Dear Scientist,

I have a chronic disease that society blames me for and many people – even some in the medical community – refuse to recognize. In fact, for many years I have blamed myself for my disease, too. It’s my fault that I’m “fat,” right? Maybe I don’t exercise enough, or don’t always eat the right foods; I make bad choices. I’ve done this to myself. 

Now I know, though, that what I am actually experiencing is the chronic disease of obesity.

When I was in my early teens and hormones were changing my body, I began a form of birth control to manage my heavy and painful monthly cycles. This was the start of my struggles with weight. I was the girl on the dance team that needed the plus-size costume. In college, instead of gaining the freshman 15, it was the freshman 50 for me. 

Then, in my early 20s, I was diagnosed with polycystic ovary syndrome, a hormone disorder than can impact reproduction, followed by many years of pregnancies, pregnancy losses, and fertility treatments. And with each of these, the weight continued to pile on. I found myself in my early 30s with three young children, at the heaviest weight in my life, and on 14 prescription medications for all of the comorbidities of obesity I was experiencing — pre-diabetes, insulin resistance, severe asthma, edema, joint pain… the list goes on. Every time I went to my primary care physician, she would add another medication to the list and say, “If you would just put the fork down and go for a walk, you would lose this weight.” 

It felt like had tried everything to lose weight:  every fad diet plan, diet medication, and exercise routine I could get my hands on. They either didn’t work at all or worked for a while (even though I was miserable and starving) but then I wouldn’t be able to maintain the extreme conditions so I would stop and then regain all the weight I had lost, plus more. 

In August 2014, I had a sleeve gastrectomy ‒ a form of weight loss surgery involving removal of the stomach by 75 to 80% in order to reduce the food consumption. I lost 100 pounds and celebrated by running three half marathons that year. But it wasn’t the end-all-be-all that “solved” obesity for me. After a few years the weight crept back even though I hadn’t abandoned my new healthy eating habits or altered my exercise routine. There was no explanation except that my body was fighting against me. My doctor ultimately prescribed a GLP-1 treatment to help me lose the additional weight and ultimately manage this chronic health condition. 

Today, through this combination of surgery, medication, as well as sustained diet and behavioral changes, I have been able to maintain my total weight loss of over 100 lbs for eight and a half years …. and counting! But regardless of what the scale says, I am a person who will live with the disease of obesity for the rest of my life.

When I started to understand that my body is not reacting normally and it wasn’t my “fault” for having this chronic disease, my entire perspective changed. I want to emphasize that for me and so many others, it isn’t only about diet and exercise! It’s such a relief when a medical provider explains to you that there are physiological reasons why your body is experiencing weight gain and difficulties losing weight and keeping it off.

As a scientist, can you help explain that this is a very complex physiological disease that deserves compassionate, non-biased medical treatment? 

Sincerely,

Kristal