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This book, Hunger, is a book about living in the world when you are not a few or even forty pounds overweight. This is a book about living in the world when you are three or four hundred pounds overweight, when you are not obese or morbidly obese but super morbidly obese according to your body mass index, or BMI.

“BMI” is a term that sounds so technical and inhumane that I am always eager to disregard the measure. Nonetheless, it is a term, and a measure, that allows the medical establishment to try and bring a sense of discipline to undisciplined bodies.

One’s BMI is one’s weight, in kilograms, divided by the square of one’s height in meters. Math is hard. There are various markers that then define the amount of unruliness a human body might carry. If your BMI is between 18.5 and 24.9, you are “normal.” If your BMI is 25 or higher, you are overweight. If your BMI is 30 or higher, you are obese, and if your BMI is higher than 40, you are morbidly obese, and if the measure is higher than 50, you are super morbidly obese. My BMI is higher than 50.

In truth, many medical designations are arbitrary. It is worth noting that in 1998, medical professionals, under the direction of the National Heart, Lung, and Blood Institute, lowered the BMI threshold for “normal” bodies to below 25 and, in doing so, doubled the number of obese Americans. One of their reasons for lowering the cutoff: “A round number like 25 would be easy for people to remember.”

These terms themselves are somewhat horrifying. “Obese” is an unpleasant word from the Latin obesus, meaning “having eaten until fat,” which is, in a literal sense, fair enough. But when people use the word “obese,” they aren’t merely being literal. They are offering forth an accusation. It is strange, and perhaps sad, that medical doctors came up with this terminology when they are charged with first doing no harm. The modifier “morbidly” makes the fat body a death sentence when such is not the case. The term “morbid obesity” frames fat people like we are the walking dead, and the medical establishment treats us accordingly.

The cultural measure for obesity often seems to be anyone who appears to be larger than a size 6, or anyone whose body doesn’t naturally cater to the male gaze, or anyone with cellulite on her thighs.

I do not weigh 577 pounds now. I am still very fat, but I weigh about 150 pounds less than that. With every new diet attempt I shave off a few pounds here, a few pounds there. This is all relative. I am not small. I will never be small. For one, I am tall. That is both a curse and a saving grace. I have presence, I am told. I take up space. I intimidate. I do not want to take up space. I want to go unnoticed. I want to hide. I want to disappear until I gain control of my body.

I don’t know how things got so out of control, or I do. This is my refrain. Losing control of my body was a matter of accretion. I began eating to change my body. I was willful in this. Some boys had destroyed me, and I barely survived it. I knew I wouldn’t be able to endure another such violation, and so I ate because I thought that if my body became repulsive, I could keep men away. Even at that young age, I understood that to be fat was to be undesirable to men, to be beneath their contempt, and I already knew too much about their contempt. This is what most girls are taught—that we should be slender and small. We should not take up space. We should be seen and not heard, and if we are seen, we should be pleasing to men, acceptable to society. And most women know this, that we are supposed to disappear, but it’s something that needs to be said, loudly, over and over again, so that we can resist surrendering to what is expected of us.