“I went to the drive through and got the biggest thing of popcorn chicken they sold and I ate every last bit of it in the car.” She had that numb, dead look in her eye that I had seen before. “Then I pulled over on the side of the road, stuck a finger down my throat, and made myself throw it all up.”
“You’ve done this before?” I asked in disbelief. “You are bulemic?”
She nodded. “Since I was a teenager. I hadn’t done it in a year or two, though.” I had been seeing her for over ten years and not an inkling of this was ever spoken of before.
“Why did you do it this time? What the hell happened?”
“That new pulmonologist you sent me to? She’s as skinny as my pinkie. She says to me as soon as she walks through the door, before we talk about anything else, ‘You are obese! You need to lose weight. The only way you will be able to lose weight is by having bariatric surgery.'”
Tears were starting to roll down her face. I handed her the Kleenex box.
“The thing is, Doc, she doesn’t know me from Adam. She has never met me before. She didn’t even try to get to know me. She just looked at me like I grossed her out.”
“Did you do any more binging and purging?”
“Every damn day since that appointment.”
Years of slowly getting her to change her diet and lifestyle, getting her to start exercising (using that nifty mini-elliptical machine I wrote about before), getting her to lose weight in the healthy way…. It had translated into her actually losing weight for a few months. Twenty pounds.
ALL down the drain.
Often, when we think we have someone’s best interests at heart, we have no clue what they really need. It is easy to forget that a few words can tear someone down so thoroughly, so quickly. Thirty seconds to undo 11 years of work is a sobering thought.
With the ACE study linking severe obesity (and even autoimmune diseases) to childhood trauma, evidence now of a genetic link to being overweight, the realization that the bacteria in the gut are different in people of different sizes…. There is much more at play here than someone simply having a sloppy lack of self control.
Remember kindness. Always, always kindness.