Emmie Mears
SFF. Queer AF.

The Intersectionality of Poverty and Invisible Illness

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The Intersectionality of Poverty and Invisible Illness

This week I finished reading SUGAR by Deirdre Riordan Hall. It’s about a Puerto Rican-Polish girl living in rural New Hampshire. She is relentlessly bullied and abused because she is fat. It’s a story about self worth, about self-love, self-care, and strength. It’s a powerful book, and it hit me in ways I wasn’t expecting.

Diverse books are so important. This book is a diverse book. Mercy (aka Sugar) is obese. She is mixed race. She is poor. Her story is vital for so many reasons, and it’s subversive in many ways. I recommend it fully — I read it in two days.

This book brought up a lot of things for me. This post will be about those things, from my relationship with food to poverty to mental health. Also inspiring this post was Sami Clara’s phenomenal piece on OCD over at Cult Noise. You should go read it.


I’m not fat, and I’ve never been fat (except as a baby, during which time I was “the beachball,” “roly poly,” and “Daddy’s little fatty”). But my relationship with food is almost identical to Sugar’s.

In Algebra II in tenth grade, I was a cheerleader (though not the popular kind — tiny school). I remember sitting at my desk with a couple of the other cheerleaders, and one of them was talking about how she’d gained weight. “My stomach has rolls when I sit down now. I need to go on a diet.”

I remember that moment so clearly, because under my cheerleading uniform, my stomach had ALWAYS rolled when I sat down. I didn’t realise other people’s didn’t.

Fast forward to my first year at university. I gained the freshman twenty-five — and for the first time I felt heavy. Food has always been a strange fascination for me. Growing up in poverty meant that it wasn’t always abundant, and when it was it wasn’t what other people were eating. I would get adrenaline rushes of excitement on food bank day, to have old doughnuts or expired sodas or box mac and cheese even if it was still generic. When I got to uni and the cafeteria was all you can eat, it was the first time I’ve ever really been able to choose what to eat. Sure, there were salads, but there were also pizzas and burgers and chicken and mashed potatoes and an ice cream machine and made to order stir fries and breakfasts full of biscuits and gravy and eggs and sausages.

Having food choice has always been a marker of Not Being As Poor Anymore. When I have money, the first spending change I make is always food, and it’s seldom GOOD food. It’s like a compulsion. If I eat McDonald’s every day, it means I’m Not As Poor as I used to be.

But it’s tied into serious self-hatred. The rage I feel at myself when I binge is daunting. For years I’ve waged a war against the scale. Six years ago when I moved to DC, I spent a few months losing weight. I lost fifteen pounds and weighed 147 when I moved here. I was proud of that — it felt good. I felt good. I was eating healthy things, like pasta dishes that were more than 50% vegetables and hearty lentil stew.

My metabolism is an unforgiving thing. My basal metabolic rate is low enough that it’s possible — maybe even likely — that I’m living undiagnosed with PCOS or some kind of thyroid issue. But because I seldom have health insurance, I’ve never gone in to see.

I have dabbled in anorexia and bulimia, insofar as anyone can dabble with either. It’s like playing tag with lava.

People will say they binged when they had a cupcake, but the way I binge is mammoth. If there’s free food, I will load up an entire plate because it’s free and it’s accessible to me when for most of my life food wasn’t. One day in February I ate Chipotle, McDonald’s, AND dinner at an Indian restaurant. I felt like a balloon about to pop. The next day I had McDonald’s again.

When I am happy, I treat my body better. I eat well. I exercise. But when I am stressed, as I have been for most of this year, I eat. Nothing makes me feel better but food. I eat Big Macs and cinnamon rolls, burritos and Pop-Tarts by the box. I’ll eat upwards of 3,000-4,000 calories a day. With my metabolism, 1200 is my maintenance amount. (Please refrain from making any remarks about how that’s “not enough” and defer to my knowledge about my body based on 30 years of living it and data I’ve collected from self-observation of amounts of food my body uses, loses, and gains.) The summer I moved here, I started teaching. And I have never been so stressed, nor have I ever gotten less rest. Tired + stressed = food. I gained twenty-five pounds over the school year, then another ten. Last year I lost thirty. I’ve gained back fifteen in the stress of this spring. I reviewed all my transactions on QuickBooks last night. You don’t want to know how many were McDonald’s.


Poverty is a form of trauma, and its effects ripple outward and cause reactions and behaviours that intersect with mental health, and sometimes those effects can mirror symptoms of PTSD. Getting ill for me is borderline triggering. When someone tells me to “just go to the doctor,” my body chemistry has a freakout. When you’ve never had good insurance and live with a medical system that is the most costly on the planet, a medical bill is a crisis that often dwarfs the illness in scope. When I was ill last week, I talked myself out of going to the ER for that reason, even though it was 4 AM and my throat was so swollen that my uvula was impeding my ability to breathe. I instead used self-soothing techniques learned from a lifetime of asthma and drank cool water until I felt somewhat sure I could fall back asleep without being in danger of suffocation.

That is what poverty does. Right there. I don’t know how much danger I was in, but I do know the terror of a thousands-of-dollars bill for ER treatment plus possibly being sent in for a tonsillectomy plus anything else made my well-being secondary to the pervasive fear of more debt. I am making more money now than I ever have before, but still a single crisis would crumble all of it.

Someone I told about that looked at me in horror and said I should have “just” called someone and that people would have helped me. Maybe, but asking for help in December took just about everything in me. Doing it again within six months never even crossed my mind, and I wouldn’t, anyway.

There is no “just go to the ER/doctor/dentist.” Being poor is knowing that those places are your adversaries, because you will not escape with peace of mind, and your bank account cannot bear their price. It doesn’t matter that your health should take priority over a number on a screen. Being poor is knowing that you have to wait until you have no other choice, and even then it will likely fill you with terror, guilt, and anxiety that crumbles you.

Being poor is being told to “take care of yourself” and not having the resources (paid leave, insurance, money for bills, money for medication, a job that allows you to take time off, money for a recuperation vacation) to do so. Being poor is knowing that you don’t get to take care of yourself. Survival is the only goal, and that lack of resources compounds itself. Add up a week’s salary, the out of pocket cost for a doctor’s visit, out of pocket prescriptions, then check it against the ability to pay rent. Also — still cheaper than $250 a month for insurance if this only happens once a year. Being poor is knowing that in the long run, insurance might be cheaper, if you get really sick, but gambling on your health because it’s cheaper to lose $600 today than $3000 if you DON’T get something bad like cancer. And knowing that with a big illness, you’d still be stuck with a deductible you couldn’t meet and copays you couldn’t pay and a policy fighting you every inch not to pay for any piece of your treatment. Being poor is constantly gambling. Your health, your food, your car — everything.

Mental Health and Disability

There are many things I live with every day, some of which I have no official diagnosis for (see above, re: insurance — the last time I went to a counselor who was supposedly covered by my brief stint of insurance, I got a bill for $400 for one hour. Also see above, re: the effect of medical bills on poor people), but that because of access to information, parents who are therapists, and knowledge of myself, I am certain I’ve been living with these things my whole life. Below is a mosaic of my head on a daily basis. Trigger warning for those who, like me, have PTSD. That section discusses rape and rape culture and daily life interacting with that. All the situations described below have actually happened to me, some of them recently. Most of the general thoughts daily or more.

Anxiety: “The worst is going to happen. Nothing good is allowed to happen to me. If anything good does happen to me, it’s only so it can get taken away and make it worse in the end. Nothing I do is ever good enough. No matter how hard I work or how hard I try, no one will ever think I’m enough. Someone will tell these stories better. They’ll get the book deal. They probably should. I’ll never deserve it, and even if I did deserve it, nobody fucking cares. What’s going to happen today? There’s an email. It’s probably bad news. It’s always bad news. A text. I did something wrong. Someone’s mad at me. Oh, it’s just a cat picture. Nothing’s going to work out for me. Everything that’s happening right now is just ready to crumble beneath me, to take me up a little higher so the fall will be that much harder. I’m not good enough. I don’t know why I keep trying. I’m going to get in trouble. I’m going to get pulled over. They’re going to give me a ticket again. I wasn’t doing anything wrong. Was I doing something wrong? I must have done something wrong. My partner is going to see who I am and hate me. They’re not going to want to hear all of this. It’s too much. I’m too much. I should just keep to myself.”

Anorexia/Bulimia: “I’m hungry. Hungry is good. Hunger means I’m going to lose weight. I gained five pounds. It’s because I’m disgusting. I can’t stop eating. I want McDonald’s. Tomorrow I’ll stop it. I’ll just purge. I’ll have it one more time, and then I’ll purge, and then I’ll eat better after that. I’ll eat those vegetables I have in the freezer. I don’t have anything to go with them. I don’t have time to cook right now. I’ll just get something at work. I only ate 300 calories yesterday when I had a fever and was sick. That’s good. That might balance something else out. I lost two pounds, so I can have a burger. I just won’t log those calories today. I know I ate them. I ate how many today? 4,000? I’m going to get fat. My butt barely fits in my pants. I can’t buy new pants. I don’t have the money for new clothes. I have to lose weight.”*

*I only used the word “purge” here for the sake of clarity. In my head I actively avoid using this word because it is indicative of a label I don’t want.

Asperger Syndrome: “Why do people on the phone have to ask how I am? They don’t care how I am. This is a stupid social norm. I’ll just say I’m fine. That’s code for leave me alone, right? They’re going to think I’m a bitch. I have to ask them back now. They’re not going to actually say anything meaningful in return. Just tell me what your problem is so I can fix it. Ask your question. I don’t want to go out to the party. I know Friends 1 and 2 will be there, but I can’t just talk to them. Maybe I can just stay for a half hour. If I only talk to one person, people will think I’m uptight. Or rude. Or something. I can do this. I’ll talk to Friend 1, and I’ll say hi to the others. I can do this. I’ve been talking to Friend 1 for ten minutes and I haven’t asked him how he is yet. Fuck. I need to ask how he’s doing. My partner’s dad’s sick and I’ve only been texting him about stupid shit. I forgot to ask how his dad’s doing. I’m a terrible person. I should just stay home. Person 1 said I was rude for not reaching out to her more? I’ve only met her once. I didn’t know any of her friends. What was I supposed to do? They were having a conversation, so what if I went and sat at the bar and drank a Coke alone? She said I was stuck up? That night was awful. I didn’t know anybody and how am I supposed to just jump in and talk to them? I didn’t know about what they’re talking about. I didn’t want to intrude. Today is terrible. My friend just said something really insensitive. Now he’s saying it was a joke. Okay. This is me just taking what he said literally. I can be okay with this. Okay. I need to get off the internet. I can’t deal with people right now. I need to be alone.”

Post Traumatic Stress Disorder: “I should go see my friend’s comedy show, but what if they make a rape joke? I don’t want to hear that. Game of Thrones is on. I should ask Friend 1 if they saw this week’s episode to see if I can watch it. Ooh, new book. This looks good. Wait. What. Fuck. ARE YOU FUCKING KIDDING ME? This is the first plot point? Pointless rape? OKAY THANKS. I’m going to read something else. Every woman in this book is fridged. Why.”

“Colleague 1 wants to show me a poster he thinks is funny, an anti-harrassment poster. Hey, that poster’s pretty good! It puts the onus of blame on the perpetrator and not the victim! Yay, points! Colleague 1 wants to know if it’s REALLY necessary to tell people not to rape unconscious people. I mean, yeah, it does need to be said. Oh, good, Colleague 2 is agreeing with me that it DOES need to be said. Thank Dog. Wait, what did Colleague 2 just say? His friend flat out bragged about raping drunk women at college? Fuck. Fuck. Fuck. I probably just yelled ARE YOU FUCKING KIDDING ME. That sounded loud. They’re going to think I’m crazy. He just said that though. He said ex friend, so that’s… Fuck, I can’t breathe. Fuck, okay. I need to sit down. Fuck you, eyes, stop. Fuck you, heart, calm down. You’re okay. You’re safe. But those women aren’t. I KNOW, OKAY? Okay. Okay. You know this happens. You know it’s common. It happened to Friend 2, Friend 3, and Friend 4. They’re okay, or at least as okay as you are. Friend 4’s rapist OD’d on something and died, so she’s safe from him now. But people asked her why she didn’t go to his funeral. Deep breaths, Emmie, deep breaths. You’re safe. You’re safe. You’re safe.”

“Okay, so Age of Ultron! Yay, Avengers. OH FOR REAL THOUGH? They called Black Widow a slut and a whore. He called you a whore. I KNOW, OKAY? I WAS THERE. You’re safe. Okay. It’s okay. But there’s a prima noctae joke in there? Like, okay, rape’s hilarious and that shows Tony Stark is just a douche because that’s all raping people would make you, douchey. Douchey is a popped collar and talking about bootstraps and trickle-down economics. Raping people isn’t douchey, it’s a whole fuckton worse. Oh, and here’s a whole battalion of people who think it’s just a joke. Yeah. Just a plot device. Just a joke. Because those are never used to say things you mean while being able to escape responsibility for them. And what people joke about never ever ever shows how underlying biases or anything. Nope. It’s just peachy. So many people think it’s okay. So many people think it’s fine to joke about a practice where women’s bodies were just playthings. I made the right choice, not reporting what happened to me. No one would have believed me anyway. Look what happens to women who do report. He’s still out there. I know. So is Colleague 2’s ex friend.”

That’s what goes on in my head. In addition to not having had the resources to get actual diagnoses for some of these things, I hate labels. I am many things, and I am not the sum of my poverty, my genitals, my sexuality, my mental illness, my disability, or my relationship with food. I am a complex person with a complex inner life. I am a human being, and I don’t want to be reduced to any label, regardless of whether it fits me or not. That said, labels can sometimes be useful. Over the past few years, learning about Asperger Syndrome (for which women are seldom diagnosed as kids) has helped me understand my past, my behaviour, and my life in an entirely new way. Recognising anxiety for what it is helps me combat it. Knowing how to self-soothe helps me cope with my PTSD, even though it doesn’t stop triggers from seriously fucking up my day sometimes. The incident at work described above caused me to sit at my desk fighting adrenaline, tears, and tachycardia for well over an hour and a half. I really did say ARE YOU FUCKING KIDDING ME when I processed what Colleague 2 said. I don’t really know if I yelled it, but I do know that my entire body reacted. That is what happens when a trigger gets pulled. And this is why those who make light of trigger warnings are so upsetting to me. A trigger warning helps me keep my agency of choice and can salvage me from spending literal hours of my day fixing my headspace.

I didn’t come out as bisexual for a long time because I’ve seen biphobia so rampantly in regards to a family member. How I feel about labels was also a factor in that. While most of my family is open and welcoming, I feared the reaction of others. I also, more and more, identify as non-binary in terms of gender. Words like “feminine” and “masculine” get under my skin in a way I don’t like. I’m not trans; my body suits me, and in spite of my myriad issues with food, I love my body as it is. I am at home in it. It’s where I live, even though with my history of sexual assault I sometimes severely dissociate from it. But gender is a social construct, and biology itself is a spectrum. My identity as a human being feels, perhaps surprisingly, like the recent statement by Miley Cyrus: “I feel like an infinite cosmic thing.” I’m not my genitals. I’m not my sexuality. I’ll wear what I want, and to hell with anyone’s perception of my gender or whether I fit their expectation of it.

Ultimately, reading one book made me sit down and write this massive post. Fiction is powerful. While I might not look like Sugar, I identified with her more strongly than I’ve identified with a fictional character in a long time. She finds strength in herself and casts off the labels and insults others try to stick onto her. She finds who she is and forges the power to build the life she wants, and in the end, whoever we are, isn’t that the goal?


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Author | Emmie Comments | 9 Date | May 16, 2015


Rebecca Jewsbury

You’re a rich, rich human being in your fulsomeness. xo

May 16, 2015 | 11:25 pm

Rebecca Jewsbury

Lest you wonder, I’m not offering fulsome praise. 🙂 Thanks for being so open. Your courage is great. xo

May 16, 2015 | 11:27 pm


    Thank you so much for reading and commenting. 🙂

    May 16, 2015 | 11:30 pm

Rebecca L Powell

I am more proud to know you every day.

May 17, 2015 | 12:44 am


That was exhausting to read, Emmie. Your life is larger than fiction. Your ability to strip away layers and get right to the core of ‘you’ is remarkable to me. I applaud you.

May 19, 2015 | 10:11 am


    <3 Thank you, Patricia.

    May 20, 2015 | 2:36 pm

Martin Berman-Gorvine

Well, your anxiety has certainly got you all wrong. You are a fine writer, you have paid your dues and you more than deserve the success you are enjoying now and in the future.

May 21, 2015 | 2:31 pm


    *salutes* Thank you! 🙂

    That’s the shitty thing about mental illness. It seldom cares much for reality and is really good at exploiting any insecurities. Bleh.

    May 21, 2015 | 3:22 pm

When Change Won’t Come Easy | Emmie Mears

[…] talked a bit about my food issues lately. I’ve also been ill for most of May. On top of that, my body has been doing some things I […]

May 25, 2015 | 9:04 am

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