The doctor glances up from the first page of my chart — the only page he actually looks at — with the condescending smile that men in bars will flash me, the fat chick, when they edge past me to chat up my friend. As if merely acknowledging me is an expression of great tolerance.

I’m at the clinic at my therapist’s behest. My therapist is a petite woman with opinions as sharp as her suits. She has told me that she will stop treating me if I don’t begin a weight loss program. I am 23 at the time, and I don’t know that I can say no to her. She’s wept when I’ve shared stories of my father’s rages; she’s asked to see my scars. And she says that, by not forcing me to confront this horrible hindrance that is my body, she is “enabling” me, allowing me to deny myself my brightest, happiest life.

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I might as well tell you now that this essay won’t end with a scene from that brighter, happier life: an image of a newly svelte me out hiking or auditioning a red dress for a hot date, reflecting that I’d never known the beauty of the world — and of myself — until I’d lost the weight. This is not that kind of essay. It’s an explanation and a celebration of a single decision: Even if I never lost a single pound, I’d be just fine. I’d be better than fine.

But this decision is still a seedling in frozen soil back when I am 23 years old and sitting in front of a doctor who is more interested in my chart than in resuming eye contact. He says something to me, but I don’t hear him over the bloodrush thumping between my ears. My last time on an exam table, a year or so earlier, a gynecologist as tiny and wizened as my Sicilian grandmother began extolling the virtues of bariatric surgery while I was in the stirrups.

“The weight just flies right off,” she’d chirped, jabbing in the speculum. I’d played off my tears as an effect of that quick pinch, but I’m still leveled by her words every time my hands sweep my hips in the shower or I look into my rearview mirror to smooth on lipstick.

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Back at the new doctor’s office, five of his cohorts crowd the doorway: They are my “treatment team.” They talk of weigh-ins and biometrics, nutritional planning and low-impact exercise eventually ramping up to “intensive cardio.”

As soon as they leave to let me get undressed, I escape like a fat girl Jason Bourne. Just like that seedling knows how to muscle up from the earth, I know that I will not be measured and weighed and found wanting. My only choices seem to be getting caught in the wheel of the weight loss bandwagon and dragged through the dirt, or standing up and dusting myself off to say "enough." I’m going to be OK as I am -- even if what I am is obese.

*****

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The arc of my life has been defined by my waistline: Shop clerks give me the side-eye, direct me to accessories; the arms of chairs pinch my hips; an old woman sitting next to me on the bus yells aloud that I’m crowding her off her seat. It never stops being painful, but as I’ve gotten older, it’s become like that sore spot on my heel, now tombed in callus. Still, that moment with my “treatment team” remains raw: It distills my experiences into an inescapable truth — that I am not my accomplishments. I am a problem to be solved.

There have never been so many ways to lose weight. As always, there are ye olde fad diets dressed in the chic new threads of scientific research. There are so many shades to the bariatric surgery rainbow: lap-bands and sleeve gastrectomies and gastric bypasses, oh my! Everything is gluten-free and nothing has carbs.

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If I’d stayed with my “treatment team,” I’d be as exuberant and fit as one of those “after” models in a Jenny Craig ad, crowing about all the energy I have now and all the cute clothes I can wear. I defiantly remain a “before.” I am 250 pounds. I wear a size 24. Whenever the women around me talk about how great so-and-so looks now that she’s joined that pricey gym or gone under the knife (even if so-and-so is still sort of a bitch), I remember purging and popping pills and eating three well-balanced meals a day; binging and starving and reading “Anna Karenina” on a StairMaster. But none of it left me happier or healthier. Just hungry.

*****

I’d packed on the pounds as a neglected child whose father passed out when his rage was spent, whose mother was petrified to move, to wake him. I was a little girl whose dinners always went cold. So I enacted a kid’s version of nourishment, swallowing fistfuls of Cheese-Its and pulling the cheese off left-over pizza. I took that lead-bellied feeling of fullness for actual satisfaction. I binged because I was frenzied with need. If I didn’t sink my teeth into something — anything — I wouldn’t know I was alive. “Food is not love” may have usurped “nothing tastes as good as thin feels” as the diet evangelist’s koan du jour, but I will never begrudge that little girl anything she had to do to survive.

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Gaining weight opened me up for heartache in all the expected ways; it also armored me. I was never going to fit in with girls who could hold slumber parties at their houses, girls whose fathers ran out for pizza and sodas (then disappeared to the den), girls who’d expect to be invited back to my house in return. My body sheathed me in distance.

Losing weight may be as simple as joining a walking after work Meetup or forgoing the homemade cupcakes a co-worker brings in on Monday, but I’m not interested in sacrifices. Not anymore. I’ve spent my whole life capitulating to other people’s expectations: to always walk on tiptoe when Daddy was drunk, to know what would set him off when guessing his triggers was like playing Whack-A-Mole; to swallow my mother’s secrets and keep racking up A’s; to become the perfect girlfriend — always down to fuck, then make breakfast in bed; always ready to talk about whatever you want to talk about, honey, to go wherever you want to go — just so I’d never be left alone.

This realization didn’t come easily, or even consciously. It was a current that first started swirling inside my therapy sessions. I’d listen to my therapist fret about how unhealthy I must be, how my weight reflected my (supposed) belief that I didn’t deserve to be happy, and I’d hear my father’s voice telling me that I was clumsy and stupid, and lucky that he knew what was best for me. I’d hear my mother tell me that he was right, that it was best to appease him, to make myself quiet and small.

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*****

When you’re obese, you are your body. Every decision you make is viewed through the prism of your weight. Do you order the salad at lunch? Good for you! You’re taking control of your health. Do your order the pasta primavera? You don’t love yourself enough. Are you sitting alone on a park bench? You’re alone and lonely: Nobody can really love you until you love yourself. You couldn’t possibly just prefer solitude.

Recently, I was outside walking sans dog and a woman in a hatchback rolled down her window to flash me a thumbs up and call out (quite sincerely): “Good for you, honey!” She assumed that, as a fat woman walking, I was trying to lose weight. I was, in fact, trying to puzzle out a particularly tricky section of the novel I’m writing.

If you don’t conform to the norm, you’re expected to sweat yourself into a headline: “How One Woman Went from Obesity to a Bikini Body.” As if the two are mutually exclusive. But if you choose, as I have chosen, to stop the presses, to throw out all the “inspirational” sizes in your closet, that your weekly meals don’t have to be more meticulously planned than the raid that killed Bin Laden, you aren’t just flipping off cultural expectations; you’re upending other people’s hopes for you.

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I remember meeting with my thesis advisor in my final week of college. I was the thinnest I’d ever been, a size 12. Starvation shrank my stomach into a fist. I felt dizzy, but I felt light, and that was all that mattered. Still, I was quietly devastated when, instead of complimenting my research and writing, my advisor praised my weight loss. “You’ve really taken control,” he said, as if my weight were some Sasquatch I’d wrestled back to its cave.

I wonder what my advisor would think of me now that I’m fatter than I’ve ever been. Perhaps he’d say I was out of control, though I have a full-time gig and a robust byline. I contain multitudes (some might say literally). I eat grilled cheese and bacon sandwiches sometimes, and sometimes I eat kale. I walk my dog for a mile a day but I will never board a StairMaster again.

This is why the Dr. Oz-approved narrative on weight loss disturbs me. Every story is a straight line from Point I’m Such a Fat Failure to Point Look at Me Now! Given that an estimated 80-90 percent of people who lose weight will gain it back within five years that straight line is made of tinsel — shimmering and pretty, but easily severed.

In every special episode about weight loss, tearful brides lament how big they look in wedding photos, as if the 26-inch waist they have now negates the husbands who’ve always loved them. Fathers choke up remembering the day they knew they “had to make a change,” the day their toddlers randomly called them fat, as if that observational indictment means more than all those “I love you’s.” There’s always a former Miss Lonelyheart, a thirtysomething virgin who — after a gastric bypass or militant adherence to the Paleo diet — has shed half her body weight and is finally ready for Mr. Right. I’ve no doubt that they really do feel healthier and happier, and honestly (truly) good for them. I just wish that the entirety of their lives weren’t reduced to a single achievement.

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Now, I’m more concerned with what my blood work reveals than what the number on the scale says. Any physician who partners with me must understand this; I want a doctor who sits across from me, not a squadron that blocks the door. And once I found a new therapist, I felt lighter than I had in years.

Some argue that classifying obesity as a disease — as the American Medical Association has recently done — destigmatizes it, but the language of disease is unremittingly aggressive: We say “Fuck Cancer” and “Beat Diabetes.” We speak of people in treatment as “fighting a battle.”

I have fought against myself for so very long, against everything I’d internalized: everything my father told me I was, everything my mother told me I couldn’t do; everything the kids at school told me I looked like, everything my (supposed) care providers swore I should be. I’ve laid down my arms. I will simply be.

I am not a pathology. I am breasts and belly that bounce softly with my every step, thighs that sweep each other, and a rear end that rolls along behind me like that final note after a song has ended.

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Whenever I doubt myself, whenever I feel ugly, I turn to the one photo I have of myself as a child. I’m seven years old, and I’m beginning to plump up. My belly strains the fabric of my footie pajamas, but I am all smiles, fists at my hips in a Superman pose, a baby blanket cape around my neck. I’m starting to be teased at school, and the lunch ladies give me smaller spoonfuls of mashed potatoes, but I’m not ashamed (not yet). I don’t care about being beautiful or fitting in. In this moment, I know that no matter what happens to me, no matter what I’ll endure, I am powerful.