That Thanksgiving she met Larry. She knew she wanted to give him her virginity as soon as they started dating; she was that grateful for his attention. She needn’t have been – anyone could have told her that she looked good and he was a bit of a pig – but Sheila wouldn’t have listened. She was too used to her old self image. Sure she’d lost weight, but her naked body looked haggard to her. Her skin sagged beneath the new clothes. She was self-conscious about being with Larry but eager to have some of what she’d read about so much.

They did it in his car. In a way that suited her just fine, because it was dark there. He drove an old Chevy and the back seat was huge. And since the sex was no great shakes for her, it didn’t bother her that they had to hurry.

Larry was a bad boyfriend. He never gave compliments or presents, and he didn’t pay attention to what Sheila said. A couple of times she tried to get a little foreplay. Once she even said no, but Larry didn’t listen.

Meanwhile, things at home could have been better. Her mother was still happy with the weight loss, but she was disappointed that Sheila wouldn’t consider a sorority. She went through that winter buying clothes for Sheila and complaining. Her father no longer nagged her about exercise but seemed too interested in what she and Larry did when they were together. Most evenings Sheila found that three ounces of seeds just weren’t enough. She’d have two servings. Or a package of cookies. She liked herself too much to throw up afterwards; she knew she’d never be bulimic. But she disliked herself too much to treat the consequent heartburn; she always figured she deserved it, and toughed it out.

Sheila will never forget the half year after Larry. She had 16 lovers before she grew too large. There was even one night with three different guys, from curiosity rather than any lust, none knowing about the others. But by the end of her freshman year she was near 200 again, the rash was back, and she took herself out of circulation. She read-and-ate, she studied, she played hours of solitaire (with cards — she didn’t get into it on the computer until 1998, when she racked up a $92,051 purse at TriPeaks in 13,292 games).

She got her bachelor’s degree in English in 1999. She’d picked the major because it meant reading fiction. She took a job at an insurance company. She weighed 310.

Sheila knew where she could get guys, but she didn’t want those guys. She’d heard about the fat groups: women’s clubs with names like Perfect Plus. They had support group meetings, shared tips on where to find fashion in sizes and how to fully appreciate whipped cream. And they had annual conventions that attracted strange men who lusted after fleshy women. She could just imagine some diminutive Filipino diving onto her, searching through folds to find an orifice. No thanks.

Her other option was an obese partner. But she knew about that too, and she didn’t find the prospect of vertical sex romantic. She stayed busy, did her job, and tried to diet. By the time she was 25 she weighed almost 500 pounds.

At that point she had to work out a way to telecommute. Fortunately her employer was big enough to have the resources to accommodate her and also the legal department to worry about not accommodating her. She was allowed to work from her condo. She bought a custom chair. She had groceries delivered. She stopped leaving home.

Sheila’s mother had given up hope but still felt obligation. She visited sometimes. Sheila’s father had become pretty large himself. His blood pressure required medication and he’d also taken up drinking. He didn’t feel well most days and he was headed for liver and kidney failure.

Sheila weighed 589 on her 26th birthday. She had heartburn which she tried as usual to ignore, but her belly hurt so much she squirmed. She couldn’t leave home; her mother found a way to bring a doctor to her. He looked and palpated and then called for some fancy sonogram machine. They had to fly it in from Nevada. “Usually the patient comes to the equipment,” he explained to them, “so not many places have portable devices.”

The doctor suspected that Sheila was hosting a large ovarian cyst, and the sonogram showed it. They had to remove her front door to get her out of there, and her first adventure in years was an ambulance ride. She wasn’t then in pain; she actually enjoyed the trip. Her mother was with her, and for once she was kind.

Sheila’s surgery was not a record breaker. Some woman named Gertrude Levandowski had a 308-pound cyst removed in 1951. That operation took 96 hours, and reduced the patient’s weight by half. Sheila’s surgery ran 18 hours, and her cyst weighed 257 pounds. She left the hospital weighing 332, so she only lost 44% of her weight. But that was a great start on her next diet.