Thank you so much for your thoughtful and relatable answer.
I’m sorry for the long delay - I had some terrible migraine problems and really was out of commission for weeks - I’m back at work now (half days still … fatigue is hard) … weight became unimportant vs unbearable pain and nausea.

I have changed the way I eat (time of day) and a few little things for older women- that has made a pretty big difference.

I had written a response so long I just now cut it and pasted it into notes as it was practically my memoir (once a writer…) …

I did change one medication (Effexor) and that may have made some difference as well.
And of course, while not recommended, having violent migraines for weeks does not lend itself to weight gain.

I’m trying to figure out how to re-create the way I live to include the fatigue.
I used to exercise away (run, hike, bike) any physical problem or moods….
Now I really am unable, but even when I have a good day and exercise- it makes fatigue much worse.

It’s not depression (which I know well) but it’s like depression.

I wonder if there is rehab for someone like me - the ‘lucky’ sliver of survivors without measurable damage. But who has to rewrite how to live.