When Body Positivity Meets Prednisone

I’m going to preface this with a trigger warning. I’m going to be talking about disordered eating and fatphobia. If these are subjects you know are likely to mess with your mental health, please stop reading now.



I hesitate to write about body image and body positivity. I haven’t always been so hesitant, but when I realized how potentially damaging it can be to the body positive movement for objectively thin people to hop on the bandwagon, I backed off, worried about adding to the problem.


That’s not to say the societal pressure to be thin is any easier, I just see it as a different movement.


As I’ve struggled with chronic pain and taking meds with serious side effects, I started waking up to an entirely different sector of the body positive movement I hadn’t given much thought to previously, one that encompasses those of us with chronic health issues.


This isn’t one-size-fits-all. It’s nuanced and I’m almost certain in talking about my experience, I’ll probably say the wrong thing at some point, but I’ll learn. I can’t speak to anyone’s experience but my own, so let’s dive in.


From the time I was around 12 until sometime in my mid-20s, food and weight took up an inordinate amount of my waking thoughts. I was obsessive. During that time, I said ( more times than I can count) that my biggest fear was getting fat.


Admitting that is embarrassing.


I was riddled with fatphobia, before “fatphobia” was a term people were using. I was aggressively fatphobic. I was judgmental. Most importantly, it had nothing to do with anyone but me.


Objectively I knew weight didn’t determine someone’s worth, but I thought it would dictate mine.


I’m too unique looking to be fat.

I’m like, “borderline,” attractive, so if I get fat, I’m shit out of luck.

My good looks depend on me staying thin.


This is the kind of shit I thought.


So I did everything I could to stay in a caloric deficit as much as possible. I got a thrill from feeling hungry, and the longer I could keep the feeling of hunger around, the better.


What I saw when I looked in the mirror, and what actually existed, were not the same thing. I didn’t know about body dysmorphia back then. It wasn’t until a therapist brought it up years later that I realized that was what I’d been experiencing most of my life.


My story isn’t particularly unique thus far, right? You can probably relate, or know someone who can.


I grew up with parents who were yo-yo dieters, oftentimes border-lining on obsessive. Then there’s society and the media and all that nonsense we’ve been inundated with our entire lives. I honestly don’t know how anyone grows up in this society and avoids having a fucked up body image and relationship with food. Rumor has it that’s a thing - people who don’t struggle with this - so like, how does it feel to be God’s favorite?


I’ve done immense amounts of work around all of this with therapists over the years and I’ve evolved in noticeable and meaningful ways, which has been a huge relief…


And then I ended up on high dose steroids - specifically, prednisone.


There was a time in my life when I avoided any and everything that could potentially make me gain weight - including medications. This year, I was faced with a choice I hope you never have to make - take steroids and be able to participate in your life, but plan to put on weight (among other things), or don’t take the steroids and lose your ability to participate in your life - you’ll probably still be thin though.


For me, there’s no choice there. You take the prednisone. Nothing else we’ve tried has worked, so here we are.


There’s a difference between gaining weight over the course of many months or years, and gaining it in weeks. It doesn’t sneak up on you as much as it’s literally like a fat magic show. One day you still look mostly like yourself, and the next, you look like you put on a Snapchat moon-pie-face filter or something.


It’s shocking.


My face feels different. My stomach is both bloated and flabby in a way it has never been in my life. I feel like a sausage half the time and definitely do not feel like my most attractive self. I mean, would you?


In March I was the thinnest I’ve been in years, thanks to my extended hospital stay and horrific string of never-ending headaches that left me nauseous and with very little appetite. That lasted all the way up to when I landed on high doses of prednisone.


At first my doctors tried a typical prednisone taper. I started at 60mg and over the course of several weeks, tapered down to nothing. When we hit 35mg my headaches came back.


They tried another taper after that - same thing happened.


For the past month and a half I’ve been on 40mg of prednisone per day with no tapering in sight. It’s been this past 6 weeks that my body has changed almost entirely.


I thought I’d be more distressed about the weight gain. If this had happened even 2 or 3 years ago I don’t know that I’d feel as much acceptance as I do, which makes me proud of the work I’ve done in this arena.


In a way, I feel like this experience is another level of healing I didn’t know I needed. It’s forcing me to look at my malfunctioning and expanding body and choose to love her anyway. It’s allowing me to see that yes, I am still worthy even now. It’s giving me the opportunity to see myself in new ways that are giving me the opportunity to strengthen my relationship with myself and continue to dismantle my own fatphobia. That shit is insidious.


Chronic pain and chronic disease deeply impact the relationship we have with our bodies. I don’t want mine to create a divide between me and my body, so I choose to think of my illness as an outside force that both me and my body are working to conquer. It’s not my body that has betrayed me. It’s not her fault. She and I are in this together. It’s us against the illness - us against the pain.


The unpredictability of chronic illness makes it very difficult to focus on weight management. It wouldn’t matter what I did right now, I’d still be gaining weight. That is my price to participate in my life at this juncture. I’ve got to figure, it’s a pretty low cost, all things considered.


What I’m seeing for the first time in my life, is that I can gain weight without feeling lesser than. My weight gain isn’t impacting my confidence in my work, or my writing. I’m not worried my girlfriend is going to leave me or not find me attractive anymore. I’m not constantly wondering what other people are thinking about me when they look at me - wondering what they see. Because honestly? Nobody cares.


One of my favorite lines in the TV series Schitt's Creek is when Alexis says to David, “People aren’t thinking about you the way you’re thinking about you.”



It’s so true. We obsess over shit that we care so deeply about, thinking other people also care so deeply, but they actually don’t. Everyone is too wrapped up in their own shit to care about your weight or what you look like.


Suddenly I realized feeling good matters more than looking good, and sometimes you can’t have both at the same time. And sometimes, feeling good means putting on weight and learning to embrace your luscious curves (though I could do without the pimply/rashy breakouts). Feeling good doesn’t always = being thin. I knew this before, on an intellectual level, but now I really know. And maybe more than that, feeling good makes you look good, period.


I’ve reached a level of acceptance I’m proud of, albeit surprised by. I can’t say I haven’t felt mortified in moments, but they never last long.


Chronic head pain has dictated a lot for me this year. It has given me a run for my money in a multitude of ways. It has tested me in ways my pain from endometriosis and from my deteriorating hip joints never did. It has been relentless, but it hasn’t broken me.


Fat is not a 4-letter word and it's a small price to pay in order to be able to function day-to-day.


I’m not going to be a ra-ra champion of the body positive movement, because it wasn’t a movement created for me. But where chronic illness and body positivity merge, we need to be able to talk about it, regardless of “what we look like.”


No one is looking at me right now thinking I’m fat. I know that. Objectively, I’m still not. Chubby? Probably more accurate. The point is- none of it matters. Fat, chubby, thin, skinny - whatever. It doesn’t fucking matter.


Being able to focus on your work and hobbies and getting to spend time doing the things you enjoy with the people you love - Living… that’s all that matters.


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