in reply to @lildiva4jc I can sympathize with your situation, having lost 40 percent of my body weight as a result of dilation of my liver and pancreatic ducts, and I completely understand you concern about your appearance. In fact, the majority of people in my community now shun me as a result of my appearance, as I do look rather anatomical. Like you, I am unable to gain any substantial amount of weight no matter what I eat. The result of the dilation of my bile ducts is that I have zero appetite, and therefore am unable to eat like "normal" people. Often I must force myself to eat, and when I do, it is usually one of those protein bars found in the refrigerated section of the grocery store, The Perfect Bar. I eat these because of the amount of protein, not necessarily the calories. When I began losing weight, I started a weight lifting program so that I would not lose muscle mass, and everyday after my shower I have a routine lifting 2 pound weights, and the habit has paid off quite well.

I have always been one of those people who care about their appearance, and have this mantra: "If I look good, I feel good." It took a long time for me to accept the fact that I was losing friends simply because of my appearance which has drastically changed. However, I have realized that those, including many who I thought of as "friends", obviously do not share the same value system as I do, and therefore, the loss of my friendship because of my physical appearance is their loss and not mine. Obviously, it took me some time to accept that many do not have a sense of humanity as I. I have been told by others that I look like a Holocaust victim and that I should purchase makeup in an effort to make myself look less gaunt. I have found on an average, women are the worst culprits, as the guys are always very complimentary, asking me how I am feeling, telling me I look great and things of that nature. The loss of my friendship is on "them" and not me. A friend of mine told me that people in general think I have cancer and they do not know what to say. Whether this is true or not is up to question.

Unlike you, I am not a "believer", however, I do believe that "God" has a plan for me, as one of my doctors recently told me. After she said this to me, it became another mantra that has brought me some comfort. This is not to say that I identify as a Christian, but I do respect your beliefs, and if they help you that is a good thing. In all honesty, I still occasionally look at myself in the mirror and am disgusted with my appearance, but also know that I am doing the best that I can in order to function and be a member of society in the best way I know how: helping others, having a lot of humility and generally being selfless, which often creates a problem, which I am working on. Just as religion brings you comfort, art gives me comfort as I am very creative and have the ability to make beautiful things. My art is my therapy. If religion works for you, I commend you for finding something that gives you the strength to get through what often feels for me, a terrible trial.

Like others have suggested, seeing a gastroenterologist is a good idea. I only found out about my bile duct issue when I went to urgent care during COVID and expressed to the doctor an ongoing pain in my upper right abdomen that I had been complaining about to my PCP for quite some time. He ordered a CT scan three years ago, and despite multiple tests and procedures, my doctors are no closer to determining my problem than they were nearly four years ago. It can be frustrating, yes, However, I have not lost sight of the fact that I can still function fairly well, and for this I have an abundance of gratitude.

Best of luck to you.