Healthy at My Size

I’ve written previously on the extremely delicate issue of Thin Privilege. Well, I didn’t get too much hate for that, so I’m giving it another go! In the news recently, we heard that Gigi Hadid had received comments about her being “too thin.” In her response to the haters, she revealed that she’s undergone a noticeable change in weight due to treatment for a thyroid condition. She shouldn’t have had to justify her existence in the first place, let alone divulge personal medical information, but I suppose it’s done something to educate the public about the condition. Most younger people won’t know that much about it, as it doesn’t tend to affect young people.

It mainly develops in middle-aged women, but some unlucky sods like Gigi Hadid, and me, get to appreciate its unique features a good 30 years before everyone else. And this illness is a right pain in the proverbial. One of the things it affects is a person’s weight, but there are plenty more surprises that the disease has in store for you. But let’s begin with that one.

People with an underactive thyroid (which is a feature of both Hadid’s condition, and of mine), tend to gain weight more easily. People with an overactive thyroid will lose weight more easily. Some conditions, like Graves Disease, mix up the under- and over-active elements, like a crazy metabolic rollercoaster, which must result in a lot more clothes shopping trips (I’m not trying to make it sound good, honest I’m not!).

So why has Gigi Hadid lost weight if she has an underactive thyroid? If she’s recently started a new or different course of medication (which she says she has), then it will have supplemented the missing thyroid hormone in her body, and regulated her metabolism properly. Hence—weight loss. But I find that there is more to it than that alone (I can’t speak for anyone else, only my experience).

We should all be trying to keep as active and healthy as we can, but I notice that I’m more adversely affected by not exercising and eating well, than I once was. And the change all seemed to happen in my early 20s, a time way before you expect middle-aged spread to occur. I got diagnosed when I was 25, and all the parts of the timeline seem to fit together around that. Anyway, as well as finding myself prone to gaining weight (both prior to, and after, diagnosis and treatment), if I am carrying a little extra fat, then it makes all my other symptoms worse. So it really pays for me to keep my weight at the lower end of the normal range. It’s not particularly fun (I really, really like cake) but overall it’s the best compromise. I can either be functional or fat; annoyingly, the two are mutually exclusive for me.

So what about those other symptoms? In spite of my light-heartedness about it, thyroid disorders are very serious. It’s possible to die from it, if left untreated. This is why people with hypothyroidism (hypo- means under, hyper- means over) get all their medication free on the NHS. Turns out, we are more beneficial to society when we’re alive and paying taxes. If I stopped taking my medication, I’d get more and more sluggish and sleepy, needing more and more hours of sleep and unable to do much with my waking hours. Eventually I could fall into a coma and die, which is far from ideal, for me at least.

The main symptom I have is the frequent tiredness, and lack of energy when I am awake. Pre-diagnosis, I was mentally and physically exhausted, and sleeping up to 16 hours at night. I need at least nine hours sleep even with treatment, and my body clock is a law unto itself. I’ve learned to embrace it rather than battle against it, as the guilt and disorientation I experienced in trying to adapt my body’s natural pattern to suit that of society’s (and an employer’s) expectations just made me even sicker. I was doubly exhausted, stressed out, and still not getting anything done. I’m partly nocturnal now, and since I stopped worrying about it, my life is more “normal” than it’s been in ages.

Returning to the subject of weight gain and loss, I am prone to cravings and weird eating patterns, which makes things a lot more complicated. I try my best to be sensible and disciplined, but sometimes I let my instinct get the better of me. And I still really, really like cake. But as I mentioned above, my dodgy eating habits contribute to my issues with managing my weight and other symptoms. And that’s not the only way this condition is self-reinforcing.

Depression is a symptom of hypothyroidism, as if depression weren’t bad enough as a separate condition! As well as the soul-sucking listlessness that comes with depression, it’s also an illness that tempts you to overeat. Even worse, many psychoactive medications have weight gain as a side-effect. That’s triple the temptation. It’s a miracle I’m not the size of a house.

Hypothyroidism has other ways of making you feel like crap. It affects your appearance, too. Your hair becomes thin and lifeless, your skin can become flaky and delicate, and your nails brittle. If you’re unlucky, you’ll get cramps in muscles you never even knew you had—which doesn’t exactly encourage you to get out of bed, raring to go. I suffer terribly from the cold, and I’ve seriously considered moving abroad to a climate more suited to my constitution. It makes me sound like an old Victorian lady… I quite like the idea of having a fainting couch, though. It could come in handy when I’m feeling a bit under the weather.

It causes a general feeling of malaise, and the brain’s not quite as quick as it should be. I’ve heard it called “brain fog,” and I think that’s a good description of what it feels like. It’s difficult to tell whether these symptoms are related to the underactive thyroid, or the depression, or even if one precipitated the other. When you feel that crappy, it doesn’t really matter. Everything is awful. And if you were to offer some well-meaning advice, especially about my weight, well, let’s just say it would not be gratefully received.

Given what I have to work with, I think I’m doing pretty well just to remain productive and alive. My relationship with food and my body is complicated—hell, my immune system is slowly eroding my thyroid gland, so I have a real battle on my hands. Sure, Gigi Hadid’s a model, and they’re the prime target for comments about thinness and how healthy the armchair medics think they are. But it’s more complicated than that—it’s not just overweight people who can blame their size on their glands. The safest option when criticising someone’s weight is… don’t. Just keep it to yourself. You don’t know what they’re dealing with, and irrespective of that, it’s just plain rude. Women’s bodies don’t need to be put under any more scrutiny, and unsolicited comments and advice do not help anyone.