WEIGHT-LOSS SURGERY AND TRANSFORMATION: An Essay In Several Parts

In December 2014 I had weight-loss surgery. People have been curious — why do it? What does it entail? Couldn’t you just diet and exercise? Indeed, a certain number of my questioners have little idea what “weight-loss surgery” means (why should they) and assume I somehow had 130 pounds of fat surgically removed. (One asked me if I “felt lighter” after the surgery, like a balloon. A charming thought, but no.) In fact, you weigh as much the day after surgery as you did the day before; the weight comes off gradually through – surprise – diet and exercise. But then, why have such surgery at all?

I am 60 years old. I have thought and read on the subject of obesity for decades, and it has brought me to certain conclusions you are free to disagree with violently. I’m going to address the things that led me here. I’m going to talk about being fat, and about not being fat, the latter experience being something I’ve only ever known for about a year. Along the way I hope to give you an idea, if you have not walked in these size-wide shoes, of what losing weight means for someone chronically obese; and why the usual advice as to how to go about it is so pointless.

Let’s begin with context. What does it mean to be fat, how does it affect your life? I know this is where people whose backs have been lashed with contempt want to get out their keyboards and argue that there’s nothing wrong with being fat, that it’s social disapproval that’s harmful. Others want to argue back and start talking about heart disease. I know this, for I am a curious soul, and I have read many pages of comments over the years, in many places. Both sides of the comment war strike me as daft — they tend to argue their certainties without definitions, as though there were no difference between healthy young women who are ten, thirty, maybe forty pounds “overweight,” and 800-pound sufferers trapped in their apartments. Clearly there is a continuum, and clearly there are people for whom weight is a major health issue, just as clearly there is an unhealthy social obsession with thinness at our current point in history. (I will note that as I wrote this last paragraph, I was casting a television show. If you think I would be permitted to cast a lead female role, or even a secondary role if it’s not comedic, with a woman as plump as the much-admired Gibson Girl of the 1900s, you are sadly uninformed.)

PART ONE: NOT OF OUR TRIBE

I find the reactions people have to weight fascinating. Whenever there’s an article that has anything to do with the subject at all, comments happen. Often highly personal, even angry comments — and I’m not talking about the ones from self-reported fat people. Recently someone asked a question: she’d noted that the comments about people in articles describing drug or alcohol addiction — though that was also behavior-related — showed much more sympathy than the comments about fat people. Why was that?

There was no good answer in that discussion, but I can tell you. The answer is simple. Fat people are disgusting.

I’m talking about a visceral, unthinking, unbidden response that is tied to the visual. That screams that fat people are inherently wrong, crooked, broken, and not of our tribe. Addiction doesn’t push the same buttons; unless the addict is actually shooting up in front of you or drunkenly vomiting on your shoes, the concept is abstract. A man or woman stands before you, perhaps dressed respectably. Therefore, they “struggle with addiction.” Fat people, however, take their visuals with them wherever they go. They are disgusting.

As anyone who is not of our tribe is disgusting. This used to apply to gay people; as a character in a book I read recently asked of a lesbian couple, “Don’t you find them revolting?” (The book was set in the 1970s.) I chose gay people for my first comparison because, like the obese, they historically had two tags attached:

1. You are different, in a bad way.

2. You should be ashamed of yourself!

First, because it’s all about behavior, right? Moral choice. No one’s putting a gun to your head and forcing you to sleep with someone of the same sex. Obviously you’re freely choosing to do things society disapproves of, because you’re a perverse and sinful person. Second, and more insidious, the mental picture conjured up of two men or two women doing that freaked straights the hell out. It was horrifying in its wrongness, and disgusting to contemplate; and part of the visceral violent response to, say, two men dancing in a public place, was how dare you put this in front of us! Bad enough it existed! Normal folk should not have the visual burned into their brains. You must be deliberately doing this to provoke us, the response went, for surely there could be no other reason.

Our recoil from anything that is different is something that, in a civilized society, we get past. Sex itself often strikes children as disgusting, but as we grow up, as we become accustomed to the idea and as we start to feel a pull in that direction ourselves, we move beyond and forget the initial reflex. And while imagining two people of the same sex in a carnal embrace would have disgusted people a few decades ago, now they’re taught to bypass that reflex if they feel it at all, to be embarrassed by it.

Oliver Sacks said, “The ‘absolutely other’ always seems uncanny and horrible and obscene and unholy and godforsaken.” But it’s the visual that pushes the button, that sticks in the craw of those most impulsively reactive. “Forcing” someone to see your enormous, jiggly thighs as you walk ahead of them is offensive and on some level, disturbing.

And the people most disturbed by it will show up in Internet comments. Of course, there are issues regarding weight on which it seems to me reasonable people can differ. What method airlines use to charge for seating, for instance; I may or may not agree with a particular argument, but I can see where a case can be made for the other side. Where it starts to get interesting is where the person arguing for fat people taking on an extra monetary burden will at some point, two or three exchanges in, finally let slip their inner loathing and say something like, “If they don’t like it, they need to put down their pie fork and waddle away from the table.” “Pie fork” is popular, though I remain blackly amused by the few who use phrases like, “I hope you enjoy using a stick to wipe your fat ass.” What begins as an apparently rational argument morphs into an online thermometer indicating the precise degree of righteous indignation and simple loathing on the part of those offended by proximity to fat.

You may be wondering if I’m over-estimating social disgust. “So, Egan, this is a mildly interesting theory of yours, but how could you prove it? You’d have to take a person who’d been blind for most of their life, give them their sight, and then check to see if they react to the visual of a morbidly obese person with an emotional disgust they’d never felt before. Good luck with — ”

I give you Crashing Through, the biography of Mike May, blinded by a chemical explosion at the age of three, who went on to win three bronze medals in the 1984 Paralympics and hold the record for downhill skiing by a person completely blind. At the age of 46, he got his sight back. But of course, when you’ve been blind for so long, vision must be re-learned. He gradually came to know his family and friends, to understand the meaning of shapes and colors. One day at Costco, he spotted a large object in an aisle, squarish and non-moving, and tried to figure out what it was. He asked his wife if it was a forklift. Embarrassed, she quickly whispered to him that it was a very heavy woman, perhaps 400 pounds or more.

Usually May liked to approach people and things, to learn more about them, to touch them if possible. This time he only wanted to get away. The woman disgusted him. He berated himself —

“But he could not stand down his contempt, the sense that her shape equaled sloth and laziness and maybe even slovenliness, that her shape equaled her. As the woman labored down the aisle May could really see her, and in the huff-and-puff of her walk he could envision her struggling to climb stairs, squeezing in beside him on an airplane, breathing. He raced to remind himself that he was the kind of man to empathize with such a plight, but his feeling overwhelmed him, and it said of the woman, ‘She disgusts me.'”

On the way home he told his wife he was ashamed to have reacted that way, to have formed an opinion about another person based solely on their appearance — that he knew very well people did that to the blind, and he didn’t want to be such a person. She assured him he was not that person. But she asked, “Have you always felt that way about very heavy people?” “That’s the thing,” he replied. “I never did when I was blind.

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This came as no surprise to me; I grew up an object of disgust and contempt. It was the 1960s, and the weight of the general population had not yet exploded to the heights it reached later. There were only two fat girls in my class — it was me and Marianne Moore, both strange and wrong and unworthy. The message came through every day, though I never spoke of it or engaged with it; it was the only way to maintain what little dignity I had.

I pretended not to hear things. I ignored. Sometimes, of course, things were arranged so that one could not ignore, and crowds would gather to see how you dealt with some confrontation or other. Usually it was simple humiliation to be gotten through, though there were times when the gauntlet led to some pummeling, or the threat of pummeling. The threat was as bad as the real thing; I remember one afternoon a group on my street demanded to see the fat kid’s newly sprouted underarm hair. (I was too nerdy to even know it was time to shave.) I refused. They headed for me, announcing their intention of holding me down, checking my pits, and maybe shaving me themselves — and I still remember my immediate panic. I grabbed my bike before they could mount theirs, just managed to out-distance them, and remained in hiding places around the neighborhood for hours, heart pounding, before I dared head home. I can’t even say why the idea so terrified me, but it did.

People I knew heaped verbal abuse; strangers occasionally added to it. It didn’t happen every day — except at home. My brother never called me by my actual name; he had a series of ugly nicknames that he cycled through, and my parents went along with it. “Where’s Flubber?” he might say, walking into the house, and I’d hear my mother reply, “She’s upstairs.” We’d go driving in the car, and he’d point at a sign and laugh: “Trucks over two tons not allowed. Get out of the car!” It was relentless, all day long, every day, often accompanied by a punch in the arm.

On TV I’d see things like The Sonny and Cher Show, where they did fat versions of classic shows like Gunsmoke (“Tonsmoke”). Everybody wore a fat suit, and whenever a food reference would come up in conversation (“He’s a CRACKERJACK shot!”) everyone would stop what they were doing, bend toward each other at the waist like clockwork automatons, rub their hands together, and mindlessly cry, “Yummmmmmm!” The stupidity of fat people was legion; you might see a movie where the fat girl and the fat boy in the diner laid into their giant milk shakes while assuring each other they’d lose weight because they were using a non-sugar sweetener in their coffee.

In books, I tore through the Beany Malone series, about a girl growing up in Colorado in the 1950s. In one, she helps another girl who is visiting in town to lose weight before she meets the boy she’d been pen pals with. The fat girl had had a fight with her family; she said that her sister had forbidden her from attending the sister’s wedding, simply because she was fat. I read on, assuming that eventually the girl would learn she’d misunderstood, that she’d been over-sensitive and too hyper-aware of her own weight, ascribing motives to the sister that weren’t really true. I suspected her attitude was the real problem. Later in the story, after she achieves a “normal” weight, she goes to her sister and apologizes, saying that she hadn’t understood what an unsightly object she’d been. I assumed that this was where the sister would set her straight as to the real reason she hadn’t wanted her at the wedding… but no. That was it. Because, really, who wants a fat sister at your wedding? (The degree of horrifying obesity here, by the way? Thirty pounds.)

As a fat child, my poor judgment and greed were evident, and created their own narrative. Once, on a rare occasion when my parents were away, I was forced to accept the 14-year-old daughter of neighbors as a babysitter. My mother had left me dinner, along with two or three Oreo cookies for dessert. I returned to school the next day to derision, where I was informed with avid interest (eyes on my face, how will she react?) that my babysitter had told everyone that I’d eaten “an entire box of cookies!” I think there was an imaginary bag of chips in there as well.

What can I say? Fat people are gluttons.

I was a teenager when Cass Elliot died. I heard it on the radio — that she’d choked on a ham sandwich. Having gone through this shit myself I was wary of fully believing the story; it seemed like such a mindless stereotype. Maybe someone had said, “She died so young, what could have caused it?” and someone else replied, “Ha! Bet she choked on a ham sandwich.” Whatever the kernel of gossip that began it, there’d be a rush to believe and repeat the story, because it would have a rough poetic justice in people’s minds: live by the sword, die by the sword. Moral superiority in spades.

I heard the story of her death confirmed by so many people over the years, I had to accept it as true. Sometimes that shit just happens. But just as I was writing this, I decided to check Wikipedia, because, well, decades later it still sounds like the kind of urban legend that would be spoken about a fat girl, and I wanted to be 100 certain.

Turns out it’s an urban legend. After all these years, I’m surprised. And yet, not. That kind of story has staying power.

As an adult, I almost never got the old familiar crap outright. The friends of fat people, in fact, will avoid ever uttering the word “fat” in any regard, with a hyper-sensitive tact that is both endearing and telling. Though you never know. A friend of mutual friends is a lawyer, who at a party once casually told us all she didn’t like to address a jury with fat people on it because they aren’t very bright and can’t follow her arguments. Hello! I thought. I’m right here in front of you! At another party, we all wrote down something our friends didn’t know about us on a slip of paper. I wrote, “I was once involved in a project to teach a chimpanzee sign language.” Someone else wrote, “I once won a pie-eating contest.” Upon hearing one of those slips read out, the lawyer turned to me playfully and said, “Dooooris?” I will let you guess which one.

This stuff doesn’t make me angry. It makes me tired, in an “oh for godsake” way.

So. Methodology. It became pretty clear to me, growing up, that I was in a hostile environment. I gave as few hostages as I could. But I was a cuckoo in the nest in any case, reading books nobody else saw the point of, so I set my sights on grander things and kept slogging ahead. This method, I find, is actually a good one for many difficulties in life; even today when fellow television writers talk to me about the frustrating choices of those with power over them, destroying good writing and rewarding evil, I say, “You know those blinders horses used to wear in the street, so they didn’t freak out? I’m just trying to pull my cart. There are some things I can’t afford to see or I can’t move ahead.” And I’ve always had a lot of moving ahead that I wanted to do.

I liked to think I escaped my trap, but I remember one day, a year or so after college, when I ran into a wealthy, slender friend from school; she had a lot of shopping to do, but suggested we meet later at Gucci’s and catch up. I hesitated — thinking, in all seriousness, will they let me into Gucci’s? I imagined some sleek, well-tailored fellow at the door barring my way, an impatient shake of his head as he directed me back onto the street. Like the angel with the flaming sword who blocked Adam and Eve from re-entering Paradise; after all, isn’t “fat” the outer evidence of inner sin, a corrupted soul, a bad character?

And all this fuck-uppery is quite aside from the physical health issues. So: given all the pain surrounding it, why do fat people even exist? By which I do not mean, why are they not all rounded up and sent off to camps for the unsightly. I mean, why do they not seek to end their suffering by changing the shapes of their bodies?

Clearly everyone has control over their weight. We know this, because people diet and lose weight, and they overeat and gain it. It’s so simple!

If it’s so damned simple, why are millions of people fat and miserable? Why can practically no one who has been morbidly obese for a long period of time lose weight and keep it off? Why do population statistics change so remarkably over time and geography? Are more Americans obese these days because Americans are just stupid? Do fat people not get how easier their lives would be if they could fit into plane seats, walk comfortably, have strong hearts?

PART TWO: THE FUCKING SCIENCE

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