Okay, actually, I do remember one thing I was going to blog about.
In the past several months, one of the things that I have been learning about is control: specifically, the illusion of having control. Just like any other codependent, I have survived by trying to exert control in areas that I truly have no control. Mostly this is about other people's behavior; we (I) think that we can control other people's behavior, but we can't. We have no control over what other people do. In fact, there is very little in life that we really have control over. It's a rather revolutionary idea, because at least in the US, a lot of our culture revolves around creating your own destiny, which implies that you have much more control over what happens in life than you really do have. Learning to let go of this idea and accept that we can't control others, or the future, or very much at all other than our own actions, is a big part of becoming more satisfied with life.
Yesterday it dawned on me that there is another area of life that I do not have control over: my own body! Now, hear me out, because I know that most weight loss gurus, of the diet/exercise variety and WLS both, tout the idea that we do have control here. But the only thing we have control over is our own behavior: what we eat, how much we eat, how and when we exercise. What our bodies do with what we give them is NOT in our control.
Think about it: studies have proven over and over that after a major weight loss, formerly obese people's metabolic rates plummet. This is why diets don't work: our bodies try to conserve by dropping our metabolic requirements dramatically, so if you start eating more food you will easily regain, even if it isn't much. There are lots of calculators available online to determine your metabolic rate based on height and weight and gender, but none of them account for your body type or any factors that mitigate your own metabolism. How could they? There are so many. It is false to believe that all women who are 5'5" and 150 pounds have the same caloric requirements; a woman who has always naturally been that size can consume more calories without gaining than a woman who got to that size after a 2 year major weight loss. We all know this instinctively, but yet are told otherwise.
My point is that we tend to believe that if we eat what we have figured out is the right amount of food and exercise the right amount, we can force our bodies to lose a particular amount of weight. In reality, we do not have control over what our bodies do with the energy we put in and use. We have a good idea of the effect we can have by doing certain things, but we do not have that control. That's why it takes trial and error to actually lose weight. Yes, we have control over what we DO. NO, we do NOT have control over what happens after that. Usually it works out the way we think it should, but we don't have that control, we only think we do. Our bodies are ingenious in altering cellular energy requirements to maximize its ability to store fuel for future use, especially among those of us more prone to obesity, and especially among those of us who have recently lost a large amount of excess weight.
This realization helped me to gain a little perspective on my recent regain. It's not a moral failing--I knew this intellectually, but not emotionally. After all this time, my body has dropped my metabolism even more, and my habits have slipped so that the combination of the two made a regain pretty easy. It makes the road back seem a little easier. I can change my behavior, and my body should respond. But I can't actually cause my body to lose the weight. Maybe this distinction seems entirely semantic, but I think it's a big difference. If I worry less about the things I can't control, I can focus more on the things I can--my behavior.
Wednesday, August 19, 2009
Unwelcome Souvenirs
I just got back from a nice week at the coast for our anniversary trip. Going to the Oregon coast has become a tradition for us--our 3 wedding anniversaries have all been spent there. It's affordable and relaxing, what's not to love? It's one of my favorite places.
Upon returning from the coast, I discovered I had gained 5 pounds. I despaired. After two days of eating carefully, the 5 pounds are mysteriously gone. So, clearly, water weight, but still. There was a number on my scale that I haven't seen in over 18 months, and I'm still too close to that number for comfort. Fill tomorrow, and much more careful eating from here on out.
It's my birthday today, and we are planning on sushi for a birthday dinner. This can be done without loads of unnecessary calories, plus it is one of my favorite foods, so that's what we'll do.
I've had a lot of blog ideas lately, but at the moment they escape me, so perhaps there will be a flurry of new posts soon? Let's hope...!
Upon returning from the coast, I discovered I had gained 5 pounds. I despaired. After two days of eating carefully, the 5 pounds are mysteriously gone. So, clearly, water weight, but still. There was a number on my scale that I haven't seen in over 18 months, and I'm still too close to that number for comfort. Fill tomorrow, and much more careful eating from here on out.
It's my birthday today, and we are planning on sushi for a birthday dinner. This can be done without loads of unnecessary calories, plus it is one of my favorite foods, so that's what we'll do.
I've had a lot of blog ideas lately, but at the moment they escape me, so perhaps there will be a flurry of new posts soon? Let's hope...!
Monday, August 3, 2009
Habit is the Enemy of Progress
I don't know if I read that somewhere or I made it up, but that is what came to mind when I started this morning's run. This, after stepping on the scale and discovering I have regained 14 pounds since my all-time low in late January.
(Here's the rationalization paragraph, brace yourself.) I will say that the way I got to my all-time low weight might have something to do with the regain. It was during that month when my personal life blew up and I was under even more stress than I have been since starting anesthesia school. The stress caused me to stop eating (I just wasn't hungry and couldn't make myself eat) and I was running to combat the stress, and I lost 12 pounds in 2 weeks. Slowly, in the 6 months since then, I have regained them, plus a couple more for good measure. Also, probably 2 pounds of this is hormonal water weight.
Still, it's not just that. I'm running more in the past few weeks, but this entire spring and early summer I have slacked off in the exercise department. And my eating goes from okay to abysmal. I went over what I ate yesterday, and I can't even record it here. It's awful. No bandster should eat as much sugar and junk as I have been eating. A fill won't fix that. That's my brain.
I think long-term weight loss success is a personal experiment. I have a scientific background, and I believe in the scientific method. For the past year I have been testing the hypothesis that I can rely entirely on my band to maintain my weight loss. I think I have established that this is not a valid theory. So it's time to come up with a new hypothesis (on purpose, this time!) and make this thing work.
I've wanted to believe that somehow, since my WLS, I could eat and act like a normal person, and maintaining my weight would become natural and easy. But I now accept the idea of food addiction, and the fact that I am a food addict. I need my band because, left to my own devices, I will eat myself to death. But even with it, I have to make some changes in my brain and keep working at them. They don't have to be hard, but the thing I have to fight is falling back into bad habits and thinking. I've developed some good eating habits, riding the wave of easily following them, and then not noticed when they slowly eroded into my old ways. Habit is the enemy of progress.
I want progress. I want to reach my goal. I want to change my brain. So how can I do that, in small, easy-to-implement steps?
1. Start noticing not-hungry again, and don't eat when not hungry
2. Start noticing 'satisfied' again, and be vigilant when eating; stop eating when satisfied.
3. Serve myself my own portions (I will eat everything on my plate, so must be more careful about this)
4. Focus on protein again
This is a start. There are a lot more things I want to change about my thinking, things like the idea that if food shows up in an unexpected place (i.e. in my classroom, at a meeting) then it's "free" and I can eat whatever it is, whether I'm hungry or not, whether it's in my plan or not. And I do need to get back to planning out my meals, the very thought of which just makes me tired and annoyed. This is much more about eating and thinking than it is about exercise.
Right now I am frustrated and tired of all of this. Why can't I be a normal person? But then, who is normal these days?
(Here's the rationalization paragraph, brace yourself.) I will say that the way I got to my all-time low weight might have something to do with the regain. It was during that month when my personal life blew up and I was under even more stress than I have been since starting anesthesia school. The stress caused me to stop eating (I just wasn't hungry and couldn't make myself eat) and I was running to combat the stress, and I lost 12 pounds in 2 weeks. Slowly, in the 6 months since then, I have regained them, plus a couple more for good measure. Also, probably 2 pounds of this is hormonal water weight.
Still, it's not just that. I'm running more in the past few weeks, but this entire spring and early summer I have slacked off in the exercise department. And my eating goes from okay to abysmal. I went over what I ate yesterday, and I can't even record it here. It's awful. No bandster should eat as much sugar and junk as I have been eating. A fill won't fix that. That's my brain.
I think long-term weight loss success is a personal experiment. I have a scientific background, and I believe in the scientific method. For the past year I have been testing the hypothesis that I can rely entirely on my band to maintain my weight loss. I think I have established that this is not a valid theory. So it's time to come up with a new hypothesis (on purpose, this time!) and make this thing work.
I've wanted to believe that somehow, since my WLS, I could eat and act like a normal person, and maintaining my weight would become natural and easy. But I now accept the idea of food addiction, and the fact that I am a food addict. I need my band because, left to my own devices, I will eat myself to death. But even with it, I have to make some changes in my brain and keep working at them. They don't have to be hard, but the thing I have to fight is falling back into bad habits and thinking. I've developed some good eating habits, riding the wave of easily following them, and then not noticed when they slowly eroded into my old ways. Habit is the enemy of progress.
I want progress. I want to reach my goal. I want to change my brain. So how can I do that, in small, easy-to-implement steps?
1. Start noticing not-hungry again, and don't eat when not hungry
2. Start noticing 'satisfied' again, and be vigilant when eating; stop eating when satisfied.
3. Serve myself my own portions (I will eat everything on my plate, so must be more careful about this)
4. Focus on protein again
This is a start. There are a lot more things I want to change about my thinking, things like the idea that if food shows up in an unexpected place (i.e. in my classroom, at a meeting) then it's "free" and I can eat whatever it is, whether I'm hungry or not, whether it's in my plan or not. And I do need to get back to planning out my meals, the very thought of which just makes me tired and annoyed. This is much more about eating and thinking than it is about exercise.
Right now I am frustrated and tired of all of this. Why can't I be a normal person? But then, who is normal these days?
Wednesday, July 29, 2009
Born to Run
The scale is fickle and stubborn. Or else, it's stuck. Seeing how it's a digital scale, I doubt it's the latter, although it would make me feel better. It might have something to do with the pies I baked over the weekend...nah! Couldn't be. I made an appointment for a fill, and they rescheduled it for 3 weeks later...bleh!
For us in the eastern part of the state, the temps have cooled down a bit to the high 80s, while the West Side (i.e. Seattle) is sweltering this week, with over 100 degree temps. They are in a temperate weather zone, and are unaccustomed to temperature extremes over there. Few homes have AC, even a window unit. People are scampering to get the last fans at the hardware stores. It's a similar scene to 7 months ago, when they were trying to get by with 2 snowplows for the entire county when they had a rare snowstorm. But here, people are more used to the hot summers, and it is a little less humid (not that it's very humid in Seattle). It makes evening running a lot more pleasant, anyway.
I'm still trying to get my mileage back up after a long spring and early summer of slacking, mainly due to scheduling problems. My school schedule is now a bit unpredictable, and when I am working evenings it can be hard to get a run in before the temps are over 85 degrees. But I was looking back at my running logs over the last 18 months and while it feels like I am stuck in a rut, I have made some progress. My times are much better than last year (although still slow). For someone who isn't "built like a runner", I still get a lot of enjoyment out of it. I have legs that are much more buffalo than gazelle, and even after a breast reduction FOLLOWED BY a 70 pound weight loss, I'm still more generously endowed than Marion Jones (or even Venus Williams, probably). But still, I have to say, the number one reason I still run is simple: because I can. It isn't enabling me to eat like a beast, or lose weight like crazy. My heart rate is much lower since I started running (it's in the normal range now, instead of being high) and my BP is lower. But that's not what keeps me going out there. It is just because after feeling like the slow, fat one for my whole life, even as a little kid, I take pleasure in being able to simply do it and not keel over. That's all. That's enough to make it enjoyable for me.
I'm reading Born to Run by Christopher McDougall right now. It is about a tribe of Mexican Indians who are known as Running People. They are like ultrarunners--those guys who run 100 mile races--but even more extreme, running for 48 hours straight. It's in their culture and their blood, they run well into old age, and they have nothing but joy in it--and no injuries--all in handmade sandals. It's a truly fascinating book. I have nothing in common with ultramarathoners. I have no ambitions to even do a half marathon, much less any craziness like the Leadville 100 in Colorado (a distance of 2 marathons plus 2 1500 ft climbs, all at once, all above 10,000 feet elevation). None! But those people are damn interesting, and I love to read about them. It gets me a little more excited to go out and get in 3 little miles up the South Hill.
For us in the eastern part of the state, the temps have cooled down a bit to the high 80s, while the West Side (i.e. Seattle) is sweltering this week, with over 100 degree temps. They are in a temperate weather zone, and are unaccustomed to temperature extremes over there. Few homes have AC, even a window unit. People are scampering to get the last fans at the hardware stores. It's a similar scene to 7 months ago, when they were trying to get by with 2 snowplows for the entire county when they had a rare snowstorm. But here, people are more used to the hot summers, and it is a little less humid (not that it's very humid in Seattle). It makes evening running a lot more pleasant, anyway.
I'm still trying to get my mileage back up after a long spring and early summer of slacking, mainly due to scheduling problems. My school schedule is now a bit unpredictable, and when I am working evenings it can be hard to get a run in before the temps are over 85 degrees. But I was looking back at my running logs over the last 18 months and while it feels like I am stuck in a rut, I have made some progress. My times are much better than last year (although still slow). For someone who isn't "built like a runner", I still get a lot of enjoyment out of it. I have legs that are much more buffalo than gazelle, and even after a breast reduction FOLLOWED BY a 70 pound weight loss, I'm still more generously endowed than Marion Jones (or even Venus Williams, probably). But still, I have to say, the number one reason I still run is simple: because I can. It isn't enabling me to eat like a beast, or lose weight like crazy. My heart rate is much lower since I started running (it's in the normal range now, instead of being high) and my BP is lower. But that's not what keeps me going out there. It is just because after feeling like the slow, fat one for my whole life, even as a little kid, I take pleasure in being able to simply do it and not keel over. That's all. That's enough to make it enjoyable for me.
I'm reading Born to Run by Christopher McDougall right now. It is about a tribe of Mexican Indians who are known as Running People. They are like ultrarunners--those guys who run 100 mile races--but even more extreme, running for 48 hours straight. It's in their culture and their blood, they run well into old age, and they have nothing but joy in it--and no injuries--all in handmade sandals. It's a truly fascinating book. I have nothing in common with ultramarathoners. I have no ambitions to even do a half marathon, much less any craziness like the Leadville 100 in Colorado (a distance of 2 marathons plus 2 1500 ft climbs, all at once, all above 10,000 feet elevation). None! But those people are damn interesting, and I love to read about them. It gets me a little more excited to go out and get in 3 little miles up the South Hill.
Saturday, July 18, 2009
Endless Summer
The summer heat has me eating a lot less and drinking more. Both are good things for me. I love summertime--love the heat, playing outside, wearing summer clothes. Even when I was obese, I loved it, though not as much since I felt less comfortable in shorts and totally uncomfortable in swim suits. But summertime just feels like freedom to me. One think I like about where I live now is that summer is hot, punctuated every couple weeks by a storm, and then is immediately hot again. There isn't a lot of humidity here. When I lived in Portland and Seattle, there was always the sense that you had to hurry up and go do something fun when it was nice out, because the rain would be back any moment. (Of course, that was tempered by the fact that on a beautiful summer day, there is no place more lovely to be than Portland or Seattle.)
Last summer, most of my free time was spent in Portland. I didn't really explore Spokane very much as a result. This year I am trying to get out more in this area and check out what there is to do here. I've spent a lot of time at the Spokane River this week, which has been lovely. I drove out to Lake Coeur D'Alene as well, but didn't find the park I was looking for.
One of my favorite things about summer is fruit...I love it when all the berries are in season, and fresh watermelon, and cherries. I eat my fill of them with zero guilt.
Hopefully the scale will reflect my reduced summertime eating, although it hasn't very much yet. Everybody get outside and enjoy summer while it's here!
Last summer, most of my free time was spent in Portland. I didn't really explore Spokane very much as a result. This year I am trying to get out more in this area and check out what there is to do here. I've spent a lot of time at the Spokane River this week, which has been lovely. I drove out to Lake Coeur D'Alene as well, but didn't find the park I was looking for.
One of my favorite things about summer is fruit...I love it when all the berries are in season, and fresh watermelon, and cherries. I eat my fill of them with zero guilt.
Hopefully the scale will reflect my reduced summertime eating, although it hasn't very much yet. Everybody get outside and enjoy summer while it's here!
Saturday, July 11, 2009
Band Thoughts
Today I was surprised and pleased to see MSNBC.com post an article about The End of Overeating, the book I just finished reading by Dr. David Kessler. Looks like he is getting some good press.
This weekend I am taking a class for my program called Law and Medicine. It is 3 days, 8 hours each day. This year because of scheduling conflicts, our last day of class is tomorrow, which is Sunday. We're pretty unhappy about that. The class is useful, but long and not terribly dynamic. Our instructor was the first CRNA in the country to earn her JD, and is very knowledgable about the subject. Amazingly, my program is the only one in the country that includes a class on law and medicine in the curriculum. Our final class will focus on how to read and negotiate an employment contract.
We get a make-up day off on Thursday, but that's not the same. Today I did a little reading, went to the gym, and spent the evening at Riverside State Park, hiking and cautiously playing in the river, which is notoriously dangerous. I stuck to parts that seemed still, avoided the current, and stayed by the bank. The park is huge and I drove out much further into it than I have before. It's such a beautiful park, I hope to have time this summer to play in it some more. My legs are tired, in a good way, from my run and from several miles of trekking.
I finally made an appointment with my new band surgeon for later this month. I will probably have to reschedule it but at least I'm on the books. Interestingly, this summer we start going on "field trips" to small CRNA-only practices in the area, and one of the places we go is the surgery center where my band surgeon operates. So once I find out when I am scheduled to go there, I'm going to see if I can schedule my appointment for the same day, for the sake of convenience. I didn't have surgery there; I had surgery in Portland, at a hospital that only has anesthesiologists (like most in Portland). But it's cool that this surgeon works exclusively with CRNAs. Anyway, I need to see the surgeon and probably need a fill. I just can't decide. I haven't been seen for my band in a long time, over a year, so I should go in anyway. I weigh about 2 pounds less than I did a year ago. I want to lose about 20 more.
At just under 2.5 years post-op, I'm a little frustrated, either with the band or with myself. I do believe that getting control of the psychological issues of weight loss are key to getting to goal for me, and would be no matter what surgery I had had. Perhaps if I had done something really major, like duodenal switch, I would have gotten to goal pretty definitively, but then I think maintenance might have been an issue, not to mention the issues associated with long-term malabsorption. But if I had it to do over again, I would probably have the sleeve gastrectomy. I have already decided that if I ever needed a revision or re-op due to a problem with the band, I would have the VSG. Why? It works like the band, but nothing needs adjusting, and there's nothing to slip. No wringing of hands trying to figure out if you need a fill or not, no convincing a provider that you really do need one. Yes, the initial attractiveness of the band was that it can be removed if necessary, and there was no permanent rearrangement of my anatomy. But, I dunno, there's just a lot to be said for having that angst taken out of the picture. I guess you have staple lines that could potentially leak, but I've seen this surgery done, and the staple lines created by the tools they use today are pretty solid, 3 rows of tiny staples. With a good surgeon, leaks are extremely rare. Any other post-op lap banders have this thought ever?
That's not to say that I haven't been happy with my band. It has served me well as the tool it was intended to be. At the time I had surgery, I wouldn't have considered amputating my stomach. Now I think it isn't as big a deal. But at the same time, since hunger isn't really the issue with me, it might not make a bit of difference, except that I wouldn't have to worry about fills or whether I have insurance to pay for them. I'd just have a smaller stomach with no moving parts. I could still eat ice cream and milkshakes and other things that would go right through. It wouldn't be any guarantee that I would be at goal now, or that I wouldn't regain.
I don't know. I wouldn't call it buyer's remorse. I'm not sorry I was banded, and I'm glad I've lost 60 lbs. (65 on a good day.) I have work to do on my eating, and thankfully, my band has helped me stay around the same weight for a year--but I am frustrated that I'm not getting any more headway in the direction I want to go. It's still a lot of work. Getting rid of hunger is only the first step, the thing that allows you to do the rest of the (much harder) work of controlling weight for life. It's still a work in progress.
This weekend I am taking a class for my program called Law and Medicine. It is 3 days, 8 hours each day. This year because of scheduling conflicts, our last day of class is tomorrow, which is Sunday. We're pretty unhappy about that. The class is useful, but long and not terribly dynamic. Our instructor was the first CRNA in the country to earn her JD, and is very knowledgable about the subject. Amazingly, my program is the only one in the country that includes a class on law and medicine in the curriculum. Our final class will focus on how to read and negotiate an employment contract.
We get a make-up day off on Thursday, but that's not the same. Today I did a little reading, went to the gym, and spent the evening at Riverside State Park, hiking and cautiously playing in the river, which is notoriously dangerous. I stuck to parts that seemed still, avoided the current, and stayed by the bank. The park is huge and I drove out much further into it than I have before. It's such a beautiful park, I hope to have time this summer to play in it some more. My legs are tired, in a good way, from my run and from several miles of trekking.
I finally made an appointment with my new band surgeon for later this month. I will probably have to reschedule it but at least I'm on the books. Interestingly, this summer we start going on "field trips" to small CRNA-only practices in the area, and one of the places we go is the surgery center where my band surgeon operates. So once I find out when I am scheduled to go there, I'm going to see if I can schedule my appointment for the same day, for the sake of convenience. I didn't have surgery there; I had surgery in Portland, at a hospital that only has anesthesiologists (like most in Portland). But it's cool that this surgeon works exclusively with CRNAs. Anyway, I need to see the surgeon and probably need a fill. I just can't decide. I haven't been seen for my band in a long time, over a year, so I should go in anyway. I weigh about 2 pounds less than I did a year ago. I want to lose about 20 more.
At just under 2.5 years post-op, I'm a little frustrated, either with the band or with myself. I do believe that getting control of the psychological issues of weight loss are key to getting to goal for me, and would be no matter what surgery I had had. Perhaps if I had done something really major, like duodenal switch, I would have gotten to goal pretty definitively, but then I think maintenance might have been an issue, not to mention the issues associated with long-term malabsorption. But if I had it to do over again, I would probably have the sleeve gastrectomy. I have already decided that if I ever needed a revision or re-op due to a problem with the band, I would have the VSG. Why? It works like the band, but nothing needs adjusting, and there's nothing to slip. No wringing of hands trying to figure out if you need a fill or not, no convincing a provider that you really do need one. Yes, the initial attractiveness of the band was that it can be removed if necessary, and there was no permanent rearrangement of my anatomy. But, I dunno, there's just a lot to be said for having that angst taken out of the picture. I guess you have staple lines that could potentially leak, but I've seen this surgery done, and the staple lines created by the tools they use today are pretty solid, 3 rows of tiny staples. With a good surgeon, leaks are extremely rare. Any other post-op lap banders have this thought ever?
That's not to say that I haven't been happy with my band. It has served me well as the tool it was intended to be. At the time I had surgery, I wouldn't have considered amputating my stomach. Now I think it isn't as big a deal. But at the same time, since hunger isn't really the issue with me, it might not make a bit of difference, except that I wouldn't have to worry about fills or whether I have insurance to pay for them. I'd just have a smaller stomach with no moving parts. I could still eat ice cream and milkshakes and other things that would go right through. It wouldn't be any guarantee that I would be at goal now, or that I wouldn't regain.
I don't know. I wouldn't call it buyer's remorse. I'm not sorry I was banded, and I'm glad I've lost 60 lbs. (65 on a good day.) I have work to do on my eating, and thankfully, my band has helped me stay around the same weight for a year--but I am frustrated that I'm not getting any more headway in the direction I want to go. It's still a lot of work. Getting rid of hunger is only the first step, the thing that allows you to do the rest of the (much harder) work of controlling weight for life. It's still a work in progress.
Wednesday, July 1, 2009
Food Rehab
I've gotten to the "meat" of my book I have been reading, "The End of Overeating." The first two-thirds of the book are dedicated to exploring the science behind what makes certain foods irresistable, or "hyperpalatable" as the author calls them. He explains that the restaurant and prepared foods industries have sort of "stumbled" on how to exploit this science, without necessarily knowing the science behind it, through trial and error, finding what it is that people buy and eat, working hard to make a product that customers will consume compulsively. It's not surprising or necessarily that sinister that they do this; this is business, and they are in the business of selling as much of their product as they can. When your business is food, you make more money if you can get people to come back over and over for your food, and eat more than they should. If it is actually addictive--and the science indicates that compulsive overeating is at least very similar to substance addictions--it just makes the stuff sell better. It took something like 80 years or more to condemn the tobacco industry for doing the exact same thing.
The last third of the book talks about how to deal with our problem of compulsive overeating. (or "conditioned hypereating" as the author calls it). It's a chronic problem, and many, many of us have it. It (probably) can't be "cured," but we can learn how to deal with it, through cognitive behavioral therapy techniques and support and practice.
Wouldn't it be great to be able to relate to food like a "normal" person? There really is such thing as a normal person when it comes to food, although at least in the USA, it seems like normal is now overeating and obesity. A truly "normal" eater doesn't eat the cookies on the table if they already ate a meal and are full. A "normal" eater doesn't think about eating when they aren't eating--like thinking about what you'll have for dinner when you just finished lunch. A "normal" eater doesn't obsess about the donuts in the break room, trying to resist an irresistable urge to go eat one, or two, or four. A "normal" eater can eat just one or two cookies, and stop, even though there are more cookies sitting right there in the package. Those people really exist!
In terms of addiction, alcoholics call people who can drink one beer and stop "normies." Some people can just have one beer, others can't resist the pull to keep drinking after just one. That's how many of us are about food. We aren't "normies". A lot of things are happening in our environment that condition more and more people to have abnormal relationships (and obsessions) with food. I like the idea that there are things we can do to combat this conditioning.
The book has a section toward the end called "Food Rehab." (I think that's awesome.) I wanted to directly quote the book on the essential principles, but I don't want to commit copyright infringement, so I'm going to paraphrase the ideas in my own words. Really, do read the book, it's very interesting.
Essential principles of Food Rehab:
-We are biologically driven to overeat. It's not a character defect or a matter of willpower. We can only get better when we stop seeing ourselves as failing at willpower.
-Treating this overeating problem is a chronic problem that can only be managed, not cured.
-Every time we eat one of our "trigger" foods, filled with sugar/fat/salt, we reinforce the habit and the reward system in our brains and make it more likely that we will do it again the next time. The way to treat this is to stop the cycle of urges and rewards.
-Diets make this problem worse when they leave us feeling deprived.
-The treatment is learning a new way to respond to food. It can only be learned when it generates a feeling of satisfaction. If the change leaves us feeling hungry, unhappy, angry or resentful, the new ways will not stick.
-To regain control, the approach has to address all the different elements that go into our overeating. It is a multi-step process.
-We won't always be perfect in this new behavior, but we can learn from our mistakes so we are less likely to repeat them.
-We can learn a new way to think about food and put it back into its proper place in our lives.
Dr. Kessler put it much better than this...check it out.
I have identified some of my own specific triggers and some ways to start learning how to avoid them. In another post I will talk about them some more. I really feel like this mental and emotional work is the key to losing my last pounds and getting to a managable, healthy weight. All the fills in the world, and all the running I can do, will not help me if I don't learn how to control my subconscious drive to eat inappropriately. I think Dr. Kessler's methods are one way to help me work through this.
The last third of the book talks about how to deal with our problem of compulsive overeating. (or "conditioned hypereating" as the author calls it). It's a chronic problem, and many, many of us have it. It (probably) can't be "cured," but we can learn how to deal with it, through cognitive behavioral therapy techniques and support and practice.
Wouldn't it be great to be able to relate to food like a "normal" person? There really is such thing as a normal person when it comes to food, although at least in the USA, it seems like normal is now overeating and obesity. A truly "normal" eater doesn't eat the cookies on the table if they already ate a meal and are full. A "normal" eater doesn't think about eating when they aren't eating--like thinking about what you'll have for dinner when you just finished lunch. A "normal" eater doesn't obsess about the donuts in the break room, trying to resist an irresistable urge to go eat one, or two, or four. A "normal" eater can eat just one or two cookies, and stop, even though there are more cookies sitting right there in the package. Those people really exist!
In terms of addiction, alcoholics call people who can drink one beer and stop "normies." Some people can just have one beer, others can't resist the pull to keep drinking after just one. That's how many of us are about food. We aren't "normies". A lot of things are happening in our environment that condition more and more people to have abnormal relationships (and obsessions) with food. I like the idea that there are things we can do to combat this conditioning.
The book has a section toward the end called "Food Rehab." (I think that's awesome.) I wanted to directly quote the book on the essential principles, but I don't want to commit copyright infringement, so I'm going to paraphrase the ideas in my own words. Really, do read the book, it's very interesting.
Essential principles of Food Rehab:
-We are biologically driven to overeat. It's not a character defect or a matter of willpower. We can only get better when we stop seeing ourselves as failing at willpower.
-Treating this overeating problem is a chronic problem that can only be managed, not cured.
-Every time we eat one of our "trigger" foods, filled with sugar/fat/salt, we reinforce the habit and the reward system in our brains and make it more likely that we will do it again the next time. The way to treat this is to stop the cycle of urges and rewards.
-Diets make this problem worse when they leave us feeling deprived.
-The treatment is learning a new way to respond to food. It can only be learned when it generates a feeling of satisfaction. If the change leaves us feeling hungry, unhappy, angry or resentful, the new ways will not stick.
-To regain control, the approach has to address all the different elements that go into our overeating. It is a multi-step process.
-We won't always be perfect in this new behavior, but we can learn from our mistakes so we are less likely to repeat them.
-We can learn a new way to think about food and put it back into its proper place in our lives.
Dr. Kessler put it much better than this...check it out.
I have identified some of my own specific triggers and some ways to start learning how to avoid them. In another post I will talk about them some more. I really feel like this mental and emotional work is the key to losing my last pounds and getting to a managable, healthy weight. All the fills in the world, and all the running I can do, will not help me if I don't learn how to control my subconscious drive to eat inappropriately. I think Dr. Kessler's methods are one way to help me work through this.
Sunday, June 28, 2009
We Are Different
I am still reading "The End of Overeating" and it is quite fascinating. The premise is pretty simple--that the food industry has contributed greatly to the obesity epidemic in the US by creating "hyperpalatable" foods that (some of) our brains basically can't resist--and most of the book is describing the science behind it, which those in research and development within the food industry most likely weren't even aware of, at least at first.
One thing this book states over and over is that people who have a tendency towards obesity have different brains than those who tend to be thin. This is both genetic and environmental, and it can be enhanced by childhood experience, i.e. eating a lot of these hyperpalatable foods as a kid, learning eating habits from our parents, etc. One interesting thing about the book is that he writes from a first-person perspective; the author is in the entire book, which makes the whole thing seem a lot less judgmental of "us fat people". He describes the development of several foods, like Oreos, Cinnabons, and certain milkshakes, going through the characteristics of each one that make them so hard to resist. I realized through reading this that all of these things are things I, too, find impossible to resist, and so I simply never eat them, or buy them. If they are around, I know I will eat them. But even so, avoiding these strongly triggering foods hasn't meant that I don't still overeat, or that I no longer have a weight problem.
But, I don't drink milkshakes, because I don't go to places that sell them. Just the idea of going through a drive-through or into a restaurant that sells them (the good ones) is enough to stop me. Okay, there is an exception: I will go to Burgerville USA (in Oregon) and have a shake while I am driving a long distance. There are lots of subconscious cues and triggers that make it very hard for me to resist it in this circumstance.
I think it has been several years since I bought a package of Oreos. I can't resist them. I haven't had a Cinnabon in at least 5 years, because HELLO! And I've changed more things too. I almost never watch TV, because the commercials are too triggering for me. We do watch some shows on DVD, without commercials. Even so, some of the shows themselves contain a lot of food triggers. I rarely go out to eat anymore, because even though I eat a lot less than I used to, I still eat too much, and it's better and cheaper to cook at home. Also, my hubby is a great cook and likes making dinner. We go out for breakfast once a week, because I love breakfast so much. That's about it, and it's a vast improvement from a few years ago.
Our brains are different. That is one thing that the past year of my 2 1/2 years post op has really taught me. There are people who can sit in front of a whole plate of Oreos, and if they aren't hungry they won't eat any. If they want a snack, they might eat a couple, but not the whole plate. Many others of us aren't like that. Even if we are full, we will eat them until they are gone. Period.
Having surgery did what I wanted it to do: it took away my physical hunger, which was real. It left me with all the other reasons that I was overweight, including compulsive overeating and emotionally conditioned eating. This past year has really opened my eyes to this reality.
This book doesn't make the food industry into the big excuse for obesity. It simply shows how the foods that were developed because consumers like them and buy them and can't resist them have contributed to our drive to eat highly caloric foods, too much of them, and too often. It's one more key to understanding how to get control of our eating, our weight, and our lives. It also points to one of the reasons that WLS is not a magic bullet, and without attention to all of our habits that contribute to the problem, we will not reach and stay at our goal long-term.
One thing this book states over and over is that people who have a tendency towards obesity have different brains than those who tend to be thin. This is both genetic and environmental, and it can be enhanced by childhood experience, i.e. eating a lot of these hyperpalatable foods as a kid, learning eating habits from our parents, etc. One interesting thing about the book is that he writes from a first-person perspective; the author is in the entire book, which makes the whole thing seem a lot less judgmental of "us fat people". He describes the development of several foods, like Oreos, Cinnabons, and certain milkshakes, going through the characteristics of each one that make them so hard to resist. I realized through reading this that all of these things are things I, too, find impossible to resist, and so I simply never eat them, or buy them. If they are around, I know I will eat them. But even so, avoiding these strongly triggering foods hasn't meant that I don't still overeat, or that I no longer have a weight problem.
But, I don't drink milkshakes, because I don't go to places that sell them. Just the idea of going through a drive-through or into a restaurant that sells them (the good ones) is enough to stop me. Okay, there is an exception: I will go to Burgerville USA (in Oregon) and have a shake while I am driving a long distance. There are lots of subconscious cues and triggers that make it very hard for me to resist it in this circumstance.
I think it has been several years since I bought a package of Oreos. I can't resist them. I haven't had a Cinnabon in at least 5 years, because HELLO! And I've changed more things too. I almost never watch TV, because the commercials are too triggering for me. We do watch some shows on DVD, without commercials. Even so, some of the shows themselves contain a lot of food triggers. I rarely go out to eat anymore, because even though I eat a lot less than I used to, I still eat too much, and it's better and cheaper to cook at home. Also, my hubby is a great cook and likes making dinner. We go out for breakfast once a week, because I love breakfast so much. That's about it, and it's a vast improvement from a few years ago.
Our brains are different. That is one thing that the past year of my 2 1/2 years post op has really taught me. There are people who can sit in front of a whole plate of Oreos, and if they aren't hungry they won't eat any. If they want a snack, they might eat a couple, but not the whole plate. Many others of us aren't like that. Even if we are full, we will eat them until they are gone. Period.
Having surgery did what I wanted it to do: it took away my physical hunger, which was real. It left me with all the other reasons that I was overweight, including compulsive overeating and emotionally conditioned eating. This past year has really opened my eyes to this reality.
This book doesn't make the food industry into the big excuse for obesity. It simply shows how the foods that were developed because consumers like them and buy them and can't resist them have contributed to our drive to eat highly caloric foods, too much of them, and too often. It's one more key to understanding how to get control of our eating, our weight, and our lives. It also points to one of the reasons that WLS is not a magic bullet, and without attention to all of our habits that contribute to the problem, we will not reach and stay at our goal long-term.
Friday, June 19, 2009
The End of Overeating?
My weight is coming down a bit. I've been able to be a bit more intentional about my eating lately, which surely has helped. Oddly, I've taken the last 2 weeks off from running because my right Achilles tendon was sore. Last night was the first time I had run in over 2 weeks, and my weight was already down 2 pounds by then. It's encouraging, but I want to see more movement than this.
I am reading a new book called "The End of Overeating" by David Kessler. It's a promising title...too promising, of course, but the premise is basically that America's overeating problem is (at least partly) caused by the manipulation by the food industry of the proportions of sugar, salt and fat in foods we commonly eat. The author argues that certain proportions of these basic ingredients trigger our brains to eat beyond our satiety. The book seeks to explain how we lose control over our eating, and promises to reveal how we can regain it. (I am thinking the answer will be in preparing more of our own foods, from scratch.) It is interesting. I'm not sure it's going to tell me a lot that I didn't already know, but even reading about overeating helps me be more conscious about what I do, so even that helps.
From the outset, this book reiterates what recent research has confirmed over and over: that we gain weight because we eat too much. It's such a simple idea, but we have fought the idea for a long time. I fought it, before I had WLS. Now I realize that I did eat more than I realized, even if the amount I ate might not cause another person to gain weight. It wasn't massive amounts, but it doesn't take much of a calorie excess to cause a lot of weight gain over time.
The book also talks in the beginning about the "setpoint" theory, that our bodies naturally maintain a certain weight range and somehow that setpoint gets messed up in people who are overweight. In fact, the author states, the setpoint, or homeostasis range, is only one factor in our weight. A lot of other things happen that override our body's weight homeostasis, and when we gain a lot of weight and then try to lose it, our setpoint often gets moved a little higher than it was before. We've all noticed that in our yo-yo cycles in the past. We blame it on dieting. It might be the actual weight gain that causes it, not the diet that revealed that changed setpoint.
I'm still fighting this seeming "setpoint" that I have reached of about 170 pounds. My body seems to want to stay here. Interestingly, it's exactly where my surgeon said I would land. But I could easily stand to lose another 20 lbs, and even 10 would make me happy. As tempting as it is to try to get there quickly through a "diet", I am resisting this urge, partly because I was always a terrible dieter, and partly because I want a more lasting weight loss. So I still work on this every day.
On the school front...I have 10 1/2 months left and I am very happy about that. The hardest part is behind me. It's nice to realize that by this time next year I will be graduated and will already have taken (and hopefully passed) my boards. We are finishing up our bioethics class next week. It's been a very interesting class. Then we will take Law and Medicine in July. Meanwhile, we are working about 30 hours/week in the OR. Tonight I am on from 3-11, which should be in OB rather than the OR--placing labor epidurals and providing anesthesia for C-sections. I enjoy OB anesthesia, and I also enjoy not getting up at 5am.
I am thinking of making an appointment to see the surgeon sometime this summer, just to check in and make sure everything is okay. I don't know if I need a fill or not. Sometimes I think I do, sometimes I don't. Since it's been over a year since my last appointment, I should go in either way.
Hope everyone is enjoying the summer!
I am reading a new book called "The End of Overeating" by David Kessler. It's a promising title...too promising, of course, but the premise is basically that America's overeating problem is (at least partly) caused by the manipulation by the food industry of the proportions of sugar, salt and fat in foods we commonly eat. The author argues that certain proportions of these basic ingredients trigger our brains to eat beyond our satiety. The book seeks to explain how we lose control over our eating, and promises to reveal how we can regain it. (I am thinking the answer will be in preparing more of our own foods, from scratch.) It is interesting. I'm not sure it's going to tell me a lot that I didn't already know, but even reading about overeating helps me be more conscious about what I do, so even that helps.
From the outset, this book reiterates what recent research has confirmed over and over: that we gain weight because we eat too much. It's such a simple idea, but we have fought the idea for a long time. I fought it, before I had WLS. Now I realize that I did eat more than I realized, even if the amount I ate might not cause another person to gain weight. It wasn't massive amounts, but it doesn't take much of a calorie excess to cause a lot of weight gain over time.
The book also talks in the beginning about the "setpoint" theory, that our bodies naturally maintain a certain weight range and somehow that setpoint gets messed up in people who are overweight. In fact, the author states, the setpoint, or homeostasis range, is only one factor in our weight. A lot of other things happen that override our body's weight homeostasis, and when we gain a lot of weight and then try to lose it, our setpoint often gets moved a little higher than it was before. We've all noticed that in our yo-yo cycles in the past. We blame it on dieting. It might be the actual weight gain that causes it, not the diet that revealed that changed setpoint.
I'm still fighting this seeming "setpoint" that I have reached of about 170 pounds. My body seems to want to stay here. Interestingly, it's exactly where my surgeon said I would land. But I could easily stand to lose another 20 lbs, and even 10 would make me happy. As tempting as it is to try to get there quickly through a "diet", I am resisting this urge, partly because I was always a terrible dieter, and partly because I want a more lasting weight loss. So I still work on this every day.
On the school front...I have 10 1/2 months left and I am very happy about that. The hardest part is behind me. It's nice to realize that by this time next year I will be graduated and will already have taken (and hopefully passed) my boards. We are finishing up our bioethics class next week. It's been a very interesting class. Then we will take Law and Medicine in July. Meanwhile, we are working about 30 hours/week in the OR. Tonight I am on from 3-11, which should be in OB rather than the OR--placing labor epidurals and providing anesthesia for C-sections. I enjoy OB anesthesia, and I also enjoy not getting up at 5am.
I am thinking of making an appointment to see the surgeon sometime this summer, just to check in and make sure everything is okay. I don't know if I need a fill or not. Sometimes I think I do, sometimes I don't. Since it's been over a year since my last appointment, I should go in either way.
Hope everyone is enjoying the summer!
Monday, June 8, 2009
Food Junkie
I never used to believe in food addiction. I didn't understand how anyone could be addicted to something you need to live. Isn't that like being an oxygen addict, or a water addict?
Well, no, I am realizing. It is not. We don't become addicted to the stuff we actually need to live, like whole grains and protein. Too bad! It is not very different from becoming addicted to gambling, or sex, or anything that produces a "high" in your brain. We actually aren't addicted to the food (or sex or gambling), we are addicted to our own brain chemicals that make us feel good. It is a pattern that we learn from childhood, for most of us. That is what tends to make it addictive: early on, we learned that certain foods make us feel good, comforted, loved. Our parents gave them to us to reward us, or we would eat them when we heard our parents fighting in the other room, or we observed other family members compulsively overeating and learned the behavior. Early on, eating certain things became associated with positive feelings, and they become our most powerful coping mechanism.
I know this isn't news to anyone reading this who has had WLS, or who has ever had a weight problem.
I am doing my own recovery work, unrelated (so I thought) to my eating, because I am married to a man with addictions. I'm learning that it was no mistake that I married an addict--wonderful person though he is. I was raised by parents who were at least food addicts, and I don't mean that in the sense of people who claim to be "addicted" to chocolate or Coach purses or Carmex. I realized when I first started goint to Al-Anon that the families people were describing were alcoholic families, and they were exactly like mine, except no one in my family drank or did drugs. They did, however, have an exceptionally unhealthy relationship with food, so much so that I believe they acted like any other addicts, and we all learned to respond to the addiction like any other codependent does. It sounds crazy if you haven't lived it. But I am certain that some of my readers have experienced the very same thing.
It has been through working my own recovery that I have realized how much I use food to cope with stress. STILL. Now that the blush of new WLS has worn off, 2 1/2 years after surgery, I don't have that "high" to keep me strictly adhering to my food plan. Like I described before, my days go pretty much according to plan, but I get home and I am "hungry" and foraging. Where I used to be able to listen to my stomach and stop if I wasn't physically hungry, now I am finding that to be much harder. I can actually notice now that eating sugar calms my anxiety and stress, something I didn't used to really be aware of. It is scary to observe this happening, and feel powerless to stop it.
I am undecided on how I want to try to get a handle on this. I feel pretty sure that I am not going to get to my goal weight (or really lose any more weight at all) if I don't get some better way to handle life than overeating. If it weren't for my band, I would be eating much more than I do now, and would have regained more than the 5 pounds I do have. I know the usual strategies, like exercising more, drinking tea, journaling, seeing a counselor etc. But I feel like this problem is much more core to who I am as a person than these simple behavior changes. I feel like something much deeper has to change if I am going to have a lasting way of maintaining my weight. It may involve going to OA meetings, although frankly OA scares me, with their Gray Sheets and eating soberly. And I don't know what their relationship with bariatric patients is like: are they accepting? Surely there must be many WLSers in OA meetings. I will probably just start by talking to our counselor about this and getting an idea from there on how I want to deal with this problem in a real and lasting way.
How have you all dealt with these kinds of issues? Any suggestions?
Well, no, I am realizing. It is not. We don't become addicted to the stuff we actually need to live, like whole grains and protein. Too bad! It is not very different from becoming addicted to gambling, or sex, or anything that produces a "high" in your brain. We actually aren't addicted to the food (or sex or gambling), we are addicted to our own brain chemicals that make us feel good. It is a pattern that we learn from childhood, for most of us. That is what tends to make it addictive: early on, we learned that certain foods make us feel good, comforted, loved. Our parents gave them to us to reward us, or we would eat them when we heard our parents fighting in the other room, or we observed other family members compulsively overeating and learned the behavior. Early on, eating certain things became associated with positive feelings, and they become our most powerful coping mechanism.
I know this isn't news to anyone reading this who has had WLS, or who has ever had a weight problem.
I am doing my own recovery work, unrelated (so I thought) to my eating, because I am married to a man with addictions. I'm learning that it was no mistake that I married an addict--wonderful person though he is. I was raised by parents who were at least food addicts, and I don't mean that in the sense of people who claim to be "addicted" to chocolate or Coach purses or Carmex. I realized when I first started goint to Al-Anon that the families people were describing were alcoholic families, and they were exactly like mine, except no one in my family drank or did drugs. They did, however, have an exceptionally unhealthy relationship with food, so much so that I believe they acted like any other addicts, and we all learned to respond to the addiction like any other codependent does. It sounds crazy if you haven't lived it. But I am certain that some of my readers have experienced the very same thing.
It has been through working my own recovery that I have realized how much I use food to cope with stress. STILL. Now that the blush of new WLS has worn off, 2 1/2 years after surgery, I don't have that "high" to keep me strictly adhering to my food plan. Like I described before, my days go pretty much according to plan, but I get home and I am "hungry" and foraging. Where I used to be able to listen to my stomach and stop if I wasn't physically hungry, now I am finding that to be much harder. I can actually notice now that eating sugar calms my anxiety and stress, something I didn't used to really be aware of. It is scary to observe this happening, and feel powerless to stop it.
I am undecided on how I want to try to get a handle on this. I feel pretty sure that I am not going to get to my goal weight (or really lose any more weight at all) if I don't get some better way to handle life than overeating. If it weren't for my band, I would be eating much more than I do now, and would have regained more than the 5 pounds I do have. I know the usual strategies, like exercising more, drinking tea, journaling, seeing a counselor etc. But I feel like this problem is much more core to who I am as a person than these simple behavior changes. I feel like something much deeper has to change if I am going to have a lasting way of maintaining my weight. It may involve going to OA meetings, although frankly OA scares me, with their Gray Sheets and eating soberly. And I don't know what their relationship with bariatric patients is like: are they accepting? Surely there must be many WLSers in OA meetings. I will probably just start by talking to our counselor about this and getting an idea from there on how I want to deal with this problem in a real and lasting way.
How have you all dealt with these kinds of issues? Any suggestions?
Subscribe to:
Posts (Atom)
Posts
