“A compelling description of the process of addiction.”
Joseph Frascella, National Institute on Drug Abuse
“A poignant, compassionate, and humorous page-turner.”
Joan Ifland, Refined Food Addiction Research Foundation
FAT BOY
THIN MAN
By
Michael
Prager
Smashwords edition
Copyright 2010, Michael Prager
ISBN: 978-0-9826720-9-9
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.
TABLE OF CONTENTS
Acknowledgements
Foreword by Kay Sheppard
Prologue
1. What Are We Talking About, Anyway?
2. Born To Eat
3. A Diet, Not a Solution
4. Getting What I Came For
5. Better, But Not Well
6. Itinerant Rehab
7. Profit in Surrender
8. Seven for Seven
Appendix A: Food plan
Appendix B: Support
Acknowledgements
I wouldn’t have this story had I not become an addict, come to understand the implications of being an addict, and been helped to see all the ways in which I was hurting myself. These discoveries were sometimes led by professionals, but most of the insight came from fellow searchers and sufferers whom I met in rehab, therapy groups, and support groups. We helped each other greatly, and I’m grateful for all the sharing; this book is one product of it.
Writing the book was not my idea. Oddly, it existed as a complete thought in the minds of two valued counselors years before I started typing. In fact, when each of them suggested it to me, separately but in the same neighborhood of time, I had no interest whatsoever. I wasn’t sure I’d even want to read such a book, never mind write it.
I wouldn’t say I ever followed their suggestion, either, although the facts that they don’t know each other, and that they broached the idea in the same general way — not, “Why don’t you write a book?” or “If you were going to write a book, what might it say?” but “When are you going to write your book?” as if it already existed — did gnaw at me as time passed.
The two counselors are Kris White of Mystical Therapies of Haverhill, Mass., and Linda Boynton, a therapist in private practice in Boston. (Contact information for both is in Appendix B.) I have been relying on Linda’s bedrock insights and mountaineer charms for more than a decade. She is strongly empathic, encyclopedic in memory, and extremely compassionate. When she tells me things about me, I give them credence, even if I don’t recognize what she’s saying as true. They often turn out to be.
Although our conversations tend more toward spiritual than practical, I trust Kris, too. I find comfort from talking with her, and she too turns out to be correct when I’m sure she can’t be.
What got me to the keyboard was the birth of the Food Addiction Institute of Sarasota, Fla. I was invited to attend an organizing session by Phil Werdell of Acorn Food Dependency Recovery Services, who has gone from eating-issues counselor to good friend and writing colleague. Three of us at the meeting — the other was Colleen Hillock of Medicine Hat, Alberta, Canada — argued that public education should be a top priority of the institute, so, of course, we were assigned to the task. After we caucused, one of my assignments was to write about 15 pages on my story of overcoming extreme obesity; when I’d reached 25 pages and felt I had only begun, I realized I had plenty to say. Though we accomplished several things, we haven’t yet carried the institute’s message to the public; over time, we have come to think that this book might achieve that.
Phil offered patronage during the time we worked together, but he has also offered unstinting encouragement and guidance. Outside my family, Phil has done more to support me than just about anyone, in every way. Additionally, though all the ideas in this book speak for me, many were broached, influenced, and/or broadened by Phil; he has been both guide and sounding board.
Theresa Wright and I have a similar story. I went to her for a food plan, and she continues to advise me. But we’ve become friendly over time and we try to speak every couple of weeks. We have also collaborated professionally, and she contributed feedback on early drafts and the best suggestion I received for this version.
Other food-addiction professionals have lent guidance and support, including Marty Lerner, Joan Ifland, Brenda Iliff, and Lori Herold. Joe Frascella, a director at the National Institute on Drug Abuse, has been both gracious and encouraging. Jeffrey Grimm of Western Washington U. and Richard Johnson of the University of Colorado in Denver are top-flight researchers who’ve found time to offer support and guidance.
I have consulted with many journalists and other writers during the book’s creation. I’m grateful to Mike Waller, Dan Haar, Ann Marsh, Deb Hagen, Deborah Jacobs, Jean Fain, Alison Bass, Geoff Edgers, Alyssa Haywoode and Linda Wertheimer, Jeffrey Marx, Peter Zheutlin, Sam Nejame, Steve Maas, and Alison Lobron and Cam Terwilliger, my teachers at Grub Street, the nonprofit arts group in Boston. My fellow students were constructive and inspiring.
I’m also grateful to writer Kay Sheppard and agent Geri Thoma, which must be unusual if not a first: thanking an agent who declined to represent me. Even so, her reactions were helpful and useful.
I thank my parents for their forbearance; there is plenty in this book they think is nobody else’s business, and would strongly have preferred that I not have mentioned them.
Meg Dreyer designed both the book and its website, which was programmed by Eddie Monroe. Both brought great spirit, energy, and skill to the project, and I appreciate their aid and expertise.
I have had a number of readers, probably too many for my own good, but that reflects on me, not them. My friend and former colleague David Mehegan gave a thoughtful and authoritative early review, and I have returned to Margaret Ann Brady repeatedly and reliably. Other helpful readers have included my wife, Georgina Fulton Prager; my brother Richard Prager and his family: Beverly, Sarah, and Alex; my father-in-law Claiborne Wilkinson; and close friends Ron Turmaine and Shelley Fried. My brother-in-law, Doug Fulton, has been a bulwark of bonhomie and support.
In addition to her editorial guidance, Georgie is in many ways responsible for my completing the book. She made my mission ours, has provided intellectual and emotional ballast when I was foundering, and has not wavered in her belief in me. I love her and do not know where I would be without her.
Foreword
Here is our chance to meet and to know Michael, as he progress in the disease of food addiction, surrenders to that fact, and learns to enjoy the progression of recovery. Within these pages he shares his experience, strength, and hope with us as he faces the baffling illness we call food addiction.
From childhood until he entered treatment at 365 pounds, Michael was trapped by a relentless compulsion to eat huge amounts of addictive trigger foods. His story tells us that certain foods can be as addictive as cocaine, nicotine, or alcohol. Addicted to multiple substances, he was surrounded by family and friends who were also trapped in addiction. During the course of his addiction, he discovered that mainstream medicine offers no effective or safe treatment for the obese, suffering food addict.
Michael allows us to see his soul — the soul of a tormented addict. Isolated and ostracized, he shares the pain of never fitting in or feeling part of his community. His life became a roller coaster ride. “Bright and sunshiny” or “dark enough to suck the sunshine from the room,” as he described himself, his colleagues never knew which Michael they were going to get.
Then one day in October 1991, his world changed. Resistant and reluctant at first, he learned to walk a different path. Upon that path he met the people who were to show him how to recover from the relentless disease of mind and body that had ruled his life. He tells us that his path is now a spiritual one. From doubter to a man of faith and prayer, he asks God’s help to be “patient, tolerant, loving, and kind.”
Beautifully written, often painfully honest, this is the most important work of this journalist’s life. It has been a privilege to meet you, Michael! Thanks for sharing your life with us.
— Kay Sheppard
Kay Sheppard, MA, is a licensed mental health counselor and a certified eating disorder specialist. Since the early 1980s, she has pioneered in the development of the concept of food addiction and has helped thousands recover, based on the theory that for some people, refined and processed foods can be as addictive as alcohol and other drugs. Her best-selling books “Food Addiction: The Body Knows,” “From the First Bite,” “A Complete Guide to Recovery from Food Addiction,” and “Food Addiction: Healing Day by Day,” have become primary resources for food addicts, their families, and addiction professionals. Sheppard is an internationally recognized consultant, trainer, and therapist who conducts workshops for food addicts and professionals worldwide. She has an online support recovery forum with a membership of more than 5,000 men and women at www.kaysheppard.com.
PROLOGUE
A 365-pound guy walks into a sub shop, with or without mustard stains on his sweater, and orders a couple of foot-longs. Anyone in the place is going to think they’re all for him, no matter what he does.
That’s why, sometimes, I’d just go in and order, and let them think what they wanted. But sometimes I’d go with the list.
I’d grab a scrap of paper off the floor of my car and scribble on it, or write it out as if it were real, in case the clerk grabbed it to check for grammar or something. Then I’d roll out the driver’s side door and roll on inside.
“Foot-long roast beef with onions and mayo, please.”
I always got that one; that one was “mine.” I’ve never understood why, for me, onions harmonize so perfectly with the richness of mayo when melded with rare, thinly sliced beef, but it had been scratching an itch since junior high.
The other sub’s ingredients were optional. If I went for the meatballs, I’d add only cheese — extra cheese — and I didn’t care if I had to pay extra for it. If it was the tuna, I’d go for everything except olives. If it was the Italian cold cuts, I might even get the olives — everyone knew I didn’t like olives, so that would help prove that it wasn’t for me. I might even add that to the repartee: “I hate olives, man, but my friend wants them.”
The friend, of course, didn’t exist, but I needed him nevertheless, to explain why I was ordering so much food. The key to the repartee was to be offhand. Casual comments, and not too many, so it was conversational without being obvious. If I went on too long, there was always the hazard of being caught in the lie, too, though as long as I got in and got out, I usually got by.
There was a temptation to stay sometimes, especially if I got a talkative guy like Scott, who owned the Subway on Farmington Avenue in Hartford. He was a young guy — younger than me, anyway — and seemed bent on building an empire based on carefully controlled portions and freshly baked bread.
I wouldn’t be surprised if he made it, either. I remember how he’d take the time to carefully rotate each tube of dough in its perforated slot in the baking tray. He was a smart guy, too; certainly smart enough to know what I was doing, and smart enough not to let on, even with a smirk.
Especially with a smirk. I’d more likely have rejected a place for that than I would have for questionable cleanliness or the orange-yellow patina that mayo develops when it hasn’t been properly chilled.
We never got to be friends, certainly, but we’d get into conversation sometimes: the Sox, or the weather, or the milder reaches of politics. For me, it might be the only companionship I’d get outside of work for days. The problem was that I couldn’t start eating while we talked, and once I had my stuff, I really didn’t want to wait.
If the ruse was going to work, of course, I was compelled to get a bag of chips for each sandwich. Just as I varied the condiments, I’d vary the varieties — usually a bag of plain, and then some salt-and-vinegar or Cheetos or whatever. I liked most of them, and besides, I never comboed sandwiches and chips the way I married onions and mayo.
By rights, I should have also bought a soda for every sandwich — what were my pals, or colleagues, or family, or whomever supposed to drink with their meals? But there were limits to my lying: Dropping 10 bucks on a snack was one thing, but the sodas would be another 3, and I didn’t want them besides. They would only take up room I wanted for food. food, and if they were fountain drinks, they’d be flat by morning.
I’d usually dig into the bag as soon as I was out of sight of the shop, for chips if not for a sandwich. The choice would depend on several factors, such as how long it had been since I’d eaten, and how far I had to go before I arrived. One of the reasons for buying multiples, whether it was sandwiches or loaves of cinnamon-raisin bread at the day-old store, was to have something for the ride home without running out once I got there.
For a good 20 years, that’s as much thinking as I put into my habit — staying stocked up while staying below the radar. But by the late 1980s, during a very slow awakening to reality prompted by therapy, the love of family, and the understanding of others, I began to realize what I was doing to myself, and that if I didn’t make changes, nothing was going to change.
That’s not to say I actually changed, however. I observed, interpreted, and commented — as if they were actions. For better than a year afterward, I continued on the same path, though at least with increasing awareness of what was going on.
I particularly remember driving down Gillett Street in the dark one night, cutting through from Farmington to Asylum on my way home from Subway. All of a sudden I recognized what I was feeling, and I broke out in guffaws. I had just visited my dealer, I had my drug, and I was set for the night. And my amusement went one better: Unlike when I’d scored pot or cocaine, I didn’t even have to worry about the cops.
1. SO WHAT ARE WE TALKING ABOUT, ANYWAY?
Most people who pick up books about dramatic weight loss want a fix, for themselves or for a loved one. They want to be told what to do. They want a guru.
Well, I’m no guru. I created practically none of the measures that have transformed me from a hapless, isolated 365-pounder to a happy, normal-bodied family man. I have benefited from the loving guidance of others. Even so, my experiences have left me with bits of wisdom, and that’s why I’ve written this book — to share attitudes, ideas, and behaviors that were shared with me, and that have worked.
Those are two key concepts: First, that they worked. For so much of my life, being “right” was my prime value, having failed to understand that being right and fat, right and lonely, right and miserable, was hollow achievement. Now, I see that the only useful standard is: Am I better off?
For comparison, consider what cancer patients do: If so advised, they accept injections of poison or bombardments of radiation, putting up with nausea, fatigue, hair loss. They’re high prices, but judged to be worth paying, if only for the hope of overcoming the disease.
And second, that I’m sharing them, not top-down but as they were shared with me, by people who had more experience, knowledge, and success than I’d had. Claiming gurudom would clearly flout that spirit.
Not only that, but I might not know what is best for you! That’s why I don’t — and won’t — prescribe.
But I do feel qualified to relate my experience, and feel confident it will help others who attempt a similar path. Why am I so confident? Simply because I’m not so special, so anything that worked for me will probably work for others.
That’s one of my bits of wisdom, and is quite unlike the attitude I had in the days leading to Oct. 21, 1991, when I entered the eating disorders unit of South Oaks, a psychiatric hospital on Long Island, N.Y. I was a 34-year-old fat man who’d been a fat kid, a fat teen, and a fat 20-something.
My favorite foods had changed over time, but my desire for volume had been constant for at least 15 years. I’d begun dieting at 10 or 11, and had been shipped away to fat-boy camp for three of my teen-age summers, to no lasting effect. I was a serial 100-pound loser who’d always gained back more. I’d been sneered at, taunted, pitied, and patronized.
My personal life had been middling at best, filled with troubled family relationships and friends who’d favored the same illegal drugs I did. At work, I’d had some success but kept getting busted in rank because I couldn’t get along with people, which was as much a sign of my stumbling as my copious fat; if only weight had been my only problem!
I’d thought that I could handle my needs, that I just had to be a little more clever and all would be well, even though my cleverness had wrought little. Incredibly, I’d also thought that I knew what was best for others, and wasn’t reluctant to share my wisdom, invited or not.
People don’t like that, it turns out.
Just because I try not to tell individuals what to do, though, doesn’t mean I don’t have opinions about what being obese is like, what non-obese people don’t understand about obesity, and the roles that all Americans contribute to the obesity epidemic, which public-health officials call the second-most cause of preventable death. Here are some of those opinions:
Mainstream America, including medicine, has no solution for obesity.
Yeah, that has the flaws of most sweeping statements, but look at the numbers: Since 1960, obesity among US adults has jumped from 13 percent to over 30 percent, and the percentage of those overweight has risen from less than half to about two-thirds.
And yet, in that time, attitudes haven’t budged. The mainstream still considers obesity to be a moral failing, and still thinks that The Zone, or Atkins, or Weight Watchers, or Jenny Direct, or fat-burning pills, or jaw wiring, or stomach stapling is an answer. These “solutions” have been around for decades, and yet the problem not only isn’t receding, it’s exploding.
It’s as though we’re under mass hypnosis, unable to perceive what we see on every street, in every mall, at every restaurant.
People who say that diets don’t work are missing the point.
I’ve lost more than 500 pounds on diets, so they do “work,” if your only goal is to lose weight — and for most people who’ve ever dieted, that was the only goal. The defect in that approach, of course, is that “diets,” as we define them, are a temporary measure.
If the weight gain owes to a temporary condition — overeating as the result of grief, or out of boredom during a convalescence, or the short-term use of a drug that has weight gain as a side effect — then a short-term change might be an appropriate resolution.
But if being overweight or obese has longer-lasting or systemic causes, of which there are many, then it is foolish to expect that a temporary change will do any more than give temporary relief.
Most obese people need more than weight loss to be healthy.
The first time I lost more than 100 pounds, I was in high school, and I thought that once I’d lost the weight, my troubles would be over: Girls would accept me. Guys would count me as one of them. My sense of isolation would fade, and my talents would become obvious.
But no; I just lost weight and learned that weight wasn’t the problem. If anything, removing the physical barrier of fat exposed me more than ever, and when people stopped telling me how great I was for losing weight, I started gaining it back.
I needed all sorts of help, which I eventually found in individual and group therapy, in more intensive counseling venues, and in peer-support groups. But back then, I didn’t have a clue.
I’m convinced that for many overweight people, and for the clear majority of obese people, weight is a symptom of other problems. Clearly, overweight is a threat to health all by itself, but if its causes extend to more than eating, then its solution will have to include more than dieting.
Addiction is a huge factor in obesity.
When I’ve advocated for food addiction in periodicals, I have been repeatedly amazed at how the notion horrifies chat-room commenters. Some of the reaction arises from political outlook, some from prejudice, and some from sheer ignorance. It’s OK; I’m here to help.
~ Not all fat people are food addicts. Not even most of them. But extrapolating statistics from alcoholism and drug addiction research, one can conservatively estimate that more than 12 million US adults are food addicts. My opinion is that there are many more.
I believe that the practices that have helped me enjoy almost 20 years of serenity and happiness in a normal-sized body, after three decades of freakish, debilitating obesity, would work for the vast majority of people who struggle with weight. But for the least affected, this kit of solutions would amount to what the writer Theodore Bernstein termed “atomic fly swatters,” effective but far greater than needed for the task.
I do not claim to know who is a food addict and who isn’t; my experience is that everyone must decide for themselves. But I’m on fairly firm ground when I say that the more serious one’s weight problem is — in severity, duration, or combination thereof — the more appropriate it is to explore the question.
~ “Food addiction” is an awful term that may actually hinder its acceptance.
People understand addiction to tobacco, or alcohol, or cocaine — a severe sensitivity to a substance that others handle in moderation. For those people, abstinence is a reliable “cure.”
The principle of abnormal sensitivity pertains to food addicts too, but applying it is much more complicated. For example, with tobacco and the others, all forms are off-limits. But I can safely eat a piece of fruit, which is loaded with sugar, while I can’t handle refinements such as table sugar. In another example, a number of substances that will lead me to overeat every time — peanuts, popcorn, and sugarless gum among them — can be taken in moderation by others who also call themselves food addicts.
Regarding abstinence: If you don’t touch food, you starve — a very severe cure indeed. But I apply the principle of abstinence nevertheless, moving the boundaries from “all or nothing” to “none of this, and clear limits on that.”
Some of my guidelines bar substances entirely. Others proscribe behaviors: The vast majority of time, for example, I determine my portions with a food scale and other measures. I’d rather not have to, but I am quite convinced that my “eye,” when asked to determine an appropriate portion, is severely compromised and probably beyond repair.
Quite emphatically, I emphasize that these measures are for me, not for everyone. I believe all food addicts need limits, and that some of the limits will apply to many of us. But few of the food addicts I know follow the exact same guidelines. [See Appendix A for the details of what I do with food.]
Some of my boundaries were suggested; others I developed from painful experience. How many times did I have to try “just one” piece of gum, or just one handful of popcorn, to get it through my head that I just wasn’t going to stop there?
As if these descriptions don’t muddle the picture enough, there’s plenty more: The term “food addiction” encompasses bulimia and anorexia, which I don’t intend to cover extensively because they haven’t been central to my eating problem. But I know, without doubt, that I have strong commonalities with both.
With bulimics, I share the tendency to binge eat. Their thing is to get rid of the load by vomiting, abusing laxatives, exercising obsessively, or other means. I haven’t done those, yet, but I can relate to the dread and despair of what I’ve done to myself with food, yet again.
My tie to anorexics is that we’re prone to controlling our experiences of the world via food. I do it by stuffing myself; they do it by proving they can tightly control their intake of food, if nothing else. I accept that we have strains of the same disease, even though I have a hard time imagining the day I’ll get a charge out of not eating.
And still more: Some people are only refined-sugar addicts, or claim an even smaller set such as “chocoholics,” but have no problem with flour or fat, for examples. At the other end of the range, I know people who have identified dozens of “trigger” foods that they must do without.
Similarly, I know overeaters who also self-identify as anorexics or bulimics; I’ve met some who say they’ve been all three, having exhibited all tendencies at different times.
A hallmark of addicts’ thinking is “all or nothing.’’ We like black and white far more than we like gray. It is evident to me that around the question of addiction, the general populace has the same tendency: Addictions that can be clearly explained are easier to accept than the one with so many permutations. Such variability makes the condition tougher for clinicians to study and to diagnose; for the rest of us, it is harder to differentiate when we’re just indulging a bit too much from when we’ve crossed irrevocably into addiction.
Problem eater or addict: What’s the difference?
In a word, choice.
I began abusing substances other than food in junior high, beginning with cigarettes and eventually getting to marijuana and cocaine. I dabbled in alcohol, amphetamines, barbiturates, and acid, as well.
Most people will have no problem accepting that every one of these substances is addictive; I sure don’t, even while conceding that not everyone who uses these substances becomes an addict. Some take them in moderation, having fun when they do but not thinking about them otherwise. This can even be true of people who occasionally take too much of one of them.
I smoked cigarettes, up to 50 a day, for a dozen years. I smoked pot for 15 years, every day it was available. I started with cocaine in college, and before I quit, I was using the crack form often enough to court trouble at work.
I don’t take any of those substances any more. I stopped cigarettes when Ronald Reagan doubled the federal cigarette tax. I stopped cocaine when I finally realized that I would never, ever, get enough of it, no matter how much time, money, or attention I devoted to it. I stopped pot on no more impetus than a writing assignment I was given while in rehab.
In each case, I decided to stop. Even with cocaine, which many regard as especially habit-forming, I decided to stop — and then actually did! Addicts often “decide” to stop, but rarely try, or succeed if they do.
Meanwhile, I’ve sworn off food on many “morning afters,” only to be back in the food by mid-morning. I have never been able to “just eat less,” not in the long term, not as a natural act. Unchecked, my eating will always expand, and so will my body, grotesquely. This is undeniable.
Some people are born with a predisposition to addiction, but anyone can develop it. It’s not necessarily a linear process, and it’s not inevitable once it’s begun. But there is the point after which all choice is lost. I hear people talk about their “drug of choice,” and I’ve known those, but with food, the correct phrase is “drug of no choice.”
I experienced that in a more easily illustrated way with cigars: For years, I was the type who bought a pack of five for a poker game and let three go stale in my car’s glove compartment. Then, seemingly overnight, I wasn’t: I’d become the type who was buying a box of 50 a week.
I can’t tell you if you’re an addict. But if you’ve been on lots of diets and just can’t seem to keep to them, or to keep the weight off with any reliability, that might be a clue.
Or, you can try some controlled eating: Buy a hot hoagie, or an ice cream cone, or whatever your current fave is. Take a few bites and then put it down. Walk away. Is it easy? Do you forget it’s there? Or does it call out to you? Normal eaters can take it or leave it, just like normal drinkers can order a drink and then forget where they put it down. Addicts hardly ever forget like that.
Insurance-supported rehab should be available to food addicts.
Rehab isn’t a guarantee: Some addicts are beyond reach; others have to rehab more than once before they achieve stable recovery. But it has been the turning point for millions of addicts, over decades of treatment. It was for me: Even though I have used alternative residential treatment options since, that interlude was central to my new way of living.
Largely speaking, that option is not available to obese people today. It certainly isn’t available to food addicts, since, of course, there is no medical-industrial-complex imprimatur for food addiction. Even if insurance companies wanted to extend this coverage to food addicts — and they don’t, because that would eat into profits — they would be hampered by the lack of accepted diagnostic standards.
Of course, I didn’t have the diagnosis of substance use disorder the day I entered South Oaks, even though I weighed in at 365 pounds. On the cusp of the managed-care era, I was diagnosed with obsessive-compulsive disorder, which was both fair and dishonest, since no doctor had ever mentioned it until the hospital sought to get me approved.
I emphasize that I don’t consider rehab to be a panacea. Among my acquaintances from that time, some got better and some didn’t. As a rule, the expectation is that a third of rehab patients overcome their dependence. If that were to hold true to food addicts, it would make it the best treatment option by far.
It doesn’t have to take 9 weeks; it doesn’t have to cost $50,000.
Those were the parameters for my South Oaks stint, and that’s in 1991 dollars. After managed care pulled the plug on hospital-based treatment, substitutes sprang up, including what I call itinerant rehab. The founders call it Acorn Food Dependency Recovery Services, based on the west coast of Florida. Instead of a brick-and-mortar institution, their workshops are offered wherever a core of people want it; so far, locales have included Massachusetts, New Jersey, North Carolina, Maine, and Florida.
Instead of the weeks-long tenures of most rehab stints, the longer Acorn events last five days, and last I heard, they’re now working with a three-day model. And instead of being facilitated in hospitals with cadres of medical and support staff, they are most often held in rented private homes.
Even so, they felt like rehab to me, especially my first one, the only one I’ve attended in crisis. It took place in December 1999 in southern Indiana, just across from Louisville. The years since Long Island had been so much better than my life before, but as I looked back through journals in preparation for this book, I saw that I seldom went more than a few months in those eight years without a food mishap of some sort — a bad meal, a bad weekend, a bad vacation.
When I enrolled with Acorn, I was on a months-long bender that had resisted the actions that had pulled me back from the edge all those other times, and I’d finally admitted I wasn’t getting better on my own.
It’s worth noting that at my worst in that stretch, I maintained more than a 100-pound weight loss — that’s a great illustration of how far the therapy, support groups, and South Oaks had brought me. But for the complex reasons of every human’s condition, it became evident that more work remained for me.
Just like in Long Island, I got what I came for, a renewed appreciation for how serious my situation was, and a renewed willingness to seek and accept the help, support, and suggestions of others. Since then, I’ve not sunk to such undependable abstinence again, and I’ve been more stable in most every other way as well.
In 1999, the five-day “intensive,” as Acorn calls them, cost about as much as a week in Miami Beach, but meals were included.
Anyone can lose weight and keep it off.
As with any large task, the issue is merely motivation, but despite the obvious stakes — from greater risks for heart disease and diabetes to joint pain and shortness of breath — most severely overweight people still view it as an inconvenience, rather than a threat.
If your house is on fire, you will race from the building, even jump from an upper-floor window if you have to. You’re not going to think how inconvenient it is to have to rise from the easy chair in the middle of “Family Guy.”
A better analogy might be a house whose timbers are under great stress, or whose poorly maintained mechanical systems are on the verge of giving out, and in that scenario, people have been known to just keep on getting by. As a teenager, I ruined an employer’s truck engine by continuing to drive it after it had clearly broken down, so I understand the tendency.
But it cost $1,600 — yes, this was some time ago — to repair it, when if I’d just halted a half-mile earlier, it would have been maybe a couple hundred.
The reliable way out of obesity is via personal responsibility.
This point has been lost on the hundreds of folks who have railed against my arguments for food addiction in periodicals, so I’m eager to make it here: No one but me put the food in my mouth. Even if I had grown up imprisoned in a crawl space under the basement stairs (I wasn’t), even if tragedy has befallen me every 15 minutes since (it hasn’t), I’m still responsible for what I eat. If my food is out of control (it was), then I’m responsible for finding, requesting, and accepting the help I need.
I wasn’t always so inclined. In childhood, I acquired and developed an attitude that nobody liked me and that the world was unfair, so I was forever seeking someone who understood, and who would champion me. That’s just about the opposite of personal responsibility.
So how did I make such a leap? In about the last fashion I ever would have expected.
Unequivocally, dependable recovery has a spiritual component.
When I heard this, I balked. I pouted. I stalled. I wanted nothing to do with religion, which I equated with spirituality. Another of my confusions was that God was both a capricious asshole and a figment of humankind, a contradiction that would have required a God-like figure to pull off.
Those who put forth the spiritual idea were friends and advisers I’d met at South Oaks, in some of the support groups I have attended, and on my own. The phrasing they used was a “power greater than myself,” which I was certain was just a bullshit soft-pedaling of God.
When I examine it today, I see I should have been eager for it, considering that even though I’d long had great willpower, having lost more than a hundred pounds several times, I’d always reached the day when that power failed. A lack of power was precisely my problem.
I suggest that anyone who has dieted repeatedly but not kept the weight off has a similar power deficit. Perhaps they too have felt they had the power but hadn’t exercised it well enough. But it wasn’t until I finally took the suggestions to open my mind toward spirituality that the power to lose weight and keep it off began to materialize.
You can think that’s coincidence if you want, but as the closest witness to this phenomenon, I’ll tell you I reached a different conclusion. And for skeptics, I’m pleased to report that religion had nothing to do with it and that I got to devise my own definition of what spirit meant to me; you can too. I just had to be willing to get out of the driver’s seat.
~/~/~
Before getting on with the story, a few words about science:
I’ve done some reading on the current inquiries, and met many of the leading obesity researchers, including Mark Gold, Ernest Noble, Bart Hoebel, Serge Ahmed, Jeff Grimm, Rick Johnson, and Kelly Brownell. I respect and admire every one of them, and am thankful for their work.
I am very confident that eventually, establishment medicine and popular culture will accept both the existence of food addiction and its implications for severely overweight and obese people who haven’t been able to change.
I’m quite clear that when that happens, it will have been largely influenced by what these researchers are doing, far more than the assertions I’m making based on my experiences and observations. This is patently obvious; I’m mentioning it to ensure readers that it is obvious to me, too.
I could have chosen to write chapter upon chapter about these interesting folks who are devoting their careers to the biggest public health threat of our time.
I may do that still, but it’s not where I wanted to begin. The best contribution I can make to the effort is a personal story that I see as a counterpoint to the research. My intention is to persuade, and perhaps even to educate in a folksy way, but it is also a story of overcoming adversity.
I wouldn’t be surprised if one of those researchers were to one day win a Nobel Prize for the research they’re doing. But when I met them, at a private conference on obesity in Bainbridge Island, Wash., that gathered researchers, clinicians, counselors, and a few storytellers, I was surprised to observe that so many of them did not know any compulsive eaters.
I don’t know whether to attribute that to the ivory tower, or if these personable, brilliant academicians merely reflect the broader population. I think most people don’t recognize the compulsive eaters among us. Some are obese, but others aren’t — there are anorexics and bulimics, for example, and I’m a compulsive eater too, even though I’m no longer obese. Not all obese people are compulsive, either.
But there are millions of us, and it would help everyone if you got to know us.
Nice to meet you.
2. BORN TO EAT
You don’t have to have an addict in your family history to become one, but it helps. The obvious one in mine was my mother’s father.
Solly Goldberg was a warm, fascinating, and boisterous fellow who established a glass business in the shadow of the Depression that’s still in the family today, employing about 135 people. He was a community leader on Boston’s North Shore who inspired love and loyalty from family, friends, employees, and associates over decades.
But once he started drinking habitually, all he had built in mortar and reputation began to crumble. By the time he died — from liver failure in 1978 — his family had been irreparably sundered and his business was a brittle shell whose survival was in doubt.
At one time, the plan was for his son-in-law, my father Robert, to succeed him, and as his drinking worsened, the transition had begun, mostly by default. But in the early 1970s, a pig- headed row worsened by Solly’s alcoholic lifestyle abruptly canceled that. Solly never stepped into our house after that, and his children never spoke civilly again.
Though it was my father who was suddenly unemployed, it was my mother, Joan, whose world was ruptured: Not only had the two most significant men in her life had a falling out, but Solly enlisted his only other child, my mother’s sister Lois, to administer the business, forever sending him and their mother, Ruth, into her orbit and leaving my mother outside it.
At her core, my mother is proactive, and here she was, a front-row spectator to catastrophe. As catastrophes go, this was mild — no one was killed, no one was made homeless, and my dad soon started a competing business that exceeded Solly’s in every way — but as my Mama Ruth would aphorize until her death three decades later, “When you stub your toe, it hurts you.” My father’s return to a strong business position was not mirrored domestically, and they ended their marriage within a few years.
It would be simplistic to blame the divorce on that one incident, and it would be facile to blame my food addiction on the undercurrents it left. It’s true that my eating worsened during that time, but I’d had abnormal thoughts, and exhibited abnormal behaviors, around food long before the strife.
I was called to food from the cradle. My mother recalls complaining to the family pediatrician that I just kept eating when my brother would have stopped. He assured her I would outgrow the proclivity, but that’s one he just got wrong.
In my first food memory, I am perhaps 4. In the essential moment, my father enters the kitchen to discover me on the countertop, reaching into the upper cabinet where the ice cream cones were kept.
I am young enough that the story could have been cute, but for me it holds no warmth. I had fallen asleep and awakened to an empty house, and became convinced they’d gone off to get ice cream without me, so I had it coming.
It turned out that no one had gone for ice cream and I’d missed out on nothing. But the story’s threads — of perceived unfairness and the primacy of food — have remained with me.
I can’t think of any explanation for either stance. Home life was neither idyllic nor depraved, but was far closer to the former and well within the normal range. I was well provided for materially and grew up amid plenty of extended family. I showed fair promise in school and was encouraged to excel. Undeniably, among the fates of birth, I landed a pretty good one.
Family in the two generations before me was centered in Salem, Mass., site of the witch trials, although when I was 2 and my sister was on the way, my parents moved us to neighboring Marblehead, part flinty Yankee harbor, part blue-blood seaside community, and part burgeoning Boston suburb.
Proof of accomplishment came from both sides of the family. Although my father entered his in-law’s business, his own father was also a success, in the leather business. Joseph Prager was a hero of his family, who had come before 5 of his 7 siblings from Eastern Europe and returned to bring the rest of the family to America.
Dad was the only surviving child, a bit lazy through school but talented once he applied himself, and so successful in his post-Solly endeavor that when he sold his business, it was a sum large enough sum to be reported in The Boston Globe. In addition to ability, his success was built on industry and iron will. I’ve never settled on whether he worked so hard because he was work-addicted, or if he just wanted to be out of the house.
I wasn’t present for the early stages of my parents’ relationship, of course, but it definitely degraded over time, and when they announced their divorce in 1983 — when we’d all gathered back in Massachusetts for a party to celebrate the marriage of my brother and his wife — the reaction among the siblings was “finally.”
One way in which they were well matched, which may be more properly expressed as poorly matched, was in their drives to achieve, and while Dad could express his in business, Mom had only the rest of the world, and it was never quite big enough.
During the years we were growing up, she got a master’s in education and eventually taught high school equivalency classes at a medium-security prison, right up until the day a plot to kidnap her was brought to light. She took her turn as president of the sisterhood at her temple, sang in a three-woman community-level performance troupe, and started Chart-a-Tour, which guided bus trips around Salem and Marblehead, whose historical claim is birthplace of America’s Navy.
But her first management venue was the home, and unquestionably, our home reflected her more than the rest of us combined. If my father’s compulsive tendency was work, my mother’s was control. Dad never exercised a strong hand at home, but as the children became teens, he withdrew even his small stake and she annexed every inch of it.
These dynamics affected each of us differently. All three kids were bright, but my older brother, Rich, was chief achiever. He won the Latin prize of his senior class, reached French 5 as well, and even took Esperanto at the community college. (In his 50s, he’s recently taken up Korean and Mandarin.) He has three college degrees: undergrad, in the classics, from Princeton, and graduate degrees from Wesleyan University and the New York State School of Forestry. He attended Outward Bound, the National Outdoor Leadership School, and walked the Appalachian Trail, from Georgia to Maine, on his own. He has climbed every peak in the Presidential Range in New Hampshire, and backpacked the world, the latter with his fiancée/wife (they married in Cyprus).
I’m proud of all he’s done, although I certainly didn’t like being the “other” Prager boy all through school. I understand today that he was driven by demons just like I was; it’s just that, unlike mine, his pushed him toward results that society honors.
It is telling that I am able to report less about how it was for my sister, Judith, who also excelled academically. After a high school education she supplemented with religious studies, she achieved an architecture degree at Barnard. (Two out of three in the Ivy League! I was, indeed, the “other” one.)
By the time she graduated in 1981, she’d already designed a future not in architecture but in Israel, where she was called to make her life. It’s as though we three were each given a normal dose of religion, but somehow Judy ended up with all three. Her brush with compulsion, if she had one, showed itself well into adulthood, when she developed an eating problem; it doesn’t appear to be like mine.
As for myself, I offer two representations of my upbringing: The first is a line we used to toss around the family dinner table: We used to say that we needed a dog for Judy. My father had my mother to hassle, she had Rich, Rich had me, and Judy had no one.
Yes, that’s an actual chuckle from the family archive.
The other comes from 1991, when, in a group therapy setting, I was asked to draw a scene of home life growing up. I did my best to place the windows proportionately and to get the flagstone walkway right, and the result wasn’t too bad, considering my drawing deficiencies. But the first feedback I got from the others had nothing to do with the lines:
Where were the people?
I certainly didn’t leave them out on purpose, but that’s what open-ended exercises reveal. I was asked about my home and I drew a building, from an outsider’s perspective.
With time to reflect, I’ve come to accept the picture as sad and accurate, if unexplained. Family anecdotes suggest I was naturally bright and sunny, outgoing and adventurous. One of my earliest memories is working the tables at my parents’ club on bingo Sunday nights, approaching strangers and inviting myself to join them for repartee.
At home, we ate normally. Dinner was taken together, at a regular time, in the dining room. Some of our best memories came around that table, usually the result of my father’s humor — before he stopped sharing it.
The food was neither awful nor awesome, but it was balanced, sensible, and occasionally suburban adventurous, such as my mother’s treasureburgers, which had baked beans, a cocktail frank, or some other leftover hidden inside.
The rest of the day was less regular, though certainly the family plan was for three meals a day. Breakfast was toast or an English muffin or a couple of Pop-Tarts, and lunch was either dispatched with us in the morning or purchased in the school cafeteria.
I ate what I was given, but unlike most of my classmates, I rarely was satisfied with that. I don’t remember the first time I stole food, but I do remember the first time I was caught, at the Giant Valu in Salem. While my mother plied the aisles, I lurked up front, grabbing a piece of candy when I could and furtively eating it outside. I don’t know how many I’d taken by the time the manager busted me, but I recall the shame I felt when he barred me from reentering.
Even so, the incident didn’t scare me straight. It just made me eager not to be caught, and into my teens, I got a lot better at it.
I wasn’t much of a saver when I was a kid, and when I came into cash, I knew where it would go. Some of the money came from generous relatives, but it also came from waitresses’ tips that I scooped up before they cleaned up, or more significantly, from the envelopes my mother used for the household accounts.
In my early teens, I was taking 10 bucks at a crack, which was not insignificant money in the early ‘70s. Eventually, my mother started noticing. I remember her complaining that money was disappearing, and she once said she suspected that one of the neighborhood kids knew about the envelopes and was entering via our unlocked back door.
It seems unfathomable, now, but I recall wondering which kid it was. I knew where I was getting my money, but I somehow didn’t connect that information with the fact that her money was disappearing. I thought that she was making it up, or that someone from outside really was coming in.
I used the money, as often as not, at Lena’s sub shop. I didn’t make a list in those days because I was only buying one sub before I headed home to dinner, and it didn’t occur to me that the clerk was taking note of me.
Turns out he was, and one day while my mother was looking for me, she met up with him. I must have asked her to pick me up there and then started walking home; I’m not sure. When she caught up with me, she confronted the issue immediately: “He told me you come in practically every day. Is that true?”
“No,” I lied. “I don’t have the money.” Incredibly, she said she believed me, which is now my symbol for the power of denial. Here I was, 14 or 15 years old and probably around 250 pounds. Clearly I was getting a lot more food than my brother or sister, and she’d just been told by a neutral source that I visited his sandwich shop every day.
“Good,” she said. “That was my first question, how you could afford it.” We didn’t discuss it again for 19 years.
In high school, I got a job at the superette around the corner. I didn’t apply with intent to steal; I was just a teenager looking for part-time work. Pretty soon, though, I was hitting the freezer for ice cream sandwiches during my shift, and taking home a small bag of junk food — Beefaroni, a pint of ice cream, Cheese Nips, whatever — after closing.