Here’s a topic I’ve never written about, but totally is related to my DID symptoms.

I am obese. I am 150 lbs over the normal weight range for my age/gender/height. If you’ve seen pictures of me, this might shock you, because from the neck up, I don’t look it (pretty standard for the medical condition I’m about to explain).

Medically, I have extreme problems losing weight because of metabolic problems associated with hormonal imbalances and insulin resistance. I am not Diabetic, but I have been diagnosed with PCOS since I was 19 years old and the weight gain began.

Because of my metabolism issues and hormonal imbalances, I have to work 2x the amount another person does to lose weight. It’s double the effort for me. Losing weight is very slow, and it gets very disheartening when we hit “plateaus” because then it’s also twice as long to get off that plateau and lose weight again.

PCOS aside, obesity as we know is a leading factor in shortening lifespan and contributes to things like developing Type 2 Diabetes, High Blood Pressure, and Heart Problems. It’s no coincidence that those with PCOS end up having a high comorbidity with these disorders.

Since COVID and spending all my time at home, I’ve put on about 20 lbs. I’ve fallen into mindless snacking habits, and my exercise has been inconsistent at best. Most days are very sedentary.

Let me break down the struggle of these two big things: mindless snacking & lack of physical activity.

Mindless Snacking

1. Poor impulse control – Let’s face it, our child parts don’t exactly have the greatest of impulse control. If they see a Reece’s cup, they want it. And they don’t give up until you do.

Other kiddos self-soothe by eating foods they find pleasant, often not the most nutritious or forgiving when dealing with insulin resistance. Think pizza, candy, chips, cookies, ice cream.

Either impulsivity or switching…it always takes the wheel and devours snacks before my brain has a chance to catch up and say “Noooo!”

2. Dissociation & disconnect from the body – Lots of folks with CPTSD struggle with feeling connected to their bodies. Because of the trauma done to our bodies, it makes sense that we started to disconnect from what our bodies were telling us. Sometimes it was physical pain which was too much to bare. Other times it was the confusion of pleasure while being sexually abused.

So none of us in our system are particularly skilled, therefore, at knowing things like: when we are thirsty, when we are hungry, when we are tired. Until it hits the extreme: dry mouth, stomach grumbling and empty, or completely fatigued.

For us, things like boredom, anxiety, loneliness — we turned to food as children to attempt to meet a need at dealing with these internal sensations. After doing that our whole life, it’s more than a habit that needs to be broken. It’s a survival skill that needs to be retrained. Now try explaining that to kid parts who still think they are being abused!

3. Dopamine – I’ll probably never know why I can’t live without antidepressants. Was I predestined due to a hereditary problem? Was it being born premature that caused a dopamine deficiency? Was it the trauma of a premature birth and ongoing chronic childhood trauma that screwed up our dopamine levels? I’ve been on these pills since I was 17. Have I messed up my brain permanently so it is dependent on antidepressants? Which came first, the chicken or the egg…and is one more important over the other?

Well, one thing we know for sure is our dopamine deficiency has a big role to play here.

A person with adequate levels of dopamine can typically stop himself from eating an entire box of cookies. Someone with low levels does not receive the brain signals alerting him to potential long-term harm — the brain focuses only on how delicious (and stimulating) the cookies are right now.

On days I am appropriately taking my medication, I do notice I regain this rare ability to say “meh I really shouldn’t eat that right now.” So, Nel, why don’t you take your medication as prescribed all the time, then? Well, again, it’s a multi-pronged issue. Maybe another part was forward during medication time, and didn’t know we needed to take meds. Maybe yet another part was forward who took the meds appropriately, but since they don’t need the meds, it doesn’t have its normal impact on the body. And sometimes I even consciously decide not to take a medication, particularly the more physically addicting ones (like stimulants) because although they work, they also give me high blood pressure. I try to take them sparingly.

Lack of Physical Activity

Again, there are sooooo many reasons why we revert to being sedentary. Many of them are connected to CPTSD and trauma triggers. The feeling of shortness of breath, being unable to breathe, heart pounding, sweating/feeling hot. I can’t think of one thing with exercise that doesn’t trigger trauma.

So it’s understandable why we would avoid it like the plague.

That sort of stuff has been manageable, though, through therapy. Between processing the trauma memories associated with the triggers and using symptom management skills, it’s become a surmountable problem.

The real problem here, for us, is one thing: DID & Time Management

Physical activity requires planning: when am I going to do it? It requires sticking to it. Both starting a new physical activity and keeping up with it is beyond difficult.

Even if we sit down and take the time to plan and organize our schedule to fit in physical activity, our brain may simply “lose” the information. Between switches, perhaps the information is not passed along, or only pieces are passed along causing confusion. In everything we do, we have a very difficult time remembering to do things.

If we write information down, that gets lost too. We will forget where we placed it. Maybe it falls on the floor and we don’t see it. We’ve even tried making notes on our phone or computer, but then parts don’t remember to check them. There have been times we have set reminder alarms and the part doesn’t remember or understand what the reminder is for.

The takeaway here? We’ve got a lot of obstacles between our medical issues, neurotransmitter deficiency, CPTSD, and DID. I’m not sure how to tackle the issue of “losing weight” from all these angles. It seems so overwhelming. I have difficulty deciding what to do first.

But I’ve got to do something. I weigh now more than I ever have. I’m starting to have mobility issues, and I’m not even 40 yet! I hate that I can’t go on some amusement park rides because my body doesn’t fit. I want to be happy with who I see in the mirror. I want to live.

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