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Nutritionists

Impending doom accompanied every birthday of my childhood. A birthday meant an annual checkup; an annual checkup meant a visit to the pediatrician. I never minded shots, I wasn’t disturbed by blood, and the poking and prodding protocols didn’t bother me. But for every year that I can remember, the cold, black scale sent a paralyzing sense of shame through me, upsetting my otherwise undisturbed youthfulness by forcing a harsh confrontation with the reality of my physical self. Until these inevitable moments, I could live in denial of and without concern for my body’s condition because it never caused me any significant hardship. I had great friends and I flirted with cute boys. I was a popular class clown and the life of every party. I had straight As, I played first base, and I danced on stage. Because I never needed to confront the issue otherwise, I avoided scales until they were literally forced below my feet. But year after year during the last week of March, or if I was lucky enough to postpone it into the early weeks of April, I had no choice but to acknowledge the problematic situation that was my weight chart, a straight diagonal line climbing up the y-axis measured against the passing of time.

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Throwback to the softball days

The younger years were the worst. The annual pattern hadn’t existed long enough back then for Dr. Blinderman to recognize the lost cause in which he tried instilling motivation. He spent time teaching my elementary school self about the benefits of weight loss and the concerns of continued weight gain. Or as I saw it, he not only acknowledged the elephant in the room, but then continued to drag out a miserably extensive elaboration of its existence. The later years were a quicker misery, in which I was repeatedly told how absolutely remarkable it was that I still had not developed diabetes and how I somehow managed to maintain a decently normal blood pressure, blood sugar, heart rate, and cholesterol level. The pediatrician would then spend almost no time launching an effortless attack on the weight issue due entirely to his professional obligation, and then close my medical file in conclusion knowing there was just nothing left to say.

***

My first nutritionist appointment took place in a typical suburban household basement, where the concept of a doctor working from home fostered my already skeptical attitude. Maybe the carpet and low ceilings were supposed to make it feel comfortable, like the familiar layout would lessen some of the blow to a girl whose age was still somewhere in the single digits would feel when forced to confront her weight issue that had somehow already become so critical. I paid no attention to the colorful illustrations of food groups and kid-friendly nutrition charts being explained on the desk beside me. Instead I gazed straight into the ground below, removing myself from the reality unfolding around me and resisting the feel of my parents’ presence next to mine. As soon as I walked in, I wanted out. That’s generous. I wanted out before I even walked in.

“I like Diet Coke better, anyway,” I remember thinking. I was clinging to the first rule I was luckily already following: instead of regular Coke, try switching to Diet Coke. They’re all very big on baby steps – don’t try cutting out anything entirely, instead make a series of minor tweaks to your daily routine. All of the other guidelines required a level of self-discipline and sacrifice that made attempting weight loss undesirable; adding vegetables and substituting snacks were changes I was not willing to make. But Diet Coke – I could do that because I was already doing that. When we meet again next week, we’ll call it an accomplishment and maybe I’ll have done something right. There was no next week. There was never a next week.

A few years later, I stared out a wide glass window in a high up office building in hopes that distracting my thoughts would help drown out the words of yet another, this time slightly condescending nutritionist, offering me all the advice I’d heard before. I reluctantly went through the motions of the familiar yet dreaded conversation of when, how much, and what I typically ate. Because I never paid a second of attention to what I put into my mouth and I don’t think I ever once made a conscious effort to be aware of the quality or quantity of my food, I strategically strung together a series of believable lies to formulate a daily intake that sounded slightly more acceptable than it really was. I answered questions the way I thought I should and I said what sounded right. I made compromises; I’ll give you a bagel with cream cheese and chocolate milk for breakfast but I’ll also take the whole wheat instead of white bread on my sandwich during lunch. It was all bullshit. I knew it, I don’t know if my parents knew it, and I guarantee the woman behind the desk didn’t care either way.

There was a childish devil within me, always manipulating the players and the game of nutrition when planted within these situations. I couldn’t make it sound like I didn’t over eat – I couldn’t ignore the reason for seeing a nutritionist when faced with a nutritionist – but I did what I could to make my eating habits seem only moderately problematic. By the time each doctor eventually asked about snacking at night, I found a twisted amusement in the opportunity to completely put on an act. I would pause, pretending to contemplate the question as if I hadn’t already prepared an answer, then shrug my shoulders, squint my eyes, and admit, “yeah, sometimes I guess.” Contrary to the verbalized response, I was well aware that my favorite meal was the frequent after dark indulgence, the one I prepared around midnight when the only light in the house came from the kitchen counter. Maybe that’s because no one was awake to watch me, remind me that it was too late, it was too much food, it was unhealthy, I knew better, or that it wasn’t allowed. Maybe it was because my parents’ sleep kept them ignorant, giving me the freedom to later blatantly lie about it at the nutritionist.

She held up a paper split into five sections: breakfast, snack, lunch, snack, and dinner. Suggestions and outlines for what each meal should look like stood next to a paper she had just scribbled on with all the ways I admitted to currently filling in my own blanks. “This is what you should do” right next to “this is what you’re doing.” After handing me a stack of papers with nutritional information and tips for weight loss that I would never once consult, she encouraged me to tackle the new dietary plan with a pen and paper. If you write down what you eat down beforehand, it’s like giving yourself a concrete plan. If you write it down after you eat, it’s a good way to hold yourself responsible. Ask me if I ever wrote down a damn thing.My third nutritionist provided a series of letdowns in addition to another miserable doctor visit. I was actually optimistic about this one, whom I met at some point during my middle school years, because she was the source of some magic fat-busting pills previously offered to my aunt. I held that medicine bottle like a promising lottery ticket and swallowed those thick little ovals every day with hope. Maybe these would be the fix! I don’t know how many weeks it took for me staring into a mirror at my unaltered reflection to realize they did absolutely nothing. In addition to her bullshit blue pills was her suggestion of a glucose tolerance test. She wrapped a tape measure around the top, middle, and lower parts of my torso, drawing the conclusion that I was very likely intolerant to many of the foods I was eating, so we should definitely take tests to verify the real reasons behind my being so grossly overweight. Maybe this was the solution! After hours of downing repulsive sugar concoctions and my personal record of eleven consecutive needle pricks – it’s hard to find a vein when you’re composed so overwhelmingly of fat – all of those tests came back negative.

***

My parents sent me into therapy after eighth grade. Their marriage gradually started to fall apart following the birth and death of my prematurely born baby sister, they finally decided to separate and demolish the happy family façade, my sister was struggling with her own issues, and I was about to start high school. I can see how it seemed like the right thing to do – evidently there was a lot for me to talk about.

Although I never felt the need to discuss any of these problems, I did it willingly. I could talk about how destroyed and heartbroken I felt by my father’s betrayal. I could talk about my perpetual state of concern for my sister’s condition. I could talk about all the ways my parents used me as a messenger and all the ways it only made their marriage worse. I could not, however, talk about my weight. All of those issues existed with or without my acknowledgement. My weight seemed only to be a problem if I let it be, and I refuse to let it be.

I did what I could, for as long as possible, to avoid the one topic that made me uncomfortable. Every time my therapist, Gila, strategically steered our conversation to that dreaded destination, I reluctantly listened to her analyze my overeating as a subconsciously chosen method of coping or dealing or suppressing or whatever. I remember her pointing out the irony of how I verbalized my feelings as if I didn’t care, as if it weren’t an issue, while simultaneously crossing my legs and arms to physically demonstrate my discomfort. You can’t trick a therapist.

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A limo ride for my friend’s birthday party; sophomore year of high school

After years of building a strong relationship of trust, respect, and genuine appreciation if not love for Gila, she divulged the truth. We needed to discuss it. “The real reason you’re here is because your parents are concerned about your weight.” The homey office that had become a comfortable safe haven for all my thoughts and feelings otherwise undisclosed was now also built upon a lie, allowing my parents to stab me in the back from the comfort of their own home.

I responded to her honesty by denying and rejecting every hypothesis and theory she posed with genuine doubt, because I just ate however much I wanted of whatever I wanted, when I wanted, and why does there need to be a reason for everything? Throughout my high school years, I maintained the same position whenever that conversation became unavoidable: she, my parents, every doctor and nutritionist that had gone out of my life as quickly as they came into it, were all probing for a deep answer to a question that didn’t exist. The conversation always picked up where it left off, never making the slightest impact on how I chose to live my life. The never-ending dialogue was kept in motion by either my unwillingness or my inability to open up about the truth of a subconscious explanation for my obesity. I still don’t know if it was because I was unwilling or if it was because I was unable. And I still couldn’t tell you the reason for my obesity.

***

I don’t know what changed. I still cannot figure out why I decided to attack what I saw as my one major flaw. I don’t know why it took me reaching over 300 pounds, I don’t know where the motivation came from and I don’t know why I was suddenly willing to give up the way of life I had so passionately clung to and defended. I don’t know why my body, which I considered only a physical shell for my inner self, began to matter. I don’t know how I had the self-discipline to tackle it they way I did. I do know that at the beginning, weight loss was only the means to an end. I know that I was going to fight through the torture of exercise and sacrifice carefree eating to finally arrive at the size and weight deemed acceptable by both social norms and in medical terms.

Losing half my body weight meant stripping my life of its only significant imperfection. Upon finally reaching my goal, I envisioned myself waking up to a body 150 pounds lighter and seeing, feeling, being, the closest to perfect I could ever be. Weight loss was supposed to fix me, and once I made up my mind to accept the challenge, I wanted to be fixed as fast as possible. It was going to be painful so I wanted to make it quick. I meant for the process to be temporary, to solve the one problem I had yet to address. I had absolutely no intention of making a “lifestyle change,” as I heard it always should be. I accepted the fact that I would never actually enjoy exercise or appreciate healthy meals; I was planning on just barely tolerating them for the time being until I could get back to enjoying my pizza and cheeseburgers.

The process itself was relatively mindless because I began by relying on packaged meals provided by a weight loss program. All I had to do was open the freezer, pick which cardboard box appealed to me most that day, stab the plastic wrapping with a fork a few times, wait between four and five microwave minutes, and make the best of the 250 calories packed inside a plastic black tray. With rare exception, I did this for every meal for roughly eight months. It wasn’t always easy, but it was always simple: some foods were allowed and some foods were not. Black and white. No exceptions, no excuses. Period.

Included with the packaged food were weekly weigh-ins and free consultations to discuss last week’s obstacles and next week’s challenges with the uneducated and overly enthusiastic counterparts to my past weight loss mentors. Though I always tried to speed up my time with what felt like phony personal cheerleaders, these meetings gradually provided me with the tools for taking matters into my own hands. I learned the basics: oatmeal is filling because of the whole grains and you can substitute a serving of milk with fat free yogurt. Then I learned the specifics: first my meal plan required 2300 calories, then 2100, then 1900…

I was being guided with patience through a process for which I had no patience. My consultants told me that it was okay to add a little dressing on my salad, splurge on the weekend, and drink alcohol if the occasion called for it. By the time I had lost enough weight that my diet called for a decrease in supplementary snacks and desserts, I had to explain that I’d stopped eating those long before. I was trying to lose as much as possible, as fast as possible; no snacks, no dessert, no dressing, no splurging, and eventually, even no alcohol. Once I was experienced enough to mimic their breakfasts, lunches, and dinners with my own food and I understood that losing more weight meant consuming fewer calories, I gave up on accepting proper guidance and decided it was time to stop paying for help I didn’t need.

***

“My friend Mary is a nutritionist. Remember Mary? Mary Myers? Maybe I can reach out to her.”

My mom could tell it was really getting to me this time. I spent the entire year mastering the art of weight loss but was now completely at a loss; every morning for two weeks brought disappointment from the scale’s display. I had everything down to a science, but the science suddenly stopped working. I used the calculators, I counted calories, I did my research; I did everything to be certain that I outputted more than I inputted. I knew how much I was supposed to eat and I ate less, I knew how much I was supposed to burn off and I burned more. I did everything to be certain that I outputted more than I inputted.

The first time I hit a plateau, the answer was to add protein to my diet. I had traveled through the spectrum of barely tolerating to genuinely enjoying vegetables, so I assumed with my limited nutritional knowledge that surviving only on greenery would benefit me most. When my weight loss stalled, I was advised to put chicken on top of my lettuce and eggs next to my tomatoes. It was that simple; weight loss continued and the frustration was history. This was supposed to be more of the same.

I was going to pick up the phone and explain my situation to this nutritionist and she was going to give me some advice about what to eat more of or less of or how I needed to switch up (intensify?) my workouts. I was going to get some insight into what I was doing wrong and how to fix it. I was going to get a solution from a qualified and knowledgeable doctor about a promising pathway for moving forward. I was going to hear that the last ten pounds were absolutely possible and that I shouldn’t lose hope because achieving the goal was still right around the corner.

Mary listened with patience as I described my lifestyle. I proudly disclosed the habits I had cultivated to reach success. I told her about my daily diet, explaining the details of my breakfast, (no snack), lunch, (no snack), and dinner, as the manifestations of incredible willpower they truly were. I wasn’t shy about telling her for how long and how hard I exercised every day because I still couldn’t believe what I was physically capable of doing and how much I loved doing it. I was certain that my weight loss driven lifestyle had been formulated with perfection, but that she would identify whatever minor flaw existed to help me move on. Now I can just imagine her, probably nodding her head the entire time my blissfully ignorant self fed her information that made so much sense to anyone with the right knowledge.

“You need to stop for now.” Pause. What? She told me that 140 pounds was an incredible feat, but I needed to consider that the crossing of a temporary finish line. She told me that I had lost too much, too fast, and my body couldn’t do it anymore. I had pushed myself too hard for too long, and what I was experiencing was not a typical weight loss plateau. It was my body shutting down. “Your body is in starvation mode. It is literally fighting you to keep weight on,” she told me. I’ll never forget those words.

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One of many “Schlos is freezing” pictures my friends took. It grew into quite a collection

If I weren’t still locked inside the mindset of my former self, confused by the mere concept of how to even consider myself having any relationship with “starvation,” I would have heard the words as they were as well as their inherently concerning implications. I would have felt stung by the sick reality I had created for myself and I would have understood how deeply troubled I really was. Had I not been still ringing with pride from my previous months of success and only concerned with continuing and completing the process, I would have been able to live in that moment rather than look past it as a temporary obstacle to soon overcome. I would have understood the true severity behind the word “starvation” – a concept previously reserved in my mind for concentration camps and dying children in third world countries. Never me – never 300 pounds, having difficulty climbing a flight of stairs, using a seatbelt extender, wearing plus size section, me. I couldn’t starve myself if I tried.

I spent my entire life being told to exercise more and eat less. I just wasn’t supposed to exercise that much or eat that little. She explained that I skipped my period for the first time in my life because my body had officially been deprived the ability to function properly. She explained that my constant shivers and purple lips were due to an insufficient diet and that my hair loss, inability to sleep, and constant fatigue, were consequences of extreme restriction. She explained that my constipation was a result of my not actually digesting anything. My daily battle to blink away floating black spots in my head existed only because of severe malnutrition.

Leading up to this reality check, my pediatrician, my parents’ doctor, and the most expensive endocrinologist on Long Island, all saw blood tests and weight charts indicating how healthy I was. My many doctor visits for the previous six months, motivated by the gradual worsening of these symptoms, were the exact opposite of what they used to be; now I was impressive, in shape, and “incredibly stable.” They all promised that I was suffering the effects of rapid weight loss, soon to subside with maintenance. Of course they couldn’t be absolutely positive in their conclusions because none had never seen a patient in this situation before. No one loses this much weight this fast.

I didn’t know what that phone call had in store for me. Had I known, I never would have made it so willingly, so eagerly, with so much enthusiasm. I like to think that I would have, but I might not have made it at all. I didn’t know that this one would be the first of many, that these “talks” would soon become scheduled “appointments,” or that Mary would become another Gila. I didn’t know that we were to spend hours over the next few months discussing the indescribable difficulty of reshaping my life and reversing the harmful tendencies I had relied on to achieve what I had. I didn’t know she was to gradually enlighten me with the unfortunate reality: the healthiest thing I had ever done for myself had unintentionally transformed over time into a concerning pattern of deep deprivation and consequent self-destruction. I didn’t know that phone call would lead to my eventual understanding of the one lesson I needed to be taught but never wanted to learn: there is no fix. No solution exists. By solving one problem I had only created another.

I knew that I once personified one extreme of the spectrum – living to eat rather than eating to live. I knew that I had a lot to lose and that I wanted to get it over with. I didn’t know that my attitude would have me mindlessly releasing the pendulum that was my eating habits to sway from one side to the other – food was a close friend and then it was a dangerous enemy. I didn’t know that I should have embraced the slow and steady weight loss, the moderate workouts, the forgiving diet, the healthy pace. The baby steps. The lifestyle change. I didn’t know that I was going to take it too far.

I didn’t know that the process of losing weight would transform me into my own worst enemy, so compulsively obsessed with controlling my diet that the mere idea of pizza and cheeseburgers made my heart pound with anxiety. I didn’t know that the gym would become my only comfort zone. I didn’t know how attached I was to the scale on my bathroom floor or the measuring cups in my kitchen cabinet. I didn’t know my social life would be sacrificed due to my avoiding alcohol and fear of dining out. I didn’t know that every hour, minute, second, of my day, would eventually be consumed with thinking, planning, calculating, writing down, and worrying, about food. I didn’t mean for it to end up this way. I just didn’t know.

If I knew what the reason was for all of my problems, I would never have been searching for it. If only I knew that phone call was ultimately saving my life by temporarily destroying it. I didn’t know. I didn’t know, and could never have expected, the heartbreaking truth to which Mary would eventually expose me: “You have an eating disorder.”

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