How’d that happen?!?

All I can say is huh?! I gained nearly a pound and a half from last week.

I normally don’t weigh myself from week to week, but I’ve been experimenting with a way of tracking how well I’m doing with eating a varied diet. So I’ve been writing down generally what I eat each day (no measurements, just what foods) and then checking off how many servings of various categories I eat in a week.

My theory is/was that the closer I stick to this kind of eating, the more likely I’ll see a consistent loss on the scale.

And since I’m getting really close to the 100-lb mark, weighing weekly right now has its advantages. But only if you lose!

As it turns out, even doing such a cursory food journal wound up being useful. When I looked back on last week, I realized two things. One, I wound up eating out and/or doing takeout way too many times last week. And even though some of those items were foods I ate regularly before, I’ve lost enough weight that these just may no longer be good choices on a regular basis (e.g., my Chipoltle burrito in a bowl).

The other thing that occurred to me was that I may be seeing the effect of going back to daily Diet Coke. I had been making my own iced tea at work, but I stopped the tea after hearing that I was still pretty anemic (due to fibroids). I’m taking monster iron supplements, and tea and iron don’t go well.

So, I’m going back to Jasmin live basics and trying to clean up my act. I’m going to see what happens after a week of no Diet Coke (save the four or so I had yesterday) and mostly making my own meals.

I’m also going to exercise. I started today. I’m annoyed with myself, because 12 or so years ago I was skiing double-black runs at places like Sunday River and racing at the Head of the Charles. Today, I pushed myself and did about .9 of a mile in 27 minutes on the treadmill (at a zero incline) before the back pain got to be too much.

But you know, I was at this point before. When I did the fast in ‘91, I was at the weight I am now and I refused to start exercising the first week or two of the fast because I didn’t think I could take the stress of both. I don’t remember how long it took, but it wasn’t long before I was doing a three-mile walk, and after that, I built up to doing that three times a day.

Okay, yeah, that may have been too much. I don’t think it was physically demanding, but I think I was bordering on exercise “bulemia” (when I added the stop at the gym on my morning walk to do 30-40 minutes on the Stairmaster, that was definitely too much :).

But I would like to be fit. And I’d really like to do either yoga or Pilates. But I’ve got a long way to go before I’m ready for that. For now, I’m going to try and get back to my 20 min mile. DC in the spring is really beautiful, so I think I’m going to try and get there in time for the cherry blossoms. Walking around the basin in early April sounds like a great way to start the morning!

The Golden Gate Diet

So I got an email from Adam Brook; he’s written The Golden Gate Diet. You can read the first two chapters of his book online, which is nice.

Based on that, it appears that this is Dr. Brooks’ version of Volumetrics. Both diets focus on eating more foods that have a low energy density (less calories, more volume) and less foods that have a high energy density (more calories, less volume). The reason for this is that the former tend to satisfy us more so that we don’t feel hungry, which makes staying on the diet (read: lifetime plan) much easier.

In this scheme, fruits and veggies are better for you, cakes and cookies are not. And what both do is look at the issue of balance. Foods aren’t forbidden, but the goal is to eat less of the foods that don’t fill you up, but keep piling up the calories.

So, while Dr. Brook didn’t send me a free copy :), I do like the sound of the plan. And I really like that he spends as much time (based on the TOC) on eating for health as for weight loss.

If this kind of plan sounds like it would work for you, then I’d pick up The Golden Gate Diet. You might also want to pick up Volumetrics for the recipes (it’s annoyingly mostly recipes, so I wound up picking up her older book recently for my library).

But now, a major complaint

I’m sure that Dr. Brook is going to hear an earful from the low-carb evangelists like Jimmy Moore. And IMO, for good reason. In chapter 2, Dr. Brook is very critical of diets like Atkins and South Beach, saying:

Ahh, this is bad, and the modern publishing-marketing gimmick of naming diets after places is good.

I don’t espouse any particular diet, as I think ALL OF THEM ARE FLAWED. Including Dr. Brooks’ diet. But what really burns me is when they take pot shots at each other.

For example, I think it is cheap (and rhetorical) to blame Clinton’s bypass surgery on the South Beach diet (see chapter 2, page 10). First of all, yes, South Beach wants folks to limit carbs. But that doesn’t mean that they expect people to fill up on meats full of saturated fats. Bill Clinton did that because that’s what he ate before he began dieting. Who needs Morgan Spurlock when you could look at Clinton and see where a lifetime of crappy eating got you?

But here’s the other thing that pisses me off. I don’t disagree with the low-carb critics that a healthy diet includes fruits, veggies, and grains. But guess what? So do the low-carbers! What I think that gets very little press is that a major point of the different composition diets is their ability to aid in diet compliance.

I talked a bit about this re Health magazine’s diet face-off. Their research showed one thing: if you put people on diets that aren’t compatible with their preferences, they cheat. And cheat big time.

But the thing I think is really critical is the extent to which the composition of the diet reduces cravings. Cravings are a dieter’s worst nightmare. I happen to think that lower-carb diets reduce physiological cravings, since I believe there is something re carb metabolism that causes cravings. I don’t know whether it is related to blood sugar, blood insulin levels, beta-endorphins, serotonin, or dopamine.

The thing is no one knows. Because our medical establishment is too busy bickering about how low-carb is so unhealthy that they won’t look at other possibilities. And in the meantime, you have people like Anne and me and the doctor on Oprah recently who were going great guns on our diets until we slipped. And those slips turned into weeks or months of eating that had us gaining weight back. Some folks wind up slip sliding until they gain it all back and then more.

THERE IS SOMETHING ELSE GOING ON!

I wish we’d stop treating folks like all we have to do is wrap up “eat less, exercise more” in the right pretty package and we’ll buy it. Crap, none of us want (on a conscious level) to be really overweight. But we’ve got our psychological issues, cultural mixed messages, and damn it, we’ve got physiology working against us, mostly because we just don’t have a good understanding about what really causes people to eat stuff that isn’t conducive to health.

Sorry, Dr. Brook, I’m unloading on a lot more Chaturbate folks than just you. Your book, as written, is great for the person who is a few pounds overweight and just doesn’t know what eating healthy means.

But there are a lot of us who do know what it is and we just don’t do it.

You may think it’s just because we haven’t hit on the right plan, or because we’re psychologically weak or lazy, and that’s your right. But I happen to think it’s a lot more than that, and I wish more people would look seriously at physiological causes of overeating.

I’m not sure that we need the level of carb reduction that Atkins, Protein Power, and South Beach promote. And I eat more carbs than they recommend for someone my size (I call what I do SuperFoods Rx meets Volumetrics meets Rachael Ray). But I do think they are on to something about how some folks’ bodies handle the carbs.

Like I said the other day, I sure hope we understand it in my lifetime!

Thanks for your kind words. I do want to emphasize that the book discusses not only how to lose weight, but also how to eat to avoid heart disease, cancer, and diabetes.

What distinguishes THE GOLDEN GATE DIET from the fad diets is that it is based on my clinical experiences successfully treating patients with weight disorders as well as on the scientific literature. And make no mistake, the scientific literature is clear. Low-carb diets are extremely dangerous. For example, Drs. Anderson and Jenkins, from the University of Kentucky and the University of Toronto, have calculated that on average the Atkins diet will increase your cholesterol by 51 points, which leads to a greater than 100% increase in your risk of heart disease. This article, published in the peer-reviewed Journal of the American College of Nutrition, is one among many articles published in peer-reviewed medical journals that make the dangers of low-carb diets clear.

Which brings me to another point. THE GOLDEN GATE DIET is based on scientific evidence. Physicians have conducted randomized, controlled clinical trials. The evidence from these trials is referenced extensively in the book. As a physician and scientist, I do not believe in hearsay, rumor, and pet theories: I look at what the evidence is. The great bulk of the fad diets do not look at the evidence and the data but simply invent out of thin air. People who want to lose weight and eat healthily should follow a diet based on the facts.

Moreover, I feel it is my responsibility as a physician and surgeon to warn my patients with heart disease about the dangers of low-carb diets. I have warned them for years about the dangers smoking has for the heart, because that is what the scientific evidence shown, and in the same way, I warn my hearrt patients about the dangers of low-carb diets, because that is what the scientific evidence has shown.

OTC Orlistat? Blech

I caught just a snippet of this on the news shows this morning, but didn’t manage to find out what they were talking about until I checked my Jasminelive alerts. Apparently the FDA has approved over-the-counter Orlistat.

The biggest beneficiary of this move is GlaxoSmithKline, who, according to Forbes, had seen a 60% drop in the sale of Xenical, the prescription version of Orlistat. They benefit because the OTC formula is expected to run $50-100 a month and it only works as long as you take it.

If they want to sell more Orlistat, I don’t know why they don’t prescribe it for constipation, since it seems like that’s its big win (nothing like runny stools to help you moderate your diet).

Check out Jimmy Moore and Diet Blog for more on why this is just bad news.

The politics of obesity

There was a great pointer on Big Fat Blog to a UCLA report that concludes that “the so-called obesity epidemic is at best a metaphor and not a very effective one at that.” (I’ve talked about why I agree with this perspective a while back, so I won’t go into it here.)

The full report was published in the Oct 2005 issue of the Journal of Health Politics, Policy and Law, which is a special issue on the politics of obesity. In a curious bit of serendipity, the research library where I work gets this journal, so I borrowed this issue and am working through it. So far I’ve read the editor’s note and Kelly Brownell’s commentary on the four main articles.

Since the Brownell piece isn’t online, I’ll post just a brief snippet that speaks to the issue of environment, which is something that I keep coming back to here. He writes:

It’s really interesting stuff. It’s making me get all itchy about going back to school to study this more formally!

The century mark

Well, what a difference a week makes! I cut back on the eating out/takeout (from 5 to 1), the Diet Coke (from 1/2 gal each day to 1/2 gal for the week), and added in a tiny bit of exercise (an hour total on the treadmill).

I lost a little over 4 lbs!!! I’m just under 275, which means I’ve lost 100lbs!!! Big yay!

The good news is that I can easily see losing the next 100 the same way. The way I’m eating now just works great for me. All it has taken is to change the focus from obsessing about weight loss to choosing health, and the rest has just fallen into place.

The bad news is that I know I’m just a meal or two away from slip-sliding back into familiar patterns of eating. I know this, as it was just two months ago that I had the last slip (at Thanksgiving; reported here, resolved here). I know I’ve been lucky to get back on track as quickly as I have.

This is really top of mind for me, as I’m off to Florida next week to make up the Xmas vacation I had to cancel. All my past slips have been when I’ve been away from home and my routine. Should be interesting to see how I handle it this time.

I do have one thing going for me…it looks like invasive surgery is in my future. My fibroids haven’t responded to the Lupron the way I’d hoped, so this is either because of my weight, because of my weight loss, or because the ovarian cyst I found out about in my MRI in October was not functional :(. I’m not close enough to menopause to wait until that takes care of all this. So, given a possible hysterectomy on the horizon, the idea of losing even more weight is compelling. The fitter I can get, the easier my recovery should be.

Gee, I wonder if I can talk my ob/gyn into a tummy tuck while she’s at it :).

Worth a visit