Thursday, September 30, 2010

5k, then and now

On Sunday, my husband and I walked a 5k together.  Well, the course was a little shorter than a 5k, truth be told, but it was nice to get outside into a beautiful area and take a walk together to support an important cause - research for a disease called Mucopolysaccharidosis. We averaged a 19:45 per mile pace over 2.29 miles with some hills thrown in for good measure.  As we enjoyed the sunshine, brisk air and oak trees of western Novato, I found myself thinking a lot about the last 5k that I did.

Like Sunday's walk, my last 5k was also to support an important cause - mental health.  As a future psychologist, doing events like the National Alliance on Mental Illness (NAMI) 5k are important to me to help de-stigmatize mental conditions as well as to build a supportive environment where folks who are having all kinds of mental struggles can find support and caring from others.  And, of course, doing a 5k is a fun, healthy way to approach those goals.

The problem was, I wasn't all that healthy when I did the NAMI walk.  It was on May 22, 2010, and I had reached my heaviest weight in my whole life - about 298 pounds.  Despite my weight, I had a vision of myself as being in "OK shape" and I truly thought I would be able to knock out a 5k with no problem.  After all, I had been working with a personal trainer for a couple of months, and had improved in my overall fitness and stamina since starting the training.

About 20 minutes into the walk, though, I started having doubts about myself.  It's the first time I've ever wondered to myself, "Can I actually finish this 5k?"  I was breathing hard, fighting asthma, and my heart was palpitating.  On top of that, my legs got tired much more easily than I expected.  When we got to the hill in the course, I thought for sure I was going to have to quit halfway through.  Fortunately, my dad was walking with me at that point, and with his consistent, comforting presence, I managed to finish the 5k in an hour and 16 minutes, at a pace of 22:35 per mile.

After that 5k, I felt exhausted, my energy completely obliterated.  I struggled to walk back to the car and collapsed into a 4-hour nap as soon as I reached the house.  When I woke up from my nap, still feeling as though my limbs were weighed down with an additional 100 pounds of lead, I made the decision to move forward with my idea to start on the MNP program.  I knew I couldn't continue to live that way any more, and I believed that the MNP program was the best hope I had for turning my life around.

Fast forward 4 months, and I am so thankful I had that experience.  Not because it was fun to go through -- it surely wasn't.  But it pointed out to me in a visceral manner just how unhealthy I had become.  I had known my weight wasn't good for me, but I'd always had a vision of myself as a healthy person other than the number on the scale.  The reality of my poor health came crashing down on me during that 5k, and allowed me to jump-start the change that has transformed my life so dramatically in such a short time.

Wednesday, September 22, 2010

The measure of a (wo)man

One of the attitudes I've really struggled with in my weight loss journey is the belief that the scale is the ultimate measure of my success at becoming more healthy, and also a measurement of my value as a person.  I think that belief is at least partially responsible for many of my failures with programs such as Weight Watchers and Jenny Craig.  It has taken a lot of soul-searching, both on my own and through MNP program, to come to a place where I can see that the number on the scale is a symptom of my behaviors, and an inconsistent one at that.

A couple of weeks ago, we were discussing this topic in my MNP group.  My group leader gave us two examples.  The first was of a person who worked hard all week, staying on program, exercising, drinking all their water, and making sure to get enough sleep.  That person weighed in, and only lost 2/10 of a pound, and felt crushed.  The other example was of a person who followed the program some days, but cheated on others, didn't exercise, and didn't worry about water or sleep.  The second person weighed in, and lost 5 pounds, and felt ecstatic.  My group leader's point was this:  Both people are wrong in their assessment of the situation.  It's not the magic of the scale that keeps the pounds off once a person is focused on maintaining their weight loss, it's the healthy behaviors the person does day in and day out that really makes the difference, and how well someone follows those healthy behaviors is the sign of success, not the pounds on the scale.  After all, if you keep doing the healthy behaviors, the weight will come off eventually.

This was a bitter pill for me to swallow.  After all, who doesn't want to see the pounds melt off, week after week?  Who doesn't get frustrated when, after putting in solid effort on healthy behaviors for a week, the scale shows little or no change?  It's so easy for me to look at the scale and think that I am a success or a failure based on the number that shows up this week.  It's a lot harder for me to look at a small weight loss and convince myself to think, "Wow, what a success!"  Our culture is built on instant gratification, and I'm definitely a member of our culture!

All that being said, I've noticed a change in myself as I've been able to remind myself to use my behaviors as a measuring stick instead of the weight on the scale.  I'm kinder to myself.  I'm more able to see the small successes which will add up over time.  And I'm making time to do little things that help me achieve those small successes.  I'm worrying less about trying for big leaps or big successes, because those aren't the ones that ultimately matter.  This mental shift has made my life a much more pleasant place to be, an unintended but highly welcome side effect of this program.

So... how do you measure yourself?  And what effect is that having on you?

Sunday, September 19, 2010

It's the little things that make all the difference.

Although I've lost over 50 pounds so far, there are days when things don't seem all that different than before I started losing weight.  Today wasn't one of those days.


As I was preparing to go to the Giants game with my husband, one of the things I wanted to do was make sure I had on good, sturdy shoes so I could walk around without discomfort.  Automatically, I went through the routine of tying my shoes, leaning down toward my feet, taking the laces in hand and looping them around.  As I finished the bow on the second shoe, I was astonished to realize I was comfortably tying them without gasping for air or having to put my foot out at an angle in order to be able to reach the laces.

Amazed, I sat for a moment on the dining room chair, thinking about what had changed.  It's not that I have become all that more flexible since beginning to lose weight, although I have definitely improved in my flexibility.  No, the real difference was the lack of bulk in my mid-section when I bent over, sitting on a dining room chair, and reached down to my feet.  Even more amazing was the fact that the situation was so ordinary-feeling that I didn't even notice until I was almost completely done tying my second shoe!  Small miracles...


As Mike and I approached the entrance to AT&T Park, a familiar anticipatory cringe rippled through me as I thought about going through the turnstiles.  They're small, I thought to myself, and I always have to squeeze through them.  I began to feel embarrassed, thinking about how I would need to turn to the side and stand up on my tippy-toes in order to force my body through the narrow opening.  My brain was working overtime preparing me for the humiliation, when I stopped to have my purse checked by the gate guard.  Then I looked at the turnstiles.  Really looked at them.  They looked small, just like I remembered, but a small voice in the back of my head reminded me, "You're smaller now too, you know."  With that thought, I took a deep breath and plunged forward.  Bravely, I faced the turnstile head-on, and pushed my way through without going on my tippy-toes.  As I finished going through the gate, a broad grin grew on my face. 

Mike had gotten several feet ahead of me, then turned around, realizing I wasn't right behind him.  He paused in the middle of his sentence, looking at the grin on my face, and said, "What?  I think I missed something." 

I nodded, the grin getting even wider so it might have cracked my face in half.  "I walked through the turnstile straight on, without even feeling squeezed!"

The grin on Mike's face echoed my own, and he leaned over to give me a kiss.  "Congratulations, sweetie. I'm proud of you."


I'm proud of me too.  I've worked hard for moments like these, and I hope to God I never forget them.

Saturday, September 18, 2010

The beginning, but not really...

As a framework for understanding the leg of the journey I'm on, it's important to understand where I was when I decided to start my weight-loss program.  I've battled my weight for the majority of my life, and by the time I signed up for the MNP program, I was almost 300 pounds.  It frightens me to admit that, and it doesn't even begin to give a sense of how miserable and desperate I was feeling about myself, my weight, and my health.  I felt like something was wrong with me, even though none of the medical tests I'd had done indicated any problems.  In some ways, the lack of medical explanation made me feel even worse about myself, because there was only one reason left in my mind for why I was still overweight: I was a weak, undisciplined failure.

Despairing of ever making the transformation to the healthy person I have always hoped to be, I began to explore more dramatic options for weight loss than I had considered before.  After all, Weight Watchers, for whatever reason, wasn't cutting it for me.  I needed something that would work, and would hep me hit a "reset button" on my health and fitness.  In the past, I've considered surgical procedures, but I have always been reluctant to go that route because of the potential side effects from the surgery as well as the fact that surgery wouldn't change how I think about eating or exercise.

Then I started hearing about very-low-calorie diet (VLCD) programs from two different friends of mine.  Each friend had been able to lose a significant amount of weight pretty quickly, and one of them was going through the maintenance program and had been able to keep her weight off for at least a year.  I'd never considered a VLCD before, but I found it an attractive option because it didn't carry the same amount of risk a surgical procedure would.  Also, both of the VLCD programs available in my area had a strong emphasis on not only losing weight, but also understanding why and how it got on there in the first place, and keeping it off.

After almost a year of research and debate with my husband, I joined the Metabolic Nutrition Program (MNP) through John Muir Hospital in Walnut Creek.  The program is a VLCD which consists of 5 shakes a day, bi-weekly doctor visits (to make sure there are no health-related problems while on the diet), and weekly group therapy meetings.  I was nervous about how well I would be able to follow the program, particularly the part about only eating 5 shakes a day, but all of the other options scared me, so I bravely charged ahead.  I had my first group meeting on June 14, and had my first MNP shake on June 15.


I've had a lot of people ask me questions about the MNP program, like "How many calories do you get a day?", "Is it safe?", "How do you get all your carbs/protein/vegetables/vitamins/minerals?", and most frequently, "How long are you going to be on it?"  I've endeavored to answer those questions below.  If you have a question you'd like answered, let me know and I'll add it to the FAQ.

1.  How many calories do you get a day?  Most days I have about 650 calories.  Each shake is about 130 calories, times 5 per day (spaced 3 hours apart).  However, we are allowed to have extra shakes if we're feeling hungry.

2.  Don't you get hungry?  Surprisingly, most of the time I'm not hungry.  When I do get hungry, especially if it's not at a mealtime, it's a cue for me to look at what's going on for me that has possibly triggered an emotional response that I would normally have addressed with food.  Today's a great example: it's been a long day spent talking about domestic violence in my clinical training program.  I'm hungrier than I normally would be, because of my emotional response to the subject matter.  But since beginning the program, I've learned that this kind of cue deserves a non-food response because it's not a nutritional need.

3.  Is it safe?  Absolutely yes.  If I thought there was even a slight chance that it would not be safe, I wouldn't be doing this program.   The reason we have bi-weekly doctor visits is to ensure that there are no detrimental effects from being on the VLCD.  This is not to say there aren't risks, but the doctor visits are designed to monitor and address any potential risks before they become serious problems.

4.  How do you get all your carbs/protein/vegetables/vitamins/minerals?  The shakes for the program are designed to have 1/5 of my daily needs for carbs, protein, vitamins, minerals, etc.  In addition, the shakes are designed to encourage the body to go into an optimal fat-burning mode while providing enough nutrients to keep your heart and organs healthy.

5.  How long will you be on it?  Until I've lost all the weight I want to lose, around 150 lbs from my initial weight.  But it's hard to say exactly, because it depends on how quickly my body releases the pounds; it could be anywhere from 9 to 12 months.  The average rate of weight loss for women is 3 pounds a week, while the average weight loss for men is 5 pounds a week.  My average weight loss right now is about 4 pounds a week.

6.  Don't you get bored of the shakes?  There's 4 shake flavors and 3 soup flavors that count for the program.  Of those, I like the chocolate and vanilla shakes, the tomato soup and the chicken soup.  Still, sometimes I get really bored of 'em.  Thankfully, we're allowed to use sugar-free flavorings as well as seasonings to change the flavors up a little bit.

7.  Can't you eat even a little regular food?  Sure, I could.  But it would probably send me to the hospital with a gall bladder attack, so I prefer not to.

8.  What happens after you've lost all your weight?  There will be a 4-week period where I work with a nutritionist to transition back to regular food and re-learn healthy eating habits.  Then I'll enter maintenance, where I'll stay for 2 years while I continue to work with a nutritionist to keep fine-tuning my diet and practicing my non-food self-care behaviors so I don't get stuck in the same trap I was in before I began losing weight.