6 Work It Girl, Phase 10,280

I can remember the exact day I uttered the dumbest string of words ever to leave my lips. It was July 1992, and I had just finished my freshman year of college. I was working part-time in the handbags section of a department store, and my coworkers and I were using the lull in the summer shopping season to discuss the important matters of hair, clothes, and makeup. The talk inevitably turned to weight, and the others started lamenting about how bad they looked in their swimsuits that year. My issues were a bit bigger than beachwear: I had recently gained back a little of the weight I’d lost my senior year of high school—a weight increase I chalked up to being in love with a great guy (finally) and not paying enough attention to what went into my mouth. I admitted to these girlfriends that I was back at my old standby weight of 165—a number on the scale I’d spent most of my teen years trying to permanently ditch. “But at least I know one thing,” I proclaimed with certainty. “I eat and eat and eat, and I never go past 165.”

If I could reach back in time and yank that stupid girl by the hair, shaking her into reality, I would most assuredly do so.

Within a year of that asinine comment, I would be approaching two hundred pounds.

And, well, we know where I went from there.

I spent most of my adult life daydreaming of being 165 pounds again. Over the years I hatched plan after scheme after program to get me there. I read all the latest diet books. I watched all the current health documentaries. I signed up for nutritional classes, for support groups. I joined walking clubs and fitness centers. I bought fresh new notebooks and filled the pages with detailed eating plans and elaborate exercise charts. I excitedly showed Michael my “Work It Girl, Phase 1 & 2” outline, sure that this time it would work. Over the years, it became a (good-natured) joke between me and my husband: “Work It Girl, Phase 10,280! This is the one!”

I know it’s hard for outsiders to believe, but I honestly thought, each and every time, that my latest plan would work. Every diet book, every weight guru drills into us the same theme: “If you are determined, and if you work hard, you will succeed.” I approached weight loss as if I were studying for a big exam: I read everything I could get my hands on, I studied caloric charts and memorized fat gram contents, I outlined detailed food intake plans and exercise routines. I put in hours and hours of time, but ultimately I got very little success in return.

I can remember being about eleven years old and desperately wanting to shed my chubby tummy. My brothers teased me endlessly, and the kids at school knew right where to go if they wanted to hurt me: “Fat pig!” was a common retort from my adversaries on the playground. During the summer months I became convinced that all my schoolyard problems would be resolved if I lost a little weight before September.

So there I was, barely a fifth grader, tuning in to the Richard Simmons Show every morning. I wrote down eating tips, I listened to the motivational stories, and I sweated to the oldies with the end workout routine. I tried to ride my bike a little more around the neighborhood, and I walked to my friends’ houses instead of having Mom drive me. I even tried to cut back on all the chips and soda around the house. Looking back it was a pretty healthy effort at weight loss, save for the fact that I was still in grammar school! I doubt if I lost any real weight, however; all it really did was mark the beginning of a lifelong struggle of desperately trying to combat nature.

I’ve already mentioned the weight loss I did achieve when I was a senior in high school. Truth be told, it was my only successful effort at shedding pounds without the aid of diet drugs or surgery. How did I do it? Where did I find the willpower? If I knew the answer to that, I would have employed it many times over again! All I know is that it was really, really hard. I can remember going to bed early, in tears, because I was so hungry and wanted to eat so badly. I recall forcing myself to drink diet soft drinks and hating every minute of it. But at the end of the effort was the reward: I’ll never forget putting on a short black skirt and having men stop and stare at me as I walked down the mall. Yeah—that feeling stands out the most!

After I was married and the weight started to pile on, I tried to find that elusive willpower again. I would go for about two weeks, managing to avoid fast food and sticking to Diet Sprite and baked potato chips. But I always, always fell off the wagon. I’d buy a candy bar and eat it fast before I really had a chance to think about it, or I would give in to temptation and stop at McDonald’s. I’d slip up, and I’d allow it to devastate me. I was never able to pick myself up, dust myself off, and keep going. I would instead wallow in self-pity, eating all I wanted, vowing to get it out of my system and then right the wrong. I thought maybe that was the way to go—thinking back to that New Year’s Eve when I ate everything and then went on to lose a bunch of weight on my own. I tried to recreate that elusive magic, time and again.

It never happened.

I became convinced I was not in charge. Willpower was a force that was going to be bestowed upon me from Heaven above, and I had to just sit and wait for it to hit. I prayed. I read. I studied. I waited. I felt weak, and I needed help. I thought if I wanted it bad enough, help would just magically appear. I was not the one in control of my destiny.

In the winter of 1997, I reached critical mass. It had been years since I’d had significant weight loss. I was approaching 280 pounds, and I grew panicked. My dreams of being a television reporter were slipping by with each passing day; I wasn’t getting any younger, and I thought I had a very narrow window in which to get my career started. Not to mention the toll my now-morbid obesity was taking on my marriage. Michael and I had only been married four years, and he was baffled by what was happening to me. He never once said anything negative to me about my weight—he was more concerned about what it was doing to me, to my self-esteem and quality of life. He wanted to help, but felt powerless and frustrated. I beat myself up daily, wondering why in the world I couldn’t get it together.

I went to my ob-gyn for my annual checkup and dissolved into tears as I opened up about my turmoil. She listened patiently as I explained the many ways in which I’d tried to shed the pounds. She ordered a full blood work-up to see if she could find a problem, but in the meantime she had a question for me: Had I ever considered diet drugs?

Up until that point, my thoughts on diet drugs were almost all negative. We’ve all heard about women getting amped up on Dexatrim or other appetite suppressants bought at the drugstore. We’ve all seen the episodes of The Facts of Life or Beverly Hills, 90210 in which one of the main characters abuses diet pills and finds herself in trouble. My mom was even part of that elite club. Back when she had me, she said doctors were really tough on women about getting baby weight off quickly after giving birth. They frequently prescribed “black beauties” to help new moms burn off the fat. The pills were speed! My mom said they worked great: She lost all her excess weight in no time—and her mind, too—as she stayed up all night cleaning the house, organizing closets, and doing everything else except sleeping. Diet drugs, to me, sounded dangerous and reckless, something I felt I should avoid.

My doctor explained that there was a new combination of drugs called fen-phen, a weight-loss regimen that was seeing a lot of success. These drugs were only prescribed to extremely heavy patients, so the potential of abuse by people who shouldn’t be taking them was all but eliminated. Whatever side effects caused by these drugs—and they really weren’t sure what those were long-term—were tempered with the great benefit of shedding weight off of morbidly obese patients whose very lives were threatened by their excess pounds. The risk seemed to be justified.

Could this be the answer? Could I solve my problems simply by taking medicine? It seemed doubtful to me, but nothing else was working at that point. My doctor was recommending it, so why not give it a chance? How bad could it be? I agreed to try it, without much hope or expectation.

It was like freedom in a bottle.

The drugs made me not care—about much of anything, really—but specifically, I didn’t care about eating. It wasn’t that I was not hungry per se, I was just indifferent toward food. And that was incredibly liberating. I could go about my day and not obsess over whether I would binge eat fast food; I truly didn’t want to. As the weight started to come off, my confidence began to build. For the first time in a long time, I had real hope. The scales were finally going in the right direction, and I felt I had that elusive control I’d fought so hard to find.

People started to notice my weight loss, and that fueled me even further. I began to exercise, and I loved it. I walked for miles around the track at the local high school, listening to Sugar Ray, Smash Mouth, and Third Eye Blind on my Walkman, feeling young, alive, and vital. I daydreamed about finally getting back into reporting, realizing my dream of continuing my on-air career. I was able to take an interest in clothes and start to look forward to buying pretty things again. Life was beginning to feel good once more.

If the drugs had negative side effects, I was unaware. The most discomfort I ever felt was dry mouth, which actually worked in my favor, causing me to drink lots of water and avoid soft drinks. I never felt dizzy or disoriented, never had that heart-racing feeling you sometimes hear about. I became convinced that these drugs were meant for me, that they were the key to reclaiming my life.

I still loved to eat and found that it was okay to do so. I just manipulated the times that I ate around the times I took my medication. For example, if I was craving a particular food, I would plan to have it for breakfast. Sure, spaghetti with meat sauce sounds a little gross first thing in the morning, but it worked for me. I stuffed myself until I was satisfied, then a couple of hours later, I took my pills and was fine for the rest of the day. I didn’t obsess over the foods I couldn’t have, I just planned them for when I could eat them. I never felt deprived, and most important, the results made me feel fabulous. I couldn’t believe I hadn’t thought of this solution sooner.

After about eight months, I’d lost fifty-five pounds. I was down to about 230, lower than I’d been in years. My dream of being a television reporter was starting to feel attainable again; I really felt as though I could do anything I wanted to. I hadn’t been this excited about the future in a long, long time.

And then the rug was yanked out from under me.

My mom called me at work. It’s kind of ironic that I am a self-proclaimed news junkie and like to think I know everything before others, and yet my mother—a decidedly non–news junkie—called me with the news.

“Jennifer! Did you see the news on Channel 5? They said those diet drugs cause heart damage. They’re pulling them off the market!”

I wasn’t too worried at first. My mom tended to be kind of alarmist about this kind of thing—not to mention not very accurate. Surely she was wrong; surely the report referred to another kind of diet drug. After all, my doctor had suggested these pills. They weren’t dangerous! There had to be a mistake.

There was no mistake. The makers of fen-phen were pulling the drugs off the market after several reports of heart valve damage. Some people had even died.

My immediate reaction was to go into self-protection mode. Look at how much weight you have lost, I told myself. You don’t need drugs anymore! You’ve started to exercise, you’ve cut down on bad foods, you can do this! The rest of the weight will come off easily!

It never once occurred to me to be worried about my health. I was twenty-five and felt invincible. My weight—at least in my warped way of thinking—had nothing to do with health and everything to do with vanity. Never mind that I had just spent eight months taking a combination of drugs that some claimed did permanent damage to their hearts. I felt fine! No need to worry about that.

No, my immediate concern was to ensure my future weight loss, to make sure I could continue to drop pounds. And for a little while, I did. I kept up the exercise, and I tried to stay with the same eating habits. Slowly the overwhelming hunger started to creep back in, no matter how hard I pushed it away. I managed to beat it back and maintain what I had lost for about a year. But eventually I succumbed to my never-ending cravings for all things bad. The negativity in my mind really started to do a number on me: You can’t do this by yourself. You tried for years, and look where it got you. The only time you really lost weight was when you had the drugs, when you had help. Don’t even try, you will fail.

The weight came back, and then some. Sure I tried to beat it. Every day I once again started something new, some different way to take control, to do it myself. For example, I once signed up for Weight Watchers. I liked the thought of using everyday, normal food, just in moderation. I had such a limited palate, I thought this would be the eating plan that would work for me. I showed up for the first meeting at the Baptist church in my small town. There wasn’t anyone in the room younger than fifty. Embarrassed, I weighed in, in front of everyone, and then sat for the group discussion. All the talk focused around cooking for families and eating sensibly at work. No one talked about obsessing every minute of every day about what they ate. Not one person offered up that they stuffed themselves until they were sick, hiding food in their homes and their cars. I had absolutely nothing in common with the group, and worse, I felt like some sort of freak. I didn’t go back.

Another example: When I worked at the radio station, employees were offered free gym memberships through one of its sponsors. I happily signed up, thinking this would be it, this would be what motivated me, what made me turn the corner. As part of the sign-up, I got a free session with a trainer. Great! An expert who could tell me exactly what I needed to do! I was a let’s-make-a-plan kind of girl, and this was going to be just the plan I needed.

The trainer was a nineteen-year-old stud named Ricky. He had a hard body and a killer smile, and I was beyond mortified. To make matters worse he acted as though he drew the short straw by having to work with the big fat radio girl. He weighed me (kill me now) and took my body fat measurements (okay, just shoot me). And then he started going over strength-training exercises. Strength training? Did I look like I needed strength training? I feigned a headache and got the hell out of there, making a beeline for the hot dog joint across the street. Again, hot tears spilling down into my food didn’t stop me from eating.

I did go back to that gym, sans trainer. But it clearly was not the place for me. All young, beautiful hard bodies were there, trolling for dates just as much as looking to exercise. I was so self-conscious, I couldn’t do much of anything.

Now could I have made these two situations better? Of course. I could have kept looking for a Weight Watchers group that worked for me, even if it meant driving to another town. I could have joined another gym, perhaps one that catered to women. Money was certainly an issue (when is it not?), but with the cash I was spending on food, I’m sure I could have scraped up the funds needed. But with every experience like the old lady Weight Watchers or the hard body gym, I just felt more and more defeated. Helpless. Hopeless. Out of time and out of luck.

It was during the really desperate times that I would go back to one idea that refused to go away: gastric bypass surgery. Reading about Carnie Wilson’s experience with the procedure and seeing her successful results made a great impression on me, but I was still skeptical. Sure, I felt pretty desperate, but having surgery seemed so drastic to me. When I first started to think it over, I’d never been hospitalized before, never had any sort of surgery. I couldn’t imagine willingly going in and allowing doctors to cut away. But the results were undeniable: Al Roker looked fantastic, Carnie Wilson was a knockout, and probably the story that had the most impact on me was Blues Traveler front man John Popper. I caught a VH1 special that detailed his experience and could hardly believe it when he said he’d lost two hundred pounds in a year. Holy crap! After a heart scare, his friends talked him into exploring gastric bypass. He said he thought there was no way he would lose the weight, no way he’d be able to give up McDonald’s french fries or Burger King hamburgers. Boy could I relate to that! After having the surgery, though, he couldn’t imagine he ever ate at those places. He’d always seen himself as a frog, and now he was slowly becoming a prince.

After watching that special, I was blown away. Was I missing something right in front of my face? I had tried so hard for so long, and I was just watching the years slip away without any solution. Was it finally time to make a permanent change?

In 2002 I thought I was ready. I started off the New Year like I did every January, full of promises and plans to lose the weight and keep it off. I did well for a bit, but then something small and inconsequential sent me straight to the drive-thru. As I polished off two chili cheese dogs and a jumbo bag of fries, I thought about how all my efforts had led to only three days of healthy eating and exercise—how someone saying the wrong thing to me made me throw away all my hard work. I knew I had a problem; I was well aware that I was simply looking for any excuse to overeat, to self-sabotage. Fed up, I vowed then and there that if I didn’t do something in the next six months, if I didn’t manage to stick to a plan and make significant headway with this problem, then I was making an appointment with a gastric bypass surgeon. I was finally disgusted with myself enough to self-issue an ultimatum—and I meant it.

And then, wouldn’t you know it, word started coming out against gastric bypass. Suddenly it wasn’t the cure-all everyone had hoped for; for all the Carnie Wilsons and Al Rokers out there, there were plenty of people who suffered serious complications from the procedure. People magazine did a piece on it in 2003, profiling several gastric bypass surgeries gone wrong, including a woman who had to have her arm amputated! I used that negative information to climb back onto my high horse about gastric bypass. That’s what happens when people take the easy way out, I told myself. It seemed like such a good idea: Go to the doctor and have him make it so you can’t overeat. Finished, end of story. But of course nothing is as easy as that, and I felt this was proof. I quickly got off of the idea, deciding that I needed to lose the weight “on my own” in order for it to really count.

I knew I was in trouble. I felt sick—and not just from the physical toll of carrying around so much weight. I felt as though I was losing my mind. I couldn’t get anything accomplished in my life. Every minute of every day was consumed with what I was eating, or when I was going to eat again. I was so hard on myself, declaring the day an unqualified failure if I ate even a morsel of food that was supposed to be off-limits. I would string together a few good days of eating well and exercising, and then I would throw it all away over something minor, like drinking a can of Mountain Dew while at work on a stressful day. That one twelve-ounce soda would lead me to eat a large pepperoni and sausage pizza or two, foot-long cheese and meatball subs. When I was thinking logically, I knew one can of soda wasn’t that bad in the grand scheme of things. But logical thinking was a rare occurrence in that state of mind. Perhaps I was just looking for an excuse to binge eat. And those excuses were quite easy to come by.

I withdrew from my family, avoiding gatherings for special occasions because I couldn’t stand to see the looks on their faces, disappointed as they realized I was as heavy as ever. I remember one Christmas, before I had kids and couldn’t shirk family duties, actually being ecstatic because Michael had to work the holiday. It allowed me to spend the day at home, alone, instead of being forced to attend another family event. I spent Christmas all by myself, hiding from the world and eating whatever I wanted. I was really happy and relieved, and that’s what ultimately scared me the most. Who is happy when she spends the holidays alone? Someone who is not well, I was sure.

I wasn’t able to avoid all family gatherings, and such was the case with that family beach trip in 2002, the one that started with such good intentions but evolved into me sneaking out at night to make a McDonald’s run. Seven whole days of facing my in-laws, with a backdrop of sand and surf, bathing suits and suntan lotion. Could I be more miserable? I didn’t think so, although the gods did smile upon me somewhat: It rained almost every single day, severely limiting our time by the ocean. Let me tell you: Rain at the beach is a fat girl’s friend!

There was at least one sunny day, and it was the day I reached a critical point, personally. We’d spent all morning at the beach, watching our nieces and nephew dance in the surf. I tried to tell myself I didn’t stand out in the crowd at all, dressed in my black T-shirt (black at the beach!) and longish khaki cropped pants (long pants! at the beach!). I was relieved when someone suggested we pack up and head back to the bungalows to fix lunch. I was loaded down, carrying a beach umbrella on a pole in one hand and a folded-up beach chair in the other (a chair that, by the way, I refused to sit on because I was afraid it would collapse under me). My butt was numb, having spent the whole morning sitting on a towel on the hard sand. We had a long way back to the cottage, and the sand was deep, my steps quite heavy. I was sweating like a pig, beads of perspiration flowing down my spine like a river. Even though I’d started out in the lead, every single family member passed me as my steps grew slower and slower.

Eventually I reached the steep staircase that led back up to street level. Taking a deep breath I started the slow journey, carrying more than three hundred pounds of flesh and various unused items of beach paraphernalia. I slowly trudged up the wooden slats, and when I finally reached the top, I made an abrupt stop. The bright sunlight started to dim, as though a huge rain cloud was passing through. But this was a cloudless day, and I knew something was wrong. I tried to steady my breath, and found that I had very little to work with. The sky above me started to spin a little, and I opened my mouth to call out to my group. Michael had already reached and crossed the street—I could see him walking way ahead with his brother, swinging our niece’s hand. All of their backs were to me: my mother and father-in-law, Michael’s grandmother, Michael’s sister, and her kids. I tried to call to them, but no sound came out of my mouth—there was no breath to make any words. The sunlight was really dimming now, and I could feel my legs start to buckle. Please turn around, I thought to myself. The voice inside my head sounded as weak as I felt.

And just like that, my sister-in-law, Molly, turned back to look at me. It was a casual movement, as if she were going to ask me what I wanted for lunch, or what I’d thought of that season of Survivor. It was an insignificant move to her, but it meant everything to me.

My breath was back. I drew in sharply as Molly made her way toward me. “It’s hot!” she exclaimed. “You okay?”

No, but I was getting there. Suddenly the sky wasn’t as dim, my head wasn’t as swimmy. I didn’t yet trust my voice to work, so I just nodded and let her talk. I was able to get my breathing under control as we slowly walked, Molly happily chatting about her family, her kids, her life. I listened in silence, grateful for a sister-in-law who liked to talk and didn’t seem to notice my lack of contribution.

We got back to the bungalow, and Michael followed me when he noticed I went straight to our bedroom. I lay on the bed and burst into tears, telling him what had happened. I also confessed the awful bingeing that had started a couple of days before. Worry clouded his face, but no anger. No judgment. Just love and concern, and it made me cry even harder.

The episode on the beach scared me into action. I didn’t know exactly what had happened, but I felt it was a warning. I had to do something. The day we returned home, I called a doctor I had heard about from my coworkers, one who specifically dealt with bariatric patients. I made an appointment for the following week. I also called a therapist who had been recommended to me a couple of years earlier. I lined her up for the next week as well.

I was frightened enough to try to do something—again. Did it stop me from overeating until the appointments? No. But why would it? I knew I had a plan, that I was going to take action, so I felt I had a license to eat until then.

I had heard great things about the bariatric doctor I was going to see. It intrigued me that she was someone who devoted her practice to overweight patients—it made me feel as though my problems were legitimate and medically based. And surely she’d know what to do. This could be the answer I was looking for!

And it was. I soon learned that her weapon of choice was diet drugs. Turns out only part of fen-phen was yanked from the market; phentermine was still available, and this doctor had seen great results in her patients. I was more than a little skeptical. Did I really want to go down this road again? My feelings were still hurt from the last time, even though five or more years had passed. I just felt so cheated, so wronged. Again, I was never worried about the possible heart damage. My only concern was that losing the drugs stopped my weight loss dead in its tracks—and eventually I’d gained it all back.

My other worry was whether or not it would be effective. I’d had such great success with the combination of drugs, would just one of them do the trick? And how did I know this medication wouldn’t soon be taken off the shelves as well?

The doctor explained that phentermine worked as the appetite suppressant, and she thought that was ideal for my problem. I couldn’t really argue with that—it seemed to me that if you took away the overwhelming hunger, you took away most of my issues. Plus, the doctor said, in order for her to prescribe the drug to me, I would have to commit to seeing her every two weeks so that she could monitor my blood pressure and other vitals. She would perform an EKG before giving me the pills, just to make sure my heart was fine. And she would quiz me extensively about my eating and exercising plans. Taking this medicine was not a long-term solution, she stressed. I was going to have to develop habits that would take me through the rest of my life. It would not be easy, but she felt I would find success.

Really, what alternative did I have? Nothing else was working, and besides, I liked the things she proposed. Eating plan? Exercise plan? Regular check-ins with her in which I would be held accountable? I loved plans! I loved goals and charts and appointments. Since I was obsessing about it all the time anyway, this was perfect!

I enthusiastically signed up, and then almost immediately suffered from sticker shock. I knew the pills would not be covered by insurance—I’d learned that during my fen-phen days. And man, were they expensive! Seventy-five dollars a month. Plus my doctor wanted me to try Xenical, a drug designed to remove fat from food before its digested. Some people experienced pretty nasty side effects (read: accidents!), but I was game. Even on my best diet days, I still had plenty of fat in my diet. I figured this drug could only help. But again, Xenical was not covered by insurance. Another seventy dollars a month! Not to mention the doctor’s visits every two weeks, which, you guess it, were not covered. Another two hundred dollars a month!

I’ll never understand the rationale of insurance companies. Most will not pay for you to see a nutritionist, to join a gym, or to take an appetite suppressant. But they will pay tens of thousands of dollars for weight-loss surgery. In fact that’s the only weight-loss tool they will pay for. Does that make any sense? No wonder so many people are turning to that alternative—it truly is their only (affordable) option!

The cost was rough, but I figured I had to do it. Michael and I were both working, and we didn’t have kids at the time, so I felt we could make the financials work. Thankfully the weekly visits to the therapist were covered by insurance, and my first visit to her occurred before I started taking the diet pills.

I had been down this road before. As a teenager I’d suffered a pretty major breakdown and my parents, at my request, placed me in a mental health treatment center. I was so tired of fighting the abusive boyfriend and so sick of feeling helpless to do anything about it. I figured taking such drastic measures would be a major step toward curing me. Only, it wasn’t. I checked in on a Friday and didn’t see a doctor the entire weekend. I was told I would start seeing a therapist on Monday, but by that time I’d talked myself out of the need for inpatient care. Truth be told, I missed the boyfriend so much, I was already over the whole idea. So I convinced my mom to check me out, and I never went back. Thousands of dollars in bills and the legacy of having entered a mental facility, and nothing to show for it.

As I became an adult, I had a few appointments here and there with therapists, always a part of my latest plan to “get well” and “fix my problems.” I never made it past the first meeting with these folks, though, because they almost immediately brought up the possibility of antidepressants. How could they know I needed something like that before they even knew me? I wasn’t opposed to medication, really; I just felt that we should do some exploring first and if we reached that conclusion, then okay. I was turned off by the fact that they were suggested right off the bat, and I subsequently didn’t go back to the counselors who were offering them.

I was a little less incensed when my medical doctors suggested antidepressants over the years. At least they knew me and had a great deal of information about what my problems were doing to me physically. I even agreed when my ob-gyn suggested I try a particular drug. She explained that it was used to treat mild forms of depression and one of the side effects was weight loss. Sounded like a win-win to me! I still wasn’t crazy about the notion, but I agreed to try. Five days into taking the pills, Michael demanded that I cease and desist. I cried nonstop. I couldn’t even function. Maybe I should have given the drugs more time. Perhaps I should have consulted with my doctor about the dosage. But I didn’t, and that was my one and only experience with antidepressant medication.

I hadn’t had the best of luck with mental health professionals. But for some reason I was optimistic about this latest appointment. Maybe it was because I knew I was getting medical help, and I just figured therapy would be icing on the cake. Whatever it was, I went into that meeting with a positive outlook—and I wasn’t disappointed. The therapist acted genuinely interested in me and helping me find a solution. She asked great questions, and from her follow-ups, I could tell she was truly listening. And she never once mentioned antidepressants. I was feeling good about the prospects.

When I finally got the phentermine, I was ready for action. The night before, I ate to my heart’s content: three plates of spaghetti, topped high with meat sauce, and garlic bread. Chocolate ice cream for dessert. And tons of Mountain Dew. I knew the next day would mark a new era, so I figured I better get it in while I could. Some crazy ways of thinking never change.

I ate a big breakfast and waited a couple of hours before taking the phentermine, when I arrived at work. In about fifteen minutes, I knew I would be just fine. The pill put me on such a high, I was knocked out, but in a good way. I found myself smiling uncontrollably, despite myself, as though I had some sort of secret. I called Michael and told him I felt GRRRREAT! And I didn’t eat a thing for the rest of the day. It was glorious!

This was a new experience for me. Each day I felt my mood alter when I took my medication. It sort of “evened me out”—I just felt steady all day long. The stress of my job didn’t affect me as much, and because my eating was in control, I felt more than fine. It wasn’t long before some of the weight came off and people began to notice. I was getting compliments, and I was feeling in control. Life, once again, felt good. I was full of promise.

After several months on this new regimen, I’d lost sixty-five pounds. Again, I felt as though the drugs were my saving grace, exactly what I needed to get going with my weight loss. When I went to see my ob-gyn for my annual checkup, she was thrilled to see I’d lost weight, and she asked how I’d done it. I happily told her I was seeing a weight doctor who put me on phentermine. She stopped short, looking at me with a cocked head. “Is that working for you?” she asked, somewhat skeptically. Obviously, yes—the scales didn’t lie! I explained to her that I felt in control, my moods were great, and I was no longer obsessed with hunger all the time. She nodded thoughtfully but didn’t really have much to say. I could tell she was a bit wary. I was puzzled, but I didn’t press it.

What I did want to talk to her about was getting pregnant. I was approaching thirty, and I felt as though time was running out. Michael and I would soon celebrate our tenth wedding anniversary, and our families were starting to wonder if we would ever have kids. At my heaviest, I was told I probably couldn’t get pregnant, that a morbidly obese woman rarely ovulates. Now that I was losing weight, my mind inevitably turned to when I would be able to have children.

I expected this doctor to say once I completed my weight loss, I should be good to go to get pregnant. But she didn’t. She asked me why I was waiting. “I’ve seen women much heavier than you have perfectly healthy babies,” she said. “Why would you deprive yourself?”

This floored me. It went against what every other doctor had told me. Yes, I’d lost sixty-five pounds, but I still had a long, long way to go before I was considered healthy. Didn’t I need to finish that mission first?

But then the other side of the argument started to make sense: How long would it take for me to lose all the weight? Another year? I wasn’t getting any younger, and besides, why would I want to lose all of my weight just to turn around and gain a bunch with a pregnancy?

I so wanted to have a baby; I had wanted to be a mother almost from the moment I’d married Michael. I felt more than ready, and I knew Michael would make a terrific father. He was scared to death even at the thought, but he allowed me to take the lead on this one. I figured I would go ahead and stop birth control pills, thinking it would take several months to get pregnant. In the meantime I could still continue the medication and continue with my weight loss. You know where this is going.

Yep. First try.

And so that ended my second round of diet drugs. Lots of success, only to be stopped abruptly before I was finished losing the weight. This time, though, I had only myself to blame.

My pregnancy also stopped my going to therapy. Even though it was going well, I viewed having to visit a shrink in direct correlation with needing to lose weight. Since I was no longer trying to shed pounds, I reasoned that I could put therapy on hold. I promised myself I would go back once I gave birth and started back on track to getting healthier.

I had a beautiful baby girl and didn’t gain a whole lot of weight. When Emma turned one, I was pregnant with her brother. After I had Eli, the twelve-pound newborn who suffered because I couldn’t get my eating under control, I knew I was done having children and ready to finally put the weight battle to rest. My health was starting to be a major concern, and I now had two small children to consider.

This time I didn’t waste efforts on other plans. I went to my new ob-gyn and asked for phentermine. She was a little wary, saying in her experience it wasn’t that effective, and she wondered about the long-term risks. I convinced her that I’d done really well with it, and that I was desperate for something, anything, to work. I was more than three hundred pounds, and once again found myself at that hopeless stage. The doctor gave me a month’s prescription, saying she had to see me in four weeks. I’d better show progress, she warned, or I wouldn’t get the pills again from her. Relieved, I filled the script and readied to take it the next day—which of course means I ate my brains out that night!

That old, euphoric feeling came back as soon as I took the pill the next morning, and again, all felt right with the world. Once more I was struck at the mood-stabilizing effect the drug had on me, and it made me wonder if I did indeed need some sort of antidepressant. It just kind of took the edge off. After taking the medication for about two weeks, though, I noticed it wasn’t lasting me all day like it used to. I at first brushed it off, thinking I was imagining things, but I secretly began to wonder if the medication was losing its effect. Still, I lost twelve pounds that first month, and my doctor was thrilled, praising my success. She happily wrote me a new prescription and told me to be back in a month.

One week into the new prescription, it was undeniable: The pills weren’t working. I’d have a couple of hours of good feeling/no hunger, but then that wore off, and I was starving. Without much resistance I would binge eat, justifying my overeating by vowing to change the way I took the medication the next day. Surely I could adjust it and do better, right? I played this game for the rest of the month, torturing myself daily with should-I-or-should-I-not-eat arguments that always landed me at the drive-thru. I wound up gaining back five pounds.

My doctor nodded patiently as I explained (lied) to her that it had been a tough month. I told her I forgot to take my medicine a lot, and I was sure it would work again once I got my act together. She showed no emotion whatsoever as she told me she was not giving me a new prescription and that I would have to get my act together on my own. I tried not to look so desperate, but I dissolved into tears. She seemed pretty unmoved, and I felt as though I’d been punched in the gut.

I was still smarting a couple of days later when her nurse called and suggested I find a general practitioner. It seemed this doctor only wanted to see me for ob-gyn issues. I cried even more, but I was also mad. Who the hell did she think she was? In my mind, she had such a God complex. “No! You can’t have it!” I imagined her saying cruelly, yanking away my one shot at losing weight.

If I’m being honest, I can’t really blame her. She’d warned me she wasn’t a huge fan of the drug, and that I would have to play by the rules. I hadn’t, so she stopped playing. But where did that leave me? I felt as though she’d abandoned me and I had nowhere to turn.

The doctor seemed perfectly nice. I explained to her my history, how I’d gained the weight after I’d gotten married, and how I had tried any number of ways to lose it over the years, with minimal success. I almost couldn’t believe it when I started really opening up. I tearfully told her that sometimes I felt like I was losing my mind, that all I thought about was how to stop eating, stop abusing food. I felt stuck in an endless cycle—with no way out—and I was helpless. She seemed to really listen, really hear what I was saying. She made it easy to be honest about my feelings.

When I’d finished, she expressed her sympathy and concern. She said she wanted to go get something for me off her desk, and she excused herself. I dried my tears and waited for her to return, feeling really hopeful for the first time in quite a while. This doctor was going to hear me. She really got what I was trying to say.

The doctor came back in with papers in her hand. “I printed for you a copy of the Food Pyramid,” she started. My jaw dropped to the floor as she continued. “I want you to see what your goals should be in terms of what kinds of food you should be eating.”

I almost expected her to burst out in laughter and say, “Just kidding!” But as she droned on and on about the importance of a balanced diet, I slowly began to realize just how serious she was. And I was angry. I was seething. Hot, angry tears seared my vision. My heart pounded so loudly in my chest, I was sure she could hear it.

Was she insane? Had my words meant nothing to her? I had poured my heart out to this woman, admitting that I thought I was addicted to food and that I might be a little crazy. Her answer was for me to look at the Food Pyramid and try to eat a more balanced diet?! Seriously?

But wait, she wasn’t finished. “I also think you should look into this faith-based organization. It’s called TOPS, or Taking Off Pounds Sensibly. They have several meeting locations in this area. I found one within a couple of miles of your zip code.”

She handed me the sheet. She had made an effort, although a horribly stupid one. I couldn’t criticize her intentions, I supposed. But I also couldn’t believe that a medical doctor couldn’t see what a real mess of a person she had before her, and how could she possibly think my answer was the Food Pyramid and a church support group? Was she an idiot?

I swallowed hard, trying my best to restrain my emotions. I was mad, but I wasn’t about to give up on what I thought was my only hope. “Thanks for this,” I said softly. “I was wondering … what do you think about phentermine? The few times I’ve had success, it was because of medication,” I said, rather weakly.

She nodded. “Well, I think it’s definitely an option for us,” she started, and my heart immediately lifted. Maybe she wasn’t so bad! Maybe she wasn’t so clueless!

“But,” she said, “I would have to see you successfully complete a three-month plan of a good diet and exercise before I could prescribe that for you.”

I was sure I hadn’t heard correctly. I indicated so, but she repeated the same thing. If I was floored before, I was absolutely flabbergasted now. Three months? I couldn’t even put three days together! Why in the world did she think I was there? Why was I seeking her help if I could do it on my own?

It became real clear, real quick that this doctor wasn’t going to help me, and I was incredibly sad. How could she not understand? How could no one understand what I was going through? And if that was the case, how was I ever going to solve the problem?

I knew there wasn’t much research about how phentermine affects the body. I knew that the whole fen-phen fiasco had made doctors skittish. But really, what’s the alternative? Walk around with an extra two hundred pounds, letting it wreak havoc on my heart? I had diabetes and high blood pressure—I was marching toward an early grave. If I knew something worked—something would help me get the weight off—didn’t it make sense to do it, whatever the cost?

That same argument would come up in the not-so-distant future.

For right then I decided to try one more doctor. My husband had a general practitioner whom I’d seen for minor things and who’d invited me to become a regular patient. I gave myself the same pep talk while I waited in his waiting room: Play it cool, Jennifer. Don’t be too anxious. As I sat on the exam table, I calmly told him about all my efforts to lose weight, mostly to no avail. And then I laid my cards right on the table: “I’ve had the most success when I’ve taken phentermine, and I’d like to try it again,” I said firmly.

This doctor, a man, was busy writing notes in my chart, and he didn’t look up when I stopped talking. “I’m not sure those are effective,” he said, still writing.

“Why not?” I shot back before I could help myself.

This time, he looked up at me.

My face felt hot, and I looked away. “I mean, nothing else is working and I am desperate here. I’ll try anything, just please.” I met his glance again, sure that I had pleading in my eyes.

He nodded. “Yes, we can try it,” he said casually.

No lectures, no God-like stance, no threats. He gave me the medicine. I could have kissed him.

I was determined not to waste this go-around. I didn’t know if I’d get the chance again. I took the medicine enthusiastically. I got the familiar buzz right off, and I was so happy. I was on my way.

The hunger punched through before lunchtime.

It was over. The medicine didn’t work anymore.

What in the hell was I going to do now?