And now, a story of my fatness.....

......because you, Dear Reader, ought to know.

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“Wow, your daughter is big!” the lady at the bank exclaims.

I instinctively correct her; “No. No she's not. She's just long for her age.”

To me, the word “big” implies “fat”, which my daughter is not. She's only a couple months old and yet already, I'm getting glances from people. People who see my fat self and assume that I must be shoveling cookies into my maw whenever I have the chance. People who see my adorable baby girl and assume that “her evil mom is going to MAKE her fat.”

It's all well and good for me to accept myself regardless of my size, but it's quite another to change the popular social belief that a fat person will always teach her “fat ways” to her children. Of course, I could go with the “disease” belief, which states that a fat person can “infect” her offspring with excess weight.

My pregnancy in and of itself was a tough thing to go through. It took me years of gaining weight for no apparent reason (and I spent my entire chunky teenagerdom thinking that I was “fat” too, so as far as I was concerned, I was simply “getting worse”) to finally speak up to the doctors and do my own research to try and figure out what was wrong with me. Even at my “best weight” (when I was on the basketball team in high school and exercised upwards of 2 hours every day, 7 days a week, I was still 140 lbs, a weight which my thin mom still said was “unacceptable.”

I avoided going to the doctor for a year or so until my mom gave me a “you're fat and going to die” talk (which just made me cry and feel ashamed). So I went to the doctor (at Kaiser). And got the whole “you're fat because you're lazy and snarfing cheeseburgers”. Even after I mentioned my diet and exercise, they ignored me and told me that “BMI doesn't lie!” My doctor was a rail-thin Indian lady who obviously came from India, and looked at me like I was an affront to those starving in third world countries when I begged her to do some bloodwork to figure out if anything was wrong. My cholesterol and triglycerides were through the roof, even though my food choices were good and “portion controlled”. They blamed the fat as a cause, not a symptom of what I was going through. I got no sympathy and was laughingly referred to a nutritionist since I “obviously didn't know what or how to eat right.” I never went back to them., but I did start a gym regimen and absurdly restrictive diet for about a year. I didn't lose a pound; and in fact, still kept gaining weight (although at a slower rate). I was dieting. And exercising. A ridiculous amount. And no matter what, I could not lose the weight or even stay at a consistent weight. You know the definition of insanity? Where you do the same thing over and over again expecting different results? Yeah. That was me. Everyone said that I would lose weight if I just dieted and exercised, so why was I still a big fat failure?

Eventually, I figured, well, might as well be guilty of the crime I'm being accused of. I stopped exercising so much (quit the gym completely), and I started eating “bad” foods from time to time again. After all, they were cheaper and I was on a very tight budget. And they were tasty.

After that, I didn't have health insurance for several years; cost being the major factor because I no longer qualified for my parent's health insurance after college. I tried to come to terms with the fact that I was probably going to be over 200 lbs for the rest of my life, and probably just get bigger and bigger and bigger no matter what I did. I felt like I had been cursed by god (if I believed in god), or that I must have just done something wrong. Even though I was enjoying my life with my husband, traveled, and had many friends, I just couldn't deal with my body. I began to avoid mirrors. I began to have this mental image of myself as “hot me” and try and imagine that when people looked at me, that they were looking at “hot me” and not how I actually looked. I went into deeper denial about how I looked just to survive and have some semblance of assertiveness about me.

A little less than a year later, I finally got a great job with the local government. And amazing health care at a much lower rate. I finally went to the doctor again, hoping to change something, anything. I was very pleasantly surprised that my primary care provider was a woman of some size. She had a similar stocky body as me, so I felt that maybe I'd get some helpful advice. No dice. She mentioned something about Weight Watchers and “calories in should be less than calories out” and then sent me on my way.

But this time, I was determined not to let the doctors get in the way of my health.

I started to do lots of research on obesity related diseases; especially those that are genetic or inborn. I know that I come from Cherokee and Creek heritage as well as Italian working-class stock. Both of these groups have issues with weight when you introduce a Western style diet that involves high carbohydrates and processed foods. I must admit, my fervor didn't come about until I started becoming a rabid fan of the show “House” and watched the episode where there was a girl with Cushing's disease who was fat regardless of what she did, and watching how everyone treated her reminded me of how others treated the fat kids when I was younger (I was strong and boyish, even though I was chubby, so no one messed with me back then-but I had very few female friends as a result of my tomboyish demeanor). It made me cry to see people treat this little girl like she was less than worthless while the teachers condoned and ignored the behavior. I worry for my own daughter-if she grows up fat, will she carry this shame? Will she refuse to tell me because that will make it “even worse” for her?

I'm getting off topic, though...

So I started researching online and started reading about diseases where the symptom was rapid weight gain at the late-teen age, including things like precocious puberty (I had noticeable boobs in the 4th grade) and aggressive tendencies (I would fight and be active and dirty and keep up with the boys, while pretty much altogether avoiding female-based preferences (like make up and fashion). I printed out a list of blood tests and things to look for. I figured, what the hell, if my doctor isn't going to do her job, I'll just get her to run this labwork and everyone will be happy.

So I went back to my doctor with my list and I told her that I wanted these tests done on me (including one that involved peeing in a giant jug all day long). I had her create base points for all my stats, including cholesterol, HDL, LDL, and triglyceride level. I had her check my cortisol levels, my testosterone levels, and more.

The tests came back with interesting results. My HDL was lowish but only by a few points. My LDL was a little high. My triglycerides were much higher than normal. My TSH (thyroid) was slightly low. My testosterone-get this- was over 200% higher than normal.

Once I went off of hormonal birth control, my high blood pressure immediately went away, followed by a marked decrease in my LDL cholesterol levels.

But it still didn't explain my testosterone levels. So I went to the doctor and asked her to get me an ultrasound of my ovaries. Sure enough, they found the “string of pearls” that told them I had PCOS.

PCOS, an endocrine disorder that affects 1 in 10 women in the world. PCOS, a disorder where one of the symptoms involves problems with weight gain for no apparent reason and ridiculously high testosterone levels.

The doctor also told me that it was unlikely that I would be fertile at all, because of my testosterone levels. This made me very very upset because I have always wanted to have children of my own.

I requested that the doctor prescribe me metformin (a drug that many studies have mentioned lowers insulin resistance (another PCOS symptom that increases cravings for refined sugar and weight gain), and helps to lower testosterone levels. After only a month of using metformin and keeping to my regular exercise and diet (which had improved as I got a higher paying job, but had done nothing to my weight), I was pregnant! I was so excited and so happy, because after being told that I may never have children, I had shown them wrong, yet AGAIN.

While I understand my doctors are very good people, I am very frustrated that I had to researhc and request the blood panels and tests to diagnose MYSELF. Diagnosing health problems before they cause irreversible effects should be the reason why doctors do what they do. The most important thing that I came away with after getting all of this work done is that you must advocate for yourself, regardless of your body size. A fat person is ignored because her fat is seen as the cause of her illness, but a thin or normal sized person is ignored because they appear to be of a normal weight. I would rather have some asshole doctor who actually did the legwork and the science to diagnose me properly than have some “nice” doctor who just assumes I'm healthy or unhealthy based on appearance and then send me on my merry way.

Anyway, so my pregnancy was interesting. I started it out at about 240-250ish lbs. The doctors immediately had me sign up with a “high risk” doctor (who actually turned out to be completely cool). Because of both my weight and the PCOS, I was told “don't get too used to being pregnant” a couple of times by various nurses and doctors. I was told it was very common for “women like you” to miscarry. And yet, the baby proved them all wrong by being healthy and awesome through the whole first trimester. The only problem was me. I was losing weight. I was exercising normally, eating healthily and often (and always feeling full and content after), and yet I kept losing one or two pounds every time I went into the doctor. The baby looked fine, but I just kept shrinking. Of course, by no means did I ever get “thin” even at the end of my pregnancy. But I dipped all the way down to about 202 lbs before gaining baby weight in the belly only. I was not trying to lose weight. And yet, everyone kept telling me how “great” I looked and how much better I was than before. I was happy and yet somewhat upset because I had not changed anything, and yet people assumed that I had changed my diet and exercise to be “better” during pregnancy. They assumed that the reason I was “healthier” than before was because I had decided to change my fattie ways during pregnancy. It was depressing, to say the least.

Of course, I dreaded the glucose tolerance test (a mandatory test they do in the second trimester). It is actually a pretty damn unscientific test if you do nearly any research about it, but they force women to do it anyway to diagnose them with “gestational diabetes” if they fail. Now, I took it and failed it both times, but I already knew that I had issues with insulin resistance because of PCOS. I had continued the metformin intake during pregnancy to hopefully keep me from developing it. And yet, I still failed. And I cried for hours after being diagnosed. Being diagnosed with anything with the word “diabetes” in it felt like it was validating all of those “you're going to die” assholes who gave me the “I'm only telling you that you're gross and horrible and fat because I love you” talks. It didn't make me feel like it was just something I would have to work through; it was like a judgment on my life and my body; yet another thing for others to throw at me to prove how undisciplined and without self-control and horrible and worthless I was.
And yet, I took it in stride. I mostly followed their “gestational diabetes” diet (which was basically the Atkin's diet), and never needed insulin (which, as I did more research, seemed to be more of a CAUSE of problems with the complications in pregnancy than a help).

The problem is that gestational diabetes is completely different than regular diabetes. It is not insulin dependent, and while glucose control is inhibited, that's actually COMPLETELY NORMAL for a pregnant woman because the placenta naturally does this to suck more nutrients to the fetus. In many of the things I read, the main reason they do such ridiculous diets and things for gestational diabetic women is because they are afraid of “big babies” (read “fat babies”). Some of the things I read about it made me worried that they were going to try and put my baby on a diet even before she was born. To me, this seemed like bullshit. Not only were they already treating me like a freak based off of my weight, but they were trying to make my offspring “thin” even before she left the womb!

So, while I watched my blood sugar levels (which, by the way, never got even close to high enough to cause concern), and I always ate enough to feel full, I still indulged in “bad” stuff every so often (like cheesecake!) because more and more I was starting to think that it was just more “fat prejudice” at work in the medical profession. My suspicions were confirmed when I was scheduled with a midwife for a follow up prenatal appointment because my regular doctor was out of town and this other doctor from the practice STORMED INTO THE EXAM ROOM and started shrieking at me about “don't you know that you have gestational diabetes?! It's DIABETES-and at your weight...!!!!! You need to see a REAL DOCTOR if that's the case! You're probably hurting your baby as we speak!!!”

My husband and I looked at each other and couldn't believe what we were hearing. I tried to calmly explain that I had it under control and that the exam was simply a basic “check the pregnant woman for basic vitals and ask her if she has any questions” sort of thing, but this lady practically came unhinged at my audacity not to be silent and listen to the Almighty Doctor. Needless to say, I made sure to send in a written complaint about this unrelated doctor who pretty much didn't know anything about my situation other than “gestational diabetes” and “fat” and then turned it into her own personal vendetta against me.

Lo and behold, when my daughter was born, she was only 6lbs and 13oz; nowhere near the “monster size” that everyone was predicting. But she WAS long. The doctor's prediction that she would probably be a tall baby was right on the money. Her vitals were perfect, and I wasn't all that bad off either. Still, I had issues with breastfeeding at first because of my breast size (easily F cup size) and my utter fear of smothering the baby with them. The lactation consultants were pretty helpful, but none of them really had expertise on breasts my size, so we ended up doing the “football” hold for quite awhile while my daughter was so small.

So now, when I see the doctor and they congratulate me on the baby gaining another pound or two, I am slightly afraid. Afraid about when the day will come when I take her to the doctor and her weight is not satisfactory to them. When the talk of gaining weight gives way to “well, she's got to lose a couple pounds” or “what are you feeding her anyway?” sorts of discussions where it is assumed that I am an evil witch fattening up my child for shits and giggles.

And whenever someone tells me, “wow, she's so big!” I inwardly cringe because I know that while they're trying to give me a compliment because she's a little more developed than babies at her age, and they're trying to validate my ability to nourish her and keep her healthy, I know that invariably, it's going to get to a point where my daughter cries when she steps on the scale. And there will probably be a day when she too starts showing signs of PCOS because it tends to be passed down genetically.
And I just keep thinking, 'what am I going to tell her?'

How am I going to make her feel ok for the genetic hand she's been dealt with the social problems and attitudes that she will invariably encounter? How am I going to protect her and keep her from being unfairly tagged as an unhealthy kid with negligent parents? How will it be when I not only have to fight for myself, but for my whole family to be treated with a high standard of care?

And all I can keep thinking is that I am glad I still have a good excess of testosterone, because I'm going to need it to do what has to be done, because I sure as hell am not going to be able to enjoy a high quality of life if I just let myself be ignored, marginalized and attacked by all levels of society.

These issues are not only issues of acceptance, but of expecting change and improvement in current “accepted” modes of treatment for people of size. I do not usually try and say that I really identify as a “fat person” but merely as a PERSON who is discriminated against based off of physical appearance. Of course, there are certain negative things that a fat person endures that others do not. But I do also think that in the case of medical care, we are all at a disadvantage, because when you appear thin, you are simply passed over, and when you are fat, your fatness is the only thing that is blamed.

No one sees fatness as a symptom of an underlying health problem. No one sees the fat as a completely unrelated thing to a health problem. All they see is the outer portions. So for your health, PLEASE, request the blood tests and the lab work to prove their so-called “assertions” about your health. If you are thin and you feel dizzy and awful, don't just listen to your doctor joke about how you probably forgot to eat in the morning. If you are fat and you have chest pains or issues with your back, request the cholesterol screen or the x-ray to look at your body.

Now, as a parent, I realize more than ever that my body size has a lot to do with not only how I am perceived, but how my family is perceived as well. And while I will do what I can to see that my daughter grows up with a good outlook on life and on her body and with good habits in eating and staying active; it does scare me to think that she may, by no fault of her own, fall into the “fat frame” and how can anyone prepare a person to be dehumanized and attacked simply based on appearance?

It makes me sad to think that I wish I was thin simply so that my daughter would not have to bear the stigmas of possibly being fat or having a fat mom. But I know that it's not something I can really change all that much unless I were to get extreme plastic surgery, which I am not willing to do. The most I can give her is a fat, active mom who enjoys balanced food choices, has a fiery spirit that won't let anyone take advantage of her, and all the love that I can give her.