a continuous monologue in my head wondering when the next attack would come. When would the next snide comment about something weight related occur once again? I practiced growing a thicker skin and ignoring any mention of, but invariable some button would be pushed, some nerve irritate, and I would blow up, the dam would break, and my self-esteem would collapse. The rate of collapse increased when it was my sister, 13 years younger, repeating some overheard “worry” or comment.
Then around the end of 2007, beginning of 2008, I began developing symptoms that would become a long and incredibly painful Crohn’s flare that was responsible for my diagnosis. It began with occasional twinges of pain in my stomach; relatively easy to ignore, although I did spend one evening in the hospital on suspicion of pancreatitis. More interestingly however, I was losing weight rapidly. On a visit from my parents, I discovered that for the first time in my life, I fit a size four. I had not even noticed the weight loss at the time. Over the following months however, the flare took a significantly darker turn. Food was passing through me without being digested at all, and I spent countless hours vomiting without control. I kept down maybe one meal in three, if that. I was constantly cold despite it being summer. I would alternate between having a mild fever, and having normal temperature. It became a regular occurrence for me to be admitted to the hospital with dehydration. The timing was such, however, that there was always some excuse for what was going on: liver infection, food poisoning due to broken fridge, flu. It was not until I realized that I had lost more than 30 pounds in the span of one month, that I realized I was in deep trouble. I went back to St. Catharines, and began the process of finding an explanation.
One aspect of this part of the story that still gets to me was the mixed messages I was receiving. It became a common occurrence for people around me to say: “I know you’re sick, but you look fantastic” Here I was, quite literally flushing my life down the drain, and the people around me though this was the time to comment on my appearance. An appearance moreover, that was a direct result of whatever was likely going to kill me if no answer was forthcoming.
Eventually I was diagnosed and then came the introduction to a medication that will forever be associated with hell in my mind: Prednisone. For those of you unfamiliar with it, Prednisone is a steroid that is used to treat autoimmune disorders. It works, I will give it that, but it has some major effects that make it not useful as a long term treatment. For one, it destroys the hip. I already have extensive damage to my right hip due to the arthritis, and prolonged exposure to this medication would move up the age at which I will need to have it replaced.
Another symptom is that it makes you gain weight. Imagine that, after months of having a body that was desperately starved for nutrients, I was put on a medication that would make me gain weight. For those of you familiar with starvation in any way, you might know, that when the body is denied food for a long period of time, one of its first reactions is to store as much fat as it can. Add to that a steroid whose purpose in part is to promote weight gain, and you end up with a deadly spiral into obesity. Prednisone when I take it makes me feel vile. Not only does it fill me with a strange type of energy that makes me want to lay down for fear of fainting dead away with the shakes and keeps me from sleeping, it leaves me with the sensation of being always full and somehow always starving. I compare it to the feeling of having a balloon (for some reason it is always red in my mind’s eye) blown to large proportions in my stomach. It presses against the sides and expands it, but is essentially hollow and begging to be filled. I try very hard when on prednisone to avoid as much unhealthy food as I can, lest the weight gain be compounded, but to no avail. No matter how careful I am, I always gain weight with prednisone.
That my Crohn’s is still not fully under control means that I am in a whirlwind of binging and purging quite beyond my control or desire. The weight gain forced by the prednisone has put me at a higher weight than I have ever been in my life and I despair. All the feelings of anxiety, of shame and guilt have returned, and with it, that deadly spiral of food obsession. Those who know me personally know that I am somewhat of a cook. I love to make lean, healthy, homemade gourmet meals at home. My diet, when discussed with nutritionists, dieticians, is praised, What isn’t seen though is the battle, the struggle, with forbidden items. I do my best to exercise how I can. The leg damage limits what is available to me being not allowed to run, bike ride, or otherwise put any pressure or stress on my hips. I swim as often as I can, and in happier times, I would dance salsa with Alex.
But the despair forced on me by the endless weight gain creates this cycle of shame, indulgence, and guilt. I indulge in chocolate, or cookies, or pop, or fast food. It isn’t often, but each indulgence fills me with such shame and guilt that I immediately rush out for more. I seek to repair the shame of indulging in that one cookie, by masking the pain with more sugar. I beg friends and my SO to help me keep from that cycle, but it backfires on me. Knowing that someone is looking over my shoulder at my eating habits only puts me back to that headspace I was in in high school and on visits home; that desperate need to use food as rebellion. To hide that box of chocolates I ate by putting the empty container inside the cereal box in the recycling. To beg Alex who puts the chocolate on a high shelf beyond my reach for just one more piece.
The horrible irony of all this is that fact that this struggle, this desperation is completely invisible. One of my best friends was honestly shocked to find out the depth of my body image issues, having always thought I was one of the most confident people she knew. What she didn’t realize is those pictures of me that I post on Facebook are just ones among hundreds. I chose the ones where I meet my exacting standards of personal appearance in a desperate attempt to remind myself that I am attractive, that these is something appealing about me and worth loving. Something to think of when my significant other tries, at times unsuccessfully to convince me of my own sexiness and beauty. Those pictures are desperate attempts at convincing myself of my attractiveness, so that I can boost my esteem enough to begin that process of healing and acceptance that will bring me out of this pit. But every word from “well-meaning” acquaintances about the benefits of fitness to people with my “conditions”, every sideways look from people on the street, every comment from doctors, and every picture of myself that I see that is not under my control, brings those attempts and that esteem crashing back down again. Those smiles in the pictures, while sincere, mark an inner struggle and pain over once again having visible proof of what I perceive as my failure as a human being.
I will pull myself out of this. It will take time, support, understanding, and a lack of judgement. It will mean isolating myself from those who raise my anxiety and stress levels to the point of critical mass that pushes me into a spiral of guilt. And I will do so while catering to my dietary needs for Crohn’s and my restrictions for my arthritis.