she’s thick boned

TRIGGER WARNING

this post is about weight, weight loss, and discussions about my body and its size.

as most of you know, I have been fat my whole life. I have had times of being fit, but always have been fat. my dad was fat his whole life, and would share the story of starving himself for two weeks so he could get down to the required size to join the navy with his brother. and my dad was always fit too - he walked miles every day, was a master electrician and would be the one crawling in and out of job sites, but was still fat. my mom would have been categorized in today’s age as thick or curvy until she had kids, then she too was fat. I have sisters that are thin, but they have different dads. my sisters that are also fat share the same dad. dad’s fat genetics were on point! so this is all to say that I have lost over 70 pounds in the last year, and am still fat.

in 2021 I injured myself on a cross country trip back to see my dad one last time, and after some x-rays and MRIs, they said I needed a hip replacement. I think this is from my mom’s genetics, because I recall my aunt getting a hip replaced at a young age, but I also have years of cheerleading, bartending, waitressing, and floor nursing that could have caused the wear and tear. regardless, the next step was talking to a surgeon to discuss a hip replacement. that’s when I learned that the surgeons at UCLA, where I am a patient, won’t work with anyone with a BMI over 40. so my primary care physician at the time, who was someone I sought out specifically for their focused care on folks with eating disorders and practiced HAES, said we could try a new weight loss med to see how I reacted. she said we’d do it with the mindset it is solely to get surgery. she, and the doctor who I started seeing regularly to inject steroids into my SI joint, would reiterate the fatphobia in medicine saying, “you have a problem not caused by your weight but they will not fix it until you lose weight.”

I started what is now known as wegovy and after 3 months I was not able to escalate to the next dose because it made me so sick. I also slid back into eating disorder land. I was thinking that if I was this sick, that meant I was losing weight. so I kept the severity of the side effects to myself, and did not tell my therapist or my doctor that I was back to restricting and starving myself. the drug then became wildly popular and I could not get a refill. my doctor had what I would call a minor meltdown in front of me, yelling about the hypocrisy of mindy kaling, and that “if she ever saw her on the street…” because patients were coming in asking for the mindy kaling drug. she told me about a patient that she had to remove from her practice because they had asked for wegovy for their daughter to “lose a few pounds before college,” and when she refused to prescribe it, the patient got it from a compounding pharamcy on her own, so when they came back because the daughter was sick, she said that she would no longer see them as patients. needless to say, she was heated, and it made me break down crying and tell her what I had been experiencing on the drug. we stopped the meds, and I was back to being fat and thinking I would probably never get a hip replacement.

in 2023 my doctor informed me she would be leaving her practice. she said that UCLA had offered her a training role for new doctors on treating patients with eating disorders and attempt to remove fatphobia in the clinical space. I was so sad to lose a doctor who I worked hard to find, but so happy to hear that the university saw how valuable she is to fat patients and wanted her to share her knowledge with the future doctors. she assured me that she trained the physicians taking over her practice, and now my new doctor, who I have been with since, has been honoring my eating disorder history and responding so well to my feedback. and at some point through the course of my doing physical therapy at a community pool, I learned about a surgeon out of USC who specialized on joint replacements in larger bodies. I set up an appointment with him in may of 2024 and he told me that my butt was too big. and I mean he quite literally said, “your butt is too big for the tool that I use so it is not a no, but it is a not right now.” I said that I have always had a large ass, no matter how fit I was, and he said “I am sure you have.” which I found hilarious. he pointed out on the x-ray how bad my hip was, how strong my femurs are, and after physical exam he commented again at how strong I am so I said, “well I gotta be to carry all this ass around.”

I had a follow up with my new doctor and she said she would request his notes and confirm a target number or goal for us to aim for, but we could try a different weight loss med together, under the supervision of her and my therapist. she said she had patients who experienced the awful side effects on wegovy that did well on zepbound and found that it helped with their eating disorders. and then we had a laugh because when she got a copy of the surgeon’s notes, it literally said what he told me in clinic - my butt was too big. there was no target number or goal mentioned. and my hip was so painful and severe that I could not pretend like I could continue this way. as with any body part, I am sure, you do not realize how much you use your hips until you don’t have one of them - I can’t even put a shoe on my right foot. so I started zepbound in the beginning of june 2024.

the process up until december was that I would get a blind weight (I don’t see it) at a checkin with my doctor and she would call my therapist to review with me in my next session. it worked really well and allowed me the space to process any feelings that came up with the weight and has so far ensured I did not slip into eating disorder land again. since december I have not needed the doctor to call my therapist, instead I get the info directly from her but have the ongoing support of them both. I decided to have a followup with the surgeon in april, thinking it had almost been a year and that I had now lost over 60 pounds. my ass specifically does not seem smaller, but I have lost 2 sizes in my bathing suit bottoms, which is something I wear every day doing the pool dance routines. please note that tracking weight loss and body changes when working for years to undo the trauma that a lifetime of trying to be thinner has done, is really difficult. the mental gymnastics I am doing on a daily basis are wild. in my apartment are framed posters that say things like “in this house we do not discuss weight,” or “our body size has nothing to do with our worth.” and meanwhile I am on medication trying to get my body smaller so that I can have a surgery to allow me to walk again. it is absurdly complicated.

I saw the surgeon a few weeks ago and it went better than expected. my doctor and therapist had prepped me to handle the worst outcome, but also reiterated that I had lost a significant amount of weight and have done it the “right way” (slowly, coupled with daily movement, and under the supervision of a supportive care team) and so I went to the appointment alone and was hesitantly optimistic. the first positive thing to happen was the x-ray tech, who also works as the patient transporter, remembered me right away while taking me to the x-ray and we talked about my weight loss. he guessed my current weight and I laughed because it was wildly under what I knew to be my recent number. and then when he weighed me, we both were surprised! it was much higher than he thought (lol), and I found out that I had lost another 10 pounds since my last appointment with my doctor, making 71 pounds lost. the surgeon came into the room and was overly impressed. he kept saying he could not believe how much I had lost in less than a year. I told him I was keeping up with daily aqua aerobics and now on the zepbound and he said “well whatever it is, keep doing it, because I can confidently say you are eligible for surgery now.” he pulled up the x-ray and pointed out the severity of my hip damage just over the last year and said he could not believe I was able to walk from the chair to the bed for the exam. he was GOING ON AND ON about how strong my femurs are and that any athlete would kill for bones as thick as mine and that he will need to order special pins for the surgery to be able to drill into my bones. I again made jokes about them needing to be strong to carry my ass around and he laughed, “oh that’s right you are the funny one, I remember now.” he told me he just placed 4th in the long jump competition in his age bracket. I left and still to this day am wondering where in the hell are long jump competitions happening for 60+ year old men, but anyway, the point is, he said I will be able to get my hip replaced this year.

we talked about that he never gave a target number and he explained that it is because all bodies are so vastly different. he could have told me to lose 100 pounds, which would seem impossible, and I would leave thinking it would never happen, and maybe never try. or if I did try, and lose 100 pounds, then I come back and he still can’t do it and says actually that was not enough, or, what if I only needed to lose 50 for it to be possible and I was trying for something that was not even necessary. it was like he was saying all the things that you want a doctor to say when dealing with large bodies, but because I was the one actively trying to get to some goal I was not aware of, it was confusing. I am not gonna lie. he also had me lay on the table in the position for the surgery so we could visualize the procedure, and I had no idea I would be side lying, that was interesting! I knew he replaced hips posteriorly, which is why he needed my ass smaller, but to be on my side was an update. he then said that he could do it today, but it would still be complicated, and that I would know when to come back. I left thinking that was some woo-woo messaging, but I understood him. I know that I can return in the end of the summer and that will be my surgery prep appointment.

so here we are - still on zepbound, still dancing every day in the pool, and watching my body shrink with the excitement of a new hip on the horizon. watching my body shrink has been a bigger hurdle for my brain than I anticipated, and I am processing it every day. the plan was to stop the zepbound as soon as hip surgery and rehab was completed. remember, my health was not impacted by my weight, so why would I stay on a drug for no reason? but now I am living in a body that is smaller than before, and fucking enjoying it. I am seeing the benefits we all know come with having a smaller body - I can sit in chairs in public without fearing my hips are too wide, or I may break it, I can drop my robe at the pool and nobody stares a little longer at my rolls, and I can even walk around a little easier because there is less weight on my bad hip. I know my weight does not affect my worth and has historically not caused my health issues, however, I can’t help but see benefits of this weight loss. and it’s still happening.

I am so grateful to my doctor and therapist because I know I can share this with them and feel supported. I know that my doctor will allow me to stay on zepbound if I change my mind after the surgery, but I can’t help but think of my former doctor who was so mad at mindy kaling. the hypocrisy is so real and so difficult to tease apart. if I stayed on the drug after recovery, how could I continue to be a loud advocate for fat bodies and fat acceptance while also on a drug to make my body smaller? and not for a life changing surgery, but instead just because I have now felt the social benefits of being in a smaller body and it is like a drug in and of itself.