Good choices

"You didn't make good choices. You had good choices."
~Little Fires Everywhere

Note: This is not a pro-GLP-1 or pro-weightloss account. I share my own experiences in order to provide one perspective, knowing that your experience, needs, and body are different from mine. I'm not here to influence, I'm here to tell my own story.

I've shared in the past that I'm in a season of digging into a bunch of health stuff, finally getting some answers for things that have felt both confusing and also a normal part of my life since I was a kid. I know lists don't make for a good essay, but they help me organize things in my mind, so here are all the things I either know I have or have good evidence that I have:

-autism
-ADHD
-POTS
-Ehlers-Danlos or some other hypermobility disorder
-chronic, almost daily migraines
-drastic weight swings / eating disorders

A couple of weeks ago I had a 4 1/2 hour ADHD assessment. Still waiting on the official results, but I have the choice to start medication on Monday. I was leaning toward waiting, but then I remembered the experience I've been having on Zepbound these last few months.

I started Zepbound back in October, not so much to help me lose weight, as I was already doing that on my own, but to try to avoid another upswing at some point in the future. I've lost and gained large amounts of weight since college, going from 155lbs at my lowest to 255lbs at my highest – that is until 2021 when I swung up to 305lbs.

Now, I try to be fat-positive and to love my body at any size. She is doing her best with everything that I have thrown at her. But what I was worried about was, what if that cycle continued for the rest of my life? What if I kept losing the weight again and again and then gained it back plus 50lbs extra each time? That would make for a difficult life in my 70s and 80s. And (from my understanding) the weight swings are worse on your heart than staying at a higher weight the whole time.

So after I'd lost about 45lbs on my own, I talked to my doctor and she prescribed Zepbound, a dual GIP and GLP-1. I didn't have bad side effects (fatigue the day or two after was the most prominent) and it did what it was supposed to do: slowed down my digestive system so that I wasn't hungry as soon after eating.

It also quieted the food noise. I'd read about this, of course, but I think I didn't fully comprehend what that would mean until I experienced it. It's like my brain has been rewired. At one point, I was eating a tasty dinner and watching TV, and after a while I looked down and saw that I had set aside my plate with some food still on it. Huh, I thought, that's odd. Why did I do that? Then I realized – I was full! I'd stopped eating because I was full. Even though there was still tasty food on my plate.

Of course, I could have still kept eating. But the medication paused my brain for long enough to make the decision. It was a pause I hadn't had since I started restricting and then binging when I was seven years old. Seven. I know because we moved out of that house right before my eighth birthday, and I remember sitting in the living room looking at the weight charts in my mom's book Let's Get Well by Adele Davis.

That moment of not finishing my pasta was revelatory. Was this what it was like in the brains of people without eating disorders? In the brains of people who hadn't restricted food their whole lives then been unable to maintain that restriction?

I thought of what Mia had said to Elena in Little Fires Everywhere: "You didn't make good choices, you had good choices." I want to be careful to acknowledge that the original quote referred to systemic racism in the US, and I'm not at all saying that my experience was as damaging as that. But the reframing explained so much. I hadn't lacked will-power before, or been lazy, or sinful. I just didn't have the same choices that someone with a different brain had.

And now that I do, I still have to make choices. But I have them to make.

I doubt I'm ever going to be thin. That's not my goal. In fact, my body seems to naturally settle somewhere around 200lbs. I feel good at that weight, and pushing lower than that feels unhealthy – for me. If I settle at 215, honestly, that's fine, too. My goal is just to settle.

Anyway, I was thinking about this idea of having good choices in the context of ADHD, and I thought, what if the Adderall gives me choices I never had before? I've worked so hard my whole life to create schedules, structures, reminders to help me get things done. But, similar to the meticulous diet and exercise plans, I could make them, but not stick to them. Or rather, I would have seasons where they worked, and get good grades, get my work done, but then the whole structure would inexplicably collapse.

What if I had better choices? What if my brain could settle?

So I'm going to try the meds. We'll see what happens. I'll let you know. And in the meantime, I'll leave you with this: Your body doesn't have to fit a certain chart or standard to be healthy or beautiful. And your brain doesn't, either. We are wild, gorgeous creatures, ultimately ungovernable by the societal structures we're forced to adapt to. But that doesn't mean that we can't use the tools we have to make our lives a bit easier.

With love and hope,
Jessica

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