In Weight-Loss Maintenance on October 25, 2010 at 2:47 pm
Frequently I compare weight loss to down-hill skiing, a difficult skill set but not nearly as challenging as cross-country skiing, which is maintenance. On a cross-country trek, you have obstacles and struggles, and it’s lonely. I think it’s helpful to acknowledge this difficulty, and talk about the boulders under the snow that disturb your otherwise peaceful trip. Today I’m going to talk about the hidden boulder that I hate most: binge impulses. I started to talk about them here. Let’s go a little deeper.
First of all, I cannot speak to the experiences of people who struggle with a legitimate binge eating disorder. I don’t think I qualify. My experience, from what I can tell, is unusual, and may be one of the blessings that has permitted me to maintain radical weight loss when other people who are as clever as I am have not. I am different from many people, because while I do binge, at about 600 calories I reach a point where I suddenly can pause and even stop myself. I don’t know whether this is a gift or whether it’s normal. I haven’t seen any studies on binge stopping points. But in any event, I know I can pause and stop, and so I call them “mini binges.” I don’t think everyone else is this lucky, and I’d like to hear others’ stories.
Prior to a mini binge, I’m generally foggy-headed and having trouble focusing. Little problems and annoyances may build up. I’m not hungry, per se, but I find myself repeatedly in the kitchen, my hand on the refrigerator door. And repeatedly I back away. Cultural mythology would suggest Read the rest of this entry »
In Weight-Loss Maintenance on October 22, 2010 at 2:24 pm
In my post earlier this week, I promised to talk about endocrine, and how weight-reduced people are different from people who are at the natural, highest weight that their body establishes for them. Let’s start with my favorite study, Cummings et. al in the New England Journal of Medicine, May 2002. These are actually MDs mostly, rather than PhDs. So maybe this mitigates the vitriol of my post last week, and maybe, too, it is a study that MDs feel comfortable taking seriously.
Cummings and crew compared plasma Ghrelin levels in samples of nonsurgically-assisted weight losers to people who underwent gastric bypass surgery.
Ghrelin is probably the best understood of the hunger hormones. In the chemical cotillion happening in our body, it dances monogamously with its partner Leptin, who creates satiety (fullness). When they dance with Leptin moving forward, we are satisfied, when Ghrelin moves forward, we feel hunger. Simple.
I like to think of Insulin as the party slut. She dances with all the Ose brothers – Dextr, MonoDextr, Gluc, Sucr, Fruct. They’re all such sweet boys. She bounces around inside us, giggling and flirting, and when she and a partner smacks into the monogamists – Leptin and Ghrelin – she pisses them off, so they may start dancing the wrong way. In Read the rest of this entry »
In Weight-Loss Maintenance on October 18, 2010 at 11:11 am
Weight loss is down-hill skiing. It requires a certain skill set and, losing more than 60 pounds, I was on nobody’s bunny slope. In down-hill skiing people cheer you on; you get regular compliments as people see your “results.” People ask your advice. Sometimes you feel like a celebrity. It’s hard work, but rewarding. Then you get to the bottom of the slope and you coast. The compliments get spaced further apart, you swoosh past the cheering crowds and leave them behind you, but you keep coasting, for a while. Try to avoid saying, “If I can do it, anyone can.” So many people end up regretting that.
When you are completely out of momentum the ski lift attendant shows up. It’s all quiet now, and he’s got your lift ticket and a coupon for the restaurant at the ski lodge. That coupon looks really tempting, because you are hungry, or something akin to that. Your stomach is calling out for food, sending you signals to eat.
In the real world, you’re impelled toward the kitchen, the pantry. Maybe you stop yourself and turn around. You ask yourself, why am I doing this? I have no good reason to be hungry. I’ve eaten plenty, according to my food journal/diet plan/calorie allotment (circle one or create your own), but I want to eat more. Something must be wrong with me. If you try to distract yourself by picking up a women’s magazine, it may advise you to distract yourself further with a bubble bath, a pedicure, a shopping trip, a walk, or Read the rest of this entry »
In Weight-Loss Maintenance on October 13, 2010 at 1:57 pm
There are many good-hearted doctors who recommend weight loss to their patients even though they know that long-term success is a long shot. Empirical research says that ninety-seven percent of dieters will fail to maintain their losses for five years, and many will weigh more than before they lost weight. Lest you think I’m making this up, here are some studies:
While these studies are a bit old, they remain valid. They’ve withstood the test of time and prove we’ve known this uncomfortable truth for a while.
Survey research is a little more forgiving than empirical. According to a recent study published by scientists at the National Weight Control Registry, 20 percent of maintainers are successful, if you define success as maintaining a 10 percent loss for one year. That’s success? I wouldn’t feel successful if I’d gained back all my weight, but waited till day 366 to begin the process. Nor would I feel successful with a mere 10 percent loss all together.
My favorite Meta analysis of long-range dieting failure is a 2007 study by UCLA. Medicare asked the scientists to conduct an overview of diet research and come back Read the rest of this entry »
In Weight-Loss Maintenance on October 11, 2010 at 12:09 pm
I was at a party yesterday, and a friend expressed concern for her mother who is regaining lost weight. My friend is unusual, in that she wasn’t engaging in the typical gossip that happens when someone regains. None of the “How could she? She looked so great!” No speculation about work or marital difficulties or other “logical” reasons the regain might be happening. It’s just happening, and her mother is in emotional pain. My friend didn’t ask for weight-loss advice, tips and tricks. She simply wants her mom to be happy, and, in my opinion, she wants the right thing.
From time to time, people will compliment me on my “will power.” They don’t understand that keeping off lost weight is NOT a function of simple “willpower.” If that were the case then no one would be fat, because the social consequences are too great. No one who has been a social pariah in the past simply loses the will to be socially acceptable. People don’t choose to be social pariahs in the first place, and they certainly don’t choose to return to that status or get lazy and allow it to happen.
From what my friend tells me about her mother, I don’t think she’s weak-willed, undisciplined, ignorant, lazy or unmotivated. While she had surgical assistance in her loss, the mom understood fully that she’d also need to make “lifestyle” changes after the surgery. She doesn’t need to be “educated” Read the rest of this entry »
In Weight-Loss Maintenance on October 8, 2010 at 8:58 am
Here’s a well written link regarding obesogens, which may be contributing to our weight gain as a society. The article offers practical suggestions at the end:
Doctor Oz on Obesogens
I have mixed feelings about referring people to Dr. Oz, because I have mixed feelings about the man’s approach to obesity. On his show, he often recommends foods and health strategies that are good for people of any size, but he hangs on to the notion that fat people should lose weight for the sake of losing weight. I don’t truck with this. All people should live more healthfully. Weight movement downward may be a pleasant side effect in some cases.
His YOU: On a Diet is absolutely the worst of the worst diet books. On p. 27 he even cites a “95% failure rate after two years of people who have lost 50 pounds or more” (no footnote — Dr. Oz is his own footnote, a common conceit among MDs), but then he goes on and proposes that people diet anyway, his way this time. Presumably, this time everyone will succeed because they understand a little more about the digestive system, they’ll exercise with help from a pencil-drawn elf, AND they’ll invoke his clever little mantra and make a “YOU-turn” every time they get off course. Moreover, the chapter on weight-loss surgery is unethical and simply an advertisement for having a Read the rest of this entry »
In Weight-Loss Maintenance on October 4, 2010 at 7:06 pm
So, you think you want to lose weight. And this time it’s forever. How are you going to select your plan? Or maybe you’re a maintainer, and you’re finding it’s a lot harder than anyone ever told you. Who are you to believe? Go get a cup of tea; this post’s a doozy.
First of all, don’t be fooled by adjectives. If a plan describes itself as “simple,” that’s a clue that it isn’t. Please understand that nothing is “Revolutionary.” Nothing qualifies as a “Breakthrough.” Just because a doctor is involved doesn’t mean it’s credible. Nothing is a miracle, automatic, intuitive, the solution, the ultimate solution, the last diet you’ll ever need or the only diet that isn’t a fad. If it claims NOT to be a diet, but rather a lifestyle, then it’s a diet. And most diet books, at some point, becomes New York Times Best Sellers. This adds no credibility. So, how do you evaluate the “experts”?
Current diet wisdom may be divided along philosophical lines that mirror life in high school. Among the social order then were juvenile delinquents, jocks, the “fit-in” crowd, mean girls, nerds and lone wolves. There are corresponding personalities in the world of diet “experts,” and they all write books and/or articles (or have them ghost written), and some push products at you.
Read the rest of this entry »