The Elephant in the Room Prologue KILLING THE HOG I have this dream. We're on a road trip, out in this house in the country, and I'm trying to talk to my wife. But this hog gets in the house. It stinks and it's slick to the touch and I can't keep it off me. I push it away but it keeps plowing back and I see tusks. I finally shove it out the door. Now I'm in bed. Here comes the hog again. I can barely stave it off with my hands. It's all over me. I get to my feet and kick it and ram it with my shoulder and we tumble out into the yard. My mouth is coated with hog-slime, and I reach in and scrape it off my tongue. I'm half-dressed, stinking, miserable. Suddenly we're back in a room and I can sense I'm being watched. Three or four official-looking people are lined up at a table, like judges on a panel. One of them says, "Here's what you have to do." I wake up knowing two things. One, I have to kill the hog. Two, the hog is a part of me. NEW YEAR'S EVE, 2014 I weigh 460 pounds. Those are the hardest words I've ever had to write. Nobody knows that number--not my wife, not my doctor, not my closest friends. It feels like confessing a crime. The average American male weighs 195 pounds; I'm two of those guys, with a ten-year-old left over. I'm the biggest human being most people who know me have ever met, or ever will. The government definition of obesity is a body mass index of thirty or more. My BMI is 60.7. My shirts are size XXXXXXL, which the big-and-tall stores shorten to 6X. I'm six-foot-one, or seventy-three inches tall. My waist is sixty inches around. I'm nearly a sphere. Those are the numbers. This is how it feels. I'm on the subway in New York City, standing in the aisle, clinging to the pole. I live in Charlotte and don't visit New York much, so I don't have a feel for how subway cars move. I'm praying this one doesn't lurch around a corner or slam to a stop because I'm terrified of falling. Part of it is embarrassment. When a fat guy falls, it's hard to get up. But what really scares me is the chance I might land on somebody. I glance at the people wedged around me. None of them could take my weight. It would be an avalanche. Some of them stare at me and I figure they're thinking the same thing. There's an old woman sitting three feet away. One slip and I'd crush her. I grip the pole harder. My palms start to sweat and all of a sudden I flash back-- to elementary school in Georgia, standing in the aisle on the bus. The driver hollers at me to find a seat. He can't take us home until everybody sits down. I'm the only one standing. Every time I spot an open space, somebody slides to the edge of the seat and covers it up. Nobody wants the fat boy mashed in next to them. I freeze, helpless. The driver glares at me in the rearview mirror. An older kid sitting in front of me--a redhead, freckles, I'll never forget his face--has a cast on his right arm. He reaches back and starts clubbing me with it, below the waist, out of the driver's line of sight. He catches me in the groin and it hurts, but not as much as the shame when the other kids laugh and the bus driver gets up and storms toward me-- and the train stops and jolts me back into now. I peel my hands from the pole and get off. I climb the stairs to the street and step to the side to catch my breath. I'm wheezing like a thirty-year smoker. My legs wobble from the climb. I'm meeting a friend near Central Park at a place called the Brooklyn Diner. Why is there a Brooklyn Diner in Manhattan? Are Manhattan diners not up to lofty Brooklyn standards? I have time to think about such things. I'm fifteen minutes early, on purpose, because I have to find a safe place to sit. The night before, I had Googled "Brooklyn Diner interior" to get an idea of the layout. Now I scan the space like a gangster, looking for danger spots. The booths are too small--I can't squeeze in. The bar stools are bolted to the floor--they're too close to the bar and my ass would hang off the back. I check the tables, gauging the chairs. Flimsy chairs creak and quake beneath me. These look solid. I spot a table in the corner with just enough room. I sit down slowly--the chair seems OK, yep, it'll hold me up. For the first time in an hour, I take an untroubled breath. My friend shows up on time. By then I've scouted out the menu. Eggs, bacon, toast, coffee. A few bites and the shame fades. At least for a little while. * * * By any reasonable standard, I have won life's lottery. I grew up with two loving parents in a peaceful house. I've spent my whole career doing work that thrills me--writing for newspapers and magazines. I married the best woman I've ever known, Alix Felsing, and I love her more now than when my heart first tumbled for her. We live in an old house in Charlotte with a yellow Lab mutt named Fred. We're blessed with strong families and a deep bench of friends. Our lives are full of music and laughter. I wouldn't swap with anyone. Except on those mornings when I wake up and take a long naked look in the mirror. My body is a car wreck. Skin tags--long, mole-like growths caused by chafing--dangle under my arms and down in my crotch. I have breasts where my chest ought to be. My belly is strafed with more stretch marks than a mother of five. My stomach hangs below my waist, giving me what the Urban Dictionary calls a front butt--as if some twisted Dr. Frankenstein grafted an extra rear end on the wrong side. Varicose veins bulge from my thighs. My calves and shins are rust-colored and shiny from a condition called chronic venous insufficiency. (You never want any medical condition that contains the words chronic and insufficiency.) Here's what it means: The veins in my legs aren't strong enough to push all the blood back up toward my heart, so it pools in my capillaries and forces little dots of iron up under my skin. The veins are failing because of the pressure caused by 460 pounds pushing downward with every step I take. My body is crumbling under its own gravity. Some days, when I see that disaster staring back, I get so mad that I pound my gut with my fists, as if I could beat the fat out of me. Other times the sight sinks me into a blue fog that can ruin an hour or a morning or a day. But most of the time what I feel is sadness over how much life I've wasted. When I was a kid, I never climbed a tree or learned to swim. When I was in my twenties, I never took a girl home from a bar. Now I'm fifty, and I've never hiked a mountain or ridden a skateboard or done a cartwheel. I've missed out on so many adventures, so many good times, because I was too fat to try. Sometimes, when I could've tried anyway, I didn't have the guts. I've done a lot of things I'm proud of. But I've never believed I could do anything truly great, because I've failed so many times at the one crucial challenge in my life. What the hell is wrong with me? * * * What the hell is wrong with us? As I write this, the Centers for Disease Control estimates that seventy-nine million American adults--forty percent of women, and thirty-five percent of men--qualify as obese. That's more than the total attendance of every Major League Baseball game last year. Our kids are right behind us--the obesity rate among American children is seventeen percent and climbing. Our collective waistline laps over every boundary--age, race, gender, politics, culture. In our fractured country, we all agree on one thing: second helpings. Fat America runs on the fuel of easy and cheap junk food, motivated by constant ads for burgers and beer, soothed and sated by oversized portions. At most movie theaters now, a small soft drink is thirty-two ounces. No reasonable definition of small encompasses a quart of Coke. The English language, like my elastic-waisted cargo shorts, has stretched to fit our expanding country. As every fat person knows, there's no such thing as a cheap buffet--you always pay later, one way or another. Fat America comes with a devastating bill. According to government estimates, Americans pay $147 billion a year in medical costs related to obesity. That's roughly equal to the entire budget for the U.S. army. But the money is just part of the cost. Every fat person, and every fat person's family, pays with anger and heartache and pain. For every one of us who can't shed the weight, there are spouses and parents and kids and friends who grieve for us. We carve lines in their faces. We sentence them to long years alone. I know this from experience. I also feel it like a burning knife right now. Because my sister, Brenda Williams, died on Christmas Eve. * * * One of the great joys in our family was getting Brenda to laugh. If somebody cracked an off-color joke, her eyes cranked open wide and her eyebrows flew up her forehead like a cartoon. Sometimes she let out a low cackle that tickled me even more. She and her husband, Ed Williams, had been married forty-three years and raised three kids. Brenda was never happier than when she had a houseful of the people she loved. But she didn't laugh as much the last few years. Her weight scared her and isolated her and eventually it killed her. Brenda was sixty-three and weighed well north of two hundred pounds. Her feet swelled so much she could hardly wear shoes. Her thighs cramped so bad, with so little warning, that she was afraid to drive. For years she dealt with sores on her legs caused by the swelling. They leaked fluid and wouldn't heal. In late December, one of the sores got infected. Brenda was tough, so by the time she admitted she was sick, she was in deep trouble. Her husband took her to the emergency room in Jesup, Georgia, as we were heading to Tennessee to spend Christmas with Alix's folks. My brother called at two in the morning on Christmas Eve and said things were getting worse. We tried to sleep for a couple of hours, got up, and got on the road. The infection turned out to be MRSA. It spread so goddamn fast. We were somewhere outside Asheville when my brother sent a text: She's gone. The funeral was on my mom's eighty-second birthday. She cried tears from the bottom of the ocean. She lived next door to Brenda and Ed for almost twenty years--we moved her there after she retired. She spent so many nights telling stories around Brenda and Ed's dining-room table. Now she won't go back in their house. All she can see is the empty space where Brenda used to be. The infection was the official cause of Brenda's death, but her weight killed her, sure as poison. What happens when someone close to you dies? People bring food. It arrived at Brenda and Ed's house, and my mom's, within minutes and in great quantities. Neighbors made potato salad and pecan pie. Folks who didn't cook brought cold cuts and light bread. One of Ed's friends arranged for the Western Sizzlin down the road to send a whole rolling cart of meat and vegetables. No matter where you stood, you were no more than ten feet from fried chicken. I crammed everything I could onto my double-thick paper plate. The sugar and grease pushed back the grief, just for a minute or two, long enough to breathe. This is the terrible catch-22. The thing that soothes the pain prolongs it. The thing that brings me back to life pushes me closer to the grave. I think a lot these days about a guy named David Poole. David and I worked together at the Charlotte Observer--he was a brilliant NASCAR writer when I was the local columnist. I weighed more than David, but he was shorter and rounder. We didn't look alike, but we were two fat guys with our pictures in the paper, so readers lumped us together. People would come up to me on the street and ask if I was him. He was one of the smartest guys I've ever met, a great reporter with a fearless voice, one of Alix's closest friends for years. David died of a heart attack when he was fifty. I'm about to turn fifty-one. Guys like us don't make it to sixty. Some of us rot away from diabetes or blow out an artery from high blood pressure, but a heart attack is what I worry about most. My doctor likes to quote a statistic: In a third of the cases of heart disease, the first symptom is death. Right now my heart tests out fine. But I can hear it thumping in my temples, eighty-some beats a minute even when I'm resting, and I know I make it work too hard. Sometimes, when it's quiet in the house, I close my eyes and listen to it strain, praying that it won't just stop like a needle lifted off a record. Every day I wonder if this is the day I might keel over in my office chair or at the bookstore or (God help me) at the wheel of my car. At 460 pounds, I'm lucky to have made it this far. It's like holding twenty at the blackjack table and waving at the dealer for another card. Without a miracle, I'm bound to bust. Bless me, Father, for I have sinned: I lust after greasy double cheeseburgers and fried chicken legs and Ruffles straight out of the bag. I covet hot Krispy Kreme doughnuts that melt on my tongue. I worship bowls full of peanut M&M's, first savoring them one by one, then stuffing my mouth with handfuls, then wetting my finger to pick up those last bits of chocolate dust and candy shell. My brain pings with pleasure; my taste buds groan with desire. This happens over and over, day after day, and that is how I got here, closer to the end of my life than the beginning, weighing almost a quarter of a ton. More than anything, I want to buy time. I want to write every story that needs to come out of me. I want to be the old retired guy with nothing to do but read books and play cards. I want to pack a bag and fill a cooler and get in the car and just ramble. I want to kiss Alix on her eightieth birthday, and I want her to kiss me on mine. I want to look back and be able to say with an honest heart that my years were not wasted. I can't say that now. I have wasted so many. After we got back from Georgia, I hung my black suit in the closet. It's my only suit. I bought it seventeen years ago to get married in. I had to have it cut special at a big men's store called Thick and Thin. We ended up going with a tuxedo for the wedding, but I kept the suit. Sometimes it's a little tight, sometimes a little loose, but it more or less fits because I've been more or less the same size all these years. I've worn it to other people's weddings, to a few fancy parties, to a couple of anniversary dinners. Mostly I've worn it to funerals. I wore it to Brenda's. Before long, I fear, it's the suit I will be buried in. * * * There are radical options for people like me. There are boot camps where I could spend thousands of dollars to have trainers whip me into shape. There are crash diets and medications with dangerous side effects. And, of course, there is weight-loss surgery. Several people I know have done it. Some say it saved them. Others had life-threatening complications. A few are just as miserable as they were before. I don't judge any people who try to find their own way. I speak only for myself here: For me, surgery feels like giving up. I know that the first step of twelve-step programs is admitting that you're powerless over your addiction. But I don't feel powerless yet. The hog in my dream terrifies me. He's vicious and strong. But somewhere under all these folds of fat is a small part of me that still believes I can take him. Being a journalist, I work best on deadline. Do you know where the word comes from? In the Civil War, in my home state of Georgia, there was a horrible Confederate prison called Andersonville. Tens of thousands of captured Union soldiers starved and suffered there. More than thirteen thousand died. Inside the prison, there was a wooden railing that separated the prisoners from the stockade walls. It wasn't much of a barrier--except that when any prisoners tried to climb it, or even touch it, the guards shot them on sight. That railing was the deadline. In my life I am the prisoner, and I am the guard. With every big meal, and every day spent on the couch, I have reached closer to the railing, and I have fired a slow bullet aimed for my heart. Here is my deadline. By the end of 2015, one year from now, I am going to lose weight and get in shape. I'm not going to set a number, because every time I've done that, I've fallen short. My goal is to prove that I can head down the right path and stay on it. I have to show that I won't quit even when it's hard, because it's going to be hard. If I get to the end of the year and I've failed, every option goes back on the table: boot camp, pills, surgery, everything. I have a long history of doing this the wrong way. I've thought about a few simple things that might help me do it right. But it will take more than just a meal plan and a walk every morning. I have to dig deep. One weekend in college, I went to Atlanta to visit Virgil Ryals and Perry Beard, my two closest friends, who at the time were students at Georgia Tech. They had a bunch of people over to their apartment, and everybody was drinking, and somebody started up a game called Questions. One person starts off by asking anybody else in the group a question. That person doesn't answer the question; instead, he or she immediately turns to somebody else and asks a different question. You go until somebody can't think of a question. It's harder than it sounds. Especially if you've been pounding Jose Cuervo and Bud Lights. A couple of guys I didn't know were at the party. They were drunker than everybody else, but they had come up with a winning strategy. Every time one of them had to take a turn, he'd look at me and go: "Tommy, why are you so fat?" They thought this was hilarious. It was even funnier, to them, that I kept losing the game--once they asked me that, I couldn't stammer out a question to anybody else. After three or four rounds of this, I slipped off into the kitchen. I thought about going back in with my own question: How would you like me to beat the shit out of you? My fists were ready, but my heart wasn't in it. Those guys were assholes, but they were asking the same question I had asked myself my whole life. Why am I so fat? I've never really understood why I eat so much and why I've never been able to slow down for good. I need to make sense of how I grew up, crack the shell on some old memories, reach down and feel around in dark places, find out what is waiting down there in the mud. I fight my cravings every day. My weight affects everything I do. It's going to kill me if I don't change. I've spent a lifetime telling other people's stories. My weight is the biggest story of my life, but I haven't told it--because I was embarrassed, because I was afraid, because I knew I didn't understand myself. It's time to tell it. It's time to go to work. I'm on deadline. Excerpted from The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing America by Tommy Tomlinson All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.