My Biologic Width, My Self

A few years ago, I was a guest at a family wedding, along with many relatives I had not seen in years. As I made my way between the tables at the reception, I could hear the sounds of various aunts, uncles, and cousins whispering, commenting on everything from my choice of dress to which of my parents I bore a greater resemblance to. But I stopped in my tracks when I caught wind of the following conversation:

Cousin: “What’s her name again?”
Uncle: “Don’t be silly. You know Diana.”
Cousin: “Oh, right. I have to remember it this way: Diana is the one who looks like Misa, except Misa is thin.”
Aunt: “That’s how I remind myself which one she is, too!”

Ouch.

Not, “Diana, the one who lives in New York City.” Not, “Diana, the one who wants to be a dentist.” Not even, “Diana, the one who spent her formative years cycling through a series of unflattering permutations of Jennifer Aniston-inspired haircuts and has never fully recovered from the psychological ramifications of those decisions.”

Nope. “Diana, the Fat One.”

I went back to my hotel room that night and took a good look at my naked body in the bathroom mirror for the first time since my mother sat me down in the fifth grade and explained that my pre-pubescent body was about to go through some changes. (I am still eagerly awaiting the arrival of my breasts, Mom. Seriously, where ARE they?)

When did I gain so much weight that it had become the defining characteristic that people most liked to attribute to me? How long had this been going on? How did I, a detail-oriented and esthetically-driven healthcare professional-in-training, let this happen?

Friends and family offered mixed reactions whenever the subject of my weight was broached. I heard, “WHAT?!? Who said you were fat?? SIZE EIGHT IS NOT FAT!!” I also heard, “Your butt got huuuuuuuge! NOBODY should be as big as you are right now!” One male classmate even said plainly that he didn’t think a girl should ever weigh more than 110 pounds, period. That a well-educated man of the 21st century could look an equally well-educated woman square in the face and say something that shallow and asinine was shocking and disgusting to me.

According to the National Institutes of Health’s guidelines for calculating body mass index (BMI), I was still firmly ensconced in the “normal” weight category. But even when the good folks at the NIH say you’re doing fine, it’s hard not to notice the looks being exchanged by those around you when you bite into a cupcake or pluck a sample from a box of chocolates.

It saddened me to know that so many people would rather focus on the circumference of my hips and ignore the achievements I had worked so hard to call my own. No matter what I accomplished as a student, doctor, or modern woman, the accolades were worth far less because everyone could see that my weight had strayed from our culture’s widely-distorted perception of ideal. Even though I had experienced success in ways that people two or three times my age never do, I was still partially a failure because I wasn’t doing it in a skinnier body.

At some point during my pursuit of a DDS, maintaining a healthy weight took a backseat to my academic and career aspirations. My metabolism, which had previously been functioning at near hummingbird-efficacy throughout my teenage years (despite an aversion to athletic activity that resulted in a relatively sedentary lifestyle), had gone into sharp decline.

Adding scrubs and sweatpants to my daily dental school wardrobe probably didn’t help, either. You don’t realize that your waistline is slowly expanding when you wake up every day and slip on billowing, shapeless drawstring pants that would make even a Brazilian bikini model look tired and sloppy.

I was not a person who liked to go to the gym to relieve stress before an exam because I felt that whatever time I spent working out would be far better devoted to locking myself in my room and devouring pan-Asian takeout while attempting to memorize information that my professors insisted would be absolutely critical to my success as a clinician. (Oh. For the record? “I trust you to take care of my teeth because of your readily apparent grasp of the Krebs cycle!” said no patient, ever.)

Some doctors say that their diplomas reek of blood, sweat, and tears. Mine probably smells of pad thai and fish sauce.

The ritual of grocery shopping became deeply depressing when I reached the checkout aisle, where cover after magazine cover glamorized borderline anorexic celebrities known for displaying atrocious behavior in the media that clearly indicated a lack of moral compass and intellect. With all my smarts and education, how was I being bested by airheads and bimbos in the weight loss game?

Why couldn’t all the brainpower and discipline I so artfully applied to mastering a foreign language or studying for the SATs be used to unlock the secret to fitting into size 0 pants? How is it that the same society that calls on highly intelligent women to meet the feminist directives of leaning in, fighting back, and moving up also chastises them for not slimming down to unhealthy proportions to meet unrealistic expectations?

It wasn’t until I finished my residency that I made a truly conscious decision to get in shape. It was important to me that I did it for all the right reasons: to embrace a healthier lifestyle overall; increase my strength and flexibility; and derive some actual enjoyment out of being active that would hopefully lead to a happier, more confident me. I resolved not to let the opinions of others be the driving force behind my quest for self-improvement.

In dentistry, the concept of biologic width is founded on the belief that any attempts to restore or improve health, function, and esthetics have to be done thoughtfully, deliberately, and in a manner that respects the existing anatomy and underlying substructure. The way I see it, this philosophy should also be used as a metaphor for the rehabilitation of the person as a whole. Before we start making aggressive changes to what everyone else can see, we first have to take stock of how those changes will affect what’s going on underneath. This will help ensure that our modifications will result in a healthy and sustainable outcome, rather than one that may lead to relapse and potentially destructive consequences.

I began my physical transformation by experimenting with different workouts and fitness classes while making sensible adjustments to my diet and adopting a willingness to try new things. I soon learned that in weight loss, just like in dental care, any product or service that promises drastic, miraculous changes after just one use is almost always too good to be true. Truly lasting results require methodical application, excellent compliance, and remarkable patience.

Was it easy? No way! First off, I am not one of those girls who loves working up a sweat and feeling the burn. I am one of those people who nervously approach a machine at the gym, take far too long to figure out how it works, and manage to injure themselves just trying to adjust the seat.

There are likely a myriad of amateur videos of me falling off stationary bikes and treadmills floating around on the Internet, posted by onlookers who couldn’t resist whipping out their phones to capture footage of my awkward and unfortunate lack of coordination. Eventually, I learned to take these embarrassing moments in stride (but still told everyone that the scrapes and bruises were from a particularly tough kickboxing session).

Over time, these little changes in my routine started to have a big effect on my energy level and self image. Though the pounds were slowly melting away, the real weight that was lifted was the burden of thinking that I had no control over the shape of my body. It was a wonderful, liberating feeling.

My weight loss journey is far from over, but I have faith that I am headed in the right direction. I have accepted the fact that while there will always be people who will judge me for not being thin enough, the adjectives they use to describe my external appearance matter not.

Although the number staring back at me on the bathroom scale may go up and down, what’s important is that my commitment to making healthy choices, staying optimistic, and maintaining an active lifestyle remains unwavering. I strive for excellence, moderation, and balance in all areas of my life, on my own terms. I continue to surround myself with people who are loving, supportive, and see the good in me, at any size.

And that, my friends, is a beautiful thing.

Diana Nguyen, DDS