“I recently had my annual physical examination, which I get once every seven years, and when the nurse weighed 
me, I was shocked to discover how much stronger the Earth’s gravitational pull has become since 1990.“
– Dave Barry
“I have gained and lost the same ten pounds so many times over and over again my cellulite must have déjà vu.”
– Jane Wagner
“In the Middle Ages, they had guillotines, stretch racks, whips and chains. Nowadays, we have a much more effective torture device called the bathroom scale.” ~Stephen Phillips
Dear Dr. Kildare,
As you wrote a new prescription for me today, you said, “Take one pill with dinner. If you skip dinner, don’t take the pill.”
Did you say, “skip dinner”? You really don’t understand me at all. I missed breakfast and lunch when I was in labor with my first daughter, and I haven’t forgiven her yet. She’s 35.
You tell me how much I weigh, as if I didn’t know. I can tell you how much I weighed at every major milestone of 
my life: when I went to my junior prom; when I got pregnant the second time; when we moved into our third house; when Luke and Laura got married on General Hospital. I can tell you exactly what I weighed this morning after my shower, and how much the flimsy clothes I chose for the appointment weighed. And I can tell you how much I weighed the morning last month when I canceled my appointment with you just because I knew how much I weighed and I knew you’d notice.
That number is my hidden shame, and when I see you, the curtain is drawn. Do you know that you and your nurse are the only people on the planet who know how much I weight?
You say I only lost four pounds. Only four pounds? That’s 14,000 calories I managed to distance from my pie hole. I’ve noticed when I gain four pounds, you don’t say it’s “only four pounds.”
Do you understand that every minute I don’t eat, it’s because I have made a conscious decision not to? I once made a chart on the computer, with one block for every hour of the day. I colored in all the hours when I managed not to eat. Those blocks looked like bricks, bricks in a wall. A brick wall. (I’ll just say my pencil didn’t need sharpening at the end of the day.)
When I go to bed at night, I think, not about what good work I’ve done that day, or the kindnesses I’ve extended, but how many calories I’ve consumed. And then I start planning breakfast. When I wake up at night and look at the clock, I think, Only three hours left until my omelet!
I used to go to a chubby doctor. When I went for my annual exam, at least one of us had joined Weight Watchers . . . again. We’d talk about how many popsicles we could eat for one point and the new Points Plus Program and which instructor we liked best. She didn’t lecture me or judge me, or act like it’s easy to lose weight. She knew that I knew that she knew how much I weighed and the attendant health risks. And she would have given me a lollipop if I had lost only four pounds.
Unlike an alcoholic, who can completely abstain from spirits, a foodaholic must eat to live. I really only know how to do two things with food: not eat any of it, or eat all of it and ask for seconds. From the first bite I take of a meal, I start grieving for the last bite. I almost never feel full or satisfied. I have slim friends who tell me they are naturally thin, that they can eat all they want. Well, I see what they eat, and they don’t want what I want.
When I’m hungry, which is nearly always, I feel unmoored. Today you suggested I eat lean meat and fish to curb my appetite. You extolled the virtues of protein like it’s some big scientific breakthrough, like you have just split the atom. You said I should snack on carrots and celery. So, so helpful. (Do you tell heroin addicts to chew gum?)
You think that we fat people just need educating, but I know more about nutrition than a dietician. I have 
committed to memory the caloric content of thousands of foods (my fish oil capsule has 20), the fat content of a single serving (1 pound) of potato chips (157 grams), and the sodium content of my V-8 (1 serving = 18% of the daily allowed). I can tally Weight Watcher points like Rainman.
Please know that I am not complacent about my weight. I have battled this blubber beast for 50 years, a freaking half century. Since puberty, I’ve had two modes: losing or gaining. Through high school, I was always dieting and self-conscious 
about my weight, and I exercised compulsively in my little pink bedroom. I remember one gadget I bought, the Twister, an eight-inch wood rotation device I’d stand on and twist, counting to 1000 on a good day. I’d get up early and exercise in my damp basement with Jack LaLanne and his dog, Happy.
If I didn’t like a new haircut, I lost weight to compensate. If I wasn’t cast in a play, I dieted for penance. If my boyfriend didn’t call, I dieted as an antidote for rejection. I hid out in the school library during lunch so I wouldn’t be tempted. I descended into anorexia and bulimia for a while, weighing myself when I got up to go to the bathroom in the middle of the night, walking five miles to work, and purging a twelve-pack of Nutty Bars.
I’ve eaten grapefruit, chia seeds, and a noxious stew of cabbage and dishwater, all to achieve weight loss. I was a 
student of the USDA Food Pyramid, which evolved into My Pyramid, and now My Plate. I have an entire shelf of my bookcase devoted to weight loss books: the Paleo Diet, the Atkins Diet, the South Beach Diet, the French Women Don’t Get Fat Diet (it’s a lie—I’ve been to France), and the one I’m currently on, the Still Fat Diet.
I once lost 85 pounds, the equivalent of a sixth grade child, in eight months following the Diet Workshop plan. When I started eating “normally” again, it was like I was drinking fat. I gained all the weight back and then some in three months. This is just one example of the numerous times I’ve journeyed 
down the cul-de-sac of dieting.
You probably think I’m overweight because I’m an emotional eater, that I dive into the Doritos because I’m sad, that I eat a package of Oreos because my mother weaned me prematurely, or that I am heavy because I eat fast-food and pork rinds; I know some overweight people do. But fat people are fat for a variety of reasons. I struggle with weight because I have a gnawing, grinding hunger all the time and because I love food—the aroma, the texture, the flavor, the preparation, the presentation. Oh, and writing about it.
I suspect that I have a very different relationship with food than you and other skinny sisters do. I don’t know if the difference is in my stomach or my brain, whether it’s genetic or learned. I consulted with a doctor about weight loss surgery who explained that obesity is a disease that scientists still don’t understand. He shared the statistics that show that dieting doesn’t work, that nearly everyone who loses a significant amount of weight will gain it back. Ta da! Exhibit A.
It’s much more complex than “eat less, move more.” Genes play a role in obesity in many ways, according to Harvard Medical School, by affecting appetite, satiety, metabolism, cravings, body fat distribution, and tendency to use food to alleviate stress. Genes can account for up to an 80% predisposition to be overweight.
I know I am betting against the risk trifecta resulting from my weight: hypertension, high cholesterol, and prediabetes. Do I deserve pity or sympathy? Absolutely not. But I also do not deserve condescension or criticism. To a large degree I have dug this hole with my own knife and fork, but I am not lazy or stupid or ignorant, and I exercise more will-power than you might imagine. If I ate what I wanted, my ass wouldn’t fit on your examining table.
Because you are the only person, besides me, who has the right and the responsibility to comment on my weight, you are receiving this letter, but the letter is really for the world of thin people who are silently judging me. You have used every tool in your pharmaceutical toolbox to keep me healthy, and I thank you for your expertise, diligence, and kindness. But as well-meaning as your advice is (“Drink a big glass of water before meals”), it is old news to me.
For some reason, it’s important to me that you know I am trying, but that weight control is complicated. When I come to your office, I feel like I’m going to see the principal, and that is probably more about how I feel about myself than about what you say. Do we really have to have this conversation every stinking time I see you? You know, it doesn’t help. I wish instead you’d say, “I know this is really hard for you. Now let’s talk about all the wonderful things going on in your body.”
I have a flaw that everyone can see. My body is a walking admission of obesity, as if I’m wearing a sandwich board. Hmm, sandwich . . .
“Believe it or not, your body has nothing but unconditional love for you. The proof? Without any effort on your part, your heart is beating, your lungs are breathing, and the rhythm of life is graciously flowing through you every second of every day—unconditionally.” ~Elaine Moran
I recommend the title story in this collection by Elizabeth Berg entitled The Day I Ate Whatever I Wanted: And Other Small Acts of Liberation. Food for thought. Now why did I just say that?
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