Medical Roller Coaster

I haven't written about my sister's cancer situation much lately because it has simply been too hard emotionally to talk about it. As some readers may recall, she hadn't had a pap test for over a decade, possibly as long as 15-20 years and I suspected it was because of her weight. She suffered from anemia for years and eventually nearly blacked out and it was finally discovered (after much other testing), that she had a large tumor in her uterus that was causing internal bleeding.

Since the initial finding, she has been told various things. You'd think that medical technology would be advanced enough to give proper diagnosis of her issues, but, no. First she was told she had cervical cancer or possibly ovarian. The tumor filled her entire uterus and would have to be shrunk with an intense sequence of radiation treatments (24 in 6 weeks). The news was bad at this point, but the cancer had not metastasized and it seemed that after a lot of suffering, she would get better.

Later, she was told that the tumor may be inoperable and unshrinkable and that she may have to live her life in a disabled state. She was told she had both uterine and cervical cancer. Essentially, she was being told that the best they could do for her was try and keep it under control because it would threaten her life if they tried to remove such a huge tumor. I'm not sure how that works, but I assume they were afraid she may bleed to death as merely touching her to examine her caused her to bleed a fair amount. The doctors haven't exactly been forthcoming with precise details.

My sister was devastated by the news that her life as she knew it was coming to an end if the tumor was not shrinkable. She was told, and this made sense, that her body can only take so much radiation treatment and if the first round wasn't relatively effective, she'd be disabled and essentially take treatment as needed to try and stop the tumor from spreading. She'd never be able to freely move again without pain or risk of bleeding. Absolutely, working would be out of the question. She was already stuck in her upstairs "apartment" (the upper level of my family home) and depressed at her limitations and now they were saying this would be the rest of her life. Of course, the unspoken addition was that, "the rest of her life" would be shorter as holding cancer at bay is always a waiting game. Eventually, it would spread.

I talked to her about this and tried to reassure her that this would not be the end of her life. The truth is that, yes, she would be limited, but her sole purpose in life was not to drag herself off to the job she had held for so long. She wasn't happy in that job in the last year or so (since her hours were cut to part-time) anyway and felt stagnated before. I told her that she had more to offer and that I would help her find it if it all came down to the worst. There was more she could do within whatever limits she would have to live with and I'd be there to help her find that path and start down it. I believed it then and I still believe it now.

After letting her stew on that for awhile, they gave her an MRI which (supposedly) revealed that the tumor was not as large as they thought. Now, they were saying that it was a smaller tumor with fluid trapped above it and looked more operable. They expect that once it is shrunk by radiation treatments, the fluid will drain off and she will experience less pain. Both of us were elated at this information, but I am cautious about reaching any conclusions. It seems that the doctors may be doing their best, but they really don't have a clear idea of what is going on as the story keeps changing.

The lesson I learned from this, and I'm sure others will as well, is that weight shaming is incredibly destructive. It's not as if I was oblivious to this before this awful situation with my sister. It kept me from seeking pap tests for about 12 years, after all. However, the only one who suffers when we give in to it is us. My sister is suffering horribly now for having avoided such testing and, while I still am not sure that she didn't get tested because of her body, I'm pretty sure that is a big part of it.

"Outsiders"

One thing I've noticed as I've read many personal blogs is that the vast majority of people consider themselves outsiders, rebels, or as being on the margins of whatever groups they tend to travel in. The interesting thing about this is that they are generally only superficially "outsiders". They say they are so because of style issues (fashion, tattoos, hair coloring, etc.), esoteric hobbies or interests, or attitudes about a specific topic. With so many vocal outsiders, one has to wonder why they feel so isolated in their respective crowds.

Of course, there are also plenty of people whose blogs I read who are fat or super fat who feel they are unique in their body size, but few are actually truly unique in this day and age. Most of them are ostracized and have issues with their esteem as a result of the way that larger society treats them, but they are hardly "outsiders" except to the extent that they view themselves that way (for good reasons which I'm about to get to). While there is no doubt that everyone around them is pointing a finger and saying, "freak" (I've been there, oh yes, have I been there for at least 35 years of my 47 on this planet), most of them are told they are different when they are really not so different. This is a way of elevating the judge at the expense of the judged and doesn't necessarily reflect on a truly odd and unusual nature of the target of such judgment.

This talk about how different one is from ones peers is of interest to me because I've noticed that there are marked similarities among such folks. One is that most of them are sad and mad most of the time. Both the sad and the mad are drawing their emotions from the well of pain that comes from feeling isolated and objectified. The normal response to being constantly bullied is to have such feelings. This is not unique, and is totally understandable. It doesn't matter what aspect of a person's persona or physicality is being targeted to propel the response, the responses would be the same. The truth is that most people are ostracized and in pain, but are not unique at all in either their fatness or their behavior and attitudes. 

At the root of all of this is a struggle not to self-hate as a result of how one is treated. I know this both because I studied psychology and I lived in this space for most of adult life. I've spent more years mad and sad than some people have actually lived. When I started this blog, I was definitely in that space. Being out of it for all of a year or so isn't enough to make me forget what that was like, but it has given me perspective on a lot of things. 

One of those things is that we draw comfort from finding an identity which sets us apart from others in a positive way. Being told you are a freak, ugly and a blight on society day in and day out is huge part of what tears you apart inside and builds in self-loathing. To find self-acceptance, people often re-define themselves as rebels, outsiders, and being anti-establishment. It is taking being objectified and turning it inside out such that it becomes a badge of honor to be fat in a world which seems to be nothing more than a conformity factory that pushes everyone to look like Barbie and Ken dolls.  

This response and effort to re-purpose rejection as something positive is not new. It happened with countercultural movements in the past. In the end, most people end up being re-absorbed back into the mainstream. They do this not because they become accepted, but because the purposeful labeling of self as an outsider is superficial and ultimately unfulfilling. Positioning yourself as a mad person because you feel persecuted will only take you so far in your identity. Eventually, you have to find out who you really are inside, not who you see yourself to be as a reaction to perceived oppressors. 

Why am I even talking about this? The reason is that I think I lived in this identity for a long time and it did not help me. In fact, I think it made it all that much harder to understand myself and love myself. If I see myself as existing in opposition to the world because the world seems to operate against me, that becomes too integrated with my sense of self and affects my actions. I eat in defiance. I go out in public in defiance. I dress in defiance. I project an attitude in defiance. All of this defiance is exhausting and discourages positive change because I see my life as a battle between myself as an outsider and oppressive "insiders" rather than as an individual or self-contained entity.

Early on in this blog, I talk about being conflicted about losing weight because there is a sense that I'm admitting people were right about certain things. They would be right that losing weight would improve my health. They would be right about perceived beauty being more important than character. They would be right that I should conform and fit in. At my core, the largest sense of this particular conflict came from feeling that I was allowing them to "win" when personality is pitted against appearance. I am not my body. I am my soul/personality. Focusing on my body so much and so hard, which is necessary to lose weight, is admitting that my body matters. A lot. As much as "they" say it does. 

The bottom line is that my body does matter a lot, but it matters to me (and my husband). Losing weight wasn't about conforming to society's standards but about stopping so many things which caused me pain both physically and emotionally (and, yes, part of that was constant social censure and not fitting into public spaces). I lost weight because my body mattered to me, not because it mattered to others. Separating this is extremely important after years of being objectified and feeling that I was "surrendering" to the forces that oppressed me. I wasn't. I was surrendering to the reality that my body as it approached 50 was suffering horribly under the strain of my weight. My joints and muscles could not support a body over 200 lbs. well, and absolutely could not support one over 300 without pain and difficulty. 

The irony is that I still feel like an "outsider", but not because of my appearance. I feel like that because of my opinions. There are two large camps out there, fat acceptance and dieting culture. I don't belong to either and feel like I'm a voice in between which does not subscribe to the rhetoric of either side. I've given up entirely on attempting to reason with the people who are clearly in these camps because the responses are generally straw man arguments that respond not to what I'm saying, but what they find easiest to argue with. Being taken at face value on the internet is always difficult, but it is more so with those who operate in an emotionally charged state and are intent on seeing themselves as "rebels". Their natural response is to disagree and to try to shout down anything which resembles opposition to their causes. This happens on both sides. 

The other part of my situation which makes me feel like a continued outsider is my focus on psychology, which is, once more, rejected by both camps (dieters and fat acceptance bloggers) as playing a significant role in dealing with weight and food. Both deny that it has a role in food relationships or weight management issues, albeit for very different reasons. The dieting group insists they suffer no psychological issues that result in overeating and can only conceptualize "psychology" as playing a part when trauma or neuroses are involved. Fat acceptance bloggers similarly refuse to see habituation, routine, or behavior modification as a part of psychology and therefore related to their weight issues, but they do so in the service of denying that they "overeat" at all. This is, unfortunately, the natural consequence of having their behaviors attacked and scrutinized throughout their lives. 

It's rather ironic that this is common ground for two groups who are diametrically opposed. I guess that there is something beautifully symmetrical for me in being the point at which two very different groups can agree, though I can't say that I am in anyway happy about it. Sometimes, you can't escape being an "outsider" whether you want to be one or not. 

How It Began

I grew up in a family of four. Each one of us was obese, though my father, at times, approached being merely "overweight". Much of his weight issues were a beer belly, a memento of being an alcoholic. Though we didn't know it, each one of us had an eating disorder. Most of the time, the only "disorders" people see when it comes to food are those in which people don't eat enough or throw up what they eat.

A lot of people think that the only psychological problems related to a bad relationship with food are connected to trauma or abuse. I did not start to overeat due to trauma, but rather because it was normalized for me. I was thin as a kid up until 4th grade when my family's habitual overeating caught up with me and I got fat. Had that behavior not been "normal" within my family, I believe all that followed would have been different.

Once I became overweight, it became a much broader issue as I became defined by my body and other issues complicated the matter. After my weight marginalized me and I became heavily objectified as a result of my body size, food became part of a more sophisticated and byzantine psychological pattern. Once fatness defined my life and food became the only ally I could trust as well as a hated enemy, the routine overeating turned into full-blown disordered compulsive eating and bingeing. What started as mere patterning as a result of being the child of parents who overate routinely (due to their own issues, most certainly) turned into emotional reliance.

The patterning was started by my mother, who, as I have said before, fed us poorly (mounds of white bread, potatoes, whole milk, cheap fatty meat, salty canned vegetables and fruit in syrup) and too much and complained when we didn't eat what she prepared. For example, she would bitterly complain if she sat and peeled many potatoes and the bowl remained largely full by the end of the meal. It never occurred to her to simply prepare less. As a child, I had no awareness of what was happening nor the consequences of eating as my family did. Since I'm 47, there wasn't nearly as much propaganda or talk about food and body size in education at that time. Even if there had been, I'm not sure that it is the responsibility of a 10-year-old to figure out how to eat properly. At that time, there was just the food pyramid, in its primitive form.

By the time I had an inkling of what was going on, I was trapped in an intricate web of psychological dependence on food from which I could not extricate myself, particularly not without a good support system or the awareness and insight that comes from education and maturity. By the time it was made clear to me that I had a problem (i.e., being fat and therefore eating too much), I was too indoctrinated by routine, family culture, and biological inclination built by habitual overeating and too young and lacking in the psychological tools to climb out. This was how my disordered relationship with food grew.

A lot of people talk about how once you become an adult, you suddenly are "responsible" for what goes in your mouth and can no longer "blame" your parents. To me, this is like repeatedly breaking a child's legs until their bones are distorted and weak and telling them when they reach 18 that they are now supposed to be capable of running because they should be capable of finding whatever it takes to simply be different or "better". Forget the past damage and just overcome it all now that the calendar has turned to some magic number. It's just not that simple.

It has taken me many decades of my life to get to where I am now and I continue to pick at and untangle knots in the web I was trapped in. I still feel stuck to it in spots and occasionally feel sucked back in and trapped, but most of me is free most of the time. The one thing that I implore anyone who is trying to lose weight to do is to stop oversimplifying and talking in Yoda-isms ("there is no try, do"). There's a reason most people regain weight after they lose it and I absolutely believe it is this oversimplification and denial of the complex psychological issues that go into changing ones relationship with food. You can't do it forever with the mental tools of brute force, abuse, pat and trite mantras, a stick-to-it attitude, etc. Eventually, for most people, the psychology that got them fat in the first place will re-assert itself and they will regain.

Make it as complicated as it is and take the time to understand that it's just not so simple for most people. You didn't get messed up in a day, week, or even a year. You got messed up over a lifetime. It isn't a short-term problem and it can't be fixed with a short-term solution (and I count dieting culture as a part of "short-term").

Julie

In a previous post, I wrote about my experience in high school with a girl named Julie who delighted more than others in tormenting me about my weight. I also mentioned that she had joined Facebook, though she had not requested me as a friend. Several days ago, she did request me as a friend and I accepted. This answered a question that had been on my mind since other people had discussed getting her to join our former class online. That question was, "was she now fat?" If you have read my other post, you will understand why this was something I would wonder about.

The main issue with fatness is that anyone who is very fat will likely avoid posting a picture of themselves. Julie's profile picture is the default grey box with white silhouette that Facebook gives everyone and she had not posted pictures of herself in her albums. However, someone tagged her in the background of a picture of two other people and revealed her current appearance. She has become extremely obese, likely close to or as heavy as I was at my highest weight.

My response to this is absolutely not a sense of triumph at the justice meted out by the universe. While I am happy that my life has been going so well, I find that I don't need others lives to be comparatively worse to feel satisfied with who I am and how I live. I mainly feel sad for her, though I'd be lying if there weren't a tiny little seed that is gratified that it is very likely she can't help but have some empathy for the fat girl she tortured in high school. I don't want her to suffer as I have, but I do want her to understand what it was like to be me and never treat another person as poorly as she treated me. Empathy is a powerful teacher and if she had to get that fat to ensure that she never hurts another fat person again, I think that is not the worst outcome.

I'm aware that I may be reaching conclusions with little more than a photo of a very fat woman as evidence. Just because she looks to weigh well over 300 lbs., it does not mean she is unhappy. Happiness, like health, is not directly related to weight. She may fully embrace bodily acceptance and be happy with who she is despite her size. However, I know too well how unlikely that is for many reasons. First of all, society makes it extremely hard to be happy at a high weight. Even if you have no health or mobility issues as a result, you are constantly reminded that you are a blight on society. Second, someone who does not post pictures of themselves and used their young, thin daughter's face as their profile picture (only to withdraw it later) is not demonstrating much in the way of bodily acceptance. For me, one thing which I forced myself to do at one point was to start putting my face out there for people to see. This was a form of accepting my appearance. Finally, Julie spent many of our youthful years using my fat body to elevate herself. There is little chance that she's now just peachy with a body which exceeds my high weight in high school.

Seeing this person who brought such misery to me in my youth end up fatter than me has been a complex emotional experience. I didn't expect necessarily to be basking in schadenfreude, so it's no surprise that I'm not doing a happy dance that my former bully is currently living out my former nightmare. Mainly, I find myself having to push a little harder to find my empathy for a fat person. This is something which has come easily for me for nearly everyone else with weight issues because I always had 100% understanding of their suffering. In her case, I think I'm having to push myself to find that kind place in myself for her. I feel little for her either way. That is, little happiness at what could be seen as a proper comeuppance and little sorrow that she is likely suffering. Considering how much glee she took in inflicting pain on me in my youth, I think I'm doing pretty well to be in neutral about her right now.

Wanting it all (answering a few good questions)

I got an excellent question from Human In Progress and the answer ended up being so huge that it exceeded Blogger's comment length. So, instead of editing down the answer, I'm going to answer in a post:

"I don't know how long I'm going to do this. The problem is, my mind is already whining about "NEVER getting to have" a big piece of cake or whatever. I probably just need to give it time: after considering a pint of ice cream to be a single serving for years and years, one scoop is bound to look paltry.

Nevertheless, I am curious: do you ever eat a sizable dessert? Did you ever do so while working actively at weight loss? Was there any particular way you convinced yourself that for the most part, "less is more" when it comes to dessert? 
"

The first thing that I should say is that I still eat more calories than “necessary” on occasion. Part of what I've done is simply accept that this is something everyone does sometimes. This probably happens at least once every 2 weeks, possibly once every ten days. That's okay because I eat less than necessary sometimes as well. It all seems to balance out. I think humans were never designed for stable consumption and that there is a drive to cram everything in sight into your maw at times, especially when you've been pushing your hunger tolerance in an effort to lose weight over a long period of time. When this happens, I never change my eating habits the next day to compensate. I also do not beat myself up or berate myself. I just see it for what it is and get on with a more “normal” eating style in the coming days.

I think it's extremely important not to moralize or judge your eating habits at all. That is, it is important to not label yourself as “bad” or “good” or to see yourself as a “success” or “failure” due to food consumption patterns. Mainly, I look at what happens as one consequence or another to my body. Awhile back, I talked about seeing eating like saving or spending money. If today, I eat a lot of something because that's what I want to do, it's like “spending” more money than budgeted. The consequence is that I'll have to spend less over the next week or so to balance out that excess expenditure. When I started to incorporate this view of food into how I regarded eating, I started to lose interest in large portions to some extent. I saw a certain “cost/benefit” ratio in play. Was I going to enjoy every bite of a big piece of cake enough to want to pay it back later? Would I “spend” the calories on that experience? Sometimes, the answer is “yes”, I am willing to pay that price, but I'd better get my money's worth and attend to enjoying every bite.

However, that being said, it is not that simple because the rational aspects are only half of the equation. Compulsive eaters and those with psychological issues related to food do not deal with food rationally. They deal with it irrationally. It took a long time to develop a fuller cost/benefit view, but it took a lot of time and mental effort to handle the other side of this coin when it comes to the "I want it all" syndrome. I also used to feel dissatisfied unless I could have as much as I wanted whenever I wanted it. I still feel that way sometimes, but not nearly as often as before (it used to be every day). The notion that the experience of eating was inadequately fulfilling if I couldn't eat a lot was one I have wrestled with for quite some time.

There was a very long and a still ongoing process of dissecting the feeling of wanting a lot and changing how I viewed such things. I can only speak to what this all entailed for me, but I'd be surprised if some people did not share similar feelings. The first was that I think that eating compulsively, that is, the mere act of putting large amounts of food in my mouth and chewing and swallowing it was immensely comforting to me. The taste, texture, and smell of food and appreciating them didn't have anything to do with this purely psychological benefit of eating. This is equivalent to perhaps how alcoholics drink not because they enjoy the taste of alcohol, but because they can numb themselves by drinking a lot of it. For them, it's not even about the initial buzz or good feeling, but about a state far removed from normal. This is the difference between a compulsive eater's thinking and that of a person who really enjoys food or even a mere sugar high. We “need” a lot of food to satisfy a deeper need than the pleasure food brings.

Fighting off this desire is not in the least bit trivial and sometimes, I say, “to hell with it” and give into it. However, I know what I'm doing when I do it. I know that I've grown weary of the battle and am deciding this time to lay down my weapons and give in. I tell myself it is okay as long as it is not something I do everyday or often. Occasionally, it is alright to do it, but I never allow it to happen for two days in a row. The “recovery” the following day gives me strength and confidence that I can give in without setting off a new pattern. Failing and succeeding so often has shown me that I control food, it does not control me. If I want to abuse it once in awhile to feel better, I damn well will. I don't have to be perfect and I don't have to be strong every single day. I've got a serious problem with food and I'm solving it, but it makes me tired emotionally so sometimes, I have to rest and give in. Some day, I think this will not happen, but not because it's not “okay” to do this, but because I'll extinguish the emotional connection over time. It's been a flame I've been suffocating for a long time, and it doesn't burn as brightly as it did in 2009. I'm patient enough with myself to give myself the time to keep working on this. I see progress in the direction I want to go. Progress is enough. Perfection is setting myself up for failure.

The next stage of analysis of this situation is understanding how I got to the point in which this sort of compulsion has evolved. Why do I derive satisfaction from cramming lots of food in my mouth and swallowing it? Many other people don't suffer this. The answer, I'm sure, in the minds of many people is biology. There certainly was a predisposition, but I think that it was a connection that grew over my entire life and it's thick and strong, but I can cut away at it like a tightly bound rope. Each time I sever a thread, the connection gets weaker. To cut it, I have to know what it does for me and why I need it. This excavation is very personal and tricky. It gets to the core of what psychology can do for a person and that's offer understanding that can lead to profound change. Unfortunately, it is often like digging holes in the yard and hoping to find treasure. I don't know when the connection I've made is “right” or not. I can only keep digging.

One little gold nugget that I have absolutely determined is a part of this is that I have spent all of my life putting my needs second. My ego structure is such that I feel like putting myself first makes me a bad person (thanks, Mom, for planting that seed and watering the hell out of it). Beyond that, growing up as a fat child, there were many dreams and positive experiences I never got to have. Other kids dated, looked cool in hip clothes, and had homes that they weren't embarrassed to bring their friends to. They weren't so poor that their father hunted squirrels to put meat on the table or scrounged for discarded bottles that could be turned in for the deposit money in order to buy milk at the end of the month. There were so many things I could not have, but I could have food. It was the one area of my life where my head decided I was going to assert my desires 100%. I was not going to deny myself on that front. Cramming that large amount of food in was me having what I wanted when I wanted it in this one way. Being denied that panicked me and made me feel powerless, because I was so powerless everywhere else in my life.

Knowing this helped me talk myself out of the pattern through time. My whole life since starting to lose weight has included a lot of internal dialogs that sometimes I am so sick of having that I'd like to scream. Even now, with decreased frequency of food issues, I still have to tell myself, “you are not hungry, you just want to eat,” a fair number of times everyday. Food is less central to me. It's less important, but it still occupies a space in my life which is greater than it is for “normal” folks. I still find myself daydreaming about food when I'm bored, or meal planning, or viewing the best part of an experience as the food.

However, this really is decreasing in frequency. It's nothing like it was even a mere 6 months ago. Yesterday, my husband and I went to a world famous amusement park and in the past, I'd be thinking about how the special food would be the best part, but that was not the case. This time, I was focusing on the rides, seeing the place, and being with my husband. The experience, not the food was the thing I was looking forward to.

I should note that there is very much an aspect of this which is “duller” than things used to be. That is, the lights were more brilliant and the colors were brighter when food was fully centralized. There is a process going on in which I can feel the things which were unimportant or of weak importance to me growing in importance while food lessens so. It's like a scale and it used to be that food was on one side and heavily weighted and stuff on the other side was so light as to be of no consequence. When I was originally changing my relationship with food, I felt like I had nothing to look forward to or enjoy as I lost what really made me so happy and had not yet found the joy of what was on the other side. I got very depressed at times at the hollowness of my life as I lost weight. I found little to enjoy without food. It is taking a long time to add weight to the other side of that scale as I remove it from the food side, but it's coming along. I can't even really control it, but I think it is happening as a natural consequence to decentralizing food in my life and trying to mentally focus on a life which has a more balanced perspective.

I have to force myself to think about and focus on other things. It is something which I must attend to actively and cannot merely be expected to happen as a result of a reduction in food consumption or applying the conventional tools of diet culture. In fact, I think I can only fully realize this by abandoning the tools of that culture because they, while educational and helpful in the initial phases, also require you to stay on the topic of food. Once I get the general habits down, I have to let them go in order to live normally and not be emotionally reliant on food. I have to become more dependent on other things and I know that if I'm stuck on food, then I've either got an emotional issue that I need to manage differently or I'm bored and thinking about food in the absence of other topics.

So, this is all a long-winded explanation of the side of wanting to eat all I want from the psychological viewpoint. I can't tell anyone else what drives them, but I would encourage you to try to understand why you need a lot of any food to satisfy you. The truth is that I think that people rarely enjoy every bite of a treat that is a big portion. That isn't to say it never happens. I've eaten an entire piece of cheesecake (a small one, but a whole piece) and relished every bite before. It wasn't compulsive and it wasn't gratifying a need to have “all I wanted”. I enjoyed it totally, and that really is what it is all about. I think one thing I can offer as advice is to think about whether or not you want it all before you even eat it. If you decide beforehand that you won't be happy unless you eat it all, then it's about something other than the experience of enjoying your food. If you end up eating it all anyway, that's okay, but just understand why and learn from that. Through doing so, eventually, you'll be able to develop a sensory relationship with food which is based on enjoying it and not using it to fulfill other psychological desires. Even if you end up eating a whole piece of cake every time, it'll be because you loved every bite, and that's the best way to approach food. So, the bottom line is you can have anything you want, but it's better for you to know that it is actually what you want and not something deeper than that cake.

Progress Report

I rarely do progress reports anymore because I'm not as concerned with progress in general. Yes, I still would like to lose more weight, but I know that I'm at a stage at which losing more weight is less important than continuing to tweak psychological issues with food. I'm in transition from what could be called "dieting" to "living normally with food." To that end, several weeks ago, I abandoned all food logging and calorie counting. It is progress along those lines that I'm going to talk about.

When I first gave up the counting, I often had a vague sense of "overeating" or feeling like I didn't know how much I was eating. Since I'd already slacked on logging a full days intake, this wasn't particularly acute. My main concern was that I'd slowly slip back into old habits and regain, not that I wouldn't lose. Again, I'd like to lose more, but in this transition phase, I'm more concerned with being able to feed myself at a maintenance level without tracking calories or food. Once I have this ability down, then I can attend more concretely to further loss of body fat.

Over the last several weeks, I can't say that I've markedly eaten differently, but I have noticed some bad habits that I had even when I was calorie counting and feel that I need to get rid of those. The  main problem is too much freestyle "grazing". This is something I had been working with before, but only in certain situations. That is, I was still comforting myself with food, but doing so with small portions such that I didn't impact weight gain or loss. I have been working effectively on not doing this because I'm tired, stressed, or anxious, but I have not been doing so well with it when I'm incidentally hungry.

What I mean by that that last part is that I will feel slightly hungry at times and decide to eat things rather than wait and eat in a consolidated manner. I well know from experience that eating when slightly hungry was a huge reason why I gained so much weight. I never knew true hunger because I never allowed my body to get there. I became incapable of tolerating true hunger because I never built up a tolerance. My incidental eating was something I saw as a road back to that sort of thing and I decided that I need to "tighten up" how I deal with food.

My approach as of yesterday was to eat incidentally if I wanted to (or "needed to"), but to make sure that I fully acknowledged the experience by plating everything I ate and carrying it to another place. There will be no more standing in the kitchen eating a piece of chocolate, a rice cracker, a few mini pretzels and a bit or two of cheese. If it isn't on a plate, I don't eat it, at least if I'm at home when I'm eating. 

I think that this grazing wasn't necessarily a slippery slope, though I acknowledge that it could have been. Mainly, I think that it would ultimately impede further weight loss. I weighed myself today and I remain at 80 kg. (176 lbs.) which is where I've been for awhile. I was actually pretty pleased with this as I hadn't gained any weight for my sloppy habits. Frankly, I have felt that I've been eating too much, particularly too many empty calories, and was concerned that I might end up gaining because of it. Fortunately, I did not, but clearly it's time to move on to some better habits. 

Yesterday, I ate five times. That was breakfast, lunch, dinner, tea time, and a later evening snack. I plated post-lunch tiny pieces of chocolate and a few cookies as well as dessert after dinner (half a small chocolate chip cupcake and strawberries). The late night snack was fruit, but I feel it was slightly indulgent. A lot of my extra eating since stopping strict counting has been eating after dinner and I know it's not absolutely necessary. It's just laziness about not putting up with being a little hungry at bedtime. Still, it's not that big a deal either, especially on the first day of tightening up my habits.

I want to write about these things more than I do, not because I believe such  mechanistic processes are so interesting, but because I want readers to know I'm not perfect and I still have work to do as well. It's not easy, though it's absolutely nowhere near as hard as it used to be. I don't know if I'll be struggling with this for the rest of my life, but I'm prepared for the possibility that I might have to. It's tiring.  It gets old, but looking back at pictures of me at my higher weight, I think it's absolutely worth it. 

Weight Loss Surgery (WLS)

Several years ago, I started reading a blog about food written by a particular woman. It had nothing to do with dieting or weight loss. She was writing reviews of various restaurants and snacks that she tried. As time went by, she stopped that blog and started another. The new one was about her life married to a man in her husband's particular profession (which is hardly rare, but relatively uncommon and wives with such husbands have unique challenges). I mention that I started reading her blogs with these topics because now she has changed to writing about having weight loss surgery. I generally do not read blogs about people who are having, have had or are contemplating WLS, but I already have a "relationship" with this writer and an interest in her life.

I've said before that I think people who have weight loss surgery are essentially putting a biological gun to their heads in order to lose weight. I still believe this is true. I also said that they are likely braver than me for having the courage not only to endure the pain of surgery, but also to force themselves into this position. That also remains true. However, I have changed my thinking about the value of such surgery as I've learned more and more that it can be an incredibly destructive force in some people's lives and a sizable number of people (somewhere in the vicinity of 1/3) end up regaining the weight they lose and more.

It seems likely that it  metabolically damages people in a manner which is more severe than extreme dieting (under 1000 calories). I once read someone say that they believed WLS would one day be considered as poor an answer to weight problems as extreme lobotomies were to mental illness. Yes, it can fix a problem, but it creates many others. People can die from WLS complications and their food issues are not fixed if they don't change their relationship with food forever as a result of that surgery. I continue to believe that psychology, not biology, is the main driving force in weight problems whether they be related to overeating or under-eating.

That is not to say that I believe some women do not ultimately benefit from WLS. Clearly, some adapt to the lifestyle change, never stretch their reduced size stomach and it becomes a catalyst for lifestyle changes that they couldn't manage pre-surgery. That being said, such adaptation would have been possible without surgery. The surgery just makes it harder to overeat initially because you vomit if you eat too much and feel full quickly. When you try to eat less without surgery, the only thing stopping you is hunger and psychological issues. Both of these are potent forces that are hard to ignore when you have the biological capacity to fully sate yourself. I don't underestimate the value of a biological stopper for people who can't find their way to eating less. However, the price to me has always seemed too high.

The woman whose blog I've followed through various permutations has presented me with a lot of personal challenge in terms of taxing my self-restraint. I have wanted to say, "don't do it, there is another way," but I realize that there may not be another way for her. I also know that everyone has to make their own choices and, yes, mistakes in life. I've been allowed to  make my own and have made plenty. I have refrained from commenting unless I can be honestly supportive in line with my views.

I wish her well, but I feel that the odds are stacked against her given that she has always been a much bigger consumer of junk food than I ever was (because I never ate that much of it). She eats out a lot. I believe that the binge before the restriction habit among people who are attempting to lose weight is always a bad sign and she went crazy the weeks before surgery and gained 17 lbs. before going on the pre-op diet that she had to endure. She eats poorly, and has already overeaten and thrown up several times with barely a week and a half of time between her and the surgery. I think that, while the pouch is small, she will be restricted and lose a lot of weight. Ultimately though, I think she'll return to old patterns with a heap of metabolic damage on top of it and be worse off in the long run. I hope I'm wrong. I'd love to be wrong.