DebraSY

Debra’s Gone Defunct (not entirely — I’m not dead)

In Weight-Loss Maintenance on October 3, 2011 at 10:10 am

Welcome, newcomers and old friends, to Debra’s Just Maintaining!  For roughly a year, starting September 29, 2010, this blog set about exploring the cultural mythology and science surrounding weight-loss maintenance, especially after “radical” loss (more than 10% of highest body weight).  As blog owner, I found myself moderating a discussion involving mostly weight-loss maintainers and size acceptance proponents, two seemingly disparate groups who ended up having more in common than any of us might have expected.   It turns out we are all betrayed by the myth that radical weight loss is some hard-won victory, to be followed (of course!) by maintenance, a less challenging, zippy “lifestyle” composed of tips and tricks.  It’s much more complicated than that. 

This blog is not a “big” blog, but big enough, and certainly has much heart.  Over the year it received just over 60,000 “views” of its various posts.  Many were repeat visits from people I came to regard as friends, dear friends.  We shared a sort of cathartic grief process as we stripped apart the mythology, and discussed from a lay vantage point some of the science surrounding weight-loss maintenance.   In addition to the maintainers and size acceptance advocates, we also entertained a scientist visitor from time to time, and a couple of trolls.

The blog is now mostly defunct because I have gone on to other time-consuming pursuits, and I also need time to be a good Mom, and to continue my weight-loss maintenance, an endeavor that I regard as a third- to half-time unpaid job.  To be competent at these things, something had to give. 

Since the blog is mostly defunct, it’s likely that you arrived here because someone sent you here or you conducted a search for “Weight-Loss Maintenance” or some topic discussed here.  A lot of people find this blog with searches to the effect: “Is obesity killing our children?”  If that is you, you are looking for this post.  Other people are apparently interested in a maintainer’s take on intuitive eating.  That would be here and here.  And a lot of people want to know what I think about journalist and anti-carb pundit Gary Taubes.  Those posts are here and here

If someone sent you here, it may be because you just lost a lot of weight and said something silly like, “If I can do it anyone can!”  Then that person wants you to start with the post subtitled Skiing as Useful Metaphor.

Other reasons someone may have sent you here: 

  •  You said something insensitive or rude about fat people being “in denial.”
  • You said something insensitive or dismissive of someone who works hard to maintain a particular weight – along the lines of “but certainly the rewards outweigh any effort you expend.” 
  • You said something definitively naïve, such as, “science has proven people are fat because of modern breakfast cereals.”  
  • You announced that you are embarking on a weight-loss process/diet (what number?), and a friend wants you to have a realistic idea of what lies ahead, more so than what some women’s magazine or morning news show may be touting today as a “breakthrough.”
  • You are struggling with weight-loss maintenance.  Perhaps your weight is sliding.  You need affirmation from a kindred spirit who knows how challenging this is, and doesn’t sugar coat it or pop off with “inspirational” platitudes.

If any of these rings true, you may wish to read this blog chronologically and thoroughly, like a book.  It won’t take you long; there are fewer than 70 posts.  Give yourself the luxury of reading the comments/discussions that follow each post.  Many of the readers/commenters are smarter and more eloquent than I am. 

Start with the “About” page, which connects with the first two posts, The Unfairness of Weight Loss Maintenance and Weight Loss Maintenance:  The Job Description and one additional post, The Slide into Hell:  Regaining Lost Weight.  That’s enough to read in one day.  You’ll want to take a nice walk, let the reality set in, and clear your head.  Then, with fresh eyes, slog on through.  Click on October 2010 and work your way to September 2011.  What you will read between the lines is the story of an angry woman (that would be me) who throughout the year grew more stoic, which is not a failure or something to be sad about.  Stoicism is not a lack of joy; it is resoluteness.  It is making peace with what is.

If you don’t want to read the whole thing, my personal favorites (in addition to About and its links)  include:

Other popular pieces (that received more than 500 views in their initial runs and are not mentioned earlier in this post) include:

I recognize that the other (roughly 40) posts are mostly on science or public policy regarding obesity.  I guess some people find that stuff dry, but I loved writing on it and would treasure others reading it.

If you are a long-time reader of this blog, as I leave I would like to offer one last word of gratitude.  You have been so sustaining to me.  Each day that I would awake to find an email message (or several) that a comment had appeared on a blog entry was a boost to my spirits – even the comments that challenged me.  Your comments of late (following my announcement to shut down) have been like having the gift of attending my own funeral.  You have shared such kind words and provided much encouragement to continue writing.   These past two weeks, I have been quite circumspect as this day approached.

Despite the blog’s mostly dead status, I hope all readers will feel free to read or reread anything of interest, and leave fresh or revised comments for me on any of the posts (WordPress will send me an email alerting me).  I will get back with you on the post itself or by email. 

Additionally, consider subscribing to this post.  This is where I will leave a comment of my own if I decide to open a new blog, or maybe even get that book published that I have drafted and keep grousing about.  I think to subscribe you may need to leave a brief word, such as “subscribed,” and check the box asking to be notified of follow-up comments.  I’ve never tried to subscribe to someone’s blog comments without leaving a comment of my own, so I don’t know whether that would work.

Much love to you all, dear friends, maintainers, size accepters.  Even as you grow wiser and older, may you also keep “maintaining.”  What a metaphor!  And it beats the alternative.

  1. Sniff…sniff…

    • Sniff, sniff back atcha. I’ve been peaking in to learn of your misadventures in our most beautiful state. Woof! I’m assuming you’re snowed under.

  2. I love your writing . . so much that I read your book six or seven times. I know that writing takes a lot of focus and energy and commitment, and that you need to focus your attention on your new calling. To be honest, if you feel like writing, I’d love to see you put the energy into your book before a blog, because I think that your book has so much potential to help people. It has so far helped me lose just over 10% this year . . . and I’ll keep the link to your blog because I very much need the support for maintenance, and your articles are very re-readable.

    So . . . after you sell/publish P&V, then you can write your book about maintenance! You’ve already made your notes . . .

    Thanks so much for all the work that you have done!

    • Teri, that’s amazing that you’ve read that manuscript so much. I’m stunned. And surprised that you found it helpful, actually. The edition you have, if I’m remembering correctly, is one of the first drafts of the original manuscript, which I have since dumped. I believe you have “The Piss and Vinegar Diet.” At that time, I was still the “joyful jogger” in my mind, but I knew there was something woefully wrong with how women’s magazines, weight-loss gurus and others were interpreting weight loss and maintenance. But I hadn’t really come up with my own vocabulary. I hadn’t come up with the job metaphor. Hadn’t addressed the unfairness issues. Just called out others as wrong (and explained why I thought so) and reported what I was doing. I since have reworked it from scratch and I gave it a working title of “Fat Chick in the Closet.” If I do determine that I need to be published, however, I’ll work it over again, and I don’t know what the title will be. I do know this blog has really helped me hone a perspective. I’ve stood up to some challenges. I’ve bent to others — a little. I’ve roared, at times and the world kept turning, and that felt good. I like to roar. But, anyway, thank you. You can’t know how dear your words are.

  3. Debra, thank you for your friendship and your wisdom. I am excited for you in the new direction you have chosen to take. I hope I checked the right things so I will hear from you if you decide to write/publish in the future.

    p.s. did you see Mr. Monk’s ‘day in the life?’

    • Well, must admit, I hadn’t. I’ve started my coursework and have put many things in the “do it on the weekend” file. But I raced over there tonight, and, oh, my, my, my. You could make that into a children’s book! What a character. My fav, like most of your readers, is when you carry him like a baby and he’s just flopped back in utter trust. It’s also hysterical that he won’t step on cracks — doesn’t want to break your back, I suppose. And he waits like a gentleman, for food and his lap time.

      Thanks back for your friendship. Did you get my verbose email waxing philosophical on bread/grains?

  4. Good luck in your new venture! I will keep reading and re-reading your words. Thank you for this blog.

  5. Debra – may I hope that some of your other projects might include taking your essays from this blog — or at least your best ones — and turning them into some kind of a book, even if just an ebook or self-published?

    I come back to your posts again and again and am not looking forward to seeing them go away. There is a lot of wisdom here, and I have enjoyed listening to your voice of sanity.

    • Thank you, FatChickinLycra.

      Perhaps, perhaps. I get a bit of a winter break. Perhaps then I’ll think about how to synthesize these things.

  6. Subscribing! Also, just found this story:

    http://www.nytimes.com/2011/10/27/health/biological-changes-thwart-weight-loss-efforts-study-finds.html?_r=1&hp

    “But it is also possible, said Dr. Jules Hirsch, an obesity researcher at Rockefeller University, that researchers just do not know enough about obesity to prescribe solutions.”

    LOL.

    Are you still interested in seeing links to studies like these? Or if other people among your readers are, this might be a good place to comment with links that people subscribed could see.

  7. Oh, closetpuritan, THAT article is spectacular. I love reading this stuff still. I just don’t have the time to compose blog posts on them. Thank you for sharing that.

    Now, if I did do a post on it, I know that I would say that I adore the work of Rudy Leibel. He is a good egg who gets how multidimensional this issue is. Oh, how I wish the NWCR would look closely at his work and PICK UP A CLUE!

    And I would also grouse again about our limited concept of hunger. Even the esteemed Times reduces the vocabulary to two words: hunger and appetite. In the article they talk of hormonal changes in Ghrelin, Leptin and Peptide YY. Since these are the three “biggies,” shouldn’t their effects merit at least three different words?

    In fact, there are probably 20 or more hormones, peptides and other chemicals that are permanently thrown out of whack in a weight-reduced person, and they may each register in our consciousness differently. I would guess that only a few produce the recognizable symptom of empty-stomach hunger (which we may rate on a scale of one to ten). Others work in the reward centers of our brain cueing subtle desires for food — possibly for specific macronutrients, some may cause salivation (which also subtly prompts us to eat), some may cue a headache or other symptom that we do not call traditional “hunger” but will attempt to cure (to our body’s delight) by eating. Impulses to eat are so complex, and yet we reduce them (even in the NY Times) to simple “hunger and appetite.” Grrrr.

  8. Hoping you’re still checking in…

    Did you read Dr. Berkeley’s response to the study referred to in the NYTimes article?

    She is all about the “primarian” diet, which she seems to tout as the answer to all our ills. Wear her diet straight jacket for the rest of your life, eschew (oh pardon the pun) any grains, sugar, the whole enchilada and you will (probably) never be hunger nor crave again. It’s the Puritan school of dieting.

    I do agree that putting the subjects on such a horrid, drastic diet sort of stacked the cards in favour of weight regain. It’s really unfortunate that no one is willing to measure hunger hormones in subjects who have lost weight through a variety of different weight-loss programs, be it WW, low-carb (the primarian diet being of version of said low-carb diet), packaged food diet food systems like Medifast, etc.

    I found neither the Australian study, nor Dr. Berkeley’s response satisfying. I’m still hungry for more!

    • Yeah, NewMe, I saw the post. Actually, I came to the game late, but I did get around to commenting on it. I told her how I found the Australian study affirming and comforting, since it looks at hunger as a dimensional thing, not a single sensation that can be measured on a scale of one to ten, and I suggested she look at (and comment on) the work of Rudy Leibel and Katarina Borer. She asked me for links and I emailed a bunch to her. She’s keeping her mind open, I think. But she acknowledges that her clinical practice informs her opinions and may create some bias.

      She is right that the study design is weak and the media coverage was overblown. And you are right, that this is only an appetizer. We need more! As small as it is, however, I feel affirmed on so many grounds. It’s like the period on the end of my blog year. I gotta thank Closetpuritan again for posting it here.

  9. I’m so sad to have discovered this wonderful resource just as it’s coming to a close, but I wanted to express my gratitude to you for leaving the site up. It has been a wonderful resource to me, and I’m still on the downhill ski, I’ve still got a long way to go before I’ll have to strap on those cross-country skis and try to follow in your trail.
    Thank you to you, and to all of your insightful commenters. My only regret is that none of you appear to be able to find the same open mindedness about those of us who choose the weight loss surgery route as everyone brought to your post on plastic surgery, such as the following:

    “But my not choosing surgery does not in any way mean that I would condemn anyone else for their choice. We all ‘gotta do what we gotta do’ and (cough, to use a 70s pat line) the world would be a better place if people were just a little less quick to judge.”

    “I think the implication–both for me and for you and for anyone who makes the decision to have surgery–is that we’re not competent to make the right decision for ourselves. That’s what’s so profoundly disturbing. We are adults but this kind of “concern” infantilizes us.”

    Of course, you’re all more than entitled to your opinions (It is YOUR blog after all! :-) ). But it saddens me, because I think there’s so much WLS maintainers could learn from you, and possibly even things you could learn from us, as we learn more about the way surgery changes the biochemical processes, giving us (at least according to the medical literature I’ve seen) more of a sporting chance at maintenance.

    Subscribing …. in hopes of seeing more of your wisdom in the future.

    • Ah, Beth. I’m glad you found this blog useful. With regard to bariatric surgery, I think what you are reading is a necessary voice, but I understand how it must feel painful to you. If I were you, reading this blog, I would, metaphorically, put my fingers in my ears and sing “la-la-la” when those conversations popped up.

      People here have felt safe challenging and even complaining about bariatric surgery, especially when it is marketed as weight-loss surgery (on mostly cosmetic grounds). Many feel their voice here helps balance the million$ in propaganda that Allergan, Johnson and Johnson, certain “weight loss” clinics and others who profit from the surgeries (and dismiss the complications) submit to the marketplace of ideas every day. I know you feel stung here, but there are a lot of places where they get stung — places where one dare not question bariatric surgery for fear of being flamed: “Don’t you get it, Moron?! These obese people are going to DIE without this!!! YOU will DIE without this!!!” Well, as you acknowledge, it’s more complicated than that. And, actually, so does everyone here. Vesta, for example, has done EVERYTHING, including bariatric surgery. And she did those things with open eyes, realistic goals, etc. Nevertheless, EVERYTHING has failed to compress her body into the “normal” or even “overweight” BMI range for any length of time, and she has more health complications than she used to, not less. She’s tried so hard to color inside the lines, I think she’s earned the right to challenge the coloring book. I also suspect that if bariatric surgery had “worked” for her, she would have been graceful about accepting her blessing and acknowledging its limitations for others. But it didn’t. And she’s hopping mad. And I’m okay with that and I join her in her anger.

      I hope you start a blog, and that you commit to being as reflective and honest as you can be about this process. While hope and optimism have their place, I think we often let them blind us or deceive us. The “zippy lifestyle” myth, for example, was born of optimism. But it is, indeed, a myth, and one that I have frequently shed light on, so we may see it if we have eyes and the inclination to open them. The myth that bariatric surgery is a “solution” to obesity and all related complications is one that you may need to expose. That it’s the “easy way out.” Uh, right. You already acknowledge that you are at the beginning of a process. Well, what does that process look like, honestly? Stripped of the mythology and dismissive assumptions and propaganda, what IS it, honestly. I think that’s a niche that needs filling. And you are right. Science is beginning (finally) to acknowledge that your endocrine profile is different from mine — likely radically different — because of the surgery. I would be honored if you would sometimes use my experiences as a foil to investigate your own. And be open to changes that happen over time. Come back and let me know when you launch your blog.

  10. I’m not sure exactly how I came across your blog, but I can say for sure I started out at the NYT article by Tara Parker-Pope http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html. This was one of the first articles on weight reduction / regain I’ve ever read that makes sense. Your ski-slope blog post is better still. I look forward to reading every page of your blog.

    Last year, I dropped from 165 to 145, because my knees are shot, and I want to avoid knee surgery as long as possible. A weight loss of 20 pounds seems trivial compared with 150 or 200 pounds, but it was, after all, more than 10% of my body weight. I’ve been experiencing the very same problems you describe, with the hormones too often winning. In fact, I’m sitting here right now feeling very, very hungry, even though I know I’ve had plenty of calories for the day. I believe that understanding more about what’s happening within may help. I find that I need more than just my wish to avoid knee surgery.

    Perhaps more important than getting help with my own weight loss and maintenance is the new attitude I’m learning from reading your blog. It’s hard not to absorb the general cultural consensus that there’s something wrong with people who are not skinny. I like that you dare to question the medical industry’s proclamation that weight causes health problems. I had never before stopped to think that the obesity studies have not taken into account the health effects of striving to lose weight, or the psychological damage, which can affect physical health. It would be interesting to compare groups of people in cultures where curviness is considered beautiful with people in cultures where thin is the standard of beauty. (I know that in the past, there were cultures in which curviness was considered beautiful; are there any such cultures now?).

    Thank you for taking the time to do so much research and writing.

    • Welcome, Barbara, and thank you for that link! Wow. First of all, let me solve your mystery. This is how you found me: The article references Lynn Haraldson, a fellow maintainer and on-going blogger. It did not provide a link. (Which it should have! Lynn is a fine resource. Pragmatically, better than some of the scientists Ms. Parker-Pope cited.) At any rate, you must have Googled Lynn. My blog is on her blog roll. You are a good researcher, and intensely interested in this topic, as am I. And actually, you aren’t alone. Now that I’m “defunct,” I can more easily see “spikes” on my blog’s stat sheet, and I’ve had a big two-day jump. Now I know why. Unless you have personally reread my entire blog three times (some posts five times), you have fellow travelers with you who have found me too.

      Again, thank you for the link. You cannot know how interesting that article is to me. Tara Parker-Pope is one of two writers from the NYT that I read from time to time. In the past, I have held her colleague, Gina Kolata (author of the book Rethinking Thin), in much higher esteem. Ms. Parker-Pope always seemed to fall into cultural mythology traps regarding weight that Ms. Kolata (a naturally trim woman) was able to avoid. Now I know why. Tara’s got a pony in the race. She’s one of us! Generally, I think it’s indulgent for journalists to insert themselves directly into their stories, but I forgive Ms. Parker-Pope this time. It explains years of slant that conveyed, subtly, a sense of fat shame and blame. Now I know that blame and shame was her own. I hope this article marks a true (also subtle) change in her tone, both for her own sense of sanity and our access to better reporting. (I was disappointed, however, that on the last page she still talked about weight loss, though modest, for the sake of loss. She’s not completely getting it yet. Health improvements are a result of behavior changes, not weight loss.)

      She quoted some of my favorite scientists and least favorite. My favs: Leibel and Rosenbaum at Columbia. These guys are breaking real ground! Do a search at Arya Sharma’s blog on Rudy Leibel for a nice lay-friendly interpretation. My least fav: Rena Wing at the National Weight Control Registry. She began her think tank with an agenda instead of a hypothesis, and she still hasn’t seen the light. It makes me sad that the NWCR maintains a database of the only people who really KNOW this conundrum, maintainers, and yet they mostly waste it. They ask us innane questions, treat us like children and do essentially NO empirical research on us — no blood or urine samples, no endocrine tests. Nor, to my knowledge, do they release us to other scientists, even though we give them permission to do so. Sigh.

      Well, thanks again for visiting. And good luck on your quest. Yours is complicated by its orthopedic nature. In order to do weight-loss maintenance, ya gotta be able to exercise, which can be hell on joints. Catch 22. At 145-165, you’re not so big that a doctor would refuse to fix your knees just as you are. Actually, unless you’re three-feet tall, that’s not big at all. My guess is that you will reach the conclusion that you gotta fix your knees first (ACK!) before you can then consider taking off a little weight and all that implies — maintaining a loss, which is more difficult than previously advertised but which may help keep your new knees good for a long time. So much to think about. Hug.

      • I stand corrected. You found me via Refuse to Regain. I see you left a comment there. I just did too. I think Barbara gets a bit tunnel visioned in her own practice, which she forgets is radically different from most other doctors’. That said, she is an INVALUABLE resource.

  11. No, I’m not big all over. Small arms, large thighs. The upper and lower parts of my torso obviously lead different lifestyles (ha). I know what you mean about exercise. Fortunately, full range-of-motion exercise seems to be good for my knees — I can, and do, use a stationary bike, lift heavy stuff when working in the garden, do push-ups and many of the pilates exercises, walk for 4 or 5 miles, climb stairs. Eventually, I’ll get knee surgery.

    They keep making improvements in the process, even taking stem cells from other parts of the body and rejuvenating them to produce new tissue. I’m trying to hold out for a time when I can grow my own new knee parts.

    It’s amazing what a difference 20 pounds makes. Before I dropped the weight, I could barely manage a flight of stairs and couldn’t walk more than a couple of blocks. I doubt that it’s been the weight loss alone — gotta also be the general change in the nature of my diet. For example, when I eat meat now, it’s mostly grass-fed-finished beef or bison or chickens I’ve raised myself or bought from someone I know. I’m pretty sure the weight loss alone is at least partly responsible for my relief, because if I’m carrying things or wearing a heavy backpack, my knees hurt when I climb a flight of stairs.

    I just read of your plans to work as a hospital chaplain and am warmed by your desire to learn all you can about many different religions.

    • I get the difference in joint comfort. Before I lost my weight I had joint issues too. They returned about four years into the maintenance, when I was a runner (running mostly on concrete). My left foot also started having complications. Such is life. I have adjusted, in my own weird way. And, like you, I will get a reminder of how vulnerable joints are if I take a set of stairs while wearing my weight vest. It sounds like you are doing, intuitively, what you need to be doing, both in diet and exercise. If there is anything I know, it’s to trust yourself. Be suspicious of helpful people, especially amateur oracles holding women’s magazines, but also trainers and doctors. Maintenance is individual and body wisdom and self monitoring are your best guides. But I think you’ve figured that out.

  12. Just saying hi and telling you I thought ALL DAY yesterday how much more awesome that NY Times article would have been with your work in the mix. A thousand times more awesome. Hope you are well and happy!

  13. Thanks, ViolaLee! And happy New Year!

  14. Yes Debra, the mainstream should be hearing your voice too. But since you don’t tow the party line, so to speak, it’ll be a cold day in hell before people listen to people like you.

    Hope your studies are going well. I miss your blog.

    • Studies are going well. Thanks for asking. They eat up as much time as I’ll give them, and I give them a lot. I like pondering imponderables. At least for a while. I’m not tired yet.

      Regarding the “mainstream,” I did a kind of ballsy thing the day before yesterday. I went to Tara Parker-Pope’s website and invited her here. Now that I know she wants to join the 3% club (though I don’t know she acknowledges that it’s that low), I figured, what the heck. She might like talking to little ol’ me, for personal reasons, not journalistic. I’m still getting a statistical “bump” from her article: people finding Lynn and then finding me. Wild.

      Now, my motives aren’t completely altruistic. Sure, I’d love to help her join the 3% club, if that remains her goal after reading everything else here. But more importantly, Tara’s voice is an important one in the marketplace of ideas. I hope this article signals a beginning to ramped up questions to “the party line,” as you say. For example, I really wish she wouldn’t quote the NWCR without qualifying it or holding their feet to the fire — The NWCR is a think tank started on an agenda, not a hypothesis, and to this day it’s still a very dangerous thing because they won’t confront that (my continual overtures to them notwithstanding). I actually think they could do some good if they would get honest with themselves. I think in Ms. Parker-Pope’s article they’re now claiming to follow 10,000 maintainers (nearly double from a couple of years ago), and they’ve started including post-surgical maintainers, which is fine, if they’d only be forthcoming about what percentage are post-surgical v. the percentage that are “gut-it-outs” like me. Instead, they just play more flim flam games and scientific sleight-of-hand to try to prove their agenda. Ms. Parker-Pope would be in a position to grill them. She has the weight and force of the NYTs. I’m praying she visits and talks to me.

      Girlfriend, Tara, you out there?! I know you get a bazillion emails, but we’re special here. Honestly!

  15. I’m leaving a comment so I can subscribe. I am also sad that I have found this so late, but better late than never. After finding a link to this post from somewhere else (I think it was a comment to you from vesta44 on another blog, about something being similar to what you were saying on your blog) and being taken to the Defunct post, I began at the beginning because that was your recommendation for someone who was struggling with weight maintenance (and I have lost the struggle several times). I have learned a lot, and it’s been quite an emotional roller coaster reading the whole thing and all the comments over the last week or so.

    I am so impressed at the conversations that have occurred between the commenters, and the level and tone of the conversations is just astonishingly respectful and informative, the like of which I have not seen anywhere else. I wish I could have been a part of those conversations when they were occurring, but I have had the thrill of witnessing them over a very short time span rather than the year+ during which they occurred.

    I hope you can afford to leave this blog up indefinitely, as it is an incredible resource for people in many different phases on the weight-loss continuum. The thoughts expressed here have helped me shift from my “I have to lose this weight to be healthy” mindset which was instrumental in my loss of almost 50 lbs. in 2009 and 2010, then blaming myself for regaining 20 lbs. in 2011, while still trying to lose, and feeling like a failure, to an understanding that this is not the result of a character flaw or moral failure, it’s my body doing what it’s supposed to do. I appreciate the straight talk about what maintenance takes, and have decided to “dig in my heels” where I am, accept the part-time job, and find ways to do what I have to regarding maintenance of this weight. I will continue to use this blog as a resource for as long as it remains accessible.

    Good luck and best wishes in your new career.

    • Thank you, Denise, your words hit me deeply. I’ve been itching to blog again, but I just don’t have the time to do it thoughtfully. I feel I owe the world thoughtfulness, even if my thoughts are mistaken.

      One thing I would blog about, if I were blogging, which I’m not, is how I have re-sythesized some of the information that unfolded here. The following has been on my mind recently, and it may help you, as a maintainer. (Apologies for wordiness.)

      At one point, early in the blog, when I was talking about the “chemical cotillion” happening inside us maintainers, I identified two dancers as monogomists: Ghrelin and Leptin. Suffice it that I’ve decided I was mistaken.

      Katarina Borer, who literally wrote the book on Endocrine and Exercise, has recently concluded that Ghrelin works on the reward center of the brain (which is different from Leptin, which sends us more direct satiety cues). She also showed in her experiments that Ghrelin responds to Moderate Intensity Exericise (which I capitalize so that I may hereafter just call it MIE). The National Weight Control Registry tells us that nearly all of us, I think it’s 94% or 96%, engage in one hour of moderate intensity exercise daily. The NWCR’s conclusion is that it’s calorie balancing, but I don’t think so. Keep these thoughts, then chew on this:

      Cummings et. al., which I also blogged on, may show us (and I believe it does, even though it’s a weak study) that Ghrelin, in non-surgical weight loss maintainers, is elevated throughout the day by 24% — in other words, on average, we maintainers are 24% hungrier when we’re hungry and 24% less satisfied when we’re satisfied. (This is different from post surgical maintainers whose Ghrelin is suppressed by 77%, at least in the time frame that Cummings studied.)

      My thought: Ghrelin, at the chemical cotillion, dances alone, to its own rhythm, some circadian thing in tune with the time of day we normally eat. It prompts us to seek food using its own unique reward-center impulse, which is a different kind of hunger from insulin-triggered, growling-tummy hunger, of course. (The Australian study that came out in the fall seemed to indicate that I am on the right track with the notion that there is more than ONE type of hunger. And, darn it, it just makes sense, when we have more than 20 hormones, peptides and other chemicals and God knows how many genetic combinations that contribute to how our eating cycles are formed.) But I digress.

      Borer shows us we can moderate the Ghrelin impulse by making it dance with one hour of strategically placed MIE. When Ghrelin moderates, changes its circadian rhythm, Leptin responds by elevating. (It doesn’t dance with Ghrelin so much as it follows it around the dance floor.) Arya Sharma has written that exercise is likely more about “calories in than calories out” and, while he didn’t identify it explicitly, this ghrelin response may be the mechanism. He has talked about Rudy Leibel’s work, which indicates that Leptin has more than one function. It is not only a satiety hormone, but when it is suppressed the body responds by slowing metabolism. Hmmm. So the key seems to be poking Ghrelin with MIE in order to get it to moderate, which will then elevate Leptin, which will serve to modestly (subtly) curb our appetites and elevate our metabolisms. Or not.

      In practical terms, my new personal experiment (n=1) is to place my one hour of exercise after a 300- to 500-calorie breakfast, which means I’m using the MIE to enhance my satiety from breakfast (and not create insulin-triggered hunger) and reset the day’s circadian rhythm for Ghrelin. So far, it seems to be helping. And while I still have some “eat impulses” they seem to be less. Could be placebo effect, I know, but it’s really interesting. I’d love to have other maintainers try it and report back.

  16. Debra, thank you for your reply, Yes, I’ve been considering how to work in more exercise. I have a moderately active job, and when my pedometer was working I found I would get between 5000 and 10,000 steps a day (I really must replace the battery in it, as I did get a sense of accomplishment from seeing that number every day). My main concern is having it be sustainable. I recently had a mini-epiphany: I don’t really enjoy walking in my neighborhood, but I do enjoy walking through department stores. I don’t need to buy anything, but I enjoy the walking much more. My joints are not happy with brisk walking, but a stroll or saunter is fine. So I have given myself permission to go to the store(s) of my choice and do my walking there.

    And speaking of joints, I would like to share with you what I have discovered that has made a miraculous difference in my levels of joint pain: gelatin. I take 40-50 grams a day, dissolved in a couple of ounces of almond milk, then added to my coffee. Yes, I weigh, measure and track what I eat/drink, just like nearly all maintainers. After a year and a half of gelatin consumption, I am amazed at the difference it has made, and it seems to just keep getting better.

    These two articles got me started:

    http://holdthetoast.com/content/gelatin-blowing-my-mind

    http://raypeat.com/articles/articles/gelatin.shtml

    I had already given up grains, which helped some, but not nearly as much as adding in the gelatin. I felt better after just a couple of days, and experimented with the best amount and method of consumption, and have ended up with the almond-milk/coffee method. It gets me a substantial amount of protein early in the morning, and I often just consider it my breakfast. It also turns a cup of broth into a more substantial snack. And it’s relatively inexpensive–I buy it 5 lbs. at a time from amazon.com.

    • Denise, an alternative to walking in stores or malls is to find a large medical center near your home. I work in a university medical center that includes a hospital and three schools (medical, nursing, healthy professions) and comprises 20 buildings that are all connected. I have mapped out two circular routes, one that is one mile and one that is a mile and a half.

      It’s really more like a starfish than a circle, because there are a bunch of corridors I walk down and then turn around and walk back. That used to really embarass me, because I was afraid someone would see me and say, “Hey, look at that fat girl turning around, she must be trying to lose weight.” I think after three years and intensive therapy I’m mostly over that. ;-)

      Since it’s a hospital and a school, most of the buildings are open even on weekends. I walk on the weekdays by myself and on the weekends with my husband and son. I like it better than mall walking because there is not the temptation to stop and shop. The most I might spend is $1.25 for a coke from the vending machine.

      And you’d think it might get boring after a while, but the medical center is constantly, and I mean CONSTANTLY renovating things, so there are always new things to look at.

  17. Teri, thanks for the suggestion, I had not thought of that. I will have to see if I can find something like that. I am careful to keep my “shopping” excursions separate from my “walking” ones, though. And while I like to look at all the things in the mall, I rarely buy anything, because I am a real penny-pincher and I can usually find what I like in the bargain stores. And very few stores have much in my size, so there are few temptations in the clothing departments.

  18. Relevant to weight maintenance, readers who came late to this blog as I did may be interested in the conversation here:

    http://itsthewooo.blogspot.com/2012/01/analogy-to-obesity-therapy.html

    Be warned that the tone of her blog is far more strident than Debra’s, and she is fluent in profanity, so if you are offended by those things, you may wish to avoid it. In spite of that I find her to be a valuable resource in my ongoing struggle to maintain a mere 10% loss (was more but I gained some back). She has maintained a 180-lb. loss for 9 years, and voraciously researches the science.

    Debra, I hope you are not offended by my posting this here, but I thought it might help some late-comers who are at different points in their journeys.

    • Wow, Denise, thanks for introducing me to that blog. I only had time to read her Jan. 31 post, and I tried to leave a comment, but it didn’t seem to take. Sigh. I like her. We are kindred spirits. It appears she was part of a leptin trial (I’m jealous) and, hence, has paid more attention to Leptin than I (I have concerned myself more with Ghrelin at the chemical cotillion), and she has developed some bitterness toward Stephen Guyenet that I have not (yet?). I look forward to reading more of her prose.

  19. Debra,

    I came across this article today, and wanted to share with you because of the reference to the NWCR.

    “When researchers affiliated with the National Weight Control Registry—a project involving more than 6,000 people who have lost more than 30 pounds—looked at the habits of successful dieters, they found that 78 percent of them ate breakfast every morning, a meal cued by a time of day. But most of the successful dieters also envisioned a specific reward for sticking with their diet—a bikini they wanted to wear or the sense of pride they felt when they stepped on the scale each day. They focused on that craving when temptations arose, cultivated it into a mild obsession. And, researchers found, it crowded out temptations.”

    http://www.slate.com/articles/arts/culturebox/2012/02/an_excerpt_from_charles_duhigg_s_the_power_of_habit_.single.html

    I’ve seen you mention that most successful maintainers eat breakfast, but not that they associated it with a specific reward. The whole article is about establishing habits, and I thought it was very interesting in its references to establishing a craving. Usually we think of cravings = bad, but in this case, they are a useful tool.

  20. Debra,

    I have some information I would like to share with you. Please email me if you receive this, when you have a minute.

  21. I wonder if you’ve seen James Fell’s article in the Chicago Tribune, Keeping up to keep weight off. It’s a little mystifying how he goes from recognizing how hard your body fights you when you exercise and/or cut calories to lose weight, to a condescending assertion that all people need to do to succeed at this is to “actually use their brains and, you know, pay some attention to reasonable and healthy food intake and exercise”.
    http://www.chicagotribune.com/site/newspaper/entertainment/sc-health-0711-obesity-20120711,0,5681975.story
    While I liked where he started off, he seems to end up at the same old insulting attitude. Sigh…

    • Thanks, Beth. I am on vacation now, but look forward to reading this. I bet I will find it frustrating. I am a glutton for that kind of punishment. When will we wake up from this nightmare? It is so clear that science screams for us to show more compassion, not less. Sigh, indeed.

  22. Wow, Denise, thanks for introducing me to that blog. I only had time to read her Jan. 31 post, and I tried to leave a comment, but it didn’t seem to take. Sigh. I like her. We are

    • Like minded? Hi, Rose. Everyone’s first comment has to be approved. (Ya’ might not think it, but spammers are big fans of weight-loss maintenance sites.) Welcome to DJM. Hope you get some new words to wrap around your experience. Over time, as I figured out that the language of “lifestyle” was inadequate, I became disheartened, which turned into despondent, and may have become “clinically depressed.” The thing that pulled me out of my malaise was writing this blog, where I used my language, which isn’t inspirational (and that means it isn’t publishable in the commercial sense) but is as truthful as I could make it. Lo, I had a lot of people affirm that I was right (and a few that chastised me for peeing in their beer). Truth and affirmation go a long way in a world like weight-loss maintenance, that is full of falsehood and white washing. Take comfort, Rose. You are not alone.

      I approved your other comment, too. The one to NewMe. She may or may not be following that thread, but she’s a blogger worth getting to know too, if you have time. There’s a link on my front page.

  23. Don’t know another way to connect and say “HI!” I haven’t seen you around the blog universe lately (maybe we frequent different galaxies?) but please know you are missed. Rather, I miss you. I hope you are well and happy! Love, RNegade (aka hopefulandfree)

  24. I’m a weight-loss maintainer, going into my second year of weight-maintenance (first year: not as successful as I need, so I do need to re-lose some weight). Lowest weight was a 24% loss, currently at 19% lost (I regained about 9 pounds over the year).

    I’ve read a few entries already, and it really strikes true to my experience– especially the endocrinology (I’m studying a small portion of reproductive endocrinology for my PhD).

    I’m definitely going to bookmark and read through this site. I love how you write, and I identify so much with it. I hope I can gain some additional insight on how to successfully maintain my weight loss… it’s so much more difficult than I expected. I know why it is– my body wants all that lost fat back. But it doesn’t make it simple to ignore, even though I know why.

    • Welcome, Chloe! I hope you find some useful information too. For the past two years, I have tried to stay on top of the world weight loss and maintenance, even as my blog has remained defunct, and what really surprises me is how little has changed. The cultural mythology is intractable. News media, women’s magazines, popular programming etc. continue to concentrate on loss, as though that’s the challenge. There is no recognition that the people who regain are the normal ones and those of us who maintain are outliers. While quite a bit of information on the endocrine connection is available, it’s rarely reported. The situation is mind-boggling and so unhelpful to people who earnestly lose weight and simply wish to maintain. Grrrr.

  25. Hi Debra…just feeling sentimental and dropping in to say hi. I didn’t read your blog much while it was live (not sure why not! I am overwhelmed by the internet) but I come back and dip through it periodically, and it always has me nodding my head and talking to my computer out loud. I don’t know if you remember me from BFB, but I always think of you fondly.

    • Oh, yes, Michelle! I do remember you. And I visit your blog too from time to time, especially when I’m really feeling fiesty. I recently read your piece on the reporter, Livingston. You got me barking: woof woof woof woof! That’s what I do when I agree.

      I’m so glad you and checked in today! Makes my week.

  26. Hi Debra, thought I would drop in and say thanks for this blog, and thank you for keeping it up. I’m into HAES. I work full time and do grad school, I don’t have time for another part time job, and I find your blog an amazing resource when the mainsteam media and medicine crowd keep telling me that being fit and size 8 can be fast and fun.

    Thank you. You help.

    • Welcome, Cheshbitten. It makes me happy to know that real people (not spammers) continue to find this blog and find value in it. It dumbfounds me that so little in society changes on this topic. While I’m not actively blogging, I continue to keep up with scientific studies. More and more the white coats find hormonal, genetic and environmental factors that confound individual efforts to artificially control weight long term, and yet the media and medical crowd just insist on remaining in roughly 1978 with their assumptions about weight gain/loss and maintenance. It’s just a zippy lifestyle doncha know?! Gaargh! When will we wake from this drawn-out nightmare?

      I’m still maintaining. The exception that justifies the rule to some, except when they bother to ask my opinion and get an earful. My recent thought is to combine my current line of exploration with my old connections here. Working title: Fat is a Spiritual Issue. (Hat tip to Fat is a Feminist Issue.) How our society treats fat people is immoral. It’s a form of oppression and social injustice. It is unsupportable in the major religions or any moral framework for living. In my own tradition, Christianity, we are taught that our bodies are temples for God. Well, God demands more and grander real estate from some people, me thinks.

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