The Body Image Post: Chronic Illness & Dealing with Weight Gain


Like most women with chronic illness– I deal with an ever-fluctuating body weight. I have a range of about 30 lbs that I waiver in between depending on my diet. When I’m on a liquid diet it’s all daisy dukes and tank tops. But let’s face it– being given the go ahead to eat normally after being on a liquid diet for weeks? You’re going to stuff your face. And you’re probably not even going to feel bad about it until you try to get into your jeans the next morning.

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This is me at our engagement party last December. I was about ten pounds under my normal weight because of a solid few weeks of gastroparesis flaring induced from anxiety about the party (and all of the events leading up to it.)  I was pretty psyched about how easily I slipped into my dress. I also missed out on eating an entire sheet cake of rainbow cookies.

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This is me in the winter 2009, after three weeks of prednisone treatment for chronic bronchitis. I had “moon face” and felt horrible–not just because prednisone in general makes you feel like you’ve been running non-stop since you woke up, but because I felt like I looked terrible! I hated not fitting into any of my clothes but sweatpants and spent a lot of nights silently hating my belly while simultaneously eating my sorrow away in the form of bagel chips and goat cheese.

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This was me in high school, maybe my junior year. And the very last time (probably in my life) that I ever wore a crop top (and a neon green bra…) (I was supposed to be white-trash Brittany Spears, I also had a baby doll and an empty beer bottle as props…this was circa 2007?) Pretty much all I ate that year was yogurt. Yogurt in the morning. Yogurt in the evening. Yogurt at dinner time. When you have undiagnosed gastroparesis–you’ll eat nothing but yogurt all the time. Fucking yogurt.

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And this is me today (well, last week, but you know what I mean.)

I’m at the upper edge of my weight range. I can’t fit into my jeans. I’ve mostly been wearing black yoga pants. My mom keeps helpfully pointing out that my face looks swollen. And I’m not oblivious. I ogle myself in the bathroom mirror before I step into the shower. And had my body looked like this five years ago I think the site of myself naked would have probably had me sobbing hysterically on my bathroom floor.

But let’s stop for a second and think about the things that my body has been through in the last few years:

  • Two abdominal surgeries to lysis adhesions that left me pretty much bedridden for over a month for each one.
  • A solid year and a half where I spent 50% of my time admitted to the hospital for a paralyzed intestinal tract…
  • A Primary Immune Deficiency Disease Diagnosis followed by two good years of antibiotic resistant infections leading to major sinus surgery and multiple hospital admissions for IV antibiotics.
  • A POTS diagnosis which left me incapable of standing up without blacking out for several months, inability to exercise until I went to cardiac rehab, immediately after which I…
  • Was diagnosed with hypersomnia so that I’m compelled to sleep the majority of the day and all night through…
  • and not to mention the 15 or so medications I take on the daily to get my heart rate to slow down, my blood pressure to go up, my intestinal tract to move my food through my body, allergy medications, acid reflux medications, and a slew of hilariously unsuccessful medications for Narcolepsy…

During those few years I

  • Went to college for two years
  • Worked full time
  • Created my own PR company
  • Moved out, financially supported myself
  • Continued a successful relationship, got engaged
  • Started raising a very spoiled poodle
  • And my living room is almost always clean.

So as bad as I want to feel about not fitting into my shorts, it’s at the very end of my list here.

And as I’ve watched my body get the metaphorical shit beaten out of it with a spiked baseball bat, I’ve learned a few things that I hope other’s experiencing the same insecurities about their physical appearance will remember:

1. You Can Buy New Jeans


Since I was 17 I’ve had a collection of pants that ranged from sizes 6-15. And I’ve worn them all at one point or another. Of course you’re going to feel like crap if you go to try on your jeans in the morning and your muffin top makes you actually crave a muffin (crying ensues.) But the pain is short lived if you’ve got another pair somewhere in the back of that closet. Take a deep breath, use a shoehorn to carve yourself out of those Levi’s, put on the next size up, and dry your tears. It happens. It happens to everyone. Even if you did 500 crunches right there on your closet floor, it wouldn’t mean you could walk out of the house this morning in the first pair. You were there once, you can be there again. But right now, you need a new pair of pants.

2. You’re Going to Eat the Waffle. Accept the Waffle.

Yeah. I ate this waffle. Want to fight about it?

Yeah. I ate this waffle. Want to fight about it?

Do you know what’s on my Do Not Eat list? To start there’s eggs, cream cheese, american cheese, french toast, tacos, bacon, coffee, alcohol, chocolate, ice cream, pizza, anything spicy, cream, beans, onions, pancakes, doughnuts, milk, orange juice, apple juice…Sorry, my hands were starting to cramp up there.

My point being that my idea of a good breakfast is dry toast with light butter. So when I attempted to eat a waffle the other day and didn’t die from it–well, my brain was committed to showing me images of belgian waffles every second of the day until I could eat another.  When your diet is limited and you can eat something without feeling excruciating pain–you’re going to eat it.

3. Chronic Illness is Cyclical

Welcome your fat like a new friend!

Welcome your fat like a new friend!

Growing up, most of the time I couldn’t keep weight on. It was like as soon as I ate a sandwich I was bolting to the bathroom. It wasn’t until my late teens that I started really gaining weight. And I panicked. And lo and behold–two weeks later the weight was gone. And then back, and then gone, and then…you get the idea. Chronic Illness (even those without remission) are almost always cyclical. Weight goes on, but there’s a fairly good chance it’ll come off without you killing yourself.


4. That’s a Good Way to Hurt Yourself

Run, fatty--RUN!

Run, fatty–RUN!

Speaking of killing yourself. Remember those 500 crunches that wouldn’t help you fit into your jeans anyways? I know this from experience (okay, maybe it was 500 crunches, but it was a lot) I actually had a period where I was so fed up with my random weight gain that I vowed to eat nothing but salads and jog for two weeks. Guess where I ended up at the end of those two weeks? My second home: the hospital! Taking extreme measures to fix fast gained weight is going to end badly. If you want to exercise, do it the right way–slowly, until you can safely build up to a healthy, challenging work out. You can’t anger yourself into being thin.


5. And It’s Okay to Be Here

Always remember to. I have this painted on a jewelry box in front of my mirror.

Always remember to. I have this painted on a jewelry box in front of my mirror.

I have watched bodies, my own and others, survive some incredible feats. When I think about the lives of those with chronic GI conditions, or chronic fatigue conditions that means you never get the “high” someone else does when exercising I’m in total awe. The things our bodies go through–the testing, the exams, the flares, the surgeries, the withering away, the slow recovery, the incredible relief strengthening even one muscle can bring–I have to believe that it’s okay to be okay with where I am. I have to believe that my body is so much more in the grand scheme of things than just a fashion accessory. And while I aim to make my body strong and healthy, I can’t hate it for showing the weathering of disease and time that’s taken place.

So when I grab both love handles in front of the mirror and say to myself “look what you’ve done to yourself!” I have to follow it up with “But, you know, I’m glad we’re still here. All extra twenty pounds of us.”




  • Sarah

    Hi Ilana,

    I have been following your blog for a couple of months (now it feels creepy because I haven’t actually commented before), and I’m right there with you with the fluctuating weight thing: I have Crohn’s Disease. When I was 15, I was losing weight to the point that it was scary, the typical first step of Crohn’s Disease. Now that I’m on an immunosuppressant, I have gained 40 pounds in the past four years…it added another layer to the “disbelief” that people with chronic health problems have “real” problems, at least for me, because Crohnies are perceived to always be underweight. In fact, they finally are producing studies that show that Remicade causes uncontrollable weight gain in people with Crohn’s. A few years ago, it was so hard to accept this, and I adopted a concerning mentality, counting calories and exercising non-stop. For months I did this with no results, and I reached a point where I had had enough and said screw it: I was going to eat normally because this was obviously pointless.

    I no longer have that mentality, partially due to acceptance of this situation, but also due to a major change of self-esteem that came in my senior year of college. When I think of how sick I was, desperately trying to stop the weight loss and unable to get out of bed, I will gladly accept being somewhat heavier for a medicine that has achieved a solid remission and that has allowed me to achieve far more with my life. Since that time, I graduated college in four years instead of three, summa cum laude, despite whatever challenges my body throws at me: regular skin debridements for an incurable infection (the pesky bugger has stuck around for five years now); intestinal blockages; random problems that have nothing to do to Crohn’s like rapidly growing sebaceous cysts (that attract the staph, obviously, like a miscellaneous skin problem party) that have required me to get excisions and then show up to class immediately after, loopy on vicodin but still in pain; writing term papers with IVs in my arm, etc… I may not look like a model, but I have had some awesome achievements. That’s far more important. I think the thing that irritates me most is always hearing people talk about how if you aren’t at a healthy weight, you aren’t trying hard enough in life, as if your physical health is reflective of your entire existence. That obviously isn’t the case.

    Now that I’m in remission, I have a healthy, moderate exercise schedule (and mentality) that works with my medical issues (joint problems, asthma, avoiding the gym due to immune suppression, etc). I eat as well as I can. With Crohn’s Disease, that’s hard: I once spent two weeks in the hospital for eating a raw fruit, and had a great time with an intestinal blockage and the works (NG tube, picc line, intestinal surgery I didn’t actually need, a nurse giving me phlebitis by running TPN at full strength through a peripheral IV). A sugar-laden Ensure is far better for me than the average fruit and vegetable (“an apple a day sends the ambulance my way”), and I’m not going to give up things I can eat. I’m certainly not going to resent the medication that has kept me moderately healthy, despite its complications. This is my healthy: it’s not ideal, but it’s what I’ve got.

  • YES! I have a 30 pound annual migration 😉

    Carrie, the Just Mildly Medicated gal

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