DebraSY

Who Are We Here? Hint: “Squeak”

In Weight-Loss Maintenance on November 29, 2010 at 1:58 pm

When I started this blog I was hoping to find some like-minded and supportive individuals. Friends, if you will, who have also found themselves in an odd and skeptical place with regard to obesity and the research surrounding it, a place that doesn’t seem to exist if you accept only the gushy daily headlines about the latest weight-loss “discoveries.” I guess I wanted to find the other weight-loss killjoys at the water cooler, and while many reside at Big Fat Blog and other fatosphere locales, I always felt like an outsider. Talking about my weight-loss maintenance there would have been rude. But I wanted to talk about it. To share my mixed feelings, and find out whether there are others like me who are as confused by our cultural mythology as I am, and who may feel betrayed.

It’s not that I need more friends in my social circle. I have party friends, neighbor friends, tap-dance class friends, etc. I’m even on my church council of Deacons. However, in any certain geography, there aren’t a lot of people who are maintaining weight loss long term. There are even fewer people who are interested in the science of it to the degree I am. Moreover, there aren’t all that many people of any size who hate the weight-loss madness on reality TV and in the daily news the way I do. There are virtually no people where I live who are both weight-loss maintainers and size acceptance proponents, or, even, who are in one of those two groups but talking to each other. I wanted that, but didn’t trust that it existed.

Wow. We do exist! And I am so happy. Some of you have come by way of Big Fat Blog and the size acceptance chat boards. You forgive me my weight-loss maintenance peccadillo and accept me in the size acceptance community, even though I’m engaged in this odd personal, scientific experiment. You trust that I will not preach that weight-loss is the answer to all your health issues, the key to happiness and the primary evidence that you have “taken control” of your otherwise pathetic lives. Yeesh.

Some of you, like me, have lost weight and then discovered, after the fact and much to your chagrin, that (while there is a ton of encouragement for weight loss) there are precious few social supports for weight-loss maintenance. You’re on your own and it isn’t the simple lifestyle myth you’d been promised.

Here we are, strange bedfellows. Weight-loss maintainers and size acceptance advocates. We shouldn’t get along, really. Cultural mythology discourages us from getting along. We’re supposed to bicker, and each is supposed to feel superior to the other. I remember that when I was a new weight-loser – still in the honeymoon phase – I was often invited to participate in trash talk about fat people, and to trash talk my former fat self. “Aren’t you so glad that now you’re . . .” Trashing fat people was supposed to be part of the “thin privilege” I had earned, but I found it horribly uncomfortable, and I’m glad I declined to participate. I had already found Big Fat Blog then, and now I’m here in this odd group that gets along so well. But why?

Permit me to brag. We are the prize lab rats of the great obesity experiment. While the average rats run obediently from one diet to the next, failing over and over to find the magic golden food pellet, or finding it and dropping it and retreating in shame, both the maintainer rats and the size acceptance rats are standing up in the maze and clearing our throats, “Scuze me! We have an opinion.” Oddly, if the scientists would listen, they’d find that our opinions are closer, one-to-the-other, than they would logically predict.

We maintainers may have found the golden food pellet, but then we are disappointed to find out how much work it takes to continually manage it, and we’re angry that the help we are offered is spare, naïve and based in false assumptions. The size acceptance advocates are no ordinary “control group.” It’s not that they are too lazy, uneducated or emotionally broken to find the golden food pellet. They have rejected it. They’ve been through the maze. Many have held the golden food pellet temporarily – some fumbled it, but refused to feel shame like the average rats. Some might be able to hold on for a year (or more) of “success” but they decline to try again, because for them the cost is higher than the reward. Nevertheless, the scientists and our culture judge them harshly. It’s their “failure to maintain behavior changes,” we are told, that sinks them. We weight-reduced rats, with our golden pellets, are encouraged to pile on in the judgment, but most of us decline.

Both weight-loss maintainers and size-acceptance advocates who are not weight-reduced recognize that hating on fat people (especially ourselves or our former selves) advances nothing but more hate in the world. Science should not advance hate, and yet in the realm of obesity research it does. It often crosses the line from curiosity and exploration to weight-loss advocacy and we, the prize lab rats, don’t like that much.

More science to review later this week. Oh, and here’s a little treat for us lab rats lay people who make a hobby of evaluating science: a nice summary of how to approach a news article on scientific research with proper skepticism. (Tip of the hat to DeeLeigh at Big Fat Blog for pointing me toward this).

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  1. Oh yes, I feel the love here. Your blog is definitely my fave. I’ll try to be more scientific in future responses but now, before I run off to the grocery store to make sure my family has food to eat, just wanted to tell you for the umpteenth time that this is my “go to” blog.

  2. Squeak! I love reading this blog, it is great to hear from someone who has decided that weight loss is worth it, but who gets the science and the reality and gets that it isn’t something everyone wants.

  3. Oh, I just wanted to ask, or maybe suggest for a future blog post topic, their is talk about radical weight lost as +10% of current weight, do you know of any work that looks at whether their are differences in the this category, ie %10 vs 25% vs %50 or 20 pounds vs 50 vs 100. Or differences based on starting weight. In short what I am wondering is are their differences in the radical weight maintenance group and if so what are they

  4. That is such a good question, Cheshire. And, of course, I think that because I have asked it myself — in one of my earlier letters to the NWCR. When I asked them for stats further out than five years, I also asked whether those stats had been/could be parsed into weight-loss categories. At that time, probably three years ago, the scientist was unaware of any studies that did that (and I hadn’t found any either).

    I suspect that the row I hoe is harder than a 25-pound loss maintainer, but easier than a 100-pound loss maintainer. I base this completely off of gut feeling and some “asking around.” I have a friend maintaining more than 100 pounds of loss for over a decade, and I know her exercise component is more time-consuming than mine. When I told her I’d decided to call maintenance a third- to half-time job, she replied, “it’s at least that!” For her, the exercise alone is third-time. (She’s a NYC actress, so she considers it part of her “real” job.) As always, I think Jared Fogle is to weight-loss maintenance what Yoyo Ma is to cello (and I acknowledge that yo-yo is a curse word in these parts). Subway, I would bet, lets him work on it close to “full time.” He hasn’t said that aloud, but the theme of the final chapter of his book is “the harder you work, the luckier you get.” In so many words, I think he’s saying he knows the big secret, even though he’s obligated by the laws of marketing to make it look like it’s all a zippy lifestyle. He’s currently training for a marathon, I believe. What a guy. Of course, he’s still pretty young. I would advise him, “Protect those joints, mon!”

    Time and age also makes a difference in whether maintenance is merely a challenge or a bloody hard struggle. While many studies like to say it gets easier with time, I think that may only be true up to a point, say, Menopause or failed joints or another life circumstance that is age related.

    • ” In so many words, I think he’s saying he knows the big secret, even though he’s obligated by the laws of marketing to make it look like it’s all a zippy lifestyle.”

      That’s … so eloquent.
      And, I’d imagine, more than likely 100% on target.

    • I’ve read that Jared gained weight in a relatively short time after a major life change — moving to college, living on his own for the first time, with different food and activity habits. As I understand it that sort of adult weight gain is easier to lose, by returning to prior types of eating and activity …

  5. The difference is that you treat people, both yourself and your commenters, with respect. Your experiences ring true.
    For example. you admit that dieters get hungry and that there’s a good physiological reason for it. You’ve probably heard, as I have many times, that eating (if you’re fat) is a substitute for some other desire. Eating means you’re rebelling against your mother. Eating means you have an eating disorder. Eating means you’re weak and contemptible and out of control. All fat people have compulsive eating disorder. And on and on and on.
    And I thought, doesn’t anyone get hungry any more?
    Do otherwise healthy people who sleep more than 8 hours a night have compulsive sleeping disorder? (Do people who tease fat people have compulsive jeering disorder?)
    I’ve also wondered, if a thing is hard to do, does that make it worth doing? I’ve heard the rosy pros of the gospel of weight loss – let’s magnify the fine print and see what else is going on.
    Keep on telling it, Debra.

    • Thanks, Mulberry. Ah, the “emotional eating” myth. It’s all chemicals; it’s all endocrine. What are emotions but an endocrine response to a situation? What is hunger? Same answer. What is a binge impulse (as I have called it) or, probably more accurate, a simple “eat now” impulse? Same answer, but much more subtle.

      What I think has really messed with people is the reality that “eat now” impulse endocrine likely overlaps with or affects, chemically, the emotional response endocrine. When I respond to a binge impulse by eating, my emotions soften and I become more “reasonable.” Hmmmm. We don’t know yet how to soften those “eat now” impulses without eating. But instead of trying to figure out ways to untangle these chemicals or acknowledge them and work with them, we have responded with social censure. Simply, we make people feel bad about themselves if they eat.

      There are times when social censure is appropriate. If a Sunday School student declines to mow me down with a gun for fear of social censure, I’m cool with that. But in the case of eating — a physical need — social censure is just unproductive! And aggravating. And wrong.

    • “I’ve also wondered, if a thing is hard to do, does that make it worth doing?”

      I think Puritans think so, which I think is one of the acids the criticism of those who’ve “failed” at it are tainted with. The “it can be done — it’s just hard work so you don’t want to do it!” jibe comes to mind.

      (The simplistic assumptions underlying that accusation make me more than a little annoyed – but that’s a different rant.)

      “(Do people who tease fat people have compulsive jeering disorder?)”
      LOL. I think they do.

  6. I have also wondered a lot about the question Cheshire asked.

    I never thought about it too much, but your statement “However, in any certain geography, there aren’t a lot of people who are maintaining weight loss long term. ” made me think about myself. I have several social/geographic circles that I run in–nursing, church, quilting. And unless I am mistaken, I am the only person I know who has lost a large amount of weight and kept it off for several years. I do know two WLS women who have kept their weight off. I also know even more WLS women who have not been able to maintain that loss.

    Can I be honest? Part of me wants to believe that if I just do what the ‘studies’ have proven to be true I will be able to maintain this weight loss. Another part of me is almost relieved to hear you talk about the other (maybe unknown) physical cellular reasons that it is difficult to maintain the loss. Relieved, but scared. I DON’T WANT TO GO BACK!!

    Thanks for the thoughtfulness that you put into this blog.

    • Debby, you are so right on. I don’t want to go back either. You sometimes gently pooh-pooh your science brain, but I would guess it has served you well. You are right that your compassion is more important, especially in your area of nursing — neonatal care. On the other hand, can you imagine how differently you, an RN, approached this whole process than some unsuspecting average Jo who is dependent solely on the mixed messages of a media complex that is kept alive on ad revenuess from diet companies plus a doctor who maybe can give her 12 minutes in an annual appointment?

      One thing the NWCR doesn’t play up much is our average level of education. I cannot recall off the top of my head the actual percentages, but most of us have at least a college education, and many have advanced degrees. Our education level is much higher than in the general population. They don’t hide this reality, but they don’t tout it as they do the fact that we all eat breakfast. I don’t know why that is. Giving them the benefit of the doubt, I think it’s wishful thinking. They really WANT to think that anyone who knows the behaviors and has the motivation to keep them going can do this. Weight-loss maintenance has become almost bigger than the original American Dream (which RNegade is personally debunking, even as we speak, with her own story). The scientists of the NWCR want us to all have a shot at permanent weight loss, but I don’t think that’s reasonable, nor is it good science.

      My mission statement, as a blogger, and I probably ought to post it somewhere, is “tell a truth; advance compassion.” I can do that, since I’m not a scientist — I just observe them. A scientist’s mission statement can only be “tell a truth; advance more research.” When they unwittingly adopt an agenda, such as “advance weight control for all,” then they betray their mission as scientists.

      • Wow, that’s fascinating about the education level of the long term maintainers. Seems to me an important factor. And you are right, even in my own journey I often wonder if the single most important factor in my ‘success’ was my skepticism, and my insistence on studying as much as I could about it all–to try to get the facts to back up the information that was being given to me.

      • Hmmm…very interesting point about the educational level. I wonder, also, about the socio-economic level of the successful maintainers – do they track that, too? Sort of reminds me of our school district – there’s one school that is in a more geographically isolated area that also has strikingly different demographics than the other schools (highly affluent, highly educated parents), and that is reflected in the huge gap in API scores.

      • “I wonder, also, about the socio-economic level of the successful maintainers – do they track that, too?”

        Pubsgal, I’m thinking if they don’t, they probably should.

  7. I find your blog a refreshing change, thank you. I’m maintaining a modest 20 lb loss that made a huge difference in my basic health. According to most of the sources out there, apparently I should lose another 20-40. Right now, I feel good, I look good and I’m pretty darned happy with that. It has been a relief to eat moderately and exercise moderately and to have time for things other than obsessing over every calorie and the vagarities of the scale. My knees suffered badly from my exercise regimen and I have to question the value of pushing them to make a number on a doctor’s chart. There is life after dieting, hurrah!

    Barb

    • Welcome, Barb! It sounds like you improved your health and as an added bonus you got 20 pounds of weight loss. You are the model of what doctors need to be prescribing. You haven’t rocked your body with an upsetting weight change, then hoped for health improvements as a bonus — the current, backward model. Hurrah, back atcha!

    • “My knees suffered badly from my exercise regimen and I have to question the value of pushing them to make a number on a doctor’s chart.”

      Yes, that’s a whole different rant.

  8. I’m a failed lab rat. I lost a hundred pounds, by terribly unhealthy means, and then spent some time maintaining that through blatantly eating-disordered behaviour, and some more time maintaining by rigidly controlled “healthy” diet and a lot of exercise.

    And I failed to maintain behaviour changes, because even the “healthy” ones had taken over my life. I didn’t have time for hobbies, or relationships, other than preparing food and working out, and I have many more interests than that. So I let go.

    Interestingly (to me) my weight has stabilised about halfway in between my lowest weight and my highest – overweight by societal and BMI standards, but sustainable (to me) and really far more comfortable than the neurotic low points – when, yes, any brief slacking off resulted in a gain of real weight that was stubbornly unyielding. (I was also getting to the point – after six years – where my joints and body in general were rebelling against the vigorous workouts maintenance of that low weight required.)

    But I have four years of food and exercise and weight journals that support much of what you’re saying here, and go against almost all conventional “it’s easy to lose weight if those fatties would only try!” wisdom. I’m always interested in learning more, even if personally I hope never to go back there, and am working instead on accepting my body as it is, fat and all.

  9. Debra,

    I’m particularly interested in the science of weight management as it applies to women. There are many aspects to this: age, point in the fertility cycle (more specifically pre-, peri-, and post-menopausal), joint health (for instance, I have recently found out that many more women than men have kneecap problems–something I am dealing with that severely limits my ability to do any type of vigorous exercise), fertility in general (weight–both under and over–and one’s ability to conceive and carry a pregnancy to term), etc. etc.

    I really don’t think that even science-based generalizations on weight loss and weight maintenance apply equally to men and women. And sadly, I think that women have the weight-management deck seriously stacked against them.

    • “I really don’t think that even science-based generalizations on weight loss and weight maintenance apply equally to men and women.”

      NewMe, I don’t think they do either. I’ve read that there are regular attempts to apply cancer statistics applicable to men to women’s health — which I find completely baffling, since we’d be the only ones vulnerable to ovarian, and, arguably, breast cancer — so it wouldn’t susprise me at all to know there are repated attempts to apply “male” weight maintenance standards to women, even when men have a “muscle mass advantage”.

      After all, so many other male-vectored “standards”, health-related and in other areas, are mindlessly applied to women — I don’t see why these wouldn’t be.

  10. Studies in which women are studied, or at least segregated from the men. Hmmmm. Sounds like a future blog post . . . if I can find any.

  11. I, too, totally enjoy this blog. It’s just not everywhere that you can talk about weight to this extent without boring everyone. Just don’t discriminate when it comes to education. Just because I didn’t go to college doesn’t mean that I didn’t continue to learn. (Maybe a little touchy on the subject because I do wish I had, sometimes!)

    It’s amazing that on NPR this morning they were talking about experiments with LAB RATS concerning whether or not food has drug-like qualities AND it seems the male and female rats reacted differently in if they would rather have sugar or cocaine!!

    Thank you for all your amazing information.

    • Ah, Mo, I’ll be the last one to conflate education and intellect. There are plenty of dim academics and plenty of brilliant people who abandon the education system for other pursuits. The NWCR’s average education figures say something, but only to the extent that all “averages” tell us something.

  12. “We maintainers may have found the golden food pellet, but then we are disappointed to find out how much work it takes to continually manage it, and we’re angry that the help we are offered is spare, naïve and based in false assumptions.”

    Oh, wow, Debra! That summarizes beautifully the frustration I feel when reading much of the current literature around eating behavior. (e.g., “Savor,” “The End of Overeating,” and various works on intuitive eating) When you’re already doing the “pat-answer” advice and are looking for more tips & tricks to help ease the burden of the part-time job of weight maintenance, there’s precious little to be found.

    I’m sort of an odd lab rat. I got about 2/3 of the “golden pellet” – which has been good enough to make my health numbers in a reasonable range for someone with type 2 diabetes and seems fairly doable maintenance-wise, yet is about 30 pounds away from even the top of my height’s “healthy BMI” range. (Oh, for a better generally-accepted measure of “healthy body” than that blasted BMI!) I keep eyeing that last 1/3 of a “golden pellet,” wondering why I’m still looking at it with a tinge of longing, even though I think it would be a royal pain in the posterior to get it and hang on to it. I think it’s because I’m afraid that I won’t be able to keep the 2/3 pellet if I take my eye off that last 1/3, if that makes any sense.

    I don’t understand fat hatred. I don’t think that’s because I’m not “thin”; it’s because hate is ugly and wrong. I will always live the struggle for a healthy body, whatever size it is at any given moment, and many of my friends and loved ones live various versions of the struggle, too: whether it’s rejecting the “pellet quest,” despairing over finding the pellet, or desparately hanging onto whatever chunk of the pellet they could get by whatever means they deem necessary.

    • Pubsgal, have you signed on to the NWCR? You should, if not. I know I give them a hard time, and for good reason — their questions are incomplete, not as helpful as they could be, they need to do more empirical studies, and they need to disassociate themselves from all weight-loss programs (Slimfast and even the Mirriam Hospital) and rethink their scientific mission devoid of a weight-loss connection. HOWEVER, gotta give ’em some credit: They are the ONLY think tank that has made an effort to gather a database of us, the real experts here, and to ask us ANYTHING.

      In answer to you and LittleM, I cannot recall whether they track socio-economic status. I’m pretty sure they do, and I could comb through their studies and find that. I wish now I’d photocopied the long form, but I really didn’t think to do that. If they did ask my household income, I would have just taken it in stride and filled it in. I’m willing to bet they did.

      Right now, I’m hestitant to do another post critical of the NWCR. I’ve barbecued that sacred cow enough. I kind of want to cut them a break for a bit. There are plenty of obesity researchers and other experts and pseudo-experts whose work merits our close scrutiny. In some ways, because the NWCR has established a link to us, that makes them most vulnerable to crazies like me. I don’t want to punish them for doing the right thing, but I really want them to do the right thing better. Squeak!

      • Well, I did it! I’d been thinking about it for awhile, but it kind of went on the back burner. Maybe because I wanted to wait until I had the whole pellet? 😉

  13. I’m incredibly grateful for this blog. It’s an island of sanity for me among the food trackers full of people my size and weight who desperately NEED! to lose 20 pounds because they’re soooo fattyfatfat and FA blogs where the notion that losing weight might have been a good answer to the fact that I would lie in bed in the morning nearly crying because I didn’t want to feel the knee pain that would come with standing is a forbidden thought.

    I’m a year and a half into maintaining a 65# loss that took a year and a bit to achieve. Some days it’s hard, some days it’s not, and it’s never something I can forget, really. It’s comforting to read other people having similar experiences, if only to know I’m not alone. The fact that you’re also into the science is just gravy.

    And one question I’ve never seen studied, that my own experience prods me to ask is this: how many successful dieters have reverted to a pre-existing settling point? Because I’m currently at a weight I was stable at for over a decade before I gained, and I suspect it’s not entirely a coincidence that I ended up here. What are the implications of that?

  14. Welcome, M*. You are NWCR eligible too, by your description. You, too, should sign on.

    Hey, Pubsgal, they have a category if you continue to lose weight. I’m not sure, but I think when you fill in the dot that says you lost more weight (or re-lost regained weight) a Publisher’s Clearing House prize patrol shows up on your doorstep two days later. It’s just a rumor.

    Now, back to you, M*. Your question on recurring set points is a good one. I haven’t seen any studies either, and that would be an excellent thing to look at — what’s happening in people’s bodies, their endocrine, etc., when they lose weight down to a prior set point? Personal experience tells me that the body does have certain weight affinities that it recognizes, and there is a kind of settling in, but the effect is only temporary. It’s kind of like a little “rest stop.” But don’t trust a prior setpoint to assist you for long when you are weight reduced. Your highest established weight is the the top dog, and it will start to howl soon.

  15. To go with the summary of how to read a news article on research, try this discussion of various types of medical studies and how to read them (skeptically). The accompanying example is cool too.

  16. Thank you for the link to that paper, it looks great! I’m often spitting out my morning coffee (although for me it’s tea).

    And I have to say, your whole blog (but especially posts like this) are really making me rethink my weight loss goals – in a positive way. I’m reevaluating my need to lose the weight in the first place, and considering that exercise is likely far more important to my long-term health (and happiness!) than simply a number on the scale. I hugely appreciate this blog!

    • Thanks, Grassdirtcorn. I see you’re “footprints” on the blog. You’ve been reading a lot and you’re liking the science posts, which I really appreciate. I’d be sunk if it weren’t for the science. We have to go back to the original studies and NOT rely on morning news programs and women’s magazines to interpret them for us, because they remarkably always reach the same conclusion — Eat Less Move More and you will lose weight permanently — even when the study contradicts it.

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