Monthly Archives: December 2013

What do maintainers need?

Something I will be doing this spring is writing a personal statement for an application to grad school, and defining what I want to do is something I think about a lot.  I am passionate about degenerative disease prevention via lifestyle change.  There are a lot of things I can say that engage negative emotions, but what I think is important is hunting down regain.  And what we know is that regain is largely psychological in nature.  What is needed is an understanding of mental health, and even mental wellness, which I define as the robust expression of brain activity above and beyond the absence of mental illness.

The hard part is not getting too detailed.  But as an analogy, fitness doesn’t have to wait on a problem free body.  If you can’t run, you walk.  If you can’t walk, you swim.  You find a way to move your body that doesn’t stress the problems you already have.  They say 5% of Americans experience clinical mental illness, but I think a far greater number struggle with lesser degrees of mood or learning problems, since only 5 to 20% of people who lose weight are able to maintain their reduced weight, and research shows that depression and disinhibited (emotional and/or binge) eating are the main reasons people regain.  It would seem that self-medicating with food (or alcohol, which is empty calories) goes hand in hand with regain.

Mood problems are one thing, but learning disorders can also contribute to disorganization and lack of motivation, when consistent and structured eating is necessary for successful weight maintenance. Both attitude and motivation can benefit from understanding cognitive behavior models.  To extend the fitness analogy, one would be like strength and the other like cardio.  I would say attitude is more like strength in that things need to be overcome, and motivation is like cardio because it involves consistency.

And then I’d say a third leg is harder to define, but is where we move into the realm of mental wellness.  It’s about creating a new identity as a weight reduced person.  For me, this has meant embracing physical health to the extent that I am now going back to school and moving toward a role in primary care or research and education.  It is a bit extreme.  Some people embrace athletics, fashion, or cuisine.  Lifestyle change must be about more than eliminating the bad; it encompasses nourishment, building the body, and thriving mentally.

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52 weeks at goal

Last week on my nutrition final there was an item about how Picabo Street, Mark Maguire, Arnold Schwarzenegger, Lou Ferrigno and Will Smith were overweight or borderline obese at their peaks (in Smith’s case, when he played Mohammed Ali).  I thought that was funny since Street was my inspiration for my goal last year of 165.

I marked a low weight at the end of the summer, and have gradually gained a bit, which I was feeling kind of bummed about.  But looking back a year I can I’m still 6 pounds less than I was then.  I also revised my weight loss goal on Sparkpeople, which had been 152 by tomorrow.  I set a starting weight of 160 (which it was about a week ago) and a goal weight of 155 in March.

I guess in the long view I there are landmarks that stand out in my first year of maintenance.  Reaching goal, of course. Getting through Christmas and New Years without going off the rails. My first freak out, am I having an eating disorder?  Valentines day I did go of the rails, but got right back on.

Studying Maintenance scholarship until my eyes bled. Being invited to help lead at the Sparkpeople Maintenance Tem and getting involved with We Keep it Off.  Finally  understanding the predictors well enough to let go of my fear that I would fall out of maintenance without realizing it was happening.

Something I haven’t really put into words was when the Spark Solution came out in May.  I read it.  I had some nice things to say about it.  I was relieved by some aspects of it, but came away with a huge sense of alone-ness as a maintainer.  That was when I started this site.  “Happily Ever After.”  The fairy god mother of weight loss has granted all your wishes, and now what do you do with your life?

About that time I decided to join the NWCR according to the broadest definition, 1 year of keeping 30 pounds off.  I did, but by the time the materials arrived…

I had started school.  This happened over the summer.  Reading the maintenance literature had kindled in me the seriousness of the weight management problem.  Preventing diabetes, heart disease, and even cancer.  (Another tidbit from Nutrition class: every cancer besides lung cancer is correlated with obesity.)

And then a bumper sticker I saw on my birthday:  “Remember who you wanted to be.”  This rattled around in my head in different ways over a course of weeks.  I thought about becoming a trainer, a public health researcher, a speech language pathologist, and eventually a nurse.

One of the maintenance predictors Sparkpeople does well with is defining triggering events, or the reason you decided to change your lifestyle.  It could be an unflattering picture or a recalcitrant seatbelt, but the NWCR found it was often a conversation with a medical provider or the illness of a loved one.  And yet many providers feel their counsel would fall on deaf ears or in some cases ignite rebellion.

I think that’s one reason I would like to become a primary care provider.  Not so I can tell everyone I meet they need to lose weight, but to be willing to turn conversations toward long term health.  Helping people know that excess bodyfat requires cell proliferation, which gives cancer a foot in the door.

One of my observations from last year was how weight loss was like going to college, and when we graduate we don’t say “well that was interesting, back to reality.”  We are supposed to take what we’ve learned and put it into practice.  What would I have thought then, if I could see me now.