fat is not an f-word
rejected titles for this issue included: 'a weight issue', 'it's a fat thing'
I’m going to talk a lot about weight in this one. If that’s not your jam, peace out now; seriously, I mean it. It’s not going to be a fun ride and I don’t want you to start thinking about it as obsessively as I have been over the past few weeks (yes, even WITH the election).
If you’ve decided to keep reading, well, okay. I won’t be talking numbers but I will be mentioning BMI and quoting things healthcare professionals have said to me. Please keep in mind.
Part i: The Ensnarement
After two summers of bad stomach issues every few weeks (and discounting it as ‘eh, I have stomach problems’) things came to a head when I genuinely thought something in/around my stomach area had exploded and I couldn’t stop vomiting or take a deep breath. Because an ambulance wouldn’t come for a few hours, my boyfriend bundled me into the car (with me puking in a bin) and whisked me to A&E.
I couldn’t wear a mask at the hospital due to the aforementioned vomiting, but after several unsuccessful tries at getting my blood (seriously, I needed an ultrasound to find any veins), they determined I wasn’t dying and sent me home with strict instructions to go to my GP the next morning.
I say ‘the next morning’. It was 6am at this point. I stayed up til 8.30 to ring, and the nurse on the other end of the phone was lovely. She reassured me it could just be one of those things and asked me to come in after I’d slept.
Weak, face drawn, leaning on my boyfriend for support, I managed to walk there. Turns out several hours of nonstop vomiting does a number on your core muscles. When the nurse saw me, her demeanour changed from sweet to decidedly more businesslike.
It probably wasn’t gallstones, she said, pressing on my stomach. If it was, I’d be screaming in pain. She was worried it was fatty liver disease - because I’m fat, and had been eating more fat since lockdown (well, yeah, lady - it was a hot summer and ice-cream helped). She could refer me for an ultrasound, but in the meantime I must have a zero-fat diet. Perhaps, she suggested, I could get my boyfriend to eat it too? She’d seen him outside.
Then she printed out a BMI chart, marked where I was (extremely in the red) and drew a sad face on it. Just to make sure my stupid fat cow-face had got the message. Because obviously nobody had ever told me being fat was bad.
Part ii: The Collected Histories
I don’t think I’ve ever been thin. I was small, due to accidental malnourishment as a child (Coeliac Disease is a hell of a thing), but - also due to the Coeliac disease - I had a pot belly. Everyone in my family carries weight in their stomachs, so it wasn’t a cause for concern. I have no coordination and am not good at socialising, so organised sports were out, reading books was in.
So, I got fatter. When you don’t move much and your vice is chocolate, it happens.
My Mum got into Slimming World in a big way, dropping ten dress sizes - but it wasn’t an appetising diet. I love broccoli and roasted onions, carrots and spinach, but I’ll always go for a salty snack over fruit and when you can’t eat a large variety of junk food - thanks, Coeliac, again, super great work - I didn’t see the point in further restriction. So I was fat. My body was just a vessel to carry my (pretty fantastic) brain around in, and once I got to uni and started wanting to date, I got a boyfriend without too much trouble. In a society where the most compelling argument for weight loss is ‘the opposite sex will like you’, it was easy to discount this point.
Occasionally doctors would tell me off for my size (I had one doctor straight-up say ‘You’re fat, and that’s bad’) but when they saw the size of my medical files (I’m currently on my third paper one) they tended to shut up, focusing on the late-term strabismus surgery, the cauterisation, the endless endoscopies and bone scans.
Part iii: The Present
So here I was eating a no-fat diet. It is and remains to be miserable. The four essential ingredients to make a good meal are salt, fat, acid and heat. Take one away and you’re left with clashing flavours, a feeling like your mouth has never been drier. And no snacks, of course. I stuck to it rigidly, because I had no desire for the pain that felt like my stomach had popped like an old balloon.
And I had my scan. Radiologists aren’t known for their bedside manner, it’s fair to say, and this one told me my liver was fine and I had three gallstones.
I lay there on the papered couch, blinking hair out of my eyes as I assessed this.
“Um,” I said, covered in cold jelly, as he washed his hands. “So… what’s the next step?”
“Surgery,” he answered, and left the room.
As I cleaned the gunk off my belly, head spinning, I wondered what to do now. Because my friend had had gallstone surgery in the past year after being hospitalised several times with infection, and going yellow due to the jaundice. I did not want to go yellow.
I called my GP the next day to let him know what the scan had found, and he booked me in for a few more blood tests. Just to rule anything out. Just to check my kidney function and liver function. And a pre-diabetic check, of course. Because I’m fat, so I must be pre-diabetic.
Part iv: The Audacity
‘It’s odd,” the healthcare assistant said as she led me down the corridor to her room. “You’re not really the demographic that gets gallstones. Female, fat, fair, and forty… well. You’re not forty.”
Part v: The Meat on the Bones
Turns out that a zero-fat diet, while reducing the current gallstone pain, can also cause it. Because if you lose weight quickly, you make more gallstones to sit in your gallbladder and hide in your bile duct, causing the pain.
I’ve been eating a low-fat diet for a while, now. It’s all to avoid pain - and to reduce the risk of being denied surgery. I’ve dropped some dress sizes. My jeans don’t fit anymore. (Having no job, I am unable to buy new ones currently.) I don’t eat enough calories a day, according to a calorie tracker I downloaded briefly to my phone, but I go to bed full. I can’t have vegetables with a non-soluble fibre component because my guts - already angry with me for upsetting their equilibrium - complain even more. No broccoli for me.
So I guess the part that’s upsetting is.. Well. There are three parts.
How easy it’s been to restrict my diet even more. How used I get to feeling hunger pangs when the gap between noon’s lunch and 7pm’s dinner yawns like an undersea trench. How I miss cheese and broccoli and baking. How joyless meals have become.
The knowledge that my body is changing without my enthusiastic consent, and I don’t like it changing because it doesn’t need to. It was doing fine apart from this and the crippling anxiety and the autoimmune disease.
The fear that I’m losing weight, sure, but I’m still not losing enough. The nurse told me my weight through puckered cat’s-bum lips; we don’t have a scale here. I don’t want to use one. I’m definitely still, by BMI standards, unable to walk unaided as my massive girth causes me to roll everywhere as I gnaw on everything I pass. I’m still in the ‘sad face’ part of the chart.
Part vi: The Future
So despite overweight patients having similar outcomes in gallbladder surgery than patients of an ideal BMI, several CCGs won’t do surgery on patients with a BMI above a slightly overweight line. (Although I’m trying to avoid numbers here, we’re talking slightly. Like, two weeks of fried food difference). They send those patients away for nine months to lose weight, ignoring how their quality of life would shoot up if they just had the bloody surgery.
The Royal College of Surgeons has condemned this, but healthcare is a business now.
I’ve found and printed off the surgery ‘checklist’ for my area. It has a box for if the patient smokes, and that’s it; I’m going to bring it with me for my appointment in two weeks.
My diet is shrinking, just like my world is shrinking: I am confined to the same breakfast, the same lunch, a rotation of 2-3 dinners. You have to eat, to get energy to do anything; but if you eat, you won’t lose as much weight. And you want to lose weight, don’t you? To be seen and treated for your pain like a thin person would be.
When my Mum lost the weight on Slimming World, she noted with some surprise how much nicer people became to her. She was offered seats, or free samples; people listened to her more.
And then she put the weight back on, and became an invisible ‘stupid fat woman’ again.
Part vii. The Lying Awake Nights
It’s past 2 in the morning. I’ve been googling information on calories, calorie trackers, how much weight you have to lose to drop a dress size, when my weightloss will become noticeable.
Then I woke up my partner because I was crying, overwhelmed, thinking about it.
Weightloss is never, ever going to be an easy thing emotionally. I’m not just talking about the ‘weight loss journeys’ those on Instagram or TikTok go on, spinning round in a dress that didn’t fit them last month and now only bulges slightly at the back. You just can’t lose weight in a bubble, thinking about what’s best for your body (eg no pain).
Everyone rich on TV is thin. Fat people are used as a joke, assumed to be jolly and somewhat dumb, like a dim and chunky labrador. Although the only thing that will change when you lose weight is the number on the scale, a million things around you will change as well.
Like how you’re treated when you go to the doctor, like how people see you come across in job interviews, like if people listen to your ideas or just nod along at them, like how many men speak to you unsolicited.
I wonder if that first nurse, the one who let me in on the horrible secret I was fat, knows how much of me is my weight and how much is everything else about me. Probably not much; she has a million patients and targets to hit. She won’t know that although I’m scared of messing up my gallbladder even more, I don’t want to speak to her again. She doesn’t know how unsafe she made me feel, or how that one shove from her has me hurtling down a dark path that’s the centre of the big question in society.
God, why can’t you just be thin?
Links
Well hey, at least Biden and Harris won! That’s something to be happy about. Or at least, Trump didn’t win - and that’s the more important thing. All the links today are going to look at the happy outcome of the election.
Trump Can't Afford to Lose | The New Yorker
I know it’s probably naive of me to hope he goes to jail but never forget, everyone hates him and even Al Capone went to prison for tax fraud.
Johnson 'in a lonely place in the world' | The Guardian
Trump losing means less success for our own mini-Trump with the stupid hair and the fascist outlook. We’re prooooobably going to get a deal now with the EU because Biden doesn’t want the Good Friday Agreement to be disregarded and he’s now the most important man in the world.
Scenes of Joy as Biden wins | Buzzfeed
Enjoy the people dancing and laughing, celebrating the first woman VP, the first female POC VP, the defeat of a fascist, that their hard work in activism paid off. I really hope the Dems get control of the Senate now too.
Here is an f word: I'm so fucking sorry you're going through this. What a macabre, unfair, monstrous thing. I love your brain, and the body that carries it around should be taken care of by the medical establishment no matter what. I hope you are able to have your surgery soon. I love you, celiac birthday twin.