This was posted at Daily Kos:
I’ve noticed the recent obesity diaries; presumably they started because of the diary about Governor Christ Christie and his reaction to a doctor saying that he ran a non-trivial risk of dying while in office.
If you are obese and feel good about it, then this diary isn’t for you. This diary is about those who are obese and do NOT want to remain that way. I took the liberty of
1. Gathering some statistical facts about obesity (e. g. actual evidence instead of “what everyone knows”) and
2. Sharing my journey from weighing 320 pounds (size 52 waist) to 190 pounds (size 34 for waist) and staying a normal size since 1995.
Yes, my story is merely one data point among thousands (millions?) and it is not complicated by unusual medical conditions, food allergies and the like.
More below the fold. Part I is a link to resources and part II is a bit more personal.
Note: I do not claim to have a “one size fits all” answer or even an answer that will work for anyone else. But I did find a pathway out that worked for me, and I decided to share it with those who are interested.
Part I: resources about obesity.
I’ve chosen articles that have a base of research to them in order to move beyond mere opinion and to avoid cherry picking factoids that “make sense to me”.
New England Journal of Medicine: this article is behind a pay wall, (I’ve linked to the abstract) but if you are a student or faculty member of a university, your library probably has an online subscription to this journal. This article lists:
1. Popular misconceptions (rebutted by the evidence).
2. Popular “notions” which have neither been rebutted nor confirmed by evidence.
3. Popular “notions” which have shown to be true.
National Institute of Health: Obesity Education Initiative.
This outlines many of the risks. Note: the risks are statistical in nature; in other words, being obese means that one’s risk for certain maladies are higher than a non-obese person’s. This is no guarantee that a fat person will get these conditions nor be inoculated from them by losing weight.
The Scientist Strangely enough, a father’s obesity can induce somewhat harmful epigenetic changes in their offspring! I admit that this sounds counterintuitive to me, but I have no training in this field.
I’ll start with “before and after” photos. And no, I am NOT “selling” anything! I used no diet industry gimmicks nor did I pay money to quacks; I am careful about what I eat and I do use a “free of charge, non-commercial” support group. And no, I didn’t “give my life to deity X”; I remain an outspoken secular atheist.
The reason for the photos: I posted running photos so my clothes can’t hide my body. I posted a non-running photo as well. As far as the weight loss: I was 320 pounds when the first photos were taken; I reduced to 185 in 1996 and have stayed mostly between 185-195 the entire time (save a time when I got a stomach flu, etc.)
What happens: I’ve found that a 53 year old man needs less food than a similarly active 37 year old man. So I’ll eat a certain way, then the pants (now size 34, down from 52) start to tighten, i weigh, then I reduce the amount of food on my plan, then the weight comes down. So yes, I eat less now than I did in 1996.
Me in 1992:
Me in 2000
Me in 2012
How I do it and other thoughts
Basically I eat 3 times a day and only set amounts; I completely abstain from foods that set me off (mostly the standard “junk” foods, snacks, sugary items etc.). There was a time when this made me feel deprived…not any longer! I honestly don’t miss it.
As far as working out: I work out on most days; I often pick from either:
1. fast walking
3. weight lifting
4. swimming (not lately)
5. yoga (not lately)
However I don’t do these activities for weight control. Example: a couple of years ago, I hurt my knee (meniscus tear) and couldn’t run; I tried to swim too far with a pull buoy and hurt my rotator cuff. So there was a several month period when all I could do was to walk easily…..and I gained no weight during that period.
Upshot: for me, these are sporting activities; they are part of my “fun”. I don’t do these for weight loss or for health benefits. These are the times when I can pretend to be an athlete.
I also don’t “diet” in terms of “temporary weight loss diet”. I just eat moderately at all times, with no “opening of the flood gates” for special occasions. I’d much rather enjoy the company of others and not be held captive by the food.
Why I enjoy being non-obese:
1. stairs are much easier, so is walking to work.
2. clothes are easier to find.
3. seats at concerts and sporting events: no problem!
4. I can safely play sports that I love.
5. I am not out of breath all of the time.
6. I almost NEVER think about food! When I was obese, I thought about food all of the time. I even remember my vacations, in part, by what I ate and where.
7. I don’t live with that “stuffed to my throat” feeling all of the time; I don’t wake up with food hangovers.
How I got obese
I overate and lied to myself about how much I was eating. Being around normal people was kind of a shock; I didn’t know that humans could exist on so little food!
As far as losing weight: I went the “support group” route; it seemed to work for me.
What I did right as an obese person: I still exercised; I lifted weights and I walked. It may have taken me 36 minutes to walk 2 miles (and that was walking as fast as I could!) but I still got it in…and no, I didn’t like the cat-calls (and I got a few).
Workout notes 4 mile untimed walk (Cornstalk course) following a weight workout:
pull ups: 6 sets of 5 (varying grips), 1 set of 10, 3 sets of 5.
incline press: 10 x 135, 3 x 155, 3 x 155, 7 x 145, 8 x 140
dumbbell bench/rows: 3 sets of 10 with 65 each exercise
dumbbell military: 2 sets of 15 x 45, 1 set of 10 with 70 each arm (machine)
pull downs/pulley curls 3 sets of 10 with each (160 with pull downs, 52.5 curls)
Obesity: Mano Singham directs us to a New England Journal of Medicine article that discusses some common misconceptions about obesity and some common ideas that are without foundation. If you are a faculty member at a university, you probably have access to the article itself, which is behind a paywall for non-subscribers.
It is worth reading; some of what “you know” isn’t so, and some “hasn’t been confirmed, or rebutted”.
Workout notes I sort of fell prey to yesterday’s 12 miler; the plan was to “run 4 on the treadmill, walk 3 on the track, walk easy 3 outside in the snow”. What happened: the first two.
Run: 42:06 for 4 miles on the treadmill; 1 mile at 0 incline, then 2.2 miles of 1, 2, 3, 4, 5, 1, 2, 3, 4, 5 (every .2 miles increase, with longer at the “5″ level”) then 3 minutes at 4 and finish the rest at 3.
Then I walked 3 miles (slightly more) on the track (high 13′ish pace; 43:06 for 24 laps.
Then I did abs, stretching and the foam roller for my piriformis (it REALLY seems to help…surprisingly). Then when I got dressed to go outside….I just had no desire…so I just walked to my car and went home. What I learned: it is easier to walk 3 slow miles after 7 slow miles than it is after higher intensity miles.
Tomorrow: blood donation, then weights. I admit that I am nervous about the blood for, well…because I know why I am donating at this time. If I didn’t know WHY it would be easier….and that is illogical. But I just feel sick for the person and the family for the person undergoing this emergency medical procedure. Again, this feeling is illogical; all I have to do is show up hydrated and extend my arm. But the thought of “what if this were for my kid” is hard to shake.
Ok, anyone who reads my blog knows that I work out very regularly and that I continue to participate in endurance sports, weight lifting and yoga.
But look at the above photo.
I find this downright insulting.
Why? Well, I certainly agree that working out regularly can increase one’s odds of being healthy as an older person. But that is all one is doing: increasing one’s odds.
An untimely disease can easily lead one to the left photo; since 2007 I’ve had three 50-60 year old friends die of cancer. ALL were fit for most of their healthy lives; one even ran a sub 3 hour marathon at 50 years of age…all had finished multiple marathons.
All were slender and stayed with it as long as they could. But this idea that someone who ends up on the left is certainly to blame for not doing things right is sheer nonsense…in fact it is insultingly stupid.
Reading this diary inspired me to gather my thoughts on this subject. This interests me because I struggled with overeating and morbid obesity; I reached my top weight of 320 pounds (size 52 pants; I am 6 feet tall) back in the winter of 1992.
I am at normal weight (188 +- 7 pounds or so) since 1995.
I’ll talk about what I’ve learned through personal experience and through research.
Diet (what we eat).
Perhaps the most important illusion is the belief that a calorie is not a calorie but depends on how much carbohydrates a person eats. There is an inflexible law of physics — energy taken in must exactly equal the number of calories leaving the system when fat storage is unchanged. Calories leave the system when food is used to fuel the body. To lower fat content — reduce obesity — one must reduce calories taken in, or increase the output by increasing activity, or both. This is true whether calories come from pumpkins or peanuts or pâté de foie gras.
To believe otherwise is to believe we can find a really good perpetual motion machine to solve our energy problems. It won’t work, and neither will changing the source of calories permit us to disobey the laws of science.
Did you ever ask whether people respond differently to diets of different compositions?
Dr. Rudolph Leibel, now an obesity researcher at Columbia University, and I took people who were of normal weight and had them live in the hospital, where we diddled with the number of calories we fed them so we could keep their weights absolutely constant, which is no easy thing. This was done with liquid diets of exactly known calorie content.
We kept the number of calories constant, always giving them the amount that should keep them at precisely the same weight. But we wildly changed the proportions of fats and carbohydrates. Some had practically no carbohydrates, and some had practically no fat.
What happened? Did people unexpectedly gain or lose weight when they had the same amount of calories but in a diet of a different composition?
No. There was zero difference between high-fat and low-fat diets.
Note: the discussion centered on body fat and not things like water retention (which can bloat and cause large weight gain).
Physically, what we have going on is this: food is taken in; it has a caloric value. This is energy input.
Some of the energy is not absorbed by the body; it is just expelled. Of the energy that is absorbed, some is used for energy (daily activities) and the rest, if any, is stored. Period.
Of course, there is human variation in how much energy is assimilated by the body (made available for use and for storage). There is also some variation in how easily one stores excess energy; some people really do gain weight easier than others. And of course, there is variation on how easily people used their energy stores. Of course, different foods interact with different people in different ways as well. But ultimately, energy that isn’t taken in can’t be stored; all of us would starve to death if we didn’t eat enough.
Of course, there is also human variation on how efficiently one uses energy. Some people have reptilian metabolisms and don’t burn off that much. Also, getting more physically fit makes one use calories more efficiently; in fact this is a big part of what endurance sports training is about.
I completely understand that nutrition is about much more than weight; one can be overweight and undernourished (as many of our poor are) and that is a big political/moral issue. I also know that one can be thin and be in poor health too.
Of course, starvation level eating isn’t good for anyone. There is some evidence that slightly undereating has some health benefits, but I don’t know what to make of it.
A quick glance at an calories per hour exercise chart shows that, unless one is an elite athlete, exercise doesn’t burn off that many calories. This matches my personal experience; I found that when I was training for a very long footrace (24 hour event), all I needed to do to meet my training energy needs was to add one or two pieces of fruit per meal!
Still, exercise is good for you; however unless one has the personality that makes them love it (as I do), they probably won’t stay with it. The non-addicted probably have to add other reasons to stick with exercise (e. g., make it part of one’s socializing with others).
Most who start exercising say the goal is to lose weight or improve their health. But those who begin on the promise of imperceptible health effects often stop, Dr. Dishman said, saying they do not have time, or are too tired after work, or they just lost interest.
And there are no good studies investigating why people keep exercising. Dr. Dishman and others suspect the motivation is sheer pleasure — feeling energized, a boost in mood, feeling restless and uncomfortable without exercise. And you may not be able to will yourself to have this response.
Biological traits, Dr. Dishman says, “seem to play a bigger role in both the choice to be active and the outcomes of being active than folks — namely public health advocates— have been willing to admit.”
Dr. Dishman cites himself as an example of someone who craves exercise. Until about five years ago, he was an avid runner. Then his knee failed him — severe osteoarthritis — and he has not been able to run since. He still has dreams that he is running.
But instead of giving up on exercise, he rides a stationary bike simply because working out feels so good to him.
“If I can feel better after 30 minutes of riding in my office, alone, going nowhere, it has got to be something about exercise,” he said. But for him, as for many others, slow, moderate exercise does not bring the same physical pleasure. It must be hard exercise, meaning it has to require real effort, the sort of workout that makes people breathe hard and drip with sweat, Dr. Dishman says.
Frankly, I got fat because I ate too much. Period. But stopping my overeating was impossible for me to do alone; I needed a support group. I still am with the group even though there are many times in my life when I just don’t feel like going. I see it as my physical therapy.
As far as eating: I stick to eating at set times; I don’t “snack”. There are also certain foods I never eat, period. They set off cravings. There was a time in my life when I felt deprived at times, but those times have faded; now-a-days, I do NOT feel deprivation, at least the vast, vast majority of the time. I simply don’t care about food all that much.
Note: I’ve had to adjust my diet (not temporary weight loss diet, but “diet” as in “what I eat”) throughout the years; an active 52 year old needs less food than a 48 year old, who needs less food than a 44 year old…etc.
Also, I take the position that I have NOT “arrived” and never will. I treat my tendency to overeat and gain weight as an ongoing, chronic condition.
I have a “before” photo followed by some “after” ones; note that I chose general election years: 1992 (top weight), 1996 (normal weight), 2000, 2004, 2008 and 2012.
Yes, I enjoy running, distance walking and swimming (as sports). But when I lay off (illness or injury), I don’t gain weight. I watch my weight so I can train; I never walk, run or swim any distance to allow myself to eat. That is a dangerous place for me to be in.
I’ve mostly chosen sports photos so you can see my body:
Me, in 1992
1996, at my wedding
2000, at the end of a 10K run.
2004, at the end of a 5K run (with a runny buddy)
2008, after a 5K open water swim. Yes, that was the official swim t-shirt and medal. This was in Chicago.
In 2012, at the finish of a 15K run.
Economy Forget the “Obama is a big spender and we need austerity” narrative. It isn’t true.
I remember talking to my doctor about chest pain. I told him the symptoms and he said “no stress test; the chances of a true positive are so low that we’d learn nothing from it.” He was right; he knew how conditional probability works. Not all medical doctors do. Upshot: even new data might not get a smart person to change their mind.
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