Carrie

One, two, three, glide. The voice of the lithe instructor could be heard throughout the gym. Carrie slid into the back row and tried to keep up with the music. Unlike her petite namesake from Sex and the City (portrayed by the actress, Sarah Jessica Parker), Carrie was a full-figured woman trying to tackle her weight for the umpteenth time. She was the type of friend that everyone could depend on and the life and soul of every party. She was the person who urged her sons out of bed and packed lunch for her husband. She was the conscientious soul who agonized about the calorie counts in pizza (184 per slice), apple pie (296 per slice), nachos with cheese (346 per serving) and other assorted junk food that would now be staples in her household during football season. She was the person who analyzed articles about stripping the nutrition out of our food and worried about obesity-related cancers. However, it seemed as if everyone saw her only as a fat chick. While she received rave reviews about her cooking, she felt less like Mario Batali, maestro of Italian cuisine, and more like a recent unflattering image of Rachael Ray shown in The National Enquirer. Today, she internalized the impersonal judgments from the press and the perceived taunts from her peers.

Her doctor did his best to restore some of her usual good humor and steered the conversation towards weight management. He mentioned gastric bypass surgery as an option.  Two of her idols, Carnie Wilson and Star Jones, had pursued this route. Hence, she paid careful attention to the explanation given by her doctor. The procedure involved creating a smaller stomach pouch and attaching a section of the small intestine directly to the pouch. Food could then bypass a large portion of the small intestine, an organ which absorbs calories and nutrients. She would be able to eat and absorb less calories as a result of a successful surgery. The resulting hormonal changes in her gut could trigger her pancreas to start making insulin again and thereby reverse the course of her Type 2 diabetes. However, he cautioned her about the risks involved in undergoing this surgery and mentioned that scientists were researching ways to mimic the stabilization of blood glucose levels without the need to go under the knife.

She trusted her doctor’s recommendations. Besides, she was a furloughed federal worker and had no idea if such a surgery would be covered by the Affordable Care Act and whether it would result in positive health outcomes. A gym membership and renewed attention to the quantity and quality of nutrients entering her body seemed like logical choices. So she followed her usual routine of taking care of her family, measuring her blood glucose, injecting herself with a glucagon-like peptide-1 (GLP-1) agonist, popping a metformin pill and consuming a nutrition shake and fiber-rich cereal for breakfast.

The medically-supervised diet of a full-figured, diabetic, middle-aged woman could be monotonous and lonely, especially when surrounded by teenage sons voraciously consuming all sorts of food without gaining any weight. Her depression, possibly also associated with hormonal and microbial changes inside her body, was momentarily alleviated by the music in her gym class. She could even crack a joke with Rachel (the girl who had saved a space for her in the last row) about the instructor’s resemblance to Miley Cyrus. She may not be able to twerk, but this time she would succeed in her quest.