An Epidemic of Hidden Fat – The Week headline, April 20, 2012
“A 55-year-old woman who looks great in a dress could have very little muscle
and mostly body fat, and a whole lot of health risks because of that.”
– Dr. Eric Braverman
Consider the clavicle.
Clavicles, actually. There are two of them, the darlings, the slender twin horizontal bones forming those small knobs at the naked shoulders’ tops, then meeting at the breastbone to shape that sweet U at the base of the throat. You see these bones, prominent and fine, on ballerinas and models, on French actresses of a certain age and good posture. These bones bespeak elegance and grace. But the clavicle – okay, the collarbone – is also the most commonly broken bone in the human body. It cracks easily, like those thin Pogen ginger snaps my mother used to buy. Clavicles are beautiful. Mine are lovely. They are my best feature.
I come from plump stock, a lineage of expansive flesh, women who were full-hipped, short-legged, large-bosomed. When I was a child my mother looked like one of those Big Beautiful Women who modeled, pre-Anna Nicole, for Lane Bryant and Leggs Queensize pantyhose, the kind of woman people called zaftig and Rubenesque. The battle with weight was my mother’s way of life; a plastic Weight Watchers scale lived on our kitchen counter, next to the ever-present package of sugary Pogens (because how can such a thin cookie be fattening?) A synthetic dusting of Sweet-N-Low lingered in the air, turning lips and fingers acrid, and our fridge was always stocked with tubs of waxy diet margarine, cartons of bluish skim milk and cases of Tab – I couldn’t understand why food at restaurants and other peoples’ homes was always so lusciously rich. Every diet was tried, every fashionable fat farm visited, every dieter’s trick given the weight of Biblical prophecy. But there were also the special-yet-quotidian occasions that warranted an ongoing celebratory splurge on food, an excuse for a glut of sugars and fats. Reasonable portion size, healthy foods, and exercise were simply never discussed. It wasn’t entirely my mother’s fault – I’ve seen the butterball baby pictures. She was dealt a low card from the genetic deck, destined to fight unfavorable odds on the wheel spin of human metabolism.
I was the freak child. A six-pound morsel, a bony baby mouse. I was born thin, grew up thin, could eat anything and everything and the effortlessness of it all seemed a miracle. My mother couldn’t get over me, her sylphlike creation. Surely I must be very delicate. Surely I would break. She loved buying me short skirts, skin-tight pants and snug “skinny-rib” sweaters, loved how bracelets always had to be resized for my dainty wrists, how shoes were always too wide for my narrow patrician feet. She loved that my ballet teacher said I had a dancer’s body – look at my elegant Giselle! I learned early on thinness was something to be prized, displayed, celebrated. And yet I felt alien in our house; I couldn’t identify with my mother’s womanly body, all that curvaceous flesh. I did the laundry, and couldn’t understand her bras the size of colanders, the underpants I could fold in eighths. I couldn’t imagine how this would happen to me, someday. I felt both longing and fear.
It was my slender father, the other familial mutation, that I took after, and recognized as kin. It was effortless for him, too – I never once saw him exercise, and in restaurants the two of us loaded up on the butter pats and processed meats. He was a sculptor, and I’d watch him in his studio while he shaped the bodies of women in clay or wood, graceful nymphs poised in mid-float. Sometimes he’d ask me to model for him. He’d align my shoulders a certain way or ask me to tilt my head or arms, and I felt special that I could help him craft something so lovely. The women he sculpted were long-limbed, bare-breasted, slim-hipped; femininity, to me, wasn’t fleshy bulges and bulk, it was a ballerina form, bird-delicate wrists and a Scarlett-sized waist. I loved the women he created; I loved that I was, in a way, one of them.
But looking like a little girl when you are a little girl is one thing; looking like a little girl after all your friends hit puberty is something else. Overnight, what had always been so celebrated at home – my lack of flesh – became a source of self-consciousness and shame out in the real world. The gals with whom I’d shared flat-chested company suddenly burst into cleavage and curves, were wearing tube tops and getting admiring leers from boys, and I felt like a sexless, androgynous kid, excluded from the rituals of this new club, their foreign aura of womanliness. It was the era of Nadia and The Turning Point, and I tried to cling to the image of a gold-medal-winning trimness, the vision of a weightless dancer floating through air. But I was no jock, and I’d given up ballet – I hated any kind of exercise or physical exertion – and Kate Moss magazine covers and ubiquitous heroin-chic waifs were still years away. I waited and waited to look like those shapely girl-women, like my mother, my grandmothers – Just look at all the women in our family, my mother pointed out, Don’t worry, your time will come, but no. Even the doctor was flummoxed by my lingering undeveloped underweightness. Shopping with my mother, which had been such an occasion of pride for her and praise for me, became complicated – skinny-knit tops and boys-department jeans only highlighted how far I was lagging behind. Sleepovers and changing for gym created moments of misery, scrambling to change in and out of clothes in a bathroom stall or wedged face-front into my open locker. Of course, I wasn’t alone in my body-shame; all of us were growing miserable with some aspect of our bodies, our selves, feeling too tall or too short, hair too curly or too straight, breasts too big or too small, always too this or too that, never feeling quite okay. The friends now obsessing over diets and the calculus of calories, about their own ripening weight, began envying me my skinnyness and freakish metabolism, but I envied their visible signs of a femininity I feared I’d never achieve. At fourteen I stole a bra from a friend’s dresser drawer, stuffed the B cups with socks and secretly jiggled around my bedroom at night, feeling so attractive, so normal.
“You have great clavicles,” an early lover once said to me. I’d never heard that particular line of seduction before – this was still the time of modest girlish giggles and leaving my shirt assertively buttoned shut and Can we turn out the light, please?– and it startled me. It thrilled. He traced his finger along my sternum and collarbones and knobby shoulders appreciatively, lustfully, and How wonderful, I thought, to be admired for this particular feature! How clever of him to compose a compliment designed to make me feel I’d achieved the perfection of Lalique! He was the first man to tap me into my bones that sexualized way, to plant the idea that my unfleshy body could be a sexualized, desirable thing. He palmed the knolls of my hipbones to better position me, and I felt so praised, so proud, my womanhood finally confirmed.
A few years later, I decided to put that confidence to the test. At a party I overheard an art professor bemoan the challenge of finding figure models for the $50/hour fee – I volunteered. I told him I had some modeling experience, of a kind. I was flattered by his studied appraisal of me, his enthusiastic agreement. When I showed up at the brightly-lit, paint-spattered studio, I found myself facing a group of brooding art students expectantly clutching charcoal. In the dressing area behind a curtain, I hesitated, remembering the high school gym locker and department store try-on mirror miseries. When I emerged in a robe I was startled to see the professor wheeling in a human skeleton dangling on a hook. We’re doing skeletal study today! the professor told me, happy. I’m so glad you’re here, it’s hard to find a model where they can really see the armature! He posed the skeleton first, a position meant to display angles and joints and sculptural line. I dropped the robe and he posed me next, in twin-image, inviting the students to examine me from all angles, compare the shadows and light on our cleanly naked bones. Students scribbled away, and I liked hearing my body captured in those stick-scratchings and strokes. For an hour I arabesque’d and postured and realigned myself on cue, feeling glorious. Feeling endorsed.
Meanwhile, my mother was losing her battle of the bulge. By her late forties her body had taken on a mind of its own, and she gave up the fight, succumbed to a wardrobe of caftans you could paper walls with, and a diet of chocolate, cheese, and chicken skin. The pains and aches began, and she increasingly struggled to walk and stand and breathe. I bought her sugar-free candies and made her dinners of poached salmon and steamed broccoli. I discussed – okay, lectured her on – portion size, trans fats and the benefits of exercise. She’d nod in seeming agreement, grumble (not-so-)good-naturedly about the meager portions I served – Was I trying to starve her, ha ha! – and then restock her freezer with ice cream and Entenmann’s. Her vertebra began to fracture and compress, inflaming nerves and curving her spine forward into a frozen capital C, hindering an upright stance. Her blood sweetened and her joints swelled. She became indignant when I expressed concern over her hobbling gait, her labored breathing, when I pointed out her growing impairment and dependence on other people to do for her the most basic of tasks, and insisted she was perfectly fine – after all, she’d never had any cardiac problems, had she, her heart was perfectly fine! Which I had to, yes, despite the cognitive dissonance of it, concede. In the hospital for her first hip replacement she was shocked at her pre-surgery scale-tipping weigh-in – How could this have happened to me? she wept, as if her own body had crept upon her in a dark alley, as if reality operated by stealth. I was shocked by her shock – how could she not have seen what was happening to her? Good, I thought at the time: This is a wake-up call, Mom. It isn’t too late. But her shock was brief, followed by a return to self-delusion and denial, and a life of increasingly chronic pain and immobility, infantilizing dependency, imprisonment in flesh. Watching her suffer, I was torn between feeling sad and afraid for her, despair at my inability to make anything better, compassion-free resentment at having to take care of her, frustration at her unwillingness to face reality and do something to change, and a guilty relief that I’d never have to deal with such problems. I’d indulge in a celebratory escapist splurge on a cheeseburger and fries, sack out on the couch and appreciate all over again how lucky I was to take after my dad.
But my rail-thin father was doing battle with his body, too – it was just less visible. He had his first heart attack at forty-nine. I was thirteen, and at the time it seemed like nothing to worry about – I mostly remember the aftermath, how nice it was to find him reading recuperatively on the couch when I got home from school. He certainly didn’t look sick. And then, a few years later, another heart attack. And then chest pains every now and again, and those tiny nitroglycerin pills always kept on hand. Angiograms, to highlight in ink and sig alert his clogged vessels. Multiple angioplasties, to balloon open and prop artery walls apart. A quintuple bypass, in his seventies. Each event seemed so out of the blue, a freak thing; he always looked so out of place in the Cardiac Care Unit, the trim golden man among a bunch of sick old men. After each incident he’d shrug it all off, return to his exercise-free, ham-and-cheese omelet ways, the danger forgotten (denied) until next time.
A few years ago I stepped on a doorway’s threshold strip the wrong way and felt a hot, cracking flash in my foot: a slew of broken metatarsals. The ER doctor was, like my once upon a time pediatrician, flummoxed – Maybe your bones are unusually delicate, he suggested, Maybe you should go for a bone-density test, and I nodded happily, in seeming agreement. For weeks I showed off my freakishly broken foot and temporary impairment with pride – Look how that hard pea of a doorway has left princess-y me so battered and bruised! I didn’t need any medical tests – I just needed more calcium-rich dairy, I told myself. Bring on the cheese and butter! After all, I hadn’t gained an ounce of flesh in twenty years. I’m so lucky that way. I’m perfectly fine. Just look at me.
Then another accident: a ceramic tile floor, rushing in fuzzy socks, a fall and snap, a fat bulge of bone where it shouldn’t be, my left wrist abruptly sculpted all wrong. My poor, dainty wrist; again, I celebrated my feminine delicacy. I even welcomed the needed surgery, the precious drama of a tiny titanium plate and doll-sized nuts and bolts to piece eggshell-me back together again, the little Frankensteinlike wrist-pins and tender, suicide-hinting scar. At my post-op visit I asked the doctor how my bones looked to him, naked and exposed, the skin and thin flesh stripped away – I liked the idea of his fingering my radius and ulna, that he’d seen inside me that intimate way. But I didn’t get praise or admiration; this time, I got warning, and admonishment. How old are you, again? he asked, shaking his head. With your thin build and family history, you’re at high-risk for osteoporosis. When was your last physical? Why haven’t you had a bone density test? Why aren’t you taking supplements, getting any weight-bearing exercise? I mumbled something about those miserable chalky horsepills, about exercise being such a time-consuming sweaty bore, and hurried out with my wrist-stitches and splint. And this time my recovery brought with it a nauseating whiff of dependency and pain, and a lot of awkward struggle to do for myself, yes, the most basic of tasks. This time, I got scared. I flashed on my mother’s walker and wheelchair and bathroom cabinet packed with pain meds, her brutal, inexorable crippling; I pictured my father lying in bed in the Cardiac Care Unit after yet another procedure to remove arterial blockage, and for the first time I realized how much I take after both of my parents.
So, a few weeks ago I went for a damn physical. My bone density is indeed dangerously low; my cholesterol and blood sugar are freakishly high. Inexplicable chest pains earned me an inexplicably abnormal EKG, and a cardiac stress-test. How did this happen, I want to wail. My joints are feeling creaky and stiff; I get winded going up a flight of stairs. (Okay, that’s another lie, I don’t take the stairs.) And maybe I haven’t gained any weight since my teens, sure, but my lack of muscle tone has made for loosening, drooping flesh, and a radical redistribution of my body’s mass that for several years now, I realize, has subliminally urged me toward the clever, illusory scrim of loose linen tunics and elastic waistband pants. I am no tiny dancer, no sculpted sylph. I’ve indulged in the lifestyle habits of a loafing frat boy while grooming the façade of a gamine, and self-righteously celebrated how effortlessly lucky I was to get away with it all. But those days are over; I’ve gotten away with exactly shit. I have been so self-deluded and hypocritical, so fucking smug. My thinness has been a lie, a sleight-of-hand trick, a coat of paint to cover the drywall cracks and brighten up the room. I’ve never been healthy; I’ve merely been fat-free. I imagine chunks of plaque are now planning to break free from my corroded arterial walls and lay siege to my heart, blood clots plotting to restrict flow to my withering brain. I’ve lost an inch of height since my last driver’s license renewal, and I picture my vertebra shrink-drying to porous old sponge. I sense a bony dowager’s hump rising at the top of my spine, threatening my elegant balletic posture and upright stance. I envision slapstick I’ve fallen and I can’t get up! tumbles sending me to bed, to crippling pain, to slow and undignified deterioration, fluid accumulating in my lungs, infantilized imprisonment in my own scrawny flesh and my lacy Pogen bones. We’re all so fragile, the thickset and unpadded alike. I feel at the precipice of sickness, atrophy, dependency. Death and decay are eager to push me off the cliff, chomping at the bit. I see my sad, dirt-clogged skeleton dissolving to dust.
But paranoid existential terror isn’t such a bad motivator. It’s a good alarm bell, and I’m finally awake now, all right? I’m not going to wait for my luck to finally run out. I will challenge genetic predisposition to a duel. I won’t be snuck up on by my own stealthy self in that sinister dark alley. I refuse to be so delicate, so breakable – I’ll re-define my messed-up aesthetic, view functionality as the most desirable essence of form. Bring on the damn horsepills, the leafy greens and sour nonfat plain yogurt, the recumbent exercise bike to nowhere and those ridiculous free weights. I will grumble and groan and gross myself out with my own sweat, but I’ll do it. (Okay, I’ll at least try.) It isn’t too late, right?
Because the most dangerous part of my family history of flesh and bones, I finally understand, isn’t obesity or osteoporosis or diabetes or heart disease: it’s the alluring prick-tease of denial.
And I’ll still love my lovely clavicles, prominent and fine. I will care for them, and take them out on the town, display them with pride. I need to live up to their promise of elegance and grace. Vanity isn’t such a bad motivator, either. They are still my favorite feature, my prettiest illusion, my anatomical trompe l’oeil.