I think one of the biggest subtexts running through my life lately is my still-unhealthy relationship with food. It’s no secret that I had bariatric surgery almost three years ago, and while that procedure removed a lot of the physical damage from my years of unhealthy eating, it didn’t magically fix the relationship itself.

For many years, my real substance of choice was food. If a substance—legal or not—is overused to cope, it qualifies as substance use, and that’s exactly what I had with food. Alongside it came a deeply unhealthy body image.

I’ve talked before about always being “the fat kid.” I wasn’t terribly overweight, just not athletic. I didn’t fit in with the sports crowd, and being both awkward and gay made that even harder. But the body-image problem never went away. Even now, I can look in the mirror and still see my 317-pound body staring back, even though I weigh 190 today. That distorted image refuses to leave.

Deciding to have bariatric surgery wasn’t easy. I tried everything else—dieting, exercise, semaglutide, prayer, and plenty of wishful thinking. I was lucky to have a nurse practitioner friend who worked in a weight-loss clinic and helped me navigate the hoops insurance companies set up for surgery candidates.

What I didn’t do was sit down and really talk about it with my spouse. By then, our conversations were rarely productive. I told him later, offered for him to sit in on my pre-op sessions, but he declined. To his credit, he did take me to the hospital that morning and was there when I came out of recovery—for about fifteen minutes before heading home. I hadn’t done it for him anyway; I did it to save my own life.

Afterward came years of subtle (and not-so-subtle) sabotage—snide comments about “losing weight the easy way,” jokes about my changing body, even complaints about the odor of my new post-surgical digestion. It was all a way of reminding me that, in his eyes, I wasn’t supposed to change. He wasn’t interested in my health, just in making sure I didn’t feel good about myself.

Fast-forward to today, and those healthy body images still haven’t magically appeared. I wish they would. I still feel unattractive most of the time, and aging hasn’t helped. I keep telling myself to stop relying on my own negative opinion and to start believing the positive things others tell me—but that’s easier said than done. After years of criticism, it’s hard to believe praise.

For once, I don’t have an easy answer. I’ve done so much work just to feel normal, and some days it’s exhausting. But maybe I should take a page from two who always made me feel extraordinary—my dog and my mom. They never saw “fat” or “flawed.” They just saw me. Maybe that’s the kind of reflection I need to practice.