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October 18, 2009

Maintenance 101: What Did YOU Learn?

By Barbara Berkeley

On Saturday, I had the opportunity to meet hundreds of people with diet and weight issues at the opening of the new TriPoint Medical Center in Concord, Ohio. The community open house for this gorgeous facility was attended by approximately 7,000 people. As medical director of weight management services for the hospital system, I was there to lecture and to encourage visitors to register for our weight loss programs.

Whenever I talk with people about weight issues, I come away with impressed with two things. First, I am amazed at how interested people are in learning more about nutrition. Despite the glut of information in magazines, on TV and on the web (or perhaps because of it), most people are deeply confused about what to eat. The second thing that always impresses me is how few dieters are able to keep the weight off permanently. Of course helping with that issue is the purpose of this site. I hope that some of those I spoke with on Saturday are reading our site today and that they will become part of our internet community. Refuse to Regain is a blog about maintenance, but it is meant for anyone with a weight issue, whether they are just beginning to lose pounds or have kept them off for years. If you are new to us, Lynn and I hope you will explore our site and become active contributors!

The first year or two of maintenance is like a course in yourself. It can yield fascinating and very specific information if only you decide to show up for school.

Most people who finish a weight loss return to a modification of old habits. Habit is the operative word. If your previous dietary style made you fat, it is likely to do so again, even with modifications. If you couldn’t control the elements of your eating plan in the past, re-exposure to those elements will probably lead to a similar fate in fairly rapid order.

During the weight loss phase, most of us are very wrapped up in our progress. This self-examination is often lost once the weight comes off. I tell my patients that the principles of weight loss are pretty much the same for everyone: 1. Reduce calories enough to force the body to burn what it has in storage, and 2. Reduce insulin enough to facilitate that process. Maintenance is a different ballgame. The rules vary widely. The only way to discover what works for you is to discover YOU.

For this reason, I suggest that new maintainers think about the first couple of years as a basic science experiment. Experiments require staying educated on your subject, close observation, recording of results, and a well-planned way of changing variables. Research also works best when it is dispassionate. By this I mean that your maintenance experiment needs to avoid emotion. If a scientist does an experiment and gets an unintended result, he or she does not indulge in agonies of self-blame. In maintenance, it’s important to look at results with curiosity but not with frustration. If one method isn’t working, draft another strategy and record results.
If you are just beginning your maintenance experiment you may be uncertain as to how to proceed. Here are a few suggestions. No doubt our experienced readers will offer others.

1. Work on the type of structure you need. Do you do best with Points, calories, portion control, or simply with diet changes based on daily weighing?

2. Identify your trigger foods. These are the foods which you really must avoid. Most people find that there are certain things they simply can’t eat moderately and that they feel a sense of peace once they are eliminated.

3. Tread carefully around your food addictions. Foods that you have eaten for pleasure can be addictive, but they are not always triggers. You may be a chocoholic but actually be able to control chocolate consumption. On the other hand, bread may cause you to fall off your diet.

4. Observe your reaction to salt. Salt acts like carbohydrate does in causing water retention. It can cause unintended weight gain that is hard to get rid of. The most common source of salt is restaurant food (have you ever really tasted the soup in most restaurants??) If you note that you are gaining after eating out, be careful of foods that may be hiding salt.

5. Pre-plan your reversal strategy (and refine that strategy if it doesn’t work). Every maintainer needs a way to quickly reverse small regains. What will that be for you?

6. Observe the effect of exercise. No one knows exactly how much will help to keep you stable. So keep a log that includes your activity, frequency of exercise and weight response. If walking is doing the trick, you don’t necessarily have to escalate to running. It is probably also possible (although not recommended) to maintain without exercise.

7. Set up some personal dietary rules. Maintainers often bristle at the idea of rules preferring to say that they will never rule out any particular food. OK. That principle can be part of your rule package, but what’s the rest of it? No one says you have to follow your own rules – after all, you created them – but having rules gives you a plan to shoot for. Follow, then observe the result. If the plan isn’t working, it’s time for an overhaul.

8. Observe the situations and environments that cause trouble for your diet. One of the most powerful tricks a maintainer can employ is keeping physically away from food. You may observe that being at home is toughest because food is always as close as your kitchen. Work on physically removing yourself from food by asking that food be kept away from you at work and bringing nothing into the house which triggers you.

9. Keep a number of basic, “safe” meals in your rotation. Feel free to eat these frequently and to experiment only when you feel quite anchored in maintenance.

10. Most importantly from my point of view, do all that you can to keep insulin stimulators low. Insulin stimulators are the starch and sugar foods including whole grains, pasta, cereal, bread, potatoes, rice and sweets. Insulin is the fat storage hormone. As long as it is not deployed, you can’t store fat. When it IS deployed, you can’t break down fat. So keep the carbs (except for fruits and veggies) LOW.

If you are a successful maintainer, please help us by sharing the things you’ve found out about yourself. The more models we have, the more possible paths we all have to try. While the basic outline above is a general scaffold, it says nothing about individual experience. What lovely, strange and unique things have you discovered as a result of your own maintenance experience. We would love to hear. Leave a comment or send us an email at refusetoregain~gmail.com.

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