Nursing Book Club

The Elephant in the Room by Tommy Tomlinson

A memoir of obesity and transformation

Fat people in the U.S. — even those who are only moderately overweight — face considerable scorn and shame, from strangers staring judgmentally if an overweight person dares to eat in public to the doctors whose answer to every health concern is, “Have you tried losing some weight?”

Sports journalist, newspaper columnist and podcaster Tommy Tomlinson was on a whole other level. Weighing well over 400 pounds with a BMI of 60.7, Tomlinson qualified as morbidly obese. “I’m 6 foot 1 inches tall. My waist is 60 inches around. I’m nearly a sphere,” he says at the beginning of his new book, The Elephant in the Room. “Those are the numbers. This is how it feels.”

Elephant is a memoir about how Tomlinson reached that level of obesity and what he set out to do about it. It is also a frank and funny account of the headaches his size has presented in his daily life. Tomlinson’s shirt size was 6XL (XXXXXXL), which is only available online or from a handful of big and tall men’s stores. Whenever he left home, his wife Alix (who couldn’t put her arms around him) had to scout ahead to find chairs or other furniture that would support his weight. He was always afraid of crushing people if he stumbled and fell on them.

Hiring Now

Flying on an airplane also presented problems. He recalls that the first time he flew, he found that the seatbelt didn’t fit. Since he didn’t know then that he could ask for a seatbelt extender, he settled for just clutching the armrests for dear life while covering his lap with a blanket so no one else would see. Tomlinson lived with these challenges (and more) for years. He would sometimes lose significant amounts of weight only to gain it back. What drove him to his most recent quest was the realization of how much it would hurt his family and friends to lose him.

A Winning Recipe

As a journalist — he’s written for ESPN, Esquire and Forbes, among others — Tomlinson is aware of weight loss fads. Rather than waste his time and money on miracle drugs or diets, he took the slow, methodical approach: eating less and exercising more. (In the book, he presents a year’s worth of his monthly statistics.)

Nursing Education

You’ll have to read the book to find the payoff for yourself, but I was rooting for him from the start. Tomlinson is a completely engaging Southern storyteller (which I offer as the highest form of praise!) and I enjoyed every single page.

His account is sometimes heart-wrenching as well as funny, as Tomlinson explores the way he has used overeating to compensate for emotional wounds, only to find himself trapped in a cycle of weight gain and self-loathing. Breaking that loop has been a vital part of his journey, just as much as finding diet and exercise habits he can live with.

For nurses, this book is an important reminder that we need to treat the whole patient, not just their symptoms. What may seem to us to be a straightforward health issue may be only the tip of a more complex iceberg that patients must come to grips with in order to effect real change, even if that change is ultimately positive.  The Elephant in the Room is a delightful and eye-opening book, and I hope you enjoy it as much as I did.

The Elephant in the Room: One Fat Man’s Quest to Get Smaller in a Growing America by Tommy Tomlinson (Simon and Schuster, 2019)


Christine Contillo, RN, BSN, PHN, is a nurse with more than 40 years of experience, ranging from infants to geriatrics. A graduate of Cornell University and The Catholic University of America, nursing has taken her from inner cities to Central America.


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