Saturday, June 30, 2012

I've hit the same plateau that I hit about this time last year.  Somewhere around 313 to 318 pounds I hit a wall.  I'm sure part of it is my body's way of trying balance itself out.  Apparently our bodies don't like to lose weight because it likes to maintain a balance.  Given that I've lost about 50lbs since January, it's not hard to understand that my body might take that as a cue that I'm starving and thus it's slowing down.

I think another reason I plateau at this point is that I've spent the last six months on a fairly strict regimen of diet and exercise and, honestly, on some level I'm tired of it.  Don't get me wrong, I feel great and I'm proud of myself, but keeping up that level of self-discipline is difficult for me.  Last night was the first time I've over-eaten in months.  E and I got my pizza last meal (more on that later), and I chose to eat half of it.  For the rest of the evening I felt like crap - no energy, too full to move, irritable, etc...  It might be that relaxing my diet slightly before I need to go on my pre-op surgery will help me improve my morale and make it easier to lose weight after surgery.  Nothing to drastic though.

Finally I think that I still haven't fully adjusted to my new work routine.  I work at a boring, monotonous job where I sit at a desk all day shuffling through papers.  The impulse to snack is overwhelming and due to being bored carrots and fruit rarely cut it.  Between now and my surgery, I've got to come up with some new strategies to keep myself focused.

A lot of people, myself included, get disheartened by plateaus.  While I'm frustrated, I'm taking this one as an opportunity to regroup and refocus.  In some ways hitting this first plateau right before surgery is a good thing because it means the balance in my body will change soon and I'm already 50lbs toward my goal.

Speaking of surgery...

Yesterday (6/29) I got the call that my insurance has approved the operation!  I've got a tentative operation date of July 24th with a pre-op exam on the 19th.  Next week on the 5th I'm getting an EKG and the final blood work that I need, and on the 10th I start my pre-op Atkin's diet in order to shrink my liver.  The smaller it is the less time the operation takes which is less time under anesthesia which makes for a safer surgery.

Needless to say I'm very excited.  This will be the culmination of four or more years of hopes, frustrations, disappointments, hard work, and dedication.  It will be the start of a new chapter in my efforts to become a healthier person.

My goals between now and the 10th are to keep up my diet and exercise, allow myself one last time to enjoy the foods I'm giving up indefinitely, and to acknowledge the good work I've done.  Too often I deny myself the satisfaction of my accomplishments and focus solely on my failures.  If I continue to do that then it will only makes things more difficult.  I'm using the next few weeks to reflect on the struggle to get to where I am now so that I'll be in the best head-space I can be for myself.

Yesterday's Last Meal: Mangieri's Pizza - Alfredo sauce with chicken and bacon.  Pizza has never been a favorite food of mine because I don't eat tomatoes.  Before I discovered pesto and alfredo, I ate my pizzas dry.  Mangier's isn't the best pizza I've had, but their chicken and alfredo is damn satisfying.  It's a thin crust pizza on wheat dough (a mistake for a last meal) so I get more of the chicken and cheese flavors.  It's cut into squares so it's easier to control portions (except for last night) and the middle, crust-less sections make for good breakfast.  All in all, an excellent choice for a last meal.  Pizza and a night of TED Talks on capitalism and western civ - a great way to spend a Friday night.

Thursday, June 28, 2012

Things I'm Looking Forward To

I think the last few entries have been a little too heavy so here's a list of some of the reasons why I chose to go through with the surgery.

1) I can buy clothes from normal stores.
2) Being comfortable on an airplane.
3) Setting a healthy example for any kids E and I might have.
4) Not being so hot all the time.
5) More self-confidence

Last Meal: Man Bites Dog hotdog
If you were afraid that Dog Almighty's disappearance would spell the end for good hotdogs outside of Frank then you're wrong.  MBD's hotdogs are every bit as good as DA's if not better.  The dog itself is juicy, smokey, and satisfyingly meaty and the bun is frankly (no pun intended) excellent.  The fries were so-so, but then I didn't choose to eat there because of the fries.  I take no shame in being a huge fan of hotdogs, and Man Bites Dog served up an excellent last meal this week.

There's more to talk about that went on this week, but I can wait until the weekend to write about it.  The stress of adjusting to a new schedule is compounded by searching for articles and books for my independent study I'm taking this fall semester.  I need to reevaluate my goals before I burn-out.

Saturday, June 23, 2012

My Fear

There's something I've run across in the last few weeks as I've become more open about my weight and preparation for surgery.  While many of my family, friends, and co-workers have been supportive, I've noticed that almost as many who seem ambivalent or even slightly judgmental about what I'm doing.  No one has outright said I shouldn't go through with it or that it's wrong for me to pursue surgery, but there are times when I get the impression that they want to say that.

I was talking with E and she mentioned a similar phenomenon when talking to other people about my weight.  We both came to the conclusion that some people see anything other than pure willpower when it comes to weight loss as a sign of weakness.  I can definitely say that I've come across some people who even tinge their judgement with a moral element.  It's as if my weight and efforts to lose it speak to my moral character.  If I weigh this much then I must lack some sort of conviction to overcome my weakness.  What I personally want to tell these people is that they should me glad I'm doing something about it and that they can keep their misguided opinions about weight to themselves.

I've come across this reaction before with the personal trainers I've had over the years.  The worst ones are those who have always been fit.  For them, being healthy is just a decision you make without consideration for outside factors.  I'm of the opinion that unless you've been overweight or obese then telling someone who is to just "make the choice to be healthy" does more harm than good.  It places the blame squarely on that person's shoulders, and in my case makes me feel horrible about myself.  Predictably, I'll then overeat because I feel bad, become upset that I overate, and then turn to food to help myself overcome that feeling. 

If weight loss was simply a matter of pure will/choice then why would I choose to be obese?  There's no advantage to it.  There's no benefit from being this unhealthy.  Ignoring all of the other factors that go in to why I eat the way I do and why it's hard for me to exercise just leads to me feeling terrible.  I ate poorly and didn't exercise because of emotional issues coupled with lack of knowledge about nutrition and cooking.  Fast food is easier, if more expensive, than cooking and the taste is comforting.  I'll be honest, I like sugar, fat, and carbs.  They taste good to me and I'm pretty sure they're supposed to given the way people ate pretty much any time before the mid 20th century.

Emotional, behavioral, biological.  Those are the factors that weigh (no pun intended) on me when I make the choices I do about what I eat and how I exercise.  I eat when I'm stressed or bored so I need to anticipate those moments.  My default food choice is fast food because it's how I ate for so long.  To be sure, I make the final decision whether I'm aware of it or not, but like all decisions I make there's a lot more that goes into it than willpower.

It bothers me that some people aren't as supportive as I'd like for them to be.  Oddly enough I get non-supportive reactions from other people with weight problems.  Perhaps it's just me, but there seems to be resentment behind their reactions.  It's as if by doing something about my own problem I'm casting judgement on them.  I think my biggest fear is that I'll upset them.  I don't want to cause resentment in others because of what I'm doing, but I'm afraid that might happen whether I like it or not.

Last Meals:  No last meals since last Sunday, but I have enjoyed a variety of tasty desserts this week.  E and I sampled the new Whole Food's bakery and I got to taste test her decorated cupcakes.  However, tonight I'll have a  great pasta dish and caramel gelato.  Mmmm.

Sunday, June 17, 2012

The Weekends Are For Cheating

Last Meal:  Shipley's Donuts.  For the longest time it seemed like Shipley's Donuts were my little secret.  They aren't anymore, but that doesn't make them any less delicious.  Their cake doughnuts are easily the best ones I've ever eaten.  Today I got both blueberry cake and a buttermilk cake (along with a kolache) and deliberately forgot my rules for portion control.  I washed them down with fresh milk from a local dairy farm that E bought yesterday at the farmer's market.  Mmm.  I'll check that one off the list.

This past Thursday I saw my dietician for the first time.  We talked about additional techniques for portion control - use utensils meant for toddlers, eat with non-dominant hand, chew 30 times, and don't drink within 5 minutes before or 60 minutes after a meal to name a few.  He identified some signs I should look out for to tell if I'm full.  One of these, pain in shoulder or upper chest, feels similar to a heart attack and may explain sensations I've had for a few years now when I eat.  Oh, I also should expect to vomit daily until I get used to eating with a stomach the size of a golf ball.  Fun times.

It was really good to talk to someone frankly about the hurdles I'll need to overcome accommodate my new lifestyle.  I'll be on a liquid diet for about 2 weeks after surgery.  Following that I'll be on pureed foods for about a week, then soft foods for another, and finally get back on regular foods about 4 to 6 weeks after surgery.  This gradual progression should help relieve pain and reduce nausea.

We also discussed how the surgery isn't a guaranteed cure like some people think it is.  He warned me that people who fail to lose wait usually do so because they still eat like crap.  My physician warned me of the same thing and said many people get frustrated that they can't eat double cheeseburgers without throwing up and have their band removed.  I wonder why they even opted to get surgery if they're going to be that oblivious.  To ensure I'll succeed, I'm going to follow 9 basic rules:
1) Eat slowly
2) Chew food thoroughly
3) Don't drink during meals (apparently you'll eat more if you drink as it cleanses the palate and softens food so it exits the stomach faster)
4) Stop eating when full
5) Eat 3 meals/day without snacking (unless they're veggies of course)
6) sip low calorie drinks between meals to alleviate hunger or 'boredom eating'
7) Select a balanced diet
8) Exercise regularly
9) Take multivitamins

I'm already working on most of these, but not drinking during meals will be the hardest.  I'll also need to avoid breads, tough meats, spicy foods, citrus, and lactose for a few months.

What I appreciated most though was that he didn't specify a specific diet or condemn any foods.  He warned me that certain junk foods, namely chips and ice cream, pass easily through the restricted opening, but that it was my choice whether to eat them or not.  I thought the lack of a prescribed diet beyond the basics really showed respect for my decisions and allowed me flexibility to change my diet according to my needs.  Balance is what's important, not whatever fad is hip this month.  That said, I'll probably be a de facto vegetarian for the most part.  This will help save money and make meats a special treat when I decide to eat them.

*Post script for the last entry*
I want to be clear that I don't hate myself or the way I look, but for a good portion of my life I've felt like a healthy, athletic person in a fat suit.  There are plenty of times I look in the mirror and see all the good physical qualities I have.  I'm handsome, have a cheerful smile, and I've got some killer baby blues.  In the right clothes I feel comfortable, and I've had enough women interested in me to assume I'm not a disgusting pig.  I feel good about myself, but I don't always feel comfortable and I want to be healthy.  I was afraid I came off as self-loathing, but those moments are few and usually coincide with other general negative feelings.

Now, it's time to finish my General Tso's because it's the weekend and I and can do that sort of thing because I take care of myself and eat healthy portions of fried chicken in a rich spicy sauce with starchy white rice.  You can really stretch it out if you split up a restaurant size portion into four meals. 

Friday, June 15, 2012

It'll Be Soon Now

I'm down to 313lbs as of this Thursday.

E made a comment last week about how I don't really enjoy my food in the sense that I savor the smell and taste of it. She's right. Truth be told, I hate eating and mostly just eat to fill time or relive stress. Don't get me wrong I enjoy the tastes and textures of the food I eat, but I don't really appreciate them for what they are. They're just sensations to me and not experiences in and of themselves if that makes sense.

I hate eating for the same reason I hate sleeping - it reminds me that I have a physical existence. Deep down I'm annoyed that my mind/personality is shackled to a body that needs things to function. Take sleep. I hate to go to bed. It's hard for me not to see sleep as a daily defeat. I'm aware of the benefits of sleep, but I hate to go to bed because I usually think it's a waste of my time. There is always something else I can do in the day.

I see eating in much the same way. I hate having to eat. Every time I eat I have to face the challenge of making healthy choices. Historically, I don't have a good track record. If I have to eat I've done something wrong therefore I'll put it off as long as possible. This is where my routine comes in. If I set my meals at certain times and prepare my meals ahead of time then I can eat without feeling bad, but if I put it off and wait until I'm shaking with hunger then I'll eat crap and feel bad physically and emotionally.

Eating and sleeping remind me that I have a body and that's just not something that I'm comfortable with. I don't feel like I belong in it. I'm not sure how it is for other people, but I'm constantly aware of where my body is in relation to my immediate surroundings or of how I look. I'm not exaggerating when I say that I'm always thinking about how I'm standing or sitting, how my clothes look on me, or where I am in relation to other people. There have been times when I've planned outings based on available seating. For example, I hate seeing movies on opening weekends. It usually means I'll have to sit next to someone other than E, and even if she's the only one I'm sitting next to I'll worry I'm crowding her.

A few weeks ago I saw the Avengers and had to sit next to a stranger! I couldn't enjoy the movie fully because I was worried that I was getting in her way. By contrast I saw Prometheus by myself and had a wonderful time because there was no one within 3 seats of me on either side.  In restaurants, airplanes, people's homes and in my own bed I spend a great deal of conscious thought trying to get out of people's way.

I think this is why I enjoy exercising during the hottest part of the day.  Other than sun burn, I like taking a 45min walk in 105 degree weather.  It just feels right.  It's not that I'm suicidal or want to harm myself, but it feels good to be out sweating, squinting, thirsty, and eventually dead tired.  I really enjoy my sleep on those days.

As I lose weight these thoughts and feelings go away.  I still obsess about how my clothes look, but now it's because they're meant for someone who's 50lbs heavier.  I still worry that I'm in someone's way, but I feel more comfortable with myself as I lose weight.  There's a lot that goes as I start to form healthy habits and change my lifestyle.  Healthy thinking leads to good decisions which in turn lead to good feelings.  When I eat right and exercise, I enjoy my sleep and I can eat without feeling bad about it.  I feel more comfortable with myself and that lets me relax when I'm around others.

No Last Meal since last Tuesday, but that's okay.  My dietician warned me about eating too many Last Meals and undoing the hard work I've done so far.  I told him I wouldn't go overboard with it.

Tuesday, June 12, 2012

Portion Control and 2, count 'em, Two! Last Meals

Today's Last Meal: Chicken Pasta with Homemade Pesto, Broccoli, and Spinach Noodles.  This is some real comfort food right here.  The nooks and crannies of the broccoli really soak up the pesto and the pasta, oh my god, the pasta.  Of course when E makes this dish there's enough for a whole week so I'll be eating this "last meal" for awhile.  Oh god the pasta.

I'm learning various techniques to help me learn healthy portion control.  For awhile now I've been really curious as to why most restaurants don't offer half-sized portions of entrees.  Part of the reason I never developed a sense of proper proportion control is because of the "clean your plate" syndrome.  Driven by guilt over starving children in third world countries, I learned that I had to eat all of the food on my plate in order to finish my meal.  As a consequence I don't consider a meal done until I'm uncomfortably full.  Unfortunately that uncomfortably full sensation doesn't hit until about 5-7 minutes after I should have stopped eating.

Here's a list of the techniques I'm starting to use to help me eat healthier.
-ask for a to-go box immediately upon getting food at a restaurant and put 2/3rds away for later.
- no eating in front of the TV or while working (still haven't got this one down)
- eat slowly (chew at least 15-20 times; place fork down while eating a small bite and wait about 30sec before taking another)
- eat off of a small plate
- eat while standing up
- eat a meal's portion of fruits and/or vegetables before going out to eat
- get the smallest portion available for any junk food

I've found that incorporating even just a few of these really helps me keep my eating under control.  Let's take a Last Meal that I ate over the weekend as an example.

Last Week's Last Meal: Dan's Hamburger and Chocolate Shake.  This greasy, cheesy, hot burger is a heart attack waiting to happen.  It's also one of the best cheese burgers I've had.  A year or so ago I'd have ordered the large double cheeseburger (you read that right, large AND double) with fries and a large shake.  Saturday I made do with a small single and a small chocolate shake.

Here's how I exercised portion control on the last grease-bomb burger I might ever eat.  I removed one of the buns and cut the remaining burger in half - instant double cheeseburger.  I chewed each bite about 12-15 times (this has the added benefit of really letting me taste the burger instead of just wolfing it down).  I bit off small quarter-sized portions, and waited until I'd finished chewing and completely swallowed the bite before taking another.  Even though I ate in front of the TV, I made sure that I set my burger down while I chewed to avoid the reflex of taking another bite while still chewing.  By eating so slowly, it was easier to tell when I was getting full.

Don't ask about the shake.  It's a chocolate shake and it might be my last one so I drank it all up.  I drank my milkshake!

  

Monday, June 11, 2012

Why Routine Works for Me.

Today's Last Meal: Costco Frozen Yogurt Swirl. Costco's FroYo has the texture and consistency of excellent soft serve ice-cream with the guilt-free label of frozen yogurt. I'm sure it's horrible for me (that might be why it tastes so good) and so it definitely made it to my list of last meals. It's 16oz of creamy chocolatey-vanilla goodness. Mmmm. They also give you the most satisfying plastic spoon to eat it with. It almost rivals Wendy's Spoon.

I also had a Sprite with it. Fountain Sprite.

One of the most important things I learned in my formative years was "thinking outside the box", "no limits", or "be a free spirit". All that created a tremendous pressure to avoid routine an discipline. The truly realized human being doesn't need the crutch of regularity, man.

Heh.

It's taken more than a decade for me to realize that I need routine to live a healthy life. Without structure or boundaries I just drift. I'll do nothing or act purely on impulse like all those lovable, quirky characters that inevitably showed up in 90s TV and movies. The only problem is in real life that got me nothing. I do well with structure because it's reliable. In the context of weight loss, routine allows me to achieve the goals I want. I'd eat the same food at the same times everyday if it meant I would lose weight. I know this because when I eat poorly I eat the same food at the same times everyday. I think the real trick was learning that self-imposed routine is a good and healthy thing. I missed that part in high school.

Today I went back to work at my job. I'll leave out the downsides of it in order to highlight one of the best things I like about it. When I'm working, it helps me maintain a healthy diet:
4:55am - light breakfast of mostly proteins
7:00am - second breakfast! fruits and cheese
10:30-11:00am - snack of carrots, celery, or more fruit
1:00pm - lunch, 1/2 turkey sandwich, snap peas, apple
3:30pm - post workout snack, I might indulge here and have a small glass of chocolate milk
7-8pm - dinner
10:30-11pm - bed
 A routine like this helps me make sure I eat right. Without it, I'll just snack on junk food throughout the workday, feel like shit, not workout, be exhausted, sleep poorly, not have time for breakfast, get something fast, eat junk, etc...

When it comes to food, I've got to keep a tight reign on myself because I have trouble maintaining self-discipline. It's not something that comes naturally to me when food is involved. It's something I'm always thinking about. Something I've got to plan ahead for. If I'm feeling down, that need for structure makes me think I'm weak. That is I were stronger I wouldn't need the routine to be healthy. That way of thinking doesn't do me any good, but it can be difficult to fight.

I think the trick to food self-discipline is to 1) forgive myself when I screw up and 2) plan for reasonable indulgences so I can still enjoy the foods I like. If I've eaten well all week then I might relax a bit on the weekends. If I do eat unhealthily, I recover much faster if I admit my mistake, forgive myself, and get back to my diet.

Saturday, June 9, 2012

Yesterday's Food and Calorie Input/Output

Yesterday I ate like shit.  I usually allow myself one day per week to eat what I want even though I never feel good afterwards.  What I ate yesterday represents a pretty standard day of what I'd eat if I'm not paying attention to my diet.

Here are the approximate calories for yesterday's food.

Chips & Queso 750
Coke 4x 8oz 388
IBC root beer 160
Apple x2  190
Chick fil a sandwich 440
Total: 1928
Cost: $31 (by comparison, this is roughly the amount of money it costs to buy fruits and vegetables for Emma and I for a full week)

Exercise: 1 hour of walking 369

 The approximate amount of calories I burned just sitting around the house: 3326

The amount of sugar, carbs, etc from all that food outweigh the net calorie loss.

So, yeah, that's hardly a healthy diet.  My main difficulties in the weeks ahead will definitely be portion control and food choice.  It's too easy for me to rationalize eating unhealthy on the weekends.  I do well most weekdays, but when the weekend comes all bets are off.  My portion control is bad as well.  If it's in front of me I'll eat it.   I've adopted some techniques to help deal with portion control, but they require me to really think about what I'm doing an not just operate on auto-pilot.


The Story Thus Far

Before the end of the summer, I'll finally get the bariatric surgery I've talked about getting for the last few years.  For a long time, it's been this nebulous goal that I could hold out in front of me as a way to dodge the responsibility of eating healthy and exercising.  As January of 2011 I started taking it seriously.  I began to eat better and exercise daily and from January to June of last year I went from 363lbs to 313lbs.

In mid-June I moved from the day shift at my job to the night shift in order to accommodate summer school.  In as many months as it took me to lose the weight it took that long to gain it back.  Working night shift is depressing.  In order to deal with the monotony of mindless clerical work, I began snacking again.  Chips, candy, cookies, and sodas helped to pass the time.  It also provided comfort me as working night shift made me feel disconnected to every relationship I had.  Night shift also killed my exercise routine because I spent most of my time before work anxious over having to go to work.

In January of 2012 I got my annual physical and decided that I would start anew.  My insurance required 6 months of medically supervised weight lose so I made regular visits to my doctor.  Again, a healthy diet and regular exercise paid off and I'm down to 323lbs as of this week.  It's a real struggle though.  I'm not sure how others deal with addiction, but for me it's a constant conscious struggle.  Eating right is something I have to think about pretty much all day.  Did I wake up in time to eat breakfast?  Did I make sure to eat enough of the right foods for breakfast?  What sort of food is available for snacking?  Did I get all my fruits and veggies in?  All of that plus the near persistent impulse to eat junk.

A few weeks ago I attended the preliminary seminar that's necessary for bariatric surgery.  This past Tuesday I met with my surgeon for the first time and next Thursday I'll meet with my dietician.  If all goes well, I'll have the surgery by the end of July.

In the mean time I'm still struggling with food.  Exercise is pretty easy for me now.  A mile or two of walking per day barely registers as work at this point.  If it didn't kill my knees I'd start jogging.  I've decided that in the coming weeks I'm going to enjoy some of my favorite meals guilt-free.  After surgery I may never get to eat another chicken fried steak or fettuccine alfredo for years if not for the rest of my life.  I'm not sad about it as eating those foods makes me feel horrible (it's funny how I didn't really notice it when I ate junk constantly), but it will be nice to eat them in healthy portions one last time.