Occam's Razor

My sad prediction for today’s “biggest losers”

My blog seems to be on something of a health kick lately. This is because over the last year I have been dealing with more than my usual number of health issues. It’s not just me. This week, my mother in law complained of chest pains. Doctors found a blockage near her heart and put in an emergency stint. She then suffered a heart attack that was followed a day later by another and worse heart attack. She was technically dead for ten minutes until they finally managed to restart her heart. She is still in intensive care and is delusional, a condition I saw my own mother go through since she also suffered from congestive heart failure. Her long-term prospects look dubious, but she is about eighty years old. She is fortunate to be alive in any condition, because she made lifetime habits of smoking and not exercising. My wife plans to fly out to Phoenix tomorrow to be with her mother. Her return date is unknown. If all this close-to-home health news were not enough, one of my sisters called me today to tell me that she has been diagnosed with the onset of adult diabetes.

So feeling my mortality, I am focused on healthy living, as are many other people including First Lady Michele Obama. Obama is busy planting a vegetable garden on the White House lawn, demonstrating healthy eating and fitness, and working to end childhood obesity. This is long overdue but of course, this being America, there is fierce resistance. The processed food industry is all up in arm about taxing nutritionally empty foods like soda that give us sugar highs and put us prematurely into the hospital. I heard one C-SPAN caller the other morning (a self professed Tea Party member) dreadfully upset that “big government” was trying to regulate sodium in our food and was thinking about raising taxes on nutritionally empty foods like sugared sodas. To me these are “better late than never” proposals, but it makes other American hopping mad. I wonder if they also object to nutritional information on packaged food. Apparently, it is more important to be nutritionally ignorant and cause millions to die prematurely and deal with wholly preventable diseases than it is to increase the size of government. You have to wonder if the nutritionally empty crap these people are likely eating is affecting their judgment.

I avoid “reality” TV shows but about a year ago, while stuck in a hotel room, I watched an entire episode of The Biggest Losers, which now has many international spinoffs. As with most of these “reality” shows, it seems to be much more about fostering unhealthy relationships between fellow contestants than losing weight. The more weight your team loses, the “better” you are doing. The grand prize of $250,000 would certainly be nice to win, but at what price? In any event, in addition to the constant sniping you can watch contestants downing protein shakes, dehydrating themselves, working with personal trainers and engaging in the vigorous cardiovascular exercise they ignored most of their lives.

If you are obese, losing weight is usually vital for your long-term health. If you are overweight, it is also a good idea. Still, losing twenty, 40, 80 and in some cases more than 100 pounds is not by itself healthy. First, if the calories you are ingesting are not nutritious, you are not being good to your body. Second, as I discovered, dehydration can result in syncopes (fainting spells), falls, concussions and even death. No wonder Biggest Loser contestants in case they should they end up in the hospital or drop dead sign forms disclaiming NBC from all responsibility. Perhaps the most likely thing that will happen when you lose weight is that soon after the cameras are tracking your progress, you will quickly rebound, putting back the weight you gained and often more, such as happened to actress Kirstie Alley. Arguably, if you were just going to gain it back, you might have been better off not dieting in the first place.

Granted I only watched one episode, but what I saw on The Biggest Losers appalled me. Not only does the extreme competition glorify sniping at fellow team members (hardly the sort of harmonious living the Dalai Lama would encourage) but extremely rapid dieting almost guarantees that you will gain back the weight. A real competition for The Biggest Losers would not emphasize how much weight contestants lost per week, but track the contestants on how long they maintained a healthy weight, ate sensibly and followed a moderate exercise regime. The show should reward those who took off lots of weight in a sensible manner: by taking off a pound a week. They should reward those who have also successfully kept the weight off. This, of course, would make for very uninteresting television, but seeing how others did it would be very instructive to the sixty percent of us either overweight or obese.

How do people manage to lose and keep the weight off? My last post is perhaps instructive, but my method is but one of many. Methods that work will be tailored to the personality of the person and work with their eating and exercise preferences. Like alcoholism, I see obesity as a lifelong disease. I will forever be at risk of being overweight and obese. It is only through incorporating effective eating and exercise strategies into my life in a natural way that I will succeed in my real goal: being at a normal weight and remaining at a normal weight. Of course, I want all this, plus I want to be fit, to have a healthy heart, get optimal nutrition and never have to worry about high blood pressure or high cholesterol. I want to pass away gently in my sleep sometime in my nineties. I’ve kind of figured out this means I won’t be eating many French fries or getting double cones at Baskin Robbins.

In sum up, The Biggest Losers contestants are almost predestined to be tomorrow’s biggest gainers, an inconvenient fact that the producers will not bother to highlight. What we need is much more clinical research into the best techniques for losing and maintaining a healthy weight. In addition, we need research on staying optimally healthy while spending our working days in office buildings typing on keyboards.

I would like to see billboards highlighting people who have taken off significant amounts of weight and have successfully maintained a healthy weight for five, ten or more years. These billboards should come with URLs to websites so people can learn more about how they did it. Like Miss America contestants, these real Biggest Losers should tour American classrooms and give public lectures spreading their gospel. Maybe this way, along with reducing sodium, calorie and fat content in our foods and restaurants and encouraging fitness both at home and work, Americans will revert to being fit and healthy again.

I would not waste your time looking for useful tips on how you can weather our obesity crisis by watching The Biggest Losers. Instead, you might want to make an appointment with your physician.

May 15th, 2010 at 05:43pm Posted by Mark | Life 2010, Sociology | no comments

One year later: my healthier living update

About a year ago, I wrote that I would periodically keep you abreast on my journey of weight loss and healthier living. (Actually, I wrote this mostly to remind myself so I would not slip.) Based on previous attempts at dieting, I discovered a truth: taking weight off is relatively easy. Keeping it off is harder. So how am I doing a year later? How am I doing after about nine months of Weight Watchers, giving up Weight Watchers because I wasn’t learning anything new and am now all on my own? Did I balloon to the size of Orson Welles (or for that matter Kirstie Alley)? Did I make it back to the same weight I was at when I was married and was a skinny thing? Did I yoyo back and forth? What great wisdom have I learned that I should share with the rest of the world?

A year later, I find myself within a couple pounds of where I was when I left Weight Watchers. That part is good. When I weighed myself on Monday, I was one pound above what is considered a healthy weight for my height. That part is not ideal, but being one pound overweight is better than being twenty three pounds overweight, which is where I was when I began my journey in January 2009.

So I can say I succeeded, with an asterisk. My goal was always to take off a chunk and then maintain it, since that was where I had failed many times before. The asterisk means that I slipped a bit. Over the holidays, I indulged too much, exercised too little, and not coincidentally, I also picked up five pounds. I knew what to do (start counting using Weight Watchers points again) but it took me a month or so to find the wherewithal to do it. When I did, it worked reliably again and the pounds came off. Yet, once I lost the few pounds I put back on, I found little incentive to keep reducing. Getting back to the weight when I was married continues to be an elusive and perhaps not very important goal.

Nevertheless, maintaining a near healthy or healthy weight for a year is a genuine accomplishment. I went back to some bad habits, but not all of them. When I wasn’t counting points on a sheet of paper, I had a good idea how much I could realistically eat and not gain weight.

I am usually fastidious during the week. For example, for breakfast this morning, I had one cup of Cheerios with skim milk and a cup of blueberries. This carried me over nicely until lunch. I packed a banana and a cup of grapes to have with lunch. When I eat at the cafeteria at work, four times out of five I am getting a soup and salad for lunch. It’s nearly automatic. My sweet tooth will not wholly be denied. I try to fit in one chocolate treat, which often means a bag of Dark Chocolate M&Ms, a favorite. My salads are quite low fat and full of healthy vegetables. I skip salad dressing and garnish the top with just a little cheese. Dinner, at least when I am eating alone, often consists of an entrée of from the diet part of the frozen food aisle. Lean Cuisine gets a fair amount of my business. Many of their entrees are quite tasty and reasonably healthy. (I particularly enjoy their Shrimp and Angel Hair Pasta, one of the best diet entrees ever, except for the sodium.) Their main value is portion control. I may supplement it with some bread, add in a banana or some other fruit. If my sweet tooth calls, have a 1-point Weight Watchers Fudge Stick.

On the weekends, I am more lax. On my Fridays off, my wife and I still engage in the fatty practice of breakfast at Silver Diner. Once or twice a month doesn’t make it a bad habit. Instead, it’s a treat. Otherwise, I have given up most restaurant eating. Recently, someone at work has been leaving out chocolate Easter eggs and I confess it is hard to pass them by without doing some grazing. I do binge at times, but not egregiously.

Over the last year, I have also been challenged by other physical problems. It is hard to follow Weight Watchers when you are having vein or tarsal tunnel surgery, and two hospitalizations these last two months hasn’t helped either. It is much easier to be good when your life is not topsy turvy.

My doctor is still not happy because my cholesterol level is still elevated, but not dangerously (110 bad cholesterol). He would like me to eat a lower fat diet than I do, but my diet is markedly lower in fat than it used to be. It would be difficult to excise too much more fat from my diet, but if driven by necessity I am sure I could. In my near future, I may end up on statins or other drugs to reduce cholesterol. Over the last eighteen months or so, I have also developed an irregular heartbeat. It is likely though that dieting has reduced heart problems rather than caused them.

My exercise is reasonably consistent, but at a lower level than when I weighed twenty pounds more. When I ate too much, I tried to make up for it by exercising more. Exercise is still a good idea, and I typically hit the health club three times a week as well as walk up many staircases. While beneficial, if you want to maintain a healthy weight, excessive exercise has no particular advantage. If anything, burning those calories makes you want to eat more. One of the lessons I have learned is that although you need enough exercise, you do not need to go overboard. If you are concerned about having and maintaining a healthy weight, calories matter more. In general, Americans consume far more calories than we need. I have trained myself to demand fewer calories than I used to. If you are struggling with this problem, I suspect you can too.

So here’s to me and my mostly successful first year, and here’s hoping a year from now if I write about my adventures in healthy living and weight loss again, I will at least be where I am now. Perhaps I will find the impetus to take off another fifteen pounds and literally be the man I was when I was married. It would make a good goal for my 25^th wedding anniversary in October.

May 12th, 2010 at 07:38pm Posted by Mark | Life 2010 | no comments

The Ten Percent Solution?

One of the reasons to read The Huffington Post is to get your celebrity kicks. I have to confess I don’t care too much about what celebrities are doing, Jewel Staite being the possible exception. Yet, it was on Huffpost that I read about the latest celebrity yo-yo dieter, in this case the actress Kirstie Alley. For a while Alley was a spokesman for Jenny Craig, which was not only financially remunerating for her but also allowed her to lose seventy-five pounds. She eventually parted ways with Jenny Craig to come up with her own diet and sell her own dieting book. She would be wise not to write any for a while. Alley put the seventy-five pounds she lost back on, and an additional eight more pounds to boot, for a total of eighty-three pounds. Now she plans to take it off again and get back to the svelte 140 pounds or so she was when she did Cheers. Good luck Kirstie.

Alley is an egregious example of a yo-yo dieter. She has plenty of company but the rest of us struggle with our weight without the glare of publicity. I too have struggled, though thankfully I never got more than twenty-five pounds above a healthy weight. I have tried a number of diets over the years too, including the Carbohydrate Addicts Diet and the South Beach Diet. For a time, both diets looked like solutions for me too. Both were ultimately a waste of my time and money.

It is too early for me to claim victory. I have claimed it before only to find myself slacking off and find the pounds had returned. However, I have reached a milestone, losing ten percent of my weight in about five months. No, I was not on Jenny Craig, which would make little sense in my case as they market primarily to women. Nor was it Nutrisystem. I am on Weight Watchers. I have this simple advice for Kirstie: if you really want to lose weight and actually keep it off, try Weight Watchers this time. There is no guarantee you will succeed with Weight Watchers either. However, I can say that after following their program these last few months I can see the results on my scale and in the extra number of free belt notches. Moreover, I have a realistic expectation that this time I will keep it off for good.

Here is the problem with virtually all the diets out there: they may succeed in helping you lose weight, but they will do little to help you keep it off permanently. That is actually fine with the diet industry. They do not want you to keep it off permanently. If you do, they have lost another customer. No, they would much prefer you take it off, get sloppy, put it back on, then give their diet another go around. If you cannot, well, there are plenty of other diets to choose from, and they need your money too.

Any diet will let you lose weight if you follow it. Only a few though have a decent track record helping you keep it off once you have lost it. Weight Watchers is a big commercial company too, and I am sure they get their legions of yo-yo dieters too. Nonetheless, if you want to lose weight and keep it off, you should stop the Jenny Craigs, the Nutrisystems and the Slim-Fasts and do Weight Watchers instead. After you lose the weight, you will at least have a decent chance of keeping it off permanently. This is because Weight Watchers is one of the few diet companies out there whose business model involves not only helping you lose weight but helping you keep it off once you have lost it.

How hard was it for me to lose ten percent of my body mass? You might expect I spent much of the last five months eating celery and carrot sticks, but that is not the case. Mostly I ate things I already liked. In many cases I ate less of what I already liked, and changed portion sizes and ingredients so that what I ate was less caloric, higher in fiber and lower in fat. Did I suffer? If I had to rate my suffering level with Weight Watchers compared with any other diet plan, with 1 being no suffering to 10 being massive suffering, Weight Watchers was about a 3. Most of the other diet plans were in the 7-9 range.

How was this possible? Mainly, I watched what I ate, exercised portion control and kept track of what I was eating. With Weight Watchers, you learn to practice a few simple rules like “eat the filling foods first”, manage hunger through small snacks, assess the impact of what you are eating through their Points system, and eat your daily point allocation. If you want to eat more, exercise more. They have a way to calculate your bonus points via your exercise level. There are also extra points you can use over the course of a week on those days when you feel you are suffering too much. Truly, it is not that hard. Are you listening Kirstie?

Since you can eat at least some what you want, you may find yourself like me getting creative. I eat the filling foods first, but I also find creative substitutes for other foods I enjoy. Whole wheat bread is healthy, but still has more calories per slice than I would prefer. A high fiber English muffin though is only 100 calories. Cut in half, with a teaspoon of butter on each half and you have something quite tasty and dense in your stomach for less than 200 calories. It comes down to choices. The big greasy slice of pizza may be out but an occasional Lean Cuisine pizza may be okay. After a while you may find, like me, that you don’t need to count points anymore because you eat many of the same sorts of foods you used to and you know what and how much you need to stay on track. In any event, the weekly weigh in helps enforce discipline that may be lacking. I think it is essential in keeping you honest.

I am not entirely there yet, but I am close to the point where my new eating habits are becoming automatic. I now find that although I could have fancier things to eat for lunch, I want a salad. I can dress it up in a way where it is filling and satisfying. My weight loss coach was very pleased when she recently announced that I lost ten percent of my weight. She said this is a key indicator of people who can develop the habits to keep the weight off permanently. By the way, unlike many yo-yo dieters you should lose weight slowly. About a pound a week is ideal. Have patience. If you lose a pound a week, in a year you weigh fifty pounds less and you are much more likely to keep it off too.

I am planning to keep losing weight even though I passed the ten percent threshold, with the goal of getting my weight down to the day I was married, which was probably the last time I was at that weight. Then I will do my best to stay there. I will use my blog, in part, as a reminder to keep at it.

I hope you can learn from my experience. I think celebrity diets are a waste of time. Find a diet program that works with your eating habits and has some track record for helping you keep the weight off once you have lost it. There is no painless approach to weight loss but plans like Weight Watchers are the only ones that have any realistic chance of succeeding in the long term.

If your freezer is full of food from Jenny Craig or Nutrisystem, you might as well chuck it because these diets at best will only succeed in taking off weight for a while. Keeping weight off permanently and developing new habits, like eating better and exercising more, is what you really need. A diet is only one component for reaching this goal. You need long-term health. This is a completely different game, but it is the only plan worth having.

June 17th, 2009 at 07:32pm Posted by Mark | Sociology | no comments

More adventures in weight loss

Since I officially started my latest diet on January 22nd, I have lost thirteen pounds. Seven weeks and thirteen pounds is close to a weight loss of two pounds a week. How hard was it? So far, not that hard.

There are lots of diet plans out there of course, but overall I think the current one I am on, Weight Watchers, is probably the best of those I have tried over the years. Any weight loss plan of course will work if you adhere to it. Unfortunately, most people will put the weight back on shortly after they take it off. I am not the exception either. I certainly did not intend to be a yo-yo dieter, but simple inattention and giving into the cravings of my body made the weight creep back up over time.

Truly, despite all the sweats that diets tend to give us Americans, taking off the pounds is the easy part. Keeping them off is the hard part. Can I successfully incorporate new eating strategies into my life for the rest of my life? It remains to be seen. Still, I can feel the weight coming off. Thirteen pounds amounts to two notches on my belt. I feel healthier and have more stamina. My blood pressure is already down into the normal range. I do not know about my cholesterol count yet. I had blood drawn on Tuesday and should get lab results soon. Since it typically takes six months for cholesterol levels to get back to normal, I probably have a way to go. I would prefer to avoid cholesterol-lowering drugs. Time will tell whether I will succeed there.

Why is a stodgy old diet plan like Weight Watchers working so well? I think it is mainly because I can choose what I want to eat. As I pointed out in my first post, it does not mean you can eat as much of what you want, unless you prefer low calorie, high fiber food. Clearly most of us losing weight do not prefer these foods; otherwise, we would not have gained the weight in the first place. Maybe once a week I will have a Lean Cuisine Spaghetti for dinner (5 points). I grew up on spaghetti dinners. So eating food I enjoy, even if in smaller quantities than I was used to, really does help. As Linda, our coach put it: “If it doesn’t taste good, don’t put it in your mouth.”

In hindsight, it is easy to see how I fell off the wagon. Throughout my weight gain, I never lacked for regular aerobic and anaerobic exercise. Granted I get little of it in the office, but I hit the gym regularly and really worked out. I deluded myself to some degree that if I exercised enough the weight gain did not matter. Of course, even if you exercise regularly, if you eat more calories than you burn, you gain weight. It is that simple. I simply chose to not pay much attention to the problem until my doctor gave me a wakeup call.

Weight Watchers has convinced me (it’s amazing how quickly we forget) that a few simple things take the pounds off: burn more calories than you take in, exercise regularly and systematically, track what you eat and use the discipline of a support group. If you can do these four things, you will lose weight. It does become much less burdensome though if you can mix in some of the foods you love (hopefully lower fat, lower calorie and higher fiber equivalents) with the healthier foods. If you chose not to do these four things most likely you will not succeed in losing all the weight you want to lose, and are likely to falter on your path.

The discipline of being weighed once a week in front of an impartial coach has an amazing effect. Simply put, it provides essential accountability. Since most of us have a hard time being accountable to ourselves, why not to a coach? Since you will not be the only one at the Weight Watchers class, you will also watch others lose weight too, and they are likely to encourage you in your journey. The social aspect of weight loss is critically important, and perhaps the most important part of succeeding.

I have also found that you can eat really tasty and nutritious food that doesn’t pack on the calories. One of my favorites is a Chicken Stir Fry. Our local warehouse club BJs makes a great chicken stir fry, loaded with tasty vegetables, spaghetti, chicken of course and garnished with soy sauce. It has 190 calories per serving. There are four servings in a bag, so if you have two servings you are getting only 380 calories and you have a huge plate full of healthy and good tasting food. Moreover, it is loaded with dietary fiber and is low in fat. Perhaps if you are salt sensitive the soy sauce is not good for you. Two servings are just six points.

There are many low calorie products out there, some of them are exceptionally good. Weight Watchers of course sells dozens of them, many of them mediocre but some seem too good to be true. Take their fudge bar. Amazingly, it is only one point but it is still quite chocolaty and actually tastes rich. If you have a sweet tooth like I do, it is manna from heaven. You have to be careful though that you do not subsist on a diet of Weight Watchers fudge bars. Your body really does need the dietary fiber from fruits and vegetables too, so you want to include healthy portions of them in your diet. They will fill up your stomach much better than a couple Weight Watchers fudge bars.

I will give you more progress reports in the weeks ahead. It drives my wife nuts at times because she has this thing against Weight Watchers. However, if the first thirteen pounds came off with such little pain, I do not see why I cannot keep going until I reach a healthy weight. I am about half way there already.

March 12th, 2009 at 09:06pm Posted by Mark | Sociology | no comments

Watching Points

Men, if you want to meet women, join Weight Watchers. At least, that appears to be true based on the class I attended the other week. There were fifteen women in the room (including the leader) and I was the only man. So I asked the women in the room: do men, like, ever do Weight Watchers? Someone remembered a man who joined briefly some months back, but in general, at least with this group, men just don’t do Weight Watchers. Maybe Nutrisystem or something is a more manly way to lose weight. After all, prominent well-remunerated ex-football coaches endorse it.

Granted, if you are looking for super skinny women you won’t find any at a Weight Watchers meeting, except for possibly the leader, who is probably already spoken for. I also happen to be spoken for and as best I could tell the other women in the room were too. However, by being the only man in the room you may find women competing for your attention. Also, you are probably far more interesting than the weekly weigh in.

My cardiologist suggested Weight Watchers. “It’s easy. You eat what you want,” she said, which is okay for her to say, as she is from India, vegetarian and as skinny as a rail. My experience in dieting over the years probably parallels yours: it is never easy. Mainly it is a matter of consistency and force of will. If you regularly slip on either of them, you tend to put on the weight again.

While I would normally no more go out of my way to attend a Weight Watchers meeting than I would an AA meeting, I had to confess to myself I do not have that excuse. A group meets weekly on my floor, in a conference room about a hundred feet down the hall. Moreover, Thursdays from 11 to Noon, their meeting time, was also a convenient time for me to attend. Having no viable excuse and knowing my cardiologist would keep giving me a hard time, I opened my wallet and signed up.

I am on Day Nine of Weight Watchers. The one thing I have not actually done since my first meeting is weigh myself. That was because yesterday I was facilitating a large meeting of more than a dozen people, most of whom were from out of town. Nevertheless, I certainly have been scrupulously tracking points. Points are what you track if you do the Weight Watchers thing. You can look up the number of points for some dish in a convenient book they give you or on their web site, or you can use their calculator to convert calories, dietary fiber and fat content into points.

The women in the meeting looked at me enviously. I hope it was because I didn’t look like I should even be at Weight Watchers. I have no beer belly and what excess fat I have tends to be in the form of modest love handles. Their envy likely had more to do with me being a male, which means I am larger, thus burn more calories, which means I get six extra points a day. I am not supposed to exceed 33 points in food per day, whereas all the women in the room were somewhere in the mid to upper 20 points per day.

It is true you can eat anything you want on Weight Watchers and theoretically lose weight, but of course, you probably cannot eat as much of you want of the foods you like. You quickly learn that if you eat what you like, such as calorie-dense food full of sugars and fat, you can earn your daily points with just a few candy bars. Moreover, these sorts of food simply make you want to eat more of them. Naturally, if you are intent on minimizing your misery you quickly discover the virtues of filling foods, i.e. foods that have few points, and are relatively low on calories and fat and high in dietary fiber. One I like is grapes. One cup of grapes is just one point. They have some dietary fiber, taste nice and sweet, contain zero fat and are available year round. However, a cup of most fresh fruits will do the same thing. As I tend to like berries, a cup of fresh raspberries or blackberries as a snack or with a meal goes down rather pleasantly.

Still, you have to keep meticulous track of what you eat, at least for the first six weeks. You also need to track activity points. That’s not a problem with me, as I already get adequate exercise, so many days I earn extra points. This of course means you can eat more and still lose weight. However, exercise does tend to make you hungrier. The benefits of exercise though go far beyond weight loss, so it makes sense to exercise and diet simultaneously.

After a couple months, my feelings may be different, but overall the first week was not as hard as I anticipated. The trick seems to be to be doggedly consistent. In the morning, before I rush off to work I usually have a bowl of cereal. Since starting, I now measure one cup of Cheerios and three quarters of a cup of soy milk. That’s four points. Mid morning snack is that cup of whole grapes: 1 point. Lunch: soup and salad from the cafeteria. We have plenty of variety in the salads we can create. The trick is to add heaps of healthy vegetables, go sparingly or skip the salad dressing and avoid the urge to load it with proteins like chicken or tuna. If you do this, the salad can be just a couple points. If your idea of a salad is a Caesar salad loaded with dressing, three cups of Caesar salad is seven points! I love soups and most are only a few points. Many though are loaded with salt, which may be a reason to avoid them. An apple is just two points and very filling so it works for dessert. Enormous dinners are out, of course, and creating even modest dinners and staying within your point range can be challenging. I make sure I reserve two points for a Skinny Cow, a sort of ice cream sandwich-lite.

The goal of Weight Watchers is not just to help you lose weight. Virtually any diet will succeed in letting you lose weight. The hard part is keeping it off permanently. It means a new way of eating. It means listening to your body so you reach for a snack while your body is just starting to get hungry and stopping when you are satisfied but not full. The goal is to stay in the “comfort zone” so hunger does not drive you to excess eating. Small binges are okay. Weight Watchers realizes some days you will crave more calories, so it adds in 35 weekly points. If you don’t use them you lose weight faster. Last week I used up about half of my weekly points.

Time will tell whether a modest decrease in my weight will reduce my cholesterol and blood pressure. I am skeptical that I can wholly relearn eating habits because if I had been successful in various strategies I have tried in the past, I would not be losing weight yet again. Americans’ relationship with food is very complex. It is incredibly easy to overeat in America without really trying. Mindfulness through the tracking of points is a bit challenging but so far has not proven overly onerous. Perhaps with persistence my blood pressure, weight and cholesterol will soon all return to the normal range again.

Stay tuned.

January 30th, 2009 at 08:31pm Posted by Mark | Sociology | no comments

Our stressed out nation

Didn’t you suspect this all along?

Scientists reported yesterday that they have uncovered a biological switch by which stress can promote obesity, a discovery that could help explain the world’s growing weight problem and lead to new ways to melt flab and manipulate fat for cosmetic purposes.

….

Moreover, the stressed-out junk-food eaters put on the worst kind of fat — deposited around the abdomen and laced with hormones and other chemical signals that promote illness. After three months, the animals became obese and developed the constellation of health problems that obese humans often get — high blood pressure, early diabetes, high cholesterol — an increasingly common condition known as metabolic syndrome.

I find a direct correlation between my weight and the amount of stress in my life. I bet the same is true with you. So the conclusion in this article was no surprise. When you are under stress, your body is in an abnormal state. Yet for many of us Americans, modern life is little but stress. Our employment often feels tenuous. Our marriages feel rocky. Our kids are difficult to manage. We work two or three jobs to pay the bills.

Therefore, we look for balms to relieve our stress. These are typically smoking, drinking, drugs and food. Of the four of these, the one that society frowns on the least is food. Unlike drugs, cigarettes and booze, food is both extremely convenient and inexpensive. You will not be carded for being underage and buying a box of Ding Dongs. Solutions to our stresses often involve more stress. If our marriage is under stress, to solve it we either have to endure months of painful and expensive marital therapy with high likelihood of failure or go through the trauma of divorce. If our children are grossly misbehaving, timeouts and a spanking are unlikely to solve the problem. Instead, they likely need to talk to social workers and psychiatrists. Often they will end up on antidepressants. Since their behavior affects Mom and Dad, they often end up on antidepressants too. However, since most stress is situational, treating stress by pill is no cure. At best, it offers only modest and temporary relief.

For many of us the best and cheapest therapy is a pet. Like Prozac, even the most devoted dog can only do so much. Therefore, it is easy to succumb to the temptation to buy that box of Krispy Kremes. A sugar high is easy to achieve and it feels so satisfying. Except of course, it is as successful at solving our stress as a bottle of booze. At best, it helps the stressful feelings recede for a few hours.

Maybe it is coincidence but as I travel America, I feel like I can accurately measure the stress level of a community by the average girth of its citizenry. Throughout much of the South and Midwest, Americans are noticeably more obese than elsewhere. Perhaps poverty in the South contributes toward its problem. Its culture probably contributes as well, which seems to emphasize a diet rich in empty carbohydrates. The filmmaker Michael Moore is quite obese and was raised in Flint, Michigan. Since my wife is also from Flint and we have relatives in the state, we visit Flint periodically. I note no lack of an obesity crisis in Northern Virginia where I live. Even so, when I go to Flint I feel appalled. With the auto industry in permanent decline, the city slipping more and more into stagnation with the passage of each year, it seems Flint’s biggest surplus is in obese people. The residents of Flint seem to have an unhealthy attraction to greasy spoons and donut shops.

As I noted in 2005, there are no lack of greasy spoons and donut shops in Canada either. You can hardly drive a mile without passing a Tim Horton’s donut shop, for which residents of Ontario seem to have an almost unnatural affection. (There is sound reason for their affection; we dined there twice.) I have seen Tim Hortons crowded even during off hours. Yet, at least around the Toronto area, I saw markedly fewer obese people than just a hundred miles away in Buffalo.

Last summer when we visited Paris I was struck by the absence of obese and overweight people. In America the typical person is more likely to be overweight than not. In Paris, you have to look for them. My belief is that because the French in general live less stress-filled lives than Americans do, they have less need to use food to cope with stress. With their nationalized health care system, they never have to worry about whether they can afford to see a doctor. Their law requires a minimum of five weeks of vacation per year. Their national holidays are also more plentiful than ours are. Downtime and safety from many of life’s worst shocks are built into their culture. As a result, the French seem to have institutionalized a form of living that minimizes stress. So, like the mice who were not subjected to stress in the study, I am not surprised that the French look so good. (As I noted then, I think this is partly because Parisians get more exercise than we do. They burn off plenty of calories just walking to and from mass transit. They are less likely to commute by car than we are.)

Our American values emphasize self-reliance. It is practically a religion. We see living by our wits as a competitive advantage. While it may have its benefits, I think it is clear that this form of living also has a dark side. We can see it manifested in our exploding girths. Just the comfort of knowing that we have universal health insurance may do more to combat our obesity crisis than a stack of surgeon general reports.

While I think self-reliance is a terrific virtue, I also note that Europeans with their nationalized health care systems and more socialized governments live longer and have less stress-filled lives than Americans have. You have to look hard for a Western European country with life expectancy rates comparable to the United States (Denmark and Portugal). In France, you are likely to live two years longer than in the United States, despite the fact that most of the French smoke. In Germany, one year longer. In Spain, two years longer. In Switzerland, two and a half years longer. In Canada, with its socialized medicine and rampant numbers of frequently patronized Tim Horton’s donut shops, Canadians live nearly two years and a half years longer than we do.

The common denominator in these countries is that they have institutionalized methods that reduce unnecessary stress on its population. Living by your wits, which is what humans did for most of their existence, reduces lifespan.

For a country that claims to value life, perhaps we can demonstrate it by inculcating a culture that supports it. Perhaps it is time to change our values.

July 4th, 2007 at 11:45am Posted by Mark | Politics 2007 | no comments

Glycemic Junk Science

Let us add this report to the list of studies that really do not tell us anything, but do sell newspapers.

When it comes to losing weight, the number of calories you eat, rather than the type of carbohydrates, may be what matters most, according to a new study.

The findings, published in the American Journal of Clinical Nutrition, suggest that diets low in “glycemic load” are no better at taking the pounds off than more traditional — and more carbohydrate-friendly — approaches to calorie-cutting.

The concept of glycemic load is based on the fact that different carbohydrates have different effects on blood sugar. White bread and potatoes, for example, have a high glycemic index, which means they tend to cause a rapid surge in blood sugar. Other carbs, such as high-fiber cereals or beans, create a more gradual change and are considered to have a low glycemic index.

If you put 8 gallons of gas in your car and it gets 20 miles to the gallon, you can expect the car to go 160 miles, plus or minus a bit. It is the energy in the gasoline, the terrain and traffic your car will traverse, and the efficiency of your car in transferring that energy into work that determines how far your car will go.

Your body is an engine too. It is unimaginably more complex than an automobile, but it is still an engine. When you ingest food, its calorie content is translated into amount of energy that your body will receive. If you take in more calories than you expend, you will gain weight. If you take in fewer calories than you burn, you will lose weight. At its most pragmatic level, it’s just math:

Future weight = current weight + ( some constant x ( calories in – calories expended ) )

If you choose 400 calories to come from donuts made with refined sugar and bleached flour as opposed to 400 calories from a high fiber, low glycemic cereal, you are still consuming the same amount of energy.

You can get fat by eating all healthy foods; you just have to eat enough of it. If you gorge yourself on enough salads, you will gain weight. Given the low density of calories per serving with salad, it is much harder to gain weight this way, but it is still possible. That is in part why dieticians recommend consuming whole foods.

Why does a study like this make the news? I think it is because so many of us who are overweight or obese are still hoping, in vain, for a painless method to weight loss. Right now diets emphasizing low glycemic foods, like the South Beach Diet, are in.

Now there are some upsides to eating foods with a lower glycemic index. Most likely these food are healthier for your body. A donut does not have much in the way of nutritional value because most of the good parts, like the fiber, have been removed. Whole foods in general are likelier to have more fiber as well as more vitamins and minerals than junk food. (Many junk foods though are needlessly fortified.) Eating many of these foods may technically be better for your body. It may provide more of what the body needs to carry out vital things like replacing blood cells. Nevertheless, by itself they cannot be a solution to weight loss.

If you want to lose weight, you already know what to do: take in fewer calories than you will burn and exercise more. Exercise burns more calories, but if you eat more calories to make up for the increased exercise you are not going to lose weight.

The real root of our obesity epidemic is that American capitalism has succeeded in creating foods that we crave, and making them readily available at inexpensive prices. Our behavior is not that different from my cat’s behavior. He has his high fiber, nutritionally optimized cat food, which does not taste good. (This is probably just as well, or he would eat more of it and get fat.) On the other hand, he can grub for handouts at mealtime, which is one of his favorite hobbies. He eats the cat food if he has to, but he does not prefer it. Unlike my housecat though, you do not have these restrictions. You can satisfy your cravings with out much difficulty.

As part of my own healthy eating strategy, I do my best not to bring the foods that I crave into my house in the first place. Having them readily available simply adds to my temptation to succumb and consume them. This strategy is not easy. When I hit the grocery store, the shelves are replete with things I want to eat. It takes discipline to avoid purchasing the sorts of foods I want but should not eat. (It helps to go after a meal.)

If you truly want to lose weight then you had better count those calories and understand portion sizes. You need to join Weight Watchers or some group like it; peer pressure can be a terrific motivator. You have to incorporate healthy practices into your life and be consistent about it. Nonetheless, your human nature and society will conspire to trip you up. Life may seem a lot less joyful by disciplining yourself this way, but it is the only way to be healthy. Nothing comes free. If you want a thin and healthy body, you have to consume a lot less and exercise a whole lot more. If you cannot make this choice then be prepared for host of preventable maladies as you age.

Now, I am off to the gym.

April 20th, 2007 at 01:38pm Posted by Mark | Advice | no comments

A Pit Stop in the Adventure of Weight Loss and Healthy Living

The good news is that since the start of the year I have lost about twenty pounds. The bad news is that I need to lose at least another ten pounds. Ideally, I should lose an additional ten pounds. If so perhaps I could again wear the same suit that I wore at my wedding.

My likelihood of my success? I hate to handicap my own odds but I will feel very fortunate if I can get down to a body mass index (BMI) where technically I no longer fall under the stigma of being overweight.

These days I feel good and think I look good too. I can slip into size 36 jeans again without effort. I get regular and sustained exercise. I eat better. In addition, with some effort, I am maintaining my weight. Depending on whose BMI scale you use, I may be on the high end of having a healthy BMI.

My daughter tells me of a saying at her high school about those brainiacs who managed to go to Thomas Jefferson High School for Science and Technology. This is a state chartered school in Alexandria, Virginia for the region’s most promising high school students. “School, friends or sleep. Pick two of the three.” This is similar to being a middle age adult with low metabolism working at a sedentary job. “Job, exercise or personal/family time. Pick two out of three.” So far, I have been picking three out of three. Maybe this explains why my weight loss has plateaued.

I continue to bike to work. This time of year, I drive the three miles to work more often than bike them. Part of it is explained that I take the car to get to the gym after work. Afternoon thunderstorms in the summer are more likely than not, which makes even getting home in the evening chancy. Over the last few weeks, aided by rampant global warming, the temperatures have predictably been on the extreme side. The stagnant hot air usually means bad air quality. Biking to work may actually make me less healthy. Now that we are in August, the weather slowly becoming more bearable. I still go to the gym three to four days a week after work. The routine consists of 30-60 minutes of aerobics, usually on an elliptical machine, followed by a half hour or so of weight training.

Thursday at the gym one of many personal trainers wandering around accosted me. He talked me into coming in for an assessment yesterday. I had a good idea of where he was going: he would want to sell me personal training sessions. Steve made a logical case. He told me that I had to continually break down different muscle sets. This way my muscles would be continuously rebuilding and I would continually build muscle mass too. As a side effect, even at rest I would have a higher metabolism and burn more calories. Moreover, I would feel better, have higher self-esteem, be attractive to babes and maybe get a pony. We went through a sample workout together. I have to admit he definitely stretched muscles I did not even know existed. Nevertheless, I was not sure I wanted to cough up $400 a month for meeting with a personal trainer four times a week.

Steve asked how serious I was about fitness. Well Steve, it was you who solicited me out, not the other way around. I said I was six on a scale of ten. My goal is not to look like Arnold Schwarzenegger, at least when he was still lifting weights. (Poor Arnold has let most of it turn to flab. See what getting married does to a man?) My goal was to maintain a healthy weight level and good muscle tone. Steve could not promise me I would end up weighing less, just that I would add muscle weight and lose body fat. There was nothing wrong with the goal, but essentially, it meant I would have to turn into a body-obsessed exercise machine. I would need to commit to spending more time at the gym and endlessly worrying about toning various kinds of muscle groups.

Then there was the usual advice to eat less, or at least differently. I have already tried all sorts of variants. What I have discovered is that these helpful suggestions just do not work for me. I cannot remember to eat when I am not hungry nor do I particularly want to remember. I actually prefer to feel hunger pangs before eating. Nor can I remember to keep guzzling from a water bottle all day long. I am sure I do need more water, but I have weak enough kidneys as it is. Must I be shuffling off to the restroom every hour on the hour?

I would rather have two larger meals a day than four or five small meals. I would like a strategy where I can eat smaller portions of things I enjoy at times that seem natural to me. Instead, to lose weight and maintain optimal health I must constantly think about food, water and exercise until it becomes all-consuming. What kind of life is that? For me this exacerbates the problem by making it a larger problem in my life than I feel it deserves.

I have gotten lots of advice on weight loss and exercise over the years. I have talked to doctors, dieticians, personal trainers, psychologists, relatives, friends, and coworkers. Maybe soon I will turn to mystics and gurus. Each has snippets of insight, but there is no one size fits all solution to weight loss and health. It amounts to what you are willing to do with the limited time you have available. It certainly does help if you have more willpower than the average person does. In addition, it does not hurt to have a support group. For most of us who have not grown up being physically active, all this sensible advice amounts to cajoling yourself to work at variance to your body’s natural patterns every day for the rest of your life.

It means smaller meals when your body wants larger meals. It means exercise on days even when you simply want a day for rest and peace and quiet. It means telling yourself that yes it really is more important to spend a couple hours in the gym rather than sort through the family finances, which also has to get done. It amounts to willpower: your ability to force yourself to do things you do not want to do.

I will measure success in the short term my maintaining my twenty-pound weight loss. I keep measuring my weight every Sunday morning and try to fine-tune my eating and exercise based on what the scale reveals. Then I hope I can summon the energy to go further. I know what it will take and it is guaranteed not be easy. I will need to coax my body into eating less than what I need to maintain my weight. Moreover, I will have to push myself to do even more exercise on a more regular basis.

For now, I take some pride and sense of accomplishment from dropping twenty pounds in eight months and keeping it there. This was, in fact, one of the strategies recommended by Heather. She is the dietician I saw during the spring. Time will tell whether her advice was better than all the others out there selling me health solutions.

August 13th, 2006 at 10:49am Posted by Mark | Life 2006 | one comment

Adventures in Weight Loss and Healthy Living

Yesterday found me back in the office of my dietician Heather. As readers may recall, Heather is helping me change my diet so I can keep losing weight and lead a healthy second half of my life. Changing eating habits is not an easy task. Yesterday’s appointment was a chance to tell her how her suggestions were working. The truth was that I was having mixed success. I had managed to take off three or four pounds, but that was over two months. Habits are hard to change, and eating habits are some of the toughest ones.

I used to have three eggs for breakfast. They would easily carry me over to noon, but likely contributed to my cholesterol problem. Now I eat a cup of Kashi cereal with a cup of 1% milk for breakfast. Along with the breakfast, I consume the protein Heather wants me to eat at every meal, so I added two ounces of pressed ham. This carried me through lunch and is only 360 calories.

Drink more water, Heather told me. The only thing is I do not feel particularly thirsty. It is hard to remember to do things like this routinely while the email is streaming in and out and while I am editing web pages. So once again, I made it to noon forgetting to hydrate myself.

Today I was only mildly hungry for lunch, until I actually started eating. I skipped the salad topped with nuts that she recommended, since I knew there was plenty of salad at home that I could have with dinner. Therefore, I bought just a cup of chicken vegetable soup from the cafeteria. It was about 100 calories. I added a zero fat but very tasty Granny Smith apple. 80 calories. 180 calories for lunch so far, but I was still hungry. I reached above my desk for my handy supply of crackers. The six Cheddar Cheese crackers were 200 calories. 740 calories so far.

During the afternoon, I felt snackish. Heather had recommended a box of raisins. They are very sweet and very tasty, and have only 130 calories. Raisins are now my favorite snack, so down the hatch they went. Later, as I waded my way through another conference call the snack monster hit again. I reached for the low fat granola bar. 180 calories. Total calories so far today: 1040.

With work over, I headed to the Gold’s Gym. I exercised for thirty minutes on the elliptical machine which listening to NPR on my headset. Then it was off to use the weight machines. I pressed 90 pounds on the vertical press, 3 sets, and 15 repetitions with each set. On the Leg Extension, I pressed 115 pounds, same counts and repetition. 165 pounds on the Dip Machine. 130 pounds on the Ab Machine. 200 pounds on the Adductor. 80 pounds and 12 repetitions on the rowing machine. I can only guess how many calories I burned. Supposedly, I burned close to 500 calories on the elliptical machine, but I suspect the real amount is a lot lower than that. There is no way to measure calories on all those weight machines, but I can definitely say they were all challenging. I am guessing I burned about 500 calories at the health club today.

I went home and after a shower, I contemplated dinner. I was in a Boston Market mood tonight so I fetched one of their turkey dinners from our freezer. This is the tastiest 360 calories I can find in a prepared dinner, which is probably a sign they have too much fat per serving. I added a small salad, which cannot be more than 75 calories. Afterwards, a banana looks inviting: 105 calories. Time for dessert: three Special K bars (90 calories each) and a cup of 1% milk to wash them down. I am up to 1960 calories.

It was time to head upstairs and blog. At least I knew what to blog about today. I bring three sugar free (but alas, not calorie free) candies for a total of 50 calories. Total calorie intake for one day: 2010 calories.

Heather tells me a big man like me (six foot, two inches) needs about 2400 calories a day to maintain my weight. In addition I need 30 minutes a day of exercise to maintain my weight and more to actually lose weight. Between the exercise and the calories consumed. I think I lost weight today. The hardest part of weight loss is simply keeping it up, day after relentless day. Food ranks right up there with sex in life’s greatest pleasures. To diminish this pleasure is surprisingly hard.

Counting calories with every serving, (her latest suggestion) definitely helps. Trying to figure out if I am eating sensible portions is tougher. I started out well back in February. I wondered if I could have spaghetti with dinner and still not exceed the portions of protein and carbohydrates she wanted me to have with dinner. I had to weigh the whole grain pasta on a scale, and four servings was not a lot of pasta. Three ounces of protein (but no more) at every meal is very easy to get. It amounts to four frozen turkey balls that I threw into the spaghetti sauce. The result was tasty but underwhelming in quantity and I had already hit my carbohydrate quota for the meal.

The body, or at least my body, wants more. It likes my weight just fine. It does not understand my obsession with Body Mass Index. “Don’t you know I’m trying to store extra fat, just in case there is a famine?” it is yelling at me. I know all the strategies, but integrating them altogether is, frankly, just another damned chore in a day full of damnable chores. Knowing how many calories are in my “standard” breakfast and lunch help. I can then plan dinner accordingly. However, with dinner I also need to balance calories with standard portions. It all amounts to the same classic dieting advice: eat less and exercise more.

Ah, exercise. That has been a challenge of late. A couple weeks ago, I broke a toe in my left foot, which put the kibosh on exercise. It was not that I did not try to exercise. At the time, I did not know my toe was broken. I figured it was just “sprained”. In fact, I did the stupid male thing and exercised anyhow. It resulted in bruising which spread to my other toes. I tried carefully biking to work: same effect. Next, I spent a week in Denver on business. There I was up before 7 a.m. and rarely retired to my hotel room before 8 p.m. There was little opportunity to exercise but at this point, I had figured it out: do not even bother until the bruises disappeared.

I was certainly mindful of the food temptations while in Denver. The Club Lite sandwich at the local deli near the Denver Federal Center tasted great. I am sure it was low fat, but it was hard to guess how many calories I was consuming. In the morning, the hotel put out a huge complementary breakfast bar billed with eggs, greasy sausages, hash browns, juices, waffles, donuts and muffins. If you looked for it, you could also find bran cereal, skim milk and fruits. I started out well but by the end of the week, I had succumbed to a muffin or two with breakfast. My dinners did not appear to be highly caloric, but their calorie content was impossible to ascertain. Because I was getting virtually no exercise because of my injury, I felt I would be lucky if I did not gain any weight during the trip.

I am home and back on my normal schedule. It is easier to follow a diet. In our modern world though it is not easy to constantly monitor a sensible diet, get the exercise your body requires, work a productive day in a sedentary job and pay attention to your significant others. Those four activities along with sleep can consume a whole day. No wonder losing weight is so hard in our culture. However, further weight loss will simply require both rigorous vigilance to my diet and upping my exercise. Now that spring is finally here and I can bike to work most days I can easily add additional exercise. After seeing the podiatrist about my toe today, I also know that I can exercise with my feet again. Exercises that hurt like running though are still out.

I wish I could be like Wendy. Wendy is a woman I traveled with last year. She is forty something, blonde, trim, in shape and consequently quite attractive. She is also a vegetarian. She has the sensible eating thing down to a science. At the hotel breakfast, she happily consumed just cup of oatmeal. She grabbed an apple and consumed it later in the morning. She staggers her eating during the day with snacks. She makes it all looks so effortless, which I suspect it actually is to her. In addition, she makes time for exercise every day no matter what. On that trip, it meant getting up at 6 a.m. and hitting the hotel’s exercise room. I figure if she can do it, so could I. The real question is can I do this relentlessly and for pretty much every day for the rest of my life? Why do I have to do it but the French do not? How do they stay so fit and trim, eat fatty foods, have so little heart disease, smoke, philander and yet live into their nineties?

I do not know these answers but I can see the appeal of living in France now. I have been getting regular exercise for a quarter of a century, but apparently it is not enough. My body is going to require a lot of persuasion. 49 years of eating habits are excruciatingly hard to change permanently.

The brownies my daughter unwisely baked were still on the kitchen counter this evening. I looked at that last brownie in the pan lustfully, then calculated that if I ate it, it would add close to 500 calories to my diet.

Reluctantly, I put it back in back the pan and reached for the Special K bars instead.

April 13th, 2006 at 09:41pm Posted by Mark | Life 2006 | one comment

Advice from Heather

Yesterday I saw a dietician. I mentioned to my doctor at my physical last month that I was having a difficult time maintaining a healthy weight. He suggested seeing a dietician. With obesity rampant in this country, you would think it would be easy to find a dietician. It is not. I have looked in the Yellow Pages before to no avail. He said you find them at hospitals. The only one around where I live with dieticians that saw people on an outpatient basis was Reston Hospital. To see a dietician, I had to schedule my appointment about a month in advance.

Fortunately, I am not obese. However, I am overweight. Like most people, I have tried a couple fad diets, as well as tried upping the exercise and cutting the calories. Each approach worked for a while. Eventually, and sometimes it took a few years, something would happen. It would be easy to say I was getting lazy, or lacked the willpower, but it truly was more than that. This latest weight gain was doubtless exacerbated by my wife’s annual holiday baking cycle. Generally, I have more willpower when junk food is not in the house. When it is constantly in my face, I can easily lose willpower.

I have written about diet and exercise before. Gone are the days where most of us can burn away excess calories through on the job physical activity. If you are like me, you spend your days doing anything but that. Hey, I am a white-collar dude. If I did not walk up the stairs, the most calorie intensive thing I would do at work would be lifting my phone’s receiver. Therefore, I must make time for exercise. I bike to work when weather permits, which is about six months a year. I also hit the gym about three times a week. When I have the time and the weather is nice, I take long bike rides. Yet apparently, I was still eating too much. On the other hand, much of the time I was eating too much of the wrong stuff. These little extra calorie habits, even with regular and vigorous exercise, have a cumulative effect.

So there I was at Reston Hospital registration, getting a band around my wrist as if I were going in for major surgery. Instead, I walked a couple hundred feet down the hall to see Heather. Of course, the dietician is named Heather. I bet there are no dieticians named Gertrude. Naturally, Heather was about five feet three, and weighed about ninety-eight pounds soaking wet. Moreover, she was half my age and stunningly attractive. Considering I had to meet a deductible because the appointment was at the hospital, instead of a co-pay, perhaps I shouldn’t complain about this fringe benefit.

It is all about portion control, Heather told me. Yeah, I knew that I told her. However, I am not the type to sit there and measure 15 grams of carbohydrates at a meal. I am a busy guy. I need to have a plan that will work with me. I need to stick to the same foods during the week, and the foods need to be foods that I will mostly enjoy. Otherwise, after too much deprivation I am going to slip.

She said she would work with me. We also made an appointment for early April so that we could meet again to assess progress and perhaps change the diet. She complemented me on the eight pounds I took off during the last month (not without the usual grumbling) and warned me the weight loss would probably slow.

Yes, success at dieting and maintaining a weight in the end takes hard work and perseverance. Most diets fail, she told me, because we set our expectations too high. Step one is to take off 10% of body weight and maintain it for four to six months. Then, if you want, work at taking off another increment. This is a formula for success. You can get to the summit of the mountain, but you will want to take a couple rest breaks on the way there to make it.

I thought I had read a lot about nutrition. Yet I am still glad that I took the time and considerable expense to consult with a dietician. For I still learned a lot from Heather. I knew about good carbs and bad carbs. However, I did not know about the importance of having protein with every meal. I never gave it a second thought. I usually saved my protein for the evening meal. Protein with any meal will help stave off hunger, Heather told me.

I also thought I was being good by skipping lunch on the weekends. After all, I was not eating until 9 AM or so. Wrong, she said. Eat three meals a day every day. Include proteins and carbohydrates at every meal. You can even enjoy snacks. Just make sure you balance the carbohydrates, protein and fats. Do the usual good things. Avoid high fat foods. Try 1% instead of 2% milk. Make sure your breads have whole grains. And of course limit portions. Needless to say, what you get at most American restaurants do not qualify as normal portions, unless you are a sumo wrestler.

Looking at what was working for me the last month she made some changes. Add food to my breakfast, she told me. A bran cereal is fine; its energy will be absorbed slowly. Using 1% milk is better than 2%. Add those sugar substitutes if you want sweetness. Also, add fruit to the meal if you want. However, make sure you add a serving of low fat meat. This is not a problem; we have plenty of pre-sliced low fat turkey and ham.

If I feel the need for a mid morning snack (I rarely do) try a granola bar (without the fruit filling), or a piece of fruit, or a small box of raisins, or even crackers with peanut butter. Of course, limit yourself to one portion, which might be the size of what you can put your fist.

For lunch, if soup and a salad are working for me now, she recommended keeping at it. Nevertheless, dress the salads up with proteins from sources like beans and nuts. She said to keep eating an apple with lunch as I am doing. It has lots of fiber and no fat. She said I could even add some starchy choices with lunch. A six-pack of crackers works for me but pretzels are even better. If I feel the need for an afternoon snack, the same morning snacks will work for afternoon snacks. Or I could try different types for variety.

During dinner she said I needed to limit myself to four starchy choices, each about 15 grams of carbohydrates each. She said to make sure I got three servings of protein, and lean meat is better. Add as many vegetables as you want, and you can have one fat choice. Of course, a fat choice is not very large. One teaspoon of olive oil is one good fat choice.

This is my diet based on my age and height, so these may not necessarily work for you. Meanwhile, she said not to slack off on the exercise. Do more exercise if I can find the time. It will not hurt, but I should still take off weight regardless. If I can do this I will naturally get the calories I need, and the exercise will help me lose weight.

As for fad diets, Heather said to ignore them. They are all a waste of time because they can only work for a while. That was my experience with the South Beach Diet and the Carbohydrate Addicts Diet. I have seen the same result with others I knew who were on the Atkins diet. Vary your diet, Heather told me. Eat foods that you naturally enjoy, but eat less of them and prefer those lower in calories and fat. Just stay within the portion limits for any given meal.

Perhaps I have finally found a diet that will work for me for life. Time will tell. I know that Heather will be there to help me succeed. She said to make sure to call her if I have questions or am having trouble sticking to the diet. She will help me rework the diet into something I can live with.

My wife scoffed when I told her I was going to see a dietician. “It won’t work for me,” she told me. “There is nothing they can tell me that I do not know.” I knew most of this too going in, but I still was not able to put it altogether. Thanks to Heather, I believe I now have now I have a plan I can live with. And I plan on living well to a very ripe age.

February 9th, 2006 at 09:25pm Posted by Mark | Life 2006 | no comments