It was January 2013, I was a couple of weeks shy of my 25th birthday, and my BMI was over 40, the result of a lifelong addiction to food and a history of binge-eating. And after months, if not years, of dilly-dallying, I’d finally decided to seriously look into bariatric surgery. So I met with a doctor in a cold hospital room in Lebanon, where I live, to discuss my options. For an hour, he poked and prodded and checked for medical soundness as I stood self-consciously in my underwear.
His verdict was definitive: I was a good candidate. Knowing I would most likely change my mind if given enough time, I asked for the surgery to be scheduled the following week. But before I could go under the knife, I had to meet with a “hospital-mandated” therapist so she could assess my psychological state and whether or not I could withstand the procedure. She had me fill out a form, asked me a couple of questions in a laconic monotone, and concluded the session by informing me I was depressed. (Needless to say, this was not a surprising diagnosis.) Still, I was cleared for surgery, and so they sliced me open, stitched me back up, and sent me home.
Two years later, it’s 7 p.m. after a stressful day at work and I’m gorging on peanut butter ice cream in a supermarket parking lot, scooping it with my fingers with feverish haste like a savage who has no use for utensils. I stop after a few minutes, suddenly aware that people can see me and feeling like my reduced stomach is about ready to implode. I wipe the ice cream off my hands, my face, my shirt, my seatbelt. It's everywhere. This is my crime scene, and I’m frenetically wiping off the blood, wondering what in God’s name I have done. As soon as I get home, I scour my kitchen for more unhealthy food to stuff down my throat. Unhappy with what I find, I take another trip to the nearest grocery store and load up on all sorts of carbonated, refined, artificial, and processed junk.
I wish I could say this was an isolated incident. But despite getting the operation, my binge-eating disorder is still going strong. On any given bingeing day, once the valves are open, it takes tremendous efforts to close them back up again, and not even the nausea and stomach cramps can quell the flood. Today, I don't regret my decision to opt for surgery, but I can’t help but feel like I should never have been allowed to have it. The crux of the matter is, I may have been qualified for it physically, but I was far from ready psychologically.
Remember, this is all taking place in Lebanon, a small and conservative country known to outsiders for its beaches, its food, its indomitable will to party its way through troubled times. But to locals, it’s not’s an easy place to live in. There's the volatile political context, the perpetual economic slump, the propensity for sectarian strife, the lack of social justice. And then there's the fact that here in Lebanon, where looks and appearances are paramount, plastic surgery qualifies as a routine procedure. Imagine conventional standards of beauty on speed. Fall short of these standards and you'll feel left out, ostracized.
Lebanese society is only part of the problem. Unscrupulous Lebanese bariatric surgeons who operate on patients with only 20 or 30 pounds to shed are also part of the problem. The media is part of the problem, so is my country's defective health care system. Pattern-repeating parents are part of the problem. Admittedly, I’m part of the problem too. I could easily gripe at length about body image, about fat shaming, about the fat acceptance movement, about the assumption that happiness is not possible unless you wear a size 12 or under, about the way some people feel entitled to comment on women’s bodies. I could argue that it's all very subliminal and insidious, and that once it takes hold of you, you feel unbelievably foolish for letting it define you, but at the same time, you feel so incredibly worthless that you forget how to function properly.
But over the years, I grew tired of pointing fingers. Personal responsibility, societal pressure, social construct — I no longer cared. The "why" of my dysphoria did not matter. I've tried to rationalize it too many times, going as far as standing in front of my bathroom mirror and sermonizing out loud as I scrutinized my bloated face: "I am not defined by my weight. It's not me, it's society. There is more to me than a number on a scale."
It didn't work. I had the surgery on the very day I turned 25.
There are different types of bariatric surgery procedures. Some can seem pretty scary. There’s the band, the sleeve, and the gastric bypass, among others. I settled on a procedure known as “gastric plication,” which entails creating a sleeve by suturing rather than removing stomach tissue. To my highly skeptical mind, it was the option that sounded less radical, and less invasive since it would be done laparoscopically. All I’d be left with, besides a significantly smaller stomach, were five small scars scattered across my belly. No foreign object inserted, no part of my stomach taken out, no organ rerouted.
The operation went well, but in the weeks that followed, I could barely eat anything. I’d only manage to get two or three bites in before I was overcome with the urge to regurgitate them. Going cold turkey from eating, let alone bingeing, was really tough. I keep one very vivid memory of my recovery, in the weeks following my return from the hospital: standing at 2 in the morning in front of my fridge, longingly sniffing every possible food item I could get my hands on. Ketchup, a can of tuna, I even once took a big whiff of a tub of butter. The compulsion was as irrepressible as it was indiscriminate. All the same, I lost a considerable amount of weight in the first six months alone.
Two years on, I've more or less managed to keep part of the weight off, although the numbers on the scale still tend to fluctuate greatly and I have yet to confront my eating disorder head-on. Food is still at the forefront of my mind every second of every day, and my struggle with addiction is not made easy by the ubiquity of junk food that I so frequently crave. I live in constant dread that I might one day lose my grip, and that my bingeing habits will resurface and plunge me back into an unstoppable maelstrom of weight gain and self-loathing. Some days, it feels like it’s only a matter of time. Think peanut butter ice cream, an entire tub of it, every day for 10 days straight (my personal best).
I don't mean to discredit weight-loss surgery altogether. After years spent shrugging it off as a last resort, a cop-out, I now realize that it can also serve as an effective way to jump-start the process, and one particularly appealing to people faced with the dispiriting prospect of having 100, 150, 300 pounds to lose. But here's the big "but": There's also something fundamentally wrong with bariatric surgery, in that it only serves to "fix" the body and not the mind. I can't help but notice that it's being increasingly touted as the panacea for our modern, busy, hyperactive times. But it is not to be treated lightly. Tremendous psychological work has to be done first or at least in parallel but it's often overlooked in favor of the contemporary truism that weight loss is all about diet and exercise.
By the time I had my surgery, I had 10 years of bad habits under my belt, and the resigned understanding that I was wasting my life away for the most frivolous and shallow of reasons. To me, that was enough. I’d put myself through so much isolation, self-loathing, self-indulgence, phony excuses, missed opportunities, a succession of last straws that never quite decisively snapped me out of my funk and spurred me into action. I thought I was ready for my life to start, and that all these years of misery had helped prepare me for the transition.
But said transition turned out to be excruciatingly long and grueling, in a way I could never have expected. I'm still trudging through, making every possible mistake in the book. One recent snag comes to mind, after a boundary-pushing, stomach-stretching binge: me sitting on the edge of my tub, pressing my thumbs hard against my temples, trying to rationalize what I was about to do, soliloquizing that this would never happen again, that Monday was only two days away, a fresh start, a way to get back on track with a clean slate. Feeling nauseated, my stomach about ready to implode, trying to muster the courage to go through with my plan. Then finally sticking a finger down my throat. Gagging, but only for a couple of seconds, and taking my finger out immediately. That was my first ever attempt at bulimia, and it ended in abject failure.
I doubt there will be ever a second attempt. But I have to stop evading the issue. At some point, I’ll have to learn how to have a healthy outlook on food. Losing weight alone will not miraculously solve everything, and I can’t keep putting my life on hold with that quixotic prospect in mind. Sometimes, it feels like only yesterday I was 15 and just beginning to turn to food for comfort, putting down the foundations for the wall I’d spend years erecting around myself, growing increasingly quiet, withdrawn, painfully avoidant in the process. Then I come to and I’m 27 and feeling like I’m at a standstill, fumbling blindly for the play button on my life, the wall still very much intact albeit carved with scratch marks from my unfruitful attempts to climb my way out. The way things stand, I’m either staring at the slippery slope of self-destruction or looking up at a towering mountain toward salvation. All I need now is to figure out how to start climbing.
If you or someone you know is struggling with an eating disorder, here are some organizations that have trained support staff available by phone:
Binge Eating Disorder Association Helpline: 1-855-855-BEDA