Friday, May 17, 2024

TMI? BMI? Can We Talk?


That's the magnolia I found blooming on my tree today when I got back from getting my hair cut. It was low enough on the branch for me to be able to reach it, pull it down a bit, and take its picture. The petals are completely unblemished, huge, waxy, and perfect. I so wanted to snap it off the branch and bring it in but I could not do it. It is exactly where it should be. 

It was so good to see Melissa. They got their power back on this very morning. So it had been off a week. They were lucky and only had one tree come down and it mostly took out their screened porch and utility room. She told me that their entire neighborhood is so stacked with huge tree trunks and limbs on the sides of the roads that you couldn't fit another stick on one of them and no one can do a darn thing until the city comes and gets all of it. 
And then I ended up talking way too much. So much that when I was done and was sitting in the car again, I made a vow to myself to shut the fuck up and let other people talk more. I know it's because I see other people so rarely and the words just pour out of me but it's ridiculous and it's sad. And Melissa is so kind and so sweet that she just let me go on. She also cut off about eight inches of my hair. The main difference it makes to me is the number of times I twist it when I put it up in a bun. Instead of having to make about five twists, I'm now good with two. 

My car is not running. Something about the 12-volt starter battery in the Prius. And of course Mr. Moon does not have time to work on that right now. Luckily, we have about half a dozen vehicles that do run in the yard so I've been driving "his" Camry. I stopped by Costco on my way home to get gas and after waiting in line for about fifteen minutes, I pulled up to the pump to realize that I had no idea how to open the gas tank. Where the lever is to open mine is where the lever is to open the hood on Glen's car. So I pulled on out and parked and found the owner's manual and looked it up. 
It was a big "duh." 
Then I drove back and got in line again and finally was able to fill it up. 

The Tom saga continues. I won't go into any details except to say that Glen finally convinced him to let him rent a small excavator or some other heavy machinery type thing to get the spot cleared for the new house. Tom fought that like a beast. There are two palm trees on the spot they need to use due to proximity to power, water, and the septic tank, and Tom is obsessed with his palm trees. They're swallowed up at this point in azaleas which have gotten so huge that you can't even see the palms so that says a lot right there. Mr. Moon promised him he'd dig up the palms and not kill them and thus, an agreement was finally reached. 
This has all gone beyond impossible. 

So okay, I want to talk about obesity and the new drugs that are changing the way we treat it. I listened to a podcast (Armchair Expert) and the guest was Sanjay Gupta who has a documentary coming out about this subject soon. 
It was rather eye-opening. 
The way these drugs work, very simply, is that after we eat, we release a hormone that tells us that we are full and we don't really worry about food until we actually need to eat again. The thing is, many people don't seem to produce enough of this hormone to tell our bodies that they've been fed and the drugs help to increase that hormonal release. Evolutionarily, not producing too much of the hormone may have been a good thing. If someone a very long time ago had access to a lot of food at one time, it was probably a sound idea to eat all they could before the food spoiled, thus storing whatever the body didn't need for fuel at that time as fat. In fact, the ability to store energy as fat was probably a trait that got passed down due to the fact that people who had it lived long enough to produce more progeny who also had the trait. But we don't live in that world any more. Or at least most of us don't. We live in a world where densely caloric foods are available to us twenty-four hours a day, seven days a week. And many of these foods are cleverly designed to trigger our appetite with chemicals and sweeteners and flavors that no one a thousand years ago had access to and, appetite triggered, we feel that we must be hungry and we reach for those foods.
I could go on for days about this. 

But let's get back to obesity. Of course there are a huge number of reasons that people become overweight. Lack of exercise and eating too much is definitely one of them and for people to whom exercise comes naturally and who have a healthy amount of the hormone that causes us to shut off what they are now calling "food chatter," that seems like the simplest thing in the world. 
Move more and eat less, you fools!
I will never forget having a friend who was preternaturally thin. I mean- so thin you wondered where her internal organs were. And she ate whatever she wanted. At that time I was literally eating about 800 calories a day and was still not at the weight I wanted to be. Yes, I did have an eating disorder. Anyway, she suggested to me that instead of eating dessert, maybe I should just try eating half a grapefruit. 
As if I ever, ever ate dessert. 

When I was at what I thought was a reasonable weight, I had literally become obsessed with diet and exercise. Not quite an eating disorder but definitely an obsession. I worked for Weight Watchers which works and is a good plan and which is healthy and sensible. I would get up at 5:45 a.m. and walk for an hour every week day. I lifted weights. I measured out my portions. I cooked beautiful meals that had to be very creative in order to fit the criteria of the food plan. And eventually, I even adopted a way of eating that I called "all healthy and shit" which was basically incredibly high in fiber (fruits and vegetables and beans and nuts and whole grains), and incredibly low in sugars, fats, flour, dairy products and red meat. 
For years, my go-to snack was raw almonds and prunes. I kept bags of them in my car and in my purse.
And this worked. I didn't have to weigh my portions. I ate from the ground up. I made my own bread so dense with flax seed, oat bran, and whole wheat flour that occasionally Mr. Moon would ask me if I could please make some "fluffy" bread. We ate quinoa and brown rice only, hardly any pasta, virtually no cheese, no butter, no...
Well. No a lot of stuff. And when you don't allow yourself to eat the "fun foods" like cheese and crackers and chicken salad with mayonnaise in it, there's not nearly as much temptation to overeat. 

Then anxiety hit me hard and for months I could not eat. When your body is in fight or flight all the time, which is what mine was, eating is not a big priority. When I finally started getting better with medication and time, my appetite returned and I just wanted for once to eat what I wanted to eat. 
And white flour and white rice and pasta and cheese were re-introduced to my diet and within a few years, I was overweight. I still exercised, I still ate relatively healthy food, but I also ate things that I had not allowed myself to eat before. 

I hate being overweight. I just do. I don't judge others for being overweight. I know quite well the place we put food in our culture and society and I know that being slim is not always being healthy and isn't the standard for beauty. But for me, I feel a great amount of shame about my body which is a WHOLE other subject. One would think that at this stage of my life I just would not care but that's not true. And it's not just about appearance. I hate taking medicine for high cholesterol, I hate taking medicine for high blood pressure. I hate my mobility being challenged in ways that it would not be if I lost weight. 
I hate that I hate looking in a mirror and that I actively and deliberately avoid it as much as possible. 

But do I hate all of this enough to go back to my obsessive ways of eating and exercising? 
Honestly, I do not. I really don't think I could.
Would I consider taking a drug that helped me to eat less? 
You fucking bet I would. 

I have a lot more to say about this. Sanjay talked a lot about how we may need to view obesity as a disorder in and of itself and quit thinking of it as just the result of bad habits. How people used to feel that anti-depressants and anxiety medications were just ways to prevent people from pulling themselves up by their bootstraps and getting on with it. People who went to psychiatrists were often considered self-absorbed and absurd. And then it became accepted knowledge that depression and anxiety and other now-diagnosed mental illnesses were indeed illnesses. I know damn well how I've felt when people have told me that depression was a choice. That they just got up every morning and decided to be happy. I should try that! 
And now we have the same beliefs about obesity. Just get up every morning and go exercise and make a decision to not eat so much! That you're somehow "cheating" if you take one of these new drugs to lose weight, just as you're weak if you need to take drugs to simply get out of bed every morning and face the world. To decide to keep on living. 

I want to discuss this some more. And I will. 

But hey! It's Friday night! Not that my husband's home to make my martini. He rented the little excavator that he needs to clear that space and he's planning on using it until dark. And then he'll get up in the morning and go use it again. It's supposed to storm here tonight and maybe tomorrow. I talked to him on the phone and told him that if Tom wants to come spend the night, to bring him home. But. That if Tom says he'll be fine in his tree-busted trailer and that he doesn't want to come over, to just let him stay there but to promise me that he will not get up at 3:00 a.m. to go get him if storms do indeed occur. 
He promised me. 

There are clean sheets on the bed but I seriously doubt that Mr. Moon would notice if I hadn't washed those sheets in months and a muddy dog had rolled around in them. 

Happy Friday, y'all. 

Love...Ms. Moon






48 comments:

  1. About your weight discussion. Every word is true. I know a person who needed a new knee but the doctor would not proceed until she lost weight. So, she lost thirty pounds. The knee was replaced. Then her nurse practitioner started her on Ozempic. Over the next year she lost seventy more pounds. Think: Lost 100 pounds. Ozempic is not a free ride. You religiously eat vitamins, drink supplements. On a schedule. Then the insurance quit paying for Ozempic for weight loss. What shortsighted stupidity! Fortunately, there is a pill replacement. Another adjustment. You must remain determined every day. It has been about two years now for this person. More power to her!

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    1. Joanne, if you feel able to share , what was the pill replacement that worked for your friend? I am in the same predicament with my insurance and am very worried about gaining all the weight back.

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    2. More power to her indeed! I bet she feels like a new woman with so much less weight on her joints and feet, not to mention the work her heart and lungs had to do.

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    3. Her replacement med is phentermine.

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  2. Food and Tom...two fascinating subjects. But since I don't know Tom I will keep my comments on food. Except for short intervals I have been overweight my entire life. I am right now. I'm on the verge of type 2 diabetes. It shames me that I don't have the discipline to make the diet changes to reverse that direction. But I'm not going to ask for any help from medicine. With the attention on Ozempic I have been very curious how people are getting it prescribed who do not qualify. So much that it's becoming hard for true diabetics. Possibly doctors are fudging the numbers? I know many morbidly obese people. Several are diabetic. I've seen them eat and it's understandable. But I don't shame them. Life is hard enough.

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    1. Well, the thing is, according to Dr. Gupta, obesity IS a disease, just like addiction. Just like depression. And we help people with those issues in medical ways. I don't think that doctors are fudging the numbers in general. I think that many of them see patients whose health would improve dramatically if they lost weight and if a drug can help with that, why not?

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  3. Weight is a much more complicated story than eating and moving. The gut biome has a lot to do with it, too, and that's partly in our DNA and slightly influenced by food intake.
    So blaming is completely wrong.

    I used to know two women, friends who'd met at, get this, Olympic long distance swimming trials! Both weighed easily 250 lbs, both swam several miles a week, both were very fit, with good stats.
    I'm half that weight, have genetic high BP and cholesterol. It's not about fitness or weight in this case. So I don't deserve credit for my steady acceptable weight, any more than my eye color.

    It think that banning anything from our foods just builds deprivation and often eventually bursting back into eating all the things. Anyway, there's a lot to it. Fat isn't always unfit, thin isn't always fit.

    My 2c, which ended up being $2.

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    1. Thank you!!! Right on target!

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    2. Thank you, dear Liz. You are exactly correct- slimness does not always translate to healthy. Genetics have a great deal to do with the whole thing. When my cholesterol started going up, I went on an almost vegan diet. NO animal fat to speak of. Just the "healthy" fats and not much of them. It changed nothing when it came to my cholesterol.

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    3. Mary, My mother had triglyceridemia , what ever its called, it is also in my genetic 23 and me - cholesterol just part of my make up, and maybe of yours too. It is normal.

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    4. I have high cholesterol. Losing weight did nothing. Stopping smoking did nothing. I’ve never eaten a fatty, fried diet. I have no blockages, so have stopped statins. My pcp said, “sometimes you just have to say ‘thanks, Mom and Dad.’” Margaret

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  4. my BMI has always been too high for what is 'healthy' but I can also carry two 9 year olds by the back of their pants after breaking up a fight so there's that too. I have digestive issues that make the weight loss drugs not accessible to me- one of our friends did lose a significant amount of weight on them but will be on the meds the rest of her life to maintain the weight loss and that kind of scares me too. fortunately my other numbers (cholesterol, BP and sugar) are 'healthy' levels. I focus on being active and trying to eat a variety of foods in reasonable portions. xxalainaxx

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    1. Regarding BMI, read this: https://www.abc.net.au/news/2022-01-02/the-problem-with-the-body-mass-index-bmi/100728416
      It is a little troubling to think of being on a drug for the rest of one's life but I'll be on antidepressants and drugs to help control cholesterol and blood pressure for the rest of my life. So, that's true too. I, too, try to be active and eat a variety of healthy foods but it's not enough for me. Obviously.

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  5. Food is a difficult obsession. Everyone HAS to eat and make choices about what to eat, how much, how they want to look and feel. Those Choices all matter. Even some people who make good Choices aren't ensured desirable results and some who made bad Choices are not as adversely affected by what they consume, or so it seems externally anyway. That Magnolia Blossom is Perfection, no wonder you couldn't bring yourself to pick it, it is just where it belongs.

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    1. You're right, Bohemian. Everyone's little personal chemical lab works differently and gets different results with the same input. So weird but true.

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  6. I'm not happy about being overweight either but I know the cause (for me) is sitting on my butt most of the day by the computer, while still eating as if I were working eight hours a day. Plus dessert. I love the sweet things.
    I also take pills for high blood pressure and high cholesterol.
    The answer for me is to get out and walk more, though I find that incredibly boring most of the time unless I can get to the beaches, which is not always easy as I get older and wish to be home before dark.
    I often wonder if it is real hunger that drives the eating or if it is the taste buds. The "mouth feel" of certain foods definitely makes me want to eat more of them, for instance yesterday I ate a delicious custard filled doughnut and right away felt I could easily enjoy another or even two more because my taste buds were so happy. Luckily I had only bought the one doughnut!

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    1. Yes. I know I eat portions that are too large. Desserts are not my problem. I do like sweets sometimes but they aren't what I crave. I quit doing much baking years ago.
      I am quite certain that it is not hunger that motivates most of us to eat. Many of us barely know what real hunger feels like. It is the promise of the experience of tasting delicious foods. That is so true.

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  7. There is eating to fill the gap in the stomach and eating to fill the hole in your soul. I fall into the latter. Meds help a bit but anxiety and depression do go hand in hand with obesity.
    Would I consider Ozempic (or whatever it's called here - there is one version just for weight loss)? Maybe. But I don't think I miss the "full"cues. When the black dog is sitting on my back I crave carbs which produce endorphins and so we go.
    Magnolias belong on trees. They are so majestic.

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    1. Your first sentence just gobsmacked me. Yes!

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    2. I agree- mental issues very much affect how our body processes food and how it craves certain foods for comfort and self-calming.
      This is a proven fact.

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  8. You worked for weight watchers? I tried WW but hated it and thought they were really a shaming bunch or rewards and subtle punishments. I tried Jenny Craig - horrible. Then, during covid, I tried nutri -system , which was delicious , measured and satisfying and 100% chemical processed lab food that threw me into an inflammation arthritic horror. Latest blurb from the doctors report " morbid obesity". Really?
    It's like " I command you to grow taller and grow thicker hair " . Anyway , I am pretty damned healthy so the doctor can fuck right off! Sure, I would like to be my younger thinner self just so that I could wear levis again, but that ain't happening, girl!
    Your Magnolia looks so good it looks fake! And isn't that the best compliment ever???
    Anyway, Mary, thanks for posting this about "I AM FAT". you are right, we are not done with this......

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    1. When I first started going to WW, I found a leader who was a man who was the funniest, sweetest, craziest guy you could imagine. The total opposite of what you'd expect to find in a WW meeting. And he really believed in the program and he made it fun. We are still friends. So he inspired me and I think I was a good leader. I wasn't one who followed the weekly guidelines on what to talk about so much. There was a lot of class participation. And I saw a lot of people lose weight in a healthy manner which was pretty cool.
      My friend Lynn always said that her weight loss goal was to just be "obese" and not "morbidly" obese. What a fucking stupid label that is. Yeah. That doctor should fuck right off.

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  9. I think Ozempic is very promising and I've seen articles saying there are indications it does other beneficial things for the body besides weight loss -- like reducing the risk of heart attack and stroke.

    I have been very fortunate in that I've never been overweight, but I went through a period in my youth when I was food- and nutrition- and weight-obsessed, and I was probably ultimately underweight during that time. I restricted my diet quite a bit and exercised obsessively. I'd call it a borderline eating disorder. Eventually I realized that also wasn't healthy and I was able to let it go and get back to moderation.

    For me, the key to a healthy weight is no processed food. If we look at what people ate a couple of generations ago, when there was nowhere near the level of obesity we see now, that seems to be the single biggest cultural change. All the soda and fast food and salty snacks and prepackaged frozen dinners are leading us down a dangerous path, it seems to me.

    But yes, you're right, addressing the problem should not be about blaming or judgement. And as Boud said, a healthy weight doesn't necessarily mean good overall health.

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    1. Yes, it does sound like you had some disordered eating going on. It's not just women by any means.
      Dr. Gupta was talking about some of the other beneficial results of these drugs like the ones you mention. And he also said that they've actually been in use for almost twenty years as a drug for diabetes and there have not been significant side effects noted. This all sounds so good.
      I am right there with you about processed food. It is absolutely created with the goal of making you want more.

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  10. SG does notice when I change the sheets but if it were up to him, they might never get changed. Also, SG was on one of those “diet” meds for his diabetes. It was great. But the pharmacy doesn’t consistently have it lately due to the diet demand and he can’t start and stop it every other month so he’s been without it for a while. It’s the pits. That magnolia is stunning. I so rarely see an unblemished one.

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    1. Mr. Moon generally notices (and thanks me!) when I change the sheets but I knew he was so tired last night that he would not notice or care.
      Dr. Gupta said that the reason for the shortages of the drugs is that only two companies make them and no one had any idea of how popular and prescribed they would become. So it's a supply chain issue.

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  11. I was always slim until I hit menopause, when I reckon I gained 40 lbs overnight (or near enough). It bothered the hell out of me for the longest time, but now, since I'm an invisible over 50 (over 65) year old woman I just thought sod it. I guess I'm lucky in that I don't see it affecting my health - maybe I'd lose it if it did. But my poor friend is about 5'2 and seriously overweight. Has been all of her life. And she has to live with a sister who is about the same height and slim as a reed. Mind you, said sister exercises constantly BUT because she loves it. I guess I can understand how "unfair" my friend feels this is!

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    1. Menopause is a bitch. Too many changes and my body just said, "Well, this is the size you're going to be." I hated having my period, but this is no fun either.

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    2. Hormones have crazy effects on weight. And the lack thereof! For those of us who have always had weight issues, menopause only made things that much worse which, in my case at least, led to me just sort of giving up. Have I accepted that? No. I haven't.
      I have a brother who has always been able to eat whatever he wants without gaining weight. And he has always eaten a LOT! Yes. I am jealous of his metabolism.

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  12. There is so much victim blaming going on with weight and obesity. It's bad. So yes, there are health issues related to body weight, obviously and diet and nutrition are also political and class issues that need attention, but so much has to do with body image and what is considered a healthy (replace that with attractive to the male gaze) looking female body. I remember the debate about upper arms when Michelle Obama appeared on the scene and how suddenly most US female news anchors were dressed in sleeveless outfits? As if slim upper arms were an indication of worth.

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    1. You're right, Sabine. Even when people talk about "beautiful older women," they are generally talking about older women who still have slim bodies. That's the ideal, no matter your age.

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  13. There's so much I could say about this, some of which you know from a private conversation we had the other day. My weight is always an issue hovering in the back of my mind every day of my life. It's exhausting. The shame of it is a lot of the reason I'm so much of a people pleaser and I never feel like I quite measure up. Trying hard to lose weight certainly doesn't equal success at it, either. I guarantee you I could eat the exact same things and have the exact same activity level as my naturally thin husband, and in a couple of months he'd be the same and I'd probably have put on a few more pounds. It's so discouraging. People who don't struggle with weight have no idea.

    I think drugs that even up the playing field are a wonderful thing. I'm glad that they're being approved for that purpose more and more these days. Lots of people at the moment seem to try to shame non-diabetics for taking them, as if obesity is less deserving. Funny, because diabetes often follows years of obesity anyway. Prevention would be better than a cure!

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    1. I love your comment that these drugs "level the playing field." Thank you for that wisdom.

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    2. "People who don't struggle with weight have no idea."
      And they should keep their mouths shut when it comes to suggesting substituting grapefruit for dessert.
      Every point you've made here is valid and reasonable. Dr. Gupta did talk about how prevention is so very important when it comes to disease and that these drugs fit right in there. It will be interesting to watch the documentary.

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  14. I also meant to mention that these drugs seem to produce the "I'm full" feeling for more than just food. People are reporting drinking less alcohol while on it, too. I think that's really interesting.

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  15. I agree with Boud. I have never been overweight but I am on high blood pressure and high cholesterol meds and blood thinners among other things. And sparklingmerlot has a good comment, too.
    You are right that there's too much judging going on and people are often doing the best they can and it would be better if we could just be supportive of each other and just help each other when we can.

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    1. Thank you, Ellen, for that very reasonable comment. You're right. Support is what is needed, not judgement or uneducated advice.

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  16. This is a lightening bolt of a post. It has me contemplating whether I should write about my own experience with GLP1 meds, which my doctor put me on a year and a half ago, and which my insurance has now decided to stop covering. I worry I will gain back the weight I lost, that the food noise will come roaring back, that even though I am no longer losing weight, I am at least not steadily regaining the 60 pounds I lost with every morsel of food that passes my lips. The scale holds steady, the way I imagine it does for normal people are. My fullness meter definitely does not work, I cannot remember ever not being hungry until I started on the meds, and then I wanted to cry, because it became so obvious that what I was dealing with was chemical, a system awry, and I glimpsed what it was like for people who don't struggle against food in every waking moment. In short, I was not a moral failure, but I had a medical condition, one that could be addressed by science. Now I will back in the wilds, forever trying to quiet the food chatter, the insulin rushes, the cravings that people seem to believe are merely indicative of poor character. Maybe I wont write that post. I already feel so emotional talking about it here. I have felt fat shamed for my entire life, and that shame is a part of my very cells at this point. But thank you for opening up this conversation, it is one we need to have, and I have so many more thoughts on this, including related to race and gender and history and science, and wealth and Big Pharma, too. But I appreciate you writing as you have, and appreciate all the comments people have left here, too. It's a thorny issue, this, not easy to pick the threads apart.

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    1. We are indeed sisters. Every word you say here rings true for me except for the fact that I have not tried the drugs and so have no idea what it would feel like not to be constantly (and I do mean constantly) obsessed with food in one way or another. Same with shame. I hope with all of my heart that you figure out a way to stay on the medication which obviously works beautifully for you. Fucking insurance.

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  17. I have been lucky, I was always skinny, even though I didn't want to be. I'm the opposite of so many people and feel full quickly. For years I always didn't eat much when stressed, so most of my life:) Menopause has caused a weight gain of about 35 pounds, which was hard to get used to but I know I am fortunate. I read up about Ozempic and found out it can cause long term guy motility problems that don't go away in some cases. Part of me feeling full, is probably the fact that my gut motility is slow and my stomach doesn't empty very quickly. Enough about me. You do what works for you, for you to feel good.

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    1. We are all so different! Both in nature and in nurture. Thank you for sharing what it's been like for you as a naturally thin person. How did the weight gain from menopause affect you beyond having to get used to it? I would be interested to hear.

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    2. It was just weird. None of my clothes fit. I could no longer eat whatever I wanted to. I felt unattractive, although that's nothing new. My body no longer did what I wanted it to do. I just felt like I was along for the ride. I've never dieted in my life so I didn't really know what to do and I'm also unwilling to give up the things I enjoy. Mostly it just sits in my head and bothers me. I know, wah, wah:)

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  18. Great topic. We've all struggled in one way or another when it comes to weight and/or health care. If science (medication) can solve a problem, it should be available to everyone. I do not like the fact that physicians/insurance companies deny treatment. Good weight helps maintain health and isn't that what we all want. A friend was diagnosed with MS and she was put on one medication after another. Nothing was working. The doc finally said he knew which medication would work but the insurance company wanted the less expensive meds to be tried first. Eventually, she got the med she needed.

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    1. The GLP1 meds do have side effects, though mine were mild and subsided, but they also have corollary benefits, such as reducing the incidence of heart attack and stroke by some 20 percent, which is huge, and mysteriously addressing addictive behavior such as compulsive drinking and drug use, and even nail biting. All worth studying more.

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    2. That's a terrible story about your friend, Susan. What a bunch of crap. That's so inhumane. Money before people. And that is capitalism for you.
      That is so interesting, isn't it, Rosemarie? One day I hope that science figures out how all of these things are related. Until then, to have a remedy for these behaviors is nothing short of a miracle.

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  19. 37P: btw, the anonymous replies to other commenters above are mine. I was on my phone, which doesn't recognize my handle.

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    1. Gotcha! I love all the input. Thank you, dear lady.

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Tell me, sweeties. Tell me what you think.