ready for my bikemo bod

Cancer and Diet Culture, Part I

Let’s talk about the diet culture of it all. Because diet culture is everywhere, and cancer is no exception.

I have been working on divesting from diet culture for several years (thanks Maintenance Phase,

Heft

, and

Virginia Sole-Smith

).

I have plenty of work still to do, and my recent cancer diagnosis is throwing many of my Under Construction Zones for Self Improvement into stark and unflattering relief.

Divesting from diet culture? What are you even talking about?

I want to help my children learn to trust their appetites, and their satiety. Meal times in our house are not a battleground over bites taken and foods avoided, or a market stall where we barter for different food groups and I control the sweets.

At least that’s the goal—but I also experience anxiety when my toddler wants to actually eat all the cookies we bake together. I have to actively police my own instincts so that I don’t introduce diet culture during a time when she should be growing and exploring her taste and learning for herself what feels good in her body.

She bites her chocolate and I bite my tongue, but the thoughts still arise and I can’t not notice them.

For my girls I wish joyful embodiment, delighted eating, radical self-acceptance and tremendous body confidence.

I’m afraid I’ve missed the boat on all that for myself. I strive for body neutrality. I’ve experienced sexual trauma and chronic back pain, so I’ve spent a lot of time dissociating from my body and trying to hang out anywhere other than inside my own skin.¹

Okay fine, but what does this have to do with cancer?

Anyway, yes, okay. I can’t lie: One of my first knee-jerk “silver lining” thoughts when trying to put a jokey spin on my ass cancer diagnosis was, Hey, at least I’ll get skinny! Bichemo body here I come!

Gross.

I made this joke in front of my mom and she said very earnestly, Well it’s good that you’re going into chemo with some extra weight. So at least I come by my conditioning honestly.²

Diet culture shows up when a doctor suggests, Just don’t eat on days you don’t want to poop in public.

It shows up in the fact that never once were the dietary changes I would need to endure after LAR surgery—and potentially for the rest of my life—mentioned. The doctors did not talk about it at all. I only know from Google and Reddit, a fact that does not seem right.

A life of restricted eating seems like a legitimate argument against surgery, or at least an item to weigh in the scales against it, but I guess that’s because I’m a weak ignorant slob who enjoys food as something more than fuel.³

Of course I would just give up all the foods I enjoy, who cares about that? That doesn’t even need to be mentioned or discussed; it’s a given, obviously. It’s for my health. How shallow, how weak, to be so enamored of food that it would be a variable in evaluating treatment options.

No more salads? But I love raw vegetables! No refined sugar? But I love sugar! The idea that food and digestion are not essential components of a satisfying life is wild to me. Sorry, I simply insist on eating! Forever!

Again, please pray for me that I get to keep my rectum.

You’re not doing surgery. We get it. Move on.

Fine. But that’s not the only place diet culture has come up. There’s diet culture everywhere in cancer, everyone desperate to sell you the one vitamin or superfood that will make your tumor disappear.

Maybe I’m overly defensive, but I feel a distinct undercurrent of Well what did you do wrong? to much of the online cancer discourse.

To me this reads as self-protective: People want to know that you were diabetic or ob*se or unhealthy or poor or that you subsisted on a diet of exclusively bacon so that they can feel safe. Well of course she got cancer, did you see what she puts through her rectum? I don’t need to worry about that for myself. I eat açai bowls and quinoa. I run marathons. I’m good. I’m safe.

Well bad news, friends, I’ve been a vegetarian for 25 years and I eat more roughage and brassicas than anyone I know. Can’t get enough of the stuff. So try again.⁴

By the same token, people who beat cancer want to attribute it to something they did right, some code they cracked. This too strikes me as superstitious and self-preservational: I was bad before, and I got cancer, but now I’m good and will never eat cake again and that will keep me safe and protected from now on.

This is orthorexia.

Basically, if you are currently living cancer-free then you want to feel reassured that it won’t come for you, or won’t come back for you. That you’re safe, that you’re doing something right or good that can offer you protection.

That’s a very normal way to feel. I don’t blame anyone for wanting to hold onto that belief. This is some prosperity gospel stuff, deeply woven into the fabric of our culture.

But I’m not sure that’s how it works. Cancer really might be random.

Or we might all be looking for patterns on the wall of the Platonic cave, forever ignorant to the nature of the true light source. We’ll never understand the flame if we don’t stop staring at the shadows.

Or maybe AI will find the pattern in the noise and it will turn out that I used too much olive oil in my cous cous on a Tuesday in June.

We don’t know what we don’t know.

Can we get back to diet culture please?

Yes, for sure. There’s a lot more.

I have been attending a lot of medical appointments, and I somehow need to be weighed every dang time. Sometimes more than once in the same day.

I don’t like being weighed this often, it’s rude. There hasn’t been enough time since the last appointment for my height or weight to have changed. Is this to verify my identity? Is that a common crime, people posing as cancer patients and stealing radiation? Somehow I suspect not.

I understand that the nurses have boxes to check on their forms, and they need to know my weight to get the dosing correct for my medications and to monitor my response to the drugs and all that. But couldn’t there be a reasonable limit to the number of times in a month that this is required? Surely it can’t be medically necessary twice a day, or even twice a week.

For my colonoscopies I have to do a low-fiber diet for three days, then completely fast for a full day. I’ve had to do this twice in the past month. That’s in addition to the laxatives and enemas.

It’s horrible. I hate being on a restricted diet of any kind. I hate being hungry. I hate that I still have to cook for and feed my children, but I can’t nibble on their leftovers or pop a stray grape in my mouth or cut an extra slice of cheese for myself. I like the freedom to follow my cravings and I miss it when it’s not there.

I understand the medical necessity for a clean colon and a successful colonoscopy. I am compliant with all the orders. But still I chafe against the restriction. It feels dangerous to me to become so rigid and obsessive about my food choices. How can I escape a cancer-related eating disorder? Orthorexia feels increasingly possible.

I worry about what this restriction models for my daughters. I take great pains to explain to my toddler that I’m only not eating so that I won’t poop on the doctors when they put tubes up my butt to monitor my lump.

These are not the lovely lady lumps Fergie so eloquently described.

At every appointment I have to verify and confirm every allergy I have and every vitamin I take. Even an innocent question like Are you still taking vitamin D? starts to feel like an accusation after this much repetition. Err, yes? Shouldn’t I be? Aren’t you the ones who told me to in the first place?

Maybe they keep asking because they just continue to be shocked by my compliance.

But I feel defensive, hostile to all these questions. What’s wrong with vitamin D? I want to ask, red-faced. Are you saying that’s what gave me ass cancer?

I agreed to participate in medical research for Dana-Farber about young-onset colorectal cancer. How many eggs do I eat in a three month period? How many tablespoons of oil do I consume in a week? How much yogurt do I eat on an average Thursday?

That last one is an exaggeration, but truly who keeps such rigid track of their food? I guess probably a lot of people. So maybe you can tell me: What is a normal number of slices of bread to eat in a week? For me it varies dramatically by season. I don’t bake sourdough in the summer because we don’t have air conditioning and you couldn’t pay me to turn the oven up to 500 degrees. Does pizza count as bread?⁵

But all the questions they ask provoke answering questions in me: Did butter give me cancer? Are you asking about carrots because there’s an association? Why do you want to know about my coffee intake? You truly don’t know anything at all, do you? You’re just stabbing in the dark, looking for correlations anywhere they might arise. Is no one in charge around here??

The tides of panic rise. My pantry is full of nothing but deadly poison, apparently.

I don’t know what to do with all this diet culture. Some of it feels necessary (colonoscopy prep), some of it feels potentially helpful (give me all the vitamins and herbs. I will shove them in as many holes as you want if you tell me that will help eliminate this tumor and preserve my rectum), and some of it feels sick and dangerous (the orthorexia of it all).

My dream is for someone who understands this stuff much more deeply than I do (looking at you

Virginia Sole-Smith

) to read this and help me work through it all.

All I can say with clarity and certainty is that I hate it and it’s terrible.

1. …Is that why I got cancer?

2. She’s not wrong, I have a larger body! And I’m sure she meant this to be supportive. I’m not trying to give her the full Dr. Irani send-up here, leave her alone.

3. This does not reflect my views, obviously. It is an articulation of diet culture.

4. And just in case this isn’t abundantly clear, I want to be incredibly explicit that no one *deserves* cancer based on their diet or lifestyle!

5. My brother-in-law has a well-developed theory that all foods are either salad or sandwiches. Hot dog? Sandwich. Pasta? That’s a salad, obviously. Sushi? Sandwich, you clown. Keep up.