Correlation or Causation?

Doesn't that just say it all when it comes to correlation and causation?

Have a good day...and learn another language!

Apologies from Canada

The New York Times is reporting the latest in "get thin quick" schemes: the intragastric balloon, which is inserted into the stomach via the oesophagus and then filled with liquid. Read about it here. By taking up room in the stomach, the balloon gives patients a feeling of satiety, thus causing them to eat less and lose weight.

Of course, the safety of this procedure--which, to be fair to Canada, is performed in Europe, South America and elsewhere in the world, though not yet in the States--is questionable. A ruptured balloon getting stuck in the intestines is not my idea of a fun afternoon. Like other weight-loss procedures, there is a non-negligible chance of death involved.

Of course, the cherry on the sundae is the comments section that follows the article. Like the Sunday brunch buffet at our local pub, it is full of the same old-same old:

-"cut out soft drinks and red meat like I did and you'll easily lose scads of weight";
-"eat less, move more";
-"stop being a glutton";
-etc. etc.

There are a few lone voices in the wilderness pointing out how difficult it is to lose, and more importantly, to keep off the weight, but as usual, they are shouted down by the nightmare on ELMM (eat less-move more) street people.

Please accept my personal apologies from Canada for this latest assault on common sense and body diversity.

Judging a Book by Its Cover

This video brought tears to my eyes for several reasons. The shame and sadness you could feel in this teen's words were overwhelming and horrific. I will never understand those who believe that shaming and blaming a fat person can ever be helpful. His friend and partner in song is truly a fine soul.

I hope this boy gets the support he deserves. As someone who studied to become a professional opera singer myself, you can take my word on this young man: he is phenomenal.

Apparently, you will have to click on the link to youtube to watch this. Please do. It's a totally amazing clip.

Power Point, Books and Washing Machines

Watch one of the best speakers I've heard in a long time, as he makes judicious and brilliant use of Power Point to make some profound statements about the world today:

It Ain't Easy

Warning:

This is a personal post that has nothing to do with weight. Feel free to skip it.

At 55, I am an energizer bunny: the last time I had my period was only 5 months ago. I'm not even officially into menopause because it has to be a year since my last period.

I am finding this time in my life physically and emotionally just HORRIBLE. Besides the hot flashes (which were worse this summer because of the ambient heat, but still a pain in the butt now because they wake me up at night), I am in a scary emotional state.

I think part of the reason I am going through a relapse of Graves disease (hyperthyroidism) is the fact that I'm starting peri-menopause. Graves is totally messing up my hormones, so I am even more emotionally unstable. I work in a very stressful environment. It's just the nature of the work and can't be changed, but my relationship with one co-worker in particular has become absolutely toxic and my ability to stay on an even keel around her is sorely tested. Although I had hoped to be able to overcome the stress of her presence thanks to the thyroid medication, the last time I worked with her (three days ago), I could literally feel my thyroid hormones going totally berserk again. I had my monthly blood test yesterday and wouldn't be surprised if my endocrinologist called to up my medication. I have some, but not total, control over whether I work with her or not. On a bad day, I am ready to quit my profession, but that would be financial suicide.

I have also been suffering from a (mostly) low-level headache for over a month. I saw my GP two days ago and we had quite the talk. We both think the headache--which is, BTW, much alleviated since I saw her--is stress related. She had me do a quick and dirty anxiety/stress measurement test. My score was frightening.

I do love my GP. She's a caring, wonderful woman. But I think she's a bit fast to prescribe pharmaceutical solutions to life's problems. When I was truly depressed over my failed hip surgery, all I needed was the promise of revision surgery to bring me out of the funk. However, I took my GP's advice and went on an anti-depressant (amitriptyline), which just made me gain weight. In retrospect, I know that it was totally unnecessary.

This time, she gave me a prescription for Effexor. Does anyone out there know anything about it? The reading that I did on the Internet has scared the pants off me. When I spoke to my GP, I specificially asked about how easy it was to wean off this drug. Her answer: no problem. That's definitely NOT what I'm reading on the Internet. Anyway, I've done my reading and talked about it with my low-key but very supportive husband and I haven't filled the Rx.

A few weeks ago, I signed up for an 8-week stress-reduction, self-esteem and mindfulness meditation course especially for women that starts at the end of this month. I told my GP about it but she still felt we should kick start my "recovery" through medication. I, on the other hand, feel that with the support of my husband, I want to wait and see how the course goes before plunging into something that may be very difficult to get out of (Effexor). I am also considering a weekend meditation retreat in mid-April. I believe very strongly in the power of one's own mind, although my mind is so "busy" that calming it down seems like a superhuman task.

Anyway, that's where I'm at. Thanks for listening.

Doing the Math

Leslie Beck is a registered dietician in Toronto who also writes a regular column entitled "Food For Thought" for the Globe and Mail.

There's nothing "health at every size"y about Ms. Beck. A large proportion of her articles deal with how to lose weight. Yes, she does stress eating healthy foods and does not tout fad diets, but her bottom-line message is that we are all better off losing weight. Weight loss is the holy grail.

I was somewhat intrigued, nevertheless, by one of her columns, "The New Weight-Loss Math", published in the G&M on February 22, in which she explains how the standard weight loss math--so beloved of so many weight-loss warriors--just doesn't work out as advertised:

According to U.S. researches, this ubiquitous weight-loss [NewMe here: in other words, cut 3,500 calories and you will automatically lose 1 pound] rule is overly simple and overly optimistic. And it can lead to unrealistic expectations about how quickly you can achieve a weight-loss goal.

The rule contends that cutting 200 calories a day from your diet would lead to a loss of 20 pounds over the course of a year and the weight loss should keep on going. But in reality that doesn’t happen. Weight loss slows and eventually comes to halt despite the drop in calorie intake.

This past weekend, at the American Association for the Advancement of Science’s annual meeting in Vancouver, an international team of researchers unveiled a new formula to better predict how people will lose weight on a diet.

The 3,500-calorie assumption doesn’t account for how metabolism changes during weight loss.

Your metabolism is the rate at which your body burns calories, and it’s largely determined by how much muscle you have, since muscle burns more calories at rest than body fat. Ultimately, it’s your metabolism that dictates how easily you will lose or gain weight.

As the body slims down, metabolism slows, causing it to burn fewer calories at rest. A smaller body also burns fewer calories during exercise. The net result: a sluggish rate of weight loss that can frustrate dieters and cause them to abandon their plan.

Now health-care professionals and researchers have a tool to more accurately predict a dieter’s expected weight loss over time, based on changes to metabolism. Having a more realistic sense of what to expect can help people stay motivated over the long term.

The new formula and accompanying web-based model were developed by researchers from the U.S. National Institutes of Health, the World Health Organization, Columbia University and Harvard School of Public Health,

The online tool – called the Body Weight Simulator – requires people to input their age, gender, body weight, height, activity level and weight goal (bwsimulator.niddk.nih.gov).

It then simulates what diet and exercise changes are required to reach the goal weight and what changes are necessary to maintain it over time.

Using this model, the researchers found that people’s bodies adapt slowly to dietary changes.

For example, the average overweight person needs to cut 100 calories from their current intake per day to lose 10 pounds over three years.

Half of the weight will be lost in one year and then you’ll reach a plateau, slowly losing the remainder by three years.

In contrast, for the same calorie reduction, the 3,500-calorie formula predicts you’ll lose 10 pounds in one year – and 30 pounds by three years.

I tried out the weight loss simulator myself and found that, given my inability to do heavy exercise, to lose weight I would have to starve. And to keep the weight off? I would have to starve slightly less. As it stands right now--and without doing a serious analysis of my daily caloric intake--I eat healthy foods in reasonable portions, ask myself if I am hungry before eating those few dried apricots, sometimes eat them anyway and sometimes desist, and am basically holding my weight steady. I really don't think that it is either healthy or feasible for me to feel constantly hungry for the rest of my life.

The only thing that I regret is the inability to do exercise that would help me increase my muscle mass. Worse yet, my orthopedic and thyroid adventures have "helped" me to lose further muscle mass. (Re)building muscle mass, I believe, would be a laudable goal--were it possible for me to do so. Indeed, I often wonder what my weight would be today if I weren't so limited in the physical activity that I can safely do. I suspect that I would weight slightly less, but that my body would never agree to be thin--unless I became anorexic and that is not in the cards.

Ms. Beck's article goes on to stress that you must soldier on, even when your weight loss stalls. She suggests the regular tactics, mainly insisting that you must be ultra-vigilant at all times with respect to every single bite you put in your mouth. It's the regular diet talk: what's considered disordered eating for an anorexic is to be applauded in a dieter.

In the meantime, as for me, I keep walking...