Wow, I cannot believe it has been almost two years since my last post. I debated on whether a new post was even necessary. I recently spent a couple of days de-publishing over 300 old blogs from the last 14 years that contained a lot of self-hate directed at my weight, and bad science about dieting. I found my writing cathartic at the time, however, in reading it back now, it seems like a lot of unnecessary complaining. I can't say this post is going to end up being much different, but I love a good update. This is going to be a little long (if you know me, you won't be surprised). Here is a "how we got here" recap (shout out to Sam and Dean), and an update for you. Sorry if you've heard the story before, but this post is the backbone of what may become something bigger later on.
For my entire life I have “battled” obesity. I was always told that it was my fault because I couldn’t control myself. Eat less. Exercise more. I just had to try a little harder with the willpower thing. I was on Weight Watchers by the time I was 13. I was drinking disgusting and unhealthy Slim Fast throughout my childhood. I was on phen fen by the time I was 21. I had gastric bypass surgery at the age of 27. I lost 165+ pounds after that surgery, although I did gain some weight back. I went from close to 350 pounds, down to 180. At my lightest, I started taking antidepressants for the first time in my life, and started gaining weight again. Eventually, I found a comfortable weight around 225 pounds. In 2013, I had foot surgery, and I rebounded up to 260, but I went gluten-free, increased my fat intake, and exercised a tiny bit more to get back down to my comfortable weight in 2016.
For my whole life, I have been sold the narrative that calories in versus calories out – calorie deficit and over-exercising – were the only way to lose weight (i.e., that willpower I apparently never had). I am not delusional – I understand food and exercise are part of the equation, but it is not 100% of the equation in a "fat" person's body. I was in the gym six to seven days a week when I was at my biggest. I was told that cardio was the best way to lose weight, and that women doing too many weight-bearing exercises were going to "look like a man." All false. No one talks about how food is now engineered to have less nutritional value and more awful preservatives. How it’s created to make you want to eat more of the bad sugary (and non-filling) stuff.
I had three siblings who had the same parents and lived in the same household. They aren’t fat. So why am I? We ate the same food. My mom always said I preferred reading books to playing sports (even though I see pictures of myself playing softball as a kid). I just wasn’t an “active kid” apparently. However, I don’t necessarily remember being a completely sedentary kid either. My friend had horses, and I went to her house to ride and play outside. I walked to school most days. I had a paper route at the age of 11 that required me to either walk or ride my bike carrying heavy rolled-up papers. My grandparents had an apricot ranch, and I remember helping them – mowing the lawn (well, on a riding lawn mower but they had eight acres, so it was still pretty active), and cutting apricots to dry. I really didn’t think of myself as a lazy kid.
I was also tall for my age – often being mistaken for being older than I was. I remember hearing a story about someone thinking I was 8 when I was only 4. At the age of 8, I have a photo of me standing next to my best friend who is a few days older than me, and I was easily double her size. My parents split at the age of 12. My dad claims this is when he really noticed me starting to get chubby. However, I got my period at the age of 13. I was put on birth control at the age of 15. These are all things that might change the body (and weight) of a child.
I remember being 16 or 17 and I started going to step aerobics, so I lost some weight. I was probably also doing slim fast, maybe even Weight Watchers too. I was a junior in high school. One of the gym teachers could not believe it was me. He kept remarking on how much thinner I looked. He was so proud of me. It felt gross while also feeling great. I loved the praise.
Post-gastric bypass, I saw how people treated you differently as a thinner person. People were nicer. I had men tripping over themselves to open doors for me, something that had never happened before. I could never figure out if it was my change in attitude, or their approval of me as a thinner person. It set me up for a lot of trust issues.
Currently, in 2024, at the age of 47, I am suddenly “battling” my weight again. When covid hit in 2020, and I was sent home to work, I ended up putting on about 40 pounds over two years. I got an Apple Watch, and started trying to be cognizant of my movement. I stabilized and was sitting around 265 pounds for the last couple of years. However, in 2023, I started to realize I had a lot of weird symptoms. Loss of strength, night sweats, insomnia, joint pain, hair loss, the before-mentioned weight gain (especially in the midsection, which makes me look very oddly shaped thanks to the plastic surgeries I had years ago), exhaustion to the point of it interfering with my life, extreme grumpiness to the point of fearing it was going to get me in trouble at work, brain fog, snoring, anxiety. Never had I been told that these symptoms could be related to perimenopause. And since they each came on slowly at different times, I just kept telling myself, well our bodies change when we get older. I thought menopause was something I wouldn’t have to deal with until I was in my 50’s or 60’s.
In September 2023, I took a Facebook quiz with the website By Winona, and realized I was having perimenopausal issues (but thanks to taking birth control for 24 years, I don't actually know if my body knows how to function without "hormonal issues"). All of these issues are related. Why is no one talking about this? If you talk to traditional doctors, they will often offer you birth control pills or anti-depressants, and tell you this is the best they can do. I didn't want to go back on birth control pills, but they promised it was a lower dose, and not the same. I had spent so many years abusing my body with medical advances, why not start using those advances to actually help me. Winona was offering a cream (estrogen/progesterone) that seemed like a better idea for me (post-gastric bypass, I can sometimes be malabsorptive in the vitamin/pill department). They were also offering a supplement called DHEA. I signed up. Within two weeks, I was feeling better. I didn’t even realize the exhaustion and joint pain were so bad until I felt better. Two weeks after starting, I was able to run down two flights of stairs to catch a BART train, something I could not have done before the hormone replacement therapy (HRT). I suddenly didn’t need Sunday to recover if I did ANYTHING on Saturday. I wasn’t feeling like biting off the head of every human I crossed paths with. It felt like a miracle.
However, after starting HRT, I suddenly gained another 15 pounds (my body loves to do everything in 15-pound increments). I am the heaviest I have been in the 20 years since gastric bypass surgery. I am unhappy (or am I?). I recognize that my joints do hurt a lot more when I am heavier. Also, my skin hurts and I feel like a sausage when I gain weight so quickly. I feel like I need to "do something" but none of my prior tricks are working. I am a decently active person. I do yoga, swim, and ride bikes. I wear an Apple Watch to make sure I am getting my steps in. In the last few years, I have tried tricks that worked in the past: 16:8 intermittent fasting, cleanses, the chicken taco diet, cutting alcohol, lowering sugar intake, increasing fat and protein intake. Nothing has really moved the scale in the “right” direction.
The American Medical Association declared obesity a disease in 2013 (and apparently this was affirmed in 2023). (Although many will argue that obesity is merely a symptom of other diseases, not a disease itself, I teeter totter on how I feel about that.) For my whole life, I was told that I was the one doing everything wrong. When I contacted a Kaiser doctor last year, asking if I could be considered for Wegovy (a GLP1 medication related to the popular diabetic drug Ozempic, which stabilizes blood sugar and has the side effect of weight loss), I was told I would have to jump through many hoops before I could be considered for Wegovy, including paying thousands of dollars out-of-pocket for Kaiser’s weight loss program, and for what I assume is highly processed, disgusting food. Even if I cleared all their hurdles, the out-of-pocket cost to me for Wegovy would be very high. Essentially, I was being told my very clearly chronicled lifelong
disease had a potential new treatment, but I wasn’t (again) working hard enough for it. I mean, I was willing to scramble my insides, and I'm still "sick," so did I not show I was serious about my
treatments?
I watched a TV show about stars who are taking Ozempic. One reality star, Heather Gay, made a comment in response to someone saying that she was taking the easy way out. This is not a direct quote, but she essentially said that if someone thinks she’s taking the easy way out then they likely have been blessed with a naturally thin body (or high metabolism). And I couldn’t agree more. I was heavily judged for having weight loss surgery, and will likely be judged for asking to take one of these GLP1s (Ozempic, Mounjaro, Wegovy, Zepbound…). However, that judgment likely comes from someone who has not spent their entire lives “battling” their weight, mind, and body.
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I think back to being a 13-year-old on Weight Watchers. The embarrassment of having to step on that scale in front of people. I think of their awful slogans, such as: “Nothing tastes as good as being thin feels.” I was always felt like a nuisance because clothes were not made for children my size (my height, not even just my weight). I now have nieces who are nine, five, four, three and two. The nine-year-old is already being called fat at school (and this kid is so active…jiujitsu, softball, soccer, basketball). Society can be awful – and it is so easy to point fingers at people and tell them they aren’t good enough. As if being fat is the worst thing you could be. I sometimes wonder how different my life could have been if I didn’t have this weight (no pun intended) hanging over me. I don’t want my nieces in particular to struggle this hard for their entire lives.
I listen to a podcast called Plain English with Derek Thompson. In episode "S2 E68: The Weight-Loss Drug Revolution, Part 1: Why These Drugs Work So Well" (published 12/12/2023), I was floored as I heard for the first time in my life that I am not simply the fat girl who can’t stop eating. Biologically, I may be unable to keep the weight off without further intervention (the drug appears to target compulsive behaviors in general, including smoking, drinking, shopping, gambling). I feel understood for the first time in my life. Gastric bypass made my stomach shrink so that I could not eat as much, however it did not fix the issues inside my brain that told me to keep eating. I have been part of a weight loss surgery support group since 2003 – one year before my surgery. I have watched so many people come into the group, lose weight, start gaining, then disappear because they were too embarrassed to face the group. I always felt sad, and I was always honest with the group about my struggles. I always felt like the problems were never truly being addressed. I talked about addiction transfer, and losing food as your coping mechanism. I begged people to get therapy as they lost weight. I usually felt like I was the only one preaching this, and that the doctors approving this surgery should have been taking the mental aspect a little more seriously. I feel validated.
I just hit the 20th anniversary of my gastric bypass surgery on March 17. I have always been told that many people gain all or more of their weight back, and the fact that I am still significantly less than what I used to weigh, I am considered a success. I don't even know if those are facts, or just "what people say." I don't even know how studies define a "successful" weight loss surgery patient. However, I do consider myself a success. I have watched a lot of people get sick and/or die from other technically unrelated health issues, but I always felt their inability to get the nutrients their body needs contributed to their body's inability to heal. I have spent 20 years dialing in my vitamins, and trying to take care of myself the best I can. I just got my blood work back and I had all perfect numbers for maybe the first time since surgery. Even my liver looks good again! On paper, I am the healthiest I have ever been.
However, I am getting a little frantic about this recent weight gain. It is easy to scream about health at every size, but my knees hurt, and I can acknowledge the extra weight is contributing to that. I am unwilling to go off the HRT. I have reaped so many other benefits, so I need to deal with the weight another way. This podcast about the GLP1s was well-timed, as I had already made an appointment with my doctor to discuss options about weight loss in the perimenopause world.
These new GLP1s are targeting gut peptides. For years, I have been hearing that we need to heal our guts in order to heal ourselves. It seems this is true. And, though I have been conditioned to feel like a failure for asking for medical intervention, I feel like there is no choice. In my 20’s, I was gaining 15 pounds per year, and was already 350 pounds at the age of 26. I could foresee a future of hitting 500 pounds in ten years if I didn’t get medical intervention. Now I am 47, and back up to 280 pounds. I have been without much help from my previous “medical intervention” for many years. The body is resilient, and I have heard many stories about how calorie malabsorption after gastric bypass only lasts about a year because the little cilia in the intestine just grows further down, allowing the calories to be absorbed again. The pouch doesn’t just stretch out, but the metabolism slows as it gets used to the lower calorie intake, meaning you can gain weight off eating a somewhat “normal” amount of food. You can’t win against this.
The podcast talks about “food noise,” or more importantly, the absence of food noise once they are taking a GLP1, an example given of thinking about what you’re going to have for lunch while you’re eating breakfast. Food and weight have consumed my entire life. I feel like I don’t have the luxury of not thinking about food, and half the time, it’s talking myself out of eating things I know I shouldn’t eat. I also get frustrated by being asked: “What do you want to eat?” As a food addict, I should have tons of opinions on what to eat, or where to go. However, I hate that decision. I don’t want to be responsible for making food decisions. I want others to make the decision, and then I will find something to eat once we are there. It even happens when I am alone in my own house. I don’t want to make a decision about what to eat for breakfast (when I know it should be a protein shake), so I don’t do anything until I end up eating some Ritz crackers (or other overly processed food), which I know isn’t a great choice for me. When I attended years ago, Overeaters Anonymous had a saying about food addiction. It was something like, when you have a drug addiction, you can put the tiger in a cage and lock it up, but when you have a food addiction, you have to take the tiger out of the cage and walk it three times a day. For some reason I always hated this statement. This just makes food the enemy. At the same time, I get it and I just want the food noise to go away so that the decision paralysis also (hopefully) goes away.
I have always tried to be careful not to reward myself with food (I am not a dog). I think my favorite part of the podcast is where Dr. Tchang says that there is a mental change once on the GLP1s where the brain sees food as only sustenance and not a source of comfort. I need that. I used to say: “Food is for fuel, not pleasure.” Not that it got me anywhere. I have over ten years of blogs showing my obsession with finding the answer to fixing my broken body and mind. I put “food is” into the search bar of my Google doc and over 1,000 hits came up. Most of them found entries for “food issues.” This makes me so sad. This has shaped my entire life, including this blog. I think I believed my blog was helping others who had the same issues I did, and maybe it did a little. I felt like the writing was cathartic. When I recently went through my almost 1,000 published blogs, I de-published over 300 of them where I felt like I was just whining about being fat, and pushing the narrative that I was being lazy. I have been told by society for my entire life that fat people are lazy, and apparently I believe that narrative about myself. I spend so much time making sure I’m never sitting at home on the couch watching too much TV, when rest and relaxation is a normal part of life that “even fat people” should get to enjoy without guilt or shame. I had gastric bypass so that food and weight would not be my main focus in life, yet it seems like food and weight have remained in the starring role no matter what I do.
I went to Kaiser last week to discuss the GLP1 injections with my doctor. I was worried I was going to have a battle on my hands. She was actually sympathetic and willing to help, but her hands are tied by the insurance company (this is why HMOs should not be making our health decisions). I have to jump through hoops to get to the GLP1s. She handed me a to do list, which included a visit with a "health educator." That visit happened this week, and it was...enlightening, or maybe terrifying.
I was told by a Kaiser health educator that I should be doing one hour of cardio, seven days a week. Not a single mention of weight bearing exercises. I think 50 years of people running on treadmills has taught us that cardio is not the gold standard for weight loss. In fact, when I was my fattest (pre-weight loss surgery), I was going to the gym six to seven days a week. It certainly did not prevent the need for surgery. I was told that intermittent fasting is making people fat (sure, could be a problem for some, but not for others). I was told that half of my dinner plate should be vegetables (as a gastric bypass patient, we are taught that protein is first). I was also told not to eat too many nuts or avocados (she also lumped milk products in here, as if they are the same as nuts or avocados). She claims she has noticed a lot of people gaining weight from avocados. I would be willing to go out on a limb and say not a single person seeking help from Kaiser got fat from eating avocados. She also believes that a plant-based diet is best, although she understands how "Americans like their meat." I personally know two people who were vegetarian or vegan, and benefitted from adding some meat to their diet. No one says you have to run out and start eating rare steaks, but some bodies do benefit from animal protein. Never once did she ask me about my sugar intake. I feel like that should have been her first question.
I was a little shocked by the information given to me. I chose not to argue with her, and I feel sorry for anyone who doesn't know anything about nutrition and might believe everything that came out of her mouth. I swear she read a book about dieting from 1980 and just regurgitated it. One size fits all is just irresponsible, and I am saddened that a person who is supposed to be a health educator said any one of those things, let alone all of them in a single conversation.
I have a follow-up with my own doctor next month, and hope she will have something to help me move the scale in the "right" direction again. Before they consider the GLP1 injections, I have to try an oral medication. I don't need to be skinny, but I would like to feel less creaky. I am tired of feeling like I'm 80 years old every time I stand up.
Years ago, when I had gained weight after my foot surgery, I went gluten-free (well, gluten-less), and started eating a bunch of chicken tacos. However, I didn't otherwise change my life a ton. I was still going out, drinking and eating in restaurants. I was mostly doing whatever activity I was already doing (yoga and pole dancing). But I was able to shed about 30 pounds. I tried the chicken taco diet in January. Not a single pound lost. I went from drinking alcohol every night while we made dinner to once a week or less. No weight loss. I am swimming, doing yoga, riding bikes. No weight loss. Calories in versus calories out logic tells me that one of those things should have at least given me the courtesy of a few lost pounds. But I got nothing. I even started cold plunging in January. Certainly, I could freeze this fat off. I was gonna ramp up that metabolism and lose 50 pounds in two months! Nothing. (However, I will say that there are other benefits that keep me cold plunging. I will probably need to write a separate blog about that.)
After all this has been said, I already know that my happiness is not tied to the number on the scale. I am the happiest and most content now – at the second fattest weight I have ever been in my life. I am in a healthy relationship, I own a home, I have a good job, I live near several family members and get to see them almost daily. In fact, the only time in my life that I needed antidepressants was when I was at my lowest weight. So why is being thin still such an attractive ideal for me? I can't really answer that question, but I love that these new drugs are finally recognizing that weight issues are as complex as the people they reside in.
I don't really know about the future of this blog. I don't want to pretend that I have a huge audience out there still following me, waiting with bated breath for signs of life. However, I do miss the Nature Goddess hiking posts. Living farther away from my favorite places to hike (and having a dog who can't go to some of those favorite places with me), has slowed down my big (or far away) hiking adventures. For the time being, I will just leave it open ended. I hope to have some more posts along the way, but if I stop posting, it doesn't necessarily mean anything terrible has happened. Life is happening in the best possible way, and you can always check in on the Nature Goddess Facebook page for those updates.
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