The Pill

The Pill by Meg Elison, is a 2021 Hugo, Nebula, and Locus-nominated novelette and can be found in the Big Girl (2020) collection published by PM Press.

In the interest of full disclosure, I’m envious. My novel-in-progress for the past several years has been an attempt at a fat-positive but dystopian story involving a weight loss drug with horrific side effects. Using Liz Gilbert’s metaphor for creative ideas–I failed to give the idea the attention it needed, so it found someone who could–Elison–who brought it to life brilliantly.

The story’s narrator is a fat high school girl who wants to make films. Her parents and her brother are all fat, and her mother tries every diet, unsuccessfully, like most fat people. The narrator has internalized anti-fat bias, but resists, as well, commiserating with her father about her mother’s diet schemes.

But the Pill is different. It does something no diet can do–it actually works to make fat people thin, and keeps them thin. Of course, there is a catch. The side effects involve a lot of time in the bathroom and a not-insignificant likelihood of death.

Elison masterfully describes the devastating effects of the Pill both on the narrator’s family and on society. What happens when most Americans are no longer fat? What happens to those who resist? Where can they go?

Because the story is about anti-fat bias taken to the extreme, it can be very difficult to read if you’re aware of the water we swim in. At the beginning, although the narrator sees her mother as desperate to become thin, and recognizes the folly in that mindset, she also tries to distinguish herself from her brother, who is fatter. She doesn’t seem to realize that this, too, is anti-fat bias. Any time we compare ourselves to someone else and find that “at least we’re not that fat” we are perpetuating diet culture and the idea that smaller bodies are better than bigger bodies. Ultimately, the narrator that she “used to see him as the enemy when he was just me.”

Elison also captures how it feels to stand against diet culture when it seems like everyone else is always trying to make themselves smaller–to make themselves less like you. Regarding the narrator’s mother: “Every time she tried to change who she was, who we all were, it was like betrayal.” There is no way to be fat-positive, to accept your body and other fat bodies as they are, and be engaged in intentional weight loss of any kind. The two things are fundamentally at odds with each other.

I’m now looking forward to reading her award-winning trilogy, The Road to Nowhere series (2014-2019): The Book of the Unnamed Midwife, The Book of Flora, and The Book of Etta.