"Listen," I told my boyfriend when I climbed up on the gurney, just before they took me into the operating room. "If I wake up after this, and I say anything like, 'What the hell did I just do to myself?' I want you to hit me, okay?"

"I'll just tell them to save all your guts. In a bowl! So they can put them back," Guy said.

"Oh," I said. "No! Oh, I won't want them back. Remind me that I won't want them back, okay, please?" I was frantic, coming off a three-day bowel prep which was every bit as disgusting and awful as you think it might have been. I was lying in my hospital gown shaking with fear, on the verge of panic, completely exhausted because I hadn't slept any of those previous three nights, and I was determined that a little post-surgery pain wasn't going to make me regret everything, make me feel like I had just done the stupidest thing of my entire life. That, and dying seemed like the two worst things that could possibly ever happen to me.

They rolled me down the hallway, helped me off the gurney and walked me into the operating room. I stood next to the table, and almost begged the nurse to tell me that I was doing the right thing. I had to hear it from someone else. No, I didn't have to hear it from anyone else. Okay, I was thinking, as I hoisted myself up onto the table. Okay, I thought, and they placed the oxygen mask on my face, told me to count back from 100, told me to breathe slowly. Okay.

I thought that when I woke up after the surgery, the regret would wash over me, mourning for the more or less intact body I used to have. I was ready for it, the feeling that I had done something ridiculous, and why didn't I just try Weight Watchers again? Jenny Craig! Kirstie Alley looks fabulous. I could have done that. Why did I give up?

Sometimes I am embarrassed to admit that I got weight loss surgery, because that's what it sounds like to people. The short-cut, throw-your-hands-up, I'm-too-weak-willed-to-diet-and-too-fat-to-exercise solution to obesity. And that is bullshit. Hasn't there been enough evidence to suggest that fat is not a moral issue but a biological one, a problem with incredible emotional and psychological facets and consequences? Haven't we gotten away yet from blaming fat people for their fat? When are we going to move on to finding a way out of the morass?

I found my own way out. I had broken my body--broken my metabolism--with yo-yo dieting, and my body was clinging to every calorie I put in my mouth. I got on the elliptical trainer and tried to sweat the fuckers off my ass, but they weren't going anywhere. They had set up camp. They had moved in to stay, those calories, and they made plenty of fat to keep them warm, and I thought I was stuck with it, that I wasn't tough enough to keep fighting, so I would live the rest of my life morbidly obese. Weight-loss surgery felt like a way to say fuck you to my body's stubbornness.

That's how I thought of it, way too often. Fuck you, body, for betraying me. But god, hadn't I betrayed my body over and over again? Hadn't I eaten things I shouldn't have eaten? Wasn't I falling into the trap, again, of blaming myself entirely and calling myself weak-willed and pathetic? The debate was ongoing in my head, even as I was setting up the doctors' appointments and sending letters to my insurance company and hurtling down the path to climbing up on that table. It's complicated. That's all I can tell you. It is complicated.

On the day I got my insurance approval and my surgeon scheduled my surgery date, I read--on a size-positive message board--about the "self-mutilators" who hate themselves and their bodies so much, they'll do anything to get away from it; the stupid people who get weight-loss surgery. I sat there for a minute, examining my reaction to that. It was no. No, that's not me. You don't have the right to judge me for getting weight-loss surgery. I know why I'm doing it, and that is certainly not the goddamn reason. For the first time since I had set the whole process in motion, I felt not just okay about my decision, but completely convinced that I was doing the right thing, for a given value of right thing, and a given value of me.

Being absolutely sure you're going to die on the table, however, is bound to give you some doubts. "Don't let me forget," is what I was telling Guy. Don't let me forget that this is what I want to do, and I know it. When I woke up in my hospital room, woozy and wiped out and aching, the first thing I thought was oh my god. Oh my god, I made it and I'm alive. The second thing I thought, or possibly the third, after "ouch," was, I can't wait to start.