A Confession from an ED Advocate

In the quest for being authentic about things, I have been thinking a lot about my promotion of Health at Every Size, the paradigm of thought based on Linda Bacon's book by the same name. I have realized that for many in my circle of influence it may seem like utter nonsense that I personally believe this message because I have rarely dealt with what it is like to be what anyone would consider overweight. I've had two seasons in my life where I have struggled with weight gain.

The first time I experienced being "larger" was in response to treatment for Lupus in the early 90's when I was taking a high dose of prednisone. I gained a lot of weight very quickly and once the medication was stopped, it took about two years before my body went back to a more normal weight for my body. (I sincerely can't believe I originally used the word "healthy" here! Instead of beating myself up, I'm going to say that it simply shows how conditioned my mind is to believe smaller is healthier. I'm so surprised that even at my best attempts to reframe this discussion, I chose that word? The whole premise of this writing is to communicate that I believe a "healthy" weight can exist at larger sizes. I really do believe that!)From the beginning I had made a conscious decision to focus on regaining my health and not worry about anything else. At the time I was also underweight due to perfectionist driven anorexia and not body image disturbance (in other words I didn't think I was "fat" when I wasn't). When you gain weight from steroids, it all rests in your middle, around your face and you get this really goofy hump on your back. You just look odd. It was a very strange time for me. The good news is that I never did go back to the "sick" weight I was before all of this.

The second and most recent experience of gaining weight was about 3 years ago after a complete hysterectomy because my body needed a place to store estrogen. I had absolutely no idea this would happen as a result of the surgery but I did my best to take a proactive approach in dealing with it. I consciously chose to love my body and to give thanks for its ability to find another place to store estrogen when my ovaries were taken away. I chose to find joy in the strength I had when I could ride my bike along a bike trail to a small town 5 miles away and make it back again. I purposefully took a photo from the ride and put it on Facebook, for me, not anyone else. I honestly and sincerely did everything in my body-love toolkit to be happy with who I was post-hysterectomy. Then everything changed.

In October I went into the hospital for a surgery to help me deal with free reflux. The sphincter muscle between my esophagus and stomach had completely stopped working and whatever I would swallow would come right back up, even water. The surgery is called a NISSEN fundoplication and was highly recommended. I waited to make sure that the best surgeon in the practice could do it. Five days after it was done, I found myself in the most intense pain ever and ended up in the Emergency Room. A CT scan revealed that my stomach had flipped up and lodged itself in my chest cavity. I was immediately sent to a hospital in Minneapolis and the surgery was repeated. This time, they stretched my esophagus with the hope that it would take care of it. It seems to have worked but unfortunately, as a result of my stomach going where it doesn't belong, I developed a plueral effusion; fluid in the space where my stomach had been. I was sent to radiology for a thoracentisis (a procedure where a catheter was placed into the plueral space to drain the accumulated fluid) and was told that whatever fluid was left, would assimilate back into my body over time.

As Thanksgiving approached my husband and I went to Nebraska for a visit. I decided to stay a bit longer and visit family and friends. While I was there I became more and more ill. I developed a cough and got winded with any exertion. After two visits to the doctor and one more thoracentisis procedure, I headed back to my surgeon's office. A chest tube was put into place and after two days a thoracic surgeon was consulted. He came into my room and told me I'd be having surgery that day. It was grueling and painful. I'm still recovering from it as the result of nerves damaged or cut altogether and a rib is still healing after it was sliced to make way for the surgeon's tools. The reason I tell you all of this is because in the process of all of these medical interventions I lost a lot of weight. I've been working hard to gain it back since. It is slowly coming but my body is clearly so focused on healing that it's going to be awhile.

I am now back to my pre-hysterectomy weight and find that it is what it is. I have been told by well meaning friends that I look SO good. Though I like hearing that I look good, I know better than anyone that I am not good. My nerves are healing but at a snail's pace of 1cm a month. I am weaker than I have ever been. My body is reeling from the loss of estrogen and even with hormone replacements I don't know when I'll ever get back to a healthy place. The thing is, my story is that I know that when I get there, I very likely will weigh more than I do now. I may need larger clothes. I may not "look" as good in the eyes of others but I know that I am very much past that. I know what Health at Every Size looks like for me and I will continue to pursue it with my whole heart.

When I write about body image, eating disorders or Health at Every Size, it is as much for me as for anyone else. I may have never been a very large woman in comparison to others but I sincerely know that health often has little to do with one's size. Health has MANY other factors to take into account that as a society we often ignore at our peril. Do you know that when I was really thin and underweight, very ill and developing one disease after another, not one medical professional asked me if I was eating enough. NOT ONE. I have since learned that medical professionals are taught very little about eating disorders and only the basics about nutrition. Most of us assume they are the experts. I know I don't have the one and only true understanding of this stuff but I can say with certainty, that what I do know is saving my life.

So...my confession to you is that I really don't know firsthand what it is like to be a very large person. I don't know what it would be like to shop for plus size clothing or to try to fit into an airplane seat made for someone much smaller than myself. I have no idea what the pain is like when you live in a society that assumes you are lazy and unhealthy because you are larger. BUT I do have a Health At Every Size story and it is my own. It's a story of NOT being healthy at my size even though society and even my doctors assumed I was. I am striving to regain my health every single day and will continue to do so.

Thanks for bearing with me as I continue on this journey!