Tuesday, February 04, 2014
Fat Black Dog
For the past couple of months or so, he's been the spectre of a Cairn terrier - tiny snatched glimpses of a fairly benign little feller, just visible out of the corner of my eye.
Yesterday he was a Staffordshire bull terrier, sitting in the hallway, panting, impatient: "Come and take me for a walk," he goaded. Pant, pant, pant, pant...
"No, you're OK. I'll just sit here and write, and maybe you'll go away, or someone else will take you for a walk."
Which they did - thank you, Jose.
Today, he's back. He's grown some overnight, too. By now he's looking something like an underfed Newfoundland: a bit scrawny, all fur coat and no...meat on his bones.
(See, even I can manage a little attempt at humour in these dark moments.)
I'll pick up on that ole black dog visual contact again in a minute, but I want to mention something else (yup, mental health's a bit haywire, so don't expect logical flow and structure. I mean, I have enough problem with that when I'm feeling OK!)
A couple of something elses, in fact. Firstly, the whole paradox of the thing.
When I'm depressed, I don't eat.
Why am I depressed? Lots of reasons. The final straw was probably not being able to complete my tax self assessment on Friday, because I couldn't find my P60, so now I'm going to be hit with a £100 fine for late completion. Oh well. <= that's the depression-related apathy kicking in.
The other major reason (on this occasion - I have frequent flyer miles):
I'm depressed because I'm fat.
That's the 'secondly' to go with the 'firstly' up there.
Putting it together...
When I'm depressed I don't eat.
I'm depressed because I'm fat.
If I don't eat, I'll lose weight.
If I lose weight, I'll become less depressed.
I'll be less depressed, my appetite will return.
I'll start eating again, get fat again...
Ah, the never-ending story.
To put it simply, if the only reason for my current, temporary dark state of mind is my BMI, then there's also only so long that the two can co-exist. However, it's enduring, repeating...more on this later.
So back to the black dog of doom and gloom whimpering at my table. He wants food. God knows, he's hungry. As I feed him he gets stronger, bigger, fatter, greedier. He wants more food. I give him more food. The more food I give him, the less food there is for me to worry about.
And that's a good thing. Yay!
If you've read this far, you're maybe thinking I should go see a doctor, get some treatment for this. Yeah, me too. Add that to the list of 'more on this later'. But for now maybe a little context will help.
I'm a fat person.
I don't sit around watching Jeremy Kyle and eating chocolate all day. I don't drink sugary pop / soda / whatever you want to call your carbonated drinks. I don't even have sugar in my coffee. I'm not overly fond of chocolate, or cake, but I do like the occasional bit of chocolate cake. I don't eat crisps. I'm not a snacker, or an in-between meals eater. I can skip breakfast and lunch without any trouble at all.
However, I don't exercise enough, even when I don't have crippling back spasms, because I find it extremely boring. I have a very active brain. I think and create all of the time. Walking, or cycling, or doing anything where I can not occupy my brain makes me go (even more) insane. Boring.
And I do have a sedentary job. I teach, mostly online and through distance learning. When I'm in the classroom, my subject is academic (social science) - lots of mental agility; not so much of the physical variety. The rest of the time I write, edit and publish.
I have really, really fit fingers! These babies could run marathons!
The rest of me? It's going to the dogs.
The black dogs.
What I also have is a lifelong abusive eating pattern - not an eating disorder in the recognised sense - I don't binge and purge; I don't starve myself, other than when depression leaves me without an appetite. OK, maybe it is an eating disorder, but it's not enough of one for doctors to acknowledge it as such, and I'm not alone in this. Au contraire! I'm betting a significant number of people who read this will be saying to themselves right about now, "I hear ya!" Because it's endemic. Obesity is a major problem in contemporary, western society. I'm going to skip the evidence to illustrate, as you can go and read it elsewhere, but you know it. Being overweight is being normalised. We expect it. Over-eating is a common problem, along with lack of exercise and eating the wrong kinds of food (processed, instant junk with too much salt, sugar, saturated fat).
We all know all of this, us fatties. So what the hell are we doing?
The social scientist in me has a few theories on this:
1. The easy one that's well known, is that it's due to the busy, modern lives we have. We work too many hours; we don't earn enough money. We're tired, the takeaway is less effort and cheaper than buying raw ingredients we don't have time to prepare. We take the logical option - in the short term. Long term? We live in a culture that is all about the here and now. Who's thinking long term? We're going to work until we die - no nice retirement package these days, so really, does it matter?
2. It's a class thing. It's true that poorer people don't have the money to buy good quality, fresh food. They're also more likely to be working long, long hours for very low wages. No time to exercise, plus high calorie, cheap, filling food leads to obesity. Obesity leads to heart disease, type 2 diabetes, etc. etc. We know, we know. Help? Please?
3. We are still living in a post-war society where people remember rationing, where they recall what it was like to not know where their next meal was coming from, sharing one egg between a family of four. They passed on their lessons to us, and we listened well.
"Eat your dinner and you can have pudding (dessert)."
"Don't waste food!"
"There are people starving in [some developing country, probably on the African continent]."
4. Food addiction is a major psychological problem that health care professionals are failing to address, unless you pay for private treatment, in which case they will tell you whatever you want to hear.
There are lots of other possible factors, but I want to stay with the personal, so here's the deal.
I am from a family where the women are big, and more often than not, die in their seventies from weight-related illnesses.
I also grew up in a household where the mealtime ethos was eat your dinner if you want your pudding. You've heard of Pavlov's dog? Not the same as the black dog, although cunningly alike from where I'm sitting.
Assuming you haven't heard of 'Pavlov's dog(s)', here's a quick summary:
Back in the early 1900s, Russian scientist Ivan Pavlov noticed that the dogs in his lab salivated (mouths watered) when the assistant who brought their food entered the lab. He reasoned it wasn't the assistant they found mouth-wateringly delicious, but the association of the assistant with the arrival of food. Pavlov ran some experiments, where he rang a bell and gave the dogs food. The dogs would naturally salivate because of the food, but over time, he was able to show that this natural response would occur if he just rang the bell.
We call this phenomenon 'classical conditioning'. Our natural responses (salivating, sneezing, feeling tired) can be triggered by unnatural things (ringing of a bell, the smell of flowers, the arrival of your normal bedtime, even if you were perfectly wide awake a moment ago).
Back to the 'eat dinner, get pudding' scenario.
We all have a built in physical mechanism that tells us we've had enough food.
- Eat food
- Belly gets full
- Belly sends message to brain to say it's full and to stop eating
- We stop eating
If you reach a point where you're full, but there's a delicious sweet treat, your brain is up for a bit of that sugary feel-good, so you crave the sweet treat. That's natural too.
And that would be OK, unless you're in that 'eat dinner, get pudding' situation.
In which case you ignore the message that your belly is sending your brain and you keep eating, even though you're full, and you're feeling a bit sick, because that high you're going to get from the sweet treat is worth it. You finish your dinner, you get your pudding.
Over time, your belly and brain's natural response of 'I am full' is insufficient to stop you eating. You learn to over-ride it, and just as Pavlov's dogs had no conscious choice over their bell-related salivations, so too do you have no conscious choice but to over-eat.
You do, however, have consciousness. Self concept. Higher cognitive processes, like rationalising, thinking, reasoning, understanding cause and consequence.
There are some fat people who might not recognise this in themselves. There are some fat people for whom this is NOT at all what is going on.
For THIS fat person, that is PRECISELY what is going on.
What's it like?
Here's a real example to demonstrate.
A while back I went to a friend's birthday party, where there was a hot buffet, which wasn't set out when we arrived, and I, like everyone else, was thinking, "Great! Can't wait for some of that delicious food."
Up to this point it's a rational, normal response.
So they bring the food out, and we all go and get some. I'm not first in the queue, as I'm still in the realm of sensible, rational, normal eating at this point.
I sit down and I eat my food.
I can feel the distant, weak message within. "You're full! Stop eating."
But there's another thing going on.
"There's still food on the table. There's still food on the table. THERE'S STILL FOOD ON THE GOD-DAMN TABLE!"
And all the while everyone else is dancing and chatting and drinking and generally having a great time celebrating, all I can think about is the food.
On this occasion I resisted. It's a bloody miracle I did, because usually I don't. Once I start eating I can't stop. If there's food there, hungry or not, I have to eat it. I can't help it. My natural, "You're full. Stop eating!" is a pathetic little tug at the fat elbow of, "There's still food left. Eat it! Eat it! EAT THE FOOD NOW!"
It is awful. It is horrible. I hate it. I hate food. HATE it!
What is this comfort eating of which you speak? That's what fat people do, isn't it?
Believe me when I say I get no comfort from food. It starts out as a necessary evil; it becomes unnecessary, and then it's just evil.
I hate food.
Talk about self-perpetuating. I hate food and I hate shopping for it. I'm quite close to hating cooking it, looking at it. I don't want to think about it, because when I start thinking about it, I can't stop, which means I leave the food preparation to the other people in my life, who do me no favours by saying, "Let's have a takeaway," or making unhealthy food. Yes, I could choose to buy healthy food and eat that, but that means engaging the enemy.
All of this is not new. I'm 44 years old. As I told my GP a couple of months ago, I've been fighting this demon for 30 years. And I'm tired. Really, really tired.
Back in 2002 I went to a gym for the first time, and the gym owner got me on the scales. I'd been busy with bringing up children and studying for my degree, so I'd ignored the gradual growth of girth for a few years.
I was 19 stone 4 pounds.
That's 270 pounds, in case you're in the US, or 122 KG, if you're a metric measurer.
"My word," says she who owns the gym, "I don't know where you're hiding it!"
Which was pretty much the response I got from my sister last week when I told her I was now 18 stone 4 (256 pounds / 116 KG). I might not look as heavy as I am. Maybe I''m good at disgusing it. Who knows. But it's still too damned fat!
And the thing is I've been down to 15 stone in between those times. It was a killer! Five years to lose 4 stone, with three 2 hour workouts a week. I was feeling awesomely fit and motivated. I swore I'd never let myself get back to this state. I'd keep putting in the effort, concentrating all the time on how much I was eating, checking I was getting enough exercise to burn off the calories, change my lifestyle forever...
I plateau-ed at 15 stone. No matter how hard I tried I couldn't pass that mark on the scales, and the motivation fled. From 2007 until 2012 I kept my weight stable. I did visit the gym on average once a week, walked the dogs most days. I focused on what I was eating. Then my weight started to go up, until...
November, 2012! Enter that old friend of mine, the black dog.
My weight plummeted.
I started eating again.
The dog went away.
January, 2013: I gave up smoking. 15 stone 12, and steady.
August, 2013: 16 stone 8 and needing to seriously deal with this. I want to go surfing. I want to go snowboarding. I'm going to get back in that gym, sort out my diet.
August, 2013, some gym trips later. 17 stone 4. Ah, fuck it.
December, 2013: my back went into spasm. Serious spasm, and I knew my weight was at least partly to blame, but the spasm meant I couldn't even walk the dogs, never mind exercise. I went to a bariatric clinic. They weighed me (17 stone 8 - not bad in four months, that). I decided I was going to have a gastric sleeve procedure.
People said, "WHAT?????"
Yeah, they be mostly people who've never been through this hell.
There was just one small stumbling block. Well, 10,000 small stumbling blocks, in the form of Great British pounds. I don't have them. I went to my GP, for my back, and to ask for help with my weight. I told her, "Before you say, 'Here's a diet sheet,' I've done diet sheets for 30 years. They don't work. I know what I'm supposed to eat. I know what I am supposed to do. This is NOT a lifestyle choice. It is a health problem."
She said, "Let's sort your back out and then come back and see me. I'll refer you to a bariatric clinic, but they'll make you try the diet first.
"It does work for most people."
I AM NOT MOST PEOPLE!
Those who are close to me will have heard me say this many times of late, but giving a fat person a diet sheet is like giving a depressed person a picture of a smiley.
"See that? That's how you're supposed to feel! Now be happy!"
January, 2014. Still got the back spasm. Can't fit into my clothes.
Buy bigger clothes? Accept this is my fate? No.
Back to pondering the bariatric surgery.
My sister, said, "But it's so permanent!"
"I can't imagine never eating a lovely meal again."
I can. To never have to be tortured by food, ever again! Ah, bliss!
February, 2014. Still here, still got the back spasm, tight clothes...
So why am I writing this?
Well, it's a gloomy, doomy, fat, pyjama wearing because my back hurts too much for me to go to work and my clothes hurt because I'm two sizes bigger than they are, don't want to eat because the black dog is licking its lips and giving me the evil eye kind of day.
It's a shout out to other fatties to say, "You're not alone."
Probably not, actually.
I'm feeling a little too apathetic for that.
I don't want sympathy. I don't want judgement. I'm fat because I eat too much of the wrong stuff and don't exercise. I'll get type 2 diabetes, more than likely, and heart failure, if I don't do something about it, and soon. But I can't do the whole 6 hours of working out, plus 7 hours of dog walking a week, and thinking about food and calorie intake all day, every day lifestyle, which is what it took to lose 4 stone in 5 years. Who has time for that? Realistically?
So, again, why am I writing this?
Because I need to. That's all.