The Unbearable Weight of Weight

As anybody know knows me is aware, I am fat. I’m what we call fatty fatty fat fat aka “morbidly obese”, for a variety of reasons. Some of these reasons are my “fault” (although I think ascribing fault to health stuff is a short walk down a bad path); I made terrible food choices when I was younger due to a combination of depression, poverty, and lack-of-give-a-heck. Some of these reasons are just… well, have you read this blog? Nothing about my body works right.

I’ve been overweight more or less my entire life, but my mobility has been variable. Back in my early twenties, I really enjoyed walking, although my ankles didn’t enjoy it. One of the things I used to do, back when I was living in Newtown and horribly depressed and only really able to afford rent or food or medication, not all three, was go out at 3am for a walk. It was nice. In that way that horrible depression isn’t.

These days, though, things are not so good mobility-wise, and not because I don’t want to exercise. My muscles are broken. Fun story: hydrocortisone, aka that stuff I need to take so that I don’t go into adrenal crisis which is a medical emergency, frequently causes muscle pain, weakness, and wasting. Other things that cause the type of muscle problems I have: anaemia. Diabetes. Anxiety and depression. Chronic pain. Medications like statins. Poor sleep schedule. Hypothyroid. Electrolyte imbalance. Adrenal insufficiency itself.

You probably recognise the pattern as All Things I Have Going On.

So right now, my muscles are in terrible shape, and I’m generally deconditioned as well. Any form of exertion is extremely painful for me. Standing at the counter to make a sandwich hurts, because my back muscles literally can’t support themselves. My GP has cautioned me not to push myself to do more than five minutes of very gentle work on my pedals per day, because funnily enough, pain makes me go into adrenal crashes. It’s not fun.

So, the weight thing. I can’t work out. I could literally exercise myself into a medical emergency very easily. When the weather warms up a bit, we’re going to try to get to the Engineer’s parents’ place for swimming, but right now it’s not safe for me to swim on my own either. I essentially need adult supervision any time I leave the house. So even with the pools reopening a bit, I can’t just go out and swim. It’s annoying, because I love swimming.

So my weight is a problem. I know this and I acknowledge this. Being this heavy is not good for me in any way; it makes managing my various conditions harder. But the thing is, my GP and my endocrinologist and I have discussed weight loss surgery (by that, I mean bariatric surgery like gastric banding, not liposuction. The Engineer thought I meant liposuction. Nobody is going to do liposuction on me and I don’t want them to) and there are the following issues with it.

1: WLS operates via one of two mechanisms. The first is reducing the size of the stomach so you can physically eat less; the second is reducing the length of the intestine so you absorb less. The problem with this? My appetite has never been the problem. I don’t have much of an appetite these days because of the gastroparesis. I already have digestion issues because of aforementioned gastroparesis in the form of delayed emptying, and the adrenal insufficiency means I’m at a much higher risk of malnutrition during crashes.

Besides that, I have never been able to lose weight regardless of how much or how little I ate. The only time I have successfully lost weight was the end of last year, when I lost about 10 kilos while eating a very low calorie diet, but that coincided with the period right before my adrenal insufficiency was diagnosed, which usually involves some weight loss anyway because your body is going AUGH WHERE IS MY CORTISOL, so it’s not clear whether the diet was responsible or whether it was, you know, the fact that I was actually horribly ill. That weight loss has certainly stopped now that I’m on steroids.

So I’m doubtful that WLS would be particularly helpful for me, and more to the point, having surgery is insanely risky for me. I’m a bleeding risk. I’m an anaesthesia risk. I’m a risk for an adrenal crisis. Getting the exploratory gastroscopy done was complicated as heck, and I didn’t have the AI diagnosis back then and it was a simple procedure. I honestly don’t know that a hospital would be all that willing to even do an “elective” surgery on me anymore, and I wouldn’t really blame them.

However, my cardiologist seems convinced that WLS is the answer to all my problems, and this is frustrating as hell. My heart is apparently in pretty good shape, which makes it about the only thing in my body that is doing what it’s supposed to be doing, so every time I have a follow-up with my cardiologist, he hammers on the WLS idea. And it’s getting really fucking frustrating.

Like, look, I would love it if I could get the surgery and it would work. I don’t like being this heavy. It’s bad for me and it makes everything more difficult. But I have looked at the idea logically and I just don’t see how it would help, and it would complicate things so much more than they already are. But it’s like it’s the only thing he can think about.

I’ve really started thinking that it might just not be possible. That sounds like a cop-out, but honestly, look at all the things I have going on that don’t play well together. I have tried. I will continue trying, but “staying alive and somewhat functional” has to come before weight loss at the moment, and that’s going to take all my focus for a while.