Monday, April 28, 2008

Thin (sigh) (a meditation on food and antidepressants)

Back to my discussion with Estelle about food and the odd atmosphere of prohibition that hangs over what we eat and how much we eat (and what our children eat and how much they eat) in a country where food is plentiful. Her question was if we, as a culture, have a disordered relationship with food. I believe she said this is the conclusion of author Michael Pollan (The Omnivore's Dilemma)--Estelle based the theme of one of the classes she teaches at the Community College on his book.

It does seem true that in our culture it's rare for there to be an uncomplicated relationship with food. We are sooooo fortunate to have plenty, why do we confound it? Perhaps it's a transmutation of guilt--for having and wasting obscene amounts when so much of the world is desperately hungry.

I've been on a project to transcribe all of my old diaries into my computer. Currently I'm on #33, which makes it at least the 25th diary (with a long, long way to go) where I'm dealing with the issue of food, eating, body image, and the western cultural imperative to be thin.

I've studied this and suffered over it for years and I don't feel any closer to understanding the imperative. I know that growing up it was implicit--'diet' was an ubiquitous verb. As a child if I went home from school with a friend my mother would ask when I got home if my friend's mother was 'heavy'. That was the euphemism.

drstaceyny writes under her profile on her blog: My contention is that every woman has an eating disorder-- not necessarily anorexia or bulimia per se, but a fixation on food/ weight/shape that is unhealthy, unwanted, and undying.

And, if I might add, wearying.

Like I said, for years I took on the subject, mainly from the point of view of why I felt so susceptible to it and the ways it jabbed me internally. Why could I not dismiss the perfection hysteria for what it is? Especially since I knew it wasn't rational, I knew it was cruel.

My current working theory is that there is a sort of anxiety-fueled need-to-win dynamic that drives it. I got a clear example of this dynamic when watching a comedy television program about a family. The father volunteered to take on coaching his son's dispirited soccer team. Obviously determined that he was going to be a nurturing coach he admonished the coach of the opposing team who was harshly screaming at his kids: "Hey! Come on, lay off, they're just kids! This is supposed to be fun!" To which the opposing coach responded by sneering to his team: "Hear that? That's LOSER talk!" Similarly, to consider swimming upstream from the main by shrugging off a cultural ideal of beauty was undermined by the idea that I was indulging in sour grapes: loser talk.

This issue has been present for most of my life, in varying degrees of intensity and urgency.

I put it in a bottom drawer for the past 3 years. Shortly after returning to Portland I was very low, very depressed. I met a physician who was confident in her ability to help me manage this medicinally.

The first antidepressant I tried was Remeron. I was shocked 3 months later at my GYN checkup when I weighed more than I had ever weighed not-pregnant. The dr. said confidently: "Everyone gains weight on Remeron. I'll often prescribe it to new mothers, stressed, underweight, and not sleeping." Well, this wasn't a time I was prepared to face down the whole weight issue and I asked my primary dr. if I could switch to something like Wellbutrin, which I'd heard had a side effect of weight loss.

The way the weight-loss side effect worked for me is that the experience of hunger was detached from my emotions. I might still feel hunger, but I didn't experience it as suffering. The eating motivator was thus less potent and I lost weight. So for the past 3 or so years I've weighed approximately my high school weight.

The thing is, the drug didn't have that much effect on my mood. Not really noticeably, anyway. Perhaps there was a subtle change to my background mood base and the alteration was so gradual that I didn't notice it. Last year when I started seeing Sharon, my counselor, I told her that I was taking antidepressants. She suggested that at some point I might want to wean off of them and "see who I was without the drugs." But I really felt I wasn't any different with or without the drugs; I felt like I knew 'who I was'. Time, situational change, and a year with both boys full time in school eased the depression symptoms; the medication didn't seem to have much effect beyond the hunger effect and a mild (not unpleasant) buzz.

It was really only the weight effect that motivated me to keep taking them.

I pushed to the back of my mind the awareness that a day of reckoning was coming where I'd face some questions:

1) What does it mean to be thin?
2) Is it important to be thin?
3) Why?
4) Is it still important to be thin when I'm 49/50/51?
5) Why?
6) What does it mean that it's important to be thin?
7) Is it legitimate to use anti-depressants as a diet pill?
8) Is it dishonest to be slender by these means?
9) To whom do I owe 'honesty' about this? If me alone, why should I feel uneasy about (dis)honesty? If someone else--no that just seems absurd. Should I carry a sign that says, "I'm slender because I take Wellbutrin"? Still, I'm dogged by the feeling of misrepresenting myself. (Then comes the 'puritan question'-- if I don't have a metabolism that makes me 'naturally', 'authentically' thin is the only way I can legitimately be thin is if I suffer to do it--either through eating less than I want or exercising mightily? Why should those means be more legitimate than an antidepressant with a convenient side effect? Who says?)

Of course this opens up a whole other can of worms, too. I can see when I read my journals that there was a lot of fevered energy that I now recognize as biological--the drive for a mate. I didn't know it then but it's plain now. A successfully sexually appealing identity once seemed very necessary.

What is the basis of sexual appeal when one is beyond childbearing age? Again, the question, is it important, is it worth an effort, is it even possible? A certain number of pounds hung on my frame now looks very different than it did when I was 20, 30.

And it's not as if I'm interested in entering the world of trying to attract a sexual partner. I have friends my age who are single, friends who are divorced, Out Looking. After 16 years of marriage there is no appeal in that for me. When I get dispatches from that field I have trouble relating personally--it seems like something that belongs to another age and another time. My friends seem very engaged: I just can't relate.

I suppose having two young children makes a mate search
additionally irrelevant. It's rare that children from one man, particularly boys, have a successful relationship with a man-not-their-father who is close to their mother.

I started tapering down the antidepressants in January. It's been several weeks now since taking my last. My mood continues to be stable, but I didn't expect to experience any differences on that front. What I'm nervous about is whether or not I'll be having to confront the old demons about appearance and weight. And whether I'll finally be able to make some peace with them.


Douglas W said...

Where do I start?

Perhaps the list of questions about the meaning of 'thin'.

The meaning of "Thin" is very subjective and always relative. It varies according to what we are comparing it to.

It varies according to what our own image of our body is.

There's a good web site run by our state government and I've taken this quote from it...

"Your body image is how you think and feel about your body. Body image involves your perception, imagination and emotions. It does not necessarily reflect what you see in the mirror or what other people see. It’s also affected by how your body feels to your own touch.

"Poor body image is often linked to dieting and many people try a lot of different diets that do not work. Some people diet because they have a poor body image, rather than because they want to be a healthy weight. While it’s important to maintain a healthy weight, constant dieting can lead to physical illness and depression, especially if your weight goes up and down after dieting.

"Some people think they are overweight when they are not. Here are some statistics:

"45 per cent of women and 23 per cent of men in the healthy weight range think they are overweight.

"At least 20 per cent of women who are underweight think that they are overweight and are dieting to lose weight....

"Men and women should aim to have a body weight within the healthy weight range. One of the measures of healthy weight is the BMI (body mass index) measure....

"It is normal for women to have fat on their hips and thighs. Frequent dieting will not remove this fat. It is vital for: Fertility and breastfeeding; Prevention of osteoporosis; Healthy skin, eyes, hair and teeth....

"Things to remember:
• Our body image may not be accurate. Many people think they are overweight when they are not.
• If you diet, you will almost certainly gain any weight lost back again once you stop dieting.
Frequent dieting affects your health and can make you depressed."

Ok... so that's what the Health Department's advice is.

So what do I think? I think you need to be the right size and weight for who you are... and for the age you are... not to satisfy some comparison with who you think you should be... or what you might have been when you were 20.

You ask about taking anti-depressants as a diet pill... see above comment about how diets can lead to depression... I suspect your suggestion risks starting a viscious circle.

You ask is it important to be "thin"... no... it's important to be the right weight for your age and build.

You speak of "honesty"... what is an "honest" weight who you are? As water finds its own level, let your weight find its own level - a level that your body and health is comfortable with, not an imaginary level that has been conjured up by the pressures of societal stereotypes.

You speak of "sexual attraction" - Well, there is more to a person than physical sexual attraction, and besides sexual attraction can be made up of so many aspects of a person's personality apart from physical "thinness".... think of the "dumb blonde" stereotype - presumably sexually attractive and slim, but hopeless when it comes to intellectual attraction.

Besides, who would you be trying to "sexually attract"? Some 25 year old who can see no further than their sexual prowess? Try somebody 50, 55, 60 who not only has the experience sexually, but some of life's wisdom to go with it... and who cares if there are a few bulges over the belt.

Man-hunting? Don't rush things. Work out what to do with the one you have before you start working out how to catch the next one. That will be easier than you think when and if the time comes. As for the children... the problem is usually that the new man is presented, or perceived, as a replacement for the old one. No, nothing can replace their father. The new one has to be slowly introduced simply as a new friend.

Old demons? Yes confront them brandishing a sword! Laugh in their face and tell them that you've won and they've lost and who cares what they think anyway!

Lori said...

Just freaking great. Now I have something to think about all day. And I thought I was going to finally finish this 3-months-in-the-making post.

Now you've got me thinking.

There was an essay I read by Annie Lamott a few years ago, where she discloses that she was nearly 40 years old before she learned to eat, to be present in her body, to eat from a physical sensation, and to recognize that sensation.

I think you could factor in to this analysis that most people don't really LIVE in their bodies. We live in our heads, we don't really like our bodies and have a strong desire to take care of them from a loving place.

I have been mindful of this the past few years and am pleased to say I'm making progress. For me, yoga really helps.

When I live in it, I take better care of it. So mindfulness is key for me.

P.S. I suspect your mom is not a very mindful person.

excavator said...

A cool thing, when I wondered 'aloud' the other night about the legitimacy of my motivations in keeping a blog, was the swiftness with which an 'answer' came: in the interview I chanced to want to hear; in the particular poem chosen.

It's exciting to see what happens when calling out a question into the void--what comes back?

It's another cool thing that I have the sense that you're poised here with me on the cliff, waiting with me for what comes back.

Wow, Doug, I don't know what to say first about the government web site you quoted. Well, I'll take that back--first, I'm very amazed that something so insightful would be on a government website. It makes me wonder if there's anything comparable in our government.

It also causes me to reflect that unfortunately there must be quite a lot of body-image issues in Australian culture for it to be addressed so directly by your government.

Yeah, Lori, my mom is not a very mindful person. It's very perplexing, really, how few of her channels are open. I can't really say it's sad, because it doesn't seem to bother her. It's more difficult for me since I gravitate naturally to the deeper places where she can't follow, and I feel like I'm gasping for air in the places she's comfortable hanging out. (She doesn't see to notice the disparity though.) It's not the best fit and I end up feeling uneasy and guilty for my discomfort.

Douglas W said...

Our various governments, state and federal, have some excellent resources for assisting people, both on the web and in print. The fact that they put the resources there doesn't mean there's an excessive problem in our society, at least no more than in any comparable western culture, but rather that it is recognised and addressed - rather than governments saying "Well, it's your problem, you deal with it" or leaving it up to the private sector to provide assistance.

excavator said...

This is one of those bind type situations where I feel like I should verify the facts of what I'm going to say, but I don't have the time or inclination to go search it out. Let's just say I'd lay a bet that you are right--that in a country that has elevated 'personal responsibility' to a sort of cult status, that I would not find anything comparable in our government literature to what you quoted from yours.