I don’t like seeing celebs looking too skinny, I love it when they look healthy and comfortable in their bodies and embrace their curves. ~ Lily James
Women I admired growing up – Debra Winger, Diane Keaton, Meryl Streep – were all beautiful and thin, but not too thin. There are a lot of actresses who are unhealthy-skinny – much, much too skinny. You can’t Pilates to that. ~ Zooey Deschanel
Really skinny actresses make me hungry – I see them and think, Honey, you need to eat! ~ Miranda Lambert
I was very skinny, but that was just my natural build. I always ate sensibly – being thin was in my genes. ~ Twiggy
I. “Have You Ever Thought Of Fasting?”
Shortly after moving back to Portland, I went to a fancy restaurant with my family. After being seated, we all picked up our menus, and as I glanced at the offerings I felt my heart sink. This was a now-familiar struggle: few, if any, of the items were things I could eat.
The menu was large and sheathed in plastic and opened like a book. I hid behind it, slumping in my chair, my eyes scanning it with frantic concern. There were cheesy pastas, savory meats, delicious-sounding salads. Everyone around me began murmuring and exclaiming to each other about what they would try. I would have to order rice and fish, I decided. But I would need to ask the server to make sure the fish had no butter or sugar in its sauce, and even then, the rice might be bad for me, since it was likely to be white and not whole grain. I couldn’t eat any of the veggies, since they all came as raw salad. I needed to avoid fiber to protect my inflamed colon.
I sighed, set down my menu and whispered my plan to Ron. From across the table, my sister caught a glimpse of my face. It was the first time I had eaten out with my family since returning to Portland with my new disease, and they had little inkling how hard the eating-out ritual had become for me. Perceptive and sympathetic, Jeannie asked me about a few items on the menu. She had noticed the fish option, too. I thanked her, trying to look cheerful, but failing.
As Jeannie and I talked, everyone became aware of the conversation and of my distress. I sensed they were all at a loss–sympathetic, but uncertain what to do with this new situation, this new version of me. Over the last several months, I had gotten somewhat used to hiding my feelings when eating with others, but being with this new-but-old group of people was making those feelings raw again. Helpless, I found myself fighting back tears under their concerned gazes.
There was an awkward pause. Jeannie tried again. “Have you ever thought of fasting? I’ve heard that can help with gut problems.”
Her idea was a good one, but I shook my head with a touch of bitterness. “I know… I’ve heard it helps. But I’m underweight, so I don’t think fasting is an option for me.”
That did it–I was going to cry. I needed to use the bathroom anyway; without another word I pushed my chair back and fled. Ron knew what to order for me.
Alone in my stall, I took deep breaths, willing the tears not to come. If they did, my face would be puffy and red for a half hour. Somehow, my family’s sympathy had only made me feel more alone with my illness, more keenly aware that I was surrounded by Healthy People who could eat whatever they wanted the way I used to be able to.
And the fasting comment had been the last straw. Being unable to even fast like a normal person made me feel like a skinny, freakish failure: abnormal because of my illness, and doubly abnormal because of my thinness. My skinniness had always made me an exception to certain things.
I disliked being an exception.
II. What It Was Like to Grow Up Skinny (And Self Conscious)
I have always been skinny, ever since I was a baby. If you can picture a skinny baby or a lanky toddler, that was me. Mom says that people predicted I’d be a piano player. “Look at those long, slender fingers!”
In middle school, my teacher recommended that I audition for the movie “Even Cowgirls Get the Blues.” This teacher, a kind, warm woman, had seen me perform recently in a children’s play at a local community theater, and she happened to know the film’s director. They were casting in Portland, looking for someone to play a middle-school flashback of the main character, and specifically seeking a girl with a long neck. After my teacher showed the director my yearbook picture, I was invited for a screen test to see whether the camera “liked me.” When I walked in, the casting director exclaimed, “Oh, her neck just goes on forever!” (I didn’t get the part–I didn’t look enough like the younger flashback, who they had recently signed.)
A year or two later on an eighth grade field trip to Washington, D.C., I went swimming with the other kids in our hotel pool. I found myself in the elevator in my swimsuit with two of the Popular Girls, also in their suits. One of them gaped at me. “You are so skinny.” It wasn’t exactly an insult, but more a gasp of astonishment. The other girl nudged her, admonishing, “That probably doesn’t make her feel very good.” Silent and by now excruciatingly shy, I said nothing.
Like most middle-school-aged girls, I had begun to develop a self consciousness about my body. For me, this self consciousness centered on my skinniness. Dad had long told me I was lucky: “For the rest of your life, you will thank God you are naturally skinny. Most women would kill to be thin.” But by eighth grade I knew what he really meant: that most women would kill to be thin, but with full figures. I was just plain thin. I felt like a failure as a woman.
In my teens and early twenties, I felt distinctly left out of womanhood. Jokes among girls and women often centered on the desire to lose weight, with the assumption that this was a universal womanly struggle, like menstrual cramps. By college, I had learned to smile demurely and keep silent when women complained about their “childbearing hips,” or about men leering at their breasts, or about the lack of muscle tone on their backs. I did have muscle tone, because I had very little fat on my body and because I had become a dedicated martial artist, more comfortable learning to fight than learning to make myself vulnerable. I hid what I saw as my freakish body beneath enormous shirts and pants, never wearing shorts because they would show my spindly legs, feeling safest when enveloped in protective folds of cloth. (I was making the tragic mistake of skinny teens everywhere, failing to realize that baggy clothes only make you look skinnier.)
Despite Americans’ worship of slender-but-full-figured young women, there is also a stigma against skinny women, especially those who are older or less conventionally attractive. They are often assumed to be anorexic or unhealthy, and also–why not?–controlling and anxious. Look for it. In literature, skinny women are almost invariably portrayed as high-strung and/or embittered, like Aunt Petunia in Harry Potter.
Then there’s the semi-healthy backlash, in recent decades, against the thinness of models and unrealistic body expectations for women in general. I have overheard countless judgmental comments about skinny women, especially from other women: “Woah, she is scary skinny.” (See the first three quotes at the top of this post.) Pop hits like “Baby Got Back” and “All About That Bass” seem almost–almost–pro-women in this light, since they rebel against those Barbie doll, magazine-cover ideals. There is an attempt at feminism in such comments and songs, misguided though that attempt may be. By putting down slender women, I realize that people are trying to uplift women with more typical figures, or those who are self-conscious about being heavy. No good person wants women to aspire to thinness if their bodies are not made for it. There are indeed many different ways to be beautiful.
But I have a better idea. How about no body shaming, of any women, including the skinny ones? How about encouraging all women to be as healthy as they can, however that looks for their bodies?
As a teen, I worried that, if people saw me jogging, they would assume I was anorexic. Why else would someone already so skinny want to do this activity that most people do to lose weight? In reality, I exercised because I loved being in shape and had boundless energy. And I ate like a horse–on at least one occasion, I easily downed a large pizza by myself. The fact was, I simply had an extraordinary metabolism.
My body-image problems finally began to heal when traveling and living in Africa. Volunteering in rural Ghana during college, I found that my whiteness eclipsed everything else that might look strange about me. All white people look alike–rural Ghanaians had trouble telling me from the other two white women in my volunteer group, despite our different hair colors, body shapes, and facial features. And young, white, American women are interesting and attractive in much of Africa, which is a symptom of both crushing poverty and of racism’s awful pervasiveness throughout the world, but which really helped boost my self esteem as a self-conscious young woman. It’s hard not to feel at least somewhat attractive when you get several marriage proposals in the span of a month.
Even in Africa, though, I sometimes felt exceptional and freakish. During Peace Corps in Tanzania, I learned that weight was generally considered attractive, a sign of health and prosperity. A slender figure was seen as worrisome. In my village, when someone returned from a long trip, a polite greeting was, “Oh, you look great! You’ve gained weight!” When friends were worried about me, they might intone, “You’ve lost weight,” with notes of concern in their voices.
Other American Peace Corps women would be irked at Tanzanians’ matter-of-fact observations about appearance. Nothing was more offensive to one of my friends than the occasional: “You are fatter than Katie!” The locals, of course, meant this as a compliment. They were often bemused by our angry protests that it was a serious insult to an American woman.
I was also sometimes told that, coupled with my frightening white skin, I looked like a wraith to the untrained eye. A few times, babies or toddlers burst into tears at the sight of me. Nearby adults would giggle, explaining that the kids thought I was a ghost, since ghosts in local stories were described as both white and skinny.
So even living in Africa, my appearance was a mixed bag.
Only when Ron and I started dating, midway through Peace Corps, did I begin fully recognizing and confronting my body-image issues. He was my first boyfriend, and up until we dated I had serious doubts that any man would ever find me attractive (unless he was African and looking for an American wife). Ron, aware of my deep self consciousness, took pains to assure me that I was pretty. He started describing me as svelte, which I loved. (He also found ways to gently tease me about it. Our joke was that I would sometimes ask him, “Does this make me look skinny?” Actually, I think I did ask that at least once!)
Later in my twenties, with therapy, I finally overcame my body-image issues. Part of that therapy was collecting mental images of women with bodies like mine who were considered beautiful, or who I thought were beautiful. I had been unconsciously collecting such images in my mind for years, I realized. Occasionally, I would encounter a slight-framed woman in art, film, or literature who did not have a full figure but who was beloved and admired. I loved finding these women, and gradually, I came to see myself as reasonably attractive, too.
I know that, in our country and many others, overweight people have a great many struggles, and that my struggles are dwarfed by theirs. The stigmas for skinny women and girls are far subtler than those for overweight women and girls. I was never, for example, subjected to outright bullying about this issue. And my slenderness has given me countless little privileges that are hard for me to even recognize, just like the subtle privilege that has always come with my white skin, my straight sexual orientation, or my health (until I lost it). Slimmer people get more respect than heavier people, especially slimmer women compared with heavier women. For all the slights I experienced as a slender woman, society is far crueller to overweight people. Just look, again, at Harry Potter–J.K. Rowling is relentless when it comes to her treatment of Aunt Petunia’s “fat” son Dudley. Did she not realize she’d have countless young readers who were struggling with body image and weight?!
So the point of this little history is not to complain about being skinny as opposed to being overweight or even average. It’s just to let you, the non-skinny person, know that thinness can have its disadvantages. And it’s to let you, the fellow skinny person, know that you were not alone in your self consciousness.
Predictably, in our society that so mercilessly objectifies women, as a teen I found ways to decide I did not measure up to the supermodels. This poor self image also had major implications for how I made health decisions all my life.
III. Not All Health Advice Applies To Me
It was always clear that I “needed” to gain weight. According to various doctors and nurses and body mass index charts, I was underweight. I didn’t yet understand that doctors don’t know everything (and often disagree), and that body mass index is a generality and there are other ways to measure health. In terms of energy levels, physical strength, immune function, sense of happiness and well-being, and any other measure besides body mass index, for most of my life my health was exceptional. But unfortunately, it was body mass index that caught the eye of medical practitioners over the years, contributing to my belief that there must be something wrong with me.
As a health-conscious adult, I would often become confused when reading nutritional advice. I’d be reading about the benefits of eggs, say, or of a plant-based diet, or of taking this or that vitamin or supplement, and just when I had become convinced to try it I would reach the inevitable: “It also helps you lose weight!” This statement made me balk. I was always left wondering whether this particular food or supplement or diet was right for me.
Virtually all diet advice, in America, is written with the assumption that the reader wants to lose weight. Since I’ve long had the opposite desire, it was not unreasonable for me to wonder, for most of my youth, if I should do the opposite of what was recommended for most people. If avoiding carbs helps you lose weight, then shouldn’t I be pigging out on pasta? If cutting meat and dairy and sugar was advisable in order to lose weight, then shouldn’t I pile on the cheeseburgers and ice cream?
Over the years, plenty of people, including medical professionals, have urged me to bulk up by eating foods that for most people would be considered unhealthy. In my teens, at least one doctor agreed with my mother that a nice, big bowl of ice cream each night was a good idea. Advice like this was always welcomed by me, of course, since these foods were the tastiest!
Later, especially in the 2000s as cooking with real, unprocessed food began making a nationwide comeback, doctors and nurses began recommending healthier fats to me, such as peanut butter and avocados. They would caution that fat quality is important…but I liked cheese and bacon far more than avocados. And, I reasoned, I could eat much more of those tasty foods than I could stomach of the healthy fats, because I enjoyed them so much more. Wasn’t fat quantity important, too? So in my day-to-day decisions about what to eat, my exceptional metabolism and the conflicting advice I had heard over the years made it easy to rationalize often opting for the tastier fats.
The same confusion prevailed around exercise. If high-intensity interval workouts were good for weight loss, then I probably shouldn’t do them too often–right? Especially in 2013, when my goal was to become healthy enough to have a baby, and “healthier” for me primarily meant “heavier.” Apparently, the only thing wrong with my health was my body mass index. It stood to reason that for me, “healthy behavior” meant eating lots of carbs and cheese and ice cream and not exercising overly much. So that was what I did.
After diagnosis with ulcerative colitis, of course, I came to recognize the folly of that thinking. Before UC, I hadn’t known anything about digestion or the risks of eating tons of inflammatory food while not exercising. The less-tasty fats were, after all, the ones I should have been choosing most of the time. No one knows the causes of my disease, but after diagnosis, I did know that I had been abusing my colon for years. My natural thinness had allowed me to.
Now, in 2014 with my colitis, my health goals had become rearranged. I had fallen into a hole and my main goal was to climb back up to to where I had started.
IV. Learning to Discern: Picking and Choosing the Right Advice for My Body
As it had all my life, my skinniness added another level of complexity to my quest for health. For instance, while it’s generally okay to get pregnant with ulcerative colitis, for me it seemed unsafe because of my still-low weight. And while macrobiotics was working well for me, I fretted about losing more weight on this diet, which of course comes with the cheerful benefit that “It’s great for losing weight!”
The perpetually low fat proportions of the macrobiotic recipes made me ravenous at first, but fortunately, Ron knows a thing or two about nutrition. He helped me learn how to adjust the meals for my thin body’s special needs–I was finally learning to eat those healthy fats that doctors had sometimes recommended. If a recipe called for a tablespoon of sesame oil, I would use three. I would also add olive oil, toasted sesame oil, coconut oil, tahini, or sugar-free almond butter as a topping, and I was learning which oils and nut butters tasted best with which recipes. I often ate avocados, and learned to tell when they were perfectly ripe, so that the skin easily peeled off and the taste was sweetly delicious. When I added enough fats and oils to my macrobiotic meals, I didn’t wind up hungry at the end. And I was beginning to enjoy and even crave their tastes the way I had once craved cheeses and meats, though I still sometimes craved those, too.
It took a discerning eye to ferret out which diet advice should be my diet advice. Most of the things Virginia Harper, or any macrobiotic proponent, wrote about macrobiotics did apply to me, but whenever weight loss was used as a justification for a particular element of the diet, I had to do a little more thinking.
For instance, take dairy. Macrobiotics forbids dairy, especially cow-milk products, because–Harper explains–the poor digestion of lactose can cause discomfort in many people, and the milk protein casein is likewise inflammatory, even sometimes stimulating Type I diabetes in sensitive people. She goes on to describe the problem of added fat:
A quart of milk contains 35 grams of fat, with 60 percent of whole milk being saturated fat. These 35 grams represent about half of all the fat an average 150-pound man should consume in one day.
That passage struck me as a scare tactic. Who drinks a quart of milk, anyway? I penciled a protest into the margin: fat = good for me. (Although it is possible to be “skinny fat”, I doubted I was in that category, especially now with my lost weight.) I wasn’t certain I was either lactose or casein intolerant, so did I, personally, really need to avoid dairy? I decided to stay off my beloved cheeses and milk products for now, since I couldn’t be sure whether they caused me inflammation. Once my health stabilized, I could experiment with them. But I knew that in my case, avoiding fat was not a good enough reason to abstain from them.
V. The Fasting Question
Fasting was another conundrum.
My sister was not the first to suggest it–my friend Alison was controlling her proctitis through veganism and fasting. The theory goes that your body typically spends so much energy digesting food that it has few resources left over to heal. When you cease eating for a while, it can turn its energy inward towards healing.
My own vegan macrobiotic diet was working for me, and I was interested in the fasting piece, too. But I needed to know whether it would be safe, so in July, before moving to Portland, I had emailed Dr. Michael Klaper, a leader in the fasting-and-veganism movement. In my email, I wrote:
I am 35 years old, stand 5’9″ and have always weighed about 117 lbs. At my heaviest, before my proctitis, I weighed 122 lbs and was proud of that weight–I am hoping to get pregnant in the next couple of years and had been told I should try to increase my body mass index. Now, with my proctitis, my weight has once again dropped… Do you have any specific recommendations for people like me? Is there a way I can safely fast?
By the time we went out to the restaurant and Jeannie asked if I had ever thought of fasting, I had not yet heard back from Dr. Klaper. But finally, on November second, he wrote me back:
I’m so sorry, I didn’t see this in my Inbox until now.
To overcome your proctitis without excessive weight loss, I suggest you call Dr. David Klein in Hawaii and work with him over the phone – he and his colleague, Dr. Azar, specialize in such conditions and predictably achieves excellent success.
I was thrilled to hear personally from this excellent doctor. He seemed to have some hope that fasting could work for me, after all! I set about contacting Dr. Klein; I will write about my experience with him in my next post.
Until colitis, I had never understood how dangerous it was to take my health for granted, but I had also not understood how mistaken doctors can be. Over the years, I had gotten the message that I was somehow unhealthy even when I had felt vital and fit and happy, simply because I was thinner than average. I wish that I had just trusted my own feelings of vitality instead of trying to “fix” something that wasn’t broken.
Nowadays, belatedly, I was taking my health very seriously. I just hoped it wasn’t too late to salvage it.