Over the last 10 years, my life has taken quite some ridiculous turns.
I have gone from struggling with a 12 year battle with Anorexia requiring hospitalisation to living in a body riddled with numerous chronic conditions, huge neurological issues and significant weight gain from medication, reduced ability for movement and disability.
I had hoped that getting surgery to fix my head back on would be the start of getting back to a healthy weight, but in true stripyside fashion my body has created significant issues in my lower back, hips and knees which have once again become issues that are impossible to work through without help.
Over the last 2 weeks I have had 2 appointments for both my hips and the plastic surgery team who would step in during the elective double mastectomy to reduce my 85% lifetime risk of breast cancer I currently carry with BRCA2 (not something I particularly want but I know its the most sensible route to take). In both of these appointments I have come up against either complete refusal to do the surgeries I need (for my hips) or the choice of no reconstruction with the mastectomy because my BMI is over the weight limits set.
I know this sounds like an easy fix, and to many able bodied people it is. Move more, eat less, get off your arse and magically the weight will fall away – because of course every overweight body belongs to someone too lazy to care about their weight. However for some of us this is not the case in the slightest. I have recently routinely come across consultants refusing to believe I ever had anorexia, instead insisting it must have been binge eating disorder, and the triggers this sets off in someone who used to get by in life literally starving themselves to survive is huge.
I have spent appointments having to ask if they know my history, have read about the fact I live with dysmotility in my digestive track (leaving room for a child-size portion per meal), know anything about the impacts of severe untreated pain from the conditions that need treating preventing movement and having to try and explain the effects of steroids, antidepressants and other meds on my weight. I have had thyroid issues, deal with constant issues with arthritis, PCOS, joint dislocations, balance problems and not to mention autonomic dysfunction turning me into someone who has gone from being willing and able to dance for 16 hours a week to becoming faint standing up at the turn of a hat.
I am not willingly stuffing my face. I am not unwilling to exercise – im trying so hard to push myself that I know I am at risk of both destroying my body further, and falling into old habits with starving myself. Not every fat person is fat out of choice (and even if you are, it should not be a barrier to healthcare). Some of us are stuck in the cycle of needing surgery to allow us to move more and aid in weight loss, but no access to surgery because we are fat. How is this ok?
The risks of such an arbitrary system of restricting surgery until you loose the weight is that it doesn’t take into account personal circumstances. There is no room for compassion, care or understanding. There is no room to understand that highlighting someones weight can cause serious harm to someones mental health – especially when other factors have played into weight gain. No understanding that numbers still trigger past eating disorders, even if someone looks far from emaciated now.
I have spent the last 2 weeks battling the urges to stop eating again. Feeling unable to leave the house because the thought of being in front of others at this weight is unbearable. Pushing my body too hard to exercise in ways that are undoubtably not sustainable and likely damaging (repeatedly dissociating shoulders self propelling in a wheelchair I suspect will end up doing more damage than good). I WISH I had been overeating because at least then there would be an easy way to fix this.
Instead of feeling empowered to loose weight as is doubtlessly the plan, I have been battling the thoughts of depression and suicide that took 12 years of treatment to begin to lift enough to have a life. I feel like I am on the edge of a cliff with my mental health and it terrifies me because I know where that ends, and chances are it will make little difference to my weight either way.
Instead of support and help from the NHS (which I have been begging for since my body ballooned in size with steroids), I have been left with very little. Other then options of group sessions which are contraindicated due to my history of anorexia, there are few places able to offer me any help at all. I am too fat for the eating disorders team, and too eating disordered for the weight management team – so I am left with the option of trying to pay £60 per session with a specialist dietician privately who may or may not be enough to stop me going backwards (and isn’t sustainable on a low income), or risk going it alone and knowing it will take all of a few weeks to end up right back in full on anorexia mode.
I feel so frustrated with this one size fits all way of treating patients. I would be only too happy to get back to a healthy weight – I have been battling my brain since becoming too unwell to manage it leading to isolation, self hatred and periods of unhealthy restriction, but with no support and no guidance I know full well the risks I am now facing to try and fit into a tick box.
Sadly I know only too well that I am not the only person in this boat. I can count off the top of my head at least 5 friends who are in the same position as me. All of us needing to access the surgeries that could provide us the ability to regain some of our mobility with histories of eating disorders, and all of us being denied reasonable support or help to access surgery without potentially triggering past eating disorders. It is infuriating to see others struggling, and scary to have also now ended up in the same boat.