Fatties United!

Does diet culture kill?

My sister E was the oldest of five children; I was the youngest. Growing up in a house where our father was at work most of the time, and our mother was tired most of the time, E did a lot of the work of raising me.

She was one of the most independent minded people I knew. She had friends and liked doing things with them, but she made her own decisions and they weren’t always what her friends would do.

She worked hard, but always on her own terms. She would use up all her vacation, and all her sick days, and she felt no guilt about it. She felt that there was no point working if you didn’t also have fun.

She’d say what was on her mind, pretty much unfiltered. Of course, she came of age in the 1970s, when “tell it like it is” was everyone’s motto. But she also knew how to sweet talk, and she could get me to do chores like no one else could.

But for all this independence, she had one weak point: she was a fat person. She was one of the most beautiful women I knew, but because she was fat, society put her in the “such a pretty face” category. She’s been on and off diets for as long as I’ve known her. They never worked long term, until about 11 years ago.

That’s when she had weight-loss surgery. I tried as best as I could to talk her out of it, but it didn’t work. She had so much self hatred because of her fatness that she wanted more than anything to lose weight and keep it off. She felt that she’d never have a husband unless she was thin, or at least thinner than she was. She knew that I was and am attracted to fat women, and was and am married to a woman much fatter than her. That didn’t matter. She just couldn’t imagine that there were others like me out there. Or maybe it didn’t matter what others thought: it was what she thought, and she thought the worst of herself simply because of her fatness.

I saw her a few years after the surgery at our father’s burial. She was a lot thinner than she had been, although not thin at that point. But she kept on saying how bad a person she was because she still ate more than she should, in her opinion.

At that time she was living near where my dad had lived, where it’s very cold in the winter, and she didn’t spend much time with other people. She talked about being depressed, and going for days without showering or bathing.

A little bit after that, she moved back to New Jersey, where we’re from. She was able to find a fairly nice place to live within her budget, and it seem like she had gotten her life in order. But she was still talking about not bathing or showering, and being sad. Another sister, C, lived nearby, and E had friends nearby as well. But she was still lonely.

C had been sick for decades, and last year, 2015, she died. After that, phone calls from E got fewer. In November 2015, E went into the hospital. She was diagnosed with an iron deficiency, got a blood transfusion, and was sent home with supplements.

She was back in the hospital in December, this time with a gallstone that had migrated to her colon. They wound up removing her gallbladder. In January 2016, she was back in the hospital again, then again in March, and again in April. Since then she’s been in an infinite loop, going from the hospital to a rehab center and then to home, but never home more than a few days until she’s back in the hospital.

Her ailments, according to the hospital doctor who has seen her the most, come down to her not eating enough. Somehow last year, through a combination of her weight-loss surgery, depression, and drugs, she had attained the ability to starve herself. Put another way, she developed an eating disorder.

I went to visit her earlier this summer on our way to a family reunion, and at that point she was in a rehab facility. The problem was, though, she wasn’t getting better. She didn’t like any of the food offered to her, and wanted special food brought in like chocolate flavored Ensure. And sometimes she didn’t like that either.

Her mental confusion increased over that period. She could never understand why she was sick, why she kept going into the hospital, why she was losing her ability to walk and do things for herself.

Eventually E went back home, but this time she had an in-home aide to help her. And for a couple of weeks, it seemed like she was actually getting better.

But she wasn’t. She wasn’t doing the physical therapy, she still wasn’t eating enough, and she wasn’t on a path to independence. A family member decided that the in-home aide was too soft on E, and so she went back east herself to nurse E back to health.

Things didn’t go as hoped. E went back into the hospital a few days later, then to rehab, then back in the hospital. We still have hope, but she’s been in decline for a long time, and it doesn’t look good.

Is diet culture killing my sister? E was an independent woman, but she could never reconcile herself to being fat. When she found a way to starve herself, there was no turning back.

This post isn’t really about fatness, but I was thinking about binge eating disorder as a diagnosis. You can take a look at the diagnostic criteria here, but it seems to get into a thorny realm because one criterion is a sense of lack of control. To me, that sounds like saying “addictive behavior” while avoiding that phrase. It leads to some questions:

Is binge eating itself a problem, or just a symptom of a deeper problem?
Does this diagnosis really help people?
Is there an issue with the diagnosis being incorrectly applied to fat people?
The diagnosis also mentions distress, disgust, etc. If one binges without these feelings, does one have the disorder?

I don’t have a firm viewpoint, but I’d like to hear yours.

Fatties United!

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