The Most Important Things

These are the ten most important things that have led to my success with weight loss: Support Group.  My support groups keep my nose pointed in the right direction week after week.  Weight loss is slow.  It is, day to day, not very exciting.  Without several things to keep me on task, I would have wandered off to some more exciting hobby by now.  They also build upon and reinforce everything else that I have needed to bring into my life to make me successful.  Through ruthlessly training my non-weight-loss friends and family, I have also been able to turn them into an extended support group. Ruthless Honesty.  An enormous amount of dishonesty has been required to support my obesity.  I have definitely not cured myself of all my dishonesty, but I'm making an effort.  I believe dishonesty is the #1 thing that could suck me back into obesity.  Some examples of my dishonesty:  I don't want to walk down the block for lunch because I will sweat in my business clothes (actually, I couldn't walk there).  I know how to lose weight and it just doesn't work (actually, I didn't know).  I don't eat too much (how the heck did I get fat then?). Accept Imperfection.  In the past, I would try to lose weight for a few days or weeks, have a day where I ate too much or more than I meant to, and quit trying.  I was not a still suffering overeater because I refused to suffer.  When I could not be perfect, I just pretended the problem didn't exist.  But here is what happened- I lost more than 50 lbs. on Weight Watchers before I ever went more than 30 days without overeating.  It is possible to lose weight while bingeing very frequently.  It is absolutely guaranteed that a person with an eating problem is going to have problems with eating.  That is just being human, it is not an excuse for obesity. Be Serious.  A friend asked me if I would at least overeat when we go out for my birthday.  I immediately communicated how I feel about food pushers and that no, after struggling through this I would not be overeating on purpose.  A flight was delayed until the early hours of the morning, and I rescheduled my meetings just to give enough time to sleep, but also to give enough time to work out.  This is either important, or it is not.  I have learned that it is important.  There is no hemming and hawing over the alternatives. Do It for Health.  I started losing weight because I felt out of control of my life and I wanted to control something.  I stayed because I started losing weight, and I wanted to be thin.  I'm successful because I want to be healthy.  There are a lot of reasons to start losing weight (one common one that I didn't have, even though I had an obesity-related disease, is fear of illness and death).  I don't think any of those reasons will hold through for success.   It turns out that weight loss just happens to be a side effect of a healthy lifestyle.  It has to be about the healthy lifestyle. Develop a Lifestyle that Involves Exercise.  The National Obesity Registry provides reports of what successful losers (defined as people who maintain their loss for more than five years) do.  One thing they do is get the equivalent of eight miles foot transportation of exercise per day.  While this is part of health, it is such a big part that it is it's own topic.  My hobbies are always going to need to include sports or walking or something that gets my exercise. Engage.  Think.  Write.  Only I can solve my problems.  In order to do that, I cannot be dishonest with them.  I have to acknowledge what my problems are and I have to be willing to grapple with them.  I have to make sure there is time to think about them.  I need to use writing to expand my thinking and to organize my plan of action.  I cannot pretend that this obesity problem does not exist. Learn About Weight Loss.  I did not know how to lose weight.  It is not "eat less, move more".  It is about eating the right amount, and I had no clue what the right amount was.  There are a lot of techniques for outsmarting my eating problem, there are a lot of medical theories about nutrition, there is always something to learn.  Having the best information about how to handle my eating needs to be a life-long hobby. Develop Confidence in My Plan.  At first I clung to the Weight Watcher's Points plan because I really didn't know anything about how to lose weight or about my body.  So step one was to have confidence in Weight Watcher's plan.  As my experience and knowledge has grown, my plan has become more my own.  Despite fat days and thin days in my head and natural ups and downs on the scale, I have a written plan of eating that I have confidence in. Accept Uncertainty.  I think a lot if my plan needs to change.  It is absolutely certain that my plan will need to change over the rest of my life.  The question is, does my plan need to change today?  And that is something that I can never be certain about.  I have to review my data from time to time and decide.  I won't regain my weight overnight; a mistake is not a disaster.  Everything is going to be okay.

Diet

How much should I eat?  Join Weight Watchers at your local center or online (see Links for both) and they will tell you.  Do what they tell you.  "But I'm not losing?" Then you might not have enough muscle mass; do what they tell you. "But..." Do what they tell you. What about carbs?  Aren't you worried about carbs?  No.  If I eat the right amount of food in total, there is no way I can eat too many carbs.  If I exercise enough, my body will ensure that I don't eat too few carbs: everyone knows that feeling when you walk out of the gym and you've got to eat!!!!  Since you asked about carbs, I think the "low carb" obsession is focussed on the wrong thing; it isn't about not eating carbs, it is about getting enough exercise for the carbs you do eat.  And anyway, most Americans aren't actually going to get to a low carb diet, they just reduce from the insane overeating that is the Standard American Diet (known as "SAD" because it is). Okay, fat?  Are you worried about fat?  Yes, I am very worried about fat, especially since my first injury after starting Weight Watcher's may be related to not getting enough fat.  Now that I'm eating the right amount of food, I've loaded up on low calorie fibrous foods, the carbs my body is demanding in response to exercise, and satisfying proteins.  Like many people, I suddenly found myself in a situation where I was getting less than 10% of my weekly calories from fat.  A healthy low-fat diet is 30% of calories from fat, and active people with no lipid-related health problems may need more than that. How much protein do you get?  I'm trying to get one gram of protein per pound of lean body mass.  On most days I fall short and get about half that, but I do insure that protein is central to every meal.  My muscles are still visibly growing and I have not yet had an injury related to insufficient protein intake. Vitamins?  A standard multivitamin like Centrum is an insurance policy in case your food intake in some way fails.  Consumer Reports studies have shown that many vitamins do not contain what they claim to contain, so stick to  a respected brand, like Centrum.  Vitamins do not "give you more energy" unless you have a serious deficiency.  Do not take a vitamin that claims that it will; it probably contains an upper.  If your lucky the upper is just caffeine, if you are not lucky it may be something more dangerous. A few things I've learned that you want to make sure you get are: -Calcium.  Weight Watchers will ask you to get 100% RDA in calcium from milk products, in addition to the calcium in multivitamin and any other food you eat.  You want to make sure you have plenty of calcium, or else your body will take it out of your bones. -Potassium.  When you are losing weight your body needs a lot of water, and this can take some of your potassium with it.  Too much potassium is very dangerous.  Fortunately, there is the right amount in your multivitamin and you can also try to eat at least one banana a day. -Vitamin C.  If you start a new exercise program and are building muscle, you need extra vitamin C.  In addition to my multivitamin, I drink one cup of orange juice each day. But I feel sort of "blah."  Isn't there some vitamin that will help?  If you have a deficiency, your doctor will need to evaluate you to find out what it is. There are two vitamins that are the likely culprits, and it seems like deficiencies tend to crop up around 20 lbs. lost.  So if you feel blah, see a doctor.  If you are fine, another thing to consider is your carb balance: Are you getting enough carbs?  Are you getting too much exercise?  Are you getting enough sleep? What is polenta?  How do you use it?  I do not understand why, but this is one of the most common food questions on the 100+ board.  Why does everyone decide to run out and start eating polenta?  For what it is, go offsite.  A lot of people hate the pre-made polenta in the plastic tubes in the produce isle, but I like it.  I cut it into quarter inch disks and pan "fry" it on a nonstick pan with no oil.  Medium heat, cook until it is becomes transparent about half-way through and then flip and cook the other half.  Use a sauce as you would for pasta.  I like to top it with black beans, salsa, and cheddar.

Exercise

How much should I exercise?  First, check with your doctor.  Next, start exercising a moderate amount a few times a week.  You don't have to suffer to get enough exercise to be effective and you don't have to give up your social life.  In fact, both of those things will be counter-productive.  The fat burning zone starts at 60% of your maximum heart rate (that is (220- your age)*0.6).  Walk for a little bit and then take your heart rate.  Probably you will be in your fat burning zone- see how easy that was!  And if you aren't, just walk a tad faster. I want to really lose really fast, so I'm going to exercise every day.  Whoa there!  Fat is consumed by being turned into energy for muscle, during exertion and during rest.  So your goal is to build as much muscle as possible.  During exertion, small amounts of muscle are consumed by the body.  During rest, the muscle recovers and grows.  For this and other reasons, periods of rest are as important as the periods of exertion.  For a fit person, "rest" may be a light exercise day.  For someone just starting exercise, rest may be an entire day without exertion.  Listen to your body; get the rest you need. I don't want to lift weights because I don't want to get big muscles.  Your muscles drive your weight loss; get yourself some.  Until you are under 30% body fat, no one can see your muscles anyway. My feet hurt.  Don't take any advice on what shoes or what treatments until you actually know what is wrong with you.  The treatments or shoes that are good for one person might put you right on crutches.  If the pain improves when you are not exercising and is not getting worse, go to a running shoe store (NOT a sporting goods store) and get fitted for shoes by someone who will watch you walk and find help you find the correct shoe for how you walk.  It turns out that buying shoes is extremely complicated and you need an expert. My feet still hurt, or they hurt worse than that. Go to an orthopedic doctor that specializes in sports medicine.  Unfortunately, a lot of orthopedic doctors will consider an obese person "good enough" if they can function, but you want to actually be well so you can exercise.  I think doctors that do sports medicine are better at understanding that you actually need to be well.  If the doctor prescribes shoe inserts, try not to go to Joe-Smoe that makes orthopedic devices.  My experience has been that he knows very little about shoe inserts.  Try to go to someone that only makes shoe inserts.  If your doctor doesn't know a place, ask the running shoe store.  You might have to go to another town and you might have to pay out of pocket.  I say, do it.

Results

I lost 20 lbs. and no one can tell!  I'm so discouraged!  The visible progress from exercise far outpaces the visible progress from weight loss.  I have seen many, many people say that they have lost 20 lbs. or more and no one can tell the difference.  By the time I lost 20 lbs. I had gone down three dress sizes and complete strangers at work were congratulating me on my weight loss.  Exercise is the difference. I'm not losing anything, in fact I'm gaining.  And I'm doing everything perfect.  Weight training.  More weight training.  Give it a month to turn things around. I just can't do this.  I mess up enough that I'm not making any progress.  See a shrink.  I absolutely believe that is impossible for a person to become obese without psychological issues.  You think you are solving a problem by how you deal with your body size, your eating, and/or your exercise.  You are not going to willingly create problems for yourself, so you aren't going to let go of your "solution" until you understand what is going on and find better solutions for yourself.  I always say that my six years of therapy are equal in value to my college education. I went over my points! I'm going to put on a gazillion pounds!  The sky is falling!  Chill out.  It takes about 3,500 calories to make a pound of fat.  Any weight over that is water and food still in your system.  But, there is better news, just as it is difficult for the body to use more than 2 pounds of fat per week, it is also difficult for the body to make more than 2 pounds of fat per week.

Travel

I spend most of my time on the road, and I'm still losing weight, so there is no reason for you to gain on the road either!  These are my top tips: -Get used to wasting food.  Pack too many snacks.  You don't want to run out and have to eat something you didn't plan on.  Realize that at a restaurant you get two things: your food, and excess food.  Your job is to divide the two.  Some people need to ask for a second plate so they can send back the excess immediately.  I just divide them apart on my plate and then eat my food and STOP.  And don't take back leftovers from the restaurant; if you didn't have points for them at the restaurant, what makes you think you should eat it later? -Eat from grocery stores.  Plan ahead and find out where the grocery store is.  Get your meals from the grocery store instead of restaurants.  You can get fresh and canned vegetables, cereal, all the stuff you eat at home.  You are going to have leftovers at the end of your stay that you will need to throw away; get over it.  Go to the grocery store first thing upon arriving at your destination.  When traveling I go to the grocery store almost every day.  Remember to pack a can opener, paper bowls, and plastic spoons.  You can eat almost anything in private with these tools!  An example of a grocery store meal is canned corn and canned black beans with salsa and shredded cheese. -Stay away from the hotel buffets.  Even if breakfast is free, it is easier to eat what you planned to eat out of your refrigerator or from the grocery store in the morning. -Get a refrigerator and microwave for your hotel room.  Try to stay in hotels that have refrigerators and microwaves in the rooms.  Holiday Inn Express and Embassy Suites are good bets.  Hotels that don't have them in every room usually will give you a refrigerator if you ask; they might charge you a small fee.  Higher end hotels often can give you a microwave too.  Hapton Inns and Hiltons often have microwaves upon request. -Going to bed without a formal "dinner" won't kill you.  It might be easier to eat a larger breakfast and lunch and eat a dinner that is more like breakfast... a yogurt or a bowl of cereal. -Be flexible.  If a free lunch appears that you want to eat, go ahead and eat it and throw away the lunch you packed for the day.  You can even eat a donut or a muffin... but just one! -Pack lots of water.  There is not enough water on an airplane to give you the amount of water you need on a longer flight.  You might have to throw out an unused bottle somewhere, but it is better than not having enough water. -Make exercise a priority.  Time your arrival and departure so that you can work out either before or after your travel.  Plan times that you will exercise while you are away.  If possible, find out where your gym is.  Remember that the hotel equipment isn't going to be available at peak times.  If you travel a lot, join a gym that is available most of the places you travel, such as Gold's or Bally's. -Avoid caffeine.  Caffeine messes up your body's ability to keep your blood sugar stable.  It also keeps you awake when really you should sleep, and a tired person cannot make good food choices.  Eventually I have to have caffeine because otherwise I cannot work after days on the road, but I try to use as little as possible.

Dishonesty

The questions that are most likely to cause the users on the ww'er 100+ board to froth at the mouth involve raging dishonesty.  Questions like: Help!  I cannot eat all my points!!  This is the singularly most irritating to me because the dishonesty seems so extreme.  Only a week or two ago, the person was eating more calories than they are eating now.  There are reasons to eat all your points, very good and very important ones, but the number one reason is to stare down this bit of insanity. Help!  I cannot lose weight because I'm super-special...  The super-special is everything from polycystic ovaries to hypothyrodism, to having to many children, being single, being married, living in the country, living in the city and, heaven help me, living on the road.  You can lose weight.  Let go of the super-special. Help!  I cannot exercise!  Baloney.  Okay, 99% of the time baloney.  Maybe you are waiting for a heart transplant or maybe you have some kind of head-to-toe total body pain thing.  Otherwise, you can exercise. Help!  I'm terrified of excess skin!  More baloney.  No one is terrified of skin.  You are scared of something worth being afraid of: Afraid it will be hard to be a normal weight but never be 18-years-old again.  Afraid you won't be sexually attractive.   Afraid of failure and looking for any excuse not to lose weight.  Whatever the real problem is, face it. Help!  I cannot control my food!  Yeah, it gains access to your presence and then leaps into your mouth all on it's own.  You are not controlling your food for a reason.  What is the reason? New lie:  Help! I'm not losing weight!  Actually, the person is losing weight and they are lying about it.  It is a very strange thing to be a liar about, and yet upon thinking over my history I realize that I myself have been sucked into this lie as well.  I don't understand exactly why this lie is so popular though. How not to be a liar:  Acknowledge that you are having a problem that is solvable.  Think through your problem as much as you can.  Only you can figure out what the problem is.  Then go to the board and ask for techniques to deal with your problem.  Or ask your weight loss friends.  Or your psychologist or physician.  Errr... except please don't ask how to eat all your points, you really do already know the answer to that question.

Gluten-Free Living

I got very ill in 2000 with autoimmune reactions to everything.  At the time, living a normal life required a gluten-free diet.  My immune system has since chilled out and I'm off the asthma medications and anti-inflammatories and in general feeling pretty well.  After starting Weight Watchers in 2006 I realized that I really wanted to eat for my optimum health, and that for that that still means a gluten-free diet because I still do have some reaction. In general, I think the non-wheat wheat replacements are silly.  I get through life just fine eating "real foods".  In fact, not being able to eat wheat is something of a blessing, as most of the crap food out there has wheat in it.  Even when it comes to the so-called "healthy" food, wheat just isn't something the average Second Millennium American needs to be eating.  Processed grains were a way for starving subsistence farmers to get a calorie-dense food product.  We are not starving subsistence farmers.  There is little need for processed grains in our diet.  In fact, newer research is showing that so-called "healthy grains" actually create a lot of health problems more popularly attributed to saturated fats. I do have a need for a food bar that I can eat when I'm stuck on an airplane or whatever and cannot find anything else.  Puffins bars fill that role quite nicely.  I also like to serve a dessert cake at dinner parties, and the "Spice Cake & Gingerbread Mix" by Gluten-Free Pantry is quite fabulous.  But other than that, I just focus on eating "real food" (fruits and vegetables) and don't make a lot of effort to find fake wheat replacements.  Also, I do have a need for something to fill in that carb place in my food plan easily and I eat rice pastas for that.

Science

Blood Pressure Obesity.  For the average person not taking blood pressure medication, blood pressure increases 1.3/1.0 per each BMI increase of 1.0.  (1)  So for a BMI change of five points (that would for example get you from the top of "healthy" to the bottom of "obese I") blood pressure increases on average 6.5/5.0.  Note that these average increases are lower now that more people are obese.  Using older numbers, which may be more associated with the "naturally" obese, and those more likely to have metabolic syndrome, the increase could be as much as 10.0/7.5. Chocolate.  Eating 100 grams of dark chocolate per day (which requires reducing the remaining food intake by 480 calories) decreases blood pressure by an average of 5.0/2.0.  A person with a height of 5'7" could reduce her blood pressure more than this by losing just seven points.  And she could eat 480 calories of nutritious varied food every day.  (1) Nadia Danon-Hersch, Arnaud Chiolero, Contrad Shamlaye, Fed Paccaude and Pascal Bovet, "Decreasing Association Between Body Mass Index and Blood Pressure Over Time"; Epidemiology, 18(4):493-500, July 2007 (2) Dirk Taubert, MD, PhD, The Journal of the American Medical Association, 27 August 2003.