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Wondering how to define “weight maintenance?” Researchers do too

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.

Wondering how to define “weight maintenance?” Researchers do too

BY ANGELA BALDO – MARCH 16, 2010
POSTED IN: ANGELA BALDO, AUTHORS, LIFE POST FAT PANTS, UNDERSTANDING MAINTENANCE RESEARCH, WHAT IS MAINTENANCE?

Maintenance isn’t always what you think it is, scientifically. What you see in all the success stories is skinny people, folks that lost weight and presumably stayed there. But the research doesn’t necessarily define maintenance that way, or even stick to one prevailing idea.

So if you’re confused about what’s actually “maintaining,” don’t worry. What we’re trying to say is, “Look, not only do you not have a universal definition of maintenance, nobody does.”

One of the problems with interpreting the scientific literature in weight management is that the working definitions of “successful maintenance” may not match our own notions. And even worse, the definitions are not consistent from one study to the next, even sometimes in papers from the same research group!

Defining “Maintenance”

No matter the differences, every definition contains two basic parameters:

- The amount of weight lost
- The amount of time the weight was kept off

From a range of scientific studies, here are a few different interpretations:

Keeping at least 5% of their body weight off for 15 years
www.ncbi.nlm.nih.gov/pubmed/10702760

Keeping 30 lbs. off for a minimum of one year
www.nwcr.ws/

Staying within 5 lbs of goal weight for one year
www.ncbi.nlm.nih.gov/pubmed/1
0224727


Keeping off at least 10% of the starting body weight for one year
www.ncbi.nlm.nih.gov/pubmed/11375440

Maintenance can be measured in terms of the original maximum weight or the lowest weight ever achieved, or both. I selected a few studies from my collection to provide some examples. The 2000 paper I mentioned in my previous column defined successful maintenance as keeping at least 5 percent of weight off for 15 years. As I mentioned earlier, roughly 6 percent of the subjects accomplished that. The data from this study span 1975 – 1990.

In 1993, the National Weight Control Registry (NWCR) began with a different definition. To participate in the program, you must keep 30 lbs. off for a minimum of a year. To participate in the Registry at all, that’s still true today.

But even then, individual studies from the NWCR use different definitions of “success.” A 1999 NWCR paper defined “successful maintenance” as staying within 5 lbs of goal weight for one year. This is what I think of when I say “maintenance,” and I’m fairly certain it’s a common idea.

This changed in 2001. Since then, NWCR publications frequently define successful weight loss maintenance as keeping off at least 10% of the starting body weight. This amount of weight lost will not usually take someone from obese to non-obese status.

They use this definition because it’s rare for many obese people to achieve a healthy BMI, what they called “weight normalization” in this paper.

So the NWCR scaled back the definition to mean a loss that is more modest in terms of actual pounds (10%) but still significant in terms of health benefits.

With the definition also comes the caveat that research draws a distinction between whether the maintenance was intentional or the result of illness.

Without a consistent definition of maintenance in the scientific literature, it makes determining your own idea of maintenance that much more confusing. Some studies consider the lowest weight within any time point between the lowest weight and now, even if it has been regained. Others consider regain between the lowest weight and now as unsuccessful maintenance, even if the subject lost the weight again later. When you actually take the second data point is significant with a process like weight management, where fluctuations are common.

Even with all of the differences between our personal definitions of “successful” maintenance and between those in various scientific studies, these are the best data we have, so we will use them. When I summarize papers in this column I will attempt to clarify the specific working definition of maintenance for each study.

But the bottom line is you’re weight’s always going to creep up. You just have to keep pushing it down. We have to do the best we can with whatever information is available. Strategies that help people keep 10 percent of their weight off presumably will help me keep 54 percent of my weight off. At least that’s my hope.

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More blog posts about maintenance definitions:

Familiar faces from Biggest Loser illustrate how wildly maintenance definitions vary
www.sparkpeople.com/mypage_pu
blic_journal_individual.asp?blog_id=43
26080


Weight Maintenance Definitions, Revisited
www.sparkpeople.com/mypage_pu
blic_journal_individual.asp?blog_id=49
24102

  
  Member Comments About This Blog Post:

MYSTERY-LADY1 8/1/2012 9:23PM

    emoticon

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WATERMELLEN 6/29/2011 10:32PM

    I like the Judith S Beck approach to differentiating between lowest achievable weight and lowest sustainable weight (in "The Diet Solution").

Haven't yet figured out my lowest sustainable weight . . . working on that.

But know for sure: I want to keep a mid number 3. Yeah!!

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KAYOTIC 6/27/2011 9:12AM

    It is interesting how many different ways there are to define "maintenance" when it comes to weight loss. For me I've picked a "goal weight" and try to keep within 5 lbs of that, and have been fairly successful at that for the past 5 years. I do go over now and again, but not drastically so, so even with those blips I feel like my maintenance has been a success.

And even though you don't like the "keep doing what you did to lose" phrase when it comes to maintenance, I must confess to using this myself. I really believe in the "lifestyle change" aspect, and so do advice folks in the loss phase to find a maintainable option, that is, no crazy "I'll just do this to lose 10, 20, 50, 100 lbs, and then go back to eating my regular diet. I believe to truly maintain a weight loss a person has to be willing to change those eating habits.

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BLVINBUTTERFLYS 6/26/2011 10:04PM

    nice!

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JENNSWIMS 6/26/2011 12:33PM

    I really enjoy the scientific and less emotional looks at the science of weight loss. Thank you.

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CASSIES 6/26/2011 10:37AM

    Thanks for your bottom line and sharing this info.

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NOMUFFINTOP3 6/26/2011 8:19AM

   

Food for thought!

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SANSANDY1 6/26/2011 7:24AM

    emoticon

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Maintenance research encourages working smarter, not just harder

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.

Maintenance research encourages working smarter, not just harder
BY ANGELA BALDO – FEBRUARY 17, 2010
POSTED IN: ANGELA BALDO, AUTHORS, LIFE POST FAT PANTS, UNDERSTANDING MAINTENANCE RESEARCH, WHAT IS MAINTENANCE?
As of December 23, 2009, with nearly 180 lbs gone, my BMI is now miraculously in the “healthy” range and under 25. My weight is under 160 and heading toward 150. I’m registered for a local half-iron triathlon in July. I can wear tiny clothes again! I’ve made it! Again, for the third time.

Breaking the Vicious Cycle

The first time was at age 10, when a pediatrician traded my entire box of macaroni and cheese for carrots and powdered milk lunches. The second was at 20 with salads and raw tofu. Now in my mid-40s, I used three different nutrition tracker programs, kept a food scale in my purse and adopted a plethora of exercise regimes. This last time’s paid off. Now I’m almost as cut and defined as my Bodypump teacher and prepping for a triathlon!

But the question remains: how do I maintain the weight I lost? How do I stay as cut as my Bodypump teacher? Personal history isn’t on my side, and for all the highly detailed information on weight loss, all the “maintenance” talk tends to be be touchy-feely and motivational. Too many are lulled into a sense of false confidence and they aren’t given a roadmap of what to do. I have my motivation already, thanks; I’ve lost and regained twice already. I just need to know what to do.

Statistics don’t offer encouragement. In 2000, The International Journal of Obesity published that 94 percent of those who lose weight didn’t sustain their goal. After my attempts, it’s clear to me that it’s not just enough to ‘keep doing what you did to get the weight off.’ What do these 6 percent actually do to maintain?

Thankfully, a promising body of scientific literature has emerged asking these same questions. And unlike my previous weight loss attempts, now I have a PhD in genetics. With that degree comes the ability to analyze this literature and apply it to my life.

But what seems to be missing is a place to transmit and evaluate this information to everyone. A place where someone explains what it means, lists the mechanics of weight management in terms of specific behaviors and strategies. I couldn’t find a place like that on the internet, so I’m creating my own, here, for all of us.

Exploring Weight Management Research

Although there is a vast amount of information about how to lose weight, a comparatively tiny body of research exists on keeping it off. There are some very interesting findings coming out of groups like the National Weight Control Registry, where scientists analyze participants’ survey responses. We are learning through this research what works for most people and what doesn’t. Other groups also research maintenance, such as the Weight Loss Maintenance Collaborative Research Group and scientists in New Zealand, the United Kingdom, Sweden and Portugal.

Like any scientific work, the studies I’ll be exploring aren’t perfect. That’s not the point — what’s important is this literature proves useful anyway. I think we know how to work hard, but that’s not enough. Managing weight off is not about how intelligent you are or how much knowledge you have.

This research encourages us to be smart about how we approach maintenance, because relapse is always waiting just around the corner. It’s about what you do — not just being smart, but taking smarter actions. Working smarter. Everyday.

Working through the new scientific literature will help us both understand the process better and improve our odds. Because if 94 percent of the weight loss success stories don’t maintain a healthy weight, but that means 6 percent do. Those 6 percent are real, live human beings with free will and determination. I am going to do everything in my power to ensure you and I are among them.

  
  Member Comments About This Blog Post:

BRIAN36 6/30/2011 8:55AM

    I am a member of the NWCR and am always interested in reading about research relating to it.

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WATERMELLEN 6/29/2011 10:39PM

    I've lost a total of 90 pounds and kept it off (pretty much) since 2002, with a few blips (up to 172 in 2009) and the most recent additional 10 pound loss this year since January.

And I do know that what I have to do is:

1. weigh myself every day and catch even a 2 pound increase;
2. track nutrition and exercise every day: pretracking works best;
3. manage my environment by concealing the trigger foods (chips, cheese, peanut butter;
4. never eat standing up; sit down and eat slowly
5. tolerate hunger, and remind myself it's not an emergency;
6. sustain awareness of sabotaging thoughts -- such as that dieting takes too much time, or that it's unfair I cannot eat spontaneously etc. etc.

The Beck Diet Solution is the source of most of these strategies derived from her cognitive psychology orientation.

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MARTHAWILL 6/26/2011 8:40AM

    Great blog.I have lost 105 lbs now and am extremely motivated and confident. I've done this several times before but never lost this much or sustained the loss for any period of time. This time seems to be different. My mindset has changed. I do plan to be in that 5-6% successful maintenance group. I'm sure everyone else is saying the same thing but you have to say it with confidence and conviction or you are giving yourself a failure option.

Congratulations on your success!

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KAYAKKIM 6/26/2011 8:16AM

    Thanks for sharing your columns...they are so informative and are getting me thinking!

Hope you are having fun paddling as well as writing this summer!

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SANSANDY1 6/26/2011 7:28AM

    emoticon

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Strength in Numbers Predictors and Behaviors of Maintenance

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:
www.rimed.org/medhealthri/2009-02/20
09-02-53.pdf


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
Counting calories
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.

  
  Member Comments About This Blog Post:

BOPPY_ 4/1/2014 4:07PM

    One of the most powerful forces in social psychology is "it takes one to know one". This can be stated in many different ways:

* Identification is the most powerful force in learning
* Role models show the way
* Existence proofs: "If X can do A, then I can too, because I'm the same as or better than) X.
* Competition: I can outdo X
...

What I've noticed about many/most of the successful folks that have reached maintenance, and then been able to stay there for any length of time:

* Recognition why change is hard. And, if you're here (at SparkPeople) "you" have recognized. at least at some level, that you need to change.
* Change requires a program, and requires consistent, continuous effort to be effective.
* They understand the purpose of measurement and recording ("tracking")
* They understand the importance of empirical data
* They understand the importance of (a) identifying a problem, (b) understanding a problem, (c) finding a solution through measurement and empiricism.
* When and how to get help.
* Setting up a feedback system that uses observation and measurement to modify program parameters both quantitatively and QUALITATIVELY to make sure that the program progresses through all stages of its evolution

Many (most?) of the folks I've "seen" on SparkPeople do not have the skill set I've outlined above. Moreover, many of them are "dedicated" to avoiding those issues. Sometimes the culprit in these mis-efforts is defense mechanisms, but most often it is a world view (including but not limited to religion) that precludes the skills from being "entertained" much less learned.

I'm trying to figure out how to make this skill-set, or meta-program more attractive or digestible to more people.

What makes Angela's efforts above and elsewhere so interesting and important is that she's made the transition from applying her powerful skill set from losing to maintaining.

Thanks,


Lee emoticon

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ELIZADUCK 3/1/2014 9:38AM

  Thanks for posting this info! I remember the first (of six times) I reached my goal weight, and was concerned about maintenance. So I went to a Weight Watchers meeting. I just wanted to check it out to decide whether to join. They kicked me out! never went back THERE!

On the depression side, I think the connection is between neurotransmitters affecting hunger hormones and consequently insulin levels.

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MANDYCAT3 1/12/2014 5:55AM

    The point about there being no money in weight maintenance programs really struck me. I'm an early bird and usually watch the local 4 am news. I forgot that today is Sunday and thus no news cast so I spent 10 minutes channel surfing. More than half the channels were paid programs and three-fourths of those featured some sort of weight-loss-for-profit plan.

As in so many things, follow the money. I guess a "before" picture of someone at a healthy weight and an "after" picture at the same healthy weight doesn't make for sales.

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MAMMAC66 11/24/2013 6:58AM

    emoticon Thanks for posting this article. It was very concise and made a lot of sense. emoticon

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OOLALA53 8/25/2013 11:47AM

    The only thing I took from the NWLR is that it seems to take 2-5 years for new habits to become ingrained, and even then there is a chance for relapse.

I think we would have more success if people were to accept this from the beginning and not be so drastic in their attempts to lose weight in one fell swoop. I've been stepping my weight down over time and don't really feel that maintenance is that hard because my changes have felt very fair. I'm more concerned that even the NWLR represents such low success rates because of the emphasis on speed and consistency of loss.

We've got whole nations that live with an abundance of food but keep low average BMI's, meaning they are not thin because they are poor. I see a lot more potential in supporting people here to adopt more of their practices than on focusing on what are actually normally failed strategies with a few exceptions getting all the attention. emoticon

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MILLIFRED 6/9/2013 3:20PM

    There is one factor I have not seen dealt with anywhere. I was almost to my goal weight 6 months ago when I went on prednisone for RA; then 3 months later I went on again for another course. The result was about a 10 pound weight gain! I have decided that prednisone (steroids) are no longer an option for me and I hope this will resolve my problem with regaining weight. I'll just have to deal with the pain and use physical therapy type treatments.

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KEEPFIT2013 5/31/2013 11:59PM

    Thanks for sharing this. I need to be reminded of these indicators to help me stick with my nutrition and fitness tracking. So easy when life gets busy to drop off!!

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JOANNEHOLL1 4/16/2013 11:19AM

    This is just what I needed this morning!

emoticon

Joanne



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WENDYANNE61 4/14/2013 1:39AM

    This is one of the most interesting blogs I have read on maintanance - thank you for collecting all this helpful information! I am already aware of the beady (envious?) eyes of a number of people watching to see how long it will take for me to start regaining weight... I like my revamped body and rejuvenated mindset and am really interested in finding out how to sustain this momentum. emoticon

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RUSSLANE 2/17/2013 7:08PM

    Yay!

While I've been boning up on the research and talking with folks in public health about this, I came across an interested study of attempted interventions and all the criteria used to demonstrate is viability.

I thought "Sweet. A checklist!"

Moreover, other researchers are just beginning studies to distinguish behaviors between losers and maintainers (a study from two years ago that was my little "I told you so!" moment, lol).

The psychological and social implications of maintaining are really what set keeping weight off apart from weight maintenance, in my opinion. Actually hitting goal, staying there and dealing with all the changes to life it brings (not just the fun stuff) is what truly separates the two.

This is more my own data having worked on this for so long -- journalism's just ethnographic data by another name, really -- is it being common one of the big reasons people stop trying -- they hate the attention they're getting in "new body" so they get fat again.

It can be a drag, frustrating, all those things. Or those of us who've learned its ins and outs can actually show people that you A) don't have to regain or B) feel like you're in life sentence of weight-loss jail.

So I truly believe that for anything with maintaining to change (amount of research, public policy, mass media attention, intervention programs) two things need to happen, as jaundiced as it sounds:

A) Maintenance must be proven to be successfully monetized. Once money's made capitalism works its magic.

B) Most businesses (including this one) look at weight regain statistics and then wonder why they should invest in maintenance programming because the market seems so low. Because there's little support (I mean infrastructurally, or attention, not "motivational speak) it's become a Catch-22. That's even more true when you factor in the amount of marketing dollars companies spend on "the success story."

Even most of the research that exists stems from folks like us putting ourselves out there. I'm always looking for men and women up to putting themselves out there a little more and breaking that Catch 22 with me.


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MANDELOVICH 2/17/2013 10:47AM

    Thank you again for this blog post. I am at the point where I've gained back almost all I lost and reading this helps me recommit and refocus. I want to be a maintainer, not a constant yo-yoer!

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JOHN__ 2/17/2013 1:07AM

    The conclusions of this analysis certainly resonate with my experience.

Both my wife and I are participants in the NWCR.

It may be up to a group of we long-term maintainers to create an evidence based program.

I just visited wekeepitoff.com. This looks like a great idea. It looks inoperable at present as I could not register. Please let me know if I can be of any help with such a project. I am a former broadcaster and journalist. I have often thought that a portal where maintainers could share their experience would be helpful in the extreme in starting a real discussion about the realities of long-term lifestyle change in the management of weight.

I am new to Sparkpeople. I never knew this resource existed. I'm looking forward to reading the backposts of your blog.

Thanks for bringing this to the front!

John



Comment edited on: 2/17/2013 1:08:27 AM

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DESERTJULZ 1/18/2013 5:10PM

    Interesting. Thank you for sending me the link.

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SANDICANE 1/13/2013 9:10AM

    Thank you for posting this!!! I am new to maintenance mode AGAIN and this is SO important to me!
Cheers,

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CATHYLIELAUSIS 11/18/2012 9:43AM

    Depression has been a long time problem for me and now I take regular medications and see my therapist weekly. It helps. However, and this is a big one, many of the medications cause weight gain. emoticon

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TORTISE110 9/20/2012 6:20AM

    I would never been able to lose weight without focusing on depression and addressing it with a good therapist. Depression casts a shadow on life possibilities and makes us think doors are closed that can open. Many Spark tools help depression, but do not replace addressing it. Great blog.

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MRS.CARLY 8/22/2012 10:01AM

    I wonder sometimes if certain foods doesn't trigger depression and over eating? For me, the weight maintenance suddenly became SOOOOOOOOO much easier than it was before after I found out about my 20 something allergies/intolerances. My mood stabilized as well (used to have severe mood swings and crying episodes in which I felt depressed). I also used to binge eat then exercise twice as hard to try to work off the calories I ate. Once I found out what was making me so sick all these years, a light bulb switched on and I suddenly figured out the connection.

I know about sugar, but I've done a lot of research into gluten intolerance and celiacs disease and I think gluten is affecting the population more than they realize.

Very interesting blog!! Thaks for posting! I agree that there needs to be more focus on maintaining!! Thats the hardest part of the game, I think.

Comment edited on: 8/22/2012 10:04:02 AM

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MANDELOVICH 8/19/2012 7:10AM

    Thank you for detailing the article's main points. I agree that the transition from weight loss to maintenance is an undersupported, underacknowledged, and underinformed area. It's also probably one of the most important, pivotal times, where those who have released weight are vulnerable and need the most support and guidance.

I'm so glad this community exists!

Thank you.

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MYSTERY-LADY1 8/5/2012 6:40PM

    emoticon

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ITSUP2MARIA 5/27/2012 11:45AM

    This is my third or fourth time "at maintenance". Based on my past "failures", I KNOW that regular weighing-in and daily tracking are critical to my maintaining my weight. It is what it is and if that is what I have to do, so be it.
In the past, I haven't incorporated less TV in to my maintenance plans. Given how easy for me to come home from work and mindlessly eat supper while mindlessly watching watch, I will work on changing this. Physically and emotionally, I will be better for it.


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BENDIEB 4/2/2012 6:46PM

    While depression can have a big impact both in weight gain and weight loss, that does not seem to be an issue for me at this time. I have found that my appetite is larger now than when I when I was in the weight loss mode -- or even when I was overweight. I have been reading that this is common and there is scientific basis for it. That after the body has loss a significant amount of weight, it thinks it might be starving and wants to gain the weight back so it releases hormones to stimulate appetite and withholds hormones that make you feel satisfied. However, with what I have read, other than will power, I have not heard any solution to the problem. Yes, we do need a good weight maintenance program that addresses these issues!

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JAMJOJAM 3/26/2012 11:30PM

    For me depression is like a catch 22. I gain weight and that makes me feel depressed, I eat sugar goodies to make me feel better that causes me to gain weight and so on and so on. Just thinking about the fat depression keeps me on track, I never want to go back to that dark place. Great blog and very thought provoking. emoticon emoticon

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ADVENTURESEEKER 3/12/2012 11:31AM

    I know this blog is not a new one, but as I approach my goal (though I still have a significant ways to go at this point) and having been close to goal before after losing 70 lbs, just to gain it all back and more, maintenance is something I am looking towards getting as much information as possible on. Maintenance actually scares me. I don't ever want to go back to the old way of being. I enjoy my healthy foods and exercise. So I read as much as I can on it.

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RUTHXG 12/2/2011 12:06PM

    A sad irony of dealing with depression is that weight is often MUCH harder to keep off when you're taking antidepressants. I haven't been on them myself, but I've seen several friends & a sister gain significantly while on the meds & then drop quite a few pounds easily once they're off.

I used to struggle with dysthymia (low-grade depression) a couple of times a year. Vigorous cardio exercise (outdoors when weather allows) now keeps me free of it. I know it doesn't solve the problem for everyone, but it does help--I wish doctors would prescribe it as readily as they prescribe drugs!

I'm close to my own goal & look forward to joining your maintenance team very soon.

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CLARKBAR01 8/30/2011 10:15AM

    I think all that was said is valid. Depression part , can be valid, it can be a excuse. It pocks around in other addictive behaviors.
Maintenance of weight after loss in itself is the battle of the mind, what we do or fail to do. I know depression , but I don't blame it, for emotion grab and eat attitude to make me feel better. I am on my 10 th month of maintenance and it is a continual evolving mind set , towards keeping this more fit body and mind.
It is to easy to blame Depression on one aspect the obesity problem.
I am an expert of myself to take charge of this gift that has been given to me.
Sparkpeople would make a killing on a book on maintenance.
Where are the experts and authors, like diets, so is maintenance , there are so many ways to keep the goal.

Comment edited on: 8/30/2011 10:46:43 AM

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KAYOTIC 6/26/2011 11:31AM

    It would be nice to have a program geared toward maintenance that was structured and evidence based.....in our dreams for now, I suppose! For now I'll continue to hobble along w/ Spark and adjust to my current needs.

The part about depression is really interesting, and so true! Mental health is such an integral part to weight gain, loss and maintenance, just from the aspect of how one sees oneself in the world. Something else to work into the program.

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DDOORN 6/26/2011 8:17AM

    It's great to hear someone zero in on depression....not to minimize the other factors, but I KNOW depression is a biggie!

Thx for sharing...haven't thought to stop by Russ' site in a while!

Don

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SANSANDY1 6/26/2011 7:32AM

    emoticon

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THERE IS NO GOING HOME.

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:
www.livestrong.com/article/422456-th
e-average-american-diet-calorie-intake/


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?"
www.sparkpeople.com/mypage_public_jo
urnal_individual.asp?blog_id=4302368

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.
www.cayugalakecreamery.com/scoop.htm
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.

  
  Member Comments About This Blog Post:

RUN2BEFREE 6/30/2011 10:09AM

    Wonderful blog! What is normal anyway? I too have struggled with this too. I want to be like the American dream of having my cake and eating it too..... this doesn't work in reality.

Who do I want to be? I need to define my "normal" - thanks for the inspiration!

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MARATHONMOM26.2 6/30/2011 9:52AM

    Great blog! I use a lot of stories to illustrate the change of mindset necessary to make this journeys lifestyle, and I love this one! I will be sharing it with my clients emoticon

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PATTILYNN224 6/28/2011 9:46AM

    The journey has been long and difficult at times but I am going to make it HOME!

Thanks for sharing this blog. It's another great one!




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SHEILAB64 6/25/2011 1:08PM

    Here's to the NEW NORMAL!

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THINWITHIN18 6/24/2011 11:38PM

    Thank you! This blog should be on everyone's reading list. emoticon

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4AMAZINGME 6/23/2011 12:39PM

    Wonderful blog! I will keep it in my mental file emoticon

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MOMASAURUS 6/23/2011 9:38AM

    Awesome blog!
emoticon emoticon

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ANNE7X7 6/23/2011 8:52AM

    I loooooove this blog!! So true! You really have to make it a permanent change. Learn to love new foods, new activities that involve the output of energy!

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BHOLTS1 6/21/2011 4:12PM

    Great blog!! You are sooo right!

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ANNIESADVENTURE 6/21/2011 12:26AM

    I have printed off your blog. It gives me hope that I can stop this yo-yo.
Annie

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JCORYCMA 6/20/2011 10:49PM

    Great blog! Normal is what normal is for me - not the masses, because the average person these days is overweight to some degree. I like your metaphor about relocating and you are right. When I hit goal, I didn't start back down the mountain. I built a cabin 'cause I plan to be here a while...

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TENACIOUSTIGER 6/18/2011 9:16AM

    yep you said it it really doesnt matter what all those other people eat cos they are not me and I have to do eat, burn , fight do whatever i need to do in order to get home, I'm not sure i have ever been home that is comfortable doing everything i need to do to be at home, plus my job and lifestyle make it difficult but im getting there, this weekend Im back on the protein shake, need to up my protein to build back the muscle.
yay hope the shoulder is improving, my hammie is not stuck now comes the big job of stretching it and rebuilding the supporting muscle, oh and moving my baby gut that has developed, have a great weekend

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SARA72121 6/17/2011 7:02PM

    Wow I feel honored that I inspired a blog lol! Thank you so much for the kind words too. It's so nice to hear that other people respect you and think you're doing a good job!

Everything you've said is so right. I know it's right too! I've just been having a moody week and watching a lot of food shows on the travel channel. I know I'll never be able to go back to eating the way I did. I just get frustrated sometimes. I still haven't learned how to eat unhealthy foods in a healthy way as a treat everyone once and a while.

I guess my biggest frustration which I didn't really touch on in my blog is I still think about food all day every day. I'm not thinking about junk food anymore but I still feel obsessed and I guess my view of "normal" is not being so obsessed with my food whether it be unhealthy or healthy.

Maybe the only way I'll ever be able to get to and maintain a normal weight is to be obsessed, I guess only the future will tell. I just hope that one day I can be more relaxed and not have to plan out every bite I take to maintain a healthy life!

Comment edited on: 6/17/2011 7:47:28 PM

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AFITONE 6/17/2011 10:57AM

    Great blog. You are spot on...we can never go back "home" if we want to enjoy the benefits of increased health and fitness...we have to create a new "home" and accept that there is no going back...I have not fully grasped this in the past and allowed myself to go back to old patterns of eating, well, because I "should" be able to (doesn't everyone?). Well, that's the piece that I really understand now, that is that, no, those people who are heatlhy, slim and fit don't call that "home" either (the old way of eating)...that's just a misconception based upon media input and on my own dysfunctional emotional eating needs...in the past I had it in my mind that eating well was a temporary punishment required to lose weight...now I get it that this is a way of life that all fit and healthy folks follow (with their own tweaking) and that its not personal but rather the facts of a different way of life...and if I want those benefits then I will need to follow it...its really that simple (but perhaps not easy!). Thanks so much for sharing your thoughts on this process.

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KJDOESLIFE 6/17/2011 10:12AM

    Great blog!!

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BAM-MA 6/17/2011 7:16AM

    So right! I am "home" as far as my lifestyle, but still getting acclimated (losing the weight). I do not look at it as a journey. The journey was getting down the techniques to the point of habit instead of as a goal to lose weight.

I am now at a point where I can say that I will live this way for the rest of my life. I am definitely NOT on a diet.

I have treats on occasion, I am stricter with intake sometimes, and less strict at other times. I work out REALLY HARD some weeks and less on other weeks. I live my life. I am still losing weight. I LOVE my new "home"!

Great Blog!

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JENNSWIMS 6/16/2011 11:02PM

    You are awesome. I love your take no prisoners approach to this not-a-journey. You rock. Seriously.

I never say "I gave up smoking" because it sounds like it is something I want back in my life... I think it is the same kind of thing, it gives the wrong impression of what we are trying to accomplish.

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DDOORN 6/16/2011 3:40PM

    The difference is WAY MORE than subtle! Where I'm at is that I "get it" in my head, but have still to "get it" in my heart, in my being. So the struggle is still there.

Love the metaphor, though and appreciate at least holding the thought and seeing if I can migrate it further down than my head! :-)

Don

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FINALLY. All green on PhysicsDiet.com. I did it! (again)

Thursday, June 16, 2011

If you go to my Physicsdiet.com page, you'll see the following thing on there:

physicsdiet.com/Public.aspx?u=4a-hea
lthy-bmi


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:

tinyurl.com/4a-healthy-bmi

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:
teams.sparkpeople.com/hackersdiet

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.

  
  Member Comments About This Blog Post:

STEPHANIE0982 6/23/2011 8:57AM

    I just signed up for a Physicsdiet.com profile - I think this will help keep me on track! Thanks for the info.

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ANNE7X7 6/23/2011 8:49AM

    Woohoo for being back in range! That's so awesome! Once you get full mobility, you will get back your muscle mass in no time!!

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JCORYCMA 6/20/2011 10:56PM

    Hmmm... Interesting concept. I made peace with the scale finally but really have to watch the freaking out. It's just a number not an indicator of a personality defect! emoticon

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2LBSATATIME 6/16/2011 6:58PM

    Congratulations, I checked out the site looks interesting I might just give it a try

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TENACIOUSTIGER 6/16/2011 9:39AM

    hey thats awesome, if you can do it maybe i can, when my leg strength lets me do heavier weights. This week has been frustrating first week back in the gym and I may have overdone it as I put my back out so back to "pink weights" till it settles down. Yay for you hope the rehab is going well.

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BREWMASTERBILL 6/16/2011 9:24AM

    This is a huge milestone. You rocked it hard through a lot of adverse scenarios over the last few months. Now you get to go through the hardest and most aggravating part ... building that weight/strength ratio. The good news is, you're not stuck on the stupid scale measurement like so many people get stuck in, wasting away muscle to make the scale go down. Once you're able to do complete workouts again, I have no doubt that good body composition will follow. Plus the overriding motivator of paddling the hell out of some water will keep you on the path.

I may have to get your phone number because if you start disappearin' from here again, I'm going to assume bad things and start calling you every hour until you log back in. emoticon

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DDOORN 6/16/2011 8:25AM

    WONDERFUL accomplishment! Especially considering your physical limitations while recovering! Great work!

Don

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