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:

• The Ultimate, Automatic, Revolutionary, Breakthrough Classification System for Evaluating Diet Experts
• It’s All Endocrine
• Why?
• Thoughts on a Peptide YY Study (with a digression on the “N” word)
• Shhhhh, They’re Talking About US!  Let’s Listen and the Talk about THEM
• Queen for a Day
• Thoughts on Science, Optimism and Bias
• Thanksgiving Thoughts

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

• Hey, MD’s:  Listen to the PhDs, Please
• What is Maintenance?  And Why I Like my Job Metaphor
• Overreactions:  The Price of Being a Maintainer?
• Let’s play Fat Roulette!  Where Will you Place your Chip?  (follow up posts here, here and here)
• As Fearful as I Ought to Be
• More on Binges:  A Digression
• Bingeing, Mini-bingeing:  Is it Addiction?
• I have Good News, And . . . (Inspired by Arya!  Arya! Arya! who, for one week following, used the word “obesities” in place of “obesity” at his own blog.  Thank you, Doctor!)
• Thin Privilege
• How Do I Reconcile Size Acceptance and Weight-Loss Maintenance?

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.

Call it serendipity.  Call it an act of God.  But a year or two into my maintenance, when I was still the “joyful jogger” in my own mind, I found Big Fat Blog.  I don’t know what I was reading that got me linked there.  It wouldn’t surprise me to learn it was a diet related blog that belittled BFB.  But I got there and got hooked.   (By the way, if you visit my profile there, it says I’ve only been a member 42 weeks, or some such.  That’s actually the time since a computer glitch eliminated my profile for a few days.  I’ve been there many years – probably since 2005 or 2006.)

I read deep into the archives and all I could think was, these people are right:  society’s hating on fat people (with the best of intentions) isn’t creating health, or even reducing the number or size of fat people.  I searched the site for information on the awful 95% failure rate statistic for weight-loss maintenance.  Even though I was well into my maintenance and I’d thought (hoped) that I’d “clicked” into some new mental or physical state that would support life-long maintenance, I was also painfully aware that I’d been part of that statistic before.  I had regained, yo-yoed, in the past, and I knew that I had not gotten any smarter (and may have, in fact, killed a few brain cells with age and Chardonnay).  I was desperate to know more about this failure rate, the science behind it, whether it was true and whether there were special “exceptions” that I might qualify for.  Sadly, my search of BFB came up dry.  But I noticed that there was another private area for “registered” people, and I thought that maybe my answer was in there.

When I registered I only briefly contemplated lying to get in.  Ultimately, I figured, I’d feel more comfortable participating if I were there honestly.  In my essay I revealed that I was a weight-reduced person, but some things just didn’t feel right.  I promised that it would not be difficult to play by the rules and avoid diet talk.  God bless Paul McAleer, the founder and moderator of BFB at that time:  he let me in.   I guess he knew I needed to be there.

Sadly, in the BFB forums, I couldn’t find an answer to my burning question about the 95% failure rate of maintenance.  But I did find there compelling, intelligent, heart-felt, truthful discussions covering the  many facets of living fat, which I had not forgotten.  (For a time, among my real-world friends, I called myself a “fat chick in the closet.”)  When I participated in discussions at BFB I never used the word “we.”  I would say “fat people fall victim to . . .”  or “most fat people understand that . . .”  To my knowledge, no one noticed this pattern.  It didn’t stick out.  I became a member of the community.  Some people there attacked me for being “healthist” (and I think I was once disparaged for being a “good fattie”), but many fat people at BFB are subject to the healthist moniker (including DeeLeigh, who now administers the blog), and we supported each other’s views.

Within a short time of my joining BFB we discussed creating “cheat sheets” to help us with the most common challenges to size acceptance.  I volunteered to write on the 95% failure rate (which I would learn is actually 97%).  It gave me an excuse to do more research.  My early musings on that topic are still there.  Above the BFB logo are two tiny links, one to Big Fat Index and the other to Big Fat Facts.  My essay is down the page and entitled NEW:  The Truth About Long-Term Diet Success.   You’ll likely recognize my “voice” if you read it.  I also helped by doing some line editing in the other pages, so my “voice” is elsewhere too.

So my acceptance at BFB should explain my embrace of Size Acceptance. 

I can only explain my weight-loss maintenance by suggesting that it’s my reality.  I am not a figment of my imagination.  I am doing this, truthfully.  Sometimes I question why, but most days I just keep going, and I find reward in discovering the right words to describe it – words that go beyond the flippant “lifestyle” vocabulary that we read everywhere. 

Early on, actually, weight-loss maintenance wasn’t that difficult for me (I could have called it a “lifestyle” without choking) because I became a running nut.  It happened gradually – I started with walking and sprinting, when I was still losing weight, which turned into longer sprints, which tied into miles of sprints at a time and no walking at all.  There’s truth to the notion that running is addictive.  My addiction lasted for more than four years, and I would still be a running nut if my joints and left foot had only remained as addicted as my head.  Grrrrr.  I think that regular running, for all the subtle hormonal adjustments it makes in one’s body, counters much of the hormonal pull and the impulses to eat that would return a body to its highest established weight.  I have not found another form of exercise as effective, though I sally onward.  I have experienced some regain, about 13 pounds, which is not enough to qualify me as a failure at this game yet.

I have also recovered from two emergency gut surgeries, one in 2008 and the other in 2009, involving a hernia and twisted bowels.   Almost immediately upon my return home from the hospital I was exercising (gently) to aerobic DVDs.  I was probably exercising sooner and harder than was “healthy” for a natural weight person, definitely harder than my doctor recommended, but I knew intuitively that to maintain my weight loss I would need to return to exercise as quickly as possible and accelerate the intensity faster than a natural weight person would.   A maintainer friend (by email) had warned me that all the established success stories she knew who later regained, did so following surgery. 

My struggles are typical.  Most legit maintainers, long out of the honeymoon phase, have war stories like mine.  And yet cultural mythology maintains that we’re all just livin’ the healthy lifestyle, a myth that simultaneously marginalizes maintainers as unremarkable (though oddly inspirational) and discredits fat people for choosing NOT to live the healthy lifestyle.  If legit maintainers regarded their maintenance as an issue of style, however, then there wouldn’t be 3% club, composed of success stories.  “Style” is optional.  The work one has to do for weight-loss maintenance isn’t.  Moreover, the work one does for maintenance is vulnerable.  If I permanently blew out a knee or something else that made the intensity of exercise that I need (which is different from other maintainers’ needs) impossible, my maintenance would be over.  If I were in an accident that put me in a convalescent home where my food choices were no longer my own, then my maintenance would be over.  I would regain, and it would feel like falling, falling, falling — helplessly falling. 

But, thankfully, I would have the soft bosom of Size Acceptance to land in.

So here I sit, living honestly a maintainer’s life (sans style), and yet knowing the veracity and compassion that is Size Acceptance.  There is no question about reconciling them.  They’re both truthful.  I don’t need to reconcile that grass is green and the sky is blue.

I had also meant, shortly after I opened the blog, to say a word or two about plastic surgery.  In my initial post on The Unfairness of Weight-Loss Maintenance, I mentioned the issue of loose skin. 

“Unfairness 7.  You hide a secret under your clothes: your body may be deformed.  Friends say you look great, but naked in front of the mirror you find your pendulous parts and saggy skin discouraging.  Some maintainers may need counseling; others undergo expensive plastic surgery.”

Well, I was one who went for plastic surgery.  I think it is important to talk about this issue openly.  So often it is reduced to a mere vanity concern, and it is not. 

For some people, I imagine radical weight loss presents a pleasing image, if not nude, then in clothing.  For many of us, however, if our skin is not elastic any more, losing radical weight results in a mirror image that we don’t recognize.  It doesn’t even look like a human as we have come to understand it.  The loose folds may conceal the parts that make us sexually capable and deform those parts that we heretofore thought defined us as sexually appealing. 

Many naturally trim people regard fat people as asexual or unappealing regardless, and Madison Avenue does much to perpetuate this notion.  Sadly, many fat people buy into the myth as well.  That, however, was not my experience with my own fat body.  On the way up, weightwise, I became accustomed to my ever increasing curves, lumps and bumps over the years it took to acquire them.  I was joyful, sexual and fully human and, to my thinking, a Boticelli babe.  On the way down it was very different.  Within a period of months, I became a conglomeration of saggy parts.  I didn’t adapt well to this change.  For example, during intimate times with my husband, instead of being present in the moment and contemplating how to please him, I became self-conscious.  I positioned myself so he wouldn’t grab handfuls of flesh. 

In my more mundane moments, as well, my body would remind me of its new predicament.  As I ran or did other aerobic exercise, the loose parts would bounce about distractingly.  Sometimes they would grow itchy from this bouncing, or hurt.  It made me angry and sad.

I decided, because I could, to get plastic surgery.  I won’t go into the details of the process.  Actually, No Celery has produced a nice accounting of a tummy tuck, if you want that.  What I would like to do however, is issue a cautionary note, both to people who are considering plastic surgery after radical weight loss and people who are in a position to support them … or not.

If you are contemplating plastic surgery, you will have misgivings, and for good reason.  I was frightened that I would leave my husband a widower and my son motherless, all because I couldn’t pull my head together enough to live peacefully with my body.  And it wasn’t for lack of support from my husband.  He loved me (enthusiastically) sags and all.  He had also loved me fat and never pushed me to diet.  He says now he would love me fat again.  When I lost the weight, he would reflect my feelings back to me, but he never tried to push me, lest I fail to lose the weight or regain whatever I lost.  He viscerally understands yo-yo weight cycling, and he knew my history did not make me immune to it.   At any rate, at that time, he told me he would support me whatever decision I made with regard to plastic surgery.  (What a great guy!)  I did research on procedures and the area doctors who did them.  I read the scary and the reassuring literature both.  I weighed the pros and cons and went for a consult.  I weighed the information more.  I prayed.  Finally, I called and set an appointment for a bilateral mastoplexy without augmentation (removing the excess skin from my breasts) and an abdominoplasty (tummy tuck).

As the date approached, I turned to a clergy friend for support.  I’d thought she would understand my misgivings without my having to brace her for them.  I told her simply that I was having the surgery and named the date.  She responded, “Oh, I don’t believe in that.” 

I was dumbstruck.  I told her the decision had been made.  She tried to reassure me and convince me to reconsider by telling me how great I looked.  I babbled at her awkwardly.  When she saw I wasn’t going to up and change my mind, she told me she would be at the hospital for me, and I told her I’d rather she’d not.  I didn’t want to have her misgivings present that day, along with my own, and I had another friend with pastoral training who could be there, along with my husband.   The exchange grew ugly.  She is no longer a friend.  She is still a pastor, but not mine.

The moral is, as in so many stories, be careful.  If you are considering plastic surgery then you’ll need supportive people in place to help you, especially during recovery, but not everyone “gets” this.  And people don’t seem to have the social filters in place to restrain their opinions.  Had I been choosing a particular cancer treatment, even an unproven alternative treatment, I’m sure this pastor would have been fully behind me.  But plastic surgery is one of those things you can choose to not “believe in,” I suppose.  I can only think that theologically she must have felt that I needed to deal with what God had given me.  That’s the only logical explanation I’ve been able to concoct for her response.

The moral for people on the other side of this decision, people who have friends or loved ones considering plastic surgery:  be neutral if you cannot be fully supportive.  My husband was the perfect model.  This issue is more complex than mere size acceptance.  It requires the acceptance of a body that you’ve never seen accurately depicted (not even humorously or disparagingly) in movies or on TV.  Leonard Nimoy hasn’t found the beauty in weight-reduced people and depicted it photographically.  These days, as each season of the Biggest Loser ticks toward its finale, the men put on T-shirts and the women cover their sports braziers once the skin starts to sag, and viola, out of sight, out of mind, out of existence.  For me, this is a travesty.

Plastic surgery:  that is this week’s loose end.  I’ve had a couple of readers recently ask me to explain how I came to reconcile Size Acceptance and Weight-loss maintenance.  That’s a simple story, really.  And I’ll try to post on that soon.  Then my final entry.  Thank you all, again, for listening this past year.  You cannot know how meaningful this has been for me.

The floor is open on the topic of plastic surgery and support thereof.

First of all, I’d like to thank everyone in my last post for being so encouraging about my writing, my perspective, my voice on this topic.   You have given me pause.  I had pretty much given up on writing about weight-loss maintenance, at least in any compensated fashion.   It is nice to think that others find my thoughts worthy. 

While I haven’t entirely given up on writing on this topic, I am going to postpone and turn my attentions elsewhere.  Mid-September, I enter training in the Clinical Pastoral Education program for St. Luke’s Hospital in my hometown of Kansas City. 

Back in January, a close friend died, one who had been encouraging me to plumb spiritual depths, ponder imponderables and (as she had done) go to seminary.  Her career path led her to edit a national religious publication for a time and serve as a congregational pastor for a time.   I was shaped most, however, by being present for nearly all of the penultimate chapter of her life, in which she was technically mostly retired (but spent her days advancing peace in creative ways), and parts of her final chapter (as I could travel, and as time allowed).  It occurred to me that being present, God’s emissary, during people’s most important and challenging chapters would make for meaningful work, especially once my nest goes empty in five years (a chapter I’d like to plan for).  

Muriel and I met shortly after she had had a radical mastectomy following breast cancer.  At the time, she decided not to follow up with chemotherapy.  She preferred to fortify her body’s defenses against the internal enemy, through nutrition and other means, rather than try to poison it and herself.  Her children were grown, her obligations on this earthly plain mostly met, so she claimed the luxury of declining an ugly fight, knowing her decision might result in a shorter, if more comfortable, life.  Actually, however, her strategy kept her alive for nine lovely years.  Years that would change me.

My friend’s death reminded me that when my mother had had a stroke in 1999, four years before she died, I learned that there was nothing more rewarding than being useful for her, comforting to her or just present.  This was not an effortless revelation.  On my two-hour drives to see her, I would squeeze the steering wheel, afraid I wouldn’t find words, afraid of awkward silences ahead.  I prayed, “just let me be useful, God.  Help me figure out what to do.  Help me find words.  Help me.”  I had a toddler at the time, who I could count on to provide some entertainment for one visit in a weekend, but toddlers are multi-faceted, and I could also count on him to test the limitations of the residential center where she lived.  It wasn’t childproof and, in fact, was designed to make electrical outlets, toxic cleaners, mini-blind cords and other dangers more accessible, not less.  So, I knew I would leave him with his other grandma for most visits, and I would go alone and try to communicate with someone I loved, who could not communicate back much.  And that was scary.  At first.

But God answered my prayers.  Cynical me.  My prayers.  I always figured out how to be useful.  How to be present.  One week her slipper had fallen off, for example, and I could see that the monthly visits by the podiatrist weren’t enough to maintain her feet.  I started giving her regular pedicures – gentle and without polish.  Just washing her feet, moisturizing the skin, clipping and smoothing the nails.  I also curled her hair with a curling iron some weekends.  We did girly things.   She helped me wrap Christmas presents.  Simple stuff.  And meaningful.  I am grateful I found the inner resources to visit despite my fears and reservations.  I know that many people need help finding those resources, and I’d like to be helpful toward that end.

My spare thoughts, therefore, have been straying from weight and health to matters spiritual.  My reading list has changed a lot.  I’m pretty ecumenical to begin with, but I must admit I wouldn’t know how to pray with a Rastafarian, Sikh, Zoroastrian, or any number of believers/nonbelievers/counter-believers and their families who might show up in the hospital and need to call on their spiritual resources to get through challenging times or pass into new chapters.  And while I hope I would simply and humbly let them lead me, I’d like to know what might be in store and how I might be supportive and avoid being insulting.  So I am bouncing about in books on various world religions.  I have a book on science and religion too (seems apropos for the medical/spiritual vortex I hope to enter).  And I have been doing a lot of soul searching and navel gazing.  I have not, however, been reading up on the science or cultural mythology of weight control. 

I’ve visited some blogs.  Left a comment here and there.  But I have not been the Data-hound Debra that I imagine myself to be for this blog.  And I’m cool with that.  I hope you all are too.

I am guessing that I will retire this blog soon.  I hope to do a wrap-up entry or two, and then, at the risk of seeming vain, pay for the domain for another year and leave it up, because I think our discussions would be helpful to people entering into weight-loss and weight-loss maintenance, or considering avoiding another round of yo-yo weight cycling.  Many people find this blog through search engine terms.  I think that’s a good thing, and they should be allowed to come and read.

I know when I started this blog I was just out-and-out angry.  There were days I felt like I was going to burst from my skin in rage because I had been served up a stinking pile of lies . . . by doctors, by scientists, by women’s magazines, TV morning news programs, and other purveyors of cultural mythology.  I had known about and been seething about these lies for years, so my first entries were fire-breathing.

But over the year my discussions with you, the readers here, have dissipated my ire, and I am now, most days, more stoic than angry.  I’m living with all the big lies in peace instead of rage.  You affirmed that I wasn’t imagining the lies.  You challenged my over-reactions to the lies.  You cheered my indignation at the lies.  You explored and analyzed the lies with me, and offered some brilliant insights.  And, some days, you just affirmed me personally.  I owe you people a lot for helping me get to a more peaceful place.  If I have any chance at being a competent hospital chaplain, it is because I went through some necessary preparation here.   Who would ‘a thunk it?

I think there are lots of angry people (or soon-to-be-angry people) who have just discovered or are about to discover the big lies regarding weight control – that it’s just portion control, that it’s just tips and tricks, that it’s a lifestyle, that it’s ridiculously easy once you’ve figured it out.  Yeesh.  What baloney!   I think our discussions will help them process the challenging journey ahead.  After a year, the science we’ve discussed in these pages will be old, possibly updated or reversed, and some links will go defunct.  In any event, after a year the blog can go where ever old blogs go.  Then you and I, my on-line friends, may be content that we have done a little something to make the world more honest and realistic about weight control, and maybe a little kinder and accepting of people of all sizes.

The idea that maintenance will be easy takes the fear out of the whole process of loss and maintenance.  That maintenance is easy, however, is the biggest, baddest weight-loss lie of all.

Most of you know, I follow Barbara Berkeley’s Refuse to Regain.  We don’t always agree to the letter, but we are sisters in spirit:  maintenance is complicated and individual.  Currently, in the comments of one of her posts, a woman is hawking a book to be released next year.  With great gall, Ms. Libby Florence tells Barbara how she used to believe as Barbara does, but now Ms. Florence has seen the light. 

Perhaps Ms. Florence is self publishing.  I would find that less tragic because the lapse in judgment would be singularly hers and not a publisher’s too. 

Or perhaps she found a publisher because she’s selling the party line:  weight loss and maintenance are effortless, once you have the “key.”  It’s all very easy, doncha know!  Her comment, before she gives the book’s website URL, ends as follows:

But there is another option. A much easier, pleasant, ENJOYABLE option. And that is to escape the addiction. To end the addiction.

People think that permanent weight loss involves constant (or at least recurrent), unpleasant deprivation…and they think that, because their own experience seems to support this theory. But I promise you, it’s not true. Escaping the obesity trap is actually ridiculously easy (almost to the point that it will make you break down and cry). I worked it out, suddenly, three years ago. I think I have discovered something that very few people know. I’m writing a book about it…

You read that right:  three years ago the magic weight fairy entered her forebrain and revealed the “truth” to her, even as she was still fat.  In 2008, she figured it all out, then she lost 37% of her weight (we don’t know how long that took) and has kept it off effortlessly (what, six months?) ever since.  Sigh.   I almost wrote a comment at Barbara’s site along the lines of “you arrogant twerp,” but then I read NewMe talking about “sour grapes,” and I knew that’s how my comment would read.  I also visited maintainer Debby, and she was gently pointing out the limitations of blogging, and somehow, together, I took those as signals:   If you don’t have anything nice to say . . . at least put it on your own blog, and don’t muck with someone else’s.

Okay, I’ll admit I’m a little jealous.  I was rejected by publishers at two conferences, and I’m too timid/lazy/fearful (circle one – depends on the day) to self-publish.  But my jealousy notwithstanding, do we really need another instant inspiration story?   

But it will sell, won’t it?  Because it contains the “secret” that came to her in a burst one night when she was sitting on a sofa.  And the “secret” removes all the fear associated with weight loss and guarantees that maintenance will be easy. 

From her shallow, one-page teasers, I understand we are trapped in a simple misunderstanding that compels us to eat wrong food, and we may escape this trap easily when we assemble the few tiny puzzle pieces that will make it easy it is to “step free,” and suddenly decide to eat the “right” food, foods that aren’t “rubbish.”   Now, don’t mistake this for willpower .  Willpower fails.   The desire to eat “right” foods becomes effortless and endless when you know the “secret,” and she is not afraid that she (or any of her followers) will regain, because this secret makes her want to eat right foods and not want to eat rubbish. 

Oh, good Lord!  Everyone remember your weight-loss honeymoon?  That time before you had to juggle maintenance with another health issue, like joint failure or bowel obstructions, or a personal or work-related complication?  Yeesh.  To this day, I still prefer good food to rubbish.  That was, indeed, part of the transformation.  But how arrogant to call maintenance “ridiculously easy” when you’ve been doing it only a few months.   Her endocrine hasn’t even had time to go out of balance yet; how the Hell does she know anything?  (Oh, and we know that ALL fat people eat rubbish, lots of it. That’s the only reason they’re fat.)  And finally, how brazen to hawk a book on someone else’s blog and to discredit the blog writer’s opinions.   Whoa, Nelly.

Hoookay.  Ms. Florence is not afraid that she or her followers will regain, but she would benefit from some healthy fear.  If it were so easy to escape “the obesity trap,” then the 97 percent recidivism rate for regain after weight loss would have been reversed by now.   Her writing doesn’t indicate that she’s the Einstein of weight loss and maintenance.  If the weight-loss maintenance equivalent of the theory of relativity has escaped Arya Sharma and other bright minds, I’m willing to bet she hasn’t found it.

She would benefit from some fear, and so would anyone else who wants to join the 3% club.  Every true maintainer (longer than a few months) I know and respect harbors at least a little of it.  Fear need not be a constant companion, or a debilitating force, but it needs to rear its ugly head from time to time.  And we as maintainers need to confront our fears, question them and, as long as we wish to remain maintainers, embrace them, at least partially.

Our fear is a bit like an actor’s stage fright.  All good actors embrace their stage fright.  They weave it into their character’s passions and motivations.  It’s healthy . . . except when it’s not.  Except when it saps the brain of its ability to think or the mouth of its ability to speak, or it becomes a Black Swan delusional thing.

And that’s why I raise questions in this blog, from time to time, as to whether my behavior or thinking is disordered, or moving in that direction.  My thoughts and behaviors are radically different from most people’s.   Most people don’t use their gulp mechanisms to measure liquids, for example.  Most people aren’t compelled to chew out good-hearted wait staff who don’t want to take back the fries  before they bring the fruit.   Most people do not meticulously plan their food intake in the shower daily.  It is not a lifestyle, it’s a strategically different way to live one’s life that involves heightened sensitivity to cultural and biological influences. 

So I am right to question.  To wonder.  And then to reframe my experience so that I can live with it, honestly and stoically.  I can call it a personal experiment, a part-time job (that need not be joyless), or a serious hobby along the lines of playing the cello.  But I cannot call it easy or effortless.  And, in service to honesty, I share my thoughts with others here, because there ain’t no book, nor will there be one in the current publishing environment and Biggest-Loser cultural climate, that is as scary (or at least as truthful) as it ought to be.

Rafting Brown's Canyon in the Arkansas River, Colorado. Photo by Performance Tours Rafting.

I didn’t give many details in my “away” post about being gone or why, because one doesn’t want to hand a map and game plan to robbers and such who troll the internet looking for people to reveal when and how long their houses will be empty.  I suppose I could have said something about hoping my house sitter’s Rottweiler would behave himself around my terrier, but that would have been an obvious ruse.

At any rate, I’m back, and the house is intact, unrobbed, and the terrier is home from the Hound-Dog Hilton.  And I have a blatant experience of thin privilege to share.  And that prompts me to talk more on the topic.

Eight years living in Maintenanceville, thin privilege is different.  I think it would be good for my size acceptance friends, in particular, to know how so.  Anyone who has ever lost and regained weight (as most people in the size acceptance community have) has had a taste of the “early” form of thin privilege and I think this is sad, because the first few months of thin privilege is tinged with the worst kind cruelty, hubris, embarrassment and awkwardness.   Eight years out, it’s still awkward and wrong, but it isn’t so cruel.

In the early days, the easy coast period of weight loss and maintenance, when people know that you used to be fat, and now you aren’t, they hand you an engraved invitation to join a bully culture.  Even as I was in my forties, when people should have grown up, I can recall friends or acquaintances my age indicating some fat restaurant patron, and assuming that I would agree with such observations as, “Can you believe she’s eating that!?” 

Perhaps they thought that inviting me to participate in fat ridicule was a harmless compliment to my hard work at weight loss, a reward, and (for those who “knew” it was a “lifestyle”) a tool to re-enforce my resolve to never be fat again.  Equally likely, however, their fat hate was an expression of insecurity and fear.  They wanted my reassurance that they would continue to avoid this fat woman’s fate, because they would stop eating such unbelievable food long before they got that big, right?  I was to offer this reassurance by re-enforcing their prejudices (and sense of superiority) by sharing some outrage with them.

I always felt wrong, but didn’t know what to say.  I responded by mumbling “Well, I don’t. . .,” or something equally incoherent.  Because the thin privilege was wrong, I was compelled to shake my head, but then I knew that was interpreted as agreement with the fat hate, “Oh no, I too cannot fathom why that fat woman is eating so!”  I just felt awful about it.  And helpless.  And I didn’t have the vocabulary or experience to express the complexity of weight management, and I lacked the courage to say, “Wow.  What qualifies you to cast stones!?”

Interestingly, it wasn’t always naturally trim people who extended the invitation to the Fat Shame Bully Society.  “Good” fat people, who eat salads and exercise, are as likely to be as hateful and fearful as anyone.  Subtext:  “Please assure me I won’t get fatter.”

Thin privilege for me now no longer solicits cruelty; it is mostly just the absence of fat shaming.  It means not having to fret at a restaurant because my friends may ask for a booth instead of a table, and the seat may be set too close for comfort.  It means the drape at the doctor’s office covers me, the doctor shows no signs of disappointment or disgust at my body, and I’m spared the weight-loss lecture.  It means I can buy expensive running shoes and no one gives me a side-long glance, “Lotta good they’re doin’ her.”  It means no one critiques the food in my grocery cart.  It means that the panty hose chart is accurate for my dimensions, so the nylon will not fray and burn lesions into the insides of my thighs.  It means that all the news reports on how bad and unhealthy it is to be fat, and how expensive it is to society, do not apply to me, so I may ignore them some days.  I get to take a break. 

Thin privilege is how people don’t look disparagingly at me (or avert their gaze uncomfortably as they pray I won’t sit with them) when I board a commercial airplane.  I would not now be subjected to the humiliation that I was when fat, of being asked to sit at the back of a commuter jet, “to balance the load.”   Thin privilege means never being treated like ballast. 

Thin privilege for me, at its worst now, is overhearing someone else’s fat-hate conversation, since the conversants will assume I’m in agreement and won’t bother to lower their voices.  My friends know my thoughts on weight loss and maintenance all too well and don’t try to engage me in anything hateful.  New friends who learn of my blog or my weight-maintenance status may ask me to acknowledge some cultural mythology:  “Children are fat now because of all the sweetened cereals and video games, right?”  I shake my head and tell them it’s more complicated than that.  They say, “Of course.” 

While thin privilege now is mostly the absence of shame, it can also be a subtle ritual, and that is what happened on this vacation.

At the beginning of any rafting trip is the requisite “scare talk,” in which you learn what to do if ejected from the raft.  Then you meet your guide and rafting companions for the day.  My family shared a raft with a family from Texas.  Because our raft had an odd number, seven, the guide told us that he’d need a partner in the stern with him, someone “light weight.”

The Texas mom looked at me, lifted her palm, and said, “You, could . . .”

I responded with a sheepish smile, “Well, I don’t . . .”

It lasted only three seconds, and anyone seeing the exchange would have no clue that a ritual in thin privilege had just occurred.  Here, however, was the subtext:

Texas Mom:  “You could volunteer.  You’re thin enough, probably three BMI points my junior, and I mean that as a compliment.  No one would think you were ridiculous or deluded if you volunteered.  (And I know you may be questioning that, because you’re a woman and, by definition, are plagued with doubts and body issues, regardless of your weight history.)  However, more importantly, the person who really should sit in the stern is my 85-pound, 12-year-old son, but he may think that idea is lame.  And I can’t step in to rescue him, but you can.”

Me:  “Well, I don’t qualify as the lightest, as you know.  Not even second lightest – that would be my 14-year-old son.  But both he and your son may think sitting in the stern is lame.  We both know that could be horribly awkward, but since you have given me permission, established my relative size qualification and offered your support, if this gets ugly, I’ll step forward and take the seat in the stern.”

Fortunately for both of us, the twelve-year-old raised his paddle and leaped to the side of our guide, “I’m lightest!  I’m in the back.”  Whew.

Yup.  Thin privilege means getting to be a hero, if only on stand-by, from time to time.  Perhaps I was also the hero when I served as the commuter jet’s ballast, but that made me cry when I reached my hotel room.  I must admit, this situation felt much better.  Thin privilege is getting to feel good about weight-related opportunities.

In the meantime, live joyfully most of the time, eat healthfully most of the time, exercise most days and treasure whatever body happens.  If you’re a blogger, do your best to tell a truth and advance compassion.  Those are the words that carry me through.

Well, I am on an email list for an online, left-leaning news analysis publication called Truthout, and, truth be told, I don’t click through very often.  But, for obvious reasons, this article, Are Chemicals Making us Fat?, caught my eye.   Could it be that the left is coming ‘round?  

It’s a rather simplistic article, written as though this conversation is brand-spanking new “Researchers have called these chemicals endocrine disruptors. . . But a new, more relevant term for these chemicals has emerged. They are now also called obesogens.”

Has emerged?  Bruce Blumberg of the University of California at Irvine takes credit for coining the term obesogen, and his research using that word seems to date back to the mid-2000s, but the conversation regarding endocrine disruptors and obesity has been going on for decades.  (Our conversation at this blog, which I extended not once, not twice, but three times, is one of the most fun conversations on the topic.)

I am uncomfortable with the Truthout article for a number of reasons.  I don’t like how it conflates and confuses obesity and diabetes, as though they are conjoined twins.  This is a common practice now, and a panic-laden term “diabesity” has “emerged” to express this concept.  Generally, if blame is assigned, the arrow indicates that obesity causes diabetes, (though that assumption is regularly challenged).  In fact, if you type into Google the phrase “diabetes causes obesity” the default search at the top of the pop-up list is “obesity causes diabetes,” as though Google feels obligated to correct you. 

The Truthout article also crosses my comfort threshold with this alarming and unfootnoted statement “For the first time in 200 years, children now have a shorter life expectancy than their parents, primarily due to obesity and diabetes.”  No doubt this is the Olshansky et. al. article being overstated and misused once again.   This sentiment has now entered the “common wisdom,” if you count panic as an act of wisdom

The article goes on to make a number of other unfootnoted statements of fact in order to pave the way for its conclusion.   I suppose this is to be expected in a commentary piece, but is it also to be forgiven?  I know I don’t forgive Fox News for its unsupported statements of “fact” which then draw its commentators to conclusions that I find unsupportable. 

In the Truthout essay, the author, Dr. Brian Moench, reaches the following conclusion:

Our regulatory agencies and even the courts are still playing by a rule book written by the tobacco industry, which states that we must always wait for unequivocal proof of damage before we can regulate. Of course, there is never unequivocal proof, more study is always needed. But that is not an excuse to not act on the evidence that we already have.

Take a look in the mirror and at your glucometer. If you don’t like what you see, you may want to reconsider whether you support the anti-regulation/personal accountability fever sweeping over the country with the new Congress. Whether you can ever be thin again or get over your diabetes may be more a matter of what happens in Congress than what happens on your treadmill.

Hmmmmm.  I have all kinds of thoughts and mixed feelings about this.  The floor is open.

You dare not criticize it.  You dare not suggest that light skin color may convey an advantage, that already having resources or growing up in a home where the parents are educated and speak proper English may help.  You will be whomped squarely with an anecdote that breaks that rule, you Negative Nelly, you!  People pull themselves up by the bootstraps every day, and if you temper your celebration of their achievement – by citing statistics or expressing compassion for the people who don’t succeed despite trying – then you will be put in your place.  It’s downright unpatriotic to suggest that the playing field isn’t even.  That’s just an excuse for laziness.

Well, the American Dream will be the platform of Miss South Carolina in this year’s Miss America pageant.  (Be sure to click through to the video.)  Technically, Bree Boyce’s platform is “Eating healthy and fighting obesity,” but the subtext is the American Dream.  Bree weighed 234 pounds when she was 17.  Now, at 22, she weighs 122.  She uses her life story as the example of the obesity-curing benefits of hard work and rugged individualism.

“I did it all on my own.  I did it for myself.”  She tells the Today Show’s Ann Curry.

She conflates being fat with being unhealthy and she conflates “it” (weight loss) with the American Dream:

“I had so many dreams and aspirations for myself.  And I knew that being so unhealthy I wouldn’t be able to accomplish any of those dreams.  So by changing my lifestyle completely, I did a 180, and it’s been completely amazing, and I’m just so excited.”

From what I can tell, however, her dreams and aspirations have been to get thin and win beauty pageants, like her older sister Tiffany.  In a family that supports those aspirations.  And she has done it. 

She works out two to three hours a day when preparing for contests and she “maintains” her “lifestyle” with half- to one-hour of daily exercise.   But she hasn’t spent much time in “lifestyle” mode, methinks.   She’s been working hard.  She loves looking at her swim suit competition pictures, and, indeed, there’s no denying that she is ripped.  She tells Ann that when she did her swim suit promenade, to keep the butterflies in her stomach at bay, she was just thinking about herself, her hard work and all the people she could inspire.  She kept herself focused on how she is “a confident and successful woman.  And to strut my stuff on that stage was the proudest moment of my life.” 

In the end, it’s all the American Dream.  She sums it up:

“Whatever it is in life that you want to do, it takes hard work.  There’s no secret.  It’s hard work, and determination and perseverance.  All those things.” 

Sweet, dear girl.  She’s only 22 and I don’t hate her.  I’m sure her competition coaches have encouraged her to declare herself an inspiration.  That’s the “hook” that will distinguish her from the other competitors.  They do not trouble her with old proverbs about pride preceding falls, or other nonsense that will get in the way of winning.  She keeps talking:

“And I want to be that inspiration for people to know that anything is possible as long as you put your mind to it and keep it up every day.  I know that there’s days that I want to give up.  But I can’t, because I look for the future.  And I look for making my dreams come true.  And getting on that Miss America stage and hopefully winning the swimsuit title there.”

She looks to the future.  A future that is just another pageant a few months away.  Is anyone else just a wee bit sad?

Score one more win for cultural mythology, likely at this sweet girl’s expense.

In my last post I explained Katarina Borer’s methodology for comparing the effects of food intake and exercise on appetite and on certain endocrine secretions.  Dr. Barry Braun describes it as “a multicondition crossover design to cleverly disentangle the relationships between energy imbalance, exercise, energy intake, putatative energy-regulating hormones and perceived appetite.”  Yup.   That’s what it was.  Now, let’s see whether I can explain in plain English what happened and what was correlated and what was not.

In her first study, Appetite Responds to Changes in Meal Content, Whereas Ghrelin, Leptin and Insulin Track changes in energy Availability, Dr. Borer found:  

1. Human appetite is influenced by the passage of food through the mouth and gastrointestinal tract.  When food went through the mouth, it triggered GIP, a gut peptide that is activated and serves as a marker for GI activity but seemingly has no affecting qualities of its own.  This peptide rose and fell in concert with participants’ reported appetites. 
2. Participants’ appetites responded to the size of meals that came in through the mouth, but were insensitive to calorie replacements (or saline placebos) that came through an IV.  Moreover, exercise did not increase appetite, but marginally suppressed it.  This led her to state that “between-meal increases in circulating nutrient load and exercise energy expenditure are not under homeostatic feedback control.”
3. Ghrelin, leptin and insulin respond in slightly different ways to changes in energy availability, but had no influence on participants’ appetites.  Whoa.  Interesting, yes?  Dr. Borer thought so too.

The graph array that interested me most, as a maintainer, however, was Figure 2 (in the second study it was reposted as Figure 4).  I was surprised, in fact, that it was not included as a “finding” in the Discussion section.

It looks fuzzy in my preview, but I was able to click on it to get a blown-up view that was very clear.  Column 4 describes the trial day that participants were given a small breakfast and no replacement nutrients in their IV, then compelled to exercise, and, hence, went to lunch with an energy deficit.  Interestingly, they ate less than the other days, though, presumably, they ate to satisfaction – ad libitum.  It looked to me as though they were satisfied with less food and a smaller energy balance after exercise.  The narrative of the study seemed to indicate this too, even though it wasn’t a “finding” of its own.  Could that be true? 

In the caption to the Figure it reads:  ”Midday meal did not compensate for the significantly lower energy balance in SED-R and EX trials (F_df4,45 = 77.13; P < 0.0001), which remained uncorrected after the meal (F_df4,45 = 10.17; P < 0.0001).” 

Huh?  Uncorrected why? 

I emailed Dr. Borer.  I asked whether that meant that the meal did not, in total, contain enough calories to compensate or whether the participants chose to eat less.  She clarified that they were allowed to eat to satisfaction and had plenty of food.  Then she said, “It looks like the exercisers (without extra calories infused into their veins) ate a bit less, but it was not statistically significant.”  (Italics mine.)  She went on to say, after some commentary  . . .  “They just lost or did not eat 400 to 500 Kcal.”  My jaw dropped reading that.  Unconsciously foregoing 400 to 500 kcal may be statistically insignificant, but my God!  AND, I’ll grant you, that over the course of a week or so, a standard-issue person will likely compensate for 400 to 500 kcal.  However, we as radical weight-loss maintainers are, ourselves, as I’ve said before, statistical outliers.  If 97 percent of people who lose weight regain it, then our results, and the behaviors we employ to produce those results, are so out-of-the-norm as to qualify us as statistically insignificant. Nothing about us is standard issue, whether we choose to be “inspirational” or cynical. So, my statistically insignificant maintainer buddies, how does this graph read to you?  To me it says exercise is not merely for energy balance, but suppresses the endocrine (which, according to these studies, is not necessarily leptin and insulin, since their rise and fall does not track consistently with appetite) that triggers our “eat impulses.”

Dr. Borer attached two articles to her email that she thought I might find meaningful. They are by MacLean, et. al.  You may note in the et. al. is Holly Wyatt, who we know here as the scientist who looks like Farrah, and is now associated with the National Weight Control Registry.  Also in the et. al. is James O. Hill, co-founder of the NWCR, which gives me pause.  I know he comes with the bias that behavior can and should be duplicated in service to radical weight-loss maintenance. I’m on heightened alert for the presences of this bias, and haven’t read the studies yet, but they look interesting, nevertheless.  Here are their titles, and links:

Regular exercise attenuates the metabolic drive to regain weight after long-term weight loss

Biology’s Response to Dieting: the Impetus for Weight Regain

Now, back to Dr. Borer and her work.  The concept of homeostasis has apparently haunted her.   She was troubled enough by it, in fact, to look at her own data with fresh eyes.  

We have struggled here at this blog with the idea of homeostasis.  Among its problems, it only works one way:  it will increase our appetites and slow down our movement to protect a higher weight.  On the other hand, when we all-too-easily gain weight (the Freshman 15, for example) it doesn’t blunt our appetites and speed us up to return us to our lower weight.  (Or at least not all of us.  It is exasperatingly inconsistent.)  Dr. Borer notes that some human and rat studies show increases in activity in subjects when weight loss is imposed on them (I wonder if that is their ancient “hunt and gather” wiring telling them to get busy and go find food) and decreases in activity when obesity is imposed (the body saying, “you may relax now; you’ve got stores”).

For Dr. Borer:  “The inconsistencies between the contemporary homeostatic concept of energy regulation and evidence implicating nonhomeostatic controls prompted us examine the role of leptin and insulin in the control of human meal-to-meal eating and appetite.”

Her original study did not find a tidy correlation between the rises and falls in leptin and insulin that would track with participants’ perceived appetites.  And instead of writing off the perceptions of her participants, she has proposed that insulin and leptin may function differently in our bodies than often supposed.  She discussed findings on circadian rhythms and hedonic circuitry that also influence our desire to eat (or not), in addition to homeostatic forces.  Her assertion: 

“Substantial evidence suggests that involvement of insulin and leptin in nonhomeostatic control of meal eating and physical activity is mediated through their actions on the brain substrates of reward.”

In other words, surges in insulin and leptin don’t communicate with us about our physical satiety; they may just shut down the mental reward party.  Specifically (Borerese):  “Low insulin and leptin levels enhance, whereas high insulin and leptin levels dampen, the rewarding value of stimulation of this circuit by suppressing the release of dopamine and related neurotransmitters.”  

This theory regarding insulin and leptin suggests to me one reason for the diverse adiposity of humans.  At Big Fat Blog we have discussed, from time to time, that some fat people do fit the stereotype – they eat to excess by many people’s sensibilities. Often, they’re “fat and jolly,” or could be but suppress that impulse, lest they get labeled as “bad” fatties, v. the “good” fatties who exercise ferociously and eat in moderation but still get fat.  This does seem unfair.  Maybe some people’s mental food reward parties are just better and last longer than others’.  Maybe they take enormous pleasure in food, for long periods of time; while other people simply don’t.  It is sad that our society, because of the “war on obesity,” has lost the ability to celebrate fat people who enjoy food, or simply accept them and treat them with basic dignity.

But I digress.  Borer’s study seems to reinforce the nonhomeostatic role for leptin and insulin on a meal-to-meal basis.  This doesn’t mean that homeostasis doesn’t exist (if defined as our bodies’ long-range compulsion to protect or return to our highest established weight) nor does it mean that leptin and insulin don’t trigger homeostatic forces, but they do so through a relationship with the brain’s reward system, not by regulating physical satiety, meal by meal over the course of a day.

I have talked an awful lot today, and am just going to force myself to stop, even though I’d like to talk about exercise more.  Again, go up and look at Figure 2 and tell me what you think.  Or the findings.  Those are interesting fodder for discussion too.  The floor is open.