The Big Lie...

For me the bottom line is this. Longitudinal studies show that for people with the severe sort of weight problem I had and that you seem to have don't often succeed with standard diet and exercise programs. You may succeed initially, but long-term, 5-years out, the success rate is below 5%. So 95% of the time the herculean effort involved in losing 50, or 100 pounds or whatever leads ultimately to disappointment.

In the meantime, we all grow up internalizing all the negative stereotypes. I grew up with a very close friend who was gay. He never came out to me until we were both in our 30s. In High School, he joined the football team to prove to himself and the world that he was straight. He even lived with a woman for a year, and had several other girlfriends over the next few years. All the time, he was secretly fantasizing about James Dean and Mick Jagger, etc. When he finally came out to the point where he could talk to me about it, I assumed it was a phase he needed to go through, but that ultimately he'd realize he was really straight (I mean, after all he was my best friend, from Brooklyn, Gravesend section, it doesn't get much more macho than that).

In the end, of course, we both came to discover that it wasn't just a phase. Watching my friend evolve into self acceptance was a profoundly moving learning experience for me. As I got to spend more time around some of his gay friends, I was struck by how much of their humor was self deprecating. Really funny stuff, a lot of it. But I came to see how destructive it was for them. You grow up in a world that makes such big fuss over not being a real man. Over time, you soak up a couple of really screwed up messages. One is that the most important thing about you is your sexual orientation. No other facet of who you are triggers anything like the excitement that that does. The second is that this crucial, defining aspect of who your are makes you not as good as anybody else. My friend, who is a warm, wonderful, decent, loving human being, wrestled with all sorts of demons making peace with being gay. I think he's come out the other side, but it's been tough.

After realizing what I've just described about my gay friend, I finally came to see how closely my own situation resembled his. And that research (showing a less-than-5% success rate for standard diet and exercise regimes) was a key part of that realization. Down deep, I'd bought into the same sort of crap. As long as I could remember, the one aspect of who I am that seemed to matter to people, that triggered all sorts of strong reactions, was the fact that I was fat. And this core aspect of my identity meant that I wasn't as good as everybody else. After all, with just a little bit of willpower I could be like everybody else. And the fact that I did manage to lose weight and then gained it back just showed that I was ultimately weak and self-sabotaging, and unworthy of respect.

Everyone on this list needs to see through this big lie. First of all, your size and shape are not the core of who you are. They are accidental characteristics. That sneaking suspicion you have that you don't deserve to be loved is a bunch of crap.

For my friend, marching in the Gay Pride parade was an important part of rebuilding his wounded self-respect. Over the years, he did a lot more than that. He ultimately wrote a doctoral dissertation that focused on the exent to which school counselors who worked with gay teenagers were, themselves, homophobic. Well guess what. An awful lot of people who claim to be in the business of helping people with weight problems are just as tainted with hidden (and sometimes overt) distaste and disrespect for the people they profess to want to help.

So going forward with your fight for recognition that this is a medical problem, a potentially life threatening one, and not just a manifestation of your _________ (fill in the blank with negative adjectives of your own choosing) is an important part of you reclaiming and repairing your own self-respect.

Dig it. You have worked hard. Part of what you have earned is paid to you in cash; part of it is paid for in the form of health insurance coverage. This is not a gift, it is a service bought and paid for by the sweat of your brow and brains. You are entitled to have the company which accepted the premiums that paid for your coverage live up to its obligation. You deserve to have your condition diagnosed in a healing oriented manner, and you deserve the most effective treatment available. After 30 years of experience, any health care professional who denies the medical efficacy of good quality weight loss surgery in appropriate cases is intellectually lazy or dishonest. And any provider who defines "appropriate" so narrowly that most of the people who need and can benefit from the treatment are denied coverage is at best benighted, at worst engaged in a shell game, promising meaningful health benefits and refusing to deliver what they have promised.

Good luck,

Ken Meissner
Originally posted to OSSG 3/20/99


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