Why You Press the Bar

Back when I was in college, I took a course in experimental psychology. As a part of the class, we had to do classic experiments with white rats, Skinner boxes, and mazes. For those who are blissfully ignorant in the jargon of psychology, "Skinner boxes" are little cages which have a bar that a rat can press to dispense a food pellet.

Many people know the basic details of these types of experiment, but they don't know what happens to the rats in order to encourage learning. Rats, like people, are lazy and will not feel motivated to learn or change without a compelling reason. In order to get the rats to care enough about the food pellet to go to the effort of searching the cage for food and stumbling on the fact that the bar relates to getting food, you have to make them pretty hungry. Without deprivation, the rat is indifferent to getting the food pellet and will just sit around in the box being happy and contemplating rat philosophy.

The rats that are trained in psychology classes are doomed to a short existence. After they have been trained, they are rendered useless and are usually destroyed. I was told, perhaps seriously, perhaps in jest, that the way this was done was to break their necks with a flick of the wrist. Since state colleges don't have a lot of funds or veterinary expertise, it is unlikely that they are chemically euthanized. When I was told this about my rat, who has taught me so much about life that I think she deserves a better name and memory than the one I tend to give her (I named her "Rat Rat"), I chose to adopt her as a pet rather than to have her head twisted around until she expired.

My rat, who I was actually not really fond of as a pet but merely saved out of humanistic impulse, was not a normal rat after the conditioning she went through. Because she was sometimes deprived of food in order to compel her to learn, she would eat as much as she could all of the time. Since I was no expert on rat health, I just fed her whenever it seemed she was hungry. Soon, she grew very fat. I tried to feed her less, but she seemed to become anxious and paced the cage nervously looking for food when her food was reduced.

Within about a year, my rat died. She wasn't very old even by rat standards, probably no more than one and a half years old. I sometimes pondered if I fed her to death or if she simply was not healthy because she was the result of too much white rat inbreeding. My professor told us that, to save money, he had to keep breeding the same pool of experimental rats until he felt it was no longer an option because fresh rats were terribly expensive. I'm guessing she may have suffered from both too much food and her bad genetic pedigree.

My rat's situation teaches some valuable lessons about behavior that can be applied to humans. As I mentioned in the linked post a few paragraphs back, she showed the power of habit, routine, and superstition. In the case I'm currently talking about, she shows the strong effect of deprivation. Had she not been made terribly hungry in order to motivate her to learn in the Skinner box, she probably would not have become so fat later. She also likely would not have grown so anxious at any food reduction. If this is starting to sound familiar, it is because it is a classic situation that human dieters go through.

Dieting requires food deprivation over an often prolonged period of time. The more severe the deprivation, the more likely one will be to develop psychological issues with food and a disordered relationship with it. That is not to say that people can't practice caloric reduction without resulting food issues, but there is little anecdotal evidence to support the idea that they don't and ample to say that they do. Just like with my rat, food deprivation fuels anxiety about eating and not eating. It encourages overeating, and creates irrational feelings about food such as attaching moral implications to the choice to eat certain things.

Because of my understanding of these issues, I decided early on not to decide that food or eating were "good" or "bad" and not to put any food out of bounds for me. While I certainly have "guideposts" that I would like to remain in, I don't get worked up if I step beyond the boundaries. I just try every day to roughly stay within them. I view choices broadly as moving in a direction I'd like them to or in one I would prefer they not go in. I realize that making a particular choice slows my progress while making another keeps it up. It's not the end of the world if I doddle a bit on the road by eating a few hundred more calories than I view as optimal.

It is perhaps a very difficult thing for people to accept that the greatest restriction they can possibly endure is not the best path to weight loss. You can explain again and again that there are complex psychological reactions at play and they will be rejected out of hand as "excuses". It generally takes multiple failures before people even begin to consider that they may not be able to tread a severe path without consequence. My poor rat didn't choose to not eat for a few days before training nor to only be able to eat what she was smart enough to earn, but we humans have the capacity and the power to do better by ourselves. Whether or not we choose to do so is an entirely different issue.

Plateau

I'm sure that every person who tries to lose weight reaches this point, and I have been fortunate up to this point not to have experienced one, but I'm currently in an extended weight loss plateau. My weight has been hovering in the low to high 180's for quite some time now, though I honestly have seen bodily changes which would indicate that fat loss continues but overall weight is not changing.

While this would be a point of despair for most people, and I am less than thrilled with being "stuck" (for reasons I will get to), I'm not surprised nor incredibly upset. For one thing, I know that this is natural and normal. I have no plans to do anything other than "stay the course" and wait for my body to do whatever it's going to do. Since my approach all along was to pretty much live the rest of my life this way, it's not like I'm waiting to jump back into eating more or moving less. At the end of the line, there won't be much more eating and there isn't that much moving now. I walk and do some very modest stretching and weight lifting, but the latter two are done for strength and fitness, not weight loss.

The main reason I'm not happy about the stuck scale is that I know that in about 7 months I'll have to buy health insurance in the United States and all they will care about is the number on the scale when assessing my rates. While I may not care about this number or how long it is "stuck", they certainly will. That being said, I know I can't do anything about it so there's no point in getting overly worked up about it. I know how much I eat. I know how much I exercise. I know that I am living reasonably and far more healthily than most people.

There is an interesting side note to all of this and that is that at one point I used the Dukan Diet (which I do not follow) "true weight calculator". When I did it, it said that I am at my true weight and that it was 84 kg. (about 186 lbs.), which is where it has been stuck for awhile. It said something like, 'you do not need to lose more weight and are at your true weight.' Unfortunately, the people who will be charging me a fortune for insurance are unlikely to concur.

So, I'm going to keep doing what I'm doing and try not to fall into the pit so many people on plateaus experience. I don't feel close to the edge of such a feeling. I'm not exactly doing cartwheels at being stuck here, but it's okay. It'll all work out eventually and I'm not struggling to live life within the liberal limits I set for myself anyway.

What a dollar a day bought me

A lot of women who plan to lose weight relish the idea of taking "before" and "after" pictures. They also preserve one pair of their pants from their largest size in order to do the cliched picture of themselves at a smaller size standing in one large leg of their trousers. Personally, I find that approach to weight loss disturbing.

The reason that this troubles me is that it trivializes the entire process and skips over the hard parts. It focuses on the beginning and end, and skips over the painful and difficult middle. The pictures of the skinny person in the fat pants that is often used is a mimicry of advertising for diet aids that used to be quite common in the 60's and 70's. There's nothing that belittles the process like aping something designed to exploit your pain and insecurity. The sad part is that people don't even know what they're copying.

Because this wasn't some game to me, nor an exercise in superficial change which I would hold out to the world with a triumphant expression on my face, I never took a "before" picture in June 2009 when I made the decision to lose weight. I did have my husband take one picture of me in October of 2009 as an experiment for tracking my visual progress by using photos (as I was not using the scale). At that point in time, I had already lost between 30-40 lbs. That is the only photo I have at a high weight as I avoided pictures like the plague. I didn't continue with progress pictures because I couldn't look at them and my husband couldn't tell any difference looking at pictures taken a few months apart. This frustrated me so I gave up on tracking by photo.

I'm putting a comparison of what I looked like then and what I look like now on my blog not as some testimonial to my success nor as an inspiration. I'm doing it because I think there are some people who read blogs in which fatties talk about trying to lose weight and believe it's for vanity, societal approval, or some other vapid reason. I want people to see what I was and realize more clearly what it meant to be that person.

Being the size I used to be meant crippling back pain every time I walked or stood for more than a minute. It meant being mocked and tormented by strangers every time I went into public. It meant being unable to shop for clothing that wasn't the largest size and stretchy (and only shopping by mail order). It meant difficulty having sex and diminished pleasure for both my husband and I. It meant never going out to restaurants, coffee shops, movie theaters, or other public areas knowing I wouldn't fit into the seating and even if I fit, I was at risk of breaking the furniture. It meant difficulty moving, heart palpitations, and having my hands go numb and my back ache when I slept because of the compression of my weight. It meant not being able to fully hug my husband or have him fully hug me. It meant digestive issues, IBS, and fatigue. It meant I was afraid to get on a plane, train or bus and would not travel far.

Losing weight for me hasn't been some "hobby" that I indulged in in order to look hot or something I used to fill an empty life with talk of diets and exercise. It's something which had to happen in order to obtain the same minimal quality of life that others take for granted. In order to understand how diminished I was, it's important to know what I was before. That is why I'm putting up a picture. My "before" body, the one 30-40 lbs. lighter than my true starting weight in the photo above, was extremely hard to live in. No amount of effort to love and accept myself was going to change that reality.

The picture is very painful for me to see. It's not because I'm so huge and I disgust myself. It is because I'm afraid I could go back if I'm not careful to continue doing what I've been doing and I remember all too vividly how hard life was to live at that weight. When I talked in a previous post about dealing with food metaphorically as if I were living on a dollar a day instead of ten dollars, I was saying that that change has bought a better life for me. It didn't buy me beauty, approval, or bragging rights. It didn't give me the upper hand in some coffee klatch discussion about weight with the girls. It bought me a normal existence in which I could walk, go outside and not be afraid or tormented, and have physical contact with my husband without my body being a barrier. It also didn't buy me instant happiness or solve all of my problems, but it did bring me a lot closer to feeling "whole" again.

A Dollar a Day

Perspective and context are extremely powerful factors in our perception of life. If you grow up poor, a middle class life seems "rich". If you grow up rich, a middle class life seems poor. On an intellectual level and in gross generalizations, such as the absurd situations that play out in movies or television, we understand this clearly. On a personal level, we fail to internalize or even comprehend it.

If you grew up receiving an allowance from your parents of $10 a day, your perspective about money would be different than if you got a dollar a day. A child with $10 per day to spend would be able to buy pretty much any toy, candy, or experience he or she might want either immediately or by saving for a short time. A child who got a dollar a day would view things rather differently. All things would come more slowly to such a child and the value of rewards, when they came, would be viewed as far greater compared to the child with the more lavish allowance.

Scarcity builds a different context for rewards and perspective affects how fortunate or blessed we feel. This applies to everything, but people tend to objectify such things much better when money is the topic at hand. Since most people understand money in concrete terms, "wealth" is something we can all identify with as a factor which can distort perspective. We think people with too much of it are spoiled and don't understand what it's like to live like "normal folks". Trying to help people see food from this same perspective is an order or two of magnitude harder. The reason for this is that "food wealth" is so common and harder to objectify.

One thing that I realized when I started modifying my behavior was that I was indulging in food like a super rich person indulges in jewelry. I felt it was normal and natural to eat what I ate because it was what I always had access to and could eat. Part of this was the patterns my parents foisted on me, but a lot of it was also cultural. Americans don't open a packet of Oreos and eat one or two cookies. They eat half or all of a sleeve. Americans don't order a small pizza and eat one or two pieces. They order a giant one and eat 4 or 5 of them. If they have one slice, it's an enormous one about the size of an entire small pizza.

Changing the context within which we view food is a challenge because of personal psychology, upbringing and culture. It's naive to believe that cultural forces do not come to bear on those who attempt to modify the scale of their eating. When I tried to change my eating when I was in high school, my father mocked and made fun of me for trying to more slowly nibble a potato chip so that I experienced it more. Many people who go out to lunch or dinner with coworkers are pressured to consume more and if they eat small portions, others remark on what they are doing. Such comments may range from accusing you of having some sort of eating disorder to saying that the person making the remark couldn't get by eating "so little". Though it is not the intention, the message is clear, 'you are acting outside of the norm, and it makes me uncomfortable.'

As difficult as the cultural pressures can be, personal ones are far harder. Our own idea of what is "enough" is very difficult to battle, and it's one that I've fought with for the last two years and have only finally wrestled to the mat in the past several months. I'm talking about the part of you that eats a cookie and it tastes so good that you want another and then another. That part has been diminishing in me for quite some time, but it hadn't fully been laid to rest until recently. Now, I rarely have interest in "another" after I've had one of a treat. My problem now, when the inclination to eat a lot hits (which fortunately isn't too often) has stretched out to a desire to sample small amounts of many things from nibbles of cheese, to chips, to cookies, to chocolate, to bits of meat, to olives. A cornucopia of bites generally doesn't add up to much, fortunately, so I can "get away with it", and I consider it a better "binge" than wanting to eat an entire bag of something, but it's still not where I want to be.

One thing I realized is that going from the food equivalent of $10 a day to $1 a day makes one feel impoverished on the food front. If you are accustomed to eating all of the cookies you want, then limit yourself to one, it feels like deprivation. If you grew up without an allowance and one day started getting a dollar a day, it'd feel like wealth. Back in the past, when food wasn't as plentiful and convenient, people who got a cookie once a week were delighted because they weren't used to having them anytime and everywhere.

The issue for most people isn't conceptualizing that they'd be better off with the food equivalent of a dollar a day. The problem is putting themselves on that budget. And note that I use a cookie as a convenient thumbnail for any food. The problem could be eating too much fruit, cheese, or whole wheat bread. You can overeat on any food. It doesn't have to be unhealthy or "fun" food. The point remains the same.

My point is that we see food as something like a bank of infinite funds. We don't budget because we don't have to. We're the kids with the big allowance having fun because there's no reason not to... at least not until something happens and we find out that we can't touch that money anymore. In the case of many fat people, that is health or mobility issues. It's like being super rich with a penchant for bling and finding out that you suddenly are allergic to all precious metals and gems and now you can't shop for jewelry anymore.

For me, one of the turning points was internalizing the fact that food wasn't something which I could indulge in in an unlimited fashion. The limit used to be what my stomach would hold (and even then I'd eat until I felt uncomfortable a lot of the time), but I had to understand that the limit was somewhat less than what my body could burn in a given day. People know this rationally, but they act irrationally. They tell themselves they need that metaphorical $10 a day and can't possibly live on any less despite ample evidence that plenty of people live fine on a (again, metaphorical) $1 without keeling over from malnutrition. We convince ourselves we "need" more food than we really do, and what is worse, we believe that we can't possibly be "overspending" if all we are overeating is "healthy" food. You can be fat on anything, including fruit, oatmeal and yogurt. You only need so much of anything to be healthy, but we're convinced otherwise.

I think the reason people have such a hard time losing weight is that they try to go from one extreme to another. If you think about this with money, again, it is easier to understand. Going from $10 to $1 is very hard. Going from $10 to $9 a day sounds doable. This is what I recommend people do in regards to food (hence my initial advice to eat two tablespoons less and drink slightly smaller amounts of caloric liquids at first), but the results aren't fast enough for most people so they move too far too fast without making the proper mental adjustments or allowing their body to acclimate. They then proclaim that all has failed and go back to their more expensive lifestyle (or more).

The thing is that we can get by with less food than we think just as those who live in wealth can get by with less money. It's all about slowly developing a different context and perspective rather than rigidly sticking to the current one and claiming that change is impossible. You have to let go of your old views if you want to change your life.

Keeping it Private

Last week, a person who I have been doing business with approximately twice a month for the last two years said, "you lost weight". Since I have been dealing with her during the transition from 380 lbs. to around 180 lbs., it seemed like an odd thing to suddenly mention. I've said before that I live in a cultural environment which is more discrete about such things and doesn't comment as freely on people's personal lives. I wondered why she "finally" said something about a matter which I assumed was rather obvious given my transformation.

I do not mention my weight loss to anyone except my husband. In fact, I think it's very important not to discuss it with people because once you involve them in the process of your own volition, they become a part of the equation. Since I don't want their input, I don't talk about it. In fact, I've already decided when I go home that I will refuse to engage in casual discussions of my eating habits or weight. I will talk about it with people who have a problem and need or want help, but I won't discuss it from any viewpoint other than a psychological one when it comes to me. I've read far too many accounts of people having their food habits picked over and bantered about by people who are simply bored and have nothing better to focus on. This is not a trivial matter to be discussed in a coffee klatch.

Getting back to my associate who mentioned my weight, since I have never talked about it with anyone, the timing was odd. She said that she really noticed that my face had gotten thinner in the last month. Usually, she sees me every fortnight, but this time there was a longer separation. I mentioned in a previous post that, though my weight had not changed from one month to the next, I was sure I'd lost body fat because I'd see changes in my overall shape and size. Her comment bore this out as she saw new cheekbone definition in my face (that I also had believed was there) and remarked on it. She said, "your face is returning to what it was when you were young," as she'd seen pictures of me at my all-time lowest weight in 1988.

I told her that she was only the third person to mention it even though I've been losing for two years. She looked a bit blank and said, "really?" I pulled up some pictures of my face on FaceBook which coincided with when we first met to show her. She was surprised. She genuinely had not noticed that I'd gradually lost about 200 lbs. because she was in my life at regular intervals during that time.

The interesting thing is that one of the other three people who mentioned my weight loss also did so after an absence from my life of approximately 6 weeks. She said, "you lost weight", and I thought she was finally recognizing the elephant in the room. She even asked if I'd lost it because of stress. I realize now that she noticed the short-term loss, not the long-term one. At the time, I also thought this sudden utterance was odd, but now I'm beginning to understand that she really hadn't noticed the gradual changes all along.

The only one of these three people to really notice was someone who hadn't seen me for five years. She prefaced it with, "don't take this the wrong way..." at which point I said, "I've lost a lot of weight." She then said, "so much healthier" and we dropped the topic. There was no need for me to go into details about how or why I lost it.

I've been very fortunate that my weight loss hasn't been a topic of public discussion for the most part. I believe the biggest reason for this, as I mentioned before, is that the only person I discuss it with is my husband. Another is that the people who see me frequently either aren't noticing (yes, it is possible that they mind their own business or the losses were so gradual that they didn't see it) or have enough respect for my privacy not to mention it. Now that it has come up a few times, I've found that the best way to continue to keep it private is to address it minimally and move on in a polite, but perfunctory fashion.

A lot of people complain about people noticing or not noticing their weight loss. If they don't notice or say anything, they get upset that the changes aren't significant enough. I'm here to say that the changes can be huge (I've lost half my body weight now) and people won't notice if you are losing slowly. I'm also going to say that I believe that if you draw attention to it overtly, then you're going to get more interference and its best never to talk about what you're doing (including how you eat). The people who deal with me do not see what or how much I eat. When they remark on my weight, I confirm that I've lost it and they say, "congratulations" (which I feel strange about hearing) and then we move on to another subject.

Of course, some people believe that weight is a topic that should be discussed openly and frankly. I don't have a problem with this as long as the discussion is objective and impersonal. I have a problem when it turns into people kibbitzing in my business, which more often than not any discussion of weight (loss or gain) turns into. Once you open the door to people being involved in what you're doing, they feel they have been invited to comment on your behaviors and that introduces a whole new wrinkle into the process of trying to change your relationship with your body and food. And, like most wrinkles in life, it's almost always unwelcome.

It's Not About How Badly You "Want" It (part 3)

part 1 is here
part 2 is here

Last night, I was talking to my husband about how I was feeling regarding my sister's circumstances, which are inextricably linked to her weight. Because of a slip of the tongue, he said that she couldn't change because she didn't "want" it badly enough. As is so often the case, we sometimes over-simplify what we mean to say with words that distort what we really mean. Even though it wasn't what he meant, it did get me thinking about how we often talk about how people have to "want" something badly enough to start taking action toward change.

A lot of people talk about "wanting" it enough to change when it comes to weight loss. I'm here to say that every fat person in the world "wants" to change. Most very desperately would like to lose weight, but "wanting" something is not the same as being able to acquire it. This is a critical mistake that people make when they either fail or decide not to even make the attempt or when they see others doing so. The reason that this is so important to distinguish from "want" is that not knowing the real cause leaves people feeling as though their motivation is what is missing rather than what is really the issue.

I discussed my sister's situation in the other parts of this sequence and I know that she would like to lose weight and speculated that she probably has secretly tried on occasion and failed. I know that I tried and failed on a small level so many times that I ultimately decided that it was inevitable that I would always weigh well over 300 lbs. Here is how it works:

You are at the bottom of a deep dark well and would like to get out. You search around for places where you can grasp the wall and start climbing out. Occasionally, you see a depression or a jutting rock and you grab at it and try to haul yourself out. Sometimes, it isn't deep enough and you can't get enough of a hold to pull your body up. At others, the rock crumbles in your hand. Sometimes, you can get a good grip and start lifting yourself out and make a little progress then you slip and fall back down again. After each effort, you find yourself back at the bottom in a sense of deep frustration and anguish. Sometimes when you fall back down, the ground gives way and you're in even deeper.

After some time has passed, you've got years of attempts under your belt. You're now an expert at recognizing what will not work. You've tried to use that stone over there or that depression here dozens of times in conjunction with other strategies and every time you have been unable to get out of the well. You are expert at what isn't going to work because you've tried and failed so many times. After awhile, you simply see no point in trying. You still want out of the well very, very badly, but can see no way to escape. Attempts to try just increase your sense of hopelessness. It's easier to simply stop thinking about escape and make the best of where you are. This includes no longer trying to get out because the failure only reminds you of how trapped and helpless you are.

This is the story of a fat person. What you "want" has  nothing to do with it. Fat people want to be thinner. They simply cannot find a way out and many eventually stop looking. This analogy fails to impress thin people or successful losers of weight because they were never stuck in that well or the one they were in was one they personally could climb out of. Each "well" is mental and unique. The sides are steeper, smoother, etc. based on the life experiences and personality of each person. Judging others by their inability to escape simply because you could get out is an act of rampant narcissism and a need to elevate oneself above others. It's just not that simple. It's very complicated.

For me, I spent nearly two decades not only sliding down to the bottom of that well, but watching the ground open up under me and swallow me a little deeper each year. From 1989 to 2009, I not only could not find a way to lose weight, but steadily gained despite wanting to lose. In 2009, the thing that changed was my strategy. Being expert at what had never worked (rigidity, exercising a lot, "dieting"), I decided that this time it had to be very, very different if I wanted to escape. This time, I had to try tactics that were atypical because "typical" tactics didn't work for me.

This time, I ate chocolate. This time, I put no food out of bounds. This time, I focused on portions over food types. This time, I didn't castigate myself for eating certain foods or for eating "too much". This time, I wouldn't worry about how fast I lost as long as I was moving in a behavioral and cognitive direction which I felt was "right" for my future. This time, I was going to work hard on my psychological issues with food rather than view it all as simplistic "choices" divorced from my psyche. This time, I wasn't going to assign value judgments to how and what I ate and I was going to focus on eating "normal" rather than "healthy" or "perfect". This time, I wasn't going to hate myself thin.  This time, I was going to tunnel sideways using a spoon rather than try and just climb straight up. And, this time, it worked... for me.

The problem is that what works for one person doesn't necessarily work for others. That being said, I think that we can see that the "tried and true" methods do not work for many people in the long run. It is unsustainable to live the path of righteous eating and rigid control for most folks. I can't say that I'm thin (yet, and may never be), but I can say that I've done this for two years and two months now and it isn't an obsession and I don't feel trapped. I absolutely do not feel like what I'm doing is a burden anymore and can happily say I'm good to live this way forever. It's amazing how not denying yourself anything makes it easier. Of course, reframing food mentally in the fashion I have done is far from "easy". I had to learn to be satisfied with one cookie, a few bites of chocolate, or a small handful of pretzels, but the mind can be tuned to be satisfied with less once the psychological issues that compel us to "need" more are dealt with.

In my sister's case, the well she's in is deeper, darker and more intimidating than the one I was in. I like to believe that, if I were there with her, I could help her the same way I have helped myself. Deep down though, I think that's ego speaking. I think the only thing I could do for her is share my cooking and role model my eating patterns to her and she could then attempt to emulate them or not. I think the psychology of her relationship with food is too deep and hidden for anyone to access, including her, and I don't know that that aspect is something she has the capacity to address emotionally. And I understand that completely. It's painful, scary, and harder than most people can possibly imagine. And, what is more, except for the part of me that wants her to have a higher quality of life, less fear, and better health, I don't care. I love my sister no matter what and know that she's an intelligent, kind, caring, and worthwhile person. I just wish that she could have the type of life she deserves and weren't so much a prisoner of the body she's in that she will be denied the type of life a truly good person deserves.

Body Prisoner (part 2)

Part 1 of this post is here.

My sister has always been heavier than me. In pictures of us as children, she was always just a little chubby whereas I spent at least a few years as a skinny child. It wasn't until around 4th grade that I started to put on weight and start my lifelong "career" as "the fat girl". Of course, in my rural town, with a class of around 30 students, there were far fewer of us fat kids than there are these days.

As she got older, my sister gained weight as well. She was "the fat girl" in the class two years ahead of me. To that end, she was tortured and tormented in the same fashion as me, though her responses were somewhat different. I acted out emotionally and tried to excel in various ways in order to prove my value. Getting straight A's, proving how smart I was, exercising my creativity in art class and being unafraid to be friends and make friends with people despite my "handicap" socially was part of my process. For my sister, the path she chose was complete withdrawal.

My sister is intelligent, but she has spent more years being crushed by her weight issues than me. It isn't only that she was fatter earlier, but that she grew larger faster. She also has never spent any time in "remission" by losing weight. I'm not sure if she has ever made a concerted effort to lose, but I'd be surprised if she didn't privately make some attempts. I know for a fact that she has never made any organized effort to exercise though, or to substantially approach food differently. That's okay. I don't judge her for anything. It's just something I note because I think that my having lost a lot of weight twice in my life fundamentally alters how I view the experience of being very overweight compared to how she may look at it.

In addition to not having had success at weight loss, my sister has also never had a boyfriend and is not married. It's pretty safe to say that she is still a virgin. She has expressed on multiple occasions that she has no interest in relationships. I don't know if that means she is asexual (I doubt it), but rather that watching so many bad relationships around her has made her quite jaded at the prospect of being in a good one. There is also the almost certain factor of her weight making her believe she would never get a decent man. I believed that was also to be my future, but things turned out quite differently for me.

My sister also continues to live with my parents, who are elderly and rely on her. Their relationship with her has always been corrosive and destructive. She has spent years in a state of depression and even now is probably in one. Her economic circumstances went from difficult to dire last year when her work was cut from full-time to part-time due to the ongoing economic issues in the United States. She is now essentially at the mercy of my childish and emotionally abusive mother and socially terrified and emotionally stunted father. They consistently demand that she exhaust herself meeting their needs, and they have her in a bind because she can't afford to move out.

I don't know what my sister currently weighs, but I'd be shocked if her weight was under 400 lbs. Chances are she's in the 430ish range, possibly a bit more. She suffers from persistent anemia, low blood pressure, and fatigue. She also has serious skin infections at the drop of a hat and is sensitive to nearly every type of soap and lotion on the market. When she still had health insurance, she was tested repeatedly to determine the cause of her problems with no results. She takes a lot of supplements and has even been hospitalized for her anemia, but nothing seems to help.

With the loss of her health insurance, which got jettisoned when the full-time job was taken away, my sister now has no means to deal with any health issues that may crop up. She can barely pay her bills and only survives because of living under my parents' roof. Today, she was telling me about the hardship of dealing with my mother when she insists my sister take her shopping. These trips involve hauling my mother all over creation (often 4 stores), pushing her in a wheelchair because she had knee replacement surgery and refuses to do therapy properly or wait to heal, and lugging around her groceries in the heat. My mother is blind and quite overweight. I believe she also suffers from Pickwickian syndrome (OHS), though it has not been diagnosed as such. She merely has difficulties with blood oxygen and has to haul around an oxygen tank to breath.

Because of my mother's special needs, these trips leave my sister physically overwhelmed and exhausted. This is certainly due to the stress in dealing with my demanding and emotionally volatile mother, but it could also be exacerbated by her weight, anemia, and the summer heat. If she refuses to help, both my mother and father scream and verbally abuse her until she capitulates.

My response to this was sympathy, and also to say I wish she'd find a job outside of the tiny rural neighborhood she lives in so that she could escape my parents. In the past, when she still had full-time work, my sister had told me she couldn't leave because my parents couldn't survive without her. Now, she can't survive without them unless she gets a better job. I told her that if something happened to her tomorrow, my parents would learn a way to cope. They could get by, but they wouldn't try unless they had to. I believe this for a fact. If my father had to pay his own bills, buy his own groceries, and make his own bank transactions, he would. If my mother had to remember when to take her own medications because me sister wasn't around to dole them out, she would. She already has some assistance to go shopping, though she demands more than is provided by social services because she is easily bored and wishes to run around outside the home as much as possible.

In the past, I have suggested for her own psychological health that she needed to look outside the immediate area for work and she said that she'd have to go at least on an hour-long commute to find work and couldn't pay for the gas. This time, when I said she may need to go where the jobs are, she said she'd have to go very far afield indeed and she couldn't afford to move. I told her that if she found such a job, I'd give her the money to move. My sister has immense knowledge about computers and networks and has been a system administrator for decades. To this, she responded by saying she couldn't get any decent job because she had no concrete certifications.

As we spoke, my sister became increasingly agitated and angry. Though I was trying to be supportive of her by saying she might want to seek an escape route and that I would help her do so and that she had good skills that would be of value, she responded as if I were personally pressuring her to do something she couldn't possibly do. I felt very bad after the conversation because my aim was to make her feel less trapped, and her responses indicated that she felt more so.

In retrospect, I realize that, though she does have skills and could seek a job elsewhere, she can't. The reason she can't isn't that she has no value as a worker, but rather that she is a prisoner of her body. She fears putting herself out there for work in an alien environment because she'd likely be rejected because of her body size. All evidence that I've read about obesity, women, and hiring (as well as wages) would suggest that her fears would be valid. For her, it's better not to try than to try and fail. She is stuck waiting for something better to fall into her lap, because she literally cannot choose to do anything else. She lacks the psychological strength to escape, no matter how hard she may want to.

A lot of people might feel that my sister has choices, but simply refuses to make the hard ones. She could do what I have done and lose weight, but that's not a choice she is capable of making. I know because it's one that I could not make for a very long time. Of course, she wants a better life, better health and a better body, but mentally, she is trapped. Her circumstances are very much worse than mine in that she has no loving, supportive environment to back her up and she has no history of success either in regard to altering her body or achieving her goals. My sister went to junior college and university and was one class short of completing her degree at either of those institutions. I have my university degree and have a body of work on various blogs (including this one) with which to recommend myself. She lacks these things and it undermines her capacity to put herself out there. I know where she is coming from mentally. I've lived there for most of my life, too. It's not that simple to change.

After my conversation with my sister, I had a profound sense of concern and a little frustration. I don't want her to be trapped and I don't want her to suffer ill health. I want her to be able to start taking baby steps to improving her life and have even recommended that taking just a little walk for 10 minutes might help her feel better. At present, she sits in the upstairs part of my parents' home, which she occupies alone almost like an apartment and avoids contact with my parents as much as possible. She essentially hides there and feels depressed and that life is stagnant.

Suggesting she get out for a walk was not meant to encourage exercise, though I'm sure that'd help her, but rather to change the circumstances a little. She said she can't because cars drive fast up and down the dirt road they  live on and it's too dangerous. I suggested she try to get back into cooking to eat more healthily (which she claims she wants to do), but she says she can't because my parents will not eat what she prepares and will nag her if she goes to the downstairs area with the kitchen. She refuses to make the smallest change, or perhaps I should say, she cannot make those choices at this point in time. Her current psychology limits the number of options she personally is capable of pursuing. This is not her will, nor her "fault". It simply "is".

For the first time, I understood from the other side what it must have felt like for my husband, who loves me so dearly, to sit by and watch me destroy my body and sink into greater physical pain, depression, and negative thinking. I knew very clearly what it's like to love someone and not be able to do a thing to help them and that sometimes the best you can do is be patient, kind, loving, and supportive, and yes, possibly even contribute to their destruction by giving them things which introduce a little happiness into their misery. I went form knowing intellectually to deeply understanding emotionally what he must have felt for all of those years. That feeling is impotence and deep concern, but coming to terms with the fact that any effort to intervene will likely be more destructive than constructive.

I can't help my sister. She has to help herself when she is ready. The truth is though, that I don't think she will ever be able to change because whatever it is that it takes to turn the corner is not in her. She's suffered far too long and too deeply and I think she's given up. Life has defeated her and all she knows how to do now is to sit by and wait to see what fate's dice roll for her. I know she has the ability to make those changes, but she doesn't, and that's what really matters.

There is one more part in this sequence here.