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Losing Control
For years, no matter what diet she tried, Joyce Dixon just seemed to gain weight. In 1996 the five-foot-three mother of two weighed more than 200 pounds. But her self-esteem was the least of her problems. Her legs were so swollen and weak that she could barely climb the stairs in her own house. Her hair was falling out, her eyesight was blurry, and her skin was red and blotchy. She was often up all night, unable to sleep, and her mood swings were dramatic -- sometimes manic, sometimes raging, often depressed.
Worst of all, she didn't know why. Doctors blamed her litany of problems on "obesity," a diagnosis that 55-year-old Joyce had heard so often she'd accepted it herself. But in the back of her mind, she knew there was more to it.
Though she says she was never super-skinny, Joyce had been a cute, active cheerleader in college. "Back then," she remembers, "if my girlfriends and I gained ten pounds, we'd diet and lose the weight. I never felt I couldn't control my weight."
But that started to change. In 1975, Joyce married Al Dixon, and gave up smoking two years later. Soon she gained 30 pounds and just couldn't seem to get rid of it. So when she heard about a radical no-carb diet that had been successful for one of Al's co-workers at IBM, she decided to try it.
The diet was designed to induce ketosis, which causes the body to burn stored fat for energy. Joyce did lose weight, but she felt lethargic. Her doctor thought she had an underactive thyroid and prescribed medication to regulate the problem. In 1982 she and Al had a baby boy. They named him Albert. (She also had another son, Mark, 16, from her previous marriage.)
Her weight, though, was not an issue at home. As her son Albert recalls, "My mother was always big, but I never thought about her being fat. That was just her normal size to me." He also thought it usual to have a refrigerator filled with diet foods.
Joyce showed great willpower with her dieting and even attended regular aerobic dance classes. "I would stay with the diet but just gained weight. That should have been a clue that there was something wrong. The doctors never believed I was sticking to the diet. It didn't make sense to them."
When Joyce and her family moved to San Francisco in 1984, she was referred to a renal doctor, who monitored her thyroid condition and medication. Her weight later ballooned to 190 pounds. With her doctor's approval, she enrolled in the Obesity and Risk Factor Program of San Francisco.
On a low-calorie liquid diet she lost 40 pounds at first, but then began to gain again. The medical staff questioned whether she was following the program, and she wasn’t: She was eating even less than the plan called for, but still gaining weight. Then her legs began to swell, her fingernails became brittle and her hair fell out so much that she had to wear a wig. She bruised for no apparent reason, her skin became jaundiced and she experienced severe memory loss. "I wasn't worried that I had to wear a wig or what I looked like," she recalls. "I was just so sick, I really couldn’t cope."
She couldn't ignore or explain away her symptoms any longer. She was referred to a highly regarded endocrinologist to have her thyroid checked yet again. But the office manager would not set up an appointment when Al wanted to meet with the doctor. Medical records from the time imply that Joyce's husband was overly attentive, and both Joyce and Al think that doctors suspected him of abusing her and causing Joyce's bruising. No doubt it was an attempt to make sense of her symptoms, which seemed otherwise unexplainable. "She kept a cheery face, but I knew she was hurting," Al says of that terrible time.
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