Christmas is a Time for Treating

Merry Xmas, Happy Holidays, etc. etc...we all know the season and the stores remind us of the reason at every opportunity. It's to overeat and indulge, right?

Well, that's what one aspect of the holiday has become. My indulgence today is to not do my weigh-in, meaning I'll do my next one on Monday. I don't need to be reminded that I'm stuck in a plateau...Merry Christmas to me!

People with the Roux-en-Y surgery...and I suspect Lap-Banding...can't really "indulge" in the way that other people do. Loosening the belt just doesn't allow us to stuff in another helping of ham or stuffing.

The bad part is that we may want to still eat the way we used to; it's a head hunger and habit. It's also bad because eating is a social bonding experience. Families equate eating with social bonding. So while the bari post-op has finished his or her small portion (actually closer to a "real portion") of food on the mini-plate, everyone else is going back for seconds or thirds.

This is a tough time for post-ops. This is my first Xmas without being able to indulge...I'm rapidly approaching one year since starting my dieting program. And in some ways it kind of sucks; I'm the type of person that just isn't happy with having a thumbnail portion of each item available, so I have my meals that I tend to stick with.

On the plus side, the reduced stomach size helps warn you when you've eaten too much. I get this half-uncomfortable blah feeling that signals that it's time to stop ingesting. Now, this can be "beaten" by just eating slowly over time, or overeating by taking many small snacks that add up the calories.

In the end losing weight comes down to calories. Eat less, lose weight. The holiday treat time is to find the one or two things you really really enjoy and have a portion of it. As long as it doesn't have sugar as a primary ingredient (a coworker makes the best fudge, and I couldn't have it this year because I would get sick as a dog if I did...I also learned that the chai at Sam's Club has sugar as a first ingredient, and it did indeed make me sick, even though most other chai teas don't).

Hopefully other post-ops are doing well with their diet efforts over the holiday season. Everyone else is probably indulging as usual and then will swear off foods until New Year's rolls around, then will make their annual promises to lose X amount of pounds. And the cycle continues...have fun!

What It's Like to Weigh 500 Pounds

I have been working on a first draft of a novel for several months now, and after over 100,000 words am finally drawing near the end (then comes the FUN part...editing and rewriting parts of the draft so I can submit it in hopes of finding an agent!)

I was exploring different ways to end the story and yes, it includes the possibility of killing someone. Maybe not in real life, but one of the characters might die. I don't know yet. In either case I remembered picking up and glancing at a bargain book at the local Barnes and Noble titled How It Feels to be Attacked by a Shark edited by Michelle Hamer. It had accounts by various people, apparently all Australian or New Zealanders, regarding their brushes with death.

It includes (on the back jacket) stories of getting shot in the heart with a nail gun, come back from the dead, getting trapped in an avalanche...interesting stuff, I thought, and maybe the recollections could help in my own shaping and description of a realistic fight or death in the story.

I started reading it and after a couple accounts of being struck by lightning and saving a kid from a storm drain after a torrential storm, I found one titled "How it feels to weigh five hundred pounds."

I had to stop for a break. Looking back at my own weight loss records, I started this year at 458 pounds. About 40 pounds shy of 500, but still it's up there. Before I had lost weight the first time, many years ago...maybe six or seven years?...I was probably pushing 500, if not a little higher. I honestly don't know if there is a record of it.

Seeing that title first had me thinking, "Is that really a life or death account?" Then I was scraping my own memories to see if I could recall what it was "really" like for me at that weight. What do I say to someone if they asked about it?

I sat back down and read the story. One thing I definitely took away from it was that not all fat people are fat in the same way.

This is the story as told by (and about) Bobby Ballantyne, 42. She hated her father's vegetables and fish, so she'd toss them aside in favor of ice cream and chips and candy. She'd make herself three or four "big, thickly sliced toasted sandwiches" instead. Hmm...okay, I don't think I normally had three or four sandwiches, but I would have two. I don't remember doing it but it's possible I had three on occasion.

She said she had seven kids, getting heavier after each one. Can't say I did that.

Then she said that one day she couldn't climb a chair to clean the top of the fridge so she just didn't do it. I don't remember not reaching a point where I couldn't get on top of a chair.

She said that as she got heavier, she found there were more things she couldn't do and fell into a depression. When she was depressed she had to think happy thoughts to get into a "tranquil frame of mind" just so she could eat, since she couldn't bring herself to eat when she was depressed. Me, I found I ate depressed or not. Happy? Sad? Morose? Angry? These enhanced eating. But it was time to eat at lunch time or dinner time or a snack time...so I ate.

She recounted eating half a dozen slices of toast with heaps of butter and grilled cheese by late morning, then a block of chocolate. She'd make tea and open a pack of biscuits (are they cookies in Australia? I'm not sure). She'd hide food from her kids so she wouldn't have to share. Me? I wasn't big on chocolates or candy. I ate lots of cheese...snacking on slices of cheese, maybe a peanut butter sandwich as a snack. Cookies if they were around. Mindless things that could be downed quickly. but not typically chocolate bars and lollipops.

She blamed fat- and sugar-laden foods in addition to the quantities that she ate. My only caution there is that there is plenty of research showing that fatty foods aren't necessarily horrible. It's how much you eat of them...so it's more likely that while she needed to vary her diet more, she was closer to the mark in saying that it was quantity that really was her problem. Calories are calories whether in fat and sugar or lean protein. Health is a totally different matter (even if you ate lean cuts of meat for your diet, eating just lean cuts of meat and nothing else will still adversely affect your health.)

She recounted deals she made with God to go on a diet if she survived her chest pains at night. Me? I don't remember chest pains when I weighed that much. In fact, I have them now periodically after losing nearly 200 pounds. Closest diagnosis I managed to find has been stress. I consciously stopped giving quite as much of a damn about some of the crap at work and much of the weird pains and chest aches have subsided. I still get them on occasion but it seems that after a couple tests with the doctors they aren't too concerned, or at least not concerned enough to keep testing. I do remember making "deals" with God, though, back when I was trying to believe in a God that cared enough to help. Obviously didn't help me in the formative years of my weight gain...maybe that was part of the reason I started more strongly questioning His existence. The answer I was given was that God helps those who help themselves, so I had to do the work. Well...then it's not Him helping me, is it? If I have to "help myself?" But that's a separate discussion. Point is that I remember making deals that never worked, and in the end I'd have to do it myself.

She said she couldn't walk far; checking for mail exhausted her. She had to wear ugly clothes because that's all that fit her. She had to wear bike shorts for underwear because that's all that fit, and they helped reduce chafing. She couldn't wear shoes because her ankles were swollen, and had to wear sandals. Hmm...I remember that yes, walking a distance was tiring, but I had to do it. I forced myself to do it, because if I couldn't make it from one end of the mall to the other (or at least as far as we needed to go to finish shopping for things) then I was admitting I was too fat. I remember going to the Renaissance Festival one year and feeling so very tired...I spent half the time wishing we were heading back to the car. I remember finding excuses to take the lazier shortcuts and procrastinating to do things that meant extra moving, but in the end I'd have to do it because...again...it was admitting I was simply too fat. I usually covered for this by complaining, griping, or moving just slow enough that I wasn't completely out of breath. People with me usually just wrote it off to me being a rude bastard and while I'm sure they made plenty of mental insults about me that would have been wrong to voice, they may not have ever stopped to think that my ornery disposition was in part a way of covering for the part that scared me; having to admit that I was a terminal fatass. Complaining and griping helped cover that part of my insecurity and redirected what I didn't have control over...my fat ass...to something I did have control over...the heat, the crowds, the prices, the disgusting bathrooms, and my vocal complaints about these things.

Ugly clothes? Yeah, I remember wearing what amounted to tents and sails. I was never one to give much of a damn about name-brand crap though. Maybe in part it stemmed from always wearing ugly clothes. Still, I don't care much about shopping at the Gap versus Walmart. I worry more about making sure my ass crack isn't on display, unlike the whorish outfits worn by teenagers now displaying their own full moons, whale tales and muffin tops overflowing.

She recounts sleeping in a chair because she thought she might choke from her weight on her throat if she laid down. Can't say I had that issue. I did develop a strong...VERY strong...snore. Came from obstructive sleep apnea. That leads to issues in itself that could easily take an entire post. After losing some weight, that largely went away. CPAP machines? No fun. Except it did let me make weird noises when I opened my mouth.

She broke several recliners that she used to sleep in, five chairs in ten years because they broke on her. Chairs, she said, were her worst enemy. Plastic chairs would break easily. She would have her son check out chairs if she were invited out to lunch; if she had to climb steps she wouldn't go, and if the the seats weren't solid wood without arms she wouldn't go. She was imposing restrictions on her life. For me, this was a creeping danger. I gradually had similar things happen and because they were gradual, it was far easier to accept. There were recliners that gradually fell apart...they were a few years old, they probably were in need of replacement anyway, etc...it wasn't just because I was too heavy for what they were designed to carry. I learned to avoid folding chairs. I literally get chest pains from anxiety when I have to sit in them. I slowly lower my arse into the chairs, constantly probing my balance to feel if one of the legs is about to give, even today. Plastic lawn chairs give me the same trepidation. I rarely sit in down unless I have to or there is a solid and sturdy chair available. I have trouble with chairs that have arms too. I hate them I hate them I hate them...and I always try to find seats without arms. Worse are the theater seats. I still don't completely fit them and constantly worry that they're going to break on me. Cars? I don't usually wear seatbelts because they went from being uncomfortable to just not fitting me at all; most people laugh or say that it's my own fault for being so fat that I have to find a car that I fit in instead of a car that suits me. The absolute worst thing for me now are cars that constantly alarm when they detect your ass in the chair without a seatbelt on. I have horrible memories of riding with my wife's father in his vehicle where it dinged until I could fit the clasp into the buckle. Again...anxiety attacks. I refuse to ride in his car anymore. I don't even like riding in other people's vehicles, period. At least in my car I can make the rules. There was one time that I remember breaking the seat in the car. I think my old jalopy I drive now has bent rails on which the seat is mounted, making it difficult to adjust. Don't tell my daughter, though. I imagine it's just an old car that has a finicky adjustment on it. She's just ding-batty enough not to put two and two together and realize the truth.

She said she was diagnosed a year and a half before she decided to lose weight with type two diabetes. Hey, I had that too! Had? I guess it's the sort of thing that doesn't go away...but still, I don't remember how long ago I was diagnosed. She said she continued to eat as she always did. I think I sort of modified my diet, but evidently it was just another item on the checklist (with dark fluid-filling ankles, hypertension, high cholesterol,...)

Her revelation came when she fell in the shower. She couldn't get up; she yelled for her son, who desperately needed her to get up again because the fire department would have to cut a wall to get her out. She started obsessing on how this was affecting her son; the harassment, humiliation, and publicity this would draw if they had to come in and do that just to get her back out of the shower. She described the huge effort it took, with pillows lining the tub, her son grabbing a kitchen chair in which he sat while she used it to lift herself up from an on-her-knees position in pain from the weight on her joints.  Okay...my recollection of the bathroom time is thus:
A) for guys, you lose sight of your anatomy. This makes peeing quite a chore due to lack of radar lock on the target. Fat guys, I know you know what I'm talking about. Leaning on the wall over the toilet helped with automatic aim. The rest of the time it was a matter of sitting to pee, which brought about two new sets of problems; seats that were too small for my diameter of butt, and constant fear of breaking the seat. It's happened. Whenever I saw broken seats, I wondered if I did it or not (and there are times where it honestly was not me).
B) I hated my wife's need for glass sliding doors on the shower. She took away the curtain, and voila'...I no longer fit in the shower. I still think she did it so she could have her own shower.
C) I despised, at the time, my wife's insistence on a jet tub. I think it's one more thing to break or have to maintain. However, this tub was big. The tub in the house where I grew up was a standard tub, and I barely fit in it anymore. Actually I could play in it by hitting the drain and letting water go down, only my tubbiness dammed the water behind me. In front of where I sat the water was gone. I'd have a full tub behind me. Then I'd lift my leg and have a flooding torrent of water rush to an equal level in the tub, and I'd pretend I was some great dam monster washing away a town in a valley. Tragic fun for self entertainment. The jet tub, though, was large. Much larger. As it happened I could only take baths at that point because this tub was actually big enough for me while I couldn't fit in the shower. The extra large two-person jet tub was actually large enough to let me sit.

Ah, the bathroom. The place where personal embarrassments are supposed to remain private whether you're fat or skinny.

Back to her story; she mentioned that people would speak slowly to her because the assumption is that if you're fat, you're stupid. She became rude so people would focus on her rude behavior instead of her weight, and she felt bad for what she imagined her kids went through. As for me, I'm sure that there were comments and rude thoughts tossed my way. I'm fairly sure part of my cynicism, my intolerance for stupidity, and several other vices were contributed to in some way by my weight. I had a thick skin develop (literally and figuratively) in large part from my weight level; I was insecure about my intelligence because I needed to be right. Being smart was my thing; I was a geek, a computer jock, at home in front of a keyboard or reading a book penned by Stephen Hawking instead of the football field, and by dammit I was good at those things. It made me fear failure (and thus makes my financial failings now, my debt, my realizations of missteps in life that lead me to worry about my debts now doubly difficult to take and cope with). I was fat but you were stupid compared to me and I was going to make sure I could claw myself above the majority of people academically because that's all I had. I defined myself by being the (unfortunately fat and) smart guy in the room. Downplay the fat, up-play the wits.

Complete strangers may think I'm a fat idiot. That's okay. Chances are that for the one reason you have to believe I'm an idiot, I've already found three or four reasons you shouldn't have been legally allowed to procreate and two reasons why you shouldn't be allowed to breath the same air as I was breathing. Yes, my mind honestly worked that fast when I caught you staring at my ginormous balloon shaped body.

What it came down to was that I couldn't control what you think. I had to learn not to mind it so much because I couldn't change my weight overnight, while most people around me were content to live in ignorance, which also didn't change overnight. It was a thought that comforted me.

In the end, she joined Weight Watchers and has lost 300+ pounds, according to this account. I had surgery and have changed many aspects of my eating behavior that has led me to a 190 pound weight loss so far with a painful several-weeks-old plateau in the 265 range and a nice dose of wallowing in a depression and whiplash from turning away from mirrors when I see my body with all the flapping loose skin.

Funny how many memories five pages in a $7 book can dredge up. I spent more time typing this entry than I did actually reading that epistle.

The next story in the book is about what it feels like to choke on a cheeseburger. Ironic?

Maintenance

I had the surgery 8 months ago. Doesn't seem that way...seems like a distant memory.

I was told that the surgery's effects will continue for a year to 18 months down the road. But seeing as it's the holidays...which can be a trying time for nerves as well as stomachs...I thought I'd reflect a little on the current state of maintenance.

As a note, I've lost about 190 pounds total. That was including the pre-surgery mandatory weight loss (the irony is still not lost on me). But for the past week or two I've been fighting a mean plateau that keeps me in the 265 pound range. The bad news is...still obese. The really bad news is...it's enough of a weight loss that I have a lot of sagging skin, making me feel like a basset hound and keeping me embarrassed enough to not show my arms (and stomach, but I normally don't show that off anyway) in public.

I keep to the same diet I've had for the most part. The big change I recently made was to cut most of my peanut butter consumption. See, I have a couple food vices, which have changed over time a little. For example I loved soft drinks. Diet Pepsi, diet orange soda, etc...the doctor said I couldn't have it anymore. Not if I had the surgery. No bubbly stuff.

Begrudgingly I gave them up.

Mini donuts and brownies? Rich, think, cakey brownies? Gone. Pumpkin pie? Gone.

Even my Chef Boyardee I last had as a puree' shortly after the surgery...not since.

Jiminy jilikers. This is getting depressing.

Two things I didn't really give up; cheese, and peanut butter.

The problem is that I slide the slippery slope. I liked peanut butter. I indulged in peanut butter. I had too much peanut butter. It's a high calorie "slider food" that when not careful will add to weight. I wondered if that contributed to my plateau.

So now I have salsa on my broccoli instead of PB.

Let me tell you I preferred it a LOT more the other way. But hey...if it means taking off more pounds, I need to cut back on it. I have a taste on a piece of it or two and that's it. But in the afternoon, I have a little bowl of broccoli with salsa.

Snacking? Yeah, I do that. Apples and bananas. More expensive, unfortunately, but it is more healthy and relatively lower in calories.

Cheese? I have 2% cheese. A couple slices on my meals. That comes to 100 calories per meal. When I look at my pre-packed lunch/breakfast/dinner, I have a tortilla from Azteca (190 calories), cheese (100 calories total), plus a couple slices of thin-shaved meat (turkey or ham) and either some tomato sauce or salad dressing rolled up with a little bit of mushroom to add bulk. So I'd roughly estimate...350 to 400 calories? 1200 a day from meals? Plus my apples and bananas I wouldn't be too surprised at a 1500 calorie to 1600 calorie day. I don't think that's horrible, but I'll have to wait and see what happens with the plateau now that I've cut out 90% of my PB intake.

I still exercise to cut (according to the computers) 300 to 500 calories or so. I haven't been to the gym as much lately; I have tried making up for it on my recumbent bike. I've had a lot of other things to do with the holidays and family and whatnot, so it's just been a pain, especially as the weather gets colder, I'm learning the ropes of a coal stove for the first time, and it's freakin' dark by the time I get home from work, making it harder to get my butt out there. Excuses? Yes, I know, but to a degree justified. If it were a top priority these excuses wouldn't stop me.

The truth is that I have trouble finding the motivation to go. I don't have a trainer. It's not exactly a bit hurrah to go to the gym; it's not a rockin' place. It's hot, sweaty, and I'm never sure if I'm doing anything right with the freeweights.

Pain. In. The. Butt.

That said, I do still go. It's just more of a drag for me than when it was sunnier during the late afternoon.

So that's my progress with maintenance. Stuck in a plateau, depressed at the holidays and riding a recumbent as I type this, about to check once more if the coal stove is getting up to temp after having to refill the coal bed. Quick note to self...coal fires really like big deep red-hot coal beds. Let it get too thinned out and it'll die quickly, heat and firewise. And that sucks.

Until next time...feel free to share your dieting stories for maintenance and challenges to that weight!

Exercise And TV

The diet-blog has an article about a Fun eXercise Bike, or FXB, for your Nintendo Wii. Basically it's an exercise bike that interfaces with video games, an example they cite on the Amazon site includes Mario Cart.

The Diet-Blog site blasts it because it's an "excuse to spend more hours in front of the TV screen in the name of exercise."  From the posting: "What ever happened to fresh air and riding real bikes outside? Why does every aspect of life need to be centered around the magic glowing box?"

I enjoy riding my bike outside. But I also enjoy my stationary bike, and have put far more miles on it. Why?

A) Weather. It's bloody cold out there right now. And the weather in here is pretty stable, thank you.
B) Hassle. I have to pack my bike to drive somewhere and ride it. There are hardly any bike trails in the area, and riding on the road guarantees that at some point I'm going to get hit.
C) Information. Stationary bikes are pretty good at tracking speed, distance, and probably aren't terribly off in their calories burned ratings. Pony up more money for a bike computer and get it set properly and you can get more information from your regular bike too, but it's still more hassle.
D) Maintenance. "Real" bikes take "real" maintenance. I don't remember having to clean and mend a chain on a stationary bike. Or clean it. Or scrape dog crap off the tires before putting it in the van.
E) Routine. I need routine. I crave routine. Biking outdoors means commitment to riding in rain, snow, sleet, wind, hail...unless you change that routine. Biking on a stationary bike? Not so much. I can count on my stationary bike being ready to go when I am. My regular bike needs to have tires checked, and the weather can't be in the 90's or in the 30's. Sorry, I'm just not that hard core.

So is there something wrong with this Wii bike? I don't think so. It's a way to encourage exercise, and it costs $99 while my regular "real" bike was around $400, and "real" bikes can easily run into the thousands (I'd love to try out a nice recumbent bike sometime...)

We live in an age where exercise is artificial. People in gyms are pumping hunks of iron, steel and aluminum and riding fake bikes and walking and running on treadmills that go nowhere. There are people who decide to get up and "go for a walk" to get exercise during the week.

In the past, people were "pumping" rocks and lumber and carrying crops and food for animals. They walked because it was the only way to get from the house to the store and back. People didn't set out to exercise. They didn't have a bloody choice in the matter.


It used to be that exercise was a side effect of trying to survive. Today it's a scheduled activity. Why complain about what form it comes in as long as you get the exercise?

Holiday Eating: Before and After

Wow...seems odd to see how the time and gone recently. It's been a very busy week and a half...two weeks? I can't even remember. Perhaps the word "hectic" is more apropos.

I have relatives come up to stay with us for several days over the Thanksgiving holiday. And then there was a family "Christmas dinner" this weekend, so relatives came and stayed with us for another weekend, and I'm well aware that with Xmas rapidly approaching we're going to have yet another round of playing "check off the list of crap to remember." For someone with my mental balance, both from Asperger's and stress, this is a trying time of the year.

But I thought maybe it would be a good idea to review some of the changes I've found since my surgery related to my diet. This time of year, the November/December Thanksgiving/Xmas seasons, are the hardest time for people with dieting issues. This is also a time where people tend to feel more able to shrug off their eating habits because come New Years, they can just promise themselves they'll work it off as yet another resolution. Stuff yourself with stuffing and turkey and gravy and ham and cake and pie and...the list goes on. Tis' the season, after all!

But it's not that way for me. To be clear, at this point in my surgery journey I could probably try a little of just about everything without much dire consequence. Because of my need for rigid routine, I don't normally indulge in such things. I stick to my favorite routine meals; wraps containing some turkey and ham with mushrooms and cheese are my biggest staples, along with my peanut butter on broccoli. I had a modified wrap for Thanksgiving; I put some stuffing in the wrap instead of mushrooms. It was a holiday indulgence.

What was Thanksgiving like before? I'll admit I missed it. I wanted to have huge helpings of stuffing, my favorite holiday treat. I wanted a slab of turkey, the double portion of pumpkin pie (a favorite of all time on my personal list of awesomeness!), and even topping it all off with that so-disgusting-it's-yummy gel-blob cranberry sauce. Mashed potatoes? Pile it on, along with a squirt of ketchup. Yes, I think it tastes good. Leave me alone.

Ooh! Is that a basket of soft, ooey-gooey fresh from oven rolls? Pass the butter! And I'll have a liter of Diet Pepsi, please. And another roll. Corn Pudding!? YES! I'll have a spoonful or three, thank you.

It sounds like so much now. Maybe it was. But it was Thanksgiving and I enjoyed the hell out of it.

This year? I smelled the aromas and indulged only in some stuffing. I had that stuffing in a single serving of a wrap rolled with a couple thin slices of turkey (from a box of turkey bought at Sam's Club, not the bird carved on the counter) and a slice of cheese.

Yesterday was a family dinner from someone on my wife's side of the family. We traveled two hours to have a get together in a Masonic Hall where there were wonderful smelling cakes and pies, meatballs of various kinds (I love...loved...those things). All sorts of little goodies.

What did I have? a standard wrap from my recipe box and a lot of the broccoli, apple slices, baby carrots and cheese cubes. I even went out for a walk during the dinner to see what the town was like because I wouldn't have enough time to go to the gym and I was feeling antsy to work off some of the calories. Did I overeat? Probably to some degree, with the cheese. Nothing hurt. Nothing "backed up" or made me ill in some way. But I did have more cheese than I should have and I tried to make up for it.

Now we'll have a slew of Xmas dinners coming up.

So if you're a bariatric patient or prospective patient, how will things change? This is my first set of holidays with a "new digestive system", and I am more nontraditional in that I avoid trying all sorts of foods most of the time. I opt instead to keep a fairly routine diet that helps establish a routine, so your mileage may very if you do this. I can only tell you what has happened to me and how my choices have affected me.

These dinners were hard. I'm not a sociable person; I find personal interactions to be hard to cope with and seriously tiresome. But the one thing I did share with everyone was the communal meal experience. This year I had my wrap, finished it in five minutes, and got to watch everyone else slurping down their taters' and turkey. I smelled the stuffing. I watched my son slurping down little meatballs sliced in half, dripping in that delicious sauce that they bubble and glurp in the crock pot for hours.

It wasn't easy. And it makes me feel more of an outsider.

I did get some benefits. For example, I went to work the next day with a small container of mashed sweet potato and a cut up banana for breakfast. It was a change of pace that tasted very good (sweet potato has a wonderful ability to taste an awful lot like pumpkin pie filling when done properly).

Previous years would have been meals filled with multiple servings of mashed potato, stuffing, and rolls. Impulse grabbing of yummy goods. This year the closest I had to impulse grabbing were some cheese cubes and stuff from the vegetable and fruit trays.

Last year would have been a lot of lounging. Watch TV, eat more, snack...have pie. Lots of pie. This year was some TV, small wrap for Thanksgiving dinner, and at the Xmas dinner I had my wrap, too much cheese and broccoli, and then went for a walk. On the way home my wife and her family went to Kohls to feed their shopping habits while I went out on an excursion by foot to get more exercise (I was too narrowly focused to have found the crosswalks to get to the Wegman's to find some broccoli I needed at home, or a Sam's Club to find better deals on broccoli). I must have walked at least a mile, maybe two, altogether that day. Last year I'd never have considered trying to get some exercise in to help compensate for a meal.

I don't know if I did well or poorly in terms of not gaining the pounds. Lately I've been plateaued around the 265 mark, meaning I lost around 195 pounds. My feeling on how these dinners went...I have not been obsessing over the meals, so I take that as a knee-jerk evaluation that I didn't do horrible in my indulgences. Mentally I feel as if I were left out of some things and I truly have missed being able to dig in to a giant plate of food. Part of me wanted that old habit back. On the other hand, the big scar on my abdomen reminds me that doing that will leave me seriously ill and/or in pain.

So I have my wrap and I try to focus on other things to take my mind off the ooey gooey goodness that I am no longer allowed to indulge in. My impulse eating is limited to fruits and vegetables and some occasional cheese cubes. No dressing/dip though. Might have something in them that could make me ill.

Anyone else have similar dieting experiences in these times of holiday mirth and gluttony?

Movie Theater Snacks

The diet-blog had a quick blurb about a study from the Center for Science in the Public Interest that states that (are you sitting for this news? Of course you are, you're reading a blog entry...) theater snacks are not healthy.

I know, it's shocking.

Basically the study drew one comparison thus: could you stomach three McDonald's quarter pounders and 12 pats of butter?

That's what you get with a medium popcorn and soda combo from Regal. At least, nutritionally they're approximately equivalent in calories and fat. ~1,600 calories and 60 grams of saturated fat.

Before my surgery I'd have had to ask if those quarter pounders had cheese or not...ha!

Anyway, this caught my attention because I recently sat through that 2-hour comedy "Twilight" with my step daughter and her friends, so movie stuff with the food angle catch my attention since I'm always reminded of the food habits I've given up since my surgery. Nowadays, not too surprised that one movie is filling you with most of your daily calorie requirements.

Of course I don't get much at the theater anymore. I've had a few of the pretzel bites from a larger theater when we've gone; a few of them aren't too bad, I can't eat more than four or five of the bits, and we rarely ever go (I think it's been months since the last movie we saw as a family, I can't remember which one it was) so having a couple of the pretzel bites are a treat. But going to the theater is just too expensive. The article noted that the combo costs $12, and it's really no secret that you're paying a premium for food that is Sam's Club-econosized with a hiked up price when you eat at the theater. Theaters make their money from snacks and then they whine when profits go down as people can barely afford the tickets, let alone the three dollar water.

Back to the point...today, I rarely go to the theater. When I do go, normally the only thing I have in my stomach is bottled water. Food there is overpriced and calorie heavy, and I try giving myself some solace in that fact when I mourn that I cannot have these things anymore (I absolutely loved Reeses Pieces or Twizzlers when I used to go to movies).

I know...it's a heretical thing to suggest, going to the movies without buying a tub of 'corn and the candy and the so-big-small-children-can-drown-in-it soda. It's part of the theater experience. Unfortunately it's also a reason that theater seats are rubbing our thighs while trying to watch two hours of sparkly vampires.

I guess my stance is that I've had to adapt to not getting all those fun things at the theater when I do end up going. Miss it sometimes, so maybe it's retroactive justification, but you do what you have to do. Anyone else change eating habits in light of economy or nutrition information about theater foods, or do you continue with what you've always done?

Plateaus Suck

For the past...oh, two weeks or so...I've been plateaued. I'd have to look at the numbers as they're listed, but for the most part I'm between 260 and 270 (I think I've actually been hovering around an average of 264/265 pounds), so I've lost somewhere in the range of 190 pounds.

I hate it.

Plateauing sucks. It means that I'm doing something wrong. I know that the formula is simple...calories in, calories out...so my broccoli and peanut butter habit is probably what is tipping this. The doctor (bariatric surgeon) said that this would happen (unless I've finished losing the weight, reaching my stabilization point); the body would lose weight, stop for anywhere from a couple days to a couple weeks, then start falling again until it hits another plateau.

So I've either leveled out or I'm plateauing and the only way to tell is...you can probably guess...wait. A weight waiting game. It's such a fun game to play, too. It's almost as much fun as being on of the last two people playing RISK and you're the guy with one country against the jerk that possesses all the other territories and just got his 200 armies to add to what is surrounding your one lousy territory. And it's his turn. And he decided to quit attacking after one roll because he's having just too much fun being a jerk.

But I digress. I don't understand the mechanisms behind weight plateaus. The venerable Wikipedia talks about this principle in vague terms of being regarded as a sign of weight loss success, and the only way to break it is to increase exercises and/or decrease portion sizes further. Ugh.

Fortunately budgeting issues gives some reason to further cut back on portions anyway. I can probably tweak my "food pellet" formula to include fewer things so that I don't need to purchase some of my habitual staples anymore, thus help curb our spending at the SamClubMart. You know...broccoli can be cut out, peanut butter, those alone should save twenty or thirty bucks a trip. Maybe cut out the peanuts, that's another ten bucks. Don't use tomato sauce to flavor the wraps anymore. That's another what...ten bucks or so? Maybe cut out some of the cheese and meat to make supplies last longer. Those things should help reduce the bill a little while reducing caloric intake.

The problem is that it takes what comfort I've become accustomed to in my routine and throws it into a bit of a tizz. I'll adapt, no doubt. I won't like it. Hopefully I'll find some other reason to enjoy something beyond my current schedule of trudging to my stressed out job during the day and coming home to look forward to the next day's rigorous schedule of...more work. What escape I had in my meals, small as they were, far smaller than pre-surgery, will just be a little...less. Again.

Cest la vie.

With any luck within the next couple weeks I'll break this plateau. When I do, it'll be more progress to report. Or I'll at least have broken out of this funky feeling...maybe it's just the joy of the holiday season getting under my skin.

Calories and Obesity

I've said before that losing weight...or anything to do with weight, really...is a matter of calories in and calories out. Eat more calories than you burn, you gain weight. Burn more calories than you eat, you lose weight. Pretty simple once you average everything out.

The diet-blog just had a posting that strikes me as one of those "Well, duh..." moments.

Some researchers apparently tried to figure out what we should weigh if obesity is tied to overeating alone, not activity level. Seems that the logistics were fairly simple.

Choose a time in the past where obesity wasn't considered an epidemic and we have data on eating habits of the population. In this study, it was the 1970's.

Next figure out how many calories you need to live. Another term for that is BMR, or basal metabolic rate, although it's not mentioned in the article.

Then compare food data of consumption by the population, average it out, and figure out how much people would gain at those calorie levels. The conclusion?

From the article:
Comparing the theoretical and actual figures demonstrated that children's weights had increased by exactly what would be expected from the increased food intake alone. Adults had put on slightly less weight than the extra food would have indicated (8.6 kilos heavier instead of 10.8). 

That would imply that people have, on average, been slightly more active than in the past. We're simply eating too damn much.

How? This isn't in the study but based on anecdotal evidence, I'd venture a guess that our food today tends to be more processed and in larger portions. Processed and pre-made stuff is often loaded with sugars, fats, and sodium to enhance flavors and textures. Couple this with an increased average portion size and it all adds up.

As crass as it sounds, the reason we're fat is because we eat too much. I've seen more blurbs on exercise (and tried doing the math as well) that shows that exercise alone, while a boost in health benefits, isn't a diet plan. When you have to work out an hour to get rid of a plain McDonald's cheeseburger, you'd have to dedicate hours of work, hours most people spend doing things like getting a paycheck, to burn off that extra helping of dinner before dessert and the cheesecake you had to have at Starbuck's yesterday. Or even to make a dent in the one meal you had at Applebee's.

People will hammer home that exercise increases your metabolism for longer time afterwards, that when you eat affects how much is burned, etc etc...do some research on calories and calorie burn and BMR. Start doing the math. While not exact and there are variables, the average will level out to show that really the biggest influence is how much you put in your mouth.

Ten minutes with a burger, or an hour on the treadmill? Which do you think would save you more time for the calories?

Holiday Eating

Happy Thanksgiving, US residents!

Holidays are here, and with it another reason to overeat. Holidays are tough. For those of us having to adjust to new portion sizes, holidays are no longer the excuse to overeat that they used to be. Normals splurge occasionally and because of their lifestyles, the weight evens out. If post-ops overeat, we're talking pain, quick visits to the toilet, or violent retching. Not fun.

I'm spending time with my in-laws and my parents (as well as my own family, of course). We're all packing into a van and heading to my parents house for a turkey and the trimmings.

I'm well aware that we're supposed to be able to eat "normal" food, with the exception of maybe the pumpkin pie, as long as it's in moderation. I don't like that because I simply suck at estimating portion sizes. As a result, I'm sticking to my original plan; I'm taking a tortilla and some turkey slices and I'll stuff it with some stuffing. A Thanksgiving Wrap, so to speak. If I find some sweet potato maybe I'll put that into the wrap too. I've found that the wrap is pretty good for making acting as a natural portion limiter. I'm sure it'll draw some ire from those around me because it's not traditional. I'm used to the looks and the dirty thoughts. I try not to let it bother me anymore. I'm doing this because I know what works for me. If I start partaking in the old ways, I just know that I'll gradually slip into overeating again. I don't want to worry about that.

New foods? I still have to be careful. It appears that even innocent things like trying a small Sam's Club sample of chai and a bite of a glazed ham slice on a toothpick was enough to trigger digestive upset (I noticed after the fact that the chai mix at Sam's Club had sugar as a primary ingredient...surprise!). So mixing up foods at a family event is not something I really feel like experimenting with.

The point is that holidays are hugely focused on eating as part of the ritual, and for some people it's a really bad idea. These type of holiday events encourage overeating. Normals may not have a problem with this. Some people like me will have to stick to our guns even if it means looking weird at the table eating prepared foods. I've worked too hard and suffered too much to give up now just because it upsets someone who doesn't walk in my shoes and wear my floppy excess skin.

Good luck to any post-op reading this, I bid you the best in getting through the holiday time. Find something to be thankful for to get you through these wonderful family gatherings without wanting to curl up in the corner and cry. If you can't, at least be courteous enough to stay out of my corner...

Biggest Loser: Truth Edition

Does anyone really watch "reality shows" and expect them to be an honest depiction of what's going on?

The Living at 400 Lbs blog has an article regarding a New York Times piece on The Biggest Loser, the show about overweight people who compete to lose weight using restricted calorie diets and six hours of exercise a day. Quoted in the article is a bit saying that they can lose up to 15 pounds in one week.

Holy Schikes!

I'll admit I never watched the show. I do know that there are lots of books babbling on about how wonderful the Biggest Loser Diet is supposed to be.

But come on...

These people are overweight due to a lifestyle. Suddenly a month or two (however long they're taping the show) of severe calorie restriction and 6 hours a day of exercise is going to set them right? Who lives like this that isn't already madly in shape because they're some kind of fitness expert or trainer (or soldier, maybe...)

The piece also says that in the first episode of the current season two contestants were sent to the hospital when they collapsed from heatstroke on a one-mile race.

When I first had the surgery, I was barely able to walk a mile. How could a group of fat people just start off on a one mile race without any practice or training and expect not to have repercussions?

A quote from the article:
The Times also quotes the waiver contestants have to sign to be on the show, including that they believe themselves to be “in excellent physical, emotional, psychological and mental health.”


Okay, there are some overweight people that may not have mental health issues. Broadly speaking, though, I've found that most people are overweight due to other issues. Addictive personality. Depression. Self-defense mechanism. Something more usually underlies the need or desire (or habit) of overeating. Again, not in all cases, but it's there. That makes this waiver utterly ridiculous. Furthermore, these people are on a show for overweight people to lose large amounts of weight in a competition...and they're certifying that they're in excellent physical health?

Is there anyone that can plead a case that this isn't a joke? I don't see how this could be a binding agreement this side of the reality barrier.

Slider Foods

Lee had mentioned slider foods recently. I don't have the reference handy or I'd link here, but I remember him mentioning that it was a new concept to him.

I haven't really thought about it, but I knew about them. Slider foods hold a special place for bariatric patients. Basically they're foods that go through the pouch pretty quickly and with little digestive effort; they go down and through easily, with very little side effects for us. Well, for the most part.

Example slider foods: pudding, yogurt, cottage cheese...you get the idea.

I've been having a half-slider food. I love having broccoli with peanut butter. It's an odd combination (but don't knock it until you try it!). Peanut butter is healthy in many ways, but probably is a slider food because of its consistency and texture.

Unfortunately, it's yummy, and high in calories. As are most slider foods. That's why they're special for bariatric patients...it's a way to cheat the diet. These foods slide through the pouch without necessarily making the post-op feeling full.

If you're lucky, you still get the negative reinforcement of a dumping effect depending on the food. If you're foolish enough to have pudding that's not sugar-free or eating sugared ice cream...there better be a clear path to the restroom. I'll leave the rest to your imagination.

I've had to watch my peanut butter obsession. Lately I've been plateaued...is it biological? Metabolic adjustment? The peanut butter obsession? I don't know, but I do know that if I start sliding the wrong way on the scale for over a week then I need to make drastic changes. As it stands I'm trying to slowly adjust my PB&Broccoli obsession to reduce caloric intake more.

So that's the skinny on slider foods. Apparently there are bariatric patients that either don't know about them or forget. They're quick calories that don't tend to stretch the stomach and usually taste sooooo good! A little is usually okay. After all...for weight loss, calories are king. So keep an eye on calories and you should be fine. Unless it has sugar. Ew.

You're Too Fat. No Diploma!

This was interesting. Apparently Lincoln University in Oxford, PA (USA) now requires students to have a BMI (body mass index) of 30 or less or they have to take a one-credit health course.

Apparently this is the first class for whom the requirement means if they haven't fulfilled the requirement from their freshman year, they won't graduate, and nearly two dozen seniors fit that requirement.

My personal feeling is that if you're going to college to specialize in a career, why do you need to have a requirement that has nothing to do with the career? Worse, why is it focusing on fat people to tell them that they're unhealthy? Are normals honestly so stupid that they think fat people don't know they're tired, short of breath, unable to walk well, or any of the other host of fat-related problems are because they're fat and unhealthy?

I find it to be stupid in that they don't encourage this policy of forced behavior through requirements on no smoking, or undereating (bulimia/anorexia), in addition to the you're-too-damn-fat requirement.

Maybe they should force a particular religion (or non-religion) onto the students as well. After all, studies have shown some evidence that spirituality improves the quality of life for students, and if you're going to preach the gospel of skinny to students why not also throw this in for good measure, since the justification for telling students that they're too fat is that it affects their quality of life?

Burger King Sued Over $1 Cheeseburgers?

I just saw this post at the Diet-Blog claiming that Burger King franchisees are suing the headquarters for forcing them to sell double cheeseburgers in a promotion that has them selling at a loss.

Apparently they will lose ten cents on each burger, while Burger King corporate believes that this will drive up patronage by %20, meaning more sales to cover the loss.

I'm torn here, perhaps because our local Burger King has rarely managed to even get our orders right to begin with. My family is still very big on fast food and we'd probably go there far more often if that place could actually get one @#% order correct. As it stands it's good exercise because we go to the drive through and end up having to walk in to get what was forgotten, missed, or given to us by mistake. To my recollection it's the only restaurant in the area we've ever actually called and complained about to headquarters...so part of me thinks that if the restaurant offered a better experience, they wouldn't need to rely on the give away the razor to sell the blades loss-leader sales gimmick. Oh, and there's the creepy King mascot, too. That can't help much for sales when kids have nightmares about the face of your product.

But that's my opinion.

I can see the corporate headquarter's gamble here. Lure customers in, hope they have a good experience and bring friends or come back more often. Kids can come hang out and keep buying stuff like soda and french fries which are crazy profit drivers.

Franchisees are probably scraping by in the tougher economy. They don't want to risk something that cuts into thin profit margins (I'm guessing, since I do know that the soda and I'm guessing fries are big profit, while other things aren't so much). If attendance is down then this is a risky gamble for them.

On the third hand I rarely see fast food as being good for you at all, and don't really weep when people can't get their grease and sodium fix. If people just aren't interested in your product and you fail to deliver a good experience, like our local BK consistently has done to us, then you quite frankly deserve to fail and drive what little loyal patrons you have to give their money to other, better businesses.

Burger King is still a large corporation that will no doubt find equilibrium before they sink. While the recent events with the economy have proven that no one is too big to fail, it also highlights that corporate scum will continue to make due, given the number of businesses that have laid off and fired workers or have been driven into near (or total) bankruptcy while at the same time giving their CEO's millions of dollars in bonuses. If the King goes bankrupt or closes some restaurants down, then the market has spoken and we'll have a small rise in the number of teens without slacker jobs for awhile, until someone else takes up the slack with a restaurant of their own (or a new franchise opens up). If not then this is just going to be another blip on the radar for people who care about this sort of thing.

Burgers and Donuts?

There are times when I miss being able to indulge in oddball foods. Take a look at this Donut Burger.

I know...disgusting, isn't it? It's only 1,500 calories. A bacon cheeseburger with a glazed donut instead of a bun. I'm repulsed and intrigued at the same time.

Alas...trying it could have repercussions with my modified stomach, so I'm forced to admire the photograph and not try it in real life.

The web site "This Is Why You're Fat" has all sorts of food that I have, at times, wondered if their concoctions taste good or not. Most of the items photographed are things that I think would have been right at home in my stomach during my college years.

One thing featured recently was Velveeta Fudge. As it happened I talked to a coworker who actually HAD that. He said that if you weren't told it was cheese fudge you'd never had known. Apparently the fudgy sugar mix was enough that you don't taste the cheese. That made me all the more curious.

I don't remember coming up with any really "weird" food combinations, although there are people who are repulsed that I put ketchup on eggs and mashed potatoes. Two separate dishes. I don't put all three together at the same time.

What's the weirdest food combination you put together? Anything adventurous?

The Hacker's Diet

Before I had the surgery I had studied as much as I could as a layman to try to figure out how the body and weight loss were related.

I try to take a common sense view of the body and how it works.

First, weight is comprised of the contents of your body. Makes sense. You stand on the scale, it's measuring the force of gravity on the contents of your body. Your bones, muscles, organs, fat, hair, clothes (if you're wearing any), all of that has a downward force on the scale due to the force of gravity. What you're trying to minimize is the excess fat in that body; the hard part is telling how much excess weight is from fat and how much is the water, food in the digestive system, water in your bladder, etc...

That is part of the reason that part of many dieter's rituals include weighing first thing in the morning after doing the morning duties in the bathroom and before getting dressed for the day. They're minimizing the effects of the "extra" weight in the body.

Second, you don't generate your own fuel. Food is fuel, and the fact that we eat food to stay alive is a good sign that sunlight alone doesn't cut it. The vast majority of life on the planet derives food from sunlight thanks to plants, which, through photosynthesis, convert sunlight to sugars and carbohydrates which then is eaten by other animals which then are eventually eaten by us. Or we directly eat the plants.

The point? We don't absorb food through our skin or the sky. We eat it.

Nothing magical about it. Our bodies fuel themselves and gather raw material for repair and growth through our food.

There had to be something to this. As much as we wished there was a simple formula that would allow us to eat all the donuts we want and still maintain our girlish figures it simply isn't true. Spicy foods speed our metabolism? Maybe, but not enough to eat that eclair. Exercise? Average exercise for an hour seems to burn off about a single McDonald's cheeseburger, 300 calories. At most probably a double cheeseburger. I'll tell you that for me riding a recumbent bike for about an hour and a half to two hours at around 7 to 8 miles per hour, according to the bike's computer, burns around 700 calories. It's not a lot when you consider that the average sit-down meal at a restaurant is easily 1000 to 1500 calories (or more, factoring in the starters and accompanying cheddar bay biscuits or breadsticks...)

But despite the fancy claims and various diet fads, it comes down to calories in and calories out. If you have 3,500 calories more going into your body than you expend the body will store it as a pound of fat.

More than what? Your Basal Metabolic Rate, which is the calories you burn just by living. Your heart beating, your brain just working, body keeping your temperature regulated, even your digestive system all take calories to function. If you woke up and sat on the couch all day, your BMR is the calorie count that would be burned by you not dying.

Burn 3,500 calories above that, you gain a pound. Burn 3,500 calories below, you lose a pound. Burn about even, and you stay at that weight level.

There are always variations based on metabolic rates and such but overall you can get a rough idea from the various MBR calculators online like this one. And again, as much as you'd like to think otherwise, your metabolism isn't going to account for why your friend can consume half a pizza and "not gain a pound". Chances are pretty good that if you kept a food diary and activity diary for that friend, you'd find that they aren't eating as much in snacks and other meals so it all evens out for the BMR.

This makes sense. Why? Because you don't absorb food from other sources. Your body can only hold what you put in; water and food, which you expel through heat, sweat, and excretions.

"But if you cut back too much, you go into starvation mode and your body will gain weight."

Neat. I don't claim to fully understand how the metabolism fully works, and I do know that your body will do certain things to conserve energy when it is low on fuel. But it's conserving energy. You become tired. Lethargic. It shifts the source of energy to fat stores instead of quicker burning sugars, going into a state of ketosis. If you continue to lower your calorie intake you'll start burning proteins in things like your muscles.

But the logical part is that you can't gain weight if the food just isn't there. Remember? Energy put into your body is all it can work with. When was the last time starving people carried a stereotype of someone who wasn't rail-thin? Their metabolism would by definition be in starvation mode. What it does is lower their energy use (lethargy, etc.), but it can't make you gain weight unless you take in more calories than your BMR is burning.

If this sounds like an engineering approach to the problem it is. I found a book on dieting that was perfect for my Aspergian mindset; John Walker, founder of Autodesk, co-programmer of world-famous AutoCAD, was overweight and decided to approach the problem as an engineer should. He applied logic and math to the problem and wrote about what he found.

And it boiled down to common sense.

The result was The Hacker's Diet. You can still download the book in various forms for free from the link I provided.

The book breaks down dieting into some very basic points, and none of them should be any surprise. Calories in equals calories out. There is no magic diet plan. Exercise is a supplement that is healthy, but not a dietary fix. Monitoring your intake and adjusting accordingly will lead you to a healthy weight level (and studies have shown that the most effective weight loss results over a long term tend to come from people who keep food diaries!)

The book is a fairly easy read. Take a look, see what it has to say. When it comes to minimum "magic formula" and maximum straightforward logic, the "rubber bag" analysis of the body makes a lot of sense. See what you think by clicking on the Hacker's Diet link!

UPDATE: A link to Jeff Atwood's (of Stackoverflow fame)  blog post about techie dieting...which also happened to mention the Hacker's Diet.

Food Workers Spitting in Your Food?

I was reading an article about being choosy about the restaurants you visit. The author had been on the receiving end of food poisoning. The gist of the article can be summed up thusly: If the bathroom is dirty, the kitchen is most likely filthy as well. Leave. Quickly. Or risk having a big plate of contaminated food.

On the surface this is just good advice. Heed the advice and you can feel better knowing that the Red Lobster you're eating in is probably not going to give you food poisoning. Or at least the chances are no worse than they would have been if you made the meal in your own kitchen.

But coincidentally I ran into this link regarding restaurant safety as well. The information in it was not pleasant to read. I hope the link is still good if you decide to read it.

For some extra information on that link, it goes to a site called Reddit. It's a site where you normally find websites linked to and commented on; different user vote stories up or down based on how much the enjoyed or hated the story. If something is big and full of buzz, it's normally at the top of Reddit.

But there's also a number of "comment" posts that people can enter, where they ask questions or ask for advice. If it's voted high enough it travels up the list to the top and other people find it and it draws more comments. That link was one of them asking whether people in the restaurant industry have or know of people spitting in the food.

The comments are...well, disconcerting. The concensus seemed to be (at the time I read it, which is a disclaimer since the questions can be edited and altered as long as the story exists on the site) that it does happen, primarily to customers that were real pricks to the staff. It wasn't a common everyday occurrence but it happens.

And there were cases where some employees just did it to do it.

Spitting in food. Stirring drinks with male anatomy.

Some said there were non-"dirty things" that were standard procedure with many restaurants and could make your skin crawl. Example: dropped chicken wings on the floor, the cook scooped them back up and dropped them in the fryer. "The dirt and bacteria are all cleaned off by the heat". I remember seeing that in a documentary about a restaurant, so I know that the comment isn't all that far-fetched.

Thinking about it is one of those things that gives me the heebie jeebies. I won't be able to go into a restaurant or fast food joint without thinking about it.

There are many things we ignore or conveniently tuck away into the recesses of our minds because the "truth" is rather disconcerting and uncomfortable. Examples: where your hamburger comes from. The truth behind the top one percent of the population having eighty percent of the wealth. The odds of you actually winning at the casino or lottery (probably not all that different from each other). Even the number of people that die every day on the streets in car accidents, or the number of people that are driving while distracted by their cell phones, texting, or reading a freakin' newspaper behind the wheel.

So how are you supposed to react? Shun all the things that a modern society gives us because of the risks associated with using these conveniences? Or just file these things away and suspend the knowledge that these things are happening?

Milk; It Does a Body Good, but Not That Good

Interesting post in the Weighty Matters blog post about the milk industry's claims regarding milk and the ability for it to help you lose weight.

I've heard the claims about milk helping you to lose weight. It was another one of those "read it a few times and filed it away" things I do.

The thing is that milk, like any other large industry (oil, restaurants, tobacco, corn,...anyone with a lobbying group wooing your congressional representatives) has their own media spinners working hard to get you, Joe Sixpack, to know just enough to associate their lobby interest with rainbows and gummi bears when you hear about their interest. They spend a lot of money on public relations companies. to get their message out there to influence you.

And it works. After all, I just said that I had heard about milk=weight loss. I don't know the mechanics, but I've heard it. They took some one-off research and turned it into a sound bite for public consumption.

The thing is that I've been stuck in the weight-loss treadmill long enough that when I look at this I see the whole thing for what it is. A sound bite for advertising their product.

As I've said before there is no magic bullet for weight loss. If drinking vitamin Yellow 13 made weight melt off or swallowing tapeworms would allow us to eat whole pizzas and maintain a perfect figure we wouldn't have an American continent that is slowly sinking into the ocean under the weight of its inhabitants. Okay, it's not really doing that. But you get the point.

Weight loss is simple in idea. Calories in greater than calories out, you store them as fat. Calories in less than calories out, you lose weight. Day to day weight varies with water retention, salt intake, biomatter in your digestive tract, etc. but averages out to your rough body weight. Weight loss "systems", if analyzed, are really just screwing with your short term caloric intake (for the most part) or giving you some "tool" for cutting down your caloric intake without thinking of those dirty words "caloric intake".

Summary: you eat too much.

Milk has fat and calories in addition to good minerals. It's not a "bad" food. The fat in it probably screws with your satiety level so you might feel fuller than you normally do, then you don't necessarily eat as much for the meal...that's possible. Fat does that. Real fat makes you feel more full so if you happen to be one of the tiny percentage of people that pay attention to how the stomach feels instead of how full the plate is then you shave 20 calories off the meal.

Is that a dramatic enough difference to justify saying it's a diet miracle food? I don't think so. I've heard similar claims about vegetables, soups, and spicy food. It still doesn't negate the fact that these things have calories and people are mostly fat out of habits, not "good food vs. bad food." These claims have a teeny tiny kernel of truth that makes the claims just good enough that you can't sue their cheerleaders paying the PR firms to tell you about them.

I'll start believing these claims when I can eat their wonderfood and then a whole pizza for a week straight and not gain any weight. Otherwise it's just another miracle cure magic bullet packaged for public consumption.

Exercise Alone Doesn't Help You Lose Weight?

It seems that there is more research buzz pointing in the direction that exercise isn't as big a factor in losing weight as people are led to believe.

The first time this splashed on my radar was from this article in Time Magazine. The author was getting virtually speared online by various pundits and squawkers for suggesting that exercise wasn't a panacea in weight loss, and worse, may actually contribute to weight gain (I exercised a lot today, so I deserve this donut!)

So you can imagine my surprise when I found this article on the diet blog saying that exercise alone won't help you lose weight. Funny enough this article references the Time article, but goes on to cite other recent work that indicates that exercise is a marginal influence on weight compared to your diet.

I've suspected this for awhile. It's not just the BS that gets spread around by gym rats like, "You're heavier because muscle weighs more than fat!" and evidently forgetting that a pound is a pound, no matter what you're weighing, and that in order to actually gain muscle a person has to be eating a surplus of calories to gain building material in the body from which to build more muscle.

I also suspected it when I found out that fat burns only about four to six calories less than muscle per pound. If you replace five pounds of fat with muscle, your body will metabolize only 30 more calories a day at rest. That's a slice of 2% cheese. I vaguely remember having touched on the topic before.

And remember, to build muscle you need to increase your intake of food. Food fuels you but it is also the supply of building material from which your body grows and repairs itself. That means you need to monitor your calorie burning while exercising to make sure you don't have a surplus in calories leading to weight gain, which in my case would be counter productive!

I suspected exercise wasn't a huge key in weight loss again when I found that walking an hour on the treadmill at between 3 and 4 miles per hour would usually lead to an estimated calorie burn of approximately one McDonald's cheeseburger. Not the meal. The burger. Plain cheeseburger (which is 300 calories, by the way). This isn't much of a dent when people snarf double cheeseburgers in two's.

One hour on the treadmill and all I can get for it is a single cheeseburger? Ouch.

Of course some of the gym rats will say things like, "Exercise revs up the metabolism for an hour or two after you exercise, so you lose weight that way too!", or, "building more muscle means burning more calories even at rest!"

Which may be true. But driving your car speeds up the erosion on it's paint and metal on the fenders due to friction with the air and bugs and pebbles that bounce off it while speeding down the road. It's technically true. Just as wind and weather wear away at rocks over time, you're speeding up these same effects on your car to some degree by driving it, since it's like having a constant 45 to 65 mile per hour wind with rocks and bugs hurling into the surface of the vehicle, thus eroding it away. Yet it's not enough of a significant impact to warrant serious concern.

It's about time for an attitude shift in exercise from health fanatics. This evidence is pointing to the need for primarily altering your eating habits, and exercise would just augment this change. None of these articles are saying you shouldn't exercise; to the contrary, they say that exercise has other benefits, while weight loss isn't really one of them. It's still well known that exercise reduces osteoporosis risk as we age. It helps with balance. It does contribute to weight loss to a small degree (although you wipe this out if you celebrate your dedications to the gym with going out for a slice of pie at that local ice cream shop.) Exercise helps your heart and keeps you fit. I'm told it improves your mood as well but I've yet to experience that.

Being active helps you with weight maintenance. But it is an adjunct to adopting better, more reasonable eating habits. Maybe even from schools; I don't recall having a class that focused on telling you that the typical American diet had you eating like a chemical-laden pig, but I do remember wondering what the point of "phys ed" was (oh boy! I get to play a sport that I can't stand watching on TV...oh boy...yeah...not fun.)

Think about it. In an hour at the gym the average person burns up what, 300 to 500 calories? Roughly? Maybe 600. That, for the average person, is the calories in one or two snacks. A snack bar is roughly 300 calories. Some go as high as 500. So your hour in the gym may have bought you a five-minute snack. It doesn't even cover a "full" breakfast at a fast food joint.

And if you're trying to lose weight it's the calories that count.

3500 calories over your burned calorie count is a pound of fat. That means cutting back 500 calories from your diet each day will result in losing a pound over the course of a week. Or every two weeks if you cut back 250 calories per day. When you look at bread and see that a couple slices amount to 100 calories or that your average slice of whole-milk cheese is 100 calories than you can see that trimming your calorie intake here and there can have a bigger effect than jamming more exercise into your schedule, especially when in real-world activities fewer people visit the gym each day and keep up sacrificing their time to hang at the gym and of those gym-goers there's apparently a healthy number that like "treating" themselves to an ice cream cone or extra slice of pizza because they were good about going to the gym.

How about you? Have you noticed a significant impact from exercise on your weight? Or have you noticed that eating less has a bigger impact on yoru weight?

Reflection on the Surgery

I started this blog for a couple reasons. One of the primary reasons was to document the bariatric surgery from the perspective of a patient and have a record to look back on, and to make those public enough for other people to look at if they were researching the surgery. All they had to do was just come here and click the tag "bariatric surgery" and voila'...a list of thoughts and hurdles encountered by me in the course of having and recovering from the surgery.

The whole ordeal has been quite a personal trip. What started as a strong recommendation from my internal medicine doctors to get weight loss surgery transformed into a month-long physical healing process, a diagnosis of depression and Asperger's, and a long series of therapy sessions to deal with my own demons and quirks as well as issues influenced by the surgery that lead me to fighting off an increase in stress from my day job.

I figured now would be a near appropriate time to reflect a little...over six months later...on my view of the surgery.

It happened long enough ago that I barely recall the recovery process. I have some vague recollections of how difficult it was to even sit up in bed. You have no idea how much you rely on muscles in your abdomen until you're unable to use them! Rereading old entries brings those memories flooding back.

I'm glad I had the open Roux-en-Y surgery. I couldn't stand the thought of having a little band strangling my stomach with the accompanying lifelong risk of erosion, or having a little "port" just under the skin where the band is adjusted in how much or how little it strangles your stomach. And while the open surgery had a much longer (and more...gruesome...) recovery, I understood that it benefited me in that the surgeon had far more flexibility in determining what he was doing and getting it done right. Laparascopic surgery is to benefit the patient; smaller scars, faster healing, etc...but it means your surgeon had to be at the top of his or her game and may have to cut corners while maneuvering around in your fat-laden abdominal cavity. Open surgery means that if he needs to lift part of your intestine to get that cut just right, he reaches in and does it.

Eating...well, here's what I can tell you. I am pretty sure that I could eat VERY SMALL quantities of something like pie or a brownie. I generally don't, though, because I'd rather not risk the dumping syndrome. Plus it runs against what the surgery was meant to help promote avoiding in the first place; eating foods that are unhealthy and against a healthy diet.

As a matter of fact I strongly believe that once the intestine and stomach heal there's very little that is "abnormal" about the dietary needs and tolerances. The change means you do run the dumping syndrome risk so you need to avoid sugars. Avoid them altogether? No. Look at food labels. You can't realistically avoid sugars altogether. And there aren't any evil foods; your body needs sugars and fats to function properly.

I could eat just about anything in moderation, in theory. I don't because I'm obsessive about routine. Because of my own habits my body doesn't like dietary changes that are abrupt anymore.

In addition to cutting down the sugar content there is one other thing that changed; I can't eat large quantities without pain. If I ever wonder if my "pouch" is still smaller than it was I could just try pushing my food intake a little more and I'll feel a big "blah" feeling, if not outright pain if I gulp too much food at once.

The smaller stomach gets full sooner. It's a good thing.

Those are the two big differences. Less sugar. Less food.

It's not a magic bullet because it can be actively sabotaged. I could keep eating until my stomach is bloated; gradually, it'll stretch. As it gets bigger I can eat bigger meals until eventually the surgery was essentially all for naught.

Or I could keep eating calorie-rich foods during the day, spreading out what was a large sit-down meal into an all day affair. That brownie I could have in small small quantity? Instead of popping it in my cakehole all at once, I could finish it off over the course of the day and avoid the sugar spill into my digestive system. All the calories and none of the immediate "oh dear oh dear oh dear" side effects.

So in my case the surgery has simply helped shape a new lifestyle of eating less. This means eating more like I should have been eating; smaller portions.

I also exercise more. I don't like it, but it helps with weight loss and supposedly makes me healthier. As weight reduces from my body the effort of moving isn't quite as high.

The last big benefit I know I've seen from the surgery and weight loss is the reduction in my other illnesses; sleep apnea, high blood sugar, cholesterol, blood pressure,...all those things are either reducing in severity or disappearing.

There are drawbacks though. I have had to deal with other issues that before I comforted through eating. Various stresses get to me even more. My Asperger traits seem to be getting stronger and asserting themselves more; little pet peeves are becoming really strong issues for me to deal with to the point where I can't stand being in the same room as people who are chewing with their mouths open.

I have folds of flesh that I can't stand looking at. I avoid mirrors whenever possible because I wince at the horrific sight of me melting. And I get a flare of anger at people who suggest I go to the gym and build a little muscle to fill the skin (are you @#% daft?! How much muscle do you think you'd have to develop to fill all this??)

I have to deal with my depression issues. They tend to run more deeply than I normally admit to others; I do wonder at times why I bother getting out of bed in the morning. Sometimes I think if it weren't for the huge bills I have to pay off then there wouldn't be a reason to get up some days. The hole used to be somewhat filled by looking forward to a tasty fudge brownie. Now...well, broccoli isn't quite as satisfying.

And there's the head hunger. The surgery cut back on physical hunger and for the first month or two there was a definite drop in the desire to eat. It was definitely freeing. Gradually, though, another hunger asserted itself. Head hunger. The emotional need to eat. Stress, boredom, anxiety, all the things that before were quelled to some degree with food now roar through me at the most inopportune moments. I fill the head hunger pangs with things that are generally more healthy...mixed nuts, activities, and broccoli (sometimes with some mustard or salsa on it). Generally low calorie items (okay, the nuts aren't low calorie; they were an energy pickup I used when I started going to the gym). No cookies. No slices of cheese or makeshift sandwiches or leftovers from the fridge.

There is also a bit of resentment. I miss some aspects of my old lifestyle, despite knowing that I gave them up for something that is supposed to be better for me. I don't have soda anymore. The doctor forbade it; the carbon dioxide fills the stomach pouch and I was told can stretch it or make it more difficult to eat the things I'm supposed to have. I am supposed to be more careful about when I drink, although I haven't noticed any side effects from when and how much I drink. I go to restaurants and wonder what it would be like to be like the old days; "mozzarella sticks look great! I'll have those!" This has morphed into, "mozzarella sticks! They're probably 300 calories apiece, plus they're fried so I'll get the craps, and I wouldn't be able to have any entree even if I did try them..."

A trip to a fast food restaurant has turned "cheeseburger" into "300 calories" when I see them on the menu.

There's the change in perception of other people and their habits. I see someone eating fries with their double cheeseburger and I think, "Do they know how much sodium they're eating?" "Why do you need all those fries with your burger?"

I have french fries once in awhile. Literally. I eat two or three sticks for a taste of the fry. That's the upper limit. I also eat the pickle off my son's burger-cheese because he doesn't like them. Otherwise, I start to obsess over whether or not it's going to get me rolling down the slippery slope of weight gain.

But I can't see other people out there with their eating habits and wonder how many of them bitch about not being able to lose weight but not see how much they're eating. Low fat foods don't equal losing weight (of course not...they're filled with other things to make up for the lost flavorings). Do you look at the calorie counts of the food you're eating? I think the majority of dieting issues would be taken care of if people were looking at their calorie expenditure and intake.

Of course, that won't help with the secondary effects of obesity, like emotional issues...but in the cut and dry, wanna-lose-weight-how-can-I-do-it approach, you cut down on calories and you should lose weight.

That is the heart of the whole weight loss surgery. It kicks you in the rear towards starting a healthier lifestyle.

There is another side to the surgery to consider. If you have an addictive personality (and let's face it, if you fill a need with food, you probably have some kind of addiction issue) then you might learn to transfer that addiction to another behavior. Some surgery patients move to alcoholism. Due to the physiological changes in your digestive system it supposedly takes a lot less alcohol to make you drunk. I haven't tested it yet, but I guess a glass of wine is supposed to be a real hoot post-surgery.

Or you become more obsessive about losing weight. I've always been like this; it wasn't the surgery that triggered it, but I live in perpetual fear that the surgery will "fail". Or as it was put to me, the surgery doesn't fail, I fail the surgery. I watch my weight. If it levels out I get worried. If it goes up, I stress. If it climbs for a week, I...don't know. It hasn't happened yet. But it very well might. I lost over 200 lbs before, about six years ago, and thought I wouldn't go back to the Fat Life. After a plastic surgeon more or less laid out to me that the skin folds were permanent (no amount of exercise was going to fill that, the connective tissue is far too damaged...by the way it's considered cosmetic surgery so you'd have to pay for it yourself) I was more depressed and saw less reason to maintain my restricted calorie lifestyle. Life moved on, I went back to old habits, I got fatter again.

These memories of my first time in "Skinnierville" leave me with the fear that this weight loss is temporary and that no matter what, the fatman is still inside these folds of flesh. And the head hunger reminds me that he wants out. My response to this is to monitor my weight periodically during the week. I keep to a routine to limit my portions growing out of control or hopefully limit the amount by which my stomach stretches. I obsess over getting a certain amount of exercise in each week.

I keep my old belt with me as a reminder. The belt was with me at my fattest and I wear it every day. I am still saddened that it doesn't reach around me twice yet. I sometimes add another notch to the band as I notice that the pants aren't holding up properly, but it's slow progress.

The surgery has been a mixed blessing. It was an aide, and it may be something to help my case if the insurance company is every to try paying for skin removal. Essentially that was another big reason for the surgery; the insurance company would never okay skin cutting if I lost the weight on my own like I did the first time around. So I had to have a really expensive surgery to do it first. Who says there's waste in healthcare?

The surgery has helped by giving me a fear of going off the lifestyle...I can't have cake and cookies, for example, and I'm in a habit now that while I could have a slice of cheese as a snack I won't for fear of what it could do to derail me. It has given me permission to be different in some ways.

The surgery has hurt in that now I have to face my other issues that promoted the weight gain. I have the sense that my Asperger's habits are asserting themselves more. My depression symptoms sometimes seem worse. And I miss the ability to go out to eat or try other things without hearing all the fears and worries and food-related anxieties swirl around in my head.

Can't say I regret having the surgery. For me, six and a half months out, it's been worth it. Everyone's mileage varies, though.

Tongue Piercing of DEATH!

Here's just some interesting thing that I stumbled on while buzzing around online. It's an article at Time about a guy that died of a tongue piercing. Check it out here.

How'd he die?

An infection that went to his brain.

It's interesting that there are people who are very, very afraid of having something like Bariatric Surgery because of the risks (although the risk of dying from the surgery is a mere .2 percent and lower if the surgeon was experienced. At the same time people don't seem to bat an eye at the risk of shoving a piece of metal into their tongue...people do that to their ears, so what's the harm?

Well, any time you jam something into your skin I'm thinking it can possibly introduce problems. The way I see it the skin is there to keep dirt and foreign objects out of the body. Any time you intentionally break the skin there's a risk that something is going to get in there that shouldn't, and putting something in there permanently, even if it's something small like a barbell in the tongue, is going to run a bigger risk than something that is allowed to heal like my post-operative hole in the gut.

The body is usually pretty good at dealing with the brain doing something stupid like piercing the tongue. The fact that people are still doing it and not dying all the time is a testament to that. However, it's not entirely without risk. Many people end up chipping or damaging teeth. Others get nerve damage to the tongue. And they always run a greater risk of having complications in the mouth. After all, they put a hole in their tongue, the same place where food and dental germs wriggle around.

I'd have assumed that there was some risk of dying considering how my dentist has taken to reminding me that infections from lack of dental hygiene can travel into your brain. I don't read of this happening frequently but it could happen.

The difference is that I see no utilitarian purpose in doing something like tongue piercing, and there are no real benefits for the risks, are there? You run a risk of chipping your teeth, having to do more to maintain your oral hygiene or risk infections, you have pain while healing...for what?

I knew someone in college that had a piercing done. He developed an infection that made his tongue look like freakin' cauliflower. No kidding. It was disgusting. And I hoped he felt like a damn fool because he did this...why? Just because?

I don't understand it any more than I understand tattoos with no real significance. Why did you get Tweety on your breast? Do you understand that it'll look like Big Bird in twenty years? Do you understand that your interest in Sailor Moon may not be at the same level in the future as it is now? Or maybe your employer will frown on the Darth Vader is my Daddy tat on your cleavage when you're trying to make more than minimum wage? There are tasteful tattoos and tattoos of cultural significance but these inked-on-a-lark or shortsighted things are, in my opinion, silly.

Kind of like random piercings that signify...nothing?

Maybe it's a form of natural selection. I tell myself that so I can come to some reconciliation for the behavior I don't understand. If someone was really doing something really stupid, they'll either regret it (and rationalize the regret away) or they'll end up with a nice infection or some other unpleasant side effect down the road.

Some people get really defensive about their decisions to do oddball things to the body. That's fine. Do what you want. You have the freedom to waste your time and pain receptors however you want just like I have the freedom to express the notion that I haven't the slightest idea why you do what you do.

Is there an actual reason for doing the body piercings and tattoos that makes sense beyond the "because I wanted to" or "just because" reasons?

The Cookie Diet

The New York Times had an article about a "Cookie Diet". The premise is pretty simple; you subscribe to a diet program where you get a certain number of little cookies for breakfast and lunch each day, and you pair those up with a "sensible dinner".

The doctor that started the program in 1975 has since started a website called cookiediet.com to sell his cookies in addition to selling them through stores like GNC and Walgreens.

It's just another system, put into a different perspective. The six cookies are roughly 800 calories; you have a light dinner, adding another 500 calories at most, and you end up with about 1200 calories for the day.

When you consider how many calories overweight people are probably taking in on average then it's a no-brainer that they'll lose weight on a 1200 calorie a day diet.

The doctor also sprinkles in some woo-ery in the form of "special ingredients" for protein and health (from his website: "Dr. Siegal’s foods contain his proprietary amino acid mixture that results from the blending of various protein food substances. They satisfy hunger without drugs and help you stick to a reduced-calorie diet.")

Take a step back and strip away the flowery talk; it's a reduced calorie diet.

Would it work? Stick with the program, sure, I don't see why not. You'll also lose weight by not eating a lot, which is essentially what this is.

What if you change this system a little? Say, encourage people to use a system where you assign points to portions of different foods, then sell charts, books, guides, and pre-packaged portions of food with your program's seal on it so people can eat healthy portions without thinking about portion sizes? That would be a sneaky way of getting people to eat fewer calories and lose weight. I'd probably call something like that...I don't know...Weight Watchers sounds good.

The key is the same as others in the field have said, once they strip away the flowery language and other BS. Eat less. Find a system of lifestyle you can live with. Weight Watchers does it by giving a simple point system for people to track and makes a metric crapload of money on the books and guides and foods carrying their logos. Other systems do it with "simple rules" that on one level are easy to follow (don't eat carbs!) but under the surface strip out a large number of calories from your diet (do you know how many calories are in common carbohydrates, especially if your favorite foods are pasta and bread?)

Is it healthy? I'm not a nutritionist. I've read countless times that these system diets usually mean having to supplement with vitamins or increasing certain food types you normally don't such as vegetables in order to make sure you don't have deficits. Others require monitoring or checkups to check your mineral levels in your blood. Generally speaking it's probably not a good idea to cut something out entirely from your diet; your body does require cholesterol and fats along with amounts of all the other things that various fad and gimmick diets vilify.

Progress Update for November 4th, 2009

After another plateau period I am down a pound today from my November 2nd weight level. Quick stats...
Weight: 263.5
Weight loss since surgery (4/7/09): 112.5
Weight loss total (1/1/09): 194.5

Most lost since January: 195.5

So I'm a pound away from my lowest weight (so far?)

My bariatric doctor said there's no way I'd hit the "healthy weight" in the sub-200 pound range in his experiences. Bariatric surgery patients just don't get into the "normal" range. They lose (for Roux-en-Y) typically lose somewhere in the neighborhood of 60 to 70 percent of the excess weight.

I don't know what exactly is going to happen, but I looked at the weight chart for the past 12 months on Fitday where I've been tracking my weight to find possible trends...

You can see how the chart starts off strong with a large drop, then bucks a little near April (when I had the surgery), then starts falling again. But the slope of the line is dropping, meaning that the rate at which I'm losing weight is slowing down.

The doctor had reiterated that what typically happens is a big loss then a gradual loss of weight as the body readjusts to the new calorie intake. What usually happens is the heavy nosedive turns into a series of "steps" (known to we fat people and chronic dieters as plateaus) where, as he said, the body will level off or gain a slight amount of weight for about a week or two then suddenly drop down anywhere from a pound to five pounds and level off again.

I wanted to believe that it wouldn't happen to me. The difference between kids (and teenagers) and cynical adults is that I understand that wanting to believe isn't the same as reality, so could it be that my irritating, frustrating, and demoralizing "plateauing" stage is coming due? Or would a change in my diet habits create another set of weight drops?

I guess I'll have to just keep an eye on my weight over time and see what happens.