DebraSY

The Unfairness of Weight-Loss Maintenance

In Weight-Loss Maintenance on September 29, 2010 at 10:30 am

Most people oversimplify why fat people “yo-yo,” or lose then regain large amounts of weight.  Cultural mythology says it’s because fat people “get lazy” or “don’t understand it’s a lifestyle change,” and return to their old ways.  In fact, most fat people (over age 20) are energetic, well-informed, earnest people who think this time they’ve found their perfect plan, forever and for good.  Something has “clicked.” Shortly after losing the weight, they go through an optimistic honeymoon phase where they endeavor to inspire their friends and family to lose weight. Yet for most people, no matter how smart, disciplined, optimistic or committed they are, the weight comes back.  It’s humiliating.  Yet their shame is a travesty.    

Only 3% of people who intentionally lose radical weight will maintain their losses for five years, according to evidence-based, empirical research. Why? 

Accept the following paradigm shift from common wisdom:  fat people are no more ignorant, lazy, weak-willed or emotionally broken than naturally trim people, but weight-loss maintenance is abjectly unfair.  In subsequent postings to this blog you will learn how to make some peace with each of the following inequities.  But today is not your pep talk; it’s plain-talk.

Unfairness 1.  Maintenance isn’t a “lifestyle”; it’s a third- to half-time, unpaid job.  It need not be joyless, but sometimes it’s a bore.

Unfairness 2.  Your boss is a tyrant.  Your food management must be scrupulous, your exercise intense, and you get no vacations.  If a maintainer “takes off” for even a week, he or she may gain back several pounds that won’t “come right off if you return to your routine” as the know-it-alls love to say.  The National Weight Control Registry confirms that only 13% of successful maintainers who partially regain will lose that weight again.

Unfairness 3.  Zero-change is a time-consuming and unsatisfying “goal.”  Sure, you can add other goals – “learn golf,” etc. – but those goals are secondary and may not contribute to your zero-change primary goal, and time is limited for most of us.

Unfairness 4. Binge impulses are real, based in biology/endocrinology, and you must circumvent them or you’ll ultimately succumb and regain the weight. Pop psychology carelessly throws around the jargon of “emotional eating,” and encourages people to take control of their emotional issues on the precept that they may then gain control of their weight issues, including their impulses to binge.  In practicality, most people are better advised to perform a “problemectomy” and separate emotions from weight.  Address weight issues as a scientific challenge.  Get separate counseling, if you need it, for emotional issues.

Unfairness 5.  Simple “portion control” is a fairy tale.  Your excess fat was (or is) probably a symptom of your body’s inability to process the poisons of a modern diet.  Maintainers eat a “cleaner” diet than most naturally trim people who do not face this challenge.

Unfairness 6. Damage to the joints from the weight you once carried makes it difficult, over time, to create and sustain an exercise regimen that is intense enough to maintain losses.

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.

Unfairness 8.  All the support you received while losing weight dries up, and often turns to sabotage.  People push food at you and lose patience with your time-consuming exercise. 

Unfairness 9.  The experts don’t have maintenance figured out, and add their authority to the mythology.  Even MDs think that maintenance is simply about willpower and portion control.  How dispiriting to those who regain weight and need their doctor’s support, not judgment! 

Unfairness 10.  Contrary to cultural mythology (“If I can do it anyone can!”), NOT everyone can do this.  In addition to having sufficient time and energy for an added third- to half-time job, you will need a stable support system, adequate resources for proper food and exercise, and other blessings.  Even with an ideal situation, your genetics and endocrine system will put up a much fiercer fight that anyone currently acknowledges.   

Weight-loss maintenance, if analyzed fairly, might qualify as a disordered mindset, though I’m not a doctor and am unqualified to diagnose.  I prefer to think of it as a job or avocation.  You may prefer to think of it as a time-consuming hobby or even as a fine art, like playing the cello.  It’s fair to speculate that YoYo Ma has done more than adopt a “cello lifestyle” to play at the concert level.  I’m no YoYo Ma of maintenance (I hold only Jared Fogle in that esteem), but I still must do more than cobble together “tips and tricks” from women’s magazines to do this. 

Weight regain is an unwitting slide into Hell that involves all the Elisabeth Kübler-Ross stages of death.  People who regain weight often think they have failed, and then they avoid doctor’s offices, gyms or other places that might contribute to their health and well-being. What a tragedy!  In truth, they accomplished something quite difficult by losing the weight in the first place, but then they were failed by a cultural mythology regarding maintenance that continues to fail us all.

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  1. Hi, Debra- As an unrepentant fat person, I’m not really in one of your target groups, but I just wanted to drop in to say “hi” and express agreement with most of what you’re saying here (although it’s hard to say whether being heavy is harder on your joints than constant, intense exercise).

    • Maybe I need to add in the Size Acceptance community. That’s where I have gotten much of my support and information over the past few years as I sorted through the question of “who am I, anyway?”

  2. Honestly, I’m willing to bet that we’ve got more people in the fat acceptance community who are 5-25% below their maximum weight than any other group you could find (it’s just that we’re still fat). HAES does do that for some people, but since we don’t think of it as a goal, we don’t discuss it. There were at least ten years when I could have been on the weight control registry, had I been interested. Of course, most people would see our participation in your blog as evidence that we’re “looking for excuses” or something. I hope that you do connect with people who want to lose weight so that they’ll know what to expect. And, whether or not it flirts with disordered eating, your approach is undoubtedly healthier than weight loss surgery.

    • Just updated my “about” entry. I think you’re right about that notion that there are many people maintaining losses that are too small for our society to get excited about. And yet any maintenance is a challenge and anything over 10% from highest established weight is Hurculean to maintain.

  3. “Weight-loss maintenance, if analyzed fairly, might qualify as a disordered mindset”

    Wow – you say so many things that I think… I usually say that I “maintain” because my current eating disorder of strict control is constantly at battle with my previous out of control disorder and between the two of them, I manage to have stasis.

  4. Stat Freak, I “get” that. Wow.

  5. HI

    I stumbled onto your blog literally by accident. I was trying to contact you in a manner that would not show up in the comment section.

    I am trying to get perspective so that I can understand more. First, Congratualtions and thanks for explaining, from a layman’s view, the challenges associated with weight maintenance.

    I am a man 57 yo. Work out at a gym 3x a week, do 30 min of cardio 3 x wk. 13 years ago I weighed close to 195, which is a lot for my 5″6 frame. I started working out, while still eating badly. Like you, I taught myself a lot about labels, exercise, nutrition and healthy living. It was kinda funny that when the world, or at least, the culture decided to debate Atkins, or the alarming growth of obesity, that I was ahead of the curve. Not to yammer on, but there are certain times of the year when I let myself “go”, end of the year especially (I’m gonna make those choc chip cookies, pound cake, mac & cheese, etc, I deserve it). When the new year arrives, might not weigh myself till the end of January, to discover, gee, weight gain. Not to worry, I live on the East Coast, we are all bundled up, who will know. Even though I have eaten badly, I continue my workout regiment throughout this time. I figure without the regiment, I would have gained more.

    As winter turns to spring and I now employ what I call a “restrictive eating plan”, no sweets, fried food, flour or bread. The weight stubbornly comes off.

    This year’s challenges has been excerbated by my recent smoking cessation. 36 days today. I weigh 180 and I had been down to 166.

    I have gone on longer than I want. I don’t want to bore you. I’m trying to understand how tall you are, how much you weighed and how much you weigh now.

    One of the gnawing challenges facing me is something you allude to: maintenance is probably no more fun than the more demanding weight loss process. Even when I get to where I need to be weight-wise, I believe some of the forbidden foods can be reintroduced into the diet. Theoretically that is probably true but even a one day a week “cheat day” catches up to you. The bottom line for me is I am still trying to find the balance. Interestingly, weight loss takes time, so does weight gain and so one becomes lulled into a few lbs more and then a close friend who complimented you before now asked whether you “backslid.”

    HAES is an interesting cultural movement. It is why I sometimes read the blogs associated with the movement. I’m overweight, but by most standards, not part of the obese landscape. I don’t want to be.

    I read your blog with interest becasue your stoic approach to weight maintenance might speak to the reality that awaits me once I shed the facade of denial.

    Can you please answer my questions, if you would be so kind, just so I can better understand your journey. Again, sorry for being so long.

    Thank you and continued success

    • Stanley, I’m glad you found me. At 5’6″ and 180-195ish, indeed, your weight alone is probably not causing you issues, and yo-yoing may only drive it up (some research supports this), which is exasperating. If you’re mobile and your joints work well, then the healthiest thing you can do — mentally and physically — is just (my mantra) live joyfully most of the time, eat healthfully most of the time, exercise most days and treasure whatever body happens. (And pooey on any friend who notes that you have “backslid.” Why is your weight someone else’s business?) With regard to the exercise and the extra efforts you put into making your diet more wholesome and less toxic, give it 8 to ten hours a week, a quarter-time job, check it off your list and say to yourself, “Job well done, Stanley. You have on your own oxygen mask, metaphorically speaking. Now you may tend to the other important aspects of your life.” Try not to obsess.

      If your cholesterol numbers, triglicerides or any other items in your blood profile are troubling, then you’re still best advised to implement health measures (maybe with more gusto) without specific weight-loss expectations.

      As I look at the description of your life, it appears you might benefit from becoming more consistent about your food. Alternating between letting yourself go and then uber-restricting is probably sending your body some confusing signals. Here’s my thought on the holidays, since they’re coming up now. The foods of that time of the year are meant to help connect us to one another in a loving fashion, not destroy our health and make us feel bloaty and overstuffed. I don’t feel any obligation to eat anything by someone whose last name is “Incorporated,” but when someone homebakes something with love, I partake. My favorite line, which also advances that idea of connecting, is “Wow, these look wonderful! Who will split one with me?”

      As to my own particulars: I’m 5’4″ and I currently weigh 147 (give or take two pounds). At my non-pregnant high, August of 2002, I was 205. From August of 2002 to November 2003, I lost 68 pounds, to a low point of 137. Even though I have regained ten pounds in seven years, the National Weight Control Registry still regards me as “maintaining” since I have never gained more than five pounds in a single year. I question their idea of “maintaining,” but accept myself for what I am, which is radically smaller than what I was and (despite the regain) leading a health-centered life that I think is unrealistically time-consuming for most people. But it’s my life. And I enjoy examining it critically. I try not to buy into cultural mythology or pseudo-medical scare tactics. The truth lies somewhere else, and science can help us figure it out I think.

      • I’m visiting from Debby’s blog, and I had to delurk to say I *love* your mantra! Fantastic!!!

      • Hey, Pubsgal! Glad you unlurked. Hope you feel free to comment. I recognize you from Barbara’s blog. It is truly a small world. I just found Debby, myself.

  6. Hi, I found your blog on the fat chat feed. I am having a difficult time with my weight right now and am so thankful for your blog, am going to read through it all this evening.

    I was 300 at my highest, 200 now, a size 18 uk. It took eight months, I take in very few calories, like 900 or so. walk an hour and do two hours of belly dancing everyday. I am trying so hard, I feel betrayed by my body. I am in my late twenties, my belly hangs, the underside of my arms look atrocious and I have very heavy legs, I can never miss out on my walks or my legs get sore. My mother is fat too. When I was thirteen I was prescribes a strong contraceptive pill the diAnette for severe acne- I now believe this had been problematic for my body, my gp kept me on it for eight years. At the time I thought I would rather be fat than have painful acne (this was before roaccutane would have been routinely suggested) now I have angry knee joints, am always cold and have skin that takes an age to heal a cut. Despite this I am soldiering on to try and get to a size 14 uk and eleven and a half stone. I completely agree with you, it is not a fun state to be in. I’ve read a lot on FA, bought many of the books too but really my body was just too painful to move around and find comfortable clothes for, I admire the girlies ands chaps that can stay the FA course, but I was just too worried, that if I felt this bad physically at a size 26 in my mid twenties what on earth would be in store for the future….things like lymphodema’s terrified me.

    Also, sorry if this comment is all over the place I am tryong

    • Ah, Whiterabbit. Your regimen is intense. And I would find the 900 calories unsustainable. In time, you may too, I fear.

      Belly Dancing and walking are wonderful things. The world needs the kind of joy they provide, but they aren’t efficient calorie burners. The time you spend — three hours a day — doesn’t shock me.

      And you have other, complicated, symptoms. It sounds like you need an endocrinologist who will work with you to try to reverse the damage done by that acne drug. I know that health care is complex in the UK (as it is here), but I think one of the hardest things we naturally fat people face is finding doctors who believe that we are telling the truth, and will work with us. What you have going for you now is that you have lost 100 pounds. My hope for you is that you leverage the clout of your weight loss to find someone to work doggedly to help you with the various symptoms you describe — the cold, the angry knee joints, etc. Sadly, with regard to the weight, if you slide, too many will throw it back at you. If your GP “prescribed” a restricted diet and exercise (as if a person needs a prescription for that), he or she will say you simply became “noncompliant” with treatment, and won’t dig for the answer as to why. Grrr.

      I’m not a doctor, so I can’t go too far with medical advice, but I can offer a little advice for making walking a more efficient calorie burner: weight vest. I do walk to and from the local coffee shop in mine, and they don’t think I’m a terrorist ready to explode (but I don’t go to the credit union in it). It cost me about $150. I’ve found it a worthwhile investment. If you get one, make sure it’s a women’s design — the weights are placed so they don’t smash your “girls.”

  7. Eeek! Some keyboard cat (sans keyboard) action there, I believe I was trying to say my comment may be all over the place as I had to type it up on my phone

  8. Debra, your blog and your writing–your thought process is so impressive. Obviously you have thought and researched long and hard on the topic of maintaining your weight. Thank you for sharing your wisdom. I will be pointing people in your direction.

  9. Thanks, Debby. Your quilts are wonderful, by the way. I don’t quilt myself, but I’m (urban) Mennonite, and that exposes me to the art.

  10. Just giving my opinion on what you’ve said:

    1. If you aren’t enjoying your lifestyle then change your ways. It’s not maintenance boring you, it’s you and your routine.

    2. Your food management doesn’t have to be ‘scrupulous’. I estimate my calorie intake and lost 30lbs this year. I also don’t do just ‘intense’ exercise, and no one has to. My easier regimes include low impact aerobics, dancing, and walking. Who can’t do that?

    3. NO ONE can have ‘zero-change’ on the scale. It’s best to stick to a range and hover near there. If you still desire change, set new goals e.g. enter a race for charity, earn a new wardrobe, tone up more, etc. Your life will only stand still if you let it.

    4. I just read about this. One binge isn’t going to make anyone balloon back to their starting weight. To gain a pound you’d need to 3500cals over your maintenance calories, so why would someone still feel the need to eat that much at this point? They must be unhappy in other areas of their life.

    5. People are successful with portion control. I lost my first 40lbs doing so, but then I started counting after my second plateau. Calorie counting gives you a genreal idea of how much to eat, so continue to eat the same amounts.

    6. Strength training will give you stronger bones. You don’t need to do intense exercises to maintain your weight. People do walking and aerobics and maintain just fine, so if you’re overexercising enough to hurt yourself then that’s your problem, not maintenance.

    7. I agree with this, but I don’t see how counselling would help.

    8. If support dries up, find new support. Millions of people are losing and maintaining weight, so find others. Saboteurs are around for some while they’re losing, so that’s not just maintenance.

    9. For the successful maintainers who are happy maintaining, it is willpower and portion control/calorie counting. Doctors will judge you regardless, so who cares what they think? They aren’t qualified in weight loss.

    10. Yes, some people don’t have the drive to lose weight for good. They could do it, but they won’t for whatever reason. Time? People burn lots of fat doing only 20mins of interval training a day. Others cook lots of food and freeze it for the weekdays. EVERYONE has the time, but pretend that they’re too busy. You defied your genetics by meeting your goal weight in the first place, so why are your genes suddenly a problem?

    You sound SO bitter. I know that maintenance is no walk in the park, but you make it sound like hell. If your genes are war with you and you don’t like your ‘job’, why haven’t you quit? Maybe you could be more balanced next time e.g. the good and bad side of maintaining.

    • Zahra: You are the expert on you, and I’m happy for you that your weight loss went so well. I will say, you aren’t an expert on me. My routine is what I can do given my medical profile. And yes, after seven years, the food management is more scrupulous than in year one, two or three (actually, until I had to stop running regularly), and the exercise is what it is because it has to be, given some surgeries and other circumstances.

      Maybe my blog just isn’t for you. There are bazillions who are like-minded with you. And for the first three years of my maintenance, I might have said many of the same things. I guarantee you can find soulmates out there in the internet world. I’m not saying this to be cold, but your circumstances are different from mine and I will only frustrate you, and I don’t plan to go silent. There are enough people who understand exactly what I’m saying. There are also people who agree with you. We aren’t on the same page.

      I wish you well, and I hope your honeymoon period with your 30 pounds of loss goes on for decades! You may wish to tuck my blog address in a drawer. There may come a day when it seems more relavent. But, hey, let’s hope not!

  11. […] against her own body as heroic or noble, only a substantial effort, roughly the equivalent of an unfair unpaid part-time job. (In addition to her jobs as a mom, a partner, and paid […]

  12. First of all, I can’t thank you enough for leaving a comment on my blog so that I could find your site. This post left me in awe while picking my jaw up from the ground. You have written such an accurate description of a maintainer, I can’t seem to find anything else to say other than, ‘Thank goodness there is someone else out there who knows how I feel!’ Truthfully, I have been so busy maintaining that I have never thought about it being a thankless job, but that is exactly what it is. I’ve kept off 105 pounds for over 6 years now and it is the hardest thing I’ve ever done.
    Thank you for this blog and for being my voice when I’m unable to put my own frustrations into words.

    • Actually Ellen, your words are great. I tried to leave a post on your “beginnings” page to that effect but, like I said, Google ate my words. Damn. Someone there (who had not yet even finished the loss part) had left you a message to tell you how it all gets easier and there are no more days of hanging on to precipices once you get your head together, or some such. I snorted. (You left them a graceful acknowledgement and thank you note, which, of course, is the right thing to do.) Ya know, I had it all figured out myself for the first four years of maintenance, I was “the joyful jogger,” maintaining weight loss too, then life threw me some corkscrews. Now I know, there are cycles of having it together (for which we are thankful), and cycles of crazy (which we try to leverage into wisdom). Cycles can last days, weeks, or longer . . . looooonger. Sigh. Nice to know you, soul sister.

  13. OMG, I have just found this blog. It is opening my eyes, and frankly, depressing me. I hit my goal on April 15, when the scale read just under 160 lbs. That was a loss of 168 lbs. Of course I have the accompanying ugly excess skin, but so far I’m happy hiding it under my clothes. Since April, I have lost an additional 15 lbs., now weighing in just under 145, for a healthy BMI (barely) of 24.7.
    I know how hard these last five months have been, but I have persevered, hoping it would get easier at some point. Your blog makes it clear it WILL NOT, even after YEARS! And I wonder if can I be one of those 3% who can do it? I doubt it. I have not been successful in the past. I do have a father who maintained a 100 lb. weight loss for the last 18 years of his life and a brother who lost 75 lbs. over 20 years ago and has kept almost all of it off. But I know both of them really worked hard at it, watching every mouthful and exercising like crazy. Like you say, what will happen to me if my knees give out and I can no longer walk? I have started doing a little jogging (I can’t call what I do running), but it is so hard on my knees. Although walking burns very few calories, maybe I will buy one of those weighted vests to help that along. I only know I simply cannot regain. It will just be too embarrassing, my doctor will be disappointed, my co-workers will talk about behind my back, as will my friends and family. My weight was at a point where it was affecting everything in my life–high BP, pre-diabetes, difficulty in walking, any exertion left me breathless. I was literally shortening my life with my lifestyle choices. That is how important it is that I keep this weight off. So fat acceptance be damned–my grandmother had a sudden stroke and died at the age of 62, my mother had a sudden heart attack and died at the age of 65, I turned 60 this year, so this weighs heavily on my mind. I wish you were going to continue your blog. I like your honesty. I don’t like to think of having to struggle forever, but I also think if I read about other’s struggles, in some way it will help me. Am I crazy?

    • You are NOT crazy, Pam! And, perhaps, my blog can serve as good news, in an odd way. In the past you have weight cycled, and that process is far more depressing than reading my blog. You yo-yoed, I would guess, because you believed (as most people do) the cultural mythology that maintenance is easier than weight loss, and you did all the “right” things, but of course they weren’t enough. And when your weight started to slide you gave in to the normal sense of resignation and defeat (along with the hormonal and metabolic changes that go with being weight reduced and compel you to regain). Well, this time will be different.

      First of all, grieve the death of the myth. Rage. Rail. Kick. Scream. Cry. Go numb. Repeat any necessary part of the grief process you want. Then resign yourself that you CAN do this. (Return to grief any time you need to.) Now, you can, indeed, join the 3% society, because you know it exists, and you know that it requires more persistance, creativity and flexibility than the women’s magazines tell us. You can dig in your heels and maintain, or at least slide verrrrrry verrrrrry slowly, over years (not like a “normal” regain in which you put the weight back on within a year). Resolve to treasure your body, regardless of what happens. Hating on yourself or your situation serves no good purpose. And then set about attaining the body wisdom that will serve your unique maintenance. Yo-yoing has health consequences, so dig in hard where you are. Be stoic. Make the other parts of your life as joyful as possible, and forcefully shoe-horn some joy into your maintenance as well. (I find tap dancing as part of my exercise plan has helped in this regard.)

      “Struggle” is not as useful a concept as “job.” Jobs can be challenging, trying, but you don’t go to them, generally, thinking “Oh, today’s going to be a struggle.” You think, “Gotta go do my job. Woof.” And you do your job — some days are good, some are bad — and you get rewards. Your paycheck may not be what you deserve, but it’s a paycheck all the same. Some of your co-workers are jerks, but others are lovely. You get by. That’s what you can expect of maintenance. You’ll get by, and it won’t be zippity fun, but it won’t be so onerous you can’t do it. You can do it better, actually, because you don’t expect it to be zippity fun. You’re realistic now.

      What will happen if your knees give out? Don’t know. Maybe you’ll find an adaptation that keeps your maintenance steady. That would be great. Or maybe you won’t and you’ll slide ten pounds and dig in there. That would be good too. Or, worst case, you’ll slide and not be able to grab a new foothold. That would be depressing, but regardless, it isn’t useful to borrow trouble from a future that may not happen.

      More good news: you come from a family that “gets” the 3% club. Your brother will be a fine resource. I doubt that he’ll sabotage your efforts at family gatherings, and he may be able to help you manage the relatives who would.

      Even more good news: I’m not dying. I’m just not posting new stuff. I’ll be continuing with my life and maintenance, and if you write a comment on an existing post, I’ll get a message from WordPress and come respond back atcha.

      Chin up, Pam, you’ll be okay.

  14. […] weight loss be worth it to me, and how much do I think I will regain?  Do I think I will sustain a net loss, or will this just result in me weighing even more than I do […]

  15. “You sound SO bitter.” What a stupid comment. Struggling with a weight regain, I am so happy that I found your blog, which I find 100 times more useful than some of the other weight maintainer blogs I have found where people blather on about how they lost 100 pounds or whatever and anyone can do it and then they go on Dr. Oz who hugs them, and see how easy it is, and ad nauseam.

    I’m more from the school of “the truth shall set you free” and rather than being discouraging, your blog is actually helping me to find the strength to try to lose — once again — the regained pounds and then to maintain the weight loss.

    Last year, at age 55, I hit size 6 (a real size 6, not one of the those fake size 6’s where a 6 is really a 10). I was thrilled and ecstatic, never thinking I could ever go there post-menopause. I’ve struggled with my weight pretty much all my life, but prior to menopause, we were talking about 30-35 extra pounds that would come and go, but after menopause my weight morphed from the overweight BMI category to the obese BMI category. Thankfully, even with my recent weight gain, I am nowhere near the obese category that I hit post-menopause.

    I have friends who struggle with their weight and they don’t seem to be able to stick to any weight reduction program and I encourage them along the fat acceptance path. However, for me, that path doesn’t work. I’m vain and I’m a clotheshorse and I’m just so much happier when I’m slender, to say nothing of the fact that I’m a single girl and it’s hard enough getting a date in your ’50’s when you are slender, much less when you are overweight.

    Your blog is an inspiration — I can only win the battle that I want to win (understanding that the fight isn’t worth it for everyone, although it is for me) if I know the enemy I am up against. Although you are not posting much these days, I’ve enjoyed the archives and will be checking back from time to time.

    • Yes, Dobie, I’m with you. The truth does set you free. Welcome! Welcome! Welcome!

      On the comment you left over at my post on “Why” I went into depth on a theory I’m working on. Would love to hear your response.

      Oh, and I should have said, I’m so glad you survived the Phen-Fen era seemingly unscathed and with a new (and to my thinking) valid perspective on the value of physiology over pop psychology. I hope you’re keeping an eye on your heart — regular check ups. While Phen-fen did help people with weight loss and maintenance, many people had other consequences. I don’t fault the gov’t for yanking it.

  16. I will check out your other comment on the theory you are examining.

    I don’t know for sure if Phen-Fen did any damage to my heart. A couple of years following the drug’s withdrawal from the market, I did go for an echocardiogram and though it was noted that I had mitral valve prolapse (something never previously detected, although I had never had an echocardiogram before), the cardiologist told me it was definitely congenital and not caused by the phen-fen. The mitral valve prolapse has never caused any symptoms and I have chosen to ignore it. Whether there really is some residual damage from the phen-fen in the long term remains to be seem. I know people were genuinely harmed by phen-fen and I don’t know why some would have been injured and others escaped. Perhaps in my case, something residual will eventually show up.

    Sadly, for all that, I can’t really say I’m sorry I took phen-fen for several years. The one thing that resonated both from your blog and from the recent New York Times article with the sidebar about the couple who have maintained a a long-term weight loss is that maintaining your weight is a very time-consuming and demanding job. The woman in the New York Times article admitted she was only able to do it because she was retired, which permitted her several hours a day to exercise and plan her meals.

    I’m a trial lawyer who routinely works 65 hours a week and I am nowhere near retirement. I don’t have time for a second job. The one thing was that was profoundly liberating to me about the phen-fen years was that suddenly I didn’t have a second job — monitoring my weight and food intake. I only had one demanding job, which was quite enough, thank you. I miss that ease. It was nice to live for awhile in the body of a naturally thin person.

    And since your post that caused me to respond was about “unfairness,” I will make one last comment. I have often rued the unfair genetic card I have been dealt. I am 100% sure that I have a genetic variant that drives me to binge on sweets (although not on alcohol or cocaine — there must be genetic subvariants that cause a craving for alcohol versus a craving for sugar). And yet I realize how lucky I am genetically because until my ’50’s, that eating behavior never resulted in me being more than 30-35 pounds overweight. I have no doubt that someone else who consumed the calories I consumed would have easily been 100 pounds or more overweight. While my weight struggles affected me socially in that I was rejected by men for not having the ideal thin figure, I was never heavy enough to suffer the indignities of people not wanting to sit next to me on planes and the like.

    In closing, let me just thank you again for you voice which is a lovely counterbalance to the Dr. Oz’s and Jillean Michaels of the world, who I really think should just STFU.

    • Thanks, Dobie, and good luck. FWIW, since I went back to school, I’ve whittled it down to a third-time job again (I’ve cut out some of the science journal scanning I used to do and just flown on self-wisdom).

      If I were a trial attorney, I would also give up some of the food prep I do and rely on resources like Whole Foods, Panera, Jason’s Deli and Chipotle (the salad w/salsa not dressing). Accept these places (and others like them) as gifts — they will supply you with prepared wholesome foods. Not everyone can afford these places, but I don’t think you can afford to NOT use them, if you want to be in the 3% club. You simply don’t have the time to always do your own chopping. With their help, you may be able to get the “job” whittled down to quarter time or (dare we wish it) even less.

  17. […] is endorsing a short-sighted focus on losing as much weight as possible, as fast as possible, when maintenance is the really hard part. By endorsing The Biggest Loser, she is endorsing the idea that exercise is punishment for weight, […]

  18. I agree with you. I’m really able to see weight loss maintenance as a third-job who is not paid. But that’s the price you have to pay to acheive it. While so many people, as the years go passing by, simply forget about a healthy lifestyle and throw themselves in fried, high-fat food, there’s a small portion of the population that really cares about their health and about fitness, and it’s time-consuming. But I believe it’s worthy. It’s so worthy to be different, to feel beautiful on the inside and on the outside and to be in your 40’s or 50’s with an amazing body and belly.

    • Welcome to Just Maintaining, Leviathan! Hope you find some things of use as you read through it. When I began it I was in a state of outrage at some of the science that I had discovered — science which confirmed my own experience at how challenging this pursuit is and yet was contrary to all the optimistic drivel I had read in fitness and women’s magazines — mythology that held that maintenance was some easier, lesser challenge than weight loss. By the end of my writing, I had become a bit more stoic, but remained clear-eyed about this process. You sound like you have a very bright attitude!

  19. I am “extremely” grateful that I came accross this site. Over last 5 years, I have maintained over a 100 lb weight loss…living life as a fifty seven year old woman in a 12 dress size has improved my mobility and overall health status. Yet, my plan of self care is a part time job!!! I had never thought about it until I read it on your blog…but you are absolutely correct!!! I am a full time professional that travels extensively, a wife and a mother of grown children. My husband, friends and children are pleased that I am taking care of my self but deep down they miss the old me. The amazing late night dinners, fabulous desserts and sugary signature drinks are gone….so is a lot of the laughter. The game room is now full of my exercise equipment and I can’t manage sugar or flour so the kitchen is full of fresh fruits and veggie’s. I wish I could say that my “new normal” behaviors are a “natural” part of my lifestyle. They are not…it still takes daily effort and sometimes prayer to plan my food, exercise daily and maintain my journal.Thanks for your blog…it has provided me with needed insights.

    • Welcome, Goodspace. I’m glad my words resonate with you. At first, during my honeymoon phase (which lasted longer than most people’s), I accepted the “lifestyle” jargon too, and then it slowly sunk in that something was wrong. I felt that I’d been sold a bill of goods, and that anger also lasted quite a while (as in a several years), until I found the words to describe this process truthfully as I experienced it. Then I expressed those words here on this blog, and heard from others that I wasn’t a nut. What a relief!!

      Everything you say resonates with me. Recently, I had to dig in my heels with my son’s orchestra teacher and my church’s hospitality chair with regard to not baking, for example. Just call me Madam Buzzkill! (Ironically, they think I’m just lazy. If they only knew the job description, right?) And yet if I were to start baking (in lieu of bringing fruit, raw veggies, cheese or other such items to potlucks and parties) then the weight slide upward would start, and with it the tsk tsking: “Wow, she did so well for so long, then she just let herself go.” Actually, many people don’t even know the fat version of me now. They’d just be dumbfounded at my sudden weight gain.

      Daily effort and sometimes prayer. You’re right on. Of the blogs on my roll that you may find of interest, go visit Debby. She is trying to integrate a spiritual life with her maintenance and several post retirement avocations — quilting, dogs, travel. I think you’ll like her, and her blog is very much alive.

  20. Just had to respond to your comment about refusing to bake. Me, too! Our church women’s group is planning the Father’s Day treat. The leader said, “We can all bake cookies to bring, right?” I had to speak out in front of them all and say, “I don’t bake cookies. I’ll do anything else, but I won’t bake cookies. If I do, I’ll be over 200 lb in a minute. It’s like asking an alcoholic to bring the beer.” It felt strange to do that, but it also felt good to be clear. Anyway, I appreciate hearing I’m not the only one!

    • Hi, Yvonne. Thanks for leaving a comment. You know, in recent years, I have found that I have been appreciated more and more for this. There is still one curmudgeon at church who thinks we all should just do it like they’ve always done it, but she’s overshadowed by many others. Not just people who want to manage their weight, but people with celiac disease or diabetes or other concerns — they appreciate when someone brings fruit or string cheese to an event, so they feel welcome too. And you’re spot on that we would NEVER consider asking an alcoholic to bring the beer!

  21. Oh, Debra, I am so happy you haven’t taken this blog down. I lost 170 pounds between June 2009 and June 2010. I was then in the honeymoon period for the next 18 months… maybe 2 years. And then the wheels fell off. Long story short, with EXTRAORDINARY effort, I’ve managed to get the ship righted and am maintaining. And with tracking everything that goes into my mouth, meal planning, a trainer at the gym for weight training, running, cycling and other cardio, THREE support groups… if 40 hours a week is a full time job, I might be approaching it. Most people find it obsessive, but it is what I need to do to keep the weight off. I saw you linked off to Dr. Arya Sharma… I met him in Calgary in July and read his guidebook. It said that to maintain a 5% body mass loss required only 10% effort, but still an effort. Moderate changes to diet, exercise, sleep, etc can maintain a 5% weight loss. His chart then went from 10% body mass requires 20% effort, 15% body mass requires 40% effort, and then … where I fall in… if you lose half of your body mass it requires 100% effort. Which is what it feels like. So I asked Dr. Sharma if that 100% effort ever decreases or if it will continue forever. His response was a wry, “No. Not forever. You will die sometime. Just probably at a much later date than if you had not lost the weight.” I left the conference very disheartened…. nobody told me this when I was losing the weight. And maybe that’s a good thing, because maybe it might have scared me off. And maybe it is a bad thing because it was a horribly cruel realization to find out after the fact.

    Now I am okay with having to put in the effort. I know it is onerous. I know it is going to be a sacrifice. But I still think the benefits have outweighed those sacrifices. Being able to run marathons, Not having to take medications. Not fearing public speaking (I know that should be unrelated, but it’s not). Actually, not fearing much of anything… I used to be scared of heights, but last year I walked around the outside of the top of the CN Tower in Toronto. So I thought I was doing okay. Until this week. I was listening to a podcast where the interviewer was talking to Scott Abel. This is what he had to say on maintainance:

    “I consider maintenance when you no longer have to think about it as a problem. I look at it as dichotomous way – people are either free of body issues or they are imprisoned by them. There is no in between. So when you are free of them, then maintenance takes care of itself. A lot of time people are just swapping addictions. They have resolved their addiction to food, but now they are addicted to their body image and a focus on maintenance is just an obsession with their present appearance. The prison bars might be a pretty colour and shinier, but it is still the same prison. I want to release people from that prison. There is a life beyond thinking about food and thinking about the scale and that is where I want to get people. Instead of declaring war on their bodies and any self-deprivation that goes with that – depriving yourself of food and punishing your body with exercise. If you really want maintenance, declare a truce with your body and practice peace with your body and in your body. THEN you can be blown away with all your body can do for you and you can start communicating with your body. Your body has been communicating with you all along. You’ve just been trying to force it to do something from the outside in whereas it is trying to help you but has lost that ability because you have beat it down so much. So when it gets to the point of maintenance it again is about are you practicing a balanced triangle of awareness (physical, mental and emotional awareness)? Do you have a calm, patient, peace of mind about yourself? If you do, this all takes care of itself. It isn’t something you need to focus on. And that is the freedom I want people to aspire to instead of this battle and war sense of mentality that is beaten to death in this industry. Maintenance is not something that you need to worry about if you are free from the problem. If you are no longer imprisoned by it then it isn’t something that you need to “struggle” with. So I don’t look at it that way. I see it as either being free of your prison of self-rejection or still being imprisoned by it regardless of your weight or size. Here is an example. I had a girl… this is Thanksgiving weekend here in Canada and every year I think about this case… a few years ago I had a client who was what you would call “drop dead gorgeous” kind of client. Major food issues. Never thought she looked good enough. The night before Thanksgiving she called her best friend at 1 or 2 in the morning. She had gotten out of bed because she couldn’t sleep because tomorrow was Thanksgiving and there was going to be lots of food there and what was she going to do? So she calls this friend from inside her bedroom closet, in tears, because she doesn’t know how she is going to face being in front of all this food. That’s not freedom no matter how she looks. That is beyond obsession. That’s neurosis; that’s an illness. Again to think someone is at maintenance because their body is at a weight we all respect and accept doesn’t tell the whole story so I don’t accept it that way in terms of maintenance. I think if you are clearly free of the problem then it’s not something you have to think about. It’s something you don’t even have to consider. You don’t have to fear about ever going back to your old weight because you don’t have a fear-based mindset anymore.”

    My heart sank. Maybe I am going about this maintainance thing all wrong. Maybe I shouldn’t need to be so obsessive. Maybe I am just weak. Maybe I have failed this whole maintainance thing. He claims there are people out there that don’t find maintainance a struggle… those that can be free from thinking of maintainance as a problem. My psychiatrist has said basically the same thing to me: “You spent the majority of your life a prisoner to your obesity; now you are spending the majority of your life a prisoner to keeping off the weight.”. But that is just what I have to do. So when I heard Mr. Abel, I was thinking that I was a complete failure at this maintainance game and had to throw out everything that I have been doing and find a different way of approaching things, because my means of maintaining are extremely far removed from what he described. I do not call friends at 2am because the next day is Thanksgiving, but I have called friends when I was gifted a Boston Creme cake at 7pm and had to find a way to not eat it before I could give it away the next morning. I have leaned on SOOO many people for support. So I’ve been wondering if there was something wrong with me. Have all my efforts been a waste? But then I stumbled across this blog and I find yourself and others who understand where I am coming from. At least I’m not the only one that finds it difficult.

    • Welcome, DonW!!!!!

      In brief: you are right. And Scott Abel is a self-important, guilt-provoking poop. I find it ironic that he has soooo many words for “just relax.” His message, moreover, is as much an “all or nothing” message as any I have ever seen. You are either “free or imprisoned”?! Boy. Feel free to feel guilty about that. Or not. I call bullsh*t! I think all or nothing thinking is cruel. And sometimes dangerous. Also, the idea that your body always tells you the right thing is just silly. Your body responds to hormones, medications, environmental poisons, stress and other outside disruptions, all kinds of things. It does its best, given the circumstances, but it ain’t the perfect messenger.

      Don, you are in a very healthy stage. Your eyes are open. Now, you are learning the wisdom of your body and comparing that with the contributions of science in a quest for a balanced (if not perfectly free) life. You are moving ahead. Here’s your good news for the holidays: when I started this blog, I was fuming mad, because I had finally put two and two and two and two and two together, and it didn’t match cultural mythology, and even MDs were wrong (or most of them, anyway — Dr. Sharma is an exception). I was just in a tiff, and it was about a half-time or more job. And as I wrote the blog, I got more stoic. Since retiring it, I have limited my mental real estate devoted to maintenance even more! It’s maybe seven to ten hours a week now. But it will never be something I’m completely free from. And that’s okay. I exercise nearly every day. I carry a daily mental (not written) calorie count. I also have the V-8 number board perched above my head (tallying fruits and vegetables) and I limit my grain and starchy carbs to less than 200 cal./day. That’s about it. I read science articles from time to time, but I don’t waste a minute on lifestyle magazines — they’re just a bunch of know-it-alls promoting the same tips and tricks that were written in 1980 or before.

      More good news, since you said your “wheels fell off” your maintenance, this may apply: I managed a reloss of roughly 10 pounds. Here’s the Readers’ Digest condensed wisdom on how to do it: Ignore the idiots who say, “Just return to what you did to lose the weight. You know what you have to do. Just do it.” Okay, that’s more guilt-provoking bullish*t. You cannot return to what you did, because you are different from who you were — hormonally, in particular. If you try to restrict your calories to the level you did in your original loss mode for more than a single day at a time, then (if you’re like me) you will first notice sleep disturbances caused by hunger/”eat impulses.” This will kick your ghrelin up and cause more “eat impulses” (and probably a chain reaction in your other hunger-satiety hormones). Your sleep disturbances will get worse — a vicious cycle, until you refeed. So, if you need to manage a reloss, just plan for it to be a long, strung-out process. It took me six months to relose those ten pounds. Stick with your maintenance exercise schedule and calorie count, and then one to three times per week restrict your calories by about an additional 300. Gentle. Gentle. And don’t try for two days in a row of this calorie restriction, lest you start the sleep-loss/ghrelin machine moving. These are my words for today. Your results may vary. n = 1. Yada yada. Good karma to you.

      • Thank you Debra for your reply. When I say the wheels fell off, the compulsive need to eat – and binge eat at that – came back with a fury. Every night I was eating way, way too much and I had no sense of being satiated. However, I was counterbalancing the compulsive binges with excessive exercise and even laxatives. When I was diagnosed a bulimic I went to see a psychologist that specialized in eating disorders and he outright explained that that compulsive need to eat was just biology. He said he’s seen it in many patients that have lost a lot of weight, particularly those that lost it over a short period of time. Going from 0 exercise and 4000 calories to burning 1200 a day while eating only 1600 over the span of less than a year likely did some crazy things to my body. The bulimic tendencies were totally psychological in that I was refusing to allow my body to gain any weight despite the binges out of a terrorizing fear of regaining the weight back. The only time I actually gained any weight is when this psychologist put me on a ultra-high carb diet (breakfast = cereal, toast AND muffins). I put on 20 pounds, I’ve lost 10 since going back to a low-starchy carb high protein diet and am not too worried about losing the other 10. I’m happy right where I am.

        I guess where I was recently struggling was that I want to do more, BE MORE, than just the guy that lost 170 pounds. I take hope from you being able to step back from maintenance being a primary focus to making it more manageable so you can accomplish your other life goals. I know you don’t like being referred to as a role model, but too bad. 🙂 People who have lost a great deal of weight is a small percentage of the population. Those that have been able to KEEP IT OFF is a smaller fraction of that fraction. Those that can keep it off long term without the singular focus must be minuscule.

      • Whoa. Net 4,000 to net 400 cal./day. Did some crazy things to your body? Uhm, Yeah. You got that right. Glad you found a psychologist you like working with and who gets that biology is important. I don’t think that’s universal in that field. (If the only tool you have is a hammer, everything is a nail syndrome.)

        I’m glad my blog is helpful. Thanks for visiting. You are more than the guy who lost 170 pounds, of course. In this Biggest Loser zeitgeist that we live in, however, that’s an aspect of your being you’ll have to manage for a while. Sigh. But there will come a time when the old you will nearly be forgotten. My 16-year-old doesn’t remember bigger me at all. I go to a different church from 2002, and none of them knew me when. It’s a mixed bag that people don’t know. I sometimes feel like I’m hiding something from them, but it doesn’t make sense to say anything. It’s odd.

  22. Thank you so much for keeping your blog active. I found you from BigFatBlog. I am a longtime fat acceptor, but I recently (at 311lb) decided to make a personal project of weight reduction. At 5’4″ & 265lb now, I am excited to see myself regain abilities I thought I’d never have again, and looking forward to being more and more active with my young child, but I have been also feeling terrified of weight cycling. I never had to deal with these fears before because, except for two yo-yos in my early 20s, I just let my weight go on upward. I struggle to find support now because the FA world abhors dieters and the dieting world is full of fat hate. Thank you so much for your work. I will be reading everything in your archives, as time allows.

    • Welcome, Elle. I hope you find some things of value. I’m still out here. Still maintaining. At over 12 years now, I’m at minus 49 pounds from highest established weight, which is not as low as minus 68 (my lowest plateau). Oh well. My exercise is still pretty much what I described on the blog. Weight vest, ankle weights and hand weights with a low-impact (Leslie Sansone) video that I double-time in interval bursts. Nearly every stinking day. I watch the news and brush my teeth while I do it (sometimes set down the weights to fold laundry) to make it less an intrusion on my life. I know I’m exercising hard enough if I sweat up my bra. I keep my daily calories under 2000. I limit my grain-based and other simple carbs. That’s the nutshell summary. When I exercise in the morning, it seems to keep the “eat impulses” at bay better than if I wait till later in the day (and I reached that conclusion as a result of my analysis of the Katarina Borer studies, which seem to play out in my experience). It also seems like my day moves along better if I get my exercise out of the way. But if I can’t get it done early, I still do it.

      My research since my year of blogging has slowed a lot, though I stay on top of Dr. Sharma’s blog. I still think the most interesting science is in the area of endocrine. It’s not our families that take us down (though they do tire of us and try to feed us stuff we don’t want so that they can believe we eat just like they do). It’s not that we suddenly forget how awful the world is to fat people (that memory never leaves us). I believe we maintainers get sandbagged most often by our own distracting “eat impulses,” which are caused by a life-long post-weight-loss imbalance of the various neurotransmitters, hormones, gut peptides and other bodily chemicals that communicate our body’s needs to us while slowing our metabolic processes. The body thinks it needs to return to highest established weight (or higher) and tries its darnedest to get us there. We must continually outsmart our own bodies. Ain’t easy. Not even after 12 years. Never becomes fully automatic.

      Life, however, can still be joyful. Family. Friends. Church for those so inclined. Meaningful work, but not so much that it gets in the way of weight-loss maintenance. I stand by my very first post: Live joyfully most of the time, eat healthfully most of the time, exercise most days and treasure the body God gives you.

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