I’ve Decided to Live.

Lucian Freud’s, ‘Benefits Supervisor Sleeping,’ 1995, was briefly the most valuable painting on the planet by a living artist, selling at auction for $33 million dollars. The model, Sue Tilley…went on a diet.

Some day I’ll be able to talk about my 2020.

Not today; I’m going to skip most of it today and bring you to Spring of 2021.

This is so I can tell you why Spring of 2022 is.

(And since you’ve survived the endless last two (billion) years same as me, I bet that sorta makes sense! Either way, hold tight, Friends. Here we go.)

Crystal’s Thigh Gap

My roommate in the psych ward was nice. That was important. Because though the facility does try…it’s not a nice place. Most of the patients are too damaged to be nice. But Crystal sat cross-legged on the zebra print throw she wasn’t supposed to have on her bed, a yellow legal pad in her lap. She was gonna help me. She ended up changing my life.

“I’ll make you a list. There are some just lovely, I mean truly, beautiful spirits here. But some…” she slapped the pad and looked at me. “Well I’m just going to say it. Helga is a real bitch. Do NOT talk to Helga.”

Helga had threatened to kill her the night before I came.  Well, Crystal wasn’t about to take THAT sitting down, and by the time the guards intervened she (now standing to re-enact the scene) was doing a “The Shining” Jack Torrance-lurch down the corridor, her sporty red aluminum walker held about her head in place of an axe. (Crystal, though outwardly the picture of MILFY, pony tailed health, suffered fibromyalgia and other debilitating “invisible” illnesses)She said the pure anger had pushed out the other pain and she became The Hulk.

“You should have seen me. I had the walker over my head I swear I would have just laid her flat out if I saw her and I was screaming like [“like“] a crazy person, ‘Hellllga! Stop hiding, you bitch!!”

I nodded, sympathetically. I’d only seen Helga in the Main Room. She was a young, hard-faced woman with a Russian accent that came and went. She was wearing a blouse as shorts when I’d arrived, legs through the sleeves. It was bold, but diaper-y.

“She’s jealous,” Crystal whispered. “I’m just…like…good with guys, right? I’m nice and they’re nice back and she’s so pissed that they talk to me. But it’s because I’m nice and she’s … (here she looked around our room as if for anyone overhearing. I don’t think anyone was; not because we had privacy of any sort – the cameras in our rooms surely had audible capacity – but from what I’d seen from the nurses and guards behind the locked enclosure in Reception, they found us, in the low-security wing, too boring to tune in to. Apparently even too boring to keep from stalking each other with aluminum walkers.

“She’s fucking Satan,” Crystal hiss-whispered.

I was not that okay that first night. I was…tired…in a way that I’d never felt before. But my survival instinct had kicked in the same time my rights as an autonomous human were taken from me along with my clothes. Survival meant regaining or faking sanity as quickly as possible. Crystal helped me get my feet under me a bit; I was having a sorta-conversation.

I use humor, always. My last safe place, my last weapon. So I said, with all the worn wry I had left, “Well, I’ve seen your thigh-gap, girl. It’s like a ten-year-old boy’s. I practically wanna kill ya myself.”   

Crystal barked a laugh and launched from the bed again, a flight of ideas winging her to a new topic.

“Oh my gosh, that’s not even real. These aren’t real either!” She patted her tightly pert breasts.

“I had weight loss surgery,” she explained, “and then there was so much loose skin I just had to have everything lifted.”

Weight loss surgery. Severe excess skin. Huh. I thought back to a special I’d seen on TLC a decade ago. “Oh! Did you get the…like where they like pull everything upwards and cut off the extra?” I like the idea of grabbing the top of one’s sagging body and giving it a good tug, smoothing out the flaps and wrinkles like a fitted sheet.

“Sorta!” She said. “Wanna see?”

Would I ever get such on offer again? Would there be any other place or time when it was appropriate?

“I’d absolutely love to,” I said.

Crystal pulled her cougar print leggings to her knees and lifted her rhinestone “Mama Bear” t-shirt.

Her breasts were positively popping forth from her chest. They were uneven, but, ehh, most breasts are. They were scared underneath and in the areola, and the nipples sat a bit wall-eyed; but it certainly wasn’t less appealing than the average middle-aged woman’s breasts. Just…differently so.

Her thigh gap didn’t look artificial, but she spun around when I complimented it and humbly showed me the rounded ‘m’ rouge scar that cradled the top of each buttock. Unsightly, but again, no more so than the buttocks of any woman succumbing to time and gravity. Or an ill-aged tattoo. Just different.

“Thank you.” I said. “That was fascinating. They did a great job, you look really good.”

On The Edge, Safe. But Look Up There.

That’s all I want to say about that time right now. Except that was the day the idea was planted in my head. The idea that weight loss surgery could actually work. It won’t keep you off the crazy ward, fair enough…but that was a very respectable thigh gap.

I’ve spent the interceding year covered in bloody gashes (some metaphorical) crawling up and away from the freezing filth of Rock Bottom. Over frozen jags that tear flesh and infects the wounds. I kept climbing. Now I sit on the side of that old well, the one with the broken plywood cover I’d stomped through, dangling my scraped and healing feet over the side. Not scared anymore. Scarred, but not scared. I can see all around now. More than dirty stone. Now I can see mountains and they’re beautiful. I wanna go. I bet I could. They can’t be harder than where I’ve come from. I want to climb them.

But…I can’t right yet. My brain doesn’t understand the Industrial Revolution has come, and I don’t need to spend 2000 calories of energy to survive a day. It can’t even comprehend how deep into The Computer/Internet Age it is, where my entire life could be lived with 60 paces a day. I wore a pedometer and counted those paces at the height of the pandemic, when I was at my most heavy and still. That’s what I did in a day. 60 steps.

You can’t climb mountains if you can only go 60 aching paces.

Why Doesn’t This Sound Crazy?

I began noticing all the people in my life who’d off handedly mentioned having a bariatric surgery in their lives. There were a lot. Except for Crystal, they were mostly still chubby, but not painfully obese. They were also universally pleased with their choice.

Drops of information began to trickle into an actual knowledge pool

“They do it laparoscopic now. Five little holes the size of a penny, and you’re up and walking the same day. Home the next morning.”

“Does it hurts? Well…one incision was pretty sore. But they gave me Tylenol. Oh. I had really serious gas when I woke up, tho. That hurt.”

“No, you eat whatever, just less once you’re healed.”

“They don’t even do that thing where they tie the intestine to the esophagus anymore [the procedure I call “the Human Centipede” but the medical world calls a far more attractive “Roux en Y” gastric bypass.] They don’t ‘bypass’ anything. They just take like…crimper scissors and snip snip titanium staple the round part of your stomach off, leaving like a banana shape instead of a football.”

“It’s so safe my sister had it done for $5000 in Tijuana. That includes airfare! She wasn’t fat enough to qualify for American surgery, she only wanted to lose 50 pounds. She’s a size four now. I’m sooo jealous.” (That one was from a nurse.)

Meanwhile, I tried another diet. Bring the total since I was seven years old to…well…all of them.

All the diets.

This one I had great hope for, though. Even though every time the diet was advertised, it appeared with a legal disclaimer “Average weight loss 12 pounds.” But SOME people have lost 200! And won marathons! So there’s always hope!

And it worked! Until it didn’t. Like always.

“Average weight loss 12lbs.” A great diet for people tired of sucking their stomachs in.

The Great Fat Hope

A word about hope.

Fat people have for a century insisted their food intake is not commiserate with the degree of obesity they suffer. They say in bafflement, obviously born of denial, that they eat very little, and they DO exercise…as much as some slender friends.

But even if they’re mystified, most still take full blame for their unacceptable fatness.

We have to.

Fat people have to believe it’s our own fault. Like sweet dear candy-striped shorts Richard Simmons told me through my childhood and adolescence. “YOU held the fork.” My own indulgences and indolence caused this.

It HAD to be my fault, my delusion, my wishful thinking. Because if it’s not my fault, if I were really born to be fat, if my body truly metabolizes calories directly into the storage of fat faster and more efficiently than slim people…

…well then I can’t fix it. And then…I’m hopeless.

I’d be fat forever. My lack of discipline and self-respect would forever be the FIRST thing people notice about me. My lack of femininity and style. My indolence, my willingness to sit life out. All of that is on full display the second you see a fat person across the room.

If it wasn’t my fault I was helpless to change. I haven’t managed yet, but I’ve been trying since I was seven, so something’s bound to work!


Grandma Never Sat Down, Tho. Also all that science.

The 20th century and it’s eternal focus on fat women has shifted. We’ve watched up close, not just our own fat but our mother’s and grandmother’s.

We watched them live and die. And it just didn’t add up.

Women with the self control and diligence to run a households on $90 a month. Women energetic enough to raise eight children after having raised their own siblings from the age of nine. Women with the impetus and strength to become EMTs, running out in the middle of the night in trucks they’d chained themselves, piecing together bodies broken on icy mountain passes. Farmwives keeping 200 head of cattle AND the men that tended them fed, clean, and fully cared for while running the business of an entire farm and still making it to church every week on time with a passel of scrubbed little kids in tow.

THESE were the woman too lazy and useless to lose some goddamn weight?

And then they died. Because fat DOES kill. Maybe the brain’s wiring gets confused when, for the first time in the history of the human race, there is so much food that poor people are fat, and rich pay extra to be thin. Maybe because they worked eight hours a day instead of 18, they became fat.

So they died at 66 of heart failure, after eating fortified gruel for a year in a nursing home… still 120lbs over weight. And the instinctive “that doesn’t seem logical” is snicked. “They should have eaten less and exercised more. They obviously lived unhealthy lives.”

(All photos “farm wives” “early 20th” from NYPL Archives)

That didn’t add up. But…it must! We must…we must just be missing the 1000s of calories they must have snuck. Just look at the old recipes! Real butter! Well that must be it, then. Even thought they only made that batch of cookies once a week and by the time the kids were through they’d only had two. Plus they…churned the butter themselves from cows they milked… But somehow… lazy and lacking self control?

Wait…no. No. Just STOP.

As we entered the 21st Century, their must have been some scientists who observed the same.

Science Suggests Some Fat People Are Fat AND People.

Thrifty gene hypothesisJames Neel, U.S., 1962Human history was marked by feast or famine. Humans who had fat reserves — who were exceptionally efficient at storing fat — were more likely to survive.
Drifty gene hypothesisJohn Speakman, U.K., 2008A counter to the thrifty gene theory. Fatness was not a survival advantage. It just stopped being a disadvantage when humans no longer had to run from predators, so obesity drifted into the population.
The thrifty
Several authorsA handful of hypotheses that revolve around the idea that poor nutrition in the womb encourages the development of diabetes when food is abundant in adulthood. 
unknown foods 
Riccardo Baschetti, Italy, 1998Obesity and diabetes occur when populations are introduced to new foods they have not adapted to. 
Aggression controlPrajakta Belsare et al, India, 2010As humans relied less on fighting and aggression to survive, a propensity for obesity emerged. Over­indulgence becomes less of a problem when being docile is no longer a life-or-death calamity.
Dyan Sellayah et al,U.K., 2014Survival in cold parts of the world favored genes that help preserve body temperature — a higher metabolic rate meant lower obesity and diabetes. In hot spots, lower metabolism meant the opposite.
Sources:  E. GennÉ-Bacon/Yale J. Biol. Med. 2014; D. Sellayah et al/Endocrinology 2014

I like to gather information. Aside from talking to as many bariatric people as I could find, from 18 years post-surgery to 18 months, to taking them out to lunch to watch in fascination how they ordered real food but only ate 1/3 of it, no regrets.

I learned every time you go on a strict diet, your body still thinks you’re trying to starve it. It panics and grabs each calories it can get and turns it to fat (by slowing you metabolism, since it needs to store that energy). And if you started restricted-calorie intake when you were seven (Hi! That’s me! And some of you!) and never stopped…by your 40s your metabolism is DONE with this bull. This constant but unexpected deprivation (“yo-yo” dieting was a cuter name) and your metabolism will be damned if they’re going to fall for it again. They’re holding on to every calorie. You’ll thank them when drought season comes!

It occured to me, after all this information had been gathered…that my entire system was corrupted. My body and brain would never give me aid nor quarter. It would demand calories and increase fat storage until it killed me. (I would say an iron willed woman with a personal chef and trainer would be able to defeat this biological demand and remain slender for life, but…one word, “Oprah.”)

My stomach would demand, and I would fight. And fall, And fight and fall, until it killed me like my parents.


Unless I got to that bitch first.

“PLEASE Take Our Money, Fat Friend!”

One of the more realistic (non-bikini non plastic surgery retrofit) before and afters)

Last October…I typed “bariatric” into my insurance company’s search bar.

Holy shit.

That was the night it became real.

The bariatric surgeries the insurance company would pay for had their own page, and it was easy to find. The one I liked best, the snip snip foot-ball to banana one, the “Gastric Sleeve” (not the “Band”…no one does that anymore.) cost $32,000 dollars.

If I qualified, (and I sure did!) the insurance paid around…$30,000 of the procedure.

Ho-leee shit!

It wasn’t the affordability that affected me. It was the fierce mercenary purposes of insurance companies. They HATE paying out money. They employ stone-hearted math geniuses and lawyers and brilliant medical teams to figure out how to NOT pay money.

And their research showed them that this expensive, preventative “elective” surgery saved them money.

Saved them prescriptions to diabetes meds, blood thinners and heart medicine. Saved them Cpaps and sleep studies. Saved them joint replacements and physical therapies. Saved them therapist bills and anti-depressants. High risk pregnancies and infertility treatment.

Saved them two years of useless home care after a fat clot choked off half my father’s brilliant brain, until he died slowly of pneumonia.

Saved them the three months in the Cardiology ICU, and the costs of the triple bypass that ended up not saving Mom’s heart.

TL:DR = I’ve Decided to Live

I’ll go to sleep on Tuesday morning in a hairnet and wake up to 2/3rds of my stomach removed. Football to a banana…a more reasonable size for my needs and lifestyle, and one my brain, even if it rebels entirely, will not be able to fully override. Unless I hook myself up to intravenous milkshakes, I cannot regain this fat.

It’s rough and dirty, it’s extreme and scary. I wish I didn’t have to do it. While being so grateful the procedure I fantasized about when I was ten and realizing I would never be properly loved until I took up just the right amount of space, has become safe and common enough to help me.

My friends. I’m having bariatric surgery. It’s not the easy way out…it’s the only exit.

I’m writing this because I’m not gonna be coy. When I shrink and you won’t have to wonder why. I had The Surgery. And…I’ll still be chubby in the end. No amount of weight loss will make marathon training look appealing or make me swear off two delicious spoonfuls slowly savored of potato salad). I’ll have weird skin, likely. I’m predicting looking a bit like a gnome candle left in a hot garage. I’ll be irritable as I try to figure out a new and peaceful relationship with food. I’m irritable now! I’m on a two week liquid fast (medically supervised starvation!) to shrink my friggin’ liver and I really hate soup.

But I’m doing it.


I’ll be able to walk anywhere by autumn.

Around stores, airports, my yard. I’ll see the ghost towns along the Oregon Trail.

I’ll chaperone my kid’s field trips.

I’ll take them to the lake in my little row boat I still can’t use because of my size, to find private picnic spots on lakes.

I’ll fit in booths and seatbelts will cross me in planes with no raised finger and knowing nod exchanged between me and the stewardess to bring an extender.

Dropping my keys won’t be a rush of despair followed by bracing for pain. I’ll be able to sleep through a power-outage, for the fat now is so thick near my windpipe I suffocate if I can’t power my Cpap.

I’ll be able to empty the dishwasher without seizing back cramps. And if I can do that…maybe I can clean and have my big white pretty house be TRULY a home.

I’ll be the first woman in my matriarchal line to live past 68, maybe. And if I die early…maybe it will be from water-skiing or something awesome.

Still Therese

I’m Therese. I’ll be getting thinner over the next year. It’s not because I’m the paragon of discipline. It’s not because I’m better than any other fat person.

I’m getting bariatric surgery because I can afford it through insurance. Because I believe it’s my only chance at a sustainable non-obese weight. I believe this after intense research of every kind, sleepless nights, my family’s wary support, and with full knowledge that this will be hard.

I will still love food in my head. I will still be Therese with sparkly rainbow of non-fat related problems, not a 20 yr old manic pixie dream girl in ripped jeans when it’s over. I will be eating the rest of my life like Richard Simmons had always told me and my mom to… except this time it won’t be miserable and doomed to fail.

Repeating the same behaviors and getting the same terrible results isn’t the definition of insanity, it’s the definition of despair.

I’m getting bariatric surgery because I don’t despair. Because I am scared but brave and ready to do hard things. And because I want to be alive.

5 thoughts on “I’ve Decided to Live.

  1. Sandy would be so happy for you. I am happy for you. I know this is scary, but the world does need you to live past 68. Love you in any format.


  2. Yay!!!
    Theresa, I’m just under 5 ft tall and never had to worry about weight gain…..A miracle since my lineage is short buxom Scandinavians and Germans, with a few chubby Irish lassies thrown in to justify my red hair.
    I felt impervious to weight gain – same way I felt about my friends all wearing “readers.”
    That’ll never happen to ME!
    (until it did)
    Age, and the damn lockdowns (covid) had other plans.
    Suddenly everyone was telling me how much I looked like my mother (a chubby Norwegian)
    My clothes were becoming camouflage, and I was glaring at the nurse who wanted to weigh me at my last Dr. Visit.
    Spat out the weight I thought I SHOULD be, and walked on past the scale like it was a broken down lie detector.
    No need…!
    Finally I got up the nerve to peek at my scale. (Normally in the storage room)
    Something’s wrong -this scale is just a broken piece of crap!!!
    I’m going on Amazon RIGHT NOW, and buying a reliable one.!
    I knew I faced my “Day of reckoning” when I heard the jingle of my Ring doorbell, and (with a smug look on my face)
    Set it up – put it down – and hoped on…..
    gained 30 pounds!!!???? How????
    Couldn’t be the afternoon wine and cheese plates?
    Chocolate is good for you….right….right???
    Is it don’t eat after 7, or go ahead and eat after 7?????
    Anyway, it caught up with me and threatened to keep piling up if I didn’t “own” (as someone said) my bad eating habits, and chubby physique.
    Plus, those days of starving for a day, and putting on a bikini were long gone.
    So….had to WORK at this one.
    For me – went on a monitored low carb/high protein diet plan with my chiropractor.
    Took about 5 months and off it came!!! Amazingly simple and excruciatingly hard.
    Got rid of my acid reflux meds, and out of the danger zone for obesity. Didn’t feel like “Fatty McFat” anymore.
    I even strolled onto the docs scale with a smug look on my face….Go ahead, make my day….
    I’ve since continued making better decisions and my weight has STAYED off.
    My husband keeps telling me I don’t have to tell everyone I meet…”I lost 30+ pounds!!!!!”
    Can u tell? Can u tell????
    Unfortunately, most people have better things to do than monitor my weight. Never really noticed I had gained…what????
    Why did I even bother loosing weight for YOU!!???
    But it was for ME, and it felt good.
    I became satisfied driving my kids nuts with pictures of my feet on a declining scale, and basked in their admiration.
    (A thumbs up text)
    Now I’m sure you are looking at a harder, scary uphill battle what with surgery and all….
    But its a beautiful thing to do for you.
    I can’t wait to read about your journey. Chin up little girl- this won’t hurt a bit. (maybe a bit)


  3. I am,do thrilled that you have made the decision to really live. You are so important to the world , your friends and your family.


  4. Therese,
    How good it is to hear from you!
    You are proving once again that you are a brave, strong woman. I look forward to following your account of this incredible step into a better future.
    Love you.


  5. I’m so happy for you. I’m glad that you’re going to feel better, inside and out. You deserve all the good things. Know that your readers are all wishing you the best. Maybe this will be fodder for a future book?


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