A ballad of dwindling flesh

April 26, 2005 6:26 AM

MyGastricBypass.com"This doctor feels that I have 25 to 30 lbs of excess flesh to come off. All the dieting the world won't remove that, so now I have some major decisions to make....Never did I think that this would be happening to me....Granted, it's better than weighing 500 lbs, but it's pretty nasty looking....The frightening thing is what happens to this skin when I get in the pool. OMG! It floats!!" - A long and actually heroic saga of self-disclosure, somehow Zen too, of one woman's successful attempt to remake her body and so her life - this rises at times to sublime heights : "I believe in a force called the Cosmic Shoe....Moorings are loosened and our boat feels adrift. When that doesn't get us moving, the Cosmic Shoe finally KICKS our ass into the direction he was trying to nudge us in the first place."
posted by troutfishing (96 comments total)

The morphing gifs are interesting, primarily for the surprisingly similarity to a balloon deflating. I hadn't expected weight loss would look so much letting the air out of a balloon.
posted by orthogonality at 6:55 AM on April 26, 2005

Dear lord. As you say: good for her, heroic efforts, and all the rest. It's great to see someone taking charge of her life like this. But forgive me just a tiny shudder as well.

::tiny shudder::

Thank you.
posted by ChrisTN at 6:58 AM on April 26, 2005

Dunno about gastric bypass, really.

Last year I dropped 50lbs over 6 months (230lbs->180lbs, ~40" waist -> ~34"), losing 1kg/week consistently. Rode my bicycle a lot, ate ~1500kcal/day+, avoided crap carbs and focused on nutrition, enough protein, and healthy unsaturated fats to keep my stomach satiated and my system not starved.

I had thought losing 10lbs was impossible, that the body would compensate its 'set point', that 10lbs required horrible starving.

Starving is only required if you are in too much a hurry. Just a gentle 500kcal/day deficit isn't going to distress most people, especially if one avoids "low fat" approaches that are too carb-heavy.

To keep the weight off, or even see real success with surgery, one needs to fundamentally alter one's relationship with food.

Here's an alternate take.

Unfortunately the guy stopped after the 16th week, down 16kg or so. Story not that encouraging really, and I think he's the norm. Most WLS patients don't end up with a happy success story.

There is no free lunch with WLS. Eating habits are still going to change. The lap band is the least worst since it is reversible.

I think nearly everyone can lose 1% of their bodyweight/week for any length of time by simple calorie control, and muscle building, tho I do understand how the morbidly obese simply lose control of the situation. It is a cascading spiral of failure and demoralization -- getting fatter makes it harder to exercise and easier to just chuck it all, paying the pain of failure with food.
posted by Heywood Mogroot at 7:09 AM on April 26, 2005

This being Metafilter, the only acceptable comments are along the lines of "she is nature's greatest hero."

So let me be the first to say that she is a victim and she did a brave, courageous thing to overcome the adversity that she absolutely had no part in bringing upon herself.

And people who are in a similar situation to the author, take solace in her struggle. Certainly, your affliction's source is due to genetics, injury or man's tampering with the environment or with the food chain. Do what this woman did, get gutted like a salmon, and feel no shame for it.
posted by Mayor Curley at 7:33 AM on April 26, 2005

Jeez, mayor, who pissed in your Post Toasties this morning?
posted by davelog at 7:46 AM on April 26, 2005

well, curley, there's a LOT of ignorance on all sides about weight gain, weight loss, and the surgery.

Gaining weight is the easiest thing in the world. Pretty hard not to, really, and the more you let yourself go the harder it is to recover control. Don't judge people unless you've been in their shoes.

I didn't know jack about losing weight until two years ago. Again, lack of understanding of important facts.

And most people don't know about the rather nasty side effects of WLS, thinking it is a magic bullet or something, when the reality is it's a pretty faustian bargain at best.
posted by Heywood Mogroot at 7:49 AM on April 26, 2005

Doesn't this line "I'm holding at around 157 and have fit into size 6's!" ring kinda false?

And am I wrong to wonder about her being fired 3 times in almost as many years? It seems almost as if the remaking of her body (including insurance form filings and documenting) may have become her primary career.

The whole situation seems so sad.
posted by DenOfSizer at 7:52 AM on April 26, 2005

See Curley, I would have guessed that your attitude would be the most prevelant. Around here, it certainly would have been a few years ago.

Is she to blame? The most appropriate answer, to me, is: who the hell cares? Is she taking the easy way out? I couldn't possibly care less. It's her body. What, assuming one is not involved in the study of obesity, is accomplished by placing blame in a situation like this?

I know it's very psychologically comforting to blame people for the bad things that happen to them. That doesn't mean that people aren't to blame for certain things, but it is something to consider.
posted by Doug at 7:55 AM on April 26, 2005

"This being metafilter"? Doesn't metafilter regularly accuse metafilter of having a blind spot when it comes to discrimination against fat people?

I think this shows exactly how nasty the consequences of obesity can be, and should probably be required reading for anyone who manages to get their BMI* over 35-40 to give them one last chance to cut back on the calories and start exercising before surgery becomes the only way out.

Multiple surgeries, lots of hospital time, all sorts of medication, an on-demand morphine drip ferchrissakes.. That's no kind of magic bullet, as [on preview] Heywood pointed out.


[* yes, fine, it's all muscle, whatever]
posted by cell at 8:01 AM on April 26, 2005

Don't judge people unless you've been in their shoes.

So because Mayor Curley hasn't been (I'm guessing) morbidly obese, he's not allowed to pass judgement on those who have let themselves get to that state?

Bullshit. Perhaps the reason he hasn't become a sad sulking sack of fat is because he's taken responsibility for his diet and exercise, working at it each and every day. In that respect, I'd say he has every right to his comments.

True, for some people, genetics is a major obstacle. But the steady rise in obesity rates over the past decade cannot be attributed to genetics--quite simply, not enough time has passed. Sedentary lifestyles coupled with high-calorie, super-sized quantities of food are the primary culprit.

Funny how you don't see everyone flocking to defend those suffering from lung cancer with statistics about how polluted our air has become.

Is she to blame? The most appropriate answer, to me, is: who the hell cares?

So we're not supposed to talk about the cause, just rally behind someone who has discovered that medical science can absolve people of self-control and personal responsibility. Great story. Real tear-jerker.
posted by Civil_Disobedient at 8:05 AM on April 26, 2005

I was under the impression that in cases of extreme obesity, such as hers, simply saying "diet and exercise" doesn't help. The person isn't able to exercise because of the stress their weight puts on their joints, and dieting puts too much stress on their body (not 100% sure about that last bit).

And gastric bypass is hardly an easy way out. It'd be a stressful surgery even if the patients weren't so terribly unhealthy--the death rate is somewhere around 1%, but I've read articles where doctors argue it's higher due to complications either from the surgery itself or people unable to keep up with the strict diet regimen they must maintain for the rest of their lives.

Anyway, it's too bad she couldn't get it in check before she had to result to surgery. Once you get far enough it's damn hard to go back.
posted by schroedinger at 8:05 AM on April 26, 2005

My stepdad had this surgery. He weighed 450 lbs. and was recently diagnosed with diabetes, his cholesterol was out of control, and both of his knees were shot from carrying around all that weight. Now he's 240, normal cholesterol, off insulin, and the proud owner of two new knees. He would have died without the surgery. (Why do I suddenly feel like I'm speaking at a support group?)
posted by goatdog at 8:10 AM on April 26, 2005

he's not allowed to pass judgement on those who have let themselves get to that state?

he can do what he wants, but it doesn't add to our understanding. 'There but the for the grace of god...' and all that.

Sure she fucked up her body by overeating. 30%+ of the country is doing the same. The question is how can we reverse this trend.

and dieting puts too much stress on their body

WLS isn't doing anything different. It's a caloric restriction thing, and the more drastic ones actually reduce absorption of nutrients so it is worse than calorie cutbacks.

The horrible thing is I think insurance companies are starting to pay for this procedure since it's a win-win for them. Either the patient dies on the table, saving them years of expenses, their gain is reversed, resulting in some degree of win.

It was thinking about the economics of WLS that first prompted me to think about how for-profit health insurance isn't about health outcomes, it's about the insurer's bottom line.
posted by Heywood Mogroot at 8:13 AM on April 26, 2005

I think insurance companies are starting to pay for this procedure since it's a win-win for them.

And meanwhile, I work full time and can't afford health insurance or surgery on my knee that was injured in a car accident through no fault of my own.
posted by fshgrl at 8:15 AM on April 26, 2005

He would have died without the surgery

At what rate did he lose weight?

Losing 200lbs would take 2-3 years at sensible dieting rates.

I think for most people WLS isn't going to do anything better than a good eating plan.

I understand people think they are too weak to control themselves, but before anyone commits to altering their physiology I'd like to see them receive a good intensive dieting regimen. WLS already has this protocol in place, but it's just a formality, a way station on the road to having the procedure done to them.

For $20/day we should be able to design a scientific diet that addresses some of the human weakness factors of overeating. That works out to $7000/yr, less than the monetary costs of WLS, and with none of the risks or life-changing effects.
posted by Heywood Mogroot at 8:21 AM on April 26, 2005

Not sure I even want to go here. My wife had WLS in 2001. She has lost probably 80 lbs and was really never in the same position as these folks.

I don't think she is any happier or healthier for the surgery. She has had 3 reconstructive surgeries since then and is stil lunhappy with herself.

She cannot eat foods that have too much sugar or she does something called "dumping". Kinda like a hypoglycemic attack where she has the sweats and all but passes out for about an hour.

This is not a magic bullet. Anyone who is thinking of this needs to be in the class of 400 lbs plus or else you need to try harder with conventional type methods.

My marriaige has been hanging by a thread for about a year, and I am still working on keeping it together. I try to be supportive, but there are SO many things that are just not do-able with her now. Eating out is a waste because she cannot eat a full meal. She has had serious issues with some neuro and other issues since the surgery, all of which can be tracked to symptoms that are similar to starvation and malnutrition, yet she takes her supplements and her blood work is good. Even with that, she is almost frail.

Trust me. This isn't the answer that many hope for. I have recently heard a statistic (no link, sorry) that up to 50% of marraiges post-WLS end in divorce.

If anyone reading this is thinking about it, think twice, then think again.
posted by the_barbarian at 8:25 AM on April 26, 2005

My sister has considered having this surgery, and the only reason she hasn't is that she cannot afford it. She has been trying to lose weight her whole adult life, but she just keeps getting bigger. I know for Mayor Curley and C_D it might be easy to look at people who are this fat and say that they are worthless and undisciplined. However, the reality is always more complex than the stereotype. I will be the first to admit that my sister is fat because she eats too much and doesn't exercise enough. The reasons she does those things, however, are quite complex. So whenever you have something that is a result of a complex mix of genetics, hormones, behavior, and psychology I think it is too easy and quick to just write of all of those fat people as worthless slobs.
posted by bove at 8:28 AM on April 26, 2005

Perhaps the reason he hasn't become a sad sulking sack of fat is because he's taken responsibility for his diet and exercise, working at it each and every day. In that respect, I'd say he has every right to his comments.

But so what? He's implying that she somehow doesn't "deserve" to lose weight because she had a gastric bypass instead of losing weight The Moral Way. Curley's position seems that be that because she made herself fat, she's somehow morally required to suffer in ways he approves of in order to lose weight.

Which is a damn stupid thing to think -- why the hell is it anybody's business whether she loses weight by gastric bypass, purging, starvation, or waddling a marathon every day? The important thing is to get healthier, by whatever means, however she got wicked fat. Hopefully she feels Curley-approved shame whenever she sees her Scar Of Moral Weakness.
posted by ROU_Xenophobe at 8:29 AM on April 26, 2005

the_barbarian, you've got to feel very strongly about this subject if it's the one that convinced you to join.

That's awesome! (except for the circumstancres that lead you to feel strongly.) I hope you'll be in more threads than this, though. Because this one will not be on any Metafilter reviewer's 10 Best list.
posted by Mayor Curley at 8:32 AM on April 26, 2005

Having gone from a metabolism that could burn through anything I ate to keep me from ever gaining a pound to being a Type I diabetic who has to fight extremely hard to keep from gaining 10 pounds a year, I have a lot of sympathy for my fellow fatties (not that I'm all that fat at 6'2" - 195 lbs, but I'd like to be 175lbs).

I once lost 30 pounds in 3 months walking seven and a half hours a day, but it is very hard to keep up that level of activity.

We can talk all you want about self-control and personal responsibility, but chances are most of you who think you are exercising self-control have intact bio-feedback mechanisms (feeling a sense of satiety when you are full), and a normal insulin response. Have you ever fasted for two days? Imagine if you felt that hungry all the time. Imagine if you could eat a three-course dinner and still feel just as hungry. Could you exercise self-control then?

What about injury? Ever break a leg or ankle? How do you work out? When you try and eat less food does your metabolism slow down so much you barely have the energy to move?

What do you do if your eating patterns were ingrained in you by your parents? If they fail to take care of your nutrition so that you are 300 lbs. by the time you are 14. You think it's easy to eat a nutritious diet when your palette has been trained to donuts and cool-aid?

From what I've heard, most gastric bypass patients are required to diet enough to lose 30-40 pounds before they can undergo the surgery. I know one Nurse-Practitioner who considers that gastric bypass should be a first resort. She argues that most people who are morbidly obese are not going to successfully keep that weight off even if they lose it in the first place.

This is also becomming a socio-economic issue. Pre-packaged foods are becoming increasingly sweet as corn-syrup is added to everything, even savory foods, both as a sweetener and preservative. Non-nutritive sweeteners are making the problem worse, as they train palettes to appreciate additional sweetness.
posted by BrotherCaine at 8:36 AM on April 26, 2005

Mayor, I have been lurking on mefi and used to wait for those rare occasions when new users were let in, but never quite caught one. You're right, though, I feel really strongly about this and it *IS* why I joined today.

Besides, now that I *HAVE* an account I have no escuse not to post elsewhere.... :)
posted by the_barbarian at 8:38 AM on April 26, 2005

Perhaps the reason he hasn't become a sad sulking sack of fat is because he's taken responsibility for his diet...

Sad sulking sack of fat? ROU_Xenophobe is exactly right, and wonderfully articulate. Some, Civil and Curley for example, see this as a moral issue. There is clearly anger behind civil's words, which makes absolutely no sense unless being fat is somehow "wrong."
posted by Doug at 8:38 AM on April 26, 2005

and of course, as is typical, I too conveniently ignore the spell check button: excuse: ee-ex-cee-you-ess-ee
posted by the_barbarian at 8:39 AM on April 26, 2005

The US government is $7.7T in debt today -- $25,000 for every man, woman, and child, with the debt set to be $9T in 2009.

Does Mayor Curley apply his Toughman Personal Ethics to this larger situation? The human brain is a wonderful organ at ignoring unpleasant realities.

barbarian: unfortunately your experiences match my general understanding of the outcomes of major WLS, like the RNY procedure that turns the stomach into a pretzel.

I'm less negatively disposed toward the lap-band, which doesn't permanently alter the physiology and is removable. Still think it is a waste of money tho, since WLS addresses the gross behaviors but not root causalities of obesity.
posted by Heywood Mogroot at 8:43 AM on April 26, 2005

I'm aghast that gastric bypass surgery is still being done so much. I've got a friend who just got the LAP-BAND, which has been in use for 20 years now, is much less invasive and is orders of magnitude safer than cutting out a hunk of your intestine (which carries a big risk of infection).

My friend was out of the hospital after an overnight stay
posted by ursus_comiter at 8:43 AM on April 26, 2005

Oops, lost some of the last sentence:

My friend was out of the hospital after an overnight stay, and was up and about and feeling pretty much normal after just a few days.
posted by ursus_comiter at 8:45 AM on April 26, 2005

Curley's position seems that be that because she made herself fat, she's somehow morally required to suffer in ways he approves of in order to lose weight.

Suffer? It sounds to me from the testimonies here that WLS is more punishing to the body than diet and exercise.

There is clearly anger behind civil's words, which makes absolutely no sense unless being fat is somehow "wrong."

Not anger, frustration--at people who would point the finger in every direction but towards themselves. BrotherCaine is right: this is a cultural issue. Combine our food industry's gluttony for money (by substituting cheaper high-fructose corn syrup for sucrose, which shunts the normal digestive process) with a society that has erased shame from its dictionary ("just be happy with yourself!"), then increase the amount of working-hours in the poor and middle-class and decrease their ability to even find nutritional substitutes for the crap on our shelves, and you have a recipe for disaster.
posted by Civil_Disobedient at 8:58 AM on April 26, 2005

(hit post accidentally)

...Each of these points, however, can be corrected with the right mindset: don't buy products with HFCS; if you can find the time to watch the average 4 hours of television a night, you can find time to exercise; learn some easy-to-cook, healthy recipes that don't require hours to prepare.

But most importantly, accept that the very notion of a diet is corrupt. A diet implies something that's temporary--once you reach your "goal" you can go right back to the cheetos and sofa. That's fundamentally wrong, and the reason why dieters rebound. There are no quick-fix solutions, no easy or lazy way out. It has to become a subconscious, reflexive decision made every day for the rest of your life.
posted by Civil_Disobedient at 9:09 AM on April 26, 2005

why the hell is it anybody's business whether she loses weight by gastric bypass, purging, starvation, or waddling a marathon every day? The important thing is to get healthier, by whatever means, however she got wicked fat.

I think the point is that gastric bypass should not be thought of as a solution but only a tool - the patient still must learn to, yes, "eat less and exercise", or all that weight will just be gained back. The surgery may provide motivation and decrease consumption by necessity, but it is still a bodily mutilation, and not a cure.

eating right and exercising are beneficial for anyone, whether or not they are overweight. Gastric bypass surgery is not something one would recommend to any but the most desperate cases. It's simply in a different category from attempting to get into shape via traditional methods. It isn't a matter of morality, but simply one of health.

A lot of overweight people seem to think that people who are in decent shape spend their days lounging around and eating doritos. There are some people who just have naturally high metabolisms, but generally speaking, remember that energy is neither created nor destroyed. Food we take in must be used by the body in some way. Some people's bodies naturally use a lot of fuel, either because they're just one of those dynamic people who's always moving, thinking, talking, tapping their foot, etc, or maybe because they're just an inefficient model. But for the most part, when you talk to people (over, 25 or 30) who are in good shape, it turns out that they do go to the gym, or for a jog, or whatever a few times a week. A lot of NYers naturally walk about a mile every day without even noticing it (a mile is about 20 blocks, so if your subway station is 5 blocks from the destination, then to & fro on each end of the commute = 1 mile). Counting stairways, and meandering sunday walks, and going to the drycleaners etc, I probably walk about 10 miles a week, but I don't count that as my exercise; I specifically go to workout 3-4x per week for an hour+.

So, sure, it's no one's business how someone else runs their life and their body, but perhaps it is worth making it clear to people who are overweight that plenty of the people in better shape were really no luckier genetically; they have just adjusted their lifestyle to accommodate the realities of this century (i.e., that physical exercise often has to be artificially inserted, not found in the course of life, and that food is so cheap, plentiful and "fun" that one has to make special efforts to avoid the habit of snacking endlessly on unnecessary calories - once the habits are established, they can seem quite obvious and simple; it's changing from one course to another that's tough).
posted by mdn at 9:16 AM on April 26, 2005

increase the amount of working-hours in the poor and middle-class and decrease their ability to even find nutritional substitutes for the crap on our shelves, and you have a recipe for disaster.

You know, I hear this a lot, and I just don't buy it. Regardless of where you shop, it is perfectly possible to find vegetables and whole grains and meats. You can prepare a nutritious, cheap meal in about 15 minutes.

Making assumptions like that just reinforce the idea that it's not a societal responsibility but the fault of some vicious grocery-store consortium or whatever. But the fact is that people eat like crap because they like it, not because they don't know where to buy veggies or because they work too many hours. And they like to eat like crap because as others have said, its easy and it's what they grew up with. Figuring out how to change that is our responsibility as a society, and blaming it on the grocery industry is, in my view, counterproductive.

*note, I am not employed or paid by any grocery stores*
posted by miss tea at 9:17 AM on April 26, 2005

I'm waiting for this stuff, to become available.
posted by Cassford at 9:28 AM on April 26, 2005

I think the schools have a major responsibility that they're, by and large, completely failing to fulfill. I'm not talking about any "this is a food pyramid" crap, either. I came out of the public school system with horrifying eating habits.

School lunches were both unappealing AND filled with fat and grease, and the alternatives supplied, IN MY PUBLIC SCHOOL, by Coca-Cola(tm) and Pizza Hut(tm) taught me that the better alternative was the fatty, greasy food that at least tasted good. It took me years of conscious effort to turn my palate around.

Folks like Commercial Alert are trying to do something about that situation, but it hasn't really captured the national consciousness. Somehow it just doesn't seem so glaringly obvious to most people, I guess.
posted by gurple at 9:29 AM on April 26, 2005

You know, I hear this a lot, and I just don't buy it.

Pun intended?

Seriously, though, it's generally cheaper and almost always easier to get "that full feeling" through crap food. Eating well can be very expensive: organic vegetables, meat and fish will quickly empty your wallet. But as I said in my follow-up, there are options available to those willing to stay on the outside of the supermarket aisles.
posted by Civil_Disobedient at 9:46 AM on April 26, 2005

Overall, I agree with mayor curley about his frustration; but let me tell you, fat people? Know all about shame. It is not *lack of shame* that keeps them fat, ok? At some point, hating yourself for your weakness goes from motivating you to removing all motivation whatsoever. Why bother if you're a sad sullen sack of fat--who cares if you stay that way? You're obviously useless (your thinking goes). Our society is full of doctors shaking their fingers* and thin role models and fat-mockers. If shaming worked, no-one would be fat.

*I once went in to the doctor for a sinus infection, and was subjected to a lecture about my weight. I was maybe 10 pounds too heavy at the time. Not an unusual experience, I have been told.

You actually do need a modicum of self-love and self-respect to take care of your body. I could not say how WLS patients fit into this, as far as if they really feel better about themselves after successful surgery or not. My suspicion is that all the issues that made them inclined to obesity will still be there when they are thin, and will have to be dealt with, or they will manifest in other destructive ways. It is partly about appetite and control, yes. It is also about pain and how to deal with it. Those who can't afford or are afraid of psychotherapy often self-medicate with food, or alcohol, or whatever. Some are lucky enough to find better ways to live. Some have a harder time of it. In the past, people simply didn't have the option of medicating with excess food, now they do.
posted by emjaybee at 9:53 AM on April 26, 2005

First off, let me say that I don't think gastric bypass is a good idea for anyone (for the reasons stated above). It is possible to address the root causes of obesity and lose the weight through conventional means, and that is a healthy and sustainable way to go. People do it, it's not beyond the realm of possibility it's just hard.

However, as someone who was recently diagnosed with a thyroid disorder I have to say that there are reasons beyond bad habits and junk food that cause people to gain weight. I'm grateful to have the tools now that I need to lose weight, but there was a very long time when I thought nothing I did would help. For example, I spent four months training for the Avon 3-Day walking vigorously for 5-7 hours a day and still gained weight, very little of it muscle. By comparison, an hour's exercise every other day has me losing at least a pound per week now, with my thyroid levels close to normal at last. And I've always eaten pretty well (if too much), mom was an Adele Davis devotee and I've kept that going thoroughout my life.
posted by cali at 9:56 AM on April 26, 2005

miss tea - I mostly agree with you, but I find that the quality of vegetables in my 'borderline ghetto' neighborhood in San Jose is so bad that it's worth driving 25 minutes to the ritzier Los Gatos supermarkets for my fruit and veggies.

Also, if you really live in the ghetto, there are no supermarkets. You get to buy your food at hostess/orowheat/entemens outlets, rainbo bakery outlets, and convenience stores. At convenience stores and mini-markets you pay up to triple price for your food, making it as cheap or cheaper to eat at restaurants, such as Church's chicken.
posted by BrotherCaine at 10:06 AM on April 26, 2005

My stepdad lost 100 pounds on the pre-surgery diet, and then 130 pounds after the surgery. He can walk without pain. He can go to the movies and to sporting events (before, he couldn't fit into the seats). He and my mom get along a lot better now: he's not depressive anymore, and his smaller size allows them to do a lot more together. Far from ruining his life, it's made him a new man. Say what you will about responsibility and shame and blame: without the surgery, I wouldn't have a father. Before and after.
posted by goatdog at 10:11 AM on April 26, 2005

So how about it quonsar?

Gonna give it a try?
posted by nofundy at 10:12 AM on April 26, 2005

Suffer? It sounds to me from the testimonies here that WLS is more punishing to the body than diet and exercise.

Curley's tone indicates that it's not the right kind of suffering. Losing weight can apparently only be moral if it's done with unadulterated self-control, or if you start by admitting that you're a big fat fuckwit and there's nobody to blame but you.

Not anger, frustration--at people who would point the finger in every direction but towards themselves.

Why would you possibly care where they point the finger? What business of yours is it what delusions they have?

Ultimately it makes no difference whether they think that they're fat because they're moral cowards with no self-control, or fat because they have some sort of metabolic disorder, or fat because fat-demons sneak into their room at night and inject fat into them. What makes a difference is that they lose some weight, become at least less wicked fat, and maybe move around a little more. And, guess what, the woman in the post ended up eating less and exercising more, because she basically removed any choice she had in the matter.

I don't give a fuck whether a smoker quits by sheer self-will, by joining some twelve-step program, by using nicotine gum and bupropion tablets, or by making burnt offerings to Thor. The important thing isn't that they take responsibility and acknowledge that they're hopeless fuckups, the important thing is to quit smoking, or to lose the fucking weight.

Is a gastric bypass optimal? Probably not. But, empirically, we know that it worked for this woman where other methods didn't, so it's almost certainly better than just continuing to be wicked fat.
posted by ROU_Xenophobe at 10:30 AM on April 26, 2005

As a man who ten years ago dropped from 150kg to 90kg by sheer exercise of will, and is currently on his way down again from 137kg by a much easier method, I think I can contribute something worthwhile to this discussion.

C-D is right when he speaks of the notion of a "diet" being corrupt, if by "diet" you mean "something I have to go on to get rid of this excess weight". He's also right that the fix has to last a lifetime. But I don't think it necessarily has to be subconscious or reflexive; it's quite possible to commit to lifelong conscious weight control, and it doesn't even have to be difficult.

Here's what I do: I have a chart on my bedroom wall with kilograms on the vertical axis and the date on the horizontal with a tick mark for each day (about six months fits on a landscape A4 sheet), and a set of scales under the bed. Every morning, the very first thing I do after crawling out from under the covers is stand on the scales and put a dot on the chart. I call the chart my Oracle.

There's a pre-plotted curve running across the chart (whose properties I'll get to in a minute); if today's dot is at least a kilo under the curve, and there haven't been too many dots over the curve in the last little while, the Oracle says "Good lad!" and I can freely eat anything I damn well please that day. It's very very satisfying to have days where I can enjoy the contemptuous stares of my local Curleys as I tuck into a huge pile of fish and chips, secure in the knowledge that doing so isn't going to make me fatter.

If I'm right on the curve, I know the Oracle will yell at me in a day or two if I go crazy with food, so I'm reminded to eat more carefully; think about whether it would be better to put that extra helping in the fridge for tomorrow instead of eaten now, for example.

If I'm over the curve, I'll take every opportunity to choose to eat less; I'll have breakfast and lunch, but will typically skip dinner or just have something steamed-vegetably or salady.

Also, if I'm on or over the curve that's my reminder to choose to walk to the shops instead of drive, or go out the back and chop a little wood, or just go for a walk to the river, or do something else moderately physical.

Naturally, my weight bounces about all over the place (the dots on my chart appear to have about 4kg of noise) but overall I've found it quite easy to keep that cloud of dots pretty well centred on the curve.

Around the end of December last year, I weighed in at 137kg. For my height, bone structure and musculature, 85kg is healthy. So I started off carrying 52kg excess weight.

I used a spreadsheet to plot a smooth curve that starts at 137kg on January 1 this year and drops by 1% of the remaining excess-over-85 each week. So I've ended up with a curve that starts by dropping at about half a kg per week, and will eventually asymptotically approach 85kg. In about four years, it will be down around 87 and so will I (I'm currently hovering around 128, which is right where the Oracle thinks I should be).

The advantages of this approach are:

1. Because the curve gets flatter as time goes by, I won't have to push my body harder and harder to lose weight; the effort required should stay roughly constant (which is to say, actually very easy). Anybody who has done a serious amount of weight loss will be familiar with the phenomenon that the last few pounds are the hardest ones to shake; a steadily flattening curve takes this naturally into account.

2. Because the curve flattens gradually, there is no point at which weight loss stops and weight maintenance begins - that is, there is no "diet" in the corrupt C-D sense, and no distant future "weight loss goal". The goal is strictly short-term, and it is achieved every single time I take the Oracle's opinion into account while making a decision about eating. If I do that, I stay on the curve - and if I stay on the curve, my weight is under control.

3. I have constantly-available and irrefutable graphical proof that what I'm doing is working, so I have simply stopped worrying about being too fat. The flab is, quite simply, doomed.

The redefinition of goals - from "losing weight" to "getting my weight under control" is absolutely crucial. As I see it, what I've done with the curve-riding approach is take an out-of-control, open-loop process (eating, often worrying about eating wrongly, and inexorably gaining weight) and apply monitoring and negative feedback to make it a closed-loop, in-control process.

This is why I disagree with C-D when he says it has to be subconscious and reflexive; ISTM that anybody with a tendency to run to fat who is countering that with a subconscious tendency to avoid "bad food" is still running an essentially open-loop eating policy - and if the amount of negative feedback their physiology is capable of is still not up to the job, they are going to end up on a slow gain.

It's taken me all of my 43 years to accept that (a) I don't and never will have the kind of physiology that can do this kind of negative feedback automatically, and that I will always have to compensate for that by external means.

What I've designed, then, is the simplest such external means I could think of - and so far it's working extremely well.

This is not a moral problem - it's essentially an engineering problem; and Mayor Curley and friends can go and get fucked, for they know not of what they speak.
posted by flabdablet at 10:31 AM on April 26, 2005 [1 favorite]

Miss tea, I gotta say, that's really not true. Even if you ignore the higher cost of healthy foods, you're still faced with the fact that nutritious meals take time to prepare. People who have to work two or three jobs and take care of their kids don't have that time.

And the poor kids can't even rely on school lunches to get their nutrition--most schools feed their kids the equivalent of prison food, low-quality stuff if the kid even bothers trying to get a nutritionally-balanced plate and doesn't opt for the soda and cookies instead.
posted by schroedinger at 10:32 AM on April 26, 2005

I think the point is that gastric bypass should not be thought of as a solution but only a tool

I think it's awfully hard to see any sort of good intention in Curley's comment, or much more of a point than "Fatties suck and need to admit it, dammit."
posted by ROU_Xenophobe at 10:35 AM on April 26, 2005

Flabdablet, what's the formula you use for your curve?
posted by schroedinger at 10:36 AM on April 26, 2005

Yesterday we had "My Vasectomy", today "My Gastric Bypass", what surgical procedure will MeFi tackle next?
posted by clevershark at 10:39 AM on April 26, 2005

clevershark - How about:
'My new hole that was carved by amateur surgeon MeFies after my FPP.'
Oh wait, that'd be a repost.
posted by BrotherCaine at 10:49 AM on April 26, 2005

what surgical procedure will MeFi tackle next?

My Self Trepanation
My Autophagy
My Auto-Amputation (by that hiker/mountain climber that had to cut his own hand off)
My Sharonectomy, the sequel to My Sharona
My Horrible Oozing Infection That I Had Lanced And It Kept On Oozing Horrible Vile Pus And Was Really Disgusting And Now It's Just A Scar Because It's Better Now Thanks Very Much But Here Are Some Pictures Of It Oozing And Some More Of It Being Lanced And Some More Of It Continuing To Ooze They're So Good You Can Practically Smell The Gangrene
posted by ROU_Xenophobe at 10:58 AM on April 26, 2005

Schroedinger, it's an Excel workbook with three sheets: Parameters, Data Table and Chart.

Parameters has

A1: "Start_date", B1: 1-Jan-05
A2: "Start_mass", B2: 136
A3: "Ideal_mass", B3: 85
A4: "Weekly_excess_loss_rate", B4: 1%

A7: "Start_excess_mass", B7: =Start_mass-Ideal_mass
A8: "Daily_excess_multiplier", B8: =(1-Weekly_excess_loss_rate)^(1/7)

and has had Insert->Name->Create run on it to turn all the labels into names.

Data Table has

A1: "Days", B1: "Date", C1: "Excess", D1: "Target"
A2: 0, B2: =A2+Start_date, C2: =Start_excess_mass, D2: =C2+Ideal_mass
A3: 1, B3: =A3+Start_date, C3: =C2*Daily_excess_multiplier, D3: =C3+Ideal_mass

Row 3 is replicated on all rows down to 182 using autofill, which makes column A count up by ones and everything else just work.

The Chart plots Data Table column D against column B.

If anybody wants a copy I can upload it and post a link.
posted by flabdablet at 11:03 AM on April 26, 2005

Wasn't there a blog some time ago with graphic pictures of a guy cutting off his own junk?
posted by clevershark at 11:04 AM on April 26, 2005

Making assumptions like that just reinforce the idea that it's not a societal responsibility but the fault of some vicious grocery-store consortium or whatever. But the fact is that people eat like crap because they like it, not because they don't know where to buy veggies or because they work too many hours.

I agree. Of course what I find interesting is how many people who believe in variations of the the "corporate culture is killing us!" stuff want to go "back" to some more "natural" way of living - except wthout the infrastructure and mechanisms made possible by the evil corporations the concept of fresh fruit and veggies available in quantity and variety for little expense would be a fantasy.

It is completely possible to eat muvh better than most people do. Hell, a hot chicken ceaser salad at McDonalds is around $3.99. Even if you are gonna complain that people don't have time or energy to cook it is cheaper than the tripple cheeseburger and as readily available.

Personal responsability re-distriution and "blame the man!" politics come together nicely in these sorts of issues for a lot of people that want someone to blame.
posted by soulhuntre at 11:19 AM on April 26, 2005

If anybody wants a copy I can upload it and post a link.

That would rock :)
posted by soulhuntre at 11:21 AM on April 26, 2005

If you're even a little worried about your weight, you should count the calories you eat and track your calorie burning.

I'm sure there's a "tipping point" when diet and exercise are no longer modifiable, but that's a pretty big point, I think.

I don't think she is any happier or healthier for the surgery. She has had 3 reconstructive surgeries since then and is stil lunhappy with herself.

Amen. Other than extreme health reasons, I can't see any reason for "reconstructive" surgery. Happiness is not so simple.

IANAP, but it sounds like your wife needs some serious counseling. Good luck, the_barbarian. I hope it works out.

Another sad lap band journal. Not a happy thread in any sense.
posted by mrgrimm at 11:30 AM on April 26, 2005

Regardless of where you shop, it is perfectly possible to find vegetables and whole grains and meats.

You've obviously never lived in a poor neighborhood. I lived in Bushwick, brooklyn for about a year some years back (it's a slightly better neighborhood now) and the supermarket was not only lacking many staple items (for veggies it had potatoes, cabbage, onion, weird exotic tubers of various sorts, iceberg lettuce, mushrooms, sometimes tomatoes, sometimes collard greens...) but it also had bugs running about on the floor, which made you often feel that perhaps it was unwise to buy unpackaged produce there. Local grocery stores were even less likely to have any sort of plant-food at all - you could get pickled pigs feet, a variety of malt liquors, junk food, canned food, and soda... This stuff is easier to ship and can stay on the shelf for ages if it doesn't sell quickly, so it's a safer investment for the small business owner.

I was living there by choice (very cheap rent for very big spaces) and was familiar with the rest of the city, so just got my groceries in town for the most part, but for people who grew up there, this was what was available. That doesn't mean they can't change things, but it does mean they have to given information about how to change things, and then make active choices to do so, which takes a lot more effort than those of us who were brought up with health food stores or "korean markets" (which in NYC were the first local grocery shops to carry extensive fresh produce, in the mid 80s) realize.
posted by mdn at 11:31 AM on April 26, 2005

Well, here we all are again.

I have noted with interest in the many, many conversations we've had over weight and obesity on MeFi in the past few years that the people who are the most ... ahem ... vocal ... in their comments (or at least the tone they take) that people who are either obese or merely overweight are completely 100% responsible for their own situation and that weight loss and weight control are somehow easy for everyone are male. I wonder why that is?

Women, in particular, face some very different obstacles than men in terms of weight gain and weight control. Pregnancy, especially multiple pregnancies, can cause added weight that is amazingly difficult to take off, especially for an exhausted mother of a newborn/toddler. The drugs that we take to avoid pregnancy can also cause weight gain, and often that weight is stubborn and almost impossible to remove while staying on the medication. Women naturally have more fat cells than men, and multiple studies (I can't find examples on-line quickly, but check your local library) show that it is easier for men to lose weight than women (i.e. for men and women at the same activity level who eat the same diet for the same period, the man will lose more weight in a specified period of time than the woman). Women also typically have more family demands on them then men (yes, I know, its not true in your house, but you and I both know its true on the broader canvass), making it more difficult to find formalized time for exercise while she works 40+ hours, does housework, cares for kids, runs a carpool, and goes to the PTA. Think about it -- how many mom's do you know who are on kid-duty before or after work while dad goes to the gym?

Regardless of where you shop, it is perfectly possible to find vegetables and whole grains and meats.

I would invite you to come on a tour of the grocery store in the town where I grew up (notice I did not use the words Super or Market in that sentence). And I grew up in a produce-producing rural state. At the front of the store there is a single cooler with a pathetic selection of sad looking onions, a couple of heads of lettuce, a few carrots, a few oranges, 25 lb bags of potatoes, plus occasionally a few grapes. The meat department is all pre-packaged meats from Purdue, etc.-- certainly nothing organic or even fat-trimmed or special cut. But there is a full 12-foot isle of potato chips. And another full 12-foot isle of "convenience foods" ranging from Mac and Cheese to weird "just heat and eat" dinners that come with a hunk of meat in a can. Oh, and three full isles of frozen foods of all sorts of types. Want to make a different choice? Fine - drive 25-30 miles to the "Super Market" in the "City" nearby.

I've been overweight (and sometimes subject to tirades like Mayor Curley's) for most of my adult life, mainly due to the medications I need to take every day in order to continue to breathe. I'm also beautiful, well-dressed, well-groomed, confident, active (hiking, canoeing, camping) as much as Maine weather permits, and healthy -- low blood pressure, low cholesterol, stable weight for many years (stable weight, by the way, being almost as important in terms of health as lower weight).

This woman's story begins with the words "I've been overweight since I can remember". If you think that being overweight is a "choice" she made with her life, consider those words carefully. Without knowing more about her story, can you judge her? Do you know how her eating habits formed? Do you know her medical history or family situation? Do you really know her as well as you think you do?
posted by anastasiav at 11:33 AM on April 26, 2005

I lost 40 pounds over 6 months, which I've kept off for the last 6 months, on the South Beach diet plus going to the gym at least 3 times a week. I don't avoid all carbs, just bad carbs like refined starch & sugar and I avoid bad fats. I eat lots of whole grains and read labels for fat content.
posted by mike3k at 11:37 AM on April 26, 2005

I was morbidly obese (~320 lbs), and then one day I woke up and started becoming who I want to be. Since then I've lost 120lbs. Losing weight isn't magic, it isn't science, it's what most overweight people are lacking, the desire to change yourself, and the willpower to make those changes happen in your life.

I had the pretty bad loose skin, but I've stayed this weight for over a year now, and my skin is slowly tightening.

If you really want to lose weight, you need to accept that you can't be the person you currently are. There are only three tenets to losing weight, and to keeping it off forever.

• Eat less
• Exercise more
• Everything in moderation

posted by patrickje at 11:45 AM on April 26, 2005

Regardless of where you shop, it is perfectly possible to find vegetables and whole grains and meats.

You've obviously never lived in a poor neighborhood. I lived in Bushwick, brooklyn for about a year some years back

Actually, mdn, I have lived in poor neighborhoods (in some cases while actually poor), including Ridgewood, Queens (just over the border from Bushwick); Sunset Park, Brooklyn; Wicker Park, Chicago (not the nice part and prior to hipsterdom); etcetera. My experience, admittedly anecdotal, was that I could eat quite well from foods purchased at C-Town, particularly local ethnic specialty foods. The veggies (plantains, cilantro, yum yum) were fairly fresh and tasty.

The stuff that's actually more expensive in areas like that is the packaged goods. I also wasn't referring to the 'healthy' diet approved by hippies (organic everything, only lean meat) but a balanced, fresh diet including cheaper cuts of meat and grains like rice and pasta.

Brother-Caine- I acknowledge that my experience with poor neighborhood grocery stores is limited to hispanic neighborhoods, which perhaps skew differently than black neighborhoods.

And schroedinger - I am aware of the studies you've referenced. In fact, I was once so poor that I ate taco bell and ramen noodles with peanut butter every day because they gave so much bang for the buck, calorie-to-price-wise. And yet...if that's true, if people are truly eating crap foods to avoid starvation due to poverty, why are they packing on the pounds rather than just maintaining? If the marginal cost of an additional 15-25 minutes a day of cooking plus $3 per day is so high that it's a barrier to good health, I think that there's still an argument to be made that even under those circumstances there's an element of societal and personal choice there.
posted by miss tea at 11:50 AM on April 26, 2005

Just wanted to chime in with my GP experience. Not really an opinion one way or the other, just another story...

My mother had this procedure almost a year ago, and within a couple months of her sister's (my aunt's) successful GP surgery.

Shortly after the surgery (within a day), her temperature started to rise, and her blood pressure drop.

When I got the call to come to the hospital's ICU a day later, she was in full septic shock due to stomach fluids leaking into her system from a small hole the surgeon had missed.

I'll never forget the look of terror on her face, with her eyes swollen beyond their sockets and her trying to mouth the word "water" from behind the tube that was taped into her mouth. The doctors weren't optimistic that she would last through the night, but luckily she did.

She ended up staying in the ICU in a sort of "induced coma", with pain killers, a paralytic, various drugs to stabilize her blood pressure and fluids, as well as lots of antibiotics. Once I counted 21 bags on 3 "trees", all feeding into various points of her body.

She then had to endure several more surgeries to open up drainage for the fluids that were accumulating (/growing) in her abdomen. These tubes remained hanging from her sides, and fed into bags on the side of her bed.

After a couple weeks in ICU, she developed an acute respiratory condition called ARDS, which her doctor told me she was unlikely to recover from (one of those fun phone calls at 5 in the morning).

Then they discovered that she had picked up drug-resistant staff infection (MRSA)... apparently it is floating around quite a bit in ICUs.

I then relieved her doctor and had him replaced with an "Intensivist".

So... LONG story short...

at the end of the ordeal, my mother had spent over 70 days in the ICU. Most of it in this sort "coma", and the last bit with all sorts of respiratory therapy through a new tracheotomy (they don't like to leave tubes down the mouth/throat for months). She did recover though, going home to spend many more months becoming accustomed to not only her new smaller stomach, but to continued respiratory therapy, physical therapy (her muscles had atrophied), MRSA drugs that cost $90 per-pill, as well as a hernia from where they cut through her abdominal wall during a drainage surgery.

Now, almost a year later, she's just become well enough to endure what should be her last GP-incident related surgery (meshing the hernia).

Overall, she is healthy and has a new positive perspective on life (although I'm not sure if that is more a credit to the weight loss or to having seen "the light at the end of the tunnel" and returned).

It's a funny thing though... on one hand I hate that she knew the risks and still put her self in a position of enduring such a terrifying ordeal, but on the other hand, I see her and my daughter playing with an energy she never had before, making me feel a lot more understanding (she told me through tears before the operation that playing with her granddaughter like a "normal" grandma was the main reason she wanted to take the risk).

Could she have lost the weight another way? Maybe if she had been more disciplined or had access to better nutritional guidance? I don't know (and never will)... I do know that she had been trying to lose weight as long as I can remember, never with any long-lasting results.

All but crazy memories now...

num-
posted by numlok at 11:55 AM on April 26, 2005

If anybody wants a copy I can upload it and post a link.

flabdablet -- yes, please!
posted by selfmedicating at 12:07 PM on April 26, 2005

As of today I've lost 219 pounds.

I love that sentence! I know exactly where she's coming from; she could have said "almost 220" or "about 215", but as with the rest of the article, she was really honest with both herself and the journal. It had to be precisely "219".

And upthread- Heywood Mogroot: Last year I dropped 50lbs over 6 months (230lbs->180lbs, ~40" waist -> ~34"), losing 1kg/week consistently. Rode my bicycle a lot, ate ~1500kcal/day+, avoided crap carbs and focused on nutrition, enough protein, and healthy unsaturated fats to keep my stomach satiated and my system not starved.

Very similar to my own story. I started this year at 236 lb. and a 40" waist. I went on one of those low-carb diets and have gotten down to 180, with my goal of 170 being dangerously close. My 34" waist pants are beginning to feel loose. I still can't believe it would be possible to lose 56 lb.- almost a quarter of my body weight- in less than 5 months. I haven't even exercised all that much (about 2 miles of walking per day).

To anyone out there who looks at my example, or Heywood's, or the lady in the link, and think "If only that were me..." Let me tell ya, it is more about committing to the decision than it is about will power. It's one BIG decision that you will lose the weight, than small fights about what to eat. If you start on a prescribed diet, there are no more decisions to make; you let the diet make it for you. All you have to do is follow directions. But to even get to that point, your really have to WANT it. I hope for those who a packing those extra pounds that you decide you do!
</infomercial>

Great post!
posted by Doohickie at 12:26 PM on April 26, 2005

People like Mayor Curley lack empathy. And that makes him less healthy than any overweight person.
posted by deborah at 12:41 PM on April 26, 2005

Very similar to my own story. I started this year at 236 lb. and a 40" waist. I went on one of those low-carb diets and have gotten down to 180, with my goal of 170 being dangerously close. My 34" waist pants are beginning to feel loose. I still can't believe it would be possible to lose 56 lb.- almost a quarter of my body weight- in less than 5 months. I haven't even exercised all that much (about 2 miles of walking per day).

To anyone out there who looks at my example, or Heywood's, or the lady in the link, and think "If only that were me..." Let me tell ya, it is more about committing to the decision than it is about will power.

I pray that it is forever, but I wonder what the chances are that in 5 years you'll still be at your "ideal weight". It IS about "committing to the decision" but how many of us make huge changes like this that last FOREVER? At 5 months out it's pretty easy to say that your life is forever altered, but that seems not very often to be the case for most people.
posted by tristeza at 12:44 PM on April 26, 2005

Chiming in to say flabdablet, that would be great.
posted by gaspode at 12:48 PM on April 26, 2005

This is why I disagree with C-D when he says it has to be subconscious and reflexive

I guess like smoking, some people can simply quit and never look back, others will have to consciously make the decision not to smoke for the rest of their lives. Either way, I'm really glad to read your story and solution, and hope it helps others here.

People like Mayor Curley lack empathy.

Enough with the pile-on. He's posted exactly two times in this thread, and the second post was a non-sequitor.
posted by Civil_Disobedient at 12:52 PM on April 26, 2005

People like Mayor Curley lack empathy. And that makes him less healthy than any overweight person.

*Rolls eyes. Vomits.*
posted by Kwantsar at 12:53 PM on April 26, 2005

Wow, this has been a very interesting discussion for me. In the last 3 years I've quit taking illicit drugs, quit drinking and quit smoking. One might think that I'd feel pretty good about making such drastic healthy changes in my life. But no, instead I obsess over the fact that I weigh 135 instead of the 120 of my youth. Seriously, OBSESS. I get depressed, count calories, work out constantly and yet I still weigh an f'ing 135 pounds and I hate it. I logically understand that I am not obese, I cannot imagine the emotional pain that being obese would cause. I'm not sure what the answer is and frankly I'm babbling but dang, it's just so difficult. To all of those who have managed to shed the weight and get healthy, awesome and congratulations!
posted by yodelingisfun at 1:02 PM on April 26, 2005

I pray that it is forever, but I wonder what the chances are that in 5 years you'll still be at your "ideal weight".
-Oh, I totally agree. That is my biggest fear is that I'll gain it all back. Wish me luck!

It IS about "committing to the decision" but how many of us make huge changes like this that last FOREVER?
-I don't know if this is forever or not; I hope it is. When I spoke of "really wanting it", part of that for me was that I had several health indicators that were going out of control. To me, this isn't about looking good (at least not entirely); it's about my prospects for preventing a heart attack.

At 5 months out it's pretty easy to say that your life is forever altered, but that seems not very often to be the case for most people.
-Again, I don't know if this is forever. I hope it is. The decision to diet came only after several years of slowly reigning in other aspects of my health and life (getting regular physicals, getting on blood pressure & cholesterol medicine, getting a hernia fixed, reducing my debt load, etc.) Maybe I'm finally growing up or something. Who knows?

***
People like Mayor Curley lack empathy.
Enough with the pile-on.

I don't think Mayor Curley cares.......!
posted by Doohickie at 1:17 PM on April 26, 2005

Exactly, Doohickie, exactly.

*pats Kwantser on the head and sends him out to play with the other kids*
posted by deborah at 1:24 PM on April 26, 2005

Having gone through many weight-loss cycles must also be a factor. I know that I have done so a few times, and now I simply seem unable to lose weight, even as I do an hour of cardio 5 days a week (and have been doing so for about 3 months).

I feel better and my shape has generally improved, but for some reason my weight just doesn't reflect it. It's very odd.
posted by clevershark at 1:32 PM on April 26, 2005

!
posted by Doohickie at 1:37 PM on April 26, 2005

-I don't know if this is forever or not; I hope it is.

I really hope it is, too, Doohickie. :)
posted by tristeza at 1:50 PM on April 26, 2005

Forget about the lion lying down with the lamb or a hen giving birth to a serpent. We'll really know that the end times have arrived when a MeFi obesity thread doesn't turn ugly fast. That's the fourth horseman of the apocalypse.
posted by anapestic at 2:04 PM on April 26, 2005

I could eat quite well from foods purchased at C-Town, particularly local ethnic specialty foods. The veggies (plantains, cilantro, yum yum) were fairly fresh and tasty.

I wasn't far from a jamaican area, where you could get decent produce, but the majority of shops in poor neighborhoods stick to the guaranteed sellers, which means that stuff which can last on the shelves longer has a much better chance. Fresh spinach will only last a few days, and if it isn't bought, that's money down the drain. If a can of beans or a bag of doritos or a sack of potatoes isn't bought, it can wait around for quite some time before being lost income.

And yet...if that's true, if people are truly eating crap foods to avoid starvation due to poverty, why are they packing on the pounds rather than just maintaining?

Because people, however stupidly, love a deal. If you can get a medium for $2 but the large is only $2.10, it often won't really matter if you specifically want the extra portion. You just notice that it's a deal. Businesses take advantage of this and offer large portions of crap food, which sells better than similarly priced small portions of better quality food.

And then people get in the habit of eating that much, and don't really feel like they're done when they eat a smaller meal. My dad was always an overeater, and I grew up with that sort of relationship to food: clear your plate and always go for seconds if there's something left. I was also an active kid so I never got overweight, but it's only been in recent years that I've learned how to really figure out if I need more fuel or am just thinking of eating as a basically enjoyable activity that I still have room to pursue. I think for a lot of people there are only the two extremes - you know what it feels like to be hungry, and you know what it feels like to be stuffed. But being "satisfied" is not the same as being "stuffed" - it's not that you couldn't eat any more, but that you realize you don't really need to eat more. And it can require some will power, especially if the food is really appealing and right in front of you. Bad habit: eating while doing something else. Make it a rule that you can only go back to whatever you were doing once you're done eating (including tv, internet, etc)
posted by mdn at 2:06 PM on April 26, 2005

The thing about being overweight is that for most, it's an addiction to food, just like any other addiction. But in my opinion, it's one of the worst addictions because you can't cut food out of your life completely. A gambler can never ever make a bet again. No stocks, no Roulette. An alcoholic can swear off alcohol, even cold medicine. A smoker can stop smoking and even going to restaurants that allow cigarettes. Even a sex addict can potentially live as a hermit and never have sex with another human again. But you cannot live without food. You can't just get an IV hooked up with a glucose drip and then never eat again. And how do you expect an alcoholic to have "just one beer?" Or a gambler to play "just one game of cards for only $5." But someone overweight is supposed to have portion control? That's far more difficult.
posted by Spencerinc at 2:09 PM on April 26, 2005

And yet...if that's true, if people are truly eating crap foods to avoid starvation due to poverty, why are they packing on the pounds rather than just maintaining?

Because crap foods are full of empty calories, fat, sugar, carbs, preservatives, etc etc.
posted by tristeza at 2:51 PM on April 26, 2005

To throw in my two cents worth...

I am fat. I am not morbidly obese, but I am nowhere near a healthy weight. Whose fault? Mine. However, I do have depression (violent depression, actually, with major mood swings and the desire to hurt myself) that, finally, is under control with medication. When I was in my 'dark' moods, all I wanted to do was sit and eat. Food made me feel good, and it was literally beyond me to do anything, anything at all. My house was a mess, dishes sat unwashed in the sink, the poor dog got to go outside only long enough to do her business and then it was back inside. It is almost impossible for me to describe and for you to know what it was like at those times. It was scary, and what finally motivated me to seek help for myself.

I am steady mentally now, for days and weeks at a time, which is a blessing. Now, I am able to tackle my serious weight problem, and I have made some progress with the simplest of tricks: eat less, exercise more.

To those of you who look on fat people with disgust, please consider that there are very likely underlying causes. As for me, I blame no one but myself for my weight issues.

*although, after reading Sue's story, I don't think I'll be doing WLS anytime soon*
posted by Sharktattoo at 3:07 PM on April 26, 2005

Clevershark: muscle weighs more than fat. If your shape is improving, that's likely to be why you're stable - it's still good. Possessing muscle uses more calories generally, so it'll be harder to gain more fat.

In order to really track changes, try getting a gauge of your body fat percentage now and in a month - most gyms will let you get a reading fairly cheaply. I recently lost about 6kg of bodyfat and replaced it with an extra 4.5kg of muscle in about 3 months ( so the scales only tell you half of the story about how Sparx got his abs back).

And schroedinger, the "poor kids" that get served crap in the school cafeteria? What, they can't fix themselves a tuna sandwich and an apple? Poor kids indeed, what with the having no limbs of their own.
posted by Sparx at 3:17 PM on April 26, 2005

Food and depression. Lots of people turn to food for solace. Witness comfort food. One thing that puzzles me a little is this so called genetic thing. I have two brothers, one older and one younger. My younger brother posts here as Fat Guy. He, like my older brother is overweight. I'm not. Same parents - obese father, mildly obese mother. Same genes. So why aren't I overweight? I think the answer is math. Calories in, calories out. Surplus or deficit? I ride bikes and lift weights. My brothers are sort of indoor people.
posted by fixedgear at 3:28 PM on April 26, 2005

My house was a mess, dishes sat unwashed in the sink, the poor dog got to go outside only long enough to do her business and then it was back inside. It is almost impossible for me to describe and for you to know what it was like at those times.

I had a friend in a similar situation. She finally ended up voluntarily confining herself to a psychiatric facility, and asked if I could visit her place and take care of her pet rabbit while she was away. She warned me the place was a mess. What I wasn't anticipating was just how bad the situation had become: rabbit feces everywhere (and thus, thousands of flies everywhere), dishes piled two sinks high, filled with the rotting remains of previous meals, papers and books scattered all over the floor, etc.

She basically had no refuge. Work brought her stress, and home was just as bad. Basically it was a giant negative feedback loop of depression begetting depression. If I had to come home after a long day of work to that, I'd probably commit myself, too.
posted by Civil_Disobedient at 4:30 PM on April 26, 2005

My younger brother posts here as Fat Guy. He, like my older brother is overweight. I'm not. Same parents - obese father, mildly obese mother. Same genes. So why aren't I overweight? I think the answer is math. Calories in, calories out. Surplus or deficit? I ride bikes and lift weights. My brothers are sort of indoor people.

Fixedgear: Genetics is only part of the answer, environment plays a part. For most of his married life, our oldest brother has a family larger than yours, including two toddlers. His commute is longer than yours. You have no children, and your commute is only a couple miles. I have to run a household with 1/2 the number of people that you have in yours. I do everything for myself, you have a wife to split tasks with. Your wife is also a professional chef.

To say that you ride bikes is an understatement. Your entire life revolves around bicycles. You enjoy bicycling, and that's great. Not very many people will ever go to the extreme of "riding a bike" that you go. I'm going to be the weekend warrior fat guy riding a clunky hybrid on the bike trail for a very long time.

I'm not trying to dis fixedgear or anything, I just wanted to point out that genetics isn't everything, environment plays a factor.

People have said to me that in order to lose weight, I need to "eat less, and exercise more". Fine, eating less, and eating more nutritious food I understand, though I admit I haven't ever been very good at either.

What about exercise? How do you exercise? No really, I've never exercised, and I would like to learn. More importantly, how do you exercise when all your life you have been very bad at exercising (I used to cut gym), and people who are good at exercising have made it a point to tell you that?

I have a YMCA membership. I haven't gone. Why? Because I don't know what to do, and the type of people who go to gyms are the type of people who disparage fat people when they attempt exercise. I think I'm at the point in my life where I can deal with the embarrassment of exercise, and now the fucking trainer won't return my emails.
posted by Fat Guy at 5:12 PM on April 26, 2005

How do you exercise? No really, I've never exercised, and I would like to learn.

Start slow and basic. Walk. Seriously, it's easy as hell, you don't have to deal with anyone thinking "Hey, look at the fat guy exercising!" -- you're just a guy out for a walk. If you'd rather keep it at home, an exercise bike is a good substitute. Studies have proven again and again that it is more efficient (and healthy) to jog slowly (or walk briskly) for a half an hour than all-out-run for 10 minutes. Aim for 30-60 minutes of sustained activity. Don't over-do it. The extra weight on your body means you'll actually be getting a more vigorous exercise than a thin person doing the same movements. But it's better to do a little for a long time than try and over-exert yourself for a short period.

The first few days are the worst. Your body will be sore, sore, sore. Give it a couple of days to heal, then try it again. Your body will hurt less each time you try, until you can do it every other day without being sore afterwards. This is honestly all you need. Just multiply it over a period of a few months, or even years, combined with a good diet with reasonable portion sizes (reasonable portion = about the size of your fist).

No soda ever again. My GF bought a carbonator to make soda water at home, and it's what got the Coke-Monster off my back. Mix soda water + orange juice and you've got Healthy Fanta.

If you're serious about spending money on a trainer, you might be better off joining a program like Weight Watchers or Jenny Craig. They both basically follow the old tried-and-true method of weight-loss (no fad diets or the like), and I've heard their mentors are very good at responding to your questions and keeping you motivated.
posted by Civil_Disobedient at 5:54 PM on April 26, 2005

I have a YMCA membership. I haven't gone. Why? Because I don't know what to do, and the type of people who go to gyms are the type of people who disparage fat people when they attempt exercise. I think I'm at the point in my life where I can deal with the embarrassment of exercise, and now the fucking trainer won't return my emails.

Well, I was going to suggest that you talk to the trainer on staff at the Y because in my experience they have been pretty helpful in showing you how to use the machines, etc., but if he's a dick then that's no good.

You can read up about various exercises and machines online, and there have been a few AskMe threads about how to construct an exercise plan to gain muscle and lose excess weight.

For a long time I was never very active, and for me it's been a conscious decision to remedy that. I do exercise videos for aerobics. I pray the weather is nice so I can get out and hit a few tennis balls. Basically, you should pick something you think you'd like to do and go from there. Tennis and swimming are two of the best sports because of all the muscles involved and the mix of aerobic and cardio work both entail.
posted by somethingotherthan at 6:05 PM on April 26, 2005

Here's a program similar to the one mentioned earlier.

This was a fascinating post-- I read the whole thing including her blog from this year. Quite a story. I have tremendous sympathy for people who are obese, partially because my mother has struggled with a serious weight problem for most of her life. After reaching a sort of crisis point where we all almost insisted she have one of these surgeries, she's lost over 100lbs in the last two years simply through eating better. Reading this article, I don't think my mother could have lived through all these complications, so I thank God that she resisted our pressure.

Lots of people in this world have problems that they can hide. But people who take emotional solace from food to the degree that that they become dangerously obese don't have that option. Everyone can tell just by looking at them. It colors most of their interactions with other human beings. People are mean and they suck often, but on the other hand, it's reasonable to be repulsed by someone who seems to care so little for themselves.

This journal also made me think of a girl at my office. I work at a place that is filled with skinny beautiful women. I feel fat there with a BMI of 23 (not mostly muscle), but I'm older than a lot of people there and already married. This girl is very young and very overweight. I feel so bad for her that I can hardly bear to be around her. I'm always running into her in the kitchen where she's preparing something awful for herself. She often tells food-related anecdotes that make me cringe.

I am disgusted at myself for avoiding her. After all, I am able to interact with lots of other people who are self-destructive in other ways, but look relatively normal on the outside. I'm really going to make an effort to at least have the same kind of shallow friendship with her that I have with all my other co-workers.
posted by snout at 6:11 PM on April 26, 2005

...the type of people who go to gyms are the type of people who disparage fat people when they attempt exercise.

I have bunches of exercise tapes that I use at home. They're kind of fun but you need to pick and choose when you are first starting out or some of those vicious bitches in the tapes who chat and smile while you are panting and gasping might turn you homicidal.

A lot of the aerobic tapes are rather like dance routines--and since I am a total klutz it took me awhile to get the steps down. But now I know all of the tapes I have and just go with it. I enjoy it.

The toughest part of doing the exercise tapes? Turning them on. It's fun once you get started, but it's just the procrastinating part of it that's tough.
posted by leftcoastbob at 6:18 PM on April 26, 2005

flab's chart idea is very similar to what I did: maintain a good but not suicidal pace via instrumentation of weight loss, using that as feedback on how much to eat each day.

This is covered in John Walker's The Hacker's Diet an excellent, but somewhat geeky, read.

I think the real secret of successful dieting is not trying to lose the weight too fast. Just let it burn off gradually.
posted by Heywood Mogroot at 7:07 PM on April 26, 2005

The person isn't able to exercise because of the stress their weight puts on their joints..

What about swimming? Just saying..
posted by c13 at 7:10 PM on April 26, 2005

What about swimming? Perhaps I'm wrong, but it seems to me that nothing would be worse for a 400 lb depressed woman than to get into a swimming suit and hit the pool. Just saying...
posted by leftcoastbob at 8:03 PM on April 26, 2005

People like Mayor Curley lack empathy. And that makes him less healthy than any overweight person.

I was thinking about a reasonable program to acquire empathy, but it would take a long time and require self-denial, so I'm obviously not going to do it. Instead, I'm going to have this awesome surgery where they cut you open and cram the empathy inside you. Then I'll be healthy!
posted by Mayor Curley at 8:29 PM on April 26, 2005

I have worked at a bariatric center for over three years. We now offer reconstructive surgery, too. I know many people who have had both, and I talk to prospective patients every day. I do think that some people rush into the decision. I am often surprised by the number of people who have not made a sincere effort to lose weight by other means. Some do tend to regard the surgery as a "quick fix" but I think most people understand that it's a major surgery. And for some people, it really can be a life-saving procedure. If you're 50 years old and weigh 400 lbs and have diabetes, hypertension, sleep apnea, etc. you're just pretty much fucked. Sure, sure, you might be able to lose the weight through more conventional methods, but if you haven't done it by 50, you probably won't ever do it. Most insurance companies will no longer approve bariatric surgery without excellent documentation of a previous diet and exercise regimen. 6-12 months is now the standard.

My job involves obtaining pre-authorizations from insurance companies, and they all require pre-op photos for the reconstructive surgery. I see these pictures everyday, and I will tell you that they are pretty shocking. A picture of one guy almost made me cry last week. It's like, great, I lost 150 lbs, but now I look like a Shar pei! Excess skin getting caught in zippers, yeast infections, chronic rashes.

Since seeing these pictures, I've vowed to quit worrying about what I look like naked.

On that note: yodelingisfun--I, too, gained some weight a few years ago and just couldn't handle it. I went from my standard 110-120 up to more than 145. I exercised every day for months and months. Cardio, weights--40 to 90 minutes a day and I couldn't lose a pound. I had always heard that you can eat whatever the hell you want as long as you exercise. Lies! I dropped about 30 lbs on the South Beach Diet. It took me a year. I feel great. I hadn't realized how much of a sugar addict I had become. I was also able to start jogging again. I can attest to how much harder even 30 extra pounds makes it to exercise. I can't imagine carrying around an extra 100 or more.
posted by apis mellifera at 9:29 PM on April 26, 2005

The horrible thing is I think insurance companies are starting to pay for this procedure since it's a win-win for them.

Not true. Insurance companies are covering it less and less. Every year, more plans exclude it specifically and those that do cover it make it harder to get. Insurance companies, like all companies, are in the business of making money and they are ultimately responsible to their share holders much more than to the insured. You may argue that it is cost effective for them in the long run to treat the cause of the various co-morbid conditions, but that assumes that they will be insuring a given individual for a lifetime, and that doesn't happen very much anymore.
posted by apis mellifera at 9:42 PM on April 26, 2005

OK. If any of you are still watching this thread, you can get my spreadsheet here. I've also included a version with all my current dots entered in, just so you can see what's on my wall at the moment. Ain't technology grand?

Heywood, Snout: this spreadsheet is actually a heavily pared back version of an earlier one I designed and mailed to assorted folks on a low-carb weight-loss forum I used to frequent, not long before I first became aware of the Hacker's Diet.

Walker's approach is similar in that he uses the idea of feedback, but like my own earlier effort it's WAY too complicated; all that calorie counting and careful planning is just so not something I want to be doing for the rest of my life.

Also, unless he's changed his formula since I read him a few years back, Walker appears to be working from the position that the excess weight is the problem and its loss is the goal, and he sets about doing that at top speed before entering a maintenance phase. I think that's flawed thinking: it seems to me that the excess weight is not the problem, it's a symptom of the problem, which is an open-loop, out-of-control relationship between the amount I eat and the amount that suits my bodily needs.

I am not patient enough to wait until the end of a possibly years-long process for my gratification fix; I want it now! And I get it every day, just by seeing my little cloud of dots staying stuck to that curve.

My earlier, more complicated method failed after about three months, because (a) I had to start up a computer and enter a figure every day instead of taking five seconds to put a dot on a chart next to my bed (b) I had included all sorts of complicated smoothing logic designed to take the noise out of the entered data, and all that did was detune the feedback loop (c) I had set my weekly excess-loss rate to an ambitious 3% instead of the gentle 1% I'm currently using, and I just didn't get enough luxury days (d) my friend Ron got me a high paying, high stress job that involved living in Germany, legendary land of beer and sausages; even cycle-commuting 10km each way every day was no match for German cuisine (did you know bacon is a vegetable in Germany? It turns up in everything!)

I got nowhere near the kind of feedback from doing it the old way that I am now getting from the simple, low-tech paper-on-the-wall and pen method.

If anybody else has any success with these sheets or otherwise wants to continue this discussion offline, feel free to mail me via com gmail flabdablet reverse the order of those three and insert dots.

Hey, Curley - I just went out for dinner with friends, and ate the BIGGEST schnitzel - they called it a Mexican, and it had full-bore nachos on top and came with chips.
posted by flabdablet at 4:38 AM on April 27, 2005

Genetics is only part of the answer, environment plays a part.

And another thing to consider is that genetics are not spread evenly from one sibling to the next. I can plainly see that each of my two brothers and I are my parents' kids. But in terms of looks, my little bro is the spittin' image of my dad, I look like mom's side of the family, and big bro is a blend of both. My dad had adult onset diabetes before he died, and I was built like all my uncles on my mom's side (i.e., skinny as kids, but developed beer bellies in middle age), a build which is high risk for diabetes. So I figure probably I got the bad cardio-vascular genes from both sides.

I'm going to be the weekend warrior fat guy riding a clunky hybrid on the bike trail for a very long time.

That's my style, too. But if you're doing it for exercise, a less-efficient bike makes you expend more energy, right?

People have said to me that in order to lose weight, I need to "eat less, and exercise more".

For me, it wasn't so much about eating less as it was eating better. Like mike3k and apis mellifera, I used South Beach. Sure, you're eating less, but because of the nature of the food, it stays with you longer and you hardly feel that dieting hunger. I lost a good chunk of weight (about 20 lb.) before I started exercising. And to this day, my exercise regime is pretty much just a 20-30 min. walk at lunch time, 4-5 times a week. I try to work a few other things in there, but the walk is the only consistent exercise I get. It is much easier to start exercise AFTER you've dropped some weight and are feeling the excess energy that not having to carry that extra weight produces. Also, since it was designed by a cardiologist for heart health first and weight loss second, if you go South Beach you'll be in better shape to start exercising after Phase I (the first two weeks).

No really, I've never exercised, and I would like to learn.

I am exactly the same way. I don't like working out; it seems like a pain in the ass. But as others said, just walk. No equipment needed, and minimal time (3 hr/week? That's hardly anything at all!) But it's easier to start if you've lost a bit of weight already. The South Beach book basically says the minimum amount of exercise you need is enough to break a sweat, several times a week. So even if you just do something vigorously for 10 minutes at a time, that's enough to get you started.

More importantly, how do you exercise when all your life you have been very bad at exercising (I used to cut gym), and people who are good at exercising have made it a point to tell you that?

Again, start with some weight loss first, so it'll be easier and you won't feel as self-conscious. Once you know you're on the right track, it gets easier to not give a shit what the experts say. Good luck Fat Guy. Know that you can drop the weight.
posted by Doohickie at 6:08 AM on April 27, 2005

flabdablet- There is always the danger I won't keep it off, but I managed to lose a pretty amazing rate (currently at 57 lb. lost in just under 5 months, and that was pretty front-loaded) and charted my weight on it. Maybe I'll link up the chart I used; I put in a target curve (that was steep in the beginning, then flattened out some as the South Beach book said I could expect). I actually got a fantastic start, so I've been ahead of the curve the whole way, which is great feedback. My weight loss has slowed somewhat the last few weeks, but I'm still ahead of my projected curve. I think metrics are good if you respond properly to them. The South Beach book said to concentrate more on how loose your pants feel and don't weigh yourself every day, but for me the weight feedback seemed to work well (maybe for most people, loose pants are a better feedback mechanism).

I had two goals which helped me stay focused: 1) I wanted to be at or near my goal by my annual physical (which is next month), with the aim of getting off some of the meds I'm on for high blood pressure, cholesterol, etc. 2) At my son's graduation this spring, and a family reunion later this summer, I will see several friends and family members that I haven't seen in a long time and I want to look my best. (I'm tired of my mom saying, "You've put on a few pounds, haven't you?"!)

I'm about 10 lb. above my goal of 170 lb., but if I don't lose another pound I'll be very happy at 6'-2", 180, which is considered skinny by most people. I wanna lose at least a couple more pounds, though, so I can say I lost 1/4 of my body weight.
posted by Doohickie at 6:29 AM on April 27, 2005

Nice, flabdablet. Thank you!
posted by gaspode at 7:20 AM on April 27, 2005

how do you exercise when all your life you have been very bad at exercising

You need to find something you enjoy doing so the exercise itself is a byproduct.

For me, like fixedgear, it's riding bikes. This started out as a means of getting some exercise (after two and a half years of anti-depressants saw me weighing half as much again as I originally did) but quickly turned into something I really enjoy and want to do, so I make time for riding and actually feel cheated on days like today when other obligations mean I have to abandon my ride.

That enjoyment factor is essential. I'm no team player - I loathed school sports - and I'm such a wimp that I'd feel monstrously out of place in a gym, so any attempt at a dedicated exercise regimen would be doomed to failure. The ironical fact that I'm currently trying to make myself a stronger rider is simply down to wanting to shed the impediment of having to walk up the steeper hills, which spoils the fun somewhat.
posted by arc at 11:09 AM on April 27, 2005

I loved that metaphor : sooner or later, the "cosmic shoe" gives us a kick in the ass.
posted by troutfishing at 10:12 PM on April 27, 2005

Doohickie: well played, that man!

And if you just keep using that chart for the rest of your life, you won't put it back on.

I have my Oracle in the same category as glasses, only not such a nuisance.

Gaspode: you're welcome. Let me know how it works out for you.
posted by flabdablet at 11:53 PM on April 27, 2005