A little backstory:
For many years, I’ve noticed that my ability to take care of myself has interacted with my depression as well as various stressful life circumstances. As is the case when people struggle with depression, it can be hard to work out regularly, prepare well balanced meals, and do things for social support and self-care that typically would help you to feel better. This past year or two in particular has been quite difficult as I’ve recovered from a few traumatic life experiences and some major life changes. Since our bodies are fairly good at communicating distress, my body started to let me know in various ways that it wasn’t feeling so good: acid reflux, digestive issues, joint pain, chronic soreness, lack of energy/fatigue, and overall just not feeling good. Also, given my family history of diabetes type II, I was particularly worried when my A1C test showed pre-diabetic levels. It might be easy for someone in this position to say, “Well why didn’t you just start working out and eating healthier to manage these concerns?” Ha. Easier said than done when you are struggling with depression.
When someone close to me decided to have a gastric procedure to manage her health concerns and seemed to be feeling much better afterward, I wondered whether it might be something for me to consider. But there was a huge barrier in the way: my relationship with my body, my fat identity, and what it would mean to have a procedure that would dramatically alter my body size.
Let me back up for a second – what is the vertical sleeve gastrectomy or VSG?
Here’s a brief snippet from an email sent to family members that I wasn’t able to tell in person:
“Basically, they’ll remove the outer portion of my stomach that has certain hormones and controls metabolism (though everything will remain intact otherwise). Most people who have the procedure can go completely off of their health-related medications within a year, including those with diabetes, high bp, cholesterol, etc. And the other benefit that draws many people is that it allows your body to reset and adjust to a natural size without the limitations of typical weight loss attempts (i.e., of people who try to lose weight naturally, 95% regain the weight plus more within 3-5 years). So, I’ll have a smaller stomach, and I won’t be able to eat quite as much at meals and will have to have more frequent, smaller and slower meals. Because I can’t eat as much in general, I’ll have to prioritize protein and water, and as a precaution I’ll need to take certain vitamins to avoid nutrient deficiency. For the first 12-18 months while my body & hormones regulate, that also means my body and weight might change dramatically, which is honestly the part I’m most nervous & uncomfortable about.”
Discomfort about my body and weight changing
Ok, so this might feel a little ranty. I have worked for years to accept and love my body at all sizes, and I feel a great sense of pride and passion about being active in the fat acceptance, body positivity, and healthy at any size communities. But it wasn’t always like that.
Cue flashback to my childhood:
I was deemed a “fat kid” after I hit puberty earlier than most of my peers in later elementary school, and while my chest developed earlier than my friends (which tbh was pretty cool), my body also expanded by the time I was in middle school. I can remember dieting as early as 7th grade when I started restricting during lunchtime in the cafeteria with my friends (who looking back I realized weren’t really my friends, because many of them poked fun at me and my body). There’s a joke in my family about the time I became “vegetarian” and would only eat cheese and mayonnaise sandwiches, though in my mind this was a way to control my body size. In terms of how I felt about myself, I vividly remember writing a letter to Montel Williams (keep up young people, he was a very cool talk show host at one time). I asked him to “fix” all of the things I didn’t like about myself, including my crooked teeth, my four eyes, my acne, and to help me lose weight. My mom found that letter and said, “if you’re going to write a letter to a talk show host, at least write to Oprah” (she’s got jokes). My mom did take me to get braces & contacts after that – thanks, Mom. I can’t remember anyone in my family saying anything negative about my body when I was younger, thankfully, or if they did, I might have blocked it out. My grandparents loved me so much and I’ve always felt unconditionally seen by them (miss you every day Nana).
I do remember being so proud of the first “official diet” I went on, which might have been shortly after graduating high school. My mom and I joined Weight Watchers (I’m choosing not to talk about the oppressive diet culture that “WW” creates, ugh). Good memories with my mom, counting points together, comparing weight loss, food shopping and making things together. I lost a whole bunch of weight that time, and I would go on to re-gain and re-lose that weight over and over in the years ahead through a series of major and minor diets, each time gaining it all back plus some, each time destroying my metabolism a bit more, and each time feeling like a failure because I didn’t have the will power to control my weight, to manipulate my body into looking the way its “supposed” to look.
In terms of exercise, I had always been actively involved in various groups and sports, but I was never athletic…running was not fun for me. At all. In fact, a few years ago I ran a race series when I lived in NH. Not because I thought it would be fun, but because a friend begged me to do it with her and I would get a free jacket in the end. I love that jacket. So, excessive exercise is something I’ve never done to manage my weight, though I do often wonder if I might have felt differently about my body if I were more athletic? It wasn’t until I discovered Aqua Zumba as a group exercise instructor that I realized how much I loved being physical for the things that I find enjoyable.
Right: Me doing one of my favorite things as an Aqua Zumba Instructor
OK, OK, back to the point:
I’ve worked really hard to unlearn those years of diet culture, body expectations, the idea that we should control and manage our weight, the idea that fat bodies are bad bodies, the idea that fat = unhealthy, and that I can’t be happy unless my body looks a certain way. Today, I love my body for what it does for me. I have strong legs, curvy assets, and bold/beautiful hair. I am anti-diet, pro-fat, pro-health, body positive, an intuitive eater (most of the time), and I basically never comment on anyone’s body size, including my own.
At all, even if it might be felt positively by the person.
I’ve learned that when we say to people, “oh my gosh you look great, have you lost weight?” what we’re actually saying is, “you know, your body was less desirable before, so I’m really glad you’re conforming to the idea of what society thinks your body should look like by restricting food and punishing your body for enjoying food.” I’ve embraced the word “FAT” for myself as a descriptive term that feels empowering, just like you might call me a white, short, blonde-haired, able-bodied person. Why is fat such a bad word? I feel strongly that other words typically used to describe fat people (let’s just call them the “o” words) are part of the problem, where we diagnose and label people as being too much of something, that they don’t deserve the term “normal” until they have restricted and shrunk their bodies to a size that feels acceptable (and don’t even get me started on the ways the medical community has fueled the fire of oppression against fat bodies, pfft, still recommending weight loss when it is a treatment that causes the exact opposite effect for 95% of people).
On being fat & having VSG:
Many people who decide to have the sleeve gastrectomy or gastric bypass are not only dealing with a history of health issues, but also have struggled for years with their weight and messages about their “bad bodies.” It makes perfect sense then that these procedures would be a great way for them to “finally get control” over their body – to achieve the body size they could only dream of because of their many failed attempts at dieting, right???
Nope!
Unfortunately, what I’ve noticed is that when people haven’t done the work to love and accept their bodies at all sizes, those chronic ideas about weight, dieting, and fears of weight re-gain still persist even after someone has lost tons of weight and maintained most of it for several years. In all but one of the VSG-related social media pages I follow, there are repeatedly posts by people who feel desperate to avoid weight re-gain, shaming themselves about what they ate, blaming themselves for failure due to re-gained weight, and posting constantly before-after photos, measurements, sharing weight loss numbers, etc. It’s pervasive and deeply triggering for someone like myself. The one safe haven I found that seems like a great resource is an intuitive eating page for those who have had gastric procedures…one out of so many options. It’s been really hard to feel like I can connect and identify with others who have had the procedure who also have a similar approach to loving their bodies and not dieting.
On the other hand, I also feel like my membership in the fat acceptance, body positivity, and healthy at any size communities has been compromised. Many of the messages center around the ways that our society needs to change to make space for and respect people of all sizes and identities – especially fat people who are constantly oppressed and given messages of not being good enough, healthy enough, worthwhile of deserving respect, quality medical care, etc. The idea of a fat person undergoing a surgery that will shrink their body seems to fly in the face of body love and acceptance. So, when I first started telling family and friends about my decision to have the surgery, I made sure to emphasize strongly how much this was not about the weight,that I wanted to feel better health-wise and didn’t care about the weight loss.
Soon after, I realized I was also trying to place myself on a pedestal above the others who did care about the weight loss. Of course those individuals who struggle with body image and dieting would resort to a major surgery! They’ve been told that being fat is bad, that they are unhealthy because they are fat, and that the way to become healthy is to be less fat. We become desperate to feel better, to be treated as humans, to be seen as “normal.” Just like people of all identities deserve the right to do whatever the heck they want to their own bodies as long as they understand the risks of whatever procedure it is (shout out to trans/non-binary folks, and to women considering abortion), fat people are able to make their own decisions about their bodies, their health, and the way they want their bodies to change.
Ragen Chastain is an amazing activist who has The Underpants Rule – “everyone is the boss of their own underpants so you get to choose for you and other people get to choose for them and it’s not your job to tell other people what to do.” The bottom line is, people shouldn’t feel pressure to make this decision based on the way they’ve been treated, the way society tells them they’re less deserving of respect, and to fit into this “ideal body size” that isn’t realistic or necessary.
So why did I ultimately decide to have the procedure?
To be honest, I’ve been against gastric procedures for years. I believed that people were having life threatening procedures to fit into the ideals of beauty and size, which felt outrageously harmful. When a person close to me shared that she had decided to have the procedure, I was convinced that she was only doing it for weight loss, and I avoided conversations about it with her because I was so worried about the risks. In an honest conversation with my doctor (who is an amazing human being that supports my anti-diet, anti-weight-talk philosophy), I reflected that I wished I had some significant medical condition that would allow me to justify the procedure, because I didn’t want to do it for weight loss reasons. My doctor was so gentle and 100% supportive in letting me know that if I wanted to consider the procedure for health reasons, she believed I would qualify and referred me to a center where her patients had a lot of positive experiences (shout out to Mount Auburn WMC in Waltham, MA). After attending a day long “immersion” program to learn more about the procedure, I felt much more confident about the option for my health and my body.
The primary reason I decided that this procedure made sense for me and my body is because it will increase my chances of successfully becoming pregnant and having a healthy pregnancy, which I’m hoping to do in the next few years. Since I’m 34, queer and currently single, there’s a chance I will need to do in vitro, so I want to have the best possible chance the first time due to the exorbitant costs of creating a baby. Another reason is because apparently people who have the procedure reduce their risk of breast cancer by up to 60% – my grandmother died of breast cancer in 2010 and women in my family tend to die young, so I’d like to minimize my risk. But overall, I just want to feel better and get back to taking care of myself in the way I know works best for me.
My surgery:
On Monday, 2/4/19, I had my VSG surgery at Mount Auburn Hospital in Cambridge, MA. My dad flew up from Raleigh, NC for a few days to help, which was amazing!! I didn’t realize how comforting it would be to have someone here during such a vulnerable time. He was a good choice, because he’s very nurturing, and I felt like our relationship could withstand any tension if I wasn’t feeling my best. Monday was pretty awful after the surgery, because there is a lot of gas pain built up in your chest and shoulder from the procedure, so I was pretty whiney. I slept A LOT on Monday and Tuesday. Each day since then has gotten a little easier, a little less painful, and I’ve felt more and more back to myself.
I’m still feeling pain in my stomach (5 mini laprascopic incisions), but otherwise feeling pretty good. And I’ve been focusing mostly on liquid-like foods, drinking lots of protein shakes, crystal light, and eating pudding, yogurt, jello, and soup. Last night, I had my first solid food since the surgery – a scrambled egg never tasted soooo yummy!!
And it will only continue to get better from here. I won’t be restricting myself from any foods in particular, unless they don’t make my body feel good. But so far, no major taste changes, and I’ve tolerated everything really well. My surgeon and dietician were surprised to hear how much protein and fluids I’ve gotten down. As my body heals and I reintroduce foods over time, I’ll be focusing on intuitive eating while prioritizing protein and fluids throughout the day to make sure I keep my body healing, satisfied, energized, hydrated, and full.
In Closing…
Thanks for reading. It means a lot that I can openly share this journey with the people I care about and with people who care to learn about my journey.
Fat (Positive) & Healthy 