Sometimes a Big Mac is as good as a cigarette.

Depression sucks. Fat depression sucks more.

I’ve gone through periods – days, weeks, months – when I simply couldn’t get out of bed. I’d lie there thinking about how sad I felt, trying to find the mental energy to get up. Sometimes the only thing that would get me up was the realization that I could go down to the kitchen and eat. Not because I was hungry, but to escape the depression. The result: Feeling worse. Back to bed.

Fat depression robs my energy and my will, just like ‘regular’ depression. But instead of leaving me alone with my sadness, fat depression hurts my body too. I have sore knees and an aching back all the time. I sweat bullets doing even the littlest physical tasks – climbing stairs, walking across a parking lot. Moving hurts; sitting still isn’t comfortable either. Armchairs can be too tight and hurt my ass. Airplane seats hurt all over. And on top of all the discomforts, weight gain has robbed me of the ability to do so many of the things I love. That’s fat depression.

The thing is, I suffer from regular, garden-variety major depression too. My emotional state has suddenly crashed more times than I care to count. Sometimes because of a job loss or a family crisis. Sometimes just because. Medication and therapy help a little, but mostly it seems I just have to ride it out. It can take months.

I don’t have much real control over my major depression. It has to do with my brain chemistry and I can’t change that. But I’ve got some measure of control over my fat depression, right? I have to believe that if I drop 140-odd pounds and hit a ‘normal weight,’ I will lose my fat depression too.

I’ve been lucky with my obesity in one sense: I haven’t (yet) suffered from any of the serious medical complications. I’ve got asthma and sleep apnea, both of which should ease with weight loss. Fat depression is the biggest obesity-related health issue I’ve dealt with. Can’t wait to kiss that one goodbye.

I’ve got this amazing wife. She’s brilliant, totally attractive in the ‘hot Jewish chick’ way I love, warm, kind, caring, hilarious. She’s my best friend. But on a cold, rainy night about 15 years ago, when I called from a payphone at 2 a.m. to say I was absolutely nuts about her, I also did something terrible. I caused her biggest fear – that I’m going to suddenly drop dead, long before my time, leaving her alone to raise our two incredible kids.

My wife’s a doc, actually. She knows better than anyone the negative effects of obesity. Intellectually, she knows about the high blood pressure, the diabetes, the cardiac disease and all the other ills the obese suffer (luckily at 40, I’ve got none of these just yet). She also knows about all the horrible things that can go wrong in surgery. She knows that the complications of obesity far outweigh the risks of surgery, and of living with WLS. Still, she’s terrified about the procedure. And terrified about what could – will – happen if I don’t have it.

My point is that, like smoking, drinking and drugs, obesity affects not only the victim, but the victim’s family as well. If I have a brain-blowing stroke and end up pushing daisies, my kids won’t have their father. They won’t have me to help with their homework and to tuck them in every night. My shoulder won’t be there for them to cry on, and they won’t know of my utter excitement over all their achievements. My wife will lie alone in our bed every night, wondering if she’ll ever find a way to be happy again. My dog will pine for me.

The trap of obesity – of all eating disorders – is that the drug addicts crave is the same one needed to fuel and sustain their life. I’ve tried for at least 30 years to stop eating the way I eat. But I can’t. Even the knowledge that with every bite I’m hurting those I love most doesn’t slow me down. That’s why I need radical (read: surgical) intervention.