“Aren’t you sleeping well?” Susan Zuckerman-Seely’s mother asked her as she noticed her daughter yawning while they ran some errands. “Ironically,” Susan recalls, “I was sleeping whenever possible because of exhaustion I assumed was from stepping in as a caregiver for my mom and stepdad while working and running my own household and caring for my thenadolescent son.
“I fell into the classic caregiver role of taking care of everyone except myself, and in my late 30s and 40s, I collected dozens of extra pounds as I dragged myself through my days. I thought my fatigue was from being depressed and down because my parents were aging while I tried to navigate being in an unhealthy relationship. Over and over, I told myself, Susan, power through even though you feel like crap.
“At every physical, my weight crept up a bit, and I carried most of it in my midsection. The doctor routinely advised me of the importance of exercise and a diet low in saturated fats and sugar, but I struggled to find the time — or energy — for activity. I knew excessive caffeine consumption is linked to sleep disturbances, but I was so tired that I was rarely without a cup of coffee in my hand.
“In mid-2009, weeks of abdominal pain sent me to the doctor, where an ultrasound showed I had the first stage of nonalcoholic fatty liver disease (NAFLD). The doctor said this develops when fat builds up in the liver. He said fatigue is a frequent symptom and obesity is a common cause. There’s no medicine to treat it, so lifestyle changes like losing weight are the only remedies.
“Annual blood tests during the next four years indicated my liver enzymes were inching up, but my doctor didn’t express concern for my well-being so my weight continued to climb. Then in 2013, one of my liver enzymes jumped and I was sent to a specialist who performed a biopsy of my liver that indicated my disease had progressed to nonalcoholic steatohepatitis, or NASH, the most severe form of NAFLD.
“Up to that point, I had no idea my life was in danger. I just thought I was fat and tired, but the biopsy showed that over 67 percent of my liver was fat. I was shocked and I became determined to lose weight.
“But my enthusiasm was short-lived. My stepdad grew ill and more frail, and I continued balancing trying to be a good mom with being an attentive daughter. For the next six years, I toyed with losing weight, shedding and regaining a few pounds. I was tired all the time.
“In May 2019, everything changed when I looked at my son, then in his early 30s, and became fearful of leaving him without a parent (his father had died in 2016) or of becoming so exhausted that I couldn’t enjoy time with him. I knew it was time to start taking my health seriously.
“I have to do whatever I can,” I told myself. I found FattyLiverFoundation.org and read that sometimes NASH is reversible, and I started to feel hopeful for the first time in over a decade.
“I saw my specialist, who suggested I lose weight, exercise and take 800 IU of vitamin E a day, which he had suggested previously but I hadn’t done. He told me vitamin E has been linked to reducing inflammation in the liver.
“I knew I also had to keep moving. I was self-conscious about my weight, so going to the gym wasn’t an option. So I leashed up my dog, Pippin, and decided I’d walk my way to healthy.
“The first few walks were tough. I couldn’t go more than a minute or two. After a couple of weeks, Pippin and I worked up to walking 10 minutes once or twice a day. At 242 pounds, it was grueling and often left me in tears, but I forced myself to keep going. This is for your son, I told myself with each step.
“I’d often make excuses to skip a walk, but the motivation to be there for my son got me out the door. After a month or so, I added a minute or two every few days. After a few months, I was walking 25 minutes two to three times a day. The more I moved, the less tired I felt! I spent years thinking I needed to preserve my energy by sitting on the couch, and now using it to move made me feel invigorated.
“Taking vitamin E, walking and losing 97 pounds reversed my NASH, and tests show I have ‘minimal measurable fat in my liver.’ I’ve never felt better!”
A version of this article originally appeared in our print magazine, First For Women.