Sunday, June 26, 2011
While Russ gets the wekeepitoff.com site back up and running, I'm going to repost my columns from there on my blog here so I can refer to them when I need to.
Strength in Numbers Predictors and Behaviors of Maintenance
BY ANGELA BALDO – JUNE 2, 2010
POSTED IN: ANGELA BALDO, AUTHORS, FORGING AHEAD, LIFE POST FAT PANTS, UNDERSTANDING MAINTENANCE RESEARCH, WHAT IS MAINTENANCE?
What are successful maintainers actually doing? Scientists are actively researching these questions and publishing their findings. Our resident fat ass-now-bad ass, computational biologist Angela Baldo, reviews those findings and distills their wisdom for you.
“Maintenance of Long-Term Weight Loss”
By J. Graham Thomas, MS, and Rena R. Wing, PhD
Published In: Medicine and Health Rhode Island, February 2009
Full text available:
If I hear one more person say, “just keep doing what you did to lose the weight,” I think I will scream. I have gained and lost 100+ pounds twice — losing weight wasn’t the problem, but keeping it off sure was.
Because while similar to weight loss, maintenance has subtle, important differences, both in procedure and in psychology. This is the whole point of the Second Helping Online, and today I will focus on some specific strategies that have been shown to be statistically associated with successful weight management after loss.
One of the most exciting aspects of emerging weight loss maintenance research is that it can help us understand what kinds of things we need to do in order to keep the weight off. The big difference between this approach and others I have seen is that there is actual scientific research backing up the claims, rather than some “expert” speaking about his or her individual personal experience or philosophy.
National Weight Control Registry team member J. Graham Thomas (interviewed recently by our own Russ Lane) published an article last year with Rena Wing in Medicine and Health Rhode Island, the official member newsletter of Rhode Island Medical Society. In this paper Thomas outlined the strategies that are most statistically associated with weight management.
Here are the best predictors of keeping weight off:
1. Longer duration of weight loss maintenance (more than 2 years)
2. Dietary consistency
3. Less fast food consumption
4. Less TV viewing
5. More frequent breakfast consumption
6. Lower levels of depressive symptoms and dis-inhibited eating
Key behaviors associated with weight maintenance are:
1. Activity levels of over 200 minutes per week (at least for women in the cited study)
2. High levels of dietary restraint, such as:
Deliberately taking small helpings
Avoiding certain foods
3. Having lower levels of depressive symptomology
4. Controlling overeating
Yes, this means that it’s important to continue logging and/or controlling eating. It’s important to keep exercising. A lot. If you want to keep the weight off, these behaviors need to continue.
One of the more interesting behaviors listed was controlling depression. This means getting help in the form of therapy and/or antidepressants, if necessary. It is not a factor one usually hears about in terms of controlling weight, but it makes sense: how is a person going to make rational, healthy decisions while suffering from mental illness?
Along with summarizing the strategies taken by successful maintainers, the article discusses how to teach these strategies. One of the most important factors associated with weight management was frequent weighing and using that information to regulate behavior.
Thus, as with any feedback system, the best control is achieved by:
1. Frequent monitoring
2. Immediate correction
Given these research findings, I find it stunning that there are no dedicated evidence-based weight management programs. Most programs focus on the weight loss, and tack on a slipshod “management” guide at the end as an afterthought. At best they tend to be based on the personal philosophies of “experts.”
I would love to see a program that leads people through the transition from loss to management, walking that delicate tightrope between exploring the wonderful new options that a healthy size offers in life while staying grounded and accountable to maintenance. There are plenty of weight loss programs out there, but why are there none oriented specifically toward weight management after loss?
Is it because weight management doesn’t pay as well as loss? Management isn’t as exciting as loss? So few people focus on management that there isn’t a market for it? A combination of these reasons?
People do successfully lose weight using weight loss programs. But unfortunately they also tend to usually gain back the weight. Is it any wonder? I would like to see this changed. Please, someone, develop an evidence-based program. But please, develop it!
Not only for me, but for the thousands upon thousands of us who spent so much time and energy (and even money) on getting the weight off. It is too important in terms of our health and our quality of life, just to let the pounds slip back on.
Thursday, June 16, 2011
Yes, weight loss is like a journey. BUT the metaphor is misleading and can lead to regain.
Why? Because this is not a journey to some mountain top after which we get to say "I made it to the top of Fuji!" (or Kilimanjaro or Mt. Washington or whatever destination you choose) and get a T-shirt and go home.
This is not a journey like a race somewhere that you get to cross a finish line and say "Yay! I ran 26 miles!" (or rode 100 or my bike! or swam a mile! or whatever goal you choose) and get your medal and go home.
THERE IS NO GOING HOME.
Because your destination IS HOME.
Let me repeat that.
YOUR DESTINATION IS HOME.
In other words, this is not like a trip to some vacationland from which you plan on returning. Unless you really WANT to gain the weight back??? (You don't, do you? I sure don't.)
THIS IS A RELOCATION. YOU ARE MOVING TO YOUR NEW "HOME."
Your current location is a barren wasteland. Where you are uncomfortable with how things are. You are going to a happy place, of comfort. Things in this new place may be unfamiliar. You will have to make adjustments. But you are going there because you believe you will have a better life.
YOU ARE EMIGRATING.
If you do not see your goal as your new home, you will surely not stay there. How can you?
I have no idea what a "normal" person eats. I guess that depends on your definition of "normal."
What a standard American eats will not keep the weight off, that's for sure. See this article for some numbers:
This came up because I found myself writing a novel-sized comment on a blog by SARA72121 that asked "Will I ever be able to eat like a normal person?"
Sara is very good at losing weight consistently. She rocked it in a recent "last one out" team challenge. I have tremendous respect for her abilities. And I'm re-posting my comment here as a blog topic in its own right, because I think it's important.
Maybe some of those people she sees are treating themselves and won't eat for the rest of the day. Maybe they're only taking two bites and leaving the rest on the plate. Maybe some of them are competitive swimmers and burn 12,000 calories in training per day. Maybe some of them are hyperthyroid and have a high basal metabolic rate.
I eat ice cream. I do. A kiddie-sized scoop in a hand-made waffle cone.
But I only do it once a month, only at the awesome place that makes their own that was written up in the NY Times, and I track it. Most of the people I see eating ice cream there are either obese or young (i.e. not yet obese). Some are just overweight. A few are healthy-looking.
But I know what I need to eat in order to keep my size at a happy place, and in the end I guess that's all that matters, because that's where I want to be.
If you don't think of a maintenance level and quality of food as "normal" then you will surely gain the weight back. I agree. And I've lived it, too. In my 20s I lost over 100 lbs and then gained it all back plus almost 100 more.
It doesn't matter what is "normal" for anyone else. What matters is MY new normal. The amount and type of food that fuels the activities I like to do and keeps me comfortable with how I feel. The amount and type of food that lets me stay "home."
Once I started seeing it that way fighting the occasional regain wasn't so onerous. I didn't feel like "Oh crap, here we go again. And I've already been there, so it's no longer novel or exciting."
Instead it was, "Oh man, I wanna go HOME again. where I can wear my favorite clothes again. Where I like how I feel and what I see in the mirror."
And that is the difference for me. It is subtle, but I think it's important.
I have to credit one of my spin instructors for explaining to me that she sees it that way. But once I got it, it really clicked. Maybe it will help you, too.
Thursday, June 16, 2011
If you go to my Physicsdiet.com page, you'll see the following thing on there:
That thing was a long time coming, the first time, back in January of 2010. My recent fight to get back to healthy (in my 40s as opposed to the other time I lost over 100 lbs in my 20s) has not been smooth, as you can see from the overall graph:
I should probably explain what you are looking at. Those are (mostly) daily weights. Physics diet works according to the Hacker's Diet principle in that weights are smoothed using a weighted moving average. There is a trend line automatically calculated by the site that works like a stock price graph. The idea is that as long as you're under the trend line you're moving in the right direction (green). If your weight pops over the trend line it goes pink.
We have a whole Spark Team about this if anyone is interested:
Doing this helps combat scale anxiety in situations where there are normal water fluctuations and plateaus. As long as you're in the green, you're going in the right direction, so no need to freak out. I sort of wish the scale haters on this site would give it a shot, because it might help them. But some people don't want to monitor frequently and they don't like numbers, which is OK. You have to find what works for you. This works for me.
Back to contemplating the graph. There were relapses in there. Most notably last year when I got all excited about white water kayaking, and sidetracked by triathlon training and started neglecting the tracking. Which resulted in a 30-lb gain.
This year I've been sidelined with a rotator cuff surgery in May that will require rehab (and no kayaking) until after October. I can't even ride my road bike outdoors yet. Bummer. But it has given me an opportunity to focus on the food (which is 90% of the battle) and try to learn patience (which I am deficient in).
So anyway, here I am, back at a "normal" BMI according even to the Physics Diet average. I would feel more excited about this except that I'm still recovering from a nasty flu and I can't actually go out and do the things I love anyway, because of my shoulder.
So I'll just have to spend my time figuring out how to stay here.
One thing I'm not so jazzed about is my loss in lean muscle mass due to the shoulder restrictions. I've lost a lot of muscle from my upper body because I can't lift. I've been trying to counter that with some limited lower body and core work, but the possible gains below the waist don't seem to be offsetting the losses above.
Normally I suggest that people get to a BMI of 30 (which I consider marginally "healthy" for most folks) and then try to focus on % body fat.
I'm having to make an exception in my case due to injury (and illness at the moment) and focus mostly on the BMI number and hope that when I'm recovered that I'll be able to build the muscle back up.
Because the point, after all, is not really the color of the font on my Physics Diet page, or the number underlying it. The point is to have a high strength to weight ratio so I can do the things I like to do.
Which I will hopefully be able to do by November.
Monday, June 13, 2011
Fredrick Ranney Lewis
Geneva; Fredrick Ranney Lewis, 51 of Yale Station Rd. passed away Sunday June 5, 2011 at Geneva General Hospital.
Funeral services will be determined at a later date by the family. He will be greatly missed.
Fred was born in Geneva on December 6, 1959 the son of Trudy Suppes Lewis and the late Richard Lewis. He was an intelligent and compassionate man who touched many lives, while working as a Respiratory Therapist for over 10 years at Geneva General Hospital among other local hospitals
Fred leaves three children; Katie, Fred and Sam Lewis; a grandson; his mother, Trudy Lewis of Geneva and his former wife; Sandra Lewis.
Arrangements have been entrusted to the McGuigan & Bero Funeral Home.
I met Fred at church. That's how he found his way here.
One of the people in church announced it today. We were surprised; we didn't know he was unwell, although we had not seen him lately.
I didn't know him well, but the few conversations we did have were genuine. The last time I saw him he said he'd turned a corner in his life, in a good way. He didn't go into details, but I was happy for him.
I'm sorry he's gone and hope he is content where he is now.
Saturday, June 11, 2011
I'm still unable to ride outdoors but I got to see DDOORN as he went by on his 79-mile tour today. Their route went right through my neighborhood.
Apparently he lost a water bottle at the beginning of his ride this morning so I brought out a big pitcher and topped off riders as they went by.
We chatted for a while and then he continued. I'm looking forward to reading how the rest of his ride (and weekend) went!
Later today I'll head down to Ithaca with my violin for a fiddle workshop to find out if:
1) Any of my bows have any hair left on them.
2) Whether I still remember how to play.
3) Whether my shoulder can even handle bowing, 6 weeks after rotator cuff repair.
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