Hot Mess Hubby and I had the talk a few weeks ago. We were talking about my struggles with food…and working out…and my weight. And he said the words that a lot of spouses are probably afraid to say.

“Babe, I’m not being mean…but at some point, don’t you have to think about surgery?”

Yowch. I’m not going to say it didn’t hurt to hear that – but after ten years of marriage, HMH knows how to take the sting out of his words. Pretty much.

He was speaking out of love, not malice. He’s watched me struggle with this for a long time now. Any normal person would be thinking “When is it going to be enough for you to just do it?” There is no pressure attached to his message, no impatience or intolerance. He loves me. He’s worried about me.

We’ve had this talk before. A few times. In the beginning, it was just my crazed ranting against surgery because I was watching a friend (or two or three) go through it without using it as a tool for healthy living. I know many people who’ve had weight loss surgery and gained it all back because they didn’t change what was really important: their thinking.

I’ve seriously considered surgery twice in my life. About five years ago I made an appointment with a local surgeon and then cancelled it the day before. Two years ago, I made an appointment with a different surgeon and kept it. I went through the entire screening process, passed the psych exam (shut up, I totally aced it), and was awaiting insurance approval when I stopped the process and decided not to go through with it. Why? Because I lost weight on my own.

Ever since the first of many of my friends had weight loss surgery, the option of doing it for myself has hung over me like a dark cloud. At one point in my life, all my closest girlfriends had done it. I lived in a world where they were so excited about their amazing weight loss that they couldn’t stop talking about it…and then they started giving me their clothes that were too big for them. As happy as I was for them, it was absolutely crushing.

There have been times when I’ve felt surgery was inevitable. There are moments when I think…what am I waiting for? How long am I going to struggle in vain before I realize that I’m just not strong enough or tough enough or smart enough to change myself?

And that’s when the answer comes. No. I’m not having surgery.

I admit it: there was a time in my life when I looked down at people who decided to have weight loss surgery. I haven’t felt that way about it for a long, long time. I understand it for what it is: a tool. I have nothing but love and support in my heart for those who choose surgery – because I’ll tell you what: unless you’ve been morbidly obese, you have no idea what this is like.

Surgery has a bad rep because there are many weight loss surgeons out there who are smarmy as hell. They get excited when they see a fat person just like a personal injury attorney gets excited when they see an accident victim. These surgeons don’t care how you gained it or why you want to lose it. They don’t care if you’re emotionally ready for it. They care about whether you have insurance or can qualify for easy financing. Weight loss surgery has become Ritalin for fat people – and that’s why it has a bad rep. I know women who have been told to gain 20 pounds in order to qualify. And I know someone who’s done exactly that.

I also know people who have had weight loss surgery and say it’s the best decision they’ve ever made in their lives. They’ve kept their weight off and they live healthy, active lives now. It’s a combination of being ready and finding a decent doctor that results in a positive, lasting experience. It’s just not for me.

I’ve pretty much fixed the inside of me. And I’m pretty damn confident that I’d be successful if I elected to have weight loss surgery. I still can’t do it. Not because I’m afraid, but because I have something to prove.

I think back to that ten year old little girl I was when I first learned what fat was. I think about the way I grew up: believing that I wasn’t enough. I wasn’t lovable enough, smart enough, pretty enough, skinny enough. (Yes, I do realize I sound like that idiot from Saturday Night Live.)

I’m just not going to tell myself that I’m not tough enough to do this the way I feel I need to do it. I’m not going to think about that ten year old kid in that mirror and know that my rotten bastard of a dance teacher was right: that my best is not good enough.

I’m not going to say that to myself. I’m just not. I would rather hurt on the elliptical than hurt in a recovery room. So it’s for her that I’m doing this…that ten year old little girl who just needed someone to stand up for her. I can’t just fix her with surgery. I have to show her that she really was enough.

The path you take to living a healthy life is a very personal one. Whatever road you choose, I wish you a safe journey…and fierce success.

Courage: Overcoming Fear and Igniting Self-Confidence