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The Substance and GLP-1s: This Is America

-I've created a Playlist that complements my words. Please listen while you read.-

“Your friend needs to lose some weight.” 

This is the first experience I had with someone commenting on my weight. I estimate I was about 6 or 7 at the time, somewhere around first or second grade. 

I was playing outside with my best friend, Julie. We were entering the door through the garage to go inside and passed by her older brother and his friend on a bike. I had never met the friend before; this was his first and only time he ever spoke to me. 

I have no idea what would possess someone to comment on a child’s weight. Well, I do now, as an adult-I live in America, where there is one beauty standard and that’s skinny. But at 6 years old, I didn’t know about beauty standards yet. All I knew was that I was just humiliated in front of my best friend and two older kids, and it cut me so deep. I just ignored it, which continued to be my tactic for the rest of the life. I didn’t know how to stand up for myself, and I learned no one else knew how to stand up for me either-not my friends, not my teachers-and I kept my bullying from my family, so they never knew. 

“Let her pass by, she’s so big.” I remember this phrase echoed by a stranger as I was walking through the crowded corridors of my high school with my friend Ashley. “What did he say?” She asked me. I shrugged. I didn’t understand why she would want me to repeat the words of someone belittling me. 

“Eddie was just intimidated because she’s bigger than him.” We played a game in history one day, I think 10th or 11thgrade, where two students went to the front of the class and faced opposite each other. The teacher asked a question, and we slammed our hands down on the desk for the chance to answer. I was first, and I got the question correct! Should be a self-esteem builder, right? But instead, as we walked back down the aisles to get back to our desks, one of the boys’ who I went up against friends blurted this aloud to the entire class. My teacher, Mr. Mobley or something similar, said nothing. No one said anything. Me either. I sat there in silence, ashamed of myself and my body. I don’t remember much about what was taught to me in this class, but I forever remember Mr. Mobley (maybe Mr. Mosley? He had fire red hair and was also the model UN teacher at my high school) saying nothing to the student who had just basically called me fat to the entire class. I couldn’t understand why the adult in charge felt no need to address this. Even to pull me aside, ask if I am ok. Or let the other student know how unacceptable it is to speak about people like that. I’m glad I skipped the Model UN event my teacher was expecting me to go to that year. Suck it Mr. Mobley Mosley. 

“I don’t care what Jessie thinks, she’s fat.” I remember reading this note at a middle school dance one day. That same “best” friend, Julie, and I were in a fight, and someone showed me this note she had written during the dance. I didn’t understand what my weight had to do with the validity of my thoughts and opinions. (I still don’t.) 

“You’re too big to fit behind here, you need to find another hiding spot.” Playing hide and seek one day in elementary school at my friend Natalie’s house, I thought I was safe as I was around my friend and her family. A few other kids were hiding behind a couch and when I went to hide with them her little brother blurted this out to me. I found a different hiding spot. The pain gnawed at me the rest of the day, the rest of the week. The rest of my life. 

“Your jeans are so tight, you’re gonna get a yeast infection!” One day a teacher in high school asked me to go deliver a note to another classroom. Easy, right? As soon as I walked in the door and handed the note, a girl shouted this out to the class. Finding clothes that were stylish and fit me was a big challenge in school. So, my jeans probably were too tight. But I just didn’t understand why someone needed to again, humiliate me in front of everyone. And again, the teacher in charge said nothing. You can suck it too, whoever you were. 

“I don’t date big girls.” I worked at an Italian restaurant in my early 20s, and I had a HUGE crush on Andy, one of the owner’s sons. It was pretty obvious. When we were all in a group one day talking before the dinner rush started, someone mentioned something about dating, and Andy quickly relayed this to us all. Of course, I can’t know for certain that this was about me but just saying that made me crumble inside. How stupid of me to have a crush on someone who would never even look at me in that light, I thought to myself. 

“I don’t think you can keep up with us.” In my early college days, I had a group of friends and we loved to go explore abandoned buildings. This was before the internet was “The Internet” so you could easily find abandoned places through word of mouth, but the owners weren’t privy to it and usually didn’t bother with security guards or too many obstacles to have to get around to enter. I miss those days! We were visiting some such spot one night, and Ryan-the boy who I had a crush on for years, in fact I was convinced I was in love with him (and knew it, everyone knew it)-told me that if we were to get caught exploring he didn’t think I would be able to keep up with the rest of them running away. I don’t know the point of his saying that was, since we were already there and entering, and I believe I had actually driven us, but he made sure to say it. After that, I remember we went to Waffle House and somehow, I was wrangled into buying Ryan and my best friend at the time Jamie dinner. I remember they both choose to get steaks, the most expensive item, and laughed about it. Years later, Ryan would let me know how upset he was with me because he once bought a concert ticket when I couldn’t afford it, and I guess I didn’t let him know I was appreciative enough. I guess he doesn’t remember this incident, or all the emotional manipulation and abuse he put me through, but that’s for another time. I also offered to pay him back, but he didn’t actually give a shit about the money. Some people just want to always have something to hold over you as a power play. That was Ryan. Probably still is, but I don’t talk to really anyone from that time period anymore. 

“I want to see if I am able to pick you up!” One night at Jamie’s apartment, suddenly, he wanted to see if he was strong enough to pick me up. The implication being I was so big it would be a challenge. I let him do it. He picked me up and I guess he felt extremely satisfied that he was able to pick up such a huge ogre. That’s how I felt about it at least. I had never seen him ask one of his skinny friends to pick them up. Years later, when Jamie (and Ryan, and Rachel, and that whole group of friends) decided to basically drop me, I couldn’t figure out why. They all kept close relationships with each other but threw me away like trash. And now when I look back on it, I realize they were never my friends to begin with; no true friend would embarrass and humiliate you like that. It still hurts though. 

There are countless other times things like this happened throughout my life. These are just the incidences that stick out the most. I still can clearly envision every one of these moments in my head; I can replay them back and I can feel how I buried the pain deep inside of my heart. I feel that pain now. It was, for some strange reason, important to the outside world to let me know I needed to be ashamed of my body. And I was. I slowly internalized all these moments, all these phrases, and it started to grow a darkness inside of me. That darkness was realized through self-hatred, and I can confidently say I have hated myself since probably the first time I was told I was too fat to deserve kindness or basic human decency. So, around 6. 

It’s clear to me now that I have severe PTSD from my childhood (and early adulthood) bullying. I have thrashed this out with every therapist I’ve had. The thing is, no amount of therapy can take the pain away. I will never understand the cruelty behind these words. I have never in my life made fun of someone for how they look. It is unfathomable to me. But unfortunately, we live in a society where it is completely acceptable to belittle people for their weight. 

And this brings me to where I am today. I turned 40 a few weeks ago, and I am at the lowest weight I have ever been. Cheers, right? We can all ride off into the sunset. I got what I always wanted, what everyone always told me I needed to be to be accepted by society. And yet the road to get here was unhealthy and dangerous. 

Let me back up. 

In my mid to late 20s, I finally went to a psychiatrist and was prescribed medicine for my depression. The medicine I took really helped, and in fact it even caused me to lose a few pounds-just 5 or so, nothing crazy-but enough for me to feel like I could actually lose some weight. I had struggled throughout high school with my eating and fitness, always trying to get in shape but falling back into the world of binge eating and feeling like no matter how much I worked out, my body didn’t seem to change. So, this felt empowering to me, and I started to explore healthy eating and exercise again. I started to eat salads with fish, and in college I learned that I actually really loved running! So I changed my habits and I did lose some weight. I decided to try weight watchers once the weight loss stalled, and that was really successful the first time. I eventually got down to 135 (I’m 5’8) and was a size 4 and people looked at me different. Men who would have never given me the time of day were now interested in me. I began dating for the first time, and eventually, at 30 I met my child’s father. (He told me early on what he was attracted to the most was “my amazing body” which felt good to hear at the time but just reinforced the fact that my self-worth would be tied to a number on the scale.) 

Of course, then I got pregnant and gained a bunch of weight. I was able to lose it pretty successfully, (thank you breast feeding) but then-Covid. At this point I was a single mom living in her parent’s basement with a young child, around two or three. We were quarantined for a while in the basement because my daughter was in daycare and my parents were worried about getting sick. I understand this now, but it was tough to be alone in a basement with a three-year-old. My weight started to creep back up. Again, I was determined to get back to a size I was comfortable with and I was able with food and exercise to lose some of the weight, but for the next 7 years or so I vacillated between around 155-175. This was unacceptable to me. I felt frumpy and gross. (I need to acknowledge here that objectively this is not a horrible range, at 164 I would still be considered a healthy weight, but my mind does not see “healthy” as good, but only “skinny” and that’s something I have to try to combat all the time.) 

I really struggled for a few years, until-a ~miracle drug~ was invented. 

Ozempic, GLP-1s, compounded semaglutide. It seemed like it was the answer to all my problems. It was tough to get at first, but technically overweight at 174 my doctor was willing to prescribe it for me, though my insurance didn’t cover it. I am a single mom so I think we all know I’m not rich, and I am not in a position to pay thousands of dollars for medicine (no one in the richest country in the world should ever have to do this, but, “This is America”). 

I was able to find an affordable option online and started my journey. The low doses didn’t do much, and I was discouraged; but then, the weight started slipping off. And something AMAZING happened: my food noise disappeared. Suddenly, I could eat small portions with no need to binge. I was not thinking about food all day, every day. I was not worried when someone invited me to a restaurant because I could just order a meal without worrying about how I would secretly just been craving a burger and fries. I could order the burger and fries if I wanted-I knew I wouldn’t be able to finish it. Or I could order the salad. Whatever.

WHATEVER??? You mean I can inject this little clear liquid into my body and decades of torment over food just disappeared??? 

Look, there’s a reason obesity is an epidemic in this country. And it’s not because people aren’t trying. I know that narrative fits so well for everyone, but it’s not true. At least not entirely. A recent Danish study explains the common belief about obesity: “Most epidemiologists trace that beginning to the 1970s, when health officials first observed an uptick in the prevalence of obesity—defined as a body mass index (BMI) above 30—in many Western nations. The crisis is usually blamed on the increased postwar availability of cheap, highly processed, and calorie-rich foods, as well as increasingly sedentary lifestyles and growing portion sizes (“The Origins of The Obesity Epidemic”). However, after digitizing over 2 million measurements from 526,115 subjects, researchers determined obesity rates were rising back in the 1930s, much before World War II. 

It is also biologically very difficult to lose weight and keep it off. Losing weight puts your body in a sort of panic mode from my understanding, and it “trigger(s) defense mechanisms to slow down your metabolism and hold on to fat” (“Why Is It So Hard”). 

So, the advent of new weight loss therapies like GLP-1s is really, really exciting. They not only help with hunger issues but also slow our digestion and improve our insulin function (“Your Friendly Guide”). And further: “Existing neuroimaging and behavioral data suggest that GLP-1s may influence neural systems underlying cue salience and reward anticipation, with several reports indicating reduced food-related intrusive thoughts.” (PMC). 

I’m not going to touch on the people that insist anyone who uses these medications for anything but diabetes is wrong, because in the history of medicine so many drugs were discovered to have beneficial effects for something other than its original purpose. That is the nature of medicine, and for people to try and gatekeep something that could potentially save people’s lives, remove the torment many people feel every day about food, and systematically reduce the obesity numbers-I just think that is insane. And for people who think GLP-1s are taking the “easy way out”, they have clearly never struggled their entire lives with constantly being tormented over their relationship with food or have still come up empty handed even when they exercise and eat right. Also, it’s really none of your fucking business why someone decides to take a medicine.

This brings me back to present day. I got as low as 127 on GLP-1s, a number I never thought would be reachable for me (but still within the healthy weight range for my height). You might be thinking, awesome, happy ending, right? 

Not exactly. The medicine hasn’t been without side effects. Once I started getting on the heavier dosages, the nausea gave way to vomiting. At one point, I was vomiting every other day. I knew that wasn’t healthy or sustainable, so I reached out to my doctors, and they suggested cutting the doses up to two times a week, instead of once a week, so I was getting a smaller dosage each time. This worked pretty well; I still threw up maybe once a week, but it was livable. (And this is probably showing some of my maladaptive thinking patterns when it comes to weight loss and my body, because of course I shouldn’t be throwing up at all because of a medicine. However, I’ve just powered through, because what else can I do?) 

In the last couple weeks, I have felt like the medicine’s efficacy was starting to decease. I remember when I first started, it was recommended to try to inject in a different spot on the body if this happened, and it worked. So, a few days ago when it was time for my next injection, I simply put it on the opposite side of my body. That day I was fine, but the next day I started to feel some severe stomach pain. It got so bad I was curled up on my bathroom floor for hours, just clutching my stomach. The next day, it was just as bad, so I had to call out of work. I couldn’t eat or drink anything, it would just come right back up. The only thing more painful I’ve experienced than this is giving birth. I had to call out of work again the next day (which is actually today, for me) because I’m so weak from not eating or drinking and the stomach issues aren’t completely gone. I probably should have gone to the ER. 

I know I must stop the medicine. But I am devastated. 

For the first time in my life, it seemed like one of the biggest obstacles I experienced every day for as long as I could remember, was gone. The freedom this medicine has given me has been unreal. But it’s not healthy for me. So I have to stop. 

I feel broken in so many ways. I feel ashamed that I am so desperate to not gain weight I’ve been willing to be sick all the time, at the most inopportune times. One day I was at Target with my daughter and her best friends’ family so they could pick out matching backpacks; mid conversation I had to tell her I had to go to the bathroom, and I tried to walk as quickly as possible, but I didn’t make it. I threw up in my purse in the Target aisles walking to the bathroom. I was so embarrassed and ashamed. I’ve thrown up at my daughter’s bus stop, at my parent’s house, all the time at work, and I kept injecting the drug. If you’ve seen the movie The Substance with Demi Moore, it felt very similar to that. I would do anything to be skinny. 

I have heard tirzepatide is an alternative that doesn’t have the same side effects, and that’s something I will maybe try. 

But I can’t help but wonder, what would life be like if I was just born skinny with no issues about food and weight? If I didn’t have the food noise, if I was never treated like dirt because of what I looked like, what is it like to move through this world never having to experience these issues? 

I’m upset because it’s clear to me, my issues with food and weight are forever. There is no magic pill. And maybe I’m just not meant to be skinny. But my hope is that researchers and scientists will continue to study the underlying issues of being overweight and continue to find new therapies to help us. And most importantly, I hope the current parents of today can teach their children that someone’s body is never an acceptable vehicle to criticize them for. I hope one day we can live in a much more accepting world that lets little girls especially know that their worth is not tied up in what they look like or what they weigh. I don’t know if I can ever untangle those ideas for my own benefit, but I do know I have an 8-year-old daughter that deserves a better shot at happiness than I had. My daughter also knows it is never acceptable to criticize or make fun of anyone for what they look like. And I hope if you are a parent, you teach your child this too. 

 

References

https://www.science.org/content/article/origins-obesity-epidemic-may-be-further-back-we-thought

https://aidendo.com/why-is-it-so-hard-to-lose-weight-an-endocrinologist-explains/

https://intermountainhealthcare.org/blogs/article/your-friendly-guide-to-glp-1-weight-loss-what-works-what-doesnt-and-whats-next

https://pmc.ncbi.nlm.nih.gov/articles/PMC12770913/

 

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