It took me many years and an obesity surgery to accept that indeed I was not behaviourly responsible for my weight gain any more or less than another person might be behaviourly responsible for their cancer, brain tumour or aids.
The World Health Organisation (WHO) has recently listed Morbid Obesity as a chronic life threatening disease.
Obesity is a disease, not a choice.
Since childhood I believed that I was causing my own obesity and in my later adult life I desperately tried to find the underlying causes for my increasing weight gains. At times I looked into my psychology and the events in my life that had traumatised me, and other times I applied a lot of focus to an effort to understand diet and related subjects. All my soul searching and 'understanding' achieved nothing regarding a weightloss. It just left me even more bewildered, sad and fearful of my future. I dieted endlessly and am an honorary graduate with distinctions at the University of Diet and Nutrition. I also must confess to a lifelong experimentation with weightloss-related forms of Quackery in the hopes that indeed a magic pill existed. There is not a diet I have not attempted and there is not a pill or drug I have not taken, in many futile attempts to cure my obesity.
I have always wondered how, considering that I dieted for at least 60% of my life, I could have ended up obese. On average I ate far less than my slim husband who happily indulged in sweets and desserts while I ate lettuce and tuna fish. I was always hungry but I managed for a very long time not to overeat until I hit the 'morbidly obese' status and an all consuming insatiable hunger that drove me into pyschological despair along with a desperate need to eat.
Only after my surgery did I become aware of how I was, quite automatically and without any thought really, just slotting into a pretty normal eating pattern. I became aware that I was showing 'normality'....at last!!! For example I potently experienced for the first time in my life a feeling of having had enough! Of being full! Recently I have experienced hunger but it is not the same intense urge-driven hunger I used to live with. Now, I wave this hunger aside and can remain without food despite it. In the past I lived in an eternal, very confusing, hunger zone. I would eat and it would appear not to even dent this incredible driven hunger. I could not speak to anyone about this.
I was so ashamed and embaressed by my 'behaviour'. I felt I was truly living up to the stereotypical 'fat greedy pig' archetype. There were many many times that I would eat in incredible anger stuffing the food into this ever demanding insatiable body. There were times I ate in fear, knowing that even if I stuffed myself in an attempt to prevent it, too soon the hunger would be upon me again. There were times that I ate weeping, because it seemed so damn unfair that I could not enjoy my food in any way. There were times I ate secretly and guiltily because I was ashamed that I had no control. Often after these sad episodes I would fast in a bid to wholly remove myself from the misery of food.
There is an irony in these acts, because I was seeking the feeling of being satisfied, and it simply was never there for me no matter how much or how little I ate. The act of eating was actually a pretty horrible state of affairs for me. It was always fraught with underlying emotions. Now at last, I understand that the frustration of living with insatiable hunger and obesity caused these emotions. It was not the emotions causing the obesity as is so commonly thought. I know I was judging myself by what appeared to be my behaviour. Like most people today I bought into the conditioning that I was to blame for my condition. I could not see that beneath this terrible hunger, lay an obvious biological cause, the nature of which humanity is still in the process of discovering.
Currently there is talk of a hormone 'Grehlin' that is secreted in the stomach. It signals hunger to the brain. It seems very possible that in Obese people grehlin is oversecreted resulting in a compulsive type of hunger pattern. This is just one of many theories currently being investigated. Very recently it has also been put forward that a virus may be responsible for obesity. Research continues.
I am delighted that at last we are taking obesity out of the psychological, behavioural arena that it has been placed in for far too many abusive years. That there is a misfiring of vital signals or chemical-biological problem in morbid obesity just makes a lot of sense to me. Today I live in a different world regarding hunger, satiation, satisfaction, 'normality'...my behaviour has spontaneously changed with no effort or willpower on my part. I ask myself...where is the psychology now? Where is the driven, uncontrollable, extreme behaviour pattern I once knew so intimately for over twenty years of my life? If this was all 'in my head' then surely despite surgery, it would still be prevalent in my daily life?
In retrospect I am deeply saddened because I learnt to hate my body so much. It's apparent feedback to me was that I had no willpower and no self control. This was so far from the truth - really I had a very ilI body. Is it any wonder that so many of us obese people lack self confidence and are often battling depression? I bought into the years of conditioning done to us obese by the medical and media fraternity. I believed them when they said, all you need to do is control yourself. Nowadays that just looks like another insult and cruelty. When someone who is not obese says this, they simply do not get the bigger picture and all the ramifications that go with such ridiculous statements. Tell an aids victim to control his aids...tell a cancer victim to control her cancer..it is utterly ludicrous. People would take umbrage and lawsuits would be filed against such inhuman comments. But tell an obesity victim to control her obesity and that is regarded as helpful advice? I don't think so.
Lately I have had the amazing luxury of being able to relook the stigma from an objective viewpoint. I now understand that the issue has got absolutely nothing to do with self control or any other such nonsense that we have projected upon the obese population. If the 'control yourself' factor is going to not die the death it urgently needs to, then it at least needs to be put into a more constructive, realistic context. Perhaps we could say that self control regarding diet might, if you are extremely lucky, put the disease into a temporary remission or halt it's progress. Losing the weight is not impossible, but keeping it off has a lousy success rate. As, at best 2-5% of dieters will keep the lost weight off in the long term, to sell ongoing dieting as the answer to a serious often life threatening disease should be seen as a huge flaw in our thinking. You might as well tell a cancer sufferer that if they adhere to eating only green vegetables they will be cured of cancer.
Moreover, research is yet to be done into the longterm implications of depriving oneself of vital nutrition. 30% of Oesteoporosis cases can be directly linked to dieting and the idea that all dairy products are fattening may have caused many people to risk their bone health.
Is there a place for dieting? Yes, of course, but we need to develop some common sense about it as a society.
We have to really question if dieting is going to help or harm the morbidly obese further. I very tentatively think that if a person is just overweight, then dieting may be possible as a working solution? I further suspect that the 2-5% of dieters in the statistics who do keep the weight off longterm are mostly merely overweight and not yet in any way obese. And the line between being overweight and obese is oceanic in it's implications. I know this firsthand as this year I have been in both states. Currently I am medically considered overweight and yet I am in no way hindered by this fact...and it is simply impossible for me to compare now with how it was to be obese.
Naturally, surgery is not the answer for every obese person. As I have said before, it is only the solution for those of us who are medically ill, or psychologically unable to carry on - or a combo of these factors. But for those of us at this stage, it is life saving in many ways.
Obesity is a huge topic, perspectives differ, biology differs, opinion differs. For many obese people, surgery may not be possible and dieting, therapy or other means may be the only way they can attempt to prevent the disease progressing. It needs to be gently explained to them that dieting will be the biggest, most demanding part of their lives and that unfortunately they will have to live their lives doing it. There will be no stopping and starting if they want to use it to try to control weight gain...it must be a daily feature of their lives forever.
This way of life needs to be understood by the medical profession who all to often are flippant about it, not understanding how terribly hard it is to live like this. One thing I resented the most, when obese, was being told to diet as if this was so very easy! As if i had not embarked on many many diets before. I hated the patronising tones when I had studied nutrition for years - all to no avail! In reality dieting is violent and hard and it is terribly difficult to do when other issues are demanding ones attention. It takes a huge amount of planning, concentration, iron-clad willpower and it's downright depressing. Deprivation and resentment, guilt, anger and fear are all emotions that accompany it. Not to mention a constant battle against extreme biological hunger. Compassion, empathy, support and understanding are absolutely vital.
As for exercise...can we please get real! To normal-weights I say, just pop your mom on your back and walk around the block a few times. See if you feel great after that or if it improves your health in any way. That's what we obese carry if not more.
Although I have no medical expertise, I strongly question the idea that to exercise is healthy for the morbidly obese. At my peak weight exercise did not help me at all. It left me in an awful state of breathlessness, exhaustion and pain. The hernia's I developed are very possibly caused by attempts to exercise that I unwisely undertook. As for heart health... I think I was putting my heart under great strain and am lucky I didn't have a heart attack. When I see a morbidly obese person, red faced, blotchy, under intense strain, exercising doggedly, I am filled with admiration...but also a sense of horror that they might not be doing themselves any good. I have seen morbidly obese people looking like they were just about to keel over and die in front of me. At a certain point in obesity, even gentle exercise may be dangerous, not helpful. It cannot be healthful to stress an already over stressed system. While it is a difficult situation and an obese person is clearly caught up in a catch 22 by not exercising - it may be more useful for an obese person to focus on breathing exercises and extremely gentle stretching of the limbs.
Obese people don't hate exercise as is often assumed - they just cannot do it. Look at me now that I am almost normal BMI. Do I exercise - you bet I do! I LOVE to use my body and make it move. The exercise that once was so painful for me is now a pleasure and a joy. I did not change. My body has made this possible.
We need to look at the deep underlying causes of obesity and not mistake the symptoms of it for the causes. Increased hunger, for example, needs to be seen as a symptom that the disease is progressing. Overeating does not spring out of a vacumn. The closer the hunger signals the more entrenched and chronic is the disease. We need to begin to put aside the volume of mumbo-jumbo that we stupidly believe and begin to approach obesity intelligently. And with the same compassion that we give all other victims of disease.
As with all chronic disease, obesity has many components. There is no one answer. Also, because you are an individual, your obesity may have different causes to mine. I might have a 60% hormonal-biological componant, a 10% environmental factor, 20% genetic componant and 10% pyschological-behavioural componant. You might have entirely different percentages and some componants may not exist for you at all while you may have other componants that don't exist for me.
If you are battling obesity, I hope this page reassures you that there is no blame. On the evidence scientists have now, it is clear that obesity is a disease caused by factors beyond our control. If, like I used to, you still live daily with a terrible sense of guilt and shame and are embaressed by your body, please consider how you would behave towards anyone else suffering a life threatening progressive disease and treat yourself with the same empathy. Expect no less from other people, particulary medical professionals and dieticians - and don't hesitate to inform them when they require informing.
Free yourself from the immense psychological burdens you carry in as much as you can. I know from bitter experience that it is not easy. Learn as much as you can about the disease. Having facts and statistics is excellent armour against ignorant people pointing fingers and making unfounded hurtful judgements.
We who suffer on every concievable level from the terrible disease obesity and who are too often treated like lepers by others, have a vast but very vital challenge - and that is to wholly educate others who still percieve obesity in a narrow minded way. The only way forward is to break with a hideously cruel traditional and untrue way of thinking and to approach obesity with a new intelligence.