Fat (13 page)

     Nope.   Xander is only lazy about his weight, not lazy about everything.  There is a bad characterization that all fat people are lazy.  That absolutely cannot be true, because fat people crowd every workplace, every square inch of society’s fabric, and if they were all lazy, the western world would literally come to a halt.  Reports would not get filed due to Little Debbies, people would call in sick all the time due to ice cream benders, and stores would close from 11-3 every day just to ensure adequate time for the lunch buffet.  Fat people are not lazy in all aspects of their lives.  It is quite easy to work and eat simultaneously.  But, the characterization persists, and it probably arises from the stereotypical picture of a lazy person: mouth agape on the couch, watching TV, cushions molded to ass from hours of sedentary living, with chips crumbs and soda cans everywhere.  And that lazy person is always fat.  Living lazily can make you gain weight, but gaining massive amounts of weight does not necessarily make you entirely lazy – only lazy about your health and well being.  It’s just an unfortunate consequence that being lazy about that one aspect of life creates such a large billboard to advertise that fact.  Because Xander’s obesity became a bare-breasted stripper advertising a $300 million dollar lottery jackpot of a highway billboard, people were going to slow traffic and bend fenders in noticing, and in their eyes, his exterior superseded everything industrious about him.  All his capacity for hard work and his monetary successes became a footnote.  That perception, and Xander’s perception of that perception, is what made his reality now.  He spent most days alone in his estate, eating away his money.

     “Kate, I know he will be happier when he loses weight and can start living a more active life.  There’s a world out there that he can’t access right now because of his weight.”

     She took another bite of my chocolate muffin.  “He used to be so full of life, and now…”

     Sure Xander was always fat, but now he was a human dirigible.  Escalated morbid obesity.  A difficult life made impossible.  How did it get to this?  Xander did what everyone does when their lives stabilize: they settle into comfort.    Slim-fit low-rider jeans become elastic-banded, high-waisted sweats, crisp poplin shirts turn into one favorite threadbare T-shirt, clean shaven gives way to a Unabomber beard.  It feels good to eat cheesy beef sandwiches and mozzarella sticks, it is comforting to down chocolate cake and whole milk in front of mindless TV every night, and a good cheeseburger and fries is pure happiness.  It sucks to run on a treadmill and feel like throwing up for a half hour, it’s really hard to pass on a few warm chocolate chip cookies, and feeling hungry feels like an alien sucking the life from belly.  Eating and vegging out become the delusion of feeling well rather than the real wellness that comes from exercising and eating well.  Life begins to be about what is comfortable rather than what is good for you.     

     I saw him one time at Baker’s Square picking up a couple pies.  Most people when they see someone pick up a couple pies assume it is for guests at a party.  When people see Xander pick up two pies, they think it must be that night’s dessert portion, and they shake their heads.  Xander must’ve known that was what people were thinking because he came in head down, mumbled his order, paid quickly and shuffled out with his pies.  I knew the pies were for a dinner party at his parent’s house the next night, because I had been invited, though I also saw him eat the entire Oreo cookie pie for dessert at that party.

      Ever eat a full pie for dessert?  Or even half a pie?  As difficult it is to maintain great physical fitness, it is equally as difficult to maintain massive weight.  Eat six thousand calories a day?  Ten thousand?  Thirty-thousand?  I have seen Xander eat an entire X-large pizza and wash it down with a 2-Liter of Pepsi.  Kate has told me he spends thirty dollars at McDonald’s for a dinner for one.  I have seen Xander picnic in the park with a lunch of sandwiches measured by loaves of bread and packs of meat.  It is a serious commitment to stay large.  A rigid regiment needs to be followed and strictly adhered.  First, ignore the fact that the quantity being eaten is multiples of even the excess portion sizes that the average person consumes -- four extra value meals for lunch, why not?  Second, eat only high calorie concentrated grub -- don’t waste valuable chewing on just a single patty burger when a triple stack can be stuffed into the mouth with just a little more effort.  Third, eat all the time -- any period not spent eating is calories lost and calories that need to be made up to maintain massive weight.  Burger King run at midnight, don’t think about it, just do it.  And lastly, stop caring and start justifying -- spiral into self-loathing and play the victim if necessary, to square away laziness and shirking personal responsibility in the mind. 

     Kate snapped back from her stare, and started crying.  “Stupid genes we gave Xander!  Stupid slow family metabolism!  He had no chance from where he came from!”

     I patted Kate’s head as she cried, but this was ridiculous.  Trying to blame obesity on a uniquely slow metabolism or a bad genetic inheritance is ridiculous.  Metabolism and genetics are varied, but the road to morbid obesity is single: intaking multiple-fold calories than burned.  Why can’t anyone just admit that obesity is created from conscious decisions to intake a perpetual tsunami of excess calories?  Deciding to make snack-size into party-size?  Deciding to trade the Happy Meal for a Super Sizer?  Deciding to be active for nothing more than just the goal of getting to the next meal?  Intaking a week’s worth of fats in one day, then de-conditioning the body to the point of becoming more slug than man, will certainly slow the metabolism, but that slowing has nothing to do genes – it’s just the inevitable consequence of poor habits.   

     Obese parents have obese kids because they pass on their poor eating habits, and not because of some abstract fat gene. Kate and Al were lean and athletic, so her claim of some fat gene was even more absurd.  Even if reality was suspended, and Kate and Al each had some unexpressed recessive fat gene they each gave to Xander, that genotype is still just a starting point, and it has nothing to do with why he is unable to improve on his phenotype.  Not everyone is going to look like Brangelina, but that does not mean a life of never taking showers and always getting bad haircuts.  Obesity is not a hopeless genetic mutation.  Xander has decided to worsen perfectly adequate genetics with terrible behaviors.  Now he has his mom buried in guilt.       

     Kate kept blubbering.  “He’s tried everything and worked so hard at his weight for so long, but his body just won’t react.” 

     As if claiming that nothing more could’ve been personally done for his weight loss was believable.  Talking about working hard is not the same as working hard.  Reading self help diet books is not the same as being on a diet.  Buying an elliptical trainer is not the same as exercising.  After cutting through all the self pity and excuses, there is just hard work.  The hard work of weight loss is to just figure out a way to burn more calories than you eat.  Simple.  That extra three hundred pounds is not due to some special medical condition.  It is due to the condition of gluttony.  An entirely selfish condition.  Playing the victim is the most pitiful means to skirt responsibility.  A victim is someone that gets shot during a robbery or someone who invested with Madoff; there is no victim when someone finishes an entire black forest cake in one sitting or decides to have an after dinner snack of a triple Whopper.  There is only obvious consequence. 

     I remember when Xander thought eating a bowl of oatmeal every morning for breakfast would be the magic ticket for weight loss.  He caught me at the grocery store one day and revealed his plan, rambling on about fiber and less fat absorption and other generic nonsense he probably read in a a blurb on some random website -- he must’ve forgotten I was a doctor and not some housewife at a book club willing to take hearsay medical knowledge as fact.  He ate plain oatmeal every morning for a month, and was puzzled that the scale wasn’t budging.  It was a good thing that he was substituting oatmeal for his usual breakfast of a packet of bacon and carton of eggs, but all he did was prune a couple leaves when the entire tree needed to come down. Never mind his triple value meal lunches, and King-sized candy bar snacking, and full extra large pizzas for dinners with entire French Silk pies for dessert, and midnight runs to Taco Bell for bedtime snacks.  He quickly went back to his usual breakfast bombs.  Fads like that are never sustainable.     

     Massive weight gain is a consequence that can easily be foreseen and expected from excessive eating behaviors; it is not a cryptic puzzle unable to be logically prevented.  The obese put too much effort into the search for a magic decoder that will unlock the mystery of weight loss, when simple logic is to eat less.  Living that simple logic may be difficult, but just because it is difficult does not mean it cannot be done or that it should not be done.  “Why” is not the appropriate question. Someone that gets HIV from sharing heroin needles during whacked out weekend benders cannot wonder why.  Taking down a whole deep fried chicken for lunch and then complaining about a five pound weight gain at the end of the week needs a shutting up.  Kate, shut up about Xander.   

     I reached into my pocket and pressed my speed dial.  I called my pager.  Katie was still tearfully musing about Xander.  The anticipation was making my stomach churn, as if I had eaten a bag of White Castle washed down with a gallon of chocolate milk, or what Xander would call a little bite.  How long does it take to go from wireless station to radio signal?  My pager finally went off.

     “Damn, it’s the hospital.  I am so sorry Kate, but I have to go.  Hey, don’t worry so much, he’ll get on the right track after surgery, I just know it.” 

     I gave Kate a hug.

     When a woman is crying, I will say almost anything to slow the tears.  I told my ex-wife at a wake that her mother was a super nice lady, even though her mother’s soul was black tar.  Xander is not going to get on the right track after surgery.  I get the feeling everyone thinks surgery is going to be an instant cure-all, and that Xander is going to be the next
People
magazine cover story of victorious weight loss.  Surgery is just a band-aid until Xander can learn to control his weight alone.  That control is never happening.  No amount of time bought under a knife is ever going to quell his need to gorge.  He is a food dumpster.

   
I broke the hug, my arm brushing her right breast at release, and then I rushed out the door into the fresh, fresh air.    

ADJUSTMENTS

     Taco Bell Fridays.  I really looked forward to my Friday nights, which nowadays consisted of picking up a chili-cheese burrito and three hard shell tacos from the Bell, sitting in front of my flat screen and watching whatever until I fell asleep on the couch.  It was just a great way to unwind from a week of work, at least for someone my age.  It was unwinding after having to deal with entitled parents all day and having to give the same schpeel ad nauseam trying to explain why every sniffle or sore throat doesn’t require antibiotics and then having them leave in a huff that they didn’t get what they wanted.   To have to deal with parents that think they know more about medicine than someone who went through med school and residency and years of practice and hundreds of hours of CME because those parents read some stuff on the internet or heard something from some other non-physician family member.  After spending my week dealing with those parents, I always choose downtime activities that require no contact with any people.

     This Friday, the drive-up was crazy, so I decided to park it and walk into the restaurant to get my order.  I caught myself at the world “restaurant”.  Taco Bell being called a restaurant?  Like a bowler being called an athlete.  It is not a  restaurant when the menu only consists of the same seven ingredients mixed and matched in slightly different combinations.

     “Hey, Dr. Grant!”

     The voice jolted me.  It was Xander.  He was seated by himself near the back window.  He looked a little bit slimmer.  I walked over towards him.

     “Hey, Xander, how are you doing?”

     “Great, really great.  Are you making a run to the border like me?”

     “Yeah, just picking up some dinner.  I love this place.”

     “Me too.   It’s a shame I can’t eat as much of it anymore.”

     I looked down at his tray and it had just three hard tacos on it. 

     “Oh yeah, your mom mentioned you might get surgery.  How’s it been going?”

     Patting his belly, “Not too bad.  I’ve lost twenty pounds in the last three weeks, so that’s pretty good.”

      “That’s great, Xander.  You look good.”

     “Thanks, doc.  I went with the gastric banding.  I’m getting so full, so fast now.  But, I have to keep going into the doctor’s office to get it retightened.”

     “Well, that’s just the process.”

     “But when I first had to get my band retightened, I felt full after only a few bites for a while, then I starting feeling hungry even with more and more food, so then had to get it retightened again.”

     “You should tell your doctor about that.”

     “I did, but all he told me was that I have to use some willpower.  Hell, if I had willpower, I wouldn’t have needed the band.”