This sludge shit is so bizarre to me even considering this is Amber.
The sludge is caused by a host of things and the risk of it causing inflamation or gall bladder issues is low compared to what abuse amber is putting her body through. A quick look at bilary sludge (which she has apparently) is good for laugh if your feeling down.
Amber, with her menagerie of health issues essentially was fat as fuck, lost weight with ozempic ("fast" weight loss can cause sludge) and used this bullshit to quit ozempic. The way you get RID of the sludge is you fucking eat right and it goes away without causing any issues most of the time. Low sodium, low fat, low carb.

️everything amber loves

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All amber had to do is continue to eat right and use the ozempic and have her doctor monitor the sludge and make sure it doesn't grow into gallstones or any other issues like inflammation and it would have been fine.
How do you weigh 500 pounds, lose (assuming honesty lol) about 80 pounds in a year, flip shit over the impact of rapid weight loss on your health when that's what you need to do to save your life.
My money is still on defensive weight. Ive already been put in the retard corner by strawberrydouche so i may as well get comfy here and say it again. Maybe if im good ill get puzzle pieces for christmas.
I don't think Amber realizes that she's going to die. I'm not saying she doesn't care about dying. I'm sure Amber doesn't want to die and that she loves her life for some fucking reason. It's not even a real possibility in her mind. A scary hypothetical scenario at the very worst. Don't mind the cancer.
Amber does everything she can to forget that shes a 500lb butter golem and sometimes reality slaps her in the face and she rullizes the situation and tries to fix it. Then about a day later when its hard she gives up and does the coping mechanisms we always see.
I believe Amber has a legit eating disorder. One that she has had for so long at such foundational times in her life that it's indistinguishable from who she is as a person. That's the bitch most people with eating disorders go through - because let's be real, it's a young woman's game. The only real motivation for changing self destructive life long habits is the inevitable moment when one realizes, "holy shit, this will kill me." That's what breaks the illusion of control central to the disorder. The very hard reality that we are at the mercy of bodies that can only take so much.
Maybe she's too stupid to wrap her mind around the concept of death happening to her, too self centered to conceptualize a world without her in it, or a combination of this or that. But Amber won't realize she's dying until it's already done.
She will never figure out what disorders she actually has because she will never go to a therapist and psychiatrist and be honest with not only the therapist but herself. Shes an addict from an addict family who had a terrible traumatic early home life and a terribly boring life as a teenager and young adult. Nobody really paid attention to her.
Shes self important and a narc so shes always torn between the two wolves who live inside her.
She is simultaneously the boring ugly girl from a broken home and the ya protagonist lesbian/bisexual plain but in a super sexy and different way super awesome and deep when you get to know her type whos destined for greatness.
Shes too busy having the money and time (mostly in the becky era) to play out her ya fantasies in real life to notice time is passing and its time to grow up and move on. Shes also addicted to believing everythings ok and playing pretend too. Shes having a watered down version of whats going on with peetz, realizing the dire situation shes in but being too retarded and addicted to the old ways to change even if the outcome may be death if she doesnt do anything constructive and long lasting about it.