The double burden of the obese

kw: book reviews, nonfiction, autobiographies, overweight, obesity

Michael S. Berman is a bit of a big shot. He's a lobbyist and political activist who has worked on campaigns since 1964, including Bill Clinton's, and was V.P. Walter Mondale's Deputy Chief of Staff. He is also a big man. How big? It varies, from 220 to 330 pounds. With the help of Laurence Shames, he chronicles the divided life and many burdens of being fat in Living Large: A Big Man's Ideas on Weight, Success, and Acceptance.

Mike Berman repeatedly states that fatness is a disease, one with compelling power, that has no cure, but can be managed. In a way, it is similar to the AA view of alcoholism, except that 12-step programs for the fat are scarce, and there is as yet very little professional support. As I see it, American society views obesity the way it viewed alcoholism in the 1950s or earlier, as a problem of self-control and depravity. As a borderline fatso myself (currently 220 pounds, but it is a struggle to stay there), I know from the inside the power of addictive compulsion.

A story. In early 2001, undergoing chemotherapy, I was warned by my doctor to keep my weight up, because of the chemo's effect on appetite. I did weigh about 180 at the time, because before my operation, I hadn't eaten for two months due to a blocked colon. I replied, "Doc, I long ago learned to dissociate enjoyment of food from hunger. That's why I was fat."

You can be addicted to alcohol, sex, cocaine, cough medicine, amphetamines, and sometimes even heroin, and manage to hide your addiction nearly all the time. How do you hide a silhouette the width of a piano? How do you hide getting stuck in armchairs? You can hide Bipolar disorder, as I do, with judicious planning; our son's band director hides his Obsessive streak most of the time, but always carries a bottle of Purell®. How do you hide the ability to eat three racks of ribs at a sitting, or to spend two or three hours at a buffet, eating nonstop?

Berman unflinchingly relates his lifelong struggle to be thinner, and his tortuous, and torturous, path to acceptance of himself. Behind the successful lawyer and lobbyist, he has been an insecure supplicant of every weight loss scheme that didn't involve surgery or overly-"instant" claims. With maturity, and nine years of therapy, he attained a balance of insight and self-control, so he can manage his life, including his health. He can't be a 170-pound athlete, but he can be as healthy as a 230-pound man can be.

His life is not over by any means. He's only 66 (maybe 67 by now). He still yo-yos some of the time. He's been very successful, and found that his family, wife, and friends don't look on him as being quite as morbidly fat as he often views himself. By his own report, he's happy more than not, now. I hope he writes a sequel, perhaps in another ten years or so. I think he, and we, will be gratified at the equilibrium even a lifelong fat man can achieve.