The Weight Perception Paradox

Like many American women, I am overweight. I have not always been overweight. In high school and even college I was a normal weight for my height (5'2"). I have never been "skinny" in the true sense of the word, but definitely healthy and fit. My husband and I have both gained since meeting and marrying; I think that this is pretty routine. When we were married, I was probably 10-15 lbs over my "goal weight." In residency, land of constant stress, little sleep, and paradoxically unhealthy hospital food, I ballooned. My first two years of residency, the now mandatory 80-hour work week was but a dream. I worked 110-120 hour weeks as an intern and second year resident. I ate grilled cheese and French fries at 4 in the morning because, dammit, I *deserved* them after the hell I was going through. I did little more than collapse onto my bed or couch once I finally darkened the door of my house. Exercise? Yeah, right. Once the 80 hour work week kicked in, I did start going to the gym every morning before 6:30 rounds. Then I got pregnant. Long story short, I've gained 50 pounds (!) in five years. Since I started private practice, I've lost 15 of those 50. I still struggle with food every day.

What's bizarre is that when I was younger and fit, I was thoroughly convinced that I was, in fact, obese. I obsessed over each pound on the scale. When I gained weight in college, drinking and midnight fried food runs, I punished myself in the gym and went every single day, skipped dessert, and ate salads. I was wearing a size 6 and berating myself for not being a 4 or a 2. I wasn't even close to fat, but I thought I was huge. Now that I am indeed overweight, I find myself looking in the mirror and thinking that I look pretty okay, a little chubby, but okay. I don't perceive myself to be overweight, even though I am *very* overweight. The only time I realize how bad it has gotten is when I look at pictures of myself. There is no denying the extra pounds in photographs. My husband relates much of the same feelings about his self perception, so we have entitled our mutual folly the "Weight Perception Paradox" and today, for the 347,000th time, we are vowing to "get back on track." As a physician, I know what it takes to lose weight and keep it off. I have just chosen not to follow. Now we have a daughter, my blood pressure is borderline, and both of our cholesterol levels are higher than they need to be. It's time to take responsibility for ourselves and our health, if not for our sake, then for the sake of our little girl. Perhaps by putting myself on the spot by journaling in cyberspace, I can start to become accountable for controlling my weight. It is definitely worth a try.