Wednesday, December 29, 2010

She's Going on a Diet

Source: BBC News

What's a self-respecting mother of the bride to do? Besides (perhaps) helping to choose the dress and hold her daughter's hand through the stress of wedding preparations, every good MOTB absolutely must go on a diet.

Unless you've been living under a rock for the past few years, you've no doubt recognized the lovely Kate Middleton in the photo above, who is set to marry England's Prince William in April 2011. Kate is seen in this photo with her mother, Carol Middleton, the very picture of extreme obesity.

Yes, already looking quite glamorous and svelte is definitely not enough for the soon to be royal Kate's mum. Word has it that she has decided to go on the "Dukan diet" to lose those unsightly pounds (read: you can't see any excess weight but it must be there) before the big day.

I googled the Dukan diet and without putting too fine a point on it, it's Atkins to the nth degree. During the initial phase of the diet, you are severely restricted in your food choices, allowed to eat lean protein ONLY to produce rapid weight loss...and vitamin deficiency, constipation, bad breath, etc. Yes, you do then start re-introducing various foods, but the extreme nature of the diet makes it unhealthy, both from a nutritional and a psychological point of view.

I think this article from WebMD sums up the madness quite well. I suggest reading the whole article, but here's a little excerpt:
There is no question this very restrictive diet will lead to weight loss, if you can actually follow it. But the elimination of healthy food groups, and the unpleasant side effects, makes The Dukan Diet an unlikely choice for the long haul.

My husband just peeked over my shoulder to see what I was writing and made an, as usual, intelligent comment: "Anyone going on TV in front of a billion people might consider going on a diet too." Yes, he's right. But Middleton's mother is also a role model for billions of people by virtue of the fact that she's the mother of the future Queen of England. And in my books, she's setting a bad example.

Monday, December 27, 2010

Musings on Metabolism

I recently came across this short article in the New York Times, entitled "Nigeria: Those Born During Biafra Famine Are Susceptible to Obesity, Study Finds", which describes how the children of those who were born to women starving during a country-wide famine have grown up to be more likely to suffer from obesity than those born of women who had enough to eat during their pregnancies. This article got me thinking: did the mother's starvation trigger a metabolic change in the foetus, in other words, was the foetus's metabolism slowing down in order to conserve as much fat (an energy source) as possible in order to survive? I'm not a scientist, but I think this is about as good as hypothesis as any, especially in view of the masses of anecdotal evidence showing how dieting messes with your metabolism and sets you up for a lifetime of starvation in a quest to maintain a lower body weight.

When the body is radically undersupplied with the number of calories it needs to maintain a steady weight, it does not perceive this as simply a "diet". The mind may think it is acting reasonably by controlling calories ingested and burning additional calories through exercise (dieting) while the perfectly designed body--working only on the instinct to survive--fails to distinguish between starvation pure and simple and this "diet".

Since the body only recognizes a state of starvation or a state of non-starvation, what does it do when it notices that it is starving? Simple: it goes into energy conservation mode. It seeks to protect what is most precious to its survival--fat--while using up the "less important" muscle stores. The human body is a master at adapting. Fewer calories in? Let's burn fewer calories since we're under attack and in danger of dying of starvation. That's the metabolism story. I suspect that's also the story of the obese Biafran adults of today.

A perfect example of how metabolism adapts (read: slows down) can be found below in Andrea's story (quoted with permission from Andrea in a response to a post on Debra's Just Maintaining):

It’s decidedly unfun to have regained 25 lbs. (of a 49 lb. weight loss) over the past two years while eating “moderately,” “intuitively,” and “healthfully,” and while exercising 5-6 days a week doing a combination of step aerobics, hi/lo aerobics, and pretty intense strength training, all done to the DVD workouts of the most advanced instructors in the industry (cardio done on all exercise days, strength sessions 3x/week -total exercise time per week 5-6 hours).

I swear I have read AND implemented all the recommendations and I just cannot maintain the weight loss without RESTRICTING my food intake and UNDEREATING. But, if I do that for too long, the “EAT” impulses get very strong and I eventually succumb. I would actually get “EAT NOW” impulses in the middle of the night and couldn’t fall back to sleep until I ate something, which was usually a piece of grilled chicken leftover from dinner or some reduced fat cheese or sliced turkey breast. It was crazy! Trust me, standing in front of an open refrigerator jamming Pollyo part-skim mozarella sticks into your mouth at 3am is really pretty cuckoo. Thankfully those episodes have stopped since I’ve gained weight.

Lest anyone think I had dieted myself to underweight, that wasn’t the case. I’m 5’6″, lost down to 147 lbs. and I’m now at 172 lbs. I don’t eat processed foods of any kind, I don’t eat out in restaurants, I cook all my meals from scratch, I eat a Meditteranean style diet, I eat tons of fresh vegetables and fruits (produce bill is outta control!), I don’t stuff myself, I don’t eat sweets AND I exercise vigorously. It drives me crazy that it’s assumed that I somehow didn’t make the necessary “lifestyle changes” because if I did I wouldn’t have regained.

The biggest myth we are fed (pardon the pun) is that once we have reached the magic number and have made those "lifestyle changes", we will be able to eat "normally". By normally, I mean eating the number of calories that your height, (new, reduced) weight and exercise expenditure should allow you to eat without regaining. Time and time again, people find that this just isn't true. Like Andrea (and Debra and countless others), they must continue to "undereat", stingily meting out a low-calorie diet to their mildly starving bodies for the rest of their lives to maintain the hard-won weight loss. And I'm referring here to people who did not revert (or perhaps never even indulged in) the fast-food lifestyle. Once again, I refer you to Andrea's comments: fresh, unprocessed food, eaten in moderation, coupled with regular, vigorous exercise...leading to weight re-gain unless caloric intake is consciously and constantly restricted.

I have a number of questions: Are some of us innately more prone to easy gain weight, no matter what our eating profile? If you are, shall we say, naturally on the heavy side, will a "clean" eating regimen only somewhat mitigate your overweight state or just slow down your return to being overweight? Is this propensity exacerbated by a lifetime of dieting, in other words, training our bodies to only maintain the new, lower weight in a semi-starved environment? What is dieting doing to our metabolism?

I am always distressed to read about bloggers who have thought they had graduated to "normal" eating, only to find that they were packing on the pounds as soon as they departed from significant caloric restriction. I'm not talking about people who have gone from perfect dieting to out of control binging. Just people like Andrea.

Monday, December 20, 2010

Big Knee News!

On Friday, I saw the surgeon who specializes in wonky knees of the feminine persuasion (I thought of saying "wonky women's knees" but then there might be some confusion: is it the women who are wonky or is it their knees? You would have to decide, and possibly not in my favour!). He was fantastic.

Dr. C. spent quite a lot of time with me (and my husband, who came as an extra set of eyes and ears), explaining what was going on with my knee (and my hip and my pelvis--I'm a walking orthopedic disaster). It was quite technical, but it was refreshing to have a specialist speak to me like an intelligent human being. He also explained that he's been doing this work for many years, how he came to this specialization and then--sounding like a young and eager student--he told us how excited he was to recently meet five other surgeons at a conference in Holland who are working in the same field. Apparently, not many surgeons know how to treat these nasty knees.

He covered my left knee with all kinds of lines showing where my kneecap is, where it should be, the direction of the tibia and an X whose meaning I have forgotten. His comment upon viewing my x-rays was "interesting". Then he launched into a very technical discussion with a fellow surgeon for a minute or so before coming back to me (I heard it through the curtain).

He explained that there were two ways to deal with the problem. One was a lot more complicated, required no weight bearing for four weeks (that means no walking on the operated leg) and fortunately not suited to my particular situation. The solution for me is a total knee replacement (TKR), but done in a way that will re-align my leg, in addition to replacing the deteriorated knee joint. He explained that a regular TKR would not solve the problem because my femur and my tibia are out of alignment...something which I realized myself a long time ago, and which has made traditional exercise like stationary biking not only painful but totally useless.

The one thing he did not ask me was how much pain I have. I found this non-question refreshing too. Part of my knee joint is "bone on bone", meaning there is no cartilage, the natural cushion between bones that enables joints to move without pain. He acknowledged the state of my knee and didn't ask me to justify why I was consulting him by begging for pain relief. The knee's a mess and he knows it. End of story.

I have some papers to fill out and mail back to his office and then I wait. It will be about 11 months before the surgery. I know that my American friends might find this shocking, but I'm perfectly fine with the timeline. As long as I don't do anything crazy like try to use my exercise bike or the elliptical trainer, my pain level is mostly quite low and I can still walk fairly long distances, as long as I don't try to speed walk. So, waiting a few months is definitely not a big deal. And remember, not one cent of this surgery, which will be done by an expert in the field, is coming out of my pocket. Well, yes it is, in the form of taxes, but I don't have to cut a cheque for X thousand dollars to be treated. This is a big plus in my books.

I admit to being scared of the surgery. My hip surgery was a nightmare, though I think it was worth it in the final analysis. But this surgery will be with a different doctor, and it's altogether a different situation. I'm not a great believer in the power of positive thinking. When things go well, they go well. When things go wrong, positive affirmations do nothing to turn things around. Believe me, I am living proof of this. What's important is to have a good surgical outcome and then put in the work to make the best recovery possible. After my hip surgery was successfully re-done, I invested a huge amount of time and energy in re-learning to walk and to the untrained eye, I walk like a normal person. It's all a question of the surgeon's skill, damn luck and hard post-op work on my part.

All this being said, I certainly won't refuse all your good wishes, though. Especially on the day of my surgery!

Monday, December 13, 2010

Change of Direction or...Overwhelmed by the Weight of It All

Those of you who are still dropping by my blog have no doubt noticed that I am blogging less and less often. There are basically two reasons for my lengthy absences: life and the fact that I am edging closer and closer to a complete change of direction.

You may have also noticed the complete revamp of my blogroll. Gone are the overtly dieting blogs. I'm sorry to have removed these blogs from my blogroll. If I chose them in the first place, it's because I really liked the writers behind the blogs and in fact, I continue to feel the sincerest good wishes towards these bloggers. And yes, I do still read them from time to time.

You'll notice that most of my blogroll is now made up of IE (intuitve eating), HAES (health at every size) and FA (fat acceptance) blogs. Every person on the face of the earth has a unique point of view. I am no exception. I therefore don't necessarily agree with every single word in the blogs I suggest, but they are much closer to my way of seeing things than the dieting blogs.

Yes, the good ship NewMe is slowly taking a new direction. After spending almost two years in the diet blogging universe, I realized that it's really not for me. There are many reasons for this change of heart.

I think I really started to feel uncomfortable with the diet blog world a few months ago when I ran across a blog that lots of fellow bloggers/readers were raving about. I started reading it every day, in fact several times a day, and I read all the comments too. I became addicted to this blog...and really not in a good way. It was filled with hate and disdain for anyone who was not following the extreme path towards weight loss that this blogger had chosen. It was filled with profanity (and believe me, I have been known to let fly with a few choice words from time to time) that I found unnecessary, demeaning and debasing. But what disturbed me by far the most was how the readership (filled with pleasant, serious bloggers I also read) followed the writer's lead with nary a peep. It was as if they actually couldn't see all the hateful blather before their eyes and instead concentrated solely on the writer's stellar weight loss achievements. And indeed, these achievements are amazing (and I imagine still are, though I have avoided reading the blog for awhile now), though I believe that they are totally unsustainable.

I realized that we are all looking for a miracle and that miracles don't exist. Make no mistake about it: I include myself in this group and it doesn't make me glad at all.

As I went cold turkey from the hate blog, I discovered Debra's Just Maintaining, a blog that in my opinion, really tells it like it is. Although Debra is one of the favoured few who has lost a substantial amount of weight and kept it off, she has no illusions about how hard both losing and maintaining are, and she is well aware of the fact that the vast, vast majority of people just can't keep the weight off.

What has particularly impressed me about Debra's blog is the amount of research she puts into her posts. Her meticulousness on the research front has actually practically stopped my own blogging dead in its tracks. I just don't feel that I can make any statements without backing them up with copious research, as is the case for Debra. So Debra, I owe you a debt of thanks for your amazing blog, but sometimes I feel you've set the bar so high that I can't imagine jumping over it myself!

And finally, my own personal experiences with weight loss since I started blogging, coupled with the research and reading that I have done, have increasingly led me to see the whole issue as so vastly complicated--both on a physiological and a psychological level--as to be virtually impossible to tackle.

The plain truths, like "calories in-calories out" are not so plain and certainly not so truthful; the role that gender plays in weight loss is truly frightening (the female body, which is naturally less muscled than the male body, is by definition at a disadvantage in the weight loss sweepstakes); the extent to which we in North America are surrounded and tempted by terrible food; the extent to which we learn to both crave and fear all foods (both good and bad) in this upside down world; the amount of hatred and self-hatred when it comes to being overweight....

...the weight of it all is overwhelming.

Like one of my favourite bloggers (you know who you are), I too "think too much". It is both a blessing and a curse.

I continue to stumble along, fighting my own weight demons and sometimes even fighting the demons I see around me. Stay tuned.

Sunday, December 5, 2010

Ft. Lauderdale


I'm in Ft. Lauderdale at a conference for a few days. This is a view from across the street from the hotel. The weather here is amazing. While it's probably just same 'ole same 'ole for Floridians, it's always amazing to leave your home where it's -1C and get off a plane in a place where it's about 25C. For my American friends, that's about 30F at home and 75-80F down south.

Although it's a lot less exciting travelling than it used to be, I really can't complain. Today is a short day and I've got the afternoon off. I'm waiting for a friend to pick me up so we can go out for lunch. The sky is gorgeously blue and I've already taken a nice walk along the beach.

I'm starving. Time for lunch!

Gratitude statement: Need I say more?