About a decade ago, I met two different folks who had lost a large amount of weight. The first was a young woman who had lost about 40 lbs and didn’t really have much more to lose; the second was an older woman who had lost 150 lbs and still needed to lose another 100 lbs, and had plateaued there.

A few months after meeting the first woman, she told me that she hadn’t been able to lose any weight until her doctor gave her a medication that essentially caused her heart rate to speed up all the time, so she was always burning tons of calories. Despite this truth, she spent a lot of time telling people (in person and through blogging) that she’d lost the 40 lbs through strict personal discipline, healthy diet, and exercise. She claimed that if she could do it, anyone could.

A few years after knowing the second woman, she suddenly began losing weight again, and dropped off that last 100 lbs. She started facebook groups dedicated to healthy living, citing her own willpower and determination over many years to lose all 250 lbs. If she could do it, anyone could. Except that behind the scenes, she’d had gastric bypass surgery, and after a long plateau, further weight loss surgery that enabled her to lose again. She didn’t tell anyone this as she sold them her services in mentoring and coaching them.

Here’s the thing. Weight loss is HARD no matter the circumstances. It’s hard to do by personal habits alone, it’s hard to manage on medications that do weird things to your body, and anyone who thinks surgery is an easy route is deluded. But in our culture, weight loss achieved by anything other than personal dedication and willpower is considered “less than” and “not real” for no reason other than fatphobic rhetoric that says fatness is a personal flaw caused by laziness and bad choices. We need to stop that crap. Weight loss is hard no matter what, and frankly, even with medical intervention, it’s often impossible to sustain longterm. Those women I mentioned above should have been able to be honest about how they got their results. I don’t blame them for not admitting the full truth (though I don’t condone selling your results dishonestly for profit). The more of us who speak the truth, the more we can work to end that fatphobic rhetoric.

Once upon a time, I did lose 100 lbs on my own willpower and determination. It took over three years, and it was extremely difficult. A few years later, I began gaining weight out of nowhere for reasons my doctors and I still haven’t fully determined, though we have a better idea now. I’ve been unable to control my weight in any way since then, regardless of how I eat or exercise. Altogether, I gained 120 lbs in two spurts (70 then 50), and the last 50-lb spurt put me over a line where my body no longer functions well. There’s pain, there’s the beginning of problems in my blood work, etc. I’ve lost mobility, and I struggle to do very basic things due to pain.

So two months ago, I spoke with my doctor and the two of us began to make a plan to hopefully help me lose weight via medical intervention. Because frankly, I don’t care how I get back to a point where I’m pain-free again. I don’t need to be super thin – I just want to be mobile and out of pain, and to have my body back on the right track again, the way it was two years ago. I won’t let fatphobia or shame or a feeling of failure to do this on my own prevent me from getting there. And I’m not going to pretend I’m doing this by my own grit and determination. I need help, and there should be no shame or guilt in accepting that help.