Teenage Waistland
This is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously. Any resemblance to actual persons, living or dead, events, or locales is entirely coincidental.
Copyright © 2010 by Lynn Biederman & Lisa Pazer
All rights reserved. Published in the United States by Delacorte Press, an imprint of Random House Children’s Books, a division of Random House, Inc., New York.
Delacorte Press is a registered trademark and the colophon is a trademark of Random House, Inc.
Visit us on the Web! www.randomhouse.com/teens
Educators and librarians, for a variety of teaching tools, visit us at www.randomhouse.com/teachers
Library of Congress Cataloging-in-Publication Data
Biederman, Lynn.
Teenage Waistland / by Lynn Biederman and Lisa Pazer.—1st ed.
p. cm.
Summary: In their separate voices, three morbidly obese New York City teens relate their experiences participating in a clinical trial testing lap-band surgery for teenagers which involves a year of weekly meetings and learning to live healthier lives.
eISBN: 978-0-375-89722-1
[1. Obesity—Fiction. 2. Clinical trials—Fiction. 3. Self-esteem—Fiction. 4. Family problems—Fiction. 5. New York (State)—New York—Fiction.] I. Pazer, Lisa. II. Title.
PZ7.B4743Tee 2010
[Fic]—dc22
2009049672
Random House Children’s Books supports the First Amendment and celebrates the right to read.
v3.1
FOR ERIC—FOR EVERYTHING
—L.B.
FOR MUMSY, SHELLEY PAZER, WHO NEVER STOPPED BELIEVING
—L.P.
Lisa is grateful to:
Stephanie Lane Elliott, our long-suffering editor at Delacorte Press, whose wisdom and insight pushed us deeper into our characters and lifted our story to creative heights we had no clue we were capable of. How does anyone write without you?
Ginger Knowlton, our agent at Curtis Brown, for her tireless efforts and enthusiasm on behalf of Teenage Waistland.
My scrumptious sons, Jake Sherman and Alex Sherman; Shelley Pazer; Doug Sherman; Sari Sunshine; Sam Sherman; Beth Bradford; Josh and Jamie Bradford; and the rest of my family and friends. You’re the best cheering section anyone could ever hope for!
David Bradford, for being my sounding board and impact attenuator throughout the writing process, but mostly for never letting me go without a cooked meal during crunch time.
My sister Dina Bassen; Todd Bassen; James Bassen; Alana Bassen; and Gregory Bassen, for that transformative holiday dinner where your love, support, and brilliant suggestions (go, Alana!) renewed my inspiration and energy for the book, just when I needed it most.
Early readers Chelsea Baken, Gaby Biederman, Lori Snow, Deanne Conrad, and Tami Yellin, for their sage advice and enthusiasm.
And most of all, Lynn “Non-Lynnear” Biederman, my co-author and friend, for one of the best adventures of my life!
Lynn is grateful to:
Superbly talented Stephanie Lane Elliott, senior editor at Delacorte Press, fellow foodie, and friend, for guiding us in your articulate and patient way. Like Unraveling, Teenage Waistland has benefited from the fine editorial hand that shaped it.
Ginger Knowlton, for her enthusiasm for Teenage Waistland right from the start. Years ago, when I heard you say agents and authors are like doubles partners, I knew you were for me.
Brilliant, beautiful daughter, Gabrielle, for her book advice, boundless encouragement, and energy—I mean really. Wonderful, special, second-to-none son, Brad; husband and best friend, Eric; brother; parents; aunts, uncles, niece, nephew, cousins, etc.
Rob Newborn, superb friend and Doc, for always coming through, and Dr. Jeff Zitsman for his incredible generosity and expertise.
All my friends, old and new, local and not, Union buds, Ladybugs, and tennis pals for the happiness and true awesomeness they bring to my life. If there was ever a competition for who has the most fabulous circle of friends, I would snap that trophy up easy as pie.
Last, but not in any way least, my coauthor, Lisa Pazer, for relentlessly insisting on making TW great, for her relentlessness in general, and yes, for her insistence too, but above all, for her sheer greatness.
Contains an afterword by Jeffrey L. Zitsman, MD, director of the Center for Adolescent Bariatric Surgery at Morgan Stanley Children’s Hospital
Contents
Cover
Title Page
Copyright
Dedication
Acknowledgements
Chapter 1 - Cattle Call: Sunday, May 3, 2009
Chapter 2 - Being Morbid: Sunday, May 3, 2009
Chapter 3 - Moobies: Sunday, May 3, 2009
Chapter 4 - The Cheat Sheet: Sunday, May 17, 2009
Chapter 5 - Evaluating Psychos: Thursday, May 28, 2009
Chapter 6 - Taking out the Queen: Tuesday, June 2, 2009
Chapter 7 - Under Cover: Saturday, June 6, 2009
Chapter 8 - Everybody in the Pool: Wednesday, June 24, 2009
Chapter 9 - Foodaholics Anonymous: Friday, June 26, 2009
Chapter 10 - Lord of the Fries: Friday, July 3, 2009
Chapter 11 - Filling Boxes: Sunday, July 5, 2009
Chapter 12 - Teenage Waistland: Friday, July 10, 2009
Chapter 13 - A Gift for Liselle: Friday, July 10, 2009
Chapter 14 - Chow and Fun: Friday, July 10, 2009
Chapter 15 - Coming of Age: Sunday, July 12, 2009
Chapter 16 - The Last Supper: Monday, July 13, 2009
Chapter 17 - Going Under: Thursday, July 16, 2009
Chapter 18 - Hotstuff: Friday, July 17, 2009
Chapter 19 - Happy Graduation, Liselle: Sunday, July 19, 2009
Chapter 20 - Least: Monday, July 20, 2009
Chapter 21 - An Unexpected Play: Tuesday, July 21, 2009
Chapter 22 - Hot & Sour: Tuesday, July 21, 2009
Chapter 23 - Invasion of the Body Snatchers: Tuesday, July 28, 2009
Chapter 24 - Konopka & Son: Tuesday, July 28, 2009
Chapter 25 - In the Basement: Thursday, July 30, 2009
Chapter 26 - Charred and Feathered: Friday, July 31, 2009
Chapter 27 - Ménage à Trois: Friday, July 31, 2009
Chapter 28 - The Unforgiven: Friday, August 7, 2009
Chapter 29 - Lost Now, Loved Forever: Sunday, August 9, 2009
Chapter 30 - Underlying Issues: Friday, August 14, 2009
Chapter 31 - Football Practice: Tuesday, August 18, 2009
Chapter 32 - Banding Together: Friday, August 21, 2009
Chapter 33 - Heavy Weight: Thursday, August 27, 2009
Chapter 34 - Avoiding Plan B: Saturday, August 29, 2009
Chapter 35 - Intervening Factors: Saturday, August 29, 2009
Chapter 36 - Teenage Waistland Redux: Friday, September 4, 2009
Chapter 37 - The Fat Ladies Sing: Friday, June 25, 2010
Afterword
About the Authors
1
Cattle Call
Sunday, May 3, 2009
Marcie, 5′4″, 288 lbs
Marcie Mandlebaum here: sixteen years old and sporting the collective girth of the Tenafly High cheerleading squad—this according to their captain, my twitorexic stepsister, Liselle. She’s too much of a dimwit to master the intricacies of a tape measure, but there’s no denying it. Her guesstimate is in the ballpark.
We’re crammed into a crummy conference room in the Midtown Sheraton, waiting for some Park Avenue doctor to pitch his clinical trial for Lap-Band weight loss surgery for teens. By we, I mean me; my mother, Abby; and every fat chick within a fifty-mile radius of New York Cit
y who could stand to drop at least one hundred pounds. A couple of fathers and maybe six fat guys are here, but it’s more a female thang—sixty or so heifers being herded around, for the most part, by tiny fat-o-phobic, lipo-sucked mothers like mine. This is nothing like SeaWorld, where every baby whale can count on having a bigger mama.
I haven’t seen so many fatties together in one place since our nightmarish visit to Graceland in Memphis last summer. We spent four sweltering hours waiting in a stampede of bulging polyester just to get in. “Ground zero for the world’s obesity epidemic.” “Welcome home, Moosie,” Liselle had snickered. But rather than injecting her usual diplomacy to avert a brawl, Abby seized the reins of Liselle’s bandwagon and said, “Of course you’re not anywhere near the size of these people, darling, but your weight has been moving in the wrong direction and you need to turn it around.” But that was more than sixty pounds ago, so now Abby’s dragged me here.
Five rows of metal folding chairs have been halfheartedly arranged in front of the stage, as if the bozos setting up for the event weren’t certain this particular audience should sit in them—for me and my tubby brethren, there’s a fine line between a chair and a catastrophe. I blow past whatever few empty death traps are left and park myself in one of the open spots against the wall. Abby, hot on my trail, wiggles her way into the three centimeters of breathing space beside me by shoving one blubbery mass into another with an apologetic smile. “Standing room only,” she whispers into my ear, ignoring their glares. To Abby, who won’t eat in a restaurant that doesn’t have a waiting list for an open table, crowds—excluding the one at Graceland—provide indisputable evidence that we’re in the right place. The thing is, we’re not.
Finally, while the groans of stressed metal die down, Dr. Hal Weinstein, the head of the Lap-Band program at Park Avenue Bariatrics, steps to the podium and tests the microphone. This is my signal to pull out my iPod—what don’t I already know about this surgery? I’ve been hearing about it blow by blow for over a year. But Abby whacks my hand and flashes her eyes at me—her behave yourself glare. “Just listen for a change. You might learn something,” Abby hisspers—her standard hiss/whisper combo—and I resign myself to a slow and painful death.
Weinstein leans forward, pauses, and then booms into the mike: “The Lap-Band is not the solution to weight loss.” My eyes fly open. WTF? Has the seminar been hijacked by some fanatical “fat power” fringe group and the real doctor is lying gutted in some back room? My hopes are dashed as he finishes his thought. “The Lap-Band is merely a tool, albeit an effective one if employed in a comprehensive supervised program that addresses the behavioral, nutritional, physiological, and psychological aspects of obesity.
“But as a long-term weight loss tool, the band is only effective if accompanied by behavioral changes. So while nutritional support and exercise are key aspects of our program, we place special emphasis on addressing the emotional issues underlying teen obesity. That’s why participation in weekly group support sessions is mandatory for the first year after the surgery.” I groan and shake my head and Abby nudges me with her elbow.
“The requirements for admission into our clinical trial are documented in your …” And then I can stand it no longer, and tune out completely.
To understand the magnitude of this disaster, you have to understand what a clinical trial is—and why, unless you have a terminal illness and nothing better to do with your time left on earth than get poked like a lab rat, it’s best to stay away from them. There’s a federal agency called the Food and Drug Administration—or FDA, to the literate few—whose job is to ensure that all food, drugs, and medical devices (like pacemakers, artificial limbs, and Liselle’s future breast implants) sold in the United States are safe and effective. To prove “safety and effectiveness” to the FDA, companies experiment on small groups of carefully selected volunteers in tightly controlled settings.
This Lap-Band thingy is one of these so-called medical devices. It’s an inflatable silicone band for super fatties that gets surgically installed around the top of their stomachs. When the band is inflated by injecting saline solution through a port implanted in the abdominal muscles, it contracts. And now you get a tiny stomach pouch into which only the smallest amount of food will fit. So when the aforementioned fatties can’t plow through their usual amount of chow, lo and behold, they lose weight. It’s a short, simple, reversible low-risk operation and you’re out of the hospital in less than a day. And the Lap-Band has already been approved by the FDA! Megatons of weight lost, safety and effectiveness totally proven, et cetera.
But of course, there’s a catch. The FDA approved the Lap-Band exclusively for adults. So livestock under eighteen can only get their hooves on this miracle of modern medicine in one of two ways: through an FDA-approved clinical trial, like the one Doc here is recruiting for, or, like my best friend, Jen, did, by going to Mexico, where the FDA can’t throw its weight around.
For obese American teens who can’t get into or afford a Lap-Band clinical trial and have xenophobic parents who won’t cross international borders for medical care, there’s another surgical option in the United States. It’s called gastric bypass, and it’s scary stuff—Abby and I looked into it last month. They pretty much slice, dice, and rearrange your entire digestive tract. Something like one to three percent of gastric bypass victims die from it, and a large percentage get seriously screwed by pulmonary embolisms, leakage, infection, malnutrition, and other health issues. But because the FDA hasn’t approved the Lap-Band for teens yet, far more of us are undergoing gastric dissection than getting banded. Shaken, Abby had marched me right out of that consultation. Her epiphany: Being fat is, in fact, preferable to being disemboweled.
It’s ten p.m. and I’m splayed on my bed, taking a break from ranting.
“Maybe Abby is right and this clinical trial isn’t the worst thing,” Jen finally pipes up, as if she’s had me on call-waiting the whole time and hasn’t heard a word. Jen, of all people, should appreciate the epic proportions of this catastrophe; I was at her bedside in Mexico—along with her mom—when she got her Lap-Band done there, the Christmas vacation before last. Besides, we’ve been inseparable since my first day at Fuller Prep—she flipped off a teacher when he corrected her pronunciation of “antebellum,” and even though she was freakishly large, and so sharp and tough that the other kids seemed terrified of her, I knew instantaneously that she was my girl.
“Jen!” I wail. “This clinical trial isn’t anything like what you did! For me to even be considered for admission, I have to get a million physical exams—bone density, pulmonary function, blood tests—”
“No kidding, genius,” she cuts in. “Everyone gets a battery of tests before surgery, no matter where they go.”
“But that’s only the beginning! There’s a mountain of paperwork—doctors’ letters, notarized releases, insurance authorizations or evidence of financial ability to—”
“So what? Abby’s going to deal with that stuff, Marce, not you. Your insurance probably won’t cover it since it’s a clinical trial, but Rich Ronny—”
“Hold your fire, Jen. There’s more! Then I’ll be interrogated by their ‘fat nazi’ shrink to make sure I can commit to the Lap-Band ‘lifestyle.’ Plus, Abby has her own evaluation, where she’s got to sell this shrink on her ability to ride my beached-whale butt into submission—as if Gran doesn’t barrage my mother with new starvation plans for me every other day. Now what do you think, Ms. In-and-Out-in-Three-Days?”
Jen snorts. “Listen, Ms. Drama Queen. I had the same evaluations. Adults never think teens are equipped to make big decisions, so they just want to be sure everyone involved understands what they’re in for. Makes total sense. Can we roll the credits on your daily diatribe now?” “Daily Diatribe” was the name of the hysterically bitter feminist poetry rant series Jen used to post on YouTube.
I snort right back at her. “Nope, saved the best for last. If I even get in after all this crap, they’re
going to make me join a cult where I’ll have to wax poetic about everything related to my eating—from my ‘feelings’ to my bowel movements—every week for a whole year!”
“Oh my God—you mean a support group like Alcoholics Anonymous? That really does suck,” Jen says in her horrified by the sheer inanity voice. Finally, she gets it. “Look, Abby is reasonable. Discuss this with her. Just do it calmly and nicely. She always listens when you’re not laying into her.”
“I guess I’ll give it one last shot. Stay tuned,” I sigh, and take off to find Abby.
“Marcie, I get it. I was there,” Abby says wearily the instant I calmly embark on my rap about how needlessly annoying and drawn out the clinical-trial admission process is compared with getting the stupid surgery done and over with south of the border. She and Ronny were polishing off a bottle of wine on the porch when I found her, and he politely took off so as not to intrude—probably his euphemism for “listen to Marcie gripe.” “Just give me your Mexican surgery spiel so that I can go to sleep,” Abby says.
I whip out my iPhone with my right hand and Abby’s credit card with my left. I really want to fling them at her, but I keep my grip on both items and wave them in her face instead. With the wine and all, she’s slow on the uptake and gives me the quizzical variation of her get to the point already look. “Mom!” I shriek. “I’m demonstrating the elegant simplicity of the Mexico option. You just need to be able to dial the freaking phone number to set up an appointment and place a deposit. That’s it! The exact same surgery! Jen was in and out of the clinic in a single day. No hoops, no groups, no one breathing down her neck for all eternity. Plus, it costs ten thousand dollars—that’s less than one-third what Park Avenue Bariatrics is charging. We can even upgrade to the all-inclusive Cancún special—the surgery plus five nights at a five-star beachfront resort, a private nurse, and—”