New Ways of Thinking - 5. Building Support

The classroom content for week 6 was 'Building Support' (week 5 was one-on-one sessions with the dietitian.  This is foundational content in that if you are not proactive in developing support relationships and if you are not assertive in stating what you need to support healthy habits, you will not have good success.

Looking back over the past year, I've very grateful for a loving and amazingly supportive wife, supportive family, and an amazing group of friends that have offered amazing support and encouragement.  These amazing people made building support relative easy for me, but others in my cohort were not so lucky and you could tell because they struggled.

Building Support









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Almost a Graduate!

I've been finding it a little more difficult to post every week.  There doesn't seem to be as much stuff that's new and exciting.  I've been going to a monthly group classroom session.  It has been disappointing.  There really hasn't been new material, and I haven't got a lot of benefit from it.  Apparently, others must feel the same - attendance has trickled down to only a few people.

I was just reading through some of my posts and it's hard to believe that only a year ago I was itching to get started with this program.  Now, I'm ready to celebrate my 1 year anniversary of starting.  It's also kind of weird figuring out what should I celebrate - when I asked for a referral to the program, December 2013?  My first group session, May 7, 2015?  My last weekly session, August 28, 2015?  Well, for now, it's very close to May 7th and I feel like celebrating.  Probably I'll celebrate again in August.

I've generally grown to be pretty comfortable in my new 'skin', but it's not 100% locked in yet.  A couple of weeks ago we were at the YMCA and I was doing some weight lifting and I happened to see this 'skinny' guy in the floor-to-ceiling mirrors - then I realized it was ME!

I'm looking forward to the warmer weather, so we can do a wider range of physical activity.  I've been very faithful with the daily 30 minute aerobic exercise, but many a time it felt more like a chore than something fun.  I've continued to be sensitive to the cold around the house and office, but I've been pleased that when I dress warmly I've been able to enjoy cold weather activity - you know, the whole two times we've had enough snow to snowshoe this Winter :-)

Still drinking 2.0 to 2.6 L of water every day.  Some days it's hard to manage, but it seems pretty normal now.  I think it's because of the high intake of water that my flabby skin is tightening up.  I still have some loose skin, but it's improved by at least 50%.  Yaaayyy.

I've been monitoring my weight and daily food intake very closely.  Still weighing and measuring most of the time.  I've gone several periods where my weight has been up 2 or 3 pounds for several weeks, and each time I've been able to catch it and gain better control - and the weight has come back down again.  It's still alarming, but not so bone chilling scary as the first time.

I've got a few goals.  I'm still working on reviewing my classroom notes, so stay tuned - I'll get them posted here eventually, I promise.  I hope to get in 4 of the 46 high peaks this Summer, and I'd like to get out kayaking at least a couple of times this Summer.  Another goal is to join the National Weight Control Registry.  It is a controlled study involving people who have lost at least 30 pounds and kept it off for at least 1 year.  I'll be able to join in a few month's time.  It will be nice to give back, and it will be a little added accountability.

So I found out this week at group that we don't actually graduate from the program until May 2017, but April 15th is my last group session and May 5th I go in for my final weigh-in, interview, and blood work - so I guess I FEEL like a graduate!

New Ways of Thinking - 4. Conditioned Eating

Our class discussion for week 4 was about automatic eating behaviors, or conditioned eating.  The session was about learning to identify your personal eating habits that are based on environmental or time-related cues rather than on physical hunger.  The concept is that if you can identify habit-based eating, then you can develop a plan to eliminate or reduce the counterproductive eating behavior.  More on that next time.

Identifying Conditioned Eating (or 'Needing' vs 'Wanting')






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New Ways of Thinking - 3. Motivation

So back to the classroom materials.  I've been taking my time to summarize and organize the classroom materials and the Optifast binder.  It's taking quite a bit of time to work my way through all the pages.

The third classroom session was called 'Values and Goal Setting'.  It was really about making sure that our specific fitness goals are aligned with more global values.  This makes sure that we will have better motivation in working towards the specific goals.  Because the theme was 'motivation', I've included some of the relevant sections from the Optifast binder and a quote from a great book that I was reading at the time.

Motivation



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Christmas Holidays # 1 Under My Belt !

Boy, Christmas holidays are a really big challenge to healthy habits ! 

Looking back at the holidays, I did Ok - I didn't gain any weight.  I make specific plans on how to deal with the high risk eating times; some worked, some not so well.  I've got some ideas on how to make the next holidays a little more health friendly, so I'm practicing the 'forgive and move on' part.

Lessons learned:

1. High risk meals need a WRITTEN plan.  One of our family traditions is to have a buffet of festive finger foods on Christmas Eve after our Christmas Church service.  Everything was healthy - nothing fried, not lots of sweets, meatballs with lean turkey, some veggie options.  I had planned to limit myself to a small plate with no refills, and have a balanced snack beforehand to reduce physical hunger.  Good.  Well when the time came, there was so large a variety of fun foods that it wouldn't fit on just one plate.  Since I had helped select the menu, I really wanted to have some of everything, so I though 'Ok, so it's Christmas, two small plates won't hurt (permission thinking), just no refills'.  The plan was also not specific enough - I had not thought through the composition of the plate.  I ended up having way too much volume of high-density stuff like meat balls, cheese balls, crackers, etc.  Another thing I hadn't planned for was the high-calorie beverage, hot spiced apple cider, yum.  I ended up having several mugs, when I should have probably had one followed by a switch to water or tea.
2. Weight loss has not 'fixed' my migraines.  I had thought that my weight loss had taken migraines out of my life - nope!  I spent the next three days suffering from a migraine episode - mostly abdominal migraine, but not fun.  It seems to have been triggered by the high volume (relatively) of high density food.  Certainly gives me some motivation to not repeat the heavy eating episode any time soon.
3. Dealing with nuts and candy dishes is hard.  Sue talked with me about the candy and nut bowls ahead of time.  We decided that we would limit these bowls to Christmas Eve/ Day and the times we actually had guests.  This worked reasonably well.  Next time, I should have a better plan on how to include these as 'treat events', in terms of how many/ how often, etc.
4. I CAN avoid Frozen cookies.  Cookies are hard for me - because I eat them so rarely, they are a highly prized treat, and of course, inherently addictive.  We were able to limit the period of time the cookies were on display, and I did plan on incorporating 2 - 3 into my 'treat events'.  All good.  Several weeks after New Year's day I happened to open the downstairs freezer.  I discovered that there were two containers of Christmas cookies.  Oh my - that was a tough evening.  I managed to stay away - but I ended up having a near binge of healthy fruit in my efforts to steer clear.  A couple of days later I mentioned to Sue that I'd have to bury these containers under other stuff in the freezer, and Sue mercifully got rid of it all.  So yes, I can avoid frozen cookies, but it's better to have an avoidance plan, like bury them or seal the containers, or something.  Better off to keep them out of the house.

So starting of 2016 with flying colors - here we come.....

New Ways of Thinking #2 - 'Best Weight'

The second week of our classroom sessions we covered this important topic.  Although it was unnerving in the early days of the program not to have a specific number goal, in the end it was very freeing and liberating to just focus on developing the healthy habits and let the numbers fall into line by themselves.  I would encourage you to think about this with an open mind.

I've been very fortunate to end up with a weight loss and body weight that I'm very happy with (maybe I should say thrilled here!).  There still are some moments when I glance at my tummy and think - hummmnnh - I wonder if I'd look a little better if I lost a few more pounds, or hey maybe I would be even healthier if I was a little closer to my ideal weight <gasp>.

Best Weight

Things I Thought I'd Never See

1. Me cold and 2. me drying clothes on high heat

All these years I've been boiling hot while every one else in the room was freezing cold.  Since I've lost the weight, I've spent a lot more time trying to get/keep warm.  I can't seem to wear enough layers - t-shirt, shirt, sweater.  Finding enough layers to wear for outdoor activities is an adventure in itself.  I feel like a bit of a baby.  I'm told this change is because I've lost so much fat - it used to keep the cold out and the heat in, now not so much.  My hands are cold all the time.  My nose is freezing cold and running - and I'm not just talking about when I'm outdoors.  Almost embarrassing.

It will be interesting to see if this is a temporary condition, or not.  If not, I guess the good news is that Summer should feel more comfortable.  In the meanwhile, come on and bring me sweaters and mittens, Santa!

Something that was always annoying over the years of weight gain was too-tight clothes.  It was crazy how the washer and dryer were always shrinking my clothes.  So much so that I have got in the habit of doing my own laundry - so I can use cold water and then dry on gentle heat - for less shrinkage.  Now it's wonderful to have clothes that fit comfortably!  And I'll even keep doing my own laundry.

Well, recently I've had a couple pairs of jeans that are just a tad loose.  Warm wash and hot dryer setting - perfect fit.

Like I said, never thought I'd see the day!

New Ways of Thinking - # 1: Why Diets Don't Work

I promised earlier that I would review my class handouts and binder materials and provide a summary.  I will be posting summaries week-by-week as I slowly work my way through a review.  I'm hoping that my mental framework will be refreshed as I do this and that I will be able to refresh my fitness skillset as I do this review.

Why Diets Don't Work



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Scary Times - No Not Black Friday At The Mall!

I think I've mentioned a few times that it is scary to be aware that I'm beginning a lifetime of maintenance - especially scary when stats show that most people that lose weight regain the weight, and more.

The past 5 or 6 weeks have been somewhat terrifying.  About 5 weeks ago I gained a pound (week's average) - not a biggie, note to self, 'be alert'.  The following week I gained another pound - ok, still no panic... Ryan has said it's normal for weight to fluctuate ... just be a little more alert.  The following week I gained another pound - hummn - I start being more careful with what I'm eating (well, at least I think I'm being more careful - and I gain 2 pounds.  At this point, I took my food log and mapped out what had been happening.  I cut back on some of the extras - for real, this time.

Well, good news - finally the weight gradually started to come back down over the next two weeks, slowly but surely.  Phew!

Emotionally, it was terrifying.  I had flashbacks about gaining all my weight back.  I had fears that I wouldn't be able to reverse the gain.  It was hard.

Now that I've worked this through, I feel like I've had a big victory.  I'm sure this is just the beginning, but I'm glad I had an 'alarm weight' and a plan for how to get back on track.  I just have to stay motivated and alert.  I'm starting to review my weekly class handouts and notes, and I have to internalize this material just a little better - for insurance - especially with the holiday festive meals and muchies coming up.

Things I Don't Miss...

I can't say that there is really anything that I miss about being obese.  I don't miss...

Sitting in a theatre seat trying to suck my elbows in so that I'm not cramming the person beside me.  Waiting for the movie to begin dreading that someone would pick the seat beside me.  It's actually enjoyable to sit in these seats and actually have room to move around!

Hitching up my pants.  I saw a fairly chunky person hitching up their pants around the belt line the other day.  I used to do that a lot, now I don't ever need to do it because my hips are actually big enough to hold my pants from falling down.

Being hot and feeling sweaty all the time, even when everyone else was feeling cold.  Now I'm the one that's cold all the time - can't say I like that part so much, but it's a small price to pay, I guess.

Hating to see myself in the mirror or shop window.  I used to really dislike what I saw in the mirror, so I'd avoid mirrors.  I hated having my photo taken.  Now I don't mind so much.

Always having to take a shower, because laying down in the bathtub felt too claustrophobic and tight.  I still don't take a lot of baths, but when I do, it's nice to have lots of room to move my elbows.

Coughing all the time.  I still have a little cough, but I feel like I've gotten fresh, brand-new lungs.

Snoring -  actually SUE doesn't miss this - she tells me that I NEVER snore anymore!

Having to shop only at the big and tall store.  It is really liberating to be able to find clothes that fit in pretty much any trendy store.  I has been frustrating all these years to have to dress like a frump because the only clothes I could find were frumpy.  What is frustrating sometimes now is that stores sometimes don't have sizes that are small enough!  That's a bummer.

Feeling like I had to hide my weight and never talking about weight with anyone.  I used to be so embarrassed that when Sue, or others, would ask about my weight I'd come up with a lower number so I would feel so awkward.  (I wonder who I thought I was fooling).

Hating exercise of all kinds.  Now I enjoy it.  I actually feel bad when I miss my exercise for a day or two.

Feeling out of control.  Blaming everything and everyone for my weight gain - except me.  It is empowering to feel like I'm in control again and 'in charge' of my health.

I'm sure there's more, but there is sure a lot that I don't miss

Before and After

Here are a couple of photos of the 'before' and the 'after' the Medical Weight Loss Program (aka Optifast).....

After

This last photo shows that Sue and I could both fit in my leather coat that was snug on my belly before.

Before

Celebration Time

I've had three really fun celebrations this year to celebrate milestones on my journey to healthy habits. 

A lovely kayaking trip at our wedding anniversary (see Week # 9).  I had lost about 25 pounds by that point (45 lbs. from January 2014).  I was very excited, and I assumed that my weight loss would taper off soon after this point.

A wonderful mountain hiking weekend away with some dear friends on my birthday (see week # 17).  At this point I had lost 54.5 pounds ((74.5 lbs. since January 2014).  It was an amazing victory over a mountain that had humiliated me 25 years ago - well actually my excess weight was what caused the humiliation, but it felt better to blame it on the mountain.  This time I nearly bounced and bounded up the mountain with amazing energy - I felt like I was 25 again!

This past weekend was another wonderful celebration.  We celebrated my dad's 86th birthday by driving down to Essex, CT so that he could drive a diesel locomotive.  Of course, you can't let a man drive a train all by himself, so I also tried my had at driving a train.  Coming at the end of my program, this was a true celebration, kind of like a graduation party :-)

Week Twenty-six - Discharged

Yesterday was the last weekly group session.  It was kind of anticlimactic.  The session was great, in itself - they presented a whole bunch of relapse scenarios and we worked through as a group how we could 'fix' the situations.  On the other had it was kind of surreal - hard to believe that it's 'over.

According to the official discharge letter, I've lost 64.4 pounds and 8.1 inches (waist) since May 7th.  That would make it 85 pounds since January 2014 when I was referred!  Excellent.  When I met with my family doctor, he said with a twinkle in his eye, that I was really normal now.  He took me off iron supplement pills, completely off Crestor (cholesterol med), and reduced my thyroid medication by nearly half.  My blood sugars are down to well within normal, as are my lipids and cholesterol levels.  My blood pressure is very good at about 105/80.  The best part is that I feel amazing!  No shortness of breath.  Much reduced arthritis pain.  Lots more energy.

My only regret is that I didn't do this sooner!

I think I've said before that this is really just the beginning, so in that sense it really doesn't feel like a victory yet.  The real celebration will be in one or two years' time!

Stay tuned.  I still have the monthly group sessions to attend for the next six months.  I will be reviewing the classroom materials over the next little while, so I'll post some short summaries here as the weeks go by.

Week 25 - Relapse Prevention

That's the fear - relapse and weight gain.  The most dangerous time is the first year after program, and the risk is serious - most people that regain any weight don't lose it.  This week's group was about relapse prevention.  Self-monitoring - like a food/activity log - is key so you can track down what went wrong.  Another key is having a plan: 1) Identify high-danger situations in advance, 2) Plan steps to prevent a lapse, 3) Have a back-up plan to get back-on-track, 4) Plan to forgive yourself if you slip up.

The past six months has been lots of work, self-evaluation, and learning to plan.  I have a really good toolkit, but honestly, I am more afraid now than I was on day one.  At least we have a monthly group session for support, and I'm grateful for caring friends and family for support.

One more group session to go.

Week 24 - Reinventing Myself

Good news – I was really happy to make it through several Thanksgiving celebration meal events without gaining any weight.  I had a well thought out plan and the plan worked.

It has been a really odd thing to re-experience my ‘thin’ body.  It is really quite something to get used to hearing myself called, ‘Skinny’ in a good way.  When people are talking about me as ‘the little guy’ I often don’t catch that they’re talking about me – “Hunh….  Who, me?”  It’s kind of funny.  On the other hand, it doesn’t always feel good when people make comments.  Simple compliments are always nice like, “my you’ve lost weight, you look good.”  What is frustrating is comments like, “You should stop losing weight – you look too thin!”  Or when my weight loss is all a person can talk about – I’m about more than just weight, you know. 

Now is a wonderful chance to reinvent my persona – who I am.  Despite the significant costs of buying new clothes, it is quite fun to shop for clothes and look at stuff that I would never have been caught dead wearing six months ago – or that wouldn’t fit me.  I get to be that energetic, active, fun guy that likes sports and activity.  I get to consider goals and pursuits that were totally ‘off limits’ to me before – it’s pretty cool.  It’s also very different as I go about replacing ID photos, like work, driver’s licence, etc.  It’s kind of like reaffirming the ‘new me.’  I find that I keep peeking in mirrors and shop windows to try and figure out ‘who is this new me?’

Today’s group session was about body image and the importance on maintaining a positive, healthy body image.  I really like my new body, for the most part.  I’ve been lucky to not have much loose skin, but I do have some saggy skin on my lower abdomen and upper thighs.  I’m trying not to be too depressed about it and hoping that some of these strategies will help:

• Continue drinking lots of water – apparently skin likes water
• Moisturize the skin
• Weekly sea salt bath – draws out toxins
• Eat soy protein like edamame beans, soy milk, tofu - to help generate more collagen in the skin
• Wait – apparently the skin often recovers given some more time

In the meanwhile, I’ll get to focus on building a positive self-image and focus on the how much healthier I am and how much more activity I can maintain.

On a side note - I have tried to be pretty low key about my weight loss adventure – other than this blog, but I have found it interesting how many people have come to me to talk about my weight loss program.  Some people have heard of the KGH program and want to know more about it – either for themselves or a loved one.  Others have not heard about the program (and don’t really care), but they’re interested in what I’ve done.  I mentioned elsewhere that I’ve been surprised by the doctors and nurse practitioners that don’t know about the program, and want to find out more information.  One of the reasons for starting this blog was to share my journey with others that might draw inspiration, information, or motivation from my ‘story’, so it is rewarding to be able to help others. 

Week 23 - Counting Down

 Only three short weeks of weekly group sessions left!  I feel like I need more information, more support, more time.  I am determined that this is just the beginning, so I really hope I am prepared for this journey.  How is this time going to be different?  It’s a very nervous time.  Well, I do have a plan….

1. I will commit to the monthly group session – without fail.
2. I will weight myself and record every day
3. I have set up an ‘alarm’ system – if my weight is 5 pounds above weight for 3 days in a row, I will drop down to the 1,300 calorie diet, and step up my exercise.
4. I will keep a strict food/exercise log for the first year
5. I will keep a healthy habits journal
6. I will continue my goal to achieve 30 minutes of aerobic exercise 6 days out of 7 days
7. I will set some exercise goals each year – Spring and Fall  (More to follow)
8. I will become a member of the National Weight Control Registry – you have to have lost 30 pounds, or more, and kept it off for one year to join.
9. I will become actively involved in helping others lose weight and make healthy choices – this should help me to stay more active and accountable
10. I will gather a support group around me to hold me accountable for my healthy habits

I would encourage you to keep checking back and see if I'm still 'on track'

It’s official – I’m not fat anymore!

I had my physical with my doctor yesterday.  After my exam, and after many questions about the program, he says with a smile, “I see we’ve got a morbid obesity alert on your file – I guess we’ll have to change that!”  (On a side note it’s surprising to me how little most doctors know about the Ontario Bariatric Network programs.) 

On the doctor’s scales I weighed 154 pounds.  That means that I am officially not overweight, based on body mass index.  At 154 pounds (daytime), I am in the ‘healthy’ range - (BMI) of 18.5 to 24.9 – even if just barely.  The BMI number is kind of an artificial number, but I started this health journey with the goal of increasing my health.  I never imagined that I would be able to get down to this weight, but now that I have this 154 weight will be my upper limit, my alarm bell so-to-speak.  It may be a little silly, but this number represents health to me; so if I can manage it, I'd like to stay just a little under - maybe 150 pounds, doctor's office.

Practically speaking, what this number means is that my metabolic syndrome (aka flubbergut + high cholesterol/high triglycerides/ high sugar) is gone, and I am at much lower risk of developing many nasty diseases – diabetes, heart disease, stroke, arthritis, cancer, Alzheimer’s and respiratory disease.  More important than the possibly longer life expectancy is the likelihood that I will be able to enjoy my life with less medical complications and more fun/freedom – yay!

On the other hand, I am no longer ‘normal’ – the most recent directly measured Canadian statistics reveal that 61% of Canadian adults are considered either overweight or obese.  Hmmmhh – does that mean that I will stand out in a crowd as the freak?

Week Twenty-two - A Calorie Prescription

I met with the nurse practitioner and the dietitian on Thursday to evaluate my progress – all good.  I was a bit taken aback by the ‘prescription’ of 1,300 to 1,500 calorie diet (the Optifast ‘maintenance’ diet).  They’re telling me this should lead to the 1 lb. per month loss that I wanted until I had built up a 5 lb. ‘cushion’ underneath my maximum or‘alarm weight’.  Since my weight loss had continued after Optifast but slowed down on the ‘maintenance’ phaseto 1 lb. per week from the 3 lb. per week during the active Optifast phase, I was expecting that I would be increasing to something like 1,800 calories per day.  Ok, well we’ll stay on the 1,300 – 1,500 diet for a while longer and  it and see what happens.

Oh, and apparently the bariatric team is talking about me as the ‘poster boy’ for the non-surgical weight loss program.  Not really sure what that means, but I guess it must be good, so I’ll take it.

Week Twenty - So Far So Good

I've been surprised, you know.  The maintenance plan is a 1,300 to 1,500 diet and I haven't felt deprived.  I've felt full most of the time.  I've had a few times I've had a craving, but it's been pretty manageable - AND I've continued to loose a pound or two each week.  Wow!  Hard to believe.  In the next couple of weeks, the dietitian will give us a calorie 'prescription' to meet our weight goals.  Many folks in the group want to loose quite a few more pounds, but for me I'll be wanting to pretty much maintain my weight 'as is'.  It will be interesting to see what that 'prescription' will look like.

Last week was interesting.  I had mentioned my struggle with ice cream.  Ryan asked me to conduct an experiment - I had to buy some ice cream, serve up 1/2 cup and enjoy it mindfully.  Well, I went to the store and bought the smallest container I could find (it just happened to be Haagen Dazs, which Sue tends to enjoy).  On date night, we enjoyed this little treat - mindful eating and all.  You know, it was Ok.  Whereas in the past, I'd have served up a 1 1/2 cup cereal bowl, then gone back for at least one more bowl, instead I was satisfied with just that 1/2 cup.  Normally I'd have gone back for more ice cream night after night until it was all gone (thus the smallest pint sized container - just in case), but this time I was Ok.  A week later and I'd forgotten it was even in the freezer.  Excellent.  The next question is how often, and I haven't got that figured out yet.  More to follow.

It is a weird thing seeing photos or videos of myself or even looking in the mirror.  It's kind of like 'who is this guy?'  Not a bad thing, just kind of an odd experience.  There's this kind of reconciliation going on where I am coming to terms with this 'new me.'

Today in group we'll be talking about how to deal with restaurant eating.  That should be interesting.

Week Nineteen - Back to 100% Food

Thursday, September 10th was the last day for an Optifast shake.  It was really kind of anticlimactic.  It was really more about losing my 'bedtime snack' - which that fourth shake has really substituted for all of these weeks.  Now THAT has been a much more monumental issue!

Being back to food has required me to think about my meals, and be much more involved in planning my food day than I ever was before.  It's not a bad thing, but it has taken extra time every day.  Sue has been a big help to accommodate the grocery requests, and to keep a supply of pre-chopped veggies in the fridge - like carrots, cauliflower, broccoli.  I've been eating very simple meals throughout Transition, in order to keep a better handle on the daily tracking.  I have been full most of the time, and I've had very few significant cravings.

Leaving behind the 'bedtime snack', however has not been all that fun.

It's not that I'm hungry between 9:00 and 10:00pm - but eating around that time gives me joy and comfort.  I did go into this program with a promise to myself to keep an open mind and to 'stick with the program.'  I'm guessing that there are important reasons why the dietician wants us to not snack during this high-risk time period (high-risk for me based on my past history).  So I'm trying to problem-solve this issue.  For now, I'm eating a small, healthy snack about 5 pm, then eating my evening meal about 8pm.  Then a half hour later I'm having a piece of fruit and a cup of hot chocolate, then I'm 'done' for the day.  We'll see this week if this is a good plan.

The weekly group sessions have been talking about recipes and strategies for each of the meals - breakfast, lunch, supper.  The topic last week was about increasing exercise - this hasn't been a huge problem for me [I thought it would be at the beginning], but I know there will be challenges coming up.  Winter will require new strategies.  I will need to be diligent to maintain the exercise over the long haul - traditionally, my exercise commitment tends to peter out after a couple of years.