Vaccine Diaries is a series of dispatches that explore the implementation of COVID-19 immunizations.
“Name.” “Date of birth.” “Do you have a pre-existing illness?”
“Yea.” I had practiced saying it out loud. “Obesity.”
I sat in the waiting room at the vaccine site, looking around at my fat brothers as if it were a very sad and sterile version of the scene of the fat girl’s party at Hulu’s pool. Strident.
When New York State announced that Phase 1B of vaccinations would include those who are “obese” or “severely obese”, I knew I would qualify. My heart sank in my stomach.
From my understanding, child therapy is just playing Chutes and Ladders with a menopausal divorcee until you agree to stop eating carbohydrates.
I’m fat. I am a fat activist. Like many older people, I embraced the word fat. This allows me to buy clothes that fit, rather than the ones that would fit if I changed. This gives me permission to go to spinning classes (on pre-pandemic days) and worry only about trying to beat other people’s scores. Allow me exist. The word fat, I made it clear to those around me and to myself, it is not associated with a moral, intellectual or health disability. It is a descriptor. I have brown hair, blue eyes, excellent taste for caftans. I am 5’9 ”and I am fat.
But among all the radical self-love mugs I’ve seen, “I love being obese” has never been one of them. The word obese it causes incomparable pain in me. When I heard the ad I was waiting for, I spent three hours in the supermarket trying to figure out what I “should” be eating for dinner that night. I wasn’t sure I would claim my place in the queue. If I confirmed my comorbidity, what would I say to people? It’s obesity. I have “obesity”.
Big-bodied people often hear that their weight is the result of their mind: lack of willpower, lack of knowledge about nutrition or, in my case, a emotional weakness. After my parents’ divorce at the age of 5, my pediatrician took a look at my BMI, told me that I was an emotional eater, and subsequently put me in therapy. Since I was literally a kindergarten child, my food intake was largely controlled by the adults in my life. Hearing that my emotional problems were to blame for my size did not make a tonne common sense, but I also didn’t have much of a choice at the time in my health decisions, so I went to therapy. Between board games with me, my Upper West Side psychiatrist drew a body diagram with a prison located on the torso. The prison was full of anthropomorphized feelings labeled “anger”, “sadness”, “guilt” and was guarded by pieces of pizza and cake. As far as I know, child therapy is just playing Chutes and Ladders with a menopausal divorcee until you agree to stop eating carbs.
Every year I had an appointment with that pediatrician at the end of the school year. Every year, as a preparation, I started an extreme diet. I wanted to maintain a “normal” BMI in the eyes of my doctor so that my overworked single mother didn’t have to worry about my health. My doctor never really asked me what my behavior in relation to food and exercise was, as long as my data point on his height / weight chart fit the right part of the curve (something I still see in my nightmares – if you know, you You know). So, fasting in seventh grade became my normal, because that’s what made me, just by the numbers, “normal”.
Periodic crises of extreme restraint and self-loathing “worked” for a while. But when I was 15, despite my healthy diet and my tri-high school athlete status, a doctor told me that I was obese for the first time. Almost every day after this conversation, I made sure that my sister’s Taylor scale number was less than the day before. To achieve a “healthy weight” for my height, my doctor told me that I had to restrict my caloric intake, stop eating all the cookies and cakes that she insisted I should be eating. There was not much to cut; I didn’t like it and I still don’t like sweets. So I did what I could with my own limited knowledge of calories going in and out, and my restrictions on food got even more extreme. I just wanted to be healthy.
Getting to the “healthy” state involved many doses of Diet Coke to feel satisfied. After I gave in to the pangs of hunger and picked up a slice of Healthy Choice turkey at 1 am, I noted that I was a “stupid fat bitch” under the glare of a clipped reading light. This classic healthy behavior led me to a BMI right in the center of the “healthy” range, and a LOT of praise. No one questioned how this was happening until the numbers continued to drop. Disordered eating affects people of all sizes and has dangerous health consequences, even for those “with obesity”. The only tip I had about it was a single Grey’s Anatomy episode in which Meredith punctured a heart during surgery – the patient was obese, but had dangerously thin organ walls because of undiagnosed anorexia.
No one noticed mine until I was an Olsen twin. Why was subsisting exclusively on carrot sticks and cherry tomatoes dipped in ketchup OK when I was 180 pounds, but not when I was 103 pounds? The BMI chart showed its ugly face again, and I had to gain weight or I couldn’t play sports or stay in school. This did not involve getting “healthy”, just continuous attempts to play the graph. Instead of fasting and taking diuretics before getting on a scale, I drank liters of Poland Spring in the bathroom of my doctor’s office before a mandatory weekly weigh-in.
A large part of my eventual recovery meant throwing away the charts and formulas at once. The last weight I saw on the scale was in the double digits. Doctors do not need to weigh you, it seems, when the risks associated with weighing exceed any preventive care that this data point could theoretically provide. (You can diagnose diabetes on the basis of blood tests – who knew?). By looking for neutral-weight doctors who would look at my health holistically, instead of making rash judgments based on their own prejudices, I could finally focus on really being and feeling healthy (mentally) and physically). I have been about the same size for a decade. And I know that I am significantly better than when I was on a diet cycle with the goal of losing weight.
But when I heard the good news about my eligibility for the vaccine, a small voice in my brain feared it would attract me back. An even smaller voice kind of liked the prospects. I found myself looking at pictures of my underweight teen self, while thinking about the deep pain of the word obesity caused her … but also about how disappointed she would be with me now. So I panicked because I was a bad fat activist. I felt that I was just a weight away from losing my chosen identity because I can’t face a number on a scale. A number on a close scale, if not greater than what I saw at 15. After all those years, for the first time, I would need to know my BMI to make sure I qualified, and I wasn’t sure I could handle it.
I remembered how problematic BMI is as a health measure and how it leads to the perpetuation of weight discrimination and the dietary-industrial complex (things that actively harm the health of large patients). I remembered that all the hustle and bustle about COVID-19’s weight and results may well say more about the impacts of fatphobia on medicine (and the intersections of these mistreatments with other forms of discrimination) than about the real relationship between a virus and someone’s body size disease. But the trauma I experienced as a result of the culture of the diet did not just disappear when I “recovered” from my anorexia.
I am now healthier than ever. I also weigh more than ever. Clinical obesity does not take into account that different people have different weights that may be healthy for them – whether you believe it based on the set point weight theory (essentially, the idea that there are genetically determined “ideal” weights for different people), or just understand that, for some, the dietary-industrial complex hurts more than it could help. Fat it’s not black and white, just as i know mine health is not black and white. Obesity It is.
As far as I’m concerned, I was fat, with a BMI ranging from 14 to 40. No matter how skinny I got, there was always a big person trying to get out. I can admit that I am fat, because I have internalized that, regardless of my weight, it is my chosen identity, an identity that, in the final analysis, gives me more freedom than it takes away from me. Obese is not an identity that I give myself: it is a label placed on me by other people over which I have no control. But if briefly calling me obese made me feel safer, it was worth it. And most importantly, I realized that it is something that I am able to do.
I looked at my weight after I got home from the three-hour walking tour of the supermarket. And now, I’m vaccinated.