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 about 195 pounds; I’m two of those guys, with a 10-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 30 or more. My BMI is 60.7. My shirts are size XXXXXXL, which the big-and-tall stores shorten to 6X. I’m 6 foot 1, or 73 inches tall. My waist is 60 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, North Carolina, 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 that 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. An old woman is 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 school 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 30-year smoker. My legs wobble from the climb. I’m meeting a friend near Central Park, at a place called the Brooklyn Diner. I’m 15 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 barstools 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. These look solid—the chair seems okay; 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’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. 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 20s, I never took a girl home from a bar. Now I’m 50, 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 courage. 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 and Prevention estimates that 79 million American adults—40 percent of women, and 35 percent of men—qualify as obese. The obesity rate among American children is 17 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. 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. 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 seven days ago, 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 43 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 63 and weighed well north of 200 pounds. Her feet swelled so much that 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. Ed took her to the emergency room in Jesup, Georgia, as Alix and I were heading to Tennessee to spend Christmas with Alix’s folks. My brother called at two in the morning on Christmas Eve and said that 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 82nd birthday. She cried tears from the bottom of the ocean. She lived next door to Brenda and Ed for almost 20 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 10 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. Related Stories How Obesity Became a Disease

You Can’t Willpower Your Way to Lasting Weight Loss

How Junk Food Can End Obesity

Why It Was Easier to Be Skinny in the 1980s 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, and one of Alix’s closest friends for years. David died of a heart attack when he was 50. I’m about to turn 51.

Guys like us don’t make it to 60. 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 say that 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, 80-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 20 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 donuts 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.

The first diet plan I remember was pills. Mama took me to a diet doctor when I was 11 or 12 and already growing out of the husky sizes at Sears. I don’t remember him saying anything about eating right or exercising. I just remember a long cabinet full of white plastic bottles. At the end of the visit, he gave me a handful of pills that looked as bright and happy as Skittles. Looking back, I’m pretty sure at least some were amphetamines. They didn’t curb my appetite—I was still sneaking into the fridge at night for bologna sandwiches or banana pudding. But the next day, I could run up and down the basketball court for hours. This seemed to me to be a good trade-off. The next diet plan I remember was candy—these little chocolate-flavored candies that came in a box like a Whitman’s Sampler. They were called Ayds, which turned out years later to be an extremely unfortunate name. They were supposed to be some sort of appetite suppressant. They did not suppress my appetite enough to keep me from eating five or six instead of one. I remember the first time carbohydrates were bad for you, back in the 1970s. The lunch counter at Woolworth’s in my hometown of Brunswick, Georgia, sold a diet plate of a hamburger patty on a lettuce leaf with a side of cottage cheese. My mom and I stared at the picture on the menu like it was a platypus at the zoo. We pretended to care about carbs for a while. Mama even bought a little carbohydrate guide she kept in her pocketbook. It said biscuits and cornbread were bad for us. It didn’t stay in her pocketbook long. I’ve done low-fat and low-carb and low-calorie, high-protein and high-fruit and high-fiber. I’ve tried the Mediterranean and taken my talents to South Beach. I’ve shunned processed foods and guzzled enough SlimFast to drown a rhino. I’ve eaten SnackWell’s cookies (low-fat, tons of sugar) and chugged Tab (no sugar, tons of chemicals, faint whiff of kerosene). I’ve been told, at different times, that eggs, bacon, toast, cereal, and milk are all bad for you. I’ve also been told that each one of those things is an essential part of a healthy diet. My brain is fogged enough at breakfast. Don’t fuck with me like this.

Here are the two things I have come to believe about diets: 1. Almost any diet works in the short term.

2. Almost no diets work in the long term. The most depressing five-word Google search I can think of—and I can think of a lot of depressing five-word Google searches—is gained all the weight back. Losing weight is not the hard part. The hard part is living with your diet for years, maybe the rest of your life. When we go on a diet—especially a crash diet—our own bodies turn against us. Nutritional studies have shown that hunger-suppressing hormones in our bodies dwindle when we lose weight. Other hormones—the ones that warn us we need to eat—tend to rise. Our bodies beg us to gorge at the first sign of deprivation. This makes sense when you think about the history of humankind. There were no Neanderthal foodies. They ate to survive. They went hungry for long stretches. Their bodies sent up alarms telling them they’d better find something to eat. Our DNA still harbors a fear that we’ll starve. But now most of us have access to food that is more abundant, cheaper, and more addictive than at any other time in human history. Our bodies haven’t caught up to the modern world. Our cells think we’re storing up fat for a hard winter when actually it’s just happy hour at Chili’s. Even worse, when people succeed at losing a lot of weight, their bodies slam on the brakes of their metabolism. Scientists from the National Institutes of Health found this out recently by studying contestants from the eighth season of The Biggest Loser. The New York Times did a big story on the study. It showed a photo of one of the contestants, Sean Algaier, and said he was now a pastor at a church in Charlotte, only 15 minutes from my house.

A few days after I read the Times story, I went out there to meet Sean. His office has sturdy chairs. In 2009, when Sean and his wife were living in Tulsa, Oklahoma, Sean’s wife found out about a Biggest Loser casting call in Oklahoma City. She told Sean he was going. He ended up on the show, but lasted just three weeks, mostly by his choice. In that time, he lost 36 pounds—dropping from 444 to 408—and volunteered to be kicked off because others on his team were struggling, and he thought they needed the trainers and counselors more than he did. He believed he could keep losing weight at home. And he did. He got all the way down to 289—a total of 155 pounds. He celebrated by running a marathon in Tulsa. It took him almost seven hours, but he crossed the finish line. “You get to a place where nothing will stop you from doing whatever it is that you want to do,” he says. But he did stop. And then he slid backward. The day we talked, about seven years after The Biggest Loser, Sean was at 444 pounds. Exactly where he’d been when he started on the show. No one thing tipped him. His job in Tulsa wasn’t going the way he had hoped, so he and his family packed up and moved. He had the normal stress of any parent raising three young children. He spent time in counseling, and it opened some old wounds. It all rolled up on him. “I developed this pattern of feeling worthless,” he told me. “And so I guess in my darkest places now, there is still a little bit of a feeling of worthlessness.”

Like me—like so many people—he tamped down those feelings with food. He’d go to a Charlotte breakfast joint called the Flying Biscuit and gorge on biscuits and gravy. He’d dig into the stashes of cake and donuts they kept around for the kids. On his best days he could avoid those things, or have just a bite or two. But when he felt down, he dove in with both hands. He knew he could lose a lot of weight. He’d done it. But when the scientists studied him and the other contestants—before the show, afterward, and six years later—they made a heartbreaking discovery. Other studies had already shown that the body’s metabolism slows down as people lose weight, which means they have to eat fewer and fewer calories to keep losing. But this study showed that, for the contestants who lost weight quickly, their metabolism kept slowing even when they started gaining weight again. Basically, however fat they had been, that’s what their bodies wanted them to be. We’re about the same size right now, Sean and I. We are two fat men trying hard to be something else. He found a better version of himself but couldn’t hold onto it. I’ve never seen my better version. Sean had nothing but good things to say about his time on The Biggest Loser. I believe him, but I can’t stand the show. I hate the way it runs the contestants until they look like they’re about to die. I hate the double-meaning dagger of the title. I hate, more than anything, the way it makes the men take their shirts off when they weigh in, all their shame displayed for ratings’ sake, so viewers will stare in disgust and tune in again next week. Under all the inspiration is the rancid smell of a freak show. And I hate it so much because I know it would probably work. If I had to take my shirt off over and over on national TV, I would goddamn sure lose weight. Or die trying.

“Eat less and exercise.” That’s what some of you are saying right now. That’s what some of you have said the whole time you’ve been reading. That’s what some of you say—maybe not out loud, but you say it—every time you see a fat person downing fried eggs in a diner, or overstuffing a bathing suit on the beach, or staring out from one of those good-lord-what-happened-to-her? stories in the gossip magazines. “Eat less and exercise.” What I want you to understand, more than anything else, is that telling a fat person “Eat less and exercise” is like telling a boxer “Don’t get hit.” You act as if there’s not an opponent. Losing weight is a fucking rock fight. The enemies come from all sides: The deluge of marketing telling us to eat worse and eat more. The culture that has turned food into one of the last acceptable vices. Our families and friends, who want us to share in their pleasure. Our own body chemistry, dragging us back to the table out of fear that we’ll starve. On top of all that, some of us fight holes in our souls that a boxcar of donuts couldn’t fill. My compulsion to eat comes from all those places. I’m almost never hungry in the physical sense. But I’m always craving an emotional high, the kind that comes from making love, or being in the crowd for great live music, or watching the sun come up over the ocean. And I’m always wanting something to counter the low, when I’m anxious about work or arguing with family or depressed for reasons I can’t understand. 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 12-step programs is admitting that you’re powerless over your addiction. But I don’t feel powerless yet.

My plan is to lose weight in a simple, steady, sustainable way. I’ll count how many calories I eat and how many I burn. If I end up on the right side of the line at the end of the day, that’s a win. I’ll be like an air mattress with a slow leak, fooling my body into thinking I’m not on a diet at all. And one day, a few years down the road, I’ll wake up and look in the mirror and think: I got there. That Jason Isbell song “Live Oak” hits me so hard, even today, in 2019. There’s a man who walks beside me

He is who I used to be

And I wonder if she sees him

And confuses him with me. The narrator is a killer who falls in love with a good woman and sees a glimmer of a better life for himself. But he wonders which version of him she’s attracted to: the one who’s trying to live straight now, or the rogue in his past. The song does not have a happy ending. I’ve never been anything but fat. Is there something in the fat version of me that also makes me likable and creative and a decent human being? Are the best parts of me all knotted up with the worst? Is there some way to untangle it and keep just the good stuff? Most of the time I think of my fat as a husk—something I have to shed so the best part of me can come out. But sometimes I wonder if I’m more like the shells you find on the beach, where the outer part is the attraction, and the animal inside is dull and shapeless. There’s no doubt: If I wrote down everything that would be better if I lose weight, the list would be as long as the Old Testament. If I wrote down everything that might get worse, it wouldn’t fill up an index card. But this is why people buy insurance—to hedge against unlikely disasters.

Four years in, there haven’t been any disasters yet. For the first time in my life, as I’ve started to lose weight, keeping it off feels sustainable. My cholesterol and blood pressure are back to normal levels. I used to wake up with headaches from sleeping so poorly. That almost never happens now. Walking is easier. When I rent a car now, I don’t have to try out three or four until I find one whose seat belt I can buckle. Of course, I have to lose more. But I’m already preparing for when the man who walks inside me comes to stay. (Emily Haasch*) I have some clothes I want him to wear. In the bottom drawer of my dresser is a stack of T-shirts that are too small for me now. There’s one for Willie’s Wee-Nee Wagon, my hometown hot-dog joint, which I maintain is the greatest restaurant in the world. There’s one for St. Paul & the Broken Bones, one of my favorite bands. There’s one for Rapala fishing lures that’s so old, I can’t remember where I got it. It’s an XL—several sizes smaller than what I wear now. If the day comes when I can wear an XL shirt again, I’ll go to my favorite bar—Thomas Street Tavern, in Charlotte—and buy a round for the house. There’s a ladder I want the man who walks inside me to climb—the pull-down ladder to our attic. It’s rated at 250 pounds. I’ve never been up in the attic, because I’m afraid the ladder won’t hold me. Whenever we need what’s up there—Christmas ornaments, winter clothes, an extension cord—Alix has to go up and get it. I’m embarrassed that there’s an entire part of our house that I’ve never been in. I want to climb that ladder with confidence.