Every morning, I step on the scale and cross my fingers. Sometimes the number is up. Sometimes it’s down. Sometimes the reason is obvious (a pizza and wine binge); other times not so much (a week of no alcohol and plenty of fruit and veggies).

I pour my morning coffee, contemplating whether I should dilute the fattening half and half with unsweetened almond milk, before injecting myself with 3 mg of Saxenda, which I credit for my weight loss of 40+ pounds in the last 11 months.

I’m not an actress or a super model trying to maintain a trim figure to please an agent and audiences. I’m just trying to be reasonably healthy.

My life is busy. I have a career, a home, a partner, pets. Exercise is a struggle for me – I’ve never been athletic (owing to my bookworm childhood and studious youth) – and placing self-care ahead of my professional or domestic responsibilities elicits guilt. I blame my parents for that.

I had accepted my status as an overweight – clinically obese – person. One could be fashionable, professionally successful, even somewhat physically active, without being thin. After all, I have a pretty active brain. Then it sideswiped me: the genetic information I had gleaned from a DNA test.

If I don’t reduce my weight, I could die.

Talk about a wakeup call. As my mid-50s zipped by – and I began to approach the age that my ancestors died of cardiac arrest – doing something to slow health decline became more important.

That, and my love of travel. A hike through a Costa Rican rain forest that I thought might kill me was a bit of inspiration, too.

My endocrinologist prescribed Saxenda, a weight loss version of the diabetes drug Victoza, to help me lose weight. Despite several levels of appeal, my health insurance wouldn’t cover it. My mail order pharmacy that provides my two blood pressure meds for a very low price charged me $1685 for a one-month supply (and refused to honor the manufacturer’s coupon that would have shaved off $200). Obviously, that wasn’t a viable option for the long term.

I found a Canadian pharmacy that caters solely to Americans who can’t afford their medication (there are several, sad commentary on the state of our government’s relationship with drug manufacturers) who offered the drug for $500 a month. I earn a good living, but I’m not rich. I discussed it with my partner, and we agreed that being bankrupt was better than being dead.

So here I am. And I’m telling my story because it’s a story shared by 70 million or so Americans classified as obese. Most of them can’t afford $500 for a drug to help them lose weight.

It’s time to take on the health care establishment, employers, insurers, and public opinion: obesity is a disease that deserves treatment.