Weight

The time has come -- finally -- for me and my therapist to talk about my weight. I've been fat since the day I was born at 9 pounds 12 ounces. There's a picture of me from a summer camp. We had picked fresh blueberries and made blueberry jam. In my mind (not sure of the reality -- have to find the picture), I have blueberry jam all over my face and hands. Jenni jelly Jaff, someone called me.

My mom was really thin and very appearance conscious. My dad was fat (with occasional shedding of the weight, only to be re-gained) until the past 10 or so years, when he took control of his eating and went low carb. My brother has always been fat, too, except for when he's been good about his carbs. I've lost a lot of weight, once getting down to where I should be, and once getting close. It didn't last. The first time, I was living in Miami and swam 100 laps a day and worked very reasonable hours -- my Crohn's was far better controlled then, and my diet was simple -- I ate once a day, anything I wanted. It worked then. It wouldn't work now. I'm a lot older now, I work crazy hours, I don't have the great weather to allow me to swim outside every day. The second time I lost a bunch of weight was more recent, but it was because I was deathly ill, so that really doesn't count.

It's difficult for me to diet. I can't eat fresh fruits or vegetables, whole grains, beans, nuts, milk products, beef for the most part (I can eat it if it's in tiny pieces, but no ground beef at all). I can manage chicken, but I don't like fish except for shrimp and lobster, both of which make me sick, so that's out. Eggs are my best form of protein. All of this gives me a great excuse to eat whatever I want. Indeed, there are times when I'm so sick that the doctors tell me to eat anything I can manage to get down and keep down. So that adds to my challenges.

But all of those practical problems can be overcome if I had the will to take control of this situation. I eat the way I eat because it's how my family taught me to eat. We would go to McDonald's and buy fries to eat on the way home in addition to the fries we would eat when we got home. We would go to Dunkin' Donuts and buy a dozen donuts and sit around and eat them all. We would go to Baskin Robbins and buy four pints of ice cream and sit on my parents' bed and eat them right out of the containers, passing them around. When my mother had to drive a long distance and was phobic about it, she would bribe me and my friend Margy with hot fudge sundaes. Margy's mother told her to stop doing that to her daughter, but nobody stopped my mom from doing it to me.

My mom fed me with one hand and was horrible towards me for being fat on the other. For a long time, she wouldn't let me wear jeans to school and she took me shopping at fat stores. Lane Bryant was nowhere near what it is today. The clothes were matronly polyester --just awful. My parents sent me to fat camp one summer, too. I got mono and had to come home early.

My weight has always been an issue, and it's no secret that I've been in an out of therapy for a lot of years to deal with a whole host of issues, from family to illness. In all this time, we've danced around my weight. But I've not been feeling well at all lately, and finally my shrink brought up the subject. Indeed, she's been more assertive about this than anything we've ever talked about. She said I play such games with myself on this issue that she felt a need to cut through it. She said that the way I was fed is nothing short of neglect. And the way I eat now is nothing short of neglecting myself. I'm trying those words on for size, if you know what I mean. She knows me incredibly well, so she's probably right. I know I eat how I eat because it's how I've always eaten. I know it's about my childhood, a last vestige of ties to my parents. I know it's unhealthy, for sure. And I know I can't be the person I want to be when I'm like this. I know I need to get ahold of this somehow, to take responsibility for what I put in my mouth. I know all that is true. The word "neglect" feels harsh, but maybe not too harsh under the circumstances. As I inch my way past 250 pounds -- I can't believe I'm saying that in public, but there it is -- I know I cannot be the person I want to be like this.

The person I want to be takes responsibility for herself, and does all she can to be as healthy as possible. I can't preach patient participation in care management when I let such a big aspect of my care run wild. I can't be the role model for people with chronic illnesses when I'm such a bad role model.

Obesity is a big part of chronic illness. I don't meet my clients so I don't know if they're overweight, but I'm often surprised to get a medical chart and see that the person is even bigger -- fatter is the word I don't want to use -- than I am. We know that diabetics struggle with obesity and that obesity can cause diabetes. But what about gastroparesis? How is it that so many patients who can't eat at all are so overweight, like me? And Crohn's patients tend to be either very thin or very fat. A diet that consists of nothing but carbs and sugar will do that to you. But so will simply not making an effort.

So I am going to make the effort. It is going to be a huge challenge. There's the psychological piece that I know my wonderful shrink will help me with. And there's the practical piece, which I have to figure out for myself, but I can and I will. It's time. I've grown so much as a person. I'm doing great work. I'm important to a lot of people. It's time I took responsibility for my health fully and actively.

Saying all of this out loud, in public, is an important first step.

Anybody want to join me? Jennifer