Sunday, February 04, 2007

Shallow John

I was going to write something entitled "Six Gun Gorilla and Global Warming" (and I may yet), but in the interim I have just clambered off the scales, and am going to talk about fat.

Last night we went out to a friend's place. It was the first time I had been out to someone's house since the hospitalisation, and the first time I had seen any of Sarah's cat-person friends since any of this blew up, and I was fairly nervous. All that guilt and fear and social withdrawal that I tell my depressed clients to expect "for months" as they gradually recover.

In any event, it went very well - we sat around the table and drank and ate and chatted, and half way though the conversation Samantha (she of the chicken giblets) mentioned how horrified she was by how much weight she had put on. This is someone five foot tall, size six or eight, someone who has probably never weighed more than fifty kilos in her life. She's put on - I don't know, maybe a kilo.

Now, there is a confounding factor here. Sam has Crohn's disease. That means as times she gets flare-ups of ulcers all up and down her gastro-intestinal tract. It's as painful and disabling as it sounds, and if the ulcers in her intestine, say, eat all the way through she can die of overwhelming infection. It also means, or has in her case, multiple episodes of surgery, gallstones, kidney stones, tiredness and ongoing weight loss.

When she was first diagnosed, and she'd lost five kilos in a few weeks, her mother took her to a dietician. He listed the things she must eat to keep weight on. "Everyone's different" he said. "Try what works for you. Cheesecake" she remembers hearing. "Steak. Italian sausages. Corn with lots of butter. Icecream - with topping."

And she stuck to this rigorous diet plan and has remained in relatively good health for the last few years. But now her metabolism has slowed down, and she is concerned about the extra kilo.

Now there are two trains of thought I could board with this. The first is the whole "big" thing - the fact that this is the kind of stuff that has been force-fed into this intelligent and pleasant woman's mind. She senses she takes up more than the absolute minimum amount of space now, and feels that that is wrong. The fact that she has a deeply decent husband, for whom her weight is as unimportant as her blood type and who would love her at any weight between twenty and two hundred kilos, maybe mitigates this somewhat, but that's one man against an entire system of thought. But others have said this better than I do.

So, the other train. Sam was describing how hard it was, now, to lose that extra few hundred grams.

"See" she said, "I hate the food I'm having to eat now. I like seeing my toothprints in the butter when I eat bread. Skim milk tastes like dishwater. Pizza where you can't see the oil isn't pizza at all. Coffee cake, with veins of cinnamon in it."

I don't know. I know that most people will get fatter over time. Most people know that's true, and most people believe it's true of everybody else but themselves. It's a common cognitive distortion - the same thing that lets smokers believe that smoking will give other people lung cancer but not them. I know that's what's happening to me.

And I rage against the whole shallowness of caring about it all. Maybe I can hand-wave a bit of it away, say some of it's the poor self-esteem associated with recent events, some of it's the residual depression, some of it's the very real awareness that the medications I am on make almost everybody fat. But I know it's shallow and stupid and juvenile.

But Sarah in the meantime has lost eight kilos - mostly due to the misery of the last few month sor so, I suspect. And I have a friend coming over from another city in a few days, someone I admire and love and upon whose insights I depend. He's twenty kilos lighter than me, and he assures me that he is over here to drink cider in pubs and swim and talk about greenie lefty stuff - the kind of stuff we love doing together. I know it shouldn't bother me but it does.

But I don't know. I got off the scale today and I'm still ninety three kilos. That's an embarrassing figure, unless it's at the start of one of those personal testimonials in men's magazines that explains "how I blowtorched my belly" or whatever, wherin the writer goes from being a hideous wobbly mass of something to something ripped and shredded and blasted (now that's a healthy way to think about your body) via extreme punishment in mediaeval devices.

For the last few years I have been one of those who seem to be stuck in the 'before' picture, the unredeemed state. Ninety three kilos, BMI thirty one. I have that squat kind of habitus that kind people call 'big boned' - although that doesn't explain why my bones appear to have got a lot bigger in the last twenty years. Less of the Legolas, more of the Gimli. Less Captain America, more... nobody, really.

As an aside, the origin of the word testimonial has to do with the swearer clutching his testicles , as in "I swear by my testicles". Quite appropriate in this case.

Anyhow. The only thing to do (broadly speaking) is eat less, and do more. I bought a bicycle today, having read the short IPCC report in its entirety, and I will be riding to and from the ICU. That plus theoretically three times a week cardio, three times a week gym, eating as little as I can stand, bread with no butter, skim milk that tastes like dishwater, pizza only once a month. And I know there's no point bitching, that in the end if you eat less and do more in smart ways you lose weight - basic physiology. If I hadn't eaten less and done more I'd be ninety eight. I was well over a hundred at medical school.

We shall see. Probably we'll see me in a year, ninety eight again, whining about the good old days of being merely obese. But you never know.

Anyway. No real coda to this one. Speak to you soon,


Blogger Camilla said...

Hey BJ, my weight's creeping over the 90kg mark(probably already crept, actually, since I haven't dared stand on the scales for quite a few weeks). So I know a bit how you feel. My hips and knees are starting to complain, and I realised to my horror last night that I was out of breath after climing *one* flight of stairs!

Some of my weight gain is emotional stuff - re-armouring, I suspect. But after a very hard and horrible week, I'm starting to see my way out again, and that will include moving more and eating less, and viewing those things not as a form of torture, but as healthy habits as much a part of daily living as breathing and tooth-brushing.

Good on you for buying a bike! I'd ride to work too if it wasn't so dangerous to cycle down a flight of stairs from our living quarters to the office on the ground floor :P (I do go for a walk everyday though, during my lunchbreak). I'll be cheering you on from over here. Good luck! :)


ps what kind of bike did you buy? Road bike, racer, mountain bike? I have a Giant Cypress, very nice touring bike.

9:25 PM  
Blogger Prom said...

John, take a look at metabolic and brain effects of eating a low carb diet. It is a great way to lose weight once you get past the induction phase and from what I can tell and from what friends report, it also stabalizes other things like brain and metabloic functions.

12:15 AM  
Blogger Juanita J. Sanchez said...

Well, here we go. I could write volumes about this issue! I could tell you that it doesn't matter what other people think, if you are uncomfortable in your own body, then you have a problem. My husband is constantly telling me I look great and don't need to lose an ounce. While I appreciate that, and certainly prefer it to a husband that complains, it doesn't make a bit of difference in the way I feel. I could tell you that I think skinny men are unattractive, and I prefer men with some meat on their bones. But that doesn't matter if you don't feel good about yourself. I could rail about the message society gives to women with the ridiculously thin movie and television personas, not to mention runway models. I could prattle on about how wonderful and humane your metric system is when it comes to personal body weight. I could tell you how much I, personally, could benefit from taking Paxil or some other SSRI now, but will not do it because I gained 20 pounds last time. I could also tell you what I like to think, which is: "Hey, it could be worse. At least I'm not big enough to elicit stares." I could justify my weight by telling myself how much better it makes my patients feel when I ask them to step on the scale since I'm not a skinny-minny myself. But all that's a waste of time, because it comes down to how you feel. Some things are so deeply embedded that it's just easier to try and lose the damn weight than to change your attitude. So good luck. To you and to me.

6:54 AM  
Blogger Foilwoman said...

I'm not even saying my numbers. I always say to myself, whenever the weight questions comes up: "But I'm tall!" or "But some guy hit on me [insert time period]s ago, and I was heavier then!" Doesn't help.

I definitely gain weight with antidepressants and lose weight with anti-ADD/ADHD medications (well, it's just amphetemines, isn't it? Of course I lose weight). I guess the two balance each other out right now. Until they kill me or whatever. Worst weight gain medicine for me? MAOI (Nardil) -- I hated that stuff.

Good luck, but take your medication. You need your brain, and you need to cook fattening food for Sarah, so the brain is more important than the body.

3:36 PM  
Blogger Bronze John said...

Hail Cam',
Don't even know if these comments will work, the computer is responding to my growing feelings of inconsequentiality by telling me I don't exist.

The things that get me about the weight are many - as I posted, our lissom mutual friend is arriving from the coast soon. It's a weird feeling to feel ashamed, and then feel guilty about feeling ashamed, and then feel anger at yourself for feeling that guilt... if only emotional beating-oneself-ups consumed calories, I'd be a bloody whippet.

Somewhere on the other side of the world (probably in Cuba) is a man doing no exercise, eating vast amounts and getting thin, every kilo of fat he gains somehow transferred to me.



9:59 PM  
Blogger Bronze John said...

That all made a lot of sense. Unfortunately, there's that problem with depression some of us get where where you can either take no anti-depressants and be a bit fat and sexless, and depressed, or you can take the medication, have less intrinsic depression but suffer the (depressing) side effects.

Anyway. Other issues. But thanks for all that.


10:02 PM  
Blogger Bronze John said...

Hail Prom,
I am trying to do something high GI/low carb - not Atkinsian, but a more moderate version. I have type II DM on both sides, so I pretty much have to.

If it weren't for the potential embarrassment I'd post a weekly "weight loss in micrograms" tally.


10:05 PM  
Blogger Bronze John said...

If I have learnt anything in the last month (and that's often doubtful) it's about taking medication. Haven't missed a dose in a month.

The MAOIs are notoriously unpopular. I have a friend on a MAOI, two antipsychotics including the dreaded olanzapine, and an anti-epileptic. She used to weigh fifty kilos and be a black belt in judo and now she needs knee reconstructions.

Plus I feel the diet is overly cautious, but that's just me and the hard cheeses.

Sarah, by the by, now eats like a bird, mainly due to the stress of living with me. I should hire myself out on one of those wife-swap shows.


10:11 PM  

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