Sara begins taking diet pills

Sara Goldfarb’s decision to take diet pills turns a wish to lose weight for television into a medically authorized routine whose early rewards help conceal its dangers. The pills promise visible progress toward her old red dress, but they also alter her appetite, energy, and behavior; later, the hospital dispute over her condition exposes how that regimen and her lack of adequate food have become part of a medical crisis.

Before the Prescription

Before seeking treatment, Sara’s expectations are already shaped by television. Watching commercials and domestic dramas, she imagines a thin, attractive wife, a happy household, and a son who will find a suitable woman and settle down. The screen offers her not just entertainment but a ready-made picture of the life she hopes to approach. Her attachment is material as well as imaginative: she has previously gone without meals so she can keep the television set, making food and the screen competing claims on her limited money.

That pattern makes the promise of weight loss especially potent. Sara worries about her appearance and hopes to fit into the red dress, while television supplies the audience and occasion for which she imagines wearing it. The eventual medical visit is therefore not an isolated effort to improve her health. It joins a longstanding wish for transformation to a public fantasy of being seen, admired, and welcomed on a quiz show.

Consultation and the Pill Routine

At the clinic, Sara joins a crowded waiting room of strangers who seem familiar to her. A nurse weighs and measures her, checks her blood pressure, and asks about her hearing and vision. The doctor then tells her that she is overweight but otherwise appears to be in good condition. He offers a package of pills, instructions, and a return appointment in a week. When Sara asks about the cost, the nurse reassures her that Medicare will cover the bill.

At home, Sara studies the instructions and sorts the pills by color and time of day: purple in the morning, red in the afternoon, orange in the evening, and green at night. She treats the schedule as a complete plan for losing weight, even jokingly substituting the pills for meals. The routine gives her a simple sequence to follow and the feeling that weight loss can now be managed by taking the right pill at the right hour.

Her first meal after beginning the regimen sharpens the contradiction. Sara takes a morning pill, then celebrates with an onion roll, cream cheese, and smoked fish, turning toward the refrigerator as if to show that she can still enjoy food. She expects that she will soon save money on groceries, but the medication initially coexists with a substantial breakfast rather than immediately displacing it. The change comes with the day’s appetite and energy: she drinks coffee, realizes she has made a second pot, and finds that lunch holds no appeal. Foods she would normally want no longer attract her. Feeling exhilarated and unusually energetic, she interprets this loss of appetite as evidence that the treatment is working.

Early Results and Escalation

The early effects reinforce Sara’s confidence. After two weeks, she has grown accustomed to teeth grinding and accepts it as a minor inconvenience in exchange for feeling good and seeing her weight fall. Each morning and evening she tries on the red dress and checks how much closer its back is to meeting. At a follow-up visit, she learns that she lost ten pounds in the first week. The number eclipses her unease about bulging eyes and other physical changes: she continues to attend weekly, be weighed, receive more pills, and sign the Medicare form.

The pills also change how Sara spends her days. At first she drinks as much as six cups of coffee, then makes another pot without fully registering how much she has consumed. Although she later limits herself to one pot in the morning and tea for the rest of the day, she remains unusually energetic and restless. She gets up repeatedly to stretch or walk while visiting with the other women, and takes pleasure in showing them her changing figure. The treatment thus becomes more than a prescription: its measurable weight loss, the repeated clinic visits, and the attention she receives all help make continued use seem successful.

Consequences and Medical Dispute

As the story progresses, the gap widens between Sara’s expectation of a television future and the reality of her deteriorating condition. She continues to focus on thinness, wears the red dress and gold shoes, and refuses food even as flesh hangs from her upper arms. Her television watching becomes increasingly bound up with her sense of herself: she imagines herself answering quiz-show questions, receiving presents, and being applauded. In another disturbing turn, figures from a program appear to leave the screen and inspect her shabby apartment; Sara experiences their scrutiny as public exposure and shame. These later scenes extend the earlier dependence on television as a source of reassurance into a frightening collapse of the boundary between broadcast fantasy and daily life.

The clinical consequences become explicit when Dr. Spencer argues over Sara’s treatment with Dr. Harwood. He reports that Sara was admitted disoriented and diagnosed by Dr. Reynolds as paranoid schizophrenic, with possible shock treatment recommended. Dr. Spencer says his examination found that she had been taking diet pills and Valium and had not eaten a decent meal for many months. In his view, her condition is medical: rest, proper food, and clearing the stimulants and depressants from her body would allow her to recover. He cites six patients with similar symptoms whom he treated medically, saying they recovered in less than a month without shock treatment or psychotropic drugs. Dr. Harwood, however, backs Dr. Reynolds’s orders and rejects Dr. Spencer’s attempt to transfer Sara to medical care. The initial prescription therefore leads into a conflict over what has happened to Sara and what kind of treatment she needs. The weight-loss routine that once seemed orderly and effective has become inseparable from inadequate nourishment, drug effects, and a struggle to have her condition recognized correctly.