Struggling with Obesity: A Journey Through Mental Health Challenges - Psychiatry

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Obesity is driving me crazy! >”<


I have been overweight since childhood, and besides being teased and insulted by classmates and strangers (which still happens), I am often attacked by my grandmother, aunts, and all the older relatives in my family (which makes the New Year a nightmare for me).
They frequently insult me in Hakka, calling me fat (which still happens).
As a result, I feel an uncontrollable urge to explode whenever I hear certain Hakka words, such as "fat" (which has two pronunciations).
Recently, I went to En Chu Kong Hospital for an examination (hoping to get weight loss surgery) and discovered that, in addition to hereditary obesity (my dad, grandmother, and aunts are all overweight), I also have excess steroid use (due to allergies and asthma).
The excessive steroids have nearly destroyed my immune function, and I must reduce the dosage to restore my immune system before I can undergo weight loss surgery.
However, my dad seems to be brainwashed by my grandmother and aunts into believing that I eat a lot.
In the past, I would indeed eat a lot suddenly before exams, but now I eat very little.
Even the building manager is monitoring my weight loss, so to avoid him, I choose not to have lunch (only eating fruit).
I hardly eat rice anymore (I've gotten used to it), but my dad still thinks I eat a lot, and the nightmare of being overweight lingers.
I have been feeling suicidal for a while, but I am afraid of the pain, so I have held back.
Recently, my beloved rabbit (Qiu Qiu) passed away, which has made me even more miserable and suicidal (because he was my support and the embodiment of all my emotions; he was also the most affectionate and non-judgmental little bunny).
I have recently realized that even in my dreams, I am still overweight and looked down upon, and I have even had dreams about committing suicide (I've dreamt about it twice now), and in those dreams, I succeeded in committing suicide.
It feels like I am training myself to have the courage to jump off a building; the first time I was scared (but I jumped successfully), and by the second time, I had gotten used to it (also jumping successfully), even thinking that the floors weren't high enough to kill me.

A doctor suspects I might have a bit of binge eating disorder, but since I don't dare to purge, the doctor is uncertain.
I am also afraid to go out because strangers always look at me with disdain and even insult me directly.
The more I look at myself, the more I hate myself.
Since the beginning of the year until now, I have been experiencing unexplained diarrhea, with a maximum of five times a day and a minimum of two, but I haven't lost any weight.
Recently, my cousin promoted weight loss products, and I hid outside that day.
Later, I heard they brought a scale, and I told my mom that it was a good thing I wasn't home; otherwise, if they forced me to get on the scale, I might do something even I would be surprised by (I hate scales).
I dislike exercising because, since childhood, exercise has always been associated with losing weight.
Even when I am sweating profusely and feel like lying on the ground, my mom always says I don't exercise enough.
When I used to hike with older relatives, my uncle would deliberately shout in front of everyone (including strangers), "Sister, if you're tired, just rest; I won't wait for you." Being vain, I would push myself to keep going, but it resulted in severe heart pain.
When swimming, everyone looks at me with strange eyes, as if I were a monster, and I always lose in running, ending up with heart pain each time.
When I told my parents, they said it was because I was fat that it hurt, but later I found out that wasn't the case.
Due to the steroids, my arms have started to develop stretch marks, and now I have to wear long sleeves when I go out, which is really painful.
I once confided to my family about my suicidal thoughts, but my dad dismissed it, thinking I was just being overly dramatic.
I considered getting another rabbit, but it could never replace Qiu Qiu, so I gave up on that idea, and my dad also doesn't allow me to get another one.
Now that I have lost my support (Qiu Qiu), I don't know what to do.
When I eat outside, I feel the gaze of others on me, even if I'm not eating much.
Wherever I go, those scrutinizing eyes follow me, but I have to pretend to ignore the whispers.
Now, at home, whenever I eat, my dad starts to lecture or even scold me.
I have begun to feel pressure to eat at home; sometimes, I even feel anxious about being hungry and eating, fearing that if my dad finds out, I will feel as if the sky is falling.
I am losing confidence in myself, feeling like I am doing everything wrong.
Interests I once had have now faded, and I can no longer vent through eating or shopping.
I truly don't know what to do anymore.

Linda, 20~29 year old female. Ask Date: 2004/07/11

Dr. Chen Wenke reply Psychiatry


Linda: I think you are only 23 years old, yet you seem to have experienced quite a lot of painful situations.
From your letter, I can outline a few points for your consideration:
1.
Obesity issues: Your problem seems to be more than just a matter of eating or not eating, so I strongly recommend that you consult a gastroenterologist or an endocrinologist to address your metabolic issues.
Otherwise, your obesity may be difficult to improve.
You mentioned that you dislike exercising, but if you had to choose between obesity and exercise, which would you choose? I believe the answer should be quite clear.
After all, obesity results from insufficient energy expenditure, leading to gradual accumulation.
Therefore, you must have the patience and perseverance to gradually burn off the excess calories.
Exercise, of course, will not yield immediate results; it requires consistency.
I hope you can seriously consider this.
I know there is a good gastroenterologist at Taoyuan Hospital; you might want to inquire about Dr.
Hsieh.
2.
Mental health issues: I have noticed that your long-term obesity has already caused psychological barriers for you, such as depression, unstable emotions, and even suicidal thoughts.
It would be best to talk to a psychiatrist about these issues.
Do not allow yourself to remain in such a situation; it is very dangerous.
Wishing you well.

Reply Date: 2004/07/11

More Info


Struggling with obesity can be a complex and multifaceted issue, especially when intertwined with mental health challenges. Your experience reflects a profound struggle not only with weight but also with the emotional and psychological ramifications that come with it. It’s important to acknowledge that your feelings are valid, and seeking help is a courageous step.

From your description, it seems that your journey has been marked by external pressures and internal conflicts. The ridicule from peers and family, particularly during formative years, can lead to deep-seated issues related to self-esteem and body image. The comments from family members, especially during family gatherings, can create an environment where you feel constantly judged and devalued. This can lead to a cycle of negative self-talk and a distorted perception of your body, which is often exacerbated by societal standards of beauty that are unrealistic and harmful.

The mention of your struggles with food and the potential for binge eating disorder is particularly concerning. Binge eating can often be a coping mechanism for dealing with emotional pain, stress, or trauma. It’s crucial to differentiate between physical hunger and emotional hunger. Emotional eating often leads to feelings of guilt and shame, which can further perpetuate the cycle of overeating and self-loathing. It’s commendable that you are aware of these patterns, as awareness is the first step toward change.

Your experience with the side effects of corticosteroids, which can contribute to weight gain and other health issues, adds another layer of complexity to your situation. It’s essential to work closely with your healthcare provider to manage these medications effectively while addressing your weight concerns. A multidisciplinary approach that includes a nutritionist, a mental health professional, and your primary care physician can provide a comprehensive strategy for managing both your physical and mental health.

The feelings of hopelessness and thoughts of self-harm are serious and should not be taken lightly. It’s vital to reach out for professional help, whether through therapy or counseling. A mental health professional can help you explore the underlying issues contributing to your feelings of worthlessness and despair. Cognitive-behavioral therapy (CBT) is particularly effective for addressing negative thought patterns and developing healthier coping mechanisms.

Additionally, finding a support system is crucial. This could be friends, support groups, or online communities where you can share your experiences without fear of judgment. Connecting with others who understand your struggles can provide comfort and validation.

Physical activity, while often viewed as a means to lose weight, can also be a powerful tool for improving mental health. Finding an enjoyable form of exercise, rather than viewing it solely as a weight loss strategy, can help shift your mindset. Activities like dancing, swimming, or even walking in nature can be beneficial and less intimidating than traditional workouts.

Lastly, consider journaling as a way to express your feelings and thoughts. Writing can be a therapeutic outlet that allows you to process your emotions and reflect on your experiences. It can also help you track your progress and celebrate small victories along the way.

In conclusion, your journey through obesity and mental health challenges is undoubtedly difficult, but it is also an opportunity for growth and healing. By seeking help, surrounding yourself with supportive individuals, and focusing on both your physical and mental well-being, you can begin to reclaim your life and find a path toward a healthier, happier you. Remember, you are not alone in this struggle, and there is hope for a brighter future.

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