I remember this moment very well. I was morbidly obese, and gaining, and scared. I met with an endocrinologist who told me I was, basically, a poster child for Syndrome X, pre-diabetes, hyper-insulinemia. Sounded exotic to me at the time, but this is a condition held by many of us who are obese or morbidly obese. She understood completely why sensible diets had stopped working for me. She could see it in my chemistry.
She told me she wanted me to stop trying to lose weight. Instead, she wanted me to shift my focus to maintaining my weight. She was sorry, but she was pretty clear: I had the makeup of a person who was likely to remain overweight. Now I had to focus on being a healthy overweight person.
I thanked her politely, paid my co-pay, and went out to my car. I started my engine, drove to the far end of the huge medical building parking lot, and sat in my car and cried. And cried. And cried. And, well, I probably howled a little. I cried until I could not produce any more tears or mucus. Until my eyes and nose were swollen. Until friends, I’m sure, wouldn’t have recognized me. I do not cry prettily.
Oh I remember that day. Was she trying to use reverse psychology on me? Absolutely not. My doctor, it turns out, was perhaps ahead of her time. Nowadays many doctors will offer the same or similar advice. Why? Because for a lot of people, losing weight and keeping it off may not be the healthiest choice. I know, that sounds a little nuts, right?
Many people, myself included, who have lost a significant amount of weight, must make radical changes to our lifestyles and eating habits in order to maintain the loss. We may consume significantly fewer calories than others around us. We may have difficulty getting adequate nutrition on our lowered calorie intake, particularly if we still eat high-calorie treats. (Darling, if you’re reading this, would you please find a better hiding spot for the Halloween candy?) We must exercise a great deal, almost daily. We need to keep up our muti-vitamins. In essence, we remain on our “diets” for our whole lives. If we’re not careful to make very nutritious food choices, living this way, in the long run, could make us ill. Ironic, ain’t it?
Mind, for some people, the changes do not feel radical, and adjusting to them is easy. For others, it’s just too much change to sustain for very long; old habits return, along with the weight.
It amounts to a quality of life equation. Is this little food, this much exercise, this much change worth it? If you’re overweight, the answer to that question is entirely yours to make. And it’s an answer you may change over time. When I was younger, through my actions, I clearly answered no. I wanted to enjoy food as much as the people around me did. When I felt lousy and looked at the possibility of becoming very ill, much too soon, the answer changed.
When my endocrinologist suggested to me that I should focus on maintaining my weight, on not gaining any more, I went into panic mode. I felt suddenly walled in by my extra weight. I could not cope with the idea that I would be heavy forever. I thought I’d just been putting off serious weight loss until I could get around to it. I didn’t know that the weight was changing me. I’d like to say this scared me into the final big push to lose weight. But it didn’t. I gained another 20 lbs. or more after that appointment. It would be another year or two before I made what I resolved would be my last great effort to lose weight.
Three years after reaching my goal, my weight loss is still very hard for me to sustain. But for me, it’s worth every bit of the effort. The tradeoffs are clear, the rewards obvious. But I’ve heard from many people who just don’t find maintaining a 25 BMI worth the struggle. They hit a plateau and understand that to lose more weight, they’ll have to eat still less, exercise still more. They choose to stop when they’ve lost some, but not all of what they thought of as their extra weight. They choose to stop when they feel and are healthy again, instead of aiming for some number on a wall chart.
And there is great wisdom in that strategy, and great hope for overweight people who do not want to overhaul their lifestyles. The hope lies in the many, many research studies that support the latest advice doctors are making to their overweight patients: Lose a little. The many benefits of exercise and weight loss — restored insulin response, lowered blood pressure, lowered blood lipids — come along very quickly, with the loss of just a small percentage of body weight. Making and maintaining small losses can do wondrous things for our health.
These losses can often be accomplished through small changes in diet or lifestyle. Just kicking a soda-pop habit. Just switching to olive oil instead of hardened oils (margarine, Crisco, butter) in our cooking, for instance. Just knocking out refined flour. Just increasing fruits and veggies. Just walking 5 minutes a day this week, 10 the next, until we can comfortably walk 30 minutes a day. Adopting small changes can make huge differences in our health while helping whittle away at the weight, little bit by little bit, only changing as much as we can comfortably handle for the rest of our lives.
And that leads to a journal assignment for your body log… Try a little dialogue with yourself about just how much permanent change you’re ready for. If you find you’re not ready to make a lot of permanent changes, decide on just a few, prioritize them, and take them one at a time.