Early one morning, decades ago, I looked down a long hallway and saw two obese women walking toward me. Backlit by the rising sun, the two women appeared in outline; all I could see of them was the dark shapes of two bodies, surrounded by golden rays. I stood, transfixed, watching their movements as they walked, their arms swinging far out from their shoulders like ribbons on a maypole. Instead of moving easily, to and fro, with each step, their arms flew back and forth like propeller blades. The force of these arm rotations supplied energy to fling their hips and torsos forward, while their legs, stiff and straight, worked to catch up with each step. Frankly, it looked like hard work. I looked away.
Then, a few years ago, having arrived early to a large celebration, I saw a woman, clearly an organizer of the event, distractedly crossing the soon-to-be-filled party room on some urgent last-minute mission. What I saw astounded me: Though of normal weight, she was flinging her arms back and forth like propeller blades. Immediately, I knew that she had not always been this size. I also knew something else, and it troubled me: part of her brain still thought she was heavy. Despite the many hours invested in her health and recovery, and despite her obvious success, not all of her had healed.
Last year I saw it once again, this time in a young woman walking along, briskly, on the sidewalk.
Gastric bypass operations have become commonplace, and many individuals who thought they were consigned to a life of obesity, diabetes and knee pain have found a way out. It’s not enough, though. We may be making headway treating the physical part of the disease, but we need to do a much better job treating the mental and emotional part. I’m sure that my friend and colleague, Dr. Sara Stein, a bariatric psychiatrist and author of Obese from the Heart, would agree.
I recently had the pleasure of reading The Body Has a Mind of Its Own, by the mother-and-son neuroscience writing team of Sandra Blakeslee and Matthew Blakeslee. Rated one of the top science books of 2007 by the Washington Post, the team of Blakeslee & Blakeslee explain that our minds create networks of body maps exquisitely related to how our bodies interact with the environment. Like trees that grow new limbs while others are pruned, body maps also change over time, shrinking and expanding in response to changes in your own body and in the environments within which you function.
Doctors, and occupational and physical therapists, are using this new research about body maps to develop methods to heal phantom limb pain, anorexia nervosa, and other body map distortions. I am looking forward to learning how they begin to use it in people whose minds need help learning that the bodies they inhabit are no longer obese.