The Body Relationship

Writing about body image in the aftermath of chronic illness has me overcome by how much shame encases this subject. To varying degrees throughout our lives—often starting when we are very young--our sense of physical self is influenced and challenged. We seek the “right” labels and permission to feel good just as we are.

But knowing this doesn’t exclude us from having a complicated relationship with our bodies. For me, it is painful and confusing to face how negatively I still see my body and how all the accoutrements of chronic illness have further complicated that. 

Chubs

I wish I could sit here and tell you that now, in my late 30s, I start and end each day comfortable in this physical body of mine. Unfortunately, that isn’t the case and I don’t really know when it has been. There are times when I still feel like an insecure, chubby kid. Like so many women—and men—I know I have a skewed perception of physical self. There’s no better evidence of this than when I see photos of myself in my 20s. I can take myself back to each snapshot and remember believing I was so unattractive. And now, I could kick myself for not loving the way I looked more. 

When I was 18 years old, I was told that I may have body dysmorphia. This was a total surprise. I had no idea what that meant, but the fact that there was anything unbalanced or unhealthy about how I treated myself never even occurred to me. In my late teens, I had stopped giving my body, and how it looks, much attention: I wasn’t “letting myself go,” but I gave up on the hope that on the other side of puberty, I would metamorphose from the ugly duckling into a regal swan. It was easier to dismiss my body than to face the pain of how I felt in it.

This self-negation is not something that happens overnight. With adult eyes, I can look back to my adolescence and pinpoint a number of factors that made me understand this widely accepted truth: being overweight in any way, shape, or form is unattractive and fundamentally wrong. From "heroin chic" supermodels and monochrome Hollywood starlets to my stick-thin pediatrician who year after year—no matter what my size—told me that I needed to lose 20 pounds to the affectionately-intended but hurtful family nickname that is the English equivalent to “chubs” to being surrounded by skinny white girls at school--what I gleaned about my body from a young age was how unattractive it was and how ashamed of it I should be.

Beyond weight

Feeling like an ugly duckling goes beyond weight. The scale played a huge part in how I saw myself. But then there was also the fact that I had been born to an undeniably beautiful woman and I felt I was a very poor reproduction of her. I remember at one time, my mother was volunteering at my school library and I stopped by to say hi. A fellow mom looked from my acne-stricken face to her flawless, smooth complexion and said, “This is your daughter?” I can still feel the sting of her reaction. 

I never strived for beauty because I felt it was out of my reach. And strangely, I never made a true connection between beauty and my body. There were just the facts. Facts like I am not beautiful like my mother and therefore I am ugly. I am overweight and therefore I am ugly. My hair isn’t naturally straight and therefore I am ugly. 

My body had become the enemy, not contorting itself into the socially acceptable shape and size that would no longer call attention to my flaws. 

The chronic illness effect

By the time I was diagnosed with trigeminal neuralgia (TN) in 2017, I was technically in the second best shape of my life (the first being in my mid-20s). Daily 60-minute workouts and a WW membership had helped me drop 20 pounds that had had me in a near-vise grip since a difficult three-year tenure in Mumbai. I felt strong in my body, but I was still negating it—albeit in a different way. I allowed myself to be more self-complimentary (in private, of course), but I didn’t want my body image to be of primary importance in my life. 

This was hard to do though. The changes in my body were obvious and my hard work was consistently praised with pride. This reiterated the messaging from my girlhood and, though I was an older, wiser adult, it was hard to shake the same thrall this body spotlight can have.

Then chronic illness happened. Suddenly, my body was no longer just for superficial appreciation. TN reminded me, in the cruelest way, that this body is the home and engine of my life. From the day I was born, this body has been full of vitality, using its cellular intelligence to refresh and heal itself constantly. And now I lived in the precarious, anxiety-inducing position of not quite understanding what was happening within. 

Chronic illness replaced one pressure with another. The pressure to lose weight and look good was replaced with the pressure to take the best care of myself I possibly could. That did include a healthy diet and exercise, but more than anything, that included making sure my body was strong enough to do what it needs to do to work through the 24/7 pain it must contend with. 

For this reason, I started to love my body without condition or complication. 

Side effects

The challenge to my newfound body appreciation are the side effects of TN and my medication. For the first year or so after diagnosis, I had to get used to how low my energy was, how regularly I was exhausted. This limits what I can reasonably expect to manage every day, but I set my priorities early on. And my first, second, and third priorities were my health and wellness. 

All medications, even the mildest prescription, have side effects. The medication I take, gabapentin, is one of the milder medications used in the treatment of TN. But the side effects are real and present—even now, after more than two years of taking it. Dizziness and fatigue are most common, but there are also some uncommon side effects, like temporary short-term memory issues and weight gain. 

Taking medication multiple times per day every day already requires acclimatization. My medication allows me to function despite intense pain, but that doesn’t mean that it was easy for me to feel good about having to rely on it. I got used to it, side effects and all. I accepted how it affects my memory and was grateful that it hadn’t (yet) affected my weight.

Of all things to worry about, that again. 

And then it started to. What no one tells you about chronic illness and medication is that a side effect like “weight gain” is a function of two things. The first is a direct consequence of the medication itself and how its biochemistry interacts with your physiology. The second is that if your condition affects your energy levels and you’re living with acute pain, you won’t be as active as you would otherwise be. The result could very well be weight gain. That’s been true for me in the past year.

In some ways, knowing that I’ve gained some weight while dealing with this illness has been more difficult than the illness itself. Like muscle memory, it brings back a lot of old thoughts and feelings, and compounds the way I see my body. I am still grateful for everything my body does for me, but I am also yo-yoing between a neutral and negative body image, which I frankly find heartbreaking at this stage in my life. 

Body positivity?

We live in a time when body positivity has taken root in social media and reached out to coax a new, more generous appreciation of the diversity of our bodies. I love the intent behind this, but it isn’t second nature just yet, especially when you live with chronic illness.

TN may have taught me to be more body positive by honoring the vitality of my cells, organs, and physiological systems. It may have shown me a better way to love this vessel that has been with me every single day of my life. But it has also asked me to revisit old patterns and recognize the chinks in my armor when it comes to loving what my body is right now. 

And some habits really do die hard. I can be hyper-critical of how my body looks, which is a doozy given that as we get older—and we’re all getting older—our bodies change. Some of those changes can be such hard pills to swallow though. Every quarter when I see my doctor and my vitals—including weight—are taken, I try my best to not affix too much or too little importance to the numbers on that scale. Every time I look in a mirror, I have to curb the urge to look away in disgust at fine lines, stretch marks, or more prominent veins. I have to fight the tendency to negate what my body does and means. 

This is really about you

I’m learning that what my body means to me may be more important than anything else when I consider my relationship to it. So much of the external noise that has informed my—and all of our—body relationships has actually done more harm than good. I’m not saying to dismiss any red flags the look and feel of your body are sending you. However, I am suggesting that only you can affix meaning to the look and feel of your body right now. 

No matter what, it’s worthy of love. 

There is no number on a scale that will tell you that you’re beautiful and worthy. There is no diet that can make you feel more comfortable in your own skin. There is no state of health that will have you living perfectly. 

Living with chronic illness means you’re constantly redefining your body relationship. You’re continually learning, unlearning, and re-learning your body’s look and feel. It’s a painful yet solid reminder that we are always changing. It’s the only thing we can truly count on. And in the course of all that change, do we want to be diminishing our importance or celebrate what is actually important?

I want you to know that it’s okay for you to have complicated feelings about how your body looks or feels, about how your condition has changed you, about how your medication has affected you. 

I want you to know that despite everything, your body is glorious. It is resilient. It is knowledgable. It is a credit to who you are, inside and out. 

You can choose to love yourself now through and with all your limitations, aches, pains, wrinkles, flubber, and imperfections. You can choose to show yourself the love and compassion your body deserves. There is that saying that the body is a temple, and I know that is usually said as a way to keep your body clean. 

But I believe that it's a reminder that no matter what, your body deserves respect. Respect for all that it has done for you and will do for you. It will be your loyal companion to your dying day. And even if it is malfunctioning to lesser or more serious degrees, start to look at it with more gratitude and understanding and love.