New Years Resolutions, Wine, Tannins, & Weight Loss

This weekend, I traveled to DC to visit my sister. We took a trip to Tarara winery. The name Tarara is Ararat spelled backwards. Ararat is the mountain where Moses spoke to God, and evidently it was mistaken as the mountain in the distance by the vineyard's owner's grandson.

I learned this weekend that the bitter notes in wine are called tannins. I had heard the word before, but now I can put a palatable experience with the word. Far from a connoisseur, and not even an amateur, I at least am learning about wine. Savoring each small amount, was a very mindful practice, relaxing, and enjoyable. Recollecting the moment as I write, I feel calmer - centered.

Being centered is not where I have been with my weight loss efforts. For 5 months, I have struggled and regained 20 pounds. I am not sure I am 100% to blame, as pretty much every aspect, both cultural and biological, is against a person trying to lose significant amounts of weight. I have read this many places, and it has its bases in scientific evidence, but the best and most recent exploration was in the New York Times.

Joyful moments like those at the Tarara winery are always soured by being overweight. It can be a quick glance in the mirror, the snugness of the booth at a restaurant, or just the constant feeling, both physical and psychological, of extra weight. Being overweight is like a wine with too many tannins - it takes the sweetness and pleasure of the moment and sours it.

Do not be mistaken however, tannins are an important aspect of wine. And if I were to continue this metaphor with weight, one may think I am suggesting that being overweight is important. Well, besides a mounting body of evidence suggesting that being a very small amount outside of the ideal body weight is coorelated with longer life and less illness, my point is different.

Tannins are important because they compliment the overall sweetness and fruitiness of the wine. Similarly, this journey continually emphasizes that weight loss and lifestyle changes should not be drastic, drachonian, and stoic. They should be gradual. There need to be moments of relief when what created the tannins, i.e., too many sweets, carbs, fried, salty, and buttery foods, are still enjoyed in moderation. To strip life of these sour notes completely is a life without important asthetics pleasures.

A life without these pleasures is a life without the relaxing moments in which we drink in the moment, savor it, and discover the taste of the tannins that life has to offer. Tannins, like rich sensual foods, are an important part of life, and lifestyle changes should take this into account.

I am taking this into account by focusing this new year on losing only 2 lbs per week. This is a slow goal, far slower than I have ever tried, and it will require patience and diligence. My experience of connecting the word, tannin, with the palatable experience this weekend taught me a lot. I learned that when trying to understand something new, something complicated like wine, I need to slow down.

Weight loss and lifestyle changes are like wine - they are complicated and contain many hidden notes. In gulping too quickly, we learn very little. So for 2012, with my lifestyle changes, I hope to slow down and understand the hidden emotional notes that may have been hindering my success in the past. My new years resolution is to find my tannins.

Leading from Depression - Asking for Help

Two Mondays ago, I suggested to my trainer that I come in for a talk. I had been binge eating, I felt overwhelmed, and I felt alone. Though I know I have the ability to make consistent lifestyle changes, I was not.

While talking with Julia, she made some suggestions. She told me she normally gives her clients homework. My response was, “really? I don’t get homework.” Of course, I quickly realized that I rarely ask for help. I research weight loss in medical journals giving me lots of information and strategies at which I am a master at making into a plan.Yet I rarely follow the plan for very long. During our conversation, I gained some insight that my knowledge may be a hindrance. Knowledge,I thought, is hindering me from asking for help.

Asking for help is the part of the first step in the recovering from depression. This process, which I recently wrote about in a paper called “Leading from Depression”, starts with honesty. A person must be honest enough with him/herself to recognize the feeling of being overwhelmed. Being overwhelmed can be solved two ways. First, slowing down and developing simple goals to get through the difficult time. Or, and usually after the first option has failed far too many times, and hopefully before a complete meltdown, we realize that we need help, we need support, we need guidance.

I wrote in my paper that books on leadership place a high value on a leaders ability to ask for help. Mentors seem to be standard for every leader, and outsourcing the parts of their business to those better suited for such tasks as accounting, marketing, etc. From my research, knowing that a person needs help and then asking for it, was a prized attribute of almost every leader. Every leader I read about succeeded, to quote Isaac Newton, because they “stood on the shoulders of giants”.

Leaders ask for help from the outset, but those suffering from mental illness usually do not. I know that I struggled and still struggle to ask for help. In seeking help, I must admit I am overwhelmed, possibly lost, and maybe even beginning lose control. Asking for assistance requires that we recognize our weaknesses. It requires vulnerability. In the context of mental illness, vulnerability is frightening, possibly terrifying. It is terrifying because we, those who suffer from mental illness, must admit that we do not have control over the one thing that makes us who we are – our mind.

Except for death, I know of no other experience worse than losing control of one’s thoughts. I have counseled many patients who try very hard but cannot get a grasp on their thoughts. They cannot stop feeling depressed, hearing voices, or having panic attacks. Maybe they even have a combination of all three symptoms. It is a darkness that spontaneously and continuously arose in my mind and filled my heart, and at that time it felt bottomless, as if without beginning, end or reason. It is an experience I never want to live through again, because I am afraid of it. No matter how much I tried, I could not seem to get control of it until I asked for help.

To say that medication was the first step in recovery would be incorrect. Getting help, admitting that I did not have the solution was the first step. Admitting this, I was forced to stop everything. I had to put down all the goals and plans I had made. I had to rethink what was and was not working. I had to reevaluate everything, because I was not making progress on my own.

And so, that is where I am with weight loss. I am not reaching my goals and I am not following my plan. I am not making the progress I wanted to make. But most importantly, I am not making the consistent progress that I know I am capable of. Therefore, I met with my trainer, my therapist, and some of my friends and I asked for help. I am, just as I did with depression, reevaluating my strategies for weight loss and lifestyle change. I am slowing down and looking for the vital behaviors to make the changes I want to make.

If this intensive reflection worked for depression, I am sure that it can work for weight loss. I will update soon on my initial findings . . .

Coping Skills, Hollow Words, and Neural Pathways

Honest reflection is difficult. While I want to lose weight, I know that tomorrow I will not want to follow the plan I made this afternoon. I am of two minds about many things, weight loss being the most prevalent.  Looking back, I see many failures and a few sprinkled successes. This reality make me think any statements going forward about weight loss goals are only hollow words. Yet, looking forward, I still feel hopeful. And, in the present moment, I feel both, and this is a confusing, exhausting struggle.

Change is difficult, and weight loss requires change. The struggle to change arises from frequent, almost constant, impulses to follow a path contrary to my overarching goal. For example, I set a goal to walk in the morning, but when I wake up I do not want to. I make a meal plan, but by 6:30pm I don’t want to follow it. I should swim, but I’m tired by the evening. If I don’t follow my plan, I feel down. When I feel, down I am likely to eat or binge. For overeating and binging have been my coping mechanisms. They are well worn neural pathways that offer safe, quick passage away from feeling downtrodden, from feeling depressed. Coping mechanisms are ingrained and very resistant to change. We know this from research on disorders such as OCD (obsessivecompulsive disorder).

Think of a road in your town. Maybe you have seen pictures of what it looked like one hundred years ago. The one in my mind is called Grove Avenue. Years ago it started as nothing more than a path worn carriages, as cars were not even a hopeful thought. However, as technology developed and the town grew so did the path. Eventually the path may have been laid with cobblestone, then paved. Maybe even widened once, twice, or even more. In your town, this path could have been made into more than a road, a highway. Take time to reflect on how much time, energy, and planning was put into the development of that road. It was built to last and offer safe, quick passage from one place to another.

Neural pathways are not much different. As children, our brain is relatively undeveloped. Through genetic and environmental  triggers paths turn to roads and roads to highways. For me, trauma was the environmental trigger which allowed coping mechanisms like binge eating and eating in secret to create a very well paved, safe neural highway – a coping interstate.

When I wake up tomorrow morning and I do not want to go for a walk or I want to eat an off plan breakfast, I will try to take a moment and reflect. I feel this way because of years of habits which originally offered me solace but now are creating suffering. I will still be frustrated tomorrow, but maybe I can smile to myself and give myself a break. Drawing from the spirit of motivational interviewing - my thought patterns are old, they are ingrained, and there are good reasons for these thoughts to be in my head. My brain is doing nothing more than helping me cope, and it is not its fault that it takes physiology longer to change than the environment around it.

I am no longer in a volatile situation. I am safe. I have a very special group of friends and family. I have two great trainers helping me. Within a year I will be a psychiatric nurse practitioner, and I enjoy this practice tremendously. I truly have much to be thankful for. Yet, my well proven coping mechanisms, like a well build road, will take a while to overgrow.

Constant diligence and mindfulness are the remedies for stopping these thought patterns, allowing old roads to grow over and new neural pathways to form. This is will take some time to accomplish. This process is physiological, and neuro-physiological restructuring takes time. The time this takes and the set backs, “using the old roads”, waylay us on our journey, increasing frustration and decreasing resolve.

However, it is important to remember that I do want change. I do want to change. Also, these impulsive desires to eat, not exercise, or follow other now problematic neurological coping pathways did serve a purpose. My brain needs time to catch up, and I would do well to cut it some slack. These old coping mechanisms, now today’s struggles, say nothing about who I am and what I want to be. If anything, I should smile to them; they have been good friends. They have helped me through hard times and are still doing the same. I will therefore take a lesson from my own book. I will smile to these thoughts, recognize them for what they are – coping mechanisms that shielded me from overwhelming emotional burdens.

I practice what I preach. I breath, reflect, smile at what is in my heart, and move forward. I am ready for new coping mechanism. I am not letting go of my goals. I am ready to train for a 70.3!

Jingle Bell 5k - Goal Setting and Non-Action

I have neither written about nor made a goal in a long time. Upon reflection over the past few days, I think there may be several reason behind this. First, the race and weight loss goals I made early this year, I did not meet. Second, most times I make a goal I also tend to sabotage, possibly as a reaction to the stress of goals that are too ambition. Last, I have found more success recently by taking each day at a time. I let go of making promises about where I would be, and I focused my energy on making healthy choices for each meal and getting in most of my exercise plan each week. This I will call my non-action method or effortless effort. While this has not resulted in perfection, it has resulted in a loss of about 20 pounds in the past 10 weeks and I have gotten back on track with regular exercise.

This is a great accomplishment, but I have also felt recently it was time to become a more serious. I spoke with my coach, Kate, and she has been encouraging me to be more consistent with my run/walks especially with my midterm runny goal of the Monument 10k next year. We discussed where I am psychologically, the success of my non-action method, and the need to start being even more consistent with both training and nutrition. These factors led to a simple, short distance run event on December 5th - The Jingle Bell Run for the Arthritis Foundation.

I have already noticed that I am tending to make too much of this race in my head. I am creating worry in my mind with unrealistic weight loss and time expectations. This has result in sabotage for my first two days of training, a pattern I cannot let continue. I want to do this 5k, I want to improve my training and nutrition consistency, and I think this will be best accomplished by merging the goal setting with my previous non-action success.

What does this all mean? It means that I need to simultaneously have a 5k goal but at the same time feel the psychological relaxation that came from just focusing on eating and exercise one day at a time. This I see as being accomplished by diminishing the humming of weight loss / training thoughts that is running in my head all day. Simply, if I can forget about the goals except for the times I need to remember, i.e., meals and exercise, I will have a perfect combination of goal setting and non-action. Through this process, I may slowly make peace with the daily consistency in my training and nutrition that I need to continue this path of a Lifestyle Change.

Last, I cannot finish without my goals. The race is 7.5 weeks away. I have been doing 10min run/walks for 2 weeks (15min miles) and losing about 2.2 pounds per week. With this in mind, my goals will then be to run the 5k in less than 44 min and lose 20lbs by Dec 5. This is equal to a pace of about 14 miles/min and loss of 2.6lbs per week. These goals I believe are a fair merger of ambition and reasonableness.

Please donate if you feel so inclined. I will keep the updates coming.

The Politics of Fat: Chris Christie, Weight Loss, and Discipline

While I am passionate about politics, thegrassinheaven is not the forum for that discussion. I devote my time here to synthesizing my weight loss thoughts, into coherent and sometimes insightful expressions. However, politics and weight loss have crossed in a unique fashion with Chris Christie, Governor of New Jersey. In this crossing, some of my thoughts are starting to synthesize regarding weight loss and discipline.

Regarding Christie, Megan McCardle writes that she finally agrees with Johnathan Chait that Micheal Kinsley is wrong - that Chris Christie is somehow unqualified to be president because he is fat is absolutely ridiculous." Other pundits have also begun to weigh in: Ezra Klein who brings in good analysis of the difference between mortality and morbidity, and Eugene Robinson who takes an opposite health concern argument

Chait writes regarding Robinson "to categorize obesity as a character flaw...ignores the extreme difficulty of sustained weight loss". Both persons have a point, and I do not just feel this truth, I know it. Losing weight extraordinarily difficult. 

Some would argue that weight loss is currently the most treatment resistant medical condition. A blog I highly recomend, Weightology Weekly did a report on Americans ability to keep weight off. 

The above graph was included but not without caveats. First, the graph, taken from NHANES data has far more positive results than other studies that show after 5 years only 3% of people have kept significant amounts of weight off. And, Weightology's author, James Krieger notes that the NHANES data only "looked at one point in time". There is just limited information about long term weight loss success, but in clinical trials the data is abysmal. In fact, people are more likely to recover from alcoholism and drug addiction than obesity.

With such low recovery rates, a strong correlation argument can be made that their must be some genetic component. Klein pointed out there does appear to be a link, yet the link is not enough to abandon the importance of free will. In fact, there is much emerging promising research regarding OCD and free will as noted in the book The Mind and The Brain. Were individuals to be able to have access to individualized therapy like the OCD patient in the book, weight loss results might be somewhat different. Or, at least, the results might reflect the success that short term clinical trials show for cognitive/behavioral modifications plus diet/exercise education programs. 

Based on numerous clinical trials, will power is a tremendous component to weight loss. This would lend credence to the anti-Christie's argument that he lacks personal discipline and this reflects his moral shortcomings to be president. However, most of these successes are 'in vitro' and are mostly lost once the patients are removed from the structured clinical trial setting. In fact, many people do not even finish the clinical trial to begin with (I have actually been one of those people).

I was too embarrassed to finish the clinical trial of a University of Richmond study, because I was actually gaining weight. I had not yet come to the point where I am today. For me, I had too many pressing emotional issues to resolve before I could turn my focus to sustained weight loss and lifestyle changes. However, I hit my 50lb marker today, but I have made sacrifices in order to get here:

1) Free Time: Possibly the most important recent change is to cut back on work outside of school. This allows me about 1 more day of free time per week spread out over the whole week. This has been a crucial psychological balance for me. It allows me time to push myself and recover, or extra recovery if I pushed to far, or to recover if I am just feeling down. This mental space is crucial.

2) Psychiatry: I have upped my Prozac and also take Wellbutrin. As I have written about before, this is to fight depression which, in my case, is exacerbated by being overweight but is not caused by it. I also see a counselor each week, and we are not almost exclusively focusing on weight loss discussion. 

3) Training: I have two different trainers: 1) Julia at FIT Richmond who I see almost once per week for an individual session, which might be just as much psychiatry as exercise, 2) Kate Lucas owner of Charlottesville Multisports who I see once per week to discuss and plan my long term 1/2 Ironman strategy, and again, is an integral psychiatric component. I also swim with a masters group at the YMCA once or twice per week, and I have started also going to Peluso Open Water when I cannot get these swims in.

4) Social Support: My friends and family are very supportive. I have a great walking buddy who keeps me going throughout the week. I have two friends that go to group training sessions at FIT Richmond with me.

5) Financial: This is the kicker. Between the one day less work per week, the psychiatric medications, weekly therapy sessions, two trainers, and YMCA and Peluso fees, I am spending a significant amount per month. And this leads me to my last and greatest resource - my Mom.

6) Mom: My mother may be the most remarkable person I know. During my darkest depression when I could barely work, was lying about going to class, starting to flounder in school, barely got out of bed, she stuck by me personally and financially. I have lived with her at home for many years which has been probably as important as all the other steps combined. It has saved me financially, personally and spiritually. The love that my mother has for me is something hard to recognize at first. She has had a steadfast, quite belief in me which has never wavered. She has seen in me what all of my friends have seen, and something that I am just barely coming to understand. That I am a good person, and I can and will and am accomplishing my weight loss objectives. I am forever indebted to her.

What does all this mean about Chris Christie? I am not really sure, except to say that I know what it has taken me to make a real change, and I am not going to fault Christie for his struggle. As Klein points out, even with vast resources, Oprah Winfrey has struggled with weight loss and she has tremendous success and discipline in her career. More important, research behind Motivational Interviewing shows that fact giving, confrontation, and problem solving do not yield the desired health changes like reflective listening, positive reinforcement, and helping the client to bring out, in his/her own time frame, his/her intrinsic wisdom and desire for change. So whatever the case, the eat a salad take a walk encouragement of Eugine Robinson is actually counter productive. 

I am sure Gov. Christie, like myself, know that walks and salads are better choices than Big Macs and TV. However, for most Americans, this decision seems to be an extremely difficult choice to make day in and day out. As noted, it can be sustained shortly in clinical trials, but once out of the lab, the results melt away like butter between a warm stack of pancakes.