Sunday, December 17, 2006

The difference between full and not hungry.

When I decided to try to limit my caloric intake to 1500 a day, I was doing so with the absolute knowledge that I would be hungry all the time. I even decided to give myself a 500 calorie emergency bump that I could invoke in case I needed it. I hoped that 2000 calories a day would be enough to keep me from feeling too hungry to stay on plan. I was sure that if I was never full, I would always be hungry. What a pleasant surprise to realize how mistaken I was.

I believe there is a big difference between experiential knowledge and intellectual knowledge. For me, learning of facts begins knowledge but experiences in and around those facts leads to understanding. I assumed that "not full" resulted directly in "hungry". Experience very quickly taught me the flaw in that logic. I was delighted to learn that when I consume 700 calories and wait a few minutes, I am no longer hungry. I was astonished to learn that eating a 280 calorie Lean Cuisine keeps hunger at bay for hours.

I don't know why my eat clock doesn't work. Perhaps because I eat as fast as anyone I've ever met. Perhaps it has to to with the extra junk in food these days. Perhaps there is just something broken within me. I do know that at 1500 calories a day, my average weekly weight loss has been 3.2 pounds and I have not felt hungry. When I finally hit my current goal, my new goal will be to maintain weight. I wonder if I will be able to train myself to eat the right amount without having to keep track. Maybe the right amount will be some set amount between "enough not to be hungry" and "full"? It is still a long way off, but I can't wait to figure it out.

There is still one thing that fills me up these days, by the way. My regular 12" turkey on wheat with pepperjack, lettuce, pickles, jalepegnos, one line of mustard and salt from Subway does the job well for 700 calories. And despite all the talk about being "not hungry" I absolutely do like feeling full. That is why you'll find me at Subway most weekdays around 11am. I'd love to find another food that provides the same ratio of fullness per calorie. If you know one, please comment!

Saturday, December 9, 2006

The answer for me?

A quick recap: I was getting physically stronger and faster due to regular sessions on the treadmill. I was over the limit for the household scale and just assumed the exercise was causing weightloss. When I went for a yearly physical the doc told me I was heavier again this year and then referred me to a bariatric center. I was shocked.

I'm one of these people that deals with one problem at a time. I obsess about it, collect information, stew a little bit, half heartedly work on something else for a while, verify some assumptions, stew a little more and eventually define a plan and execute it. The problem is that the problems I obsess about are not always related to the work that needs doing. Usually they are, but not this time. I found myself sitting at my desk in front of the computer and incapable of focusing on the code. I was too distracted by thoughts about my weight to get any programming done. So, just like I do when stuck on a programming problem, I fired up Google and started researching.

It turns out that at 6'2" (1.88 meters) my ideal weight is about 191 pounds (86.6 kilograms). These things vary depending on which insurance charts or doctors charts you choose to believe but 191 is about right for me and my frame. I clearly remember thinking, "I am literally over twice as heavy as I should be. That's in--f@#$ing--sane." I'd just learned that for every pound of person that is me, I had an additional pound of fat. Oh, and when I run out of people pounds to count? Yup, there's still some fat pounds left over. Even more motivated now, I continued searching for answers...

Relatively quickly, a book title caught my eye in the search results. A programmer turned startup CEO turned bajillionaire decided to solve his weight problem. Based on his results, John Walker wrote an guide to losing and maintaining weight called The Hackers Diet. Perhaps it's because I'm a programmer that the explanations and enumerated requirements resonated with me. Perhaps it's simply because his book is almost totally goal oriented without any extra distractions about food pyramids and only a little about exercise thrown in. I dunno why, but I took away two key ideas that now govern my every food choice.

The first idea I took away was that weight loss is not the same thing as fat loss. There are other things that contribute to weight changes and end up confounding dieters. These fluctuations are due to poo and water weight. One can easily imagine gaining 2 pounds of water and losing 1/3 pound of fat in a day. How would you know you made progress? It turns out, you can almost ignore these fluctuations by weighing yourself every day at the same time and keeping a record along with a 10 day running average or other trend calculation. This provides a much clearer idea of fat lost. So I now use a modified version of The Hacker's Diet companion spreadsheet. In addition to the provided trend calculation, I added a ten day running average. I weigh myself each morning, plug the result in to the spread sheet, and have a much better idea about how I'm really doing every day.

The second thing that stuck with me-- and this really hit home-- is that a pound of fat is 3500 calories. Use 3500 calories more than you eat and you will lose a pound of fat. Eat 3500 calories more than you burn and you gain a pound of fat. I weighed roughly 200 pounds extra, so I had an extra 700,000 calories to use up. The only way to use them up is to eat 700,000 calories less than actually used. So how much was I using? The various calculators out there told me it takes about 3700 calories a day to maintain 370 pounds. Then I checked my goal weight and learned that I'd burn about 2300 a day when I got there. So, after discussing with the spouse, I settled on a daily limit of 1500 calories.

1500 is the value that governs my every food choice now. The value that matters is 1500. 100 for breakfast and 700 each for lunch and supper. I have always preferred two meals a day anyway so this works well for me. I can and do borrow from one meal to accommodate making the other meal larger. I just make sure I will be at or below, that's right, 1500 when the day is done.

Here is a typical meal day:

Breakfast - Coffee and a 100 calorie cookie to help the multivitamin go down - 100 calories

Lunch - Subway 12 inch turkey on wheat with pepperjack cheese, lettuce, pickles, jalepeno peppers, one line of yellow mustard and salt - Less than 700 calories

Supper - Whatever the spouse makes (assuming the a reasonably accurate calorie count is known) or a TV dinner for 300 - 500 calories. Perhaps a snack pack sized bag of chips (or two!) for 100 calories each. Maybe 100 calorie cookie or 100 calorie bag of cookies. Occasionally one beer or other 100 calorie adult beverage.

Yes, yes. The subway diet is cliche after Jerod. But their marketing department is telling the honest to goodness truth. It works. I have found no other food that gives you the value in feeling full for the calories eaten. Several of the Subway sandwiches are fantastic in this regard. If you know of any other chain that comes close, I'd sure love to hear about it. Other places are decent, yes, but Subway is the best I've seen so far.

If I know I'm having a large supper, I have a 6' sub for lunch. If the opposite is true, I reduce or eliminate supper. I keep a mental tally every day and consciously consider where I'm at in the 100+700+700 formula when it comes time to eat. If I'm still hungry a few minutes after eating, then I allow myself to eat more. Ok, I lied, 1500 isn't really the number. I will let the maximum slide up to 2000 calories in a given day but that's my absolute ceiling. Oddly, this hasn't been an issue very often. I am rarely still hungry after consuming 700 calories.

I do have to admit that I totally ignored these rules while we were on a trip for the Thanksgiving holiday. Both calculated values on my spreadsheet showed an uptrend (!!!) for two days or more as a result. This translated to having to lose the eight pounds from 362 to 354 all over again. But otherwise this is working well for me. I finally bought a scale that can handle up to 450 pounds. Kinda crazy to buy a freaking expensive treadmill BEFORE buying the forty dollar Walmart scale, I know. In any case, today I stand %18 of the way toward my goal of shedding 200 pounds and the trend lines continue to look good.

If you made it this far, thanks for reading.

Tuesday, November 14, 2006

The Bariatric Center

When we were done with the rest of the physical , the doctor asked the nurse to set me up with an appointment at the bariatric center. The center staff asked which program being referred and the nurse had no answer. The doctor had gone on to see other patients, of course, so we couldn't ask her. I finally asked the nurse for the bariatric center's number and had her verify with them that it was OK I call directly.

When I called the next day I learned that this particular center offers three things:

1) Nutritionist services.

2) Medically supervised weight loss.

3) Gastric bypass surgery.

The person on the phone said that there was an introductory meeting coming up in a day or two. So, the significant other and I found ourselves sitting through the HMR sales pitch. The nutritionist giving it was friendly enough but she was basically recruiting for a group of people to run through option number two. Either she didn't know much about options one and three or she feigned ignorance.

I had to ask pointed questions of the nutritionist to get her to enumerate the costs. Then some direct questions to break break the costs down further to startup and periodic. She told us that insurance usually covers the nutritionist, doctor/nurse practitioner, and lab tests. She was also honest in saying that insurance almost never covers the required food and/or shakes. Let me tell you, this is not a cheap thing to do.

So, after that meeting the SO and I had a serious conversation about the HMR program. When the conversation started, I was leaning toward doing the program. Somewhere along the line I realized that this program would teach me to lose and maintain weight but in a way that left me basically dependent on their shakes and food. I remembered mention of a "transition phase" but that was all that was said. At that point, I realized that I needed to find another way because I want to lose weight living in the real world. The quest for a weight loss solution continued...

Sunday, November 12, 2006

Exercise is not the answer.

It has been roundly obvious for some time that I could stand to shed a great deal of weight. So, we shopped around and finally found a treadmill that can handle my girth. It sucks but, unless traveling or hurt, you can reliably find me chugging away Monday, Wednesday, and Friday mornings. My progress over the months has been clearly reflected in the increasingly steep inclines and faster speeds required to maintain 75% of max heart rate. But I kept gingerly stepping on the scale every now and again hoping to see 349 instead of ERR. I'm getting faster and stronger. I'm feeling good. I must be losing weight too!

Partially due to my extreme weight, I have actually remembered to schedule and go to my yearly physical three years in a row. This is undoubtedly my first physical three-peat since the pediatrician years. Of course, the nurse weighed me. What do you think the results were? I posted a double digit year over year gain. In fact, my gain was larger than the year prior when I wasn't exercising! What a disappointment. I asked the doctor about my unexpectedly increased weight. She brought up watching what I eat. I discounted it as impossible. She suggested walking seven days a week. I replied honestly that my joints could not handle that. She did get me to agree to add one additional day on the treadmill per fortnight. Then, she shocked me by referring me to the local bariatric center. What a kick in the testis. I have a reasonably accurate body image and I know I'm morbidly obese, but to refer me to the place that does gastric bypass?! My blood work is good, the Red Cross nurses regularly compliment me on my blood pressure, I put miles on the treadmill each and every week. Are you kidding me? I was just referred to a bariatric center?! I thought exercise was the answer!

My time on the treadmill burns about 1200 calories a week. I now understand we are only talking about one pound every three weeks. It is clear to me now that when folks talk about weight loss depending on "diet and exercise" what they mean to say is "almost all diet and a little bit exercise." I still get on the treadmill three days a week but now do it because it is good for me, not for the slight weight loss addition.

This first post describes the event that made me feel that my situation required urgent attention. I considered a few new options and found a solution that seems to be working for me. So far I am over 10% of the way toward my goal weight in only five weeks. Thanks for reading the first entry of a journal to document what will hopefully become a 200 pound journey. This was the first lesson learned along the way, I can't wait to see how many more there are.