Tuesday, March 19, 2013

On the Sidelines

I started to seriously pick up weight around the time that I entered the 3rd grade. Before then, I was a fairly average kid. By the age of 11, my life in school was a daily hell of bullying by kids who loved nothing more than to say ugly things to both my sister and me about our bodies.

There was nothing I hated worse than riding the school bus. As the first kids on and the last kids off, we were subjected to a total of an hour and a half of potential teasing, tormenting, and abuse five days a week. School was no great shakes, but riding the bus, in which kids were rarely monitored for anything other than standing up or getting loud enough to annoy the driver, was far worse.

One day, after a particularly brutal session of bullying by the kids riding the bus with us, I snapped. As the two of us were ready to disembark the soon to be empty bus, I started screaming at the driver in frustration for his failure to protect me from the suffering I endured day after day. At that point, I had spent at least 3 years being tormented and I could not fathom why an adult in a position of authority would do nothing while that went on so openly and blatantly.

My sister stood behind me as I laid into him in the manner that a 12 year-old can do. When I was done and stepped off the bus in tears, he essentially said something to her which was tantamount to, 'what's her problem?' I'm not sure if he genuinely had no idea what went on on that bus, or if he simply felt that I had no reason to expect him as the only adult  present to look out for my welfare, but he seemed perplexed at how upset I was.

The truth is that many adults stood on the sidelines as I moved from being a child to a young adult and did nothing to stop the suffering being inflicted upon me. Teachers knew I was being teased mercilessly about my weight. A few of them did a little extra nurturing of me by praising me in class for my artistic ability or my intelligence, but none ever tried to step between me and the abuse or to put a stop to it.

I don't know if things would be different in this day and age in schools. The repercussions of being the responsible adult and not stepping in while a kid is abused in some fashion may be enough of a threat to get an adult to step in nowadays, but I somehow doubt it. There was a news story in the last year or so about a fat boy in Australia who was being tormented by a smaller boy (including being hit) who got fed up and picked his tormenter up and dropped him on his head (in a move he emulated from a pro wrestler). The internet applauded the tormented boy while some parents fretted that the bigger boy could have harmed the smaller one.

It has seemed to me all too often that the world has stood by while I was hurt by people because of my body. I spent many years of my life full of anger because of this. Starting at a young age, I felt vulnerable and like someone should be protecting me. When no one did, and, indeed, when I was often told by various "caring" adults that I wouldn't be teased if I lost weight, I just felt more hostile and resentful. They were blaming me for my pain, rather than placing the fault on those who inflicted it.

As a kid, and even as a teen, I didn't know why I was so fat in light of the fact that I never ate the sorts of food believed to make you fat back then (cookies, chips, soda, pastries). I saw skinny people eat that sort of stuff and they never gained weight. I ate boring food that poor people ate like potatoes, white bread that cost 30 cents a loaf, cheap cuts of meat, and pasta. None of that stuff was the stereotypical stuff of fatness. Of course, now I know better about the factors that contributed to my childhood obesity. Then, I just was a poor kid being fed what my parents provided me and being criticized for not eating what was cooked simultaneously with being taken to task for being fat.

Emotionally, I felt vulnerable on all fronts. Kids hurt me. Adults validated the manner in which they hurt me by saying it was my fault. If I just conformed, they would leave me alone. The seeds of self-loathing and world-hating were being planted every day in deep soil. They would grow for many more years than they would lie fallow.

I realize how profound an effect the situation in which I grew up had on me. If you put an animal in a cage and poke at it repeatedly with sticks or shock it with cattle prods, it will grow increasingly hostile and defensive. If even the most caring of individuals tries to approach such an animal, it will attack first as a defensive measure. In a world that hates fat people and isn't afraid to let them know it, I think we're going to see a lot more people developing a personality in line with the constant abuse they suffer. That will be the subject of my next post.

Monday, March 11, 2013

Not mentally ill, just big-boned

In my previous post, I talked about "normal" and "abnormal" and how such things impact how we are treated. People tend to think that the purpose of psychological treatment is to target "abnormal" and to make it "normal". That is not the of purpose psychological intervention or study. It has never been and never will be about reshaping people to some sort of acceptable average or filing off their quirks and character traits so that we are all the same.

In fact, there are critical rules for when something is considered pathological as opposed to merely "different". Unless you are demonstrably and clearly a danger to yourself or others, there is actually no way in which someone can force you to be treated. Most people who see therapists are going to them because they have problems they want help with. No one is making them change. They want to change. It's not about forcing "normal" on them, but rather their desire to find a new "normal" for themselves.

"Normal", as I said in my previous post, is a relative state within a system, but it also can be a reflection of where one falls in a statistical range. Recently, it was announced that narcissistic personality disorder was being removed from the "bible" of psychological disorder diagnoses, the DSM. In the DSM V (currently, the DSM-IV-TR is in use), narcissistic personality disorder will not appear. The reason for this is that self-absorption and self-involvement are so prevalent in society in the internet age that these are no longer considered atypical behaviors. What is more, and this is critical, they are no longer considered personality aspects which lead to functional impairment in the current social order. When everyone is self-involved, it is seen as  "normal" within the system and those who display such traits are accepted rather than rejected when it comes to jobs and relationships.

I mention this situation because it is important to remember that what is considered "disordered" and "normal" are fluid. Just as a mental state that was once considered a problem can disappear when the zeitgeist catches up with it, a mental state which wasn't a problem in the past can become one now. Changes in society can erase the idea of abnormality, and they can create new abnormal states.

The two core aspects, statistics and functionality, are important to consider when thinking about whether something should be considered a psychological disease. The former is not enough to consider a behavior or state a disease that one would do well to treat. Statistically, there may be few people who are hearing the voice of God in their heads on a regular basis, but their state is not of concern until it interferes with their functioning. If such a person can live a life as a productive member of society or at (least a non-disruptive and independent member) regardless of their atypical state, it does not matter whether they receive treatment. No one will force someone who is capable of self-care and who is not interfering with others to be treated no matter what their mental condition.

Of course, people who hear voices are often unable to function because their impairment is so great that they cannot survive in society. Indeed, there is an extremely high rate (50%) of self-injury (either suicide or self-mutilation ) among people with psychotic disorders such as schizophrenia. They are not only distracted and troubled by the voices they hear, but they are driven to harm. However, it is not unheard of that extraordinary people who suffer such disorders can develop the capacity to cope with their problems without psychiatric or pharmacological intervention.

This was the subject of the movie, "A Beautiful Mind". However, such people are extremely rare and their anecdotal cases cannot be used as reasons to fail to treat others with their condition or as an excuse to "depatholigize" a pathological condition. If you are one among thousands who has a condition and does not suffer functionally for it, that is not a reason to expect that others will manage in the same manner as you. Such exceptions are inspiring, but are nearly meaningless is the greater scheme of things.

So, while a handful of critically mentally ill people are capable of functioning despite their atypical life circumstances, the vast majority will require treatment to improve their quality of life and be functional. A necessary precursor to treatment is diagnosis, and that's why things like the DSM exist. It's also why obesity is currently being considered for insertion as a mental disorder into the DSM V.

The idea that obesity is a mental health issue is hotly debated both by laymen and experts. Personally, I think that obesity is a physical state and a symptom of a potential mental disorder or a set of disorders. The state of being obese is not, in and of itself, anything other than a reflection of body composition in regards to fat percentage. Sometimes it has an organic basis and sometimes it has a mental one. Whether you are super skinny or super fat, your functioning in life is impeded and the underlying issue, whether medical or psychological or both, could be improved if treated.

Just as an anorectic's skeletal appearance reflects deep emotional problems, the super fat person's body size also very likely reflects deep problems. The notion that one extreme is a mental disorder and the other is not seems absurd. Starving yourself to dysfunction and possible death is a mental health issue. Why isn't eating yourself to dysfunction and death one as well? This seems illogical and hypocritical.

The answer to why being super obese isn't a sign that someone has a mental disorder is, my opinion, because of both prejudice and a lot of denial. The prejudice comes from people who think that fat people are gluttons who lack self-control and if they merely exercised some restraint and moved around more, they wouldn't be fat. This is an oversimplification which is gratifying to those who need to elevate their self-worth at the expense of others. It's not seen as a mental health issue, it's a deficiency of character.

The aforementioned denial comes from the very people who could be helped by a DSM V classification of obesity or an obesity-related mental state diagnosis. The claim is that 'they're not mentally ill, they're just big-boned'. There are numerous assertions about the compositions of their diets, homeostasis, exercise habits, health issues, etc. as ways of explaining being super fat.

I have no doubt that some people are naturally fat, just as some people are naturally thin. I also have little doubt that most women of average height and build (excluding the very tall, very short, and very muscular) are not naturally at a homeostatic point over 200 lbs. and most men at a point over 250 lbs. Even if you were born to be fat, chances are you weren't born to be super fat. There is either an underlying biological issue that needs some attention or a psychological one (or both).

Without a doubt, there are many organic disorders and medications that can make someone obese. No small number of drugs are known to induce metabolic syndrome and taking them requires a concurrent change in lifestyle which can be seen as "unfair." People on such drugs have to eat far fewer calories and often limit carbohydrates compared to an average person. Emotionally and physically, this can be very hard, but such restriction does not result in a loss of health due to poor nutrition. It just is very, very hard to accept that you eat 1500 calories a day and struggle not to gain weight while another person can eat 2500 a day and not worry. It's also terribly difficult to be hungry all of the time because of this type of restriction.

That being said, I personally believe the inability to comply with such restricted diets is largely (but not entirely) psychological for most people. I've been researching a lot of underweight people's lifestyles and behaviors and what I have found is that such people actually don't eat much. Many quite thin people really do just "go hungry" for so long that they learn to ignore hunger.

There's a BBC television show called "Supersize Vs. Super Skinny" that can be viewed for free on YouTube which gives a lot of anecdotal examples of the differences in eating habits between very  heavy and very thin people. It goes some way toward showing different mindsets as well as different habits. People who don't have eating disorders view food and hunger differently than those of us who do. While I don't think someone who has been fat will ever tolerate hunger as well as someone who has never been fat (because having been fat, especially for a lot of your life fundamentally changes biochemistry), I do believe one can use behavioral techniques to stretch their tolerance levels and re-frame the role of food in their lives to help improve their relationship with food. 

The fact that obesity can be brought on by drugs or organic conditions does not negate treating it or regarding it as a pathological condition. There are many organic disorders that can create psychoses, anxiety, depression, and antisocial behavior. These include brain tumors, cancers, thyroid problems, and hormonal imbalances. All of those disorders when brought on by organic or pharmacological agents are treated with concurrent medical intervention and therapy. Why should obesity, especially super obese states, be regarded differently than these other conditions? Why is it simply explained away by fat activists as being a natural state of being for some people? Well, because fat people don't want to see themselves as "sick". They just want to see themselves as fat.

Here's the thing, crazy people often don't think they're sick either. It often takes significant pressure or serious difficulty in functioning for them to come to terms with their illness. Even for those who are seriously ill, and they might be cutting themselves, drinking cleaning fluids, and beheading people on buses, they are sure they are behaving rationally.

Weighing 300+ pounds at average or near average height and saying you are in no way sick borders on the absurd. Something is wrong somewhere. Such a body will not function well in the long run and many are not performing optimally in the short haul either. Sure, there are some cases of very heavy people who are extraordinarily healthy and mobile. They are the stuff of an obesity-based version of "A Beautiful Mind", but their cases are not typical and cannot be generalized to everyone who is morbidly obese or super obese.

I'm not saying fat people are crazy, but I am saying there's a mental health issue in many cases (along with an accompanying physical one in most cases as well) and denying it doesn't change the fact that functionality is impeded, quality of life is degraded, and relationships with food are disordered. Anorectics, incidentally, similarly feel (off and on) that there is nothing wrong with their weight or relationship with food. It's not them that has a problem, it's the rest of the world. These days, fat advocates say the same thing. It's not them that has a problem, it's the rest of the world.

The question of whether obesity is a sign of a mental disorder is a tricky one because the media so often focuses on the symptoms rather than the causes. Just as being skinny (not mentally ill) isn't the same as being anorexic (mentally ill), being obese isn't the same as being super obese and engaging in the behaviors that made one so. What is more, anorexia is not a bodily state. It is a set of behaviors and thinking that result in a bodily state. Classifying obesity as a mental disorder is wrong, but classifying the set of behaviors that lead to a level of obesity that creates functional impairment would be a step toward dealing with the problem productively and without political and judgmental statements.

The bottom line is that I believe that there is a set of behaviors that lead to super obesity. A new term, I might suggest "redundorexia" (excess appetite, which is the opposite of anorexia or no appetite), might be in order. The term would not refer to body size, though body size would be one of the symptoms. It would refer to a set of behaviors that result in obesity that functionally impairs someone. Now I will say that, if such a disorder existed, I would be diagnosed with it (possibly with it being seen as being in a state of remission at present, possibly not). The characteristics would be as follows:
  • high body weight (at least obese, if not class 1 or 2 obesity)
  • strong identification with body size
  • restriction of social or work activities due to feelings related to body size
  • feelings of dissociation of mind from body (e.g., the sense that the body has betrayed one or that one exists separately from ones body)
  • inability to operate in the world due to body size (e.g., inability to use public facilities like stall-size toilets, ride on airplanes due to seat size, etc.)
  • physical impairment due to comorbid health issues brought on by body size (e.g., back pain, type 2 diabetes, joint pain, edema, etc.)
  • impairment of relationships due to body size (including conflict over weight with significant others, inability to be physically intimate for physical or psychological reasons, misdirected anger or paranoia about being judged because of ones weight, etc.)
  • preoccupation with food or dietary habits
  • anxiety about eating in front of others
  • inability to moderate eating habits despite repeated attempts (e.g., repeated attempts at "dieting")
  • hidden eating/hiding food
  • moralizing of food and changes in self-esteem in line with what sort of food one eats ("good food"/"bad food")
This is not a complete list of potential issues, and certain other disorders (comorbidities) would be common. In particular, anxiety and depression would often accompany a diagnosis with an obesity-related mental disorder.As is the case with all DSM disorders, one would have to meet all or a certain high number of these criteria in order to be considered to have such a disorder and those behaviors would have to persist over a long period of time (at least a year, if not longer). Merely having several would not be enough and engaging in them only occasionally would also not be enough. Most people have experienced some of these attributes, if not all of them, on occasion in their lives. Persistent suffering is always a part of whether or not someone has an actual disorder.

Why am I talking about diagnosing obesity-related behaviors as a mental health disorder? Well, I'm talking about it because it would be a significant step forward in dealing with the problem in a manner which does not blame the sufferer as well as create a system which would facilitate treatment. Before there was a term for H.I.V., there wasn't a treatment system. There was just labeling and blame, especially in the gay community.

Beyond the fact that a diagnosis will create a system for research and treatment, it also creates an economic avenue for receiving help. Insurance companies won't pay for things which are not officially called diseases. If you are obese and want therapy for your condition, it's harder to get your insurance company to pay for it than something like bariatric surgery. They recognize that being fat is a health issue, but not a mental health issue. If you want CBT (cognitive behavioral therapy) to deal with your food relationship, you may or may not get insurance coverage for it.

Mental disorders come and go with the times as we can see by the removal of narcissistic personality disorder from the DSM. Given modern lifestyles, I think it's more than past the time that "redundorexia" or something to that effect was added to the list of possible mental health disorders. In my next post, there is another related disorder which I have noticed has evolved as a result of the obesity epidemic and the manner in which fat people are treated.

Saturday, March 9, 2013

What "Normal" Is

As some of my readers may recall, I've been taking a graduate school class with my husband over the past couple of months. I'm able to do this because his school graciously allows partners to audit (take part, but receive no official credit) one class per year. The experience has been an emotional one for me on many levels, but has failed to significantly challenge me intellectually for the most part.

The "emotional" aspect has come from being faced with the various personalities of the participants (of which there are about a dozen) and the perspectives they present. All of them are younger than me, and have significantly different (and more limited) life experiences. Sometimes, I'm very frustrated at the myopia they exhibit, but much more frustration is elicited by the lack of critical thinking that is displayed.

The dearth of critical thinking is shown in a variety of areas, but one in which many psychology students struggle is with the notion of normality. At my husband's school in particular, an institution which is more expansive, open-minded, and embraces a holistic approach to living, healing, and mental illness, the idea that "normal" can be defined is more resisted than among the population at large. These are people who are in that place because they reject conventional thinking on multiple levels, and that means they do not want to pigeonhole or embrace concepts that are as limited as a notion of "normal".

While I think it is important not to try to reshape everyone into a round shape so they can be placed in the corresponding round hole, the notion of "normal" is of value and embracing it should not be viewed as a destructive pattern of thought. The idea of defining it should not be seen as an effort to marginalize, isolate, or pathologize people, but rather to understand states which create the greatest functionality and healing.

I'm talking about the concept of "normal" here because, in terms of body weight, the idea of "normal" is very controversial. Often, it is medically determined in a manner which simplifies rather than rationally explains why body size matters. That being said, I don't believe the concept of a "normal" weight has to be considered a toxic means of straitjacketing the populace into fitting into socially or medically determined forms. A more complex and nuanced notion of "normal" in terms of all things, not just weight, is of value. To that end, I have been pondering the idea of "normal" as of late.

The first thing that is important to keep in mind is that "normal" is a relative state. What is more, it is relative within various "systems". For example, hearing voices, taking hallucinogenic compounds, and sacrificing animals is normal within some tribal systems that have shamanistic practices. That being said, though these activities and experiences are generally normal, they are only appropriate (and therefore "normal") in certain settings. Even in societies in which hearing voices is a normal part of ritual experiences, it is not a normal part of everyday life. A person who is actively psychotic and hears voices outside of the ritual setting (and who is not an appointed individual for whom such experiences are considered part of their role) are definitively deemed abnormal and will be socially isolated, rejected, or marginalized.

Similarly, certain types of dress are utterly normal within a certain system, but would be considered inappropriate and "abnormal" in more mundane ones. If I were to wear an evening gown to an orchestral performance, it would be seen as "normal". If I were to wear one to work, it would be considered "abnormal". Context matters. The system you are operating within determines whether or not you are "normal".

This leads me to talk of body size and appearance. Part of what got me intro trouble recently on Facebook was talking about one of the more zealous fat activists and how she looks. I asserted that her appearance, which is far outside the mainstream in ways unrelated to her weight, muddles her ability to represent the oppression that fat people endure. In no way did I say that the obese and especially the super obese (so-called "death fats", of which I have been a part of for the vast majority of my life) are not treated abysmally and with great cruelty. However, what I said was that her extremely atypical choice of style of appearance muddled the picture significantly and made her a poor choice of example for how fat people are publicly humiliated.

The truth is all people who appear "strange" will elicit abuse, and I cited an article in a psychology journal in support of this notion. Unfortunately, I can't link to it here because it's an academic article behind a pay wall that I could only access via my husband's academic account, but you'll have to trust me when I say the study exists and that what I say about it is true. That study was conducted with normal weight people who dressed, styled their hair, etc. in highly atypical fashion. They wore large polka dot prints or other "loud" patterns and displayed unusual hair coloring. The purpose of the study was to measure the responses of strangers who encountered these unusually groomed and attired people in public. The results showed that, quite overwhelmingly, "abnormal" appearance elicited aggression. This happened when weight was not a factor.

So, I think if you are going to hold your treatment out there as a fat person and say that you are abused, you have to "control" for this factor. It muddles the picture if you are both very fat and dress in a manner which the society you are operating in deems "abnormal". If your clothing and style choices are far outside the norm, it will be very difficult to tell whether you are treated poorly because you are fat or because of your unusual style. Beyond confusing the true motivation among bystanders for their negative attention, it also undermines the sympathy of others when hearing your story. They will look at the strangely dressed person and not think, "she's abused because she's fat," but rather, "she's abused because she dresses so weirdly." It undercuts the potential for empathy and harms the cause of fat activism.

My talking about this is not to be confused with condoning the abuse of anyone based on appearance. I don't care what people dress like or look like. I spent more than enough years of my life being treated like a walking pile of fat garbage to condone the abusive behavior people heap on others for their appearance. What I'm doing here is talking about the reality, not making an excuse for it.

The reality, very likely, is informed by evolutionary forces. Our distant ancestors that responded aggressively to those who appeared markedly different very likely survived. Those who were tolerant and accepted likely did not. Conformity promotes recognition among the tribe and means that you will see the enemy as the enemy and a friend as a friend. Bystanders who see a stranger who looks weird (or acts strangely) are therefore fearful and become aggressive and they probably don't give a second thought to whether or not the response is rational.

There's probably some part of their brain in the amygdala (the home of our aggressive and fearful responses for the most part) that activates. In order not to have those feelings, they must engage in active suppression and process cognitively. Such processing requires awareness, energy, and the taking of an advanced perspective that people are unlikely to do simply to benefit a random stranger. The question of whether they "should" do it is another one entirely. Of course, they "should", but we do not yet live in a world in which children are taught to question and mitigate this response at a young age, and that is where the process should start.

My purpose in broaching this topic is not to explain what happened on Facebook and upset someone else. This is actually only part of the picture and, as I said before, I was at fault because of how I characterized the individual in question (in a manner which was uncharacteristically derogatory and which I apologized for twice). This is just the start of my talking about conclusions I've reached about the "fat mindset" and my feelings about obesity as a mental disorder. The reason I'm talking about "normal" and how "abnormal" is to set the stage for what will no doubt be a series of posts about the topic that will lead up to my conclusions.

The bottom line is that being super fat is not "normal" within the current systems in most societies. Aggressive responses to abnormal appearance are, unfortunately, a part of human nature regardless of the reasons or shape of that "abnormality". Well-meaning and self-serving attempts to "normalize" atypical behavior across the board will not change the reality of human biochemical responses to that which is markedly different and one cannot control the behavior of others, particularly when they are operating in line with societal norms and biochemical responses beyond their control. Just as they cannot easily regulate their heart beat, they cannot stop the rush of chemicals that create an aggressive response when they experience something which is not normal within their system. This is, in essence, where the seeds of what is considered pathological are sown.

Thursday, March 7, 2013


Me at age 12, wearing the sort of stretch pants my mother bought for me which helped make me even more of a social pariah than I already was as a result of my weight.

Recently, in an exchange on Facebook in which I was frankly at least somewhat (if not greatly) out of line, one of my friends by way of the internet seemed to be saying that, since I'm no longer living in the "death fat" range of weight, I can't understand or appreciate the value of fat activists. I cannot say whether or not this is true. The truth is that I wasn't in the fat activism camp even when I was in the super morbidly obese weight range. I always had problems with the skewed manner in which many of them frame their world and the denial of the health problems that come along with being super morbidly obese.

I can't speak to how having lost weight may have impacted my view of the value of fat activists. I can only say that, the implication that I can't relate to the pain of being dramatically overweight and what it is like to live like that upset me. I felt as if my experiences and knowledge were being invalidated because I've not been in that weight range for the last few years.

Me at age 14, trying to hustle out of camera range because I loathed having my picture taken because I was so disgusted by my appearance. Note the double chin which I hated.

That being said, perhaps the fault lies with me because I haven't spent enough time talking about my history and what I grew up like. It's one thing to follow my recovery process. It's another to know very clearly how little of my life has been spent in any mental or physical space that can be considered in the ballpark of "recovered". To that end, I'm offering this post.

Me at 17, at my high school graduation sporting the sort of body that insured that I'd never get a date, go to a prom, or be seen as anything but an ugly mass of flesh. This was in 1982, and I was the only fat girl in my entire class. The world was not yet full of super obese people.

I have lost significant amounts of weight twice in my life. The first time I remained at various weights under 200 lbs. for approximately 3-4 years before regaining. Most recently, in the past 3 1/2 years, I've lost weight and maintained around 180-190 lbs. in the last year only. Note that I choose the sub-200-pound range because I have learned that that is the point at which you tend to not be treated as in incredible fat freak in my experience. I'm speaking of the perceptions of that weight range at this time in history only. When I was growing up, I was tormented for weighing less than that.

Keeping in mind that I had to go down from 380 to my current weight and spent many of my "losing" years at extremely high weights and totaling the years of my adult life, here are some numbers:

lowest weight ever: approx 160 lbs.
time spent at lowest weight ever: approx. 1 year

highest healthy weight for someone my height: 145 lbs.
number of adult years spent at a "normal" weight: 0

Current age: 48
number of adult years spent at under 200 lbs.: approx. 5
number of childhood years spent at a "normal" weight: 8
number of years spent in the obese or super obese range: 35

Me before my wedding (age 24), having regained a lot of the weight I lost at the end of college. This was hardly the end of it. Much more was to come.

That means that I've spent 35 years of my life and all but about 5 of my adult years grossly overweight and in a state of self-loathing, social isolation and torment, and physical difficulty. The 8 years I spent as a child (from birth to some point in 3rd grade) were hardly ones in which I was aware enough to appreciate not being fat.

And just for the record, the pic on the left was me in 2009 (age 46) after having already lost about 30 lbs. I looked like that for at least 10 years. A line can be drawn from how I looked at my wedding in 1989 to 2009 to show how my weight escalated.There aren't any pictures, because I wouldn't let them be taken at that weight.

My point is that I could hardly have forgotten what it is like to live in the world as a super fat person given that I spent 35 years mired in such a state. That means I've been obese or super obese longer than some overzealous fat activists have been alive! I have spent a lot more time being afraid to leave the house for fear of mocking, afraid of not fitting in chairs, afraid of the physical pain that came with walking in that body, and afraid of not being able to two squeeze into narrow spaces than I've spent not thinking about such things.

Sometimes, I still think about them, to be honest. Ridding myself of that mindset doesn't come easy. I still think about whether or not I'll fit in a bathroom stall, squeeze my fat ass past a narrow gap between chairs in a  restaurant, or if people are staring and pointing at my gut and laughing at me. If people look in my direction and say something to a friend and laugh, I still think it's about my body. I still suffer from fat PTSD.

Also, it's not like I'm all skinny and trim now. I'm 5' 4" (164 cm) and weigh on average 185 lbs. (84 kg.) I'm still technically obese.I still have a huge flap of skin hanging down from my stomach as well as a large belly. I'm still fat, just not fat enough to prohibit me from walking, getting on public transportation, or going to a restaurant. I'm not complaining about my current weight, but I am still fat. There's no mistaking that.

What I'm realizing is that my voice is now doubly not taken seriously because of where I'm at. I'm not fat enough to be taken seriously as someone who has experienced life as a "death fat" (despite spending an overwhelming amount of my life in that range) and I'm not thin enough to be taken seriously as a person who has successfully lost weight.

Neither of these tribes would welcome me as a member because I'm a betrayer to both. By losing weight, my years and years of experience suffering as a super fat person appear to have lost all validity. By not losing enough weight, the manner in which I have lost has no validity. Frankly, while I find it upsetting that anyone could think I've forgotten how horrible it is to be super fat in a world which hates you, I've also figured out a few other things about the "fat mindset" as a result of this which are setting me along an entirely new path of thinking. I'm sure I'll share it here when I'm ready. And I'm nearly as sure that it'll get me in a lot of trouble.