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  #136   ^
Old Tue, Apr-06-10, 12:31
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Demi Demi is offline
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April 06, 2010

Cleveland’s "Plain Dealer" Weighs in on Obesity Discrimination

By Barbara Berkeley


Last Sunday, Cleveland’s major newspaper, The Plain Dealer, announced the roll out of a year-long series on obesity. I applaud The Plain Dealer for this enormous effort. Like most urban American areas, Cleveland has a significant obesity problem, but excess body size is not confined to the cities alone. The state of Ohio is one of the ten most obese states in the nation. I have long believed that our global obesity problem won’t be solved until we start to attack it on literally hundreds of fronts. Continuing to keep the topic in focus, as this series does, reminds us that being too overweight is serious and not to be ignored: an important start.

Yet in the three days since the PD launched its obesity series, all of the problems that come with addressing the issue have been on display. The difficulty is this: obesity has so many forms, so many faces, so many underlying causes that it is unlike most other societal problems. Today’s front page article illustrates the point well. Entitled, In Their Words: What It Feels Like to be Obese,” the story explores the worlds of five people who have struggled with significant weight issues. Many of their comments are wonderfully insightful (and probably not unfamiliar to many of you). But the article primarily focuses on the discrimination that obese people experience.

“They are lazy or funny or a joke,” says the author. “That’s what the world tells them, but only when it happens to notice that they exist at all.”

A psychiatrist who is herself obese and is profiled in the piece says, “ It’s fascinating to be taking up so much space in a room and have people act as it you don’t exist.” She goes on to tell this story, one of many included in the article:

(She) remembers a day in her medical residency, back before she lost so much weight, when a professor began to humiliate her about her size in front of her fellow residents.

“He just went on and on until one of my friends in residency said, ‘I feel like she’s getting raped.’ And that’s what it felt like. It was like somebody just ripping your guts open and saying, ‘You are a worthless piece of whatever’ because of the way you look.”

“We’re kind of the last bastion of discrimination,” she goes on to say, “ and nobody’s saying, ‘Hey, wait a minutes, it’s wrong.’ If you switched the word fat to black or Jewish or gay or female or any of a dozen different ways of being, it would be illegal, the stuff they’re saying.”

Unfortunately, this assertion is where the incredible complexity of the obesity problem makes itself manifest. Obese people have as many different reasons for being overweight as there are individuals. In my clinical experience, the most common reason is a broken food-processing system that becomes highly sensitive to modern foods coupled with a lack of good information about what steps to take. However, I’ve also treated people who eat to medicate themselves, people who stay heavy as a way to hide, people who punish themselves with obesity, and people who simply don’t care and just love to eat…damn the consequences.

This diversity of causation makes the discrimination argument a tough one. You can’t help being Jewish, gay, black or female, but society sees obesity as a problem that you CAN control if you want to. While those of us who understand obesity recognize the extreme practical difficulties involved, the fact that a subpopulation of obese people create their own problem allows discrimination to flourish.

And, what’s worse, the overweight are sucked into the very same belief vortex. After describing the unfair discrimination leveled against them, the article goes on to talk about how several lost weight via small changes like “eating more fruits and vegetable….smaller portions, (and) going outside to play more often.”

The article continues, “(T)here are few other things those who are…obese want you to know. For one, they take responsibility for their weight. “I am to blame for this,” (one of the group members) says. “No one forced me to eat all these bad meals. I really need to say, OK, enough is enough. I need to lose this weight so I can fit comfortably into places and I don’t need two airplane tickets…I have to discipline myself and change it. We all control our own destinies.”
In other words, the overweight person doesn’t want to be discriminated against, but then apologizes for her weakness, admitting that she could control the problem if only she tried. In fact, she believes that she wouldn’t be obese if she simply exerted a little more discipline. This is a major problem when the very core of discrimination this exact belief: that obesity is controllable with just a little will power.

What’s true? Unfortunately, all of it and none of it.

For some people, it’s a matter of getting good information and buckling down. For most, it’s a lifelong struggle to battle the addicting nature of our food supply and the over-availability of foods that we can’t process properly. For others, food has become the club they use to beat themselves with. Until underlying problems are solved, it will remain their weapon of choice. And to make matters even more complicated, there is a little of each truth in every person. Our reasons for eating are kind of like a horoscope: read any one of them and they pretty much fit you.

What I do believe with certainty is that the reasons we are overweight are much more difficult and complex than a simple lack of willpower. Whether an individual’s fat mass is due to primal mismatches in food partitioning or deeply seated emotional issues, society has to get serious about the fact that these are tough problems to control. We can’t simply continue to prescribe trivial solutions. And with experts predicting an 80% overweight and obesity rate by 2030, we’d better not be discriminating lest we find the stones aimed at ourselves.
http://refusetoregain.com/refusetor...rimination.html
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  #137   ^
Old Tue, Apr-20-10, 15:13
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April 20, 2010

Exercise and Weight Loss: The Conversation Goes On

By Barbara Berkeley


For native New Yorkers there is a certain imperative that comes along with the weekend: that would be reading the Sunday “New York Times.” When Don and I moved to Cleveland in 1987, my first question was whether I could get the “Times” delivered. Fool that I was, it seemed to me at the time that I was relocating to a vast wasteland where contact with civilization (read Manhattan) was not guaranteed.

Although we’ve become inveterate Clevelanders (Go Cavs!), certain habits die hard. The “Times” is one of those. So, for the past 23 years, our intrepid delivery guy has been tossing the paper in that perfect spot at the base of the garage door.

My first stop in the Sunday paper is the magazine section. My mother is a crossword fanatic and has always shamed the entire family by completing the Sunday “Times” puzzle with lightening speed. She still does this (and just as fast) at age 91. If you want proof of the brain-enhancing effects of mental gymnastics, look no farther than my Mom. When my sister and I entered our late 20s, we decided that we had better carry on this family tradition. All three of us do the Sunday puzzle, occasionally calling each other for consultations here or there.

This morning’s magazine section, however, diverted me from my intense pursuit of across and down. Today, the “Times” decided to devote its magazine to Wellness. I couldn’t resist dipping into the cornucopia of articles. I soon was scribbling notes all over the pages, a sure sign that I was headed toward a blog post.

You can read all of the Wellness articles in the Magazine by logging onto the “New York Times” website and scrolling down to Magazine. I may write about some of the other topics in future posts, but today I want to focus on the excellent article detailing recent research into exercise and weight loss.

I call this article excellent, of course, because it supports my beliefs on the subject. Where exercise, diet and health are concerned, we should be honest and say that – if we look hard enough – we can find research evidence that supports almost any position. In my case, the beliefs I hold come from what I’ve observed in more than 15 years of working with dieters. Thus, I am thrilled when reasonable science confirms what I’ve seen in practice and I’m suspicious of results that say that something I have never observed clinically is bound to be true.

This is an article that confirms the belief that exercise is weak for weight loss and strong for maintenance. Since I’ve been pilloried on the Internet in the past for saying that exercise doesn’t cause weight loss, I’d like to begin by clarifying my position at bit:

1. I am an exercise fanatic and believe in the vital importance of physical activity. I would advise everyone to exercise, both during weight loss and thereafter. Nevertheless, we need to be realistic about one particular property of exercise. In and of itself, it can’t be relied upon as an effective tool for weight reduction.

2. The potency of exercise as a weight loss aid may have a lot to do with amount. It’s obviously true that someone who is running marathons will lose weight if they don’t compensate with extra calories. But how many of us are marathoners?

3. Who you are may also matter. Youngish men appear to get more loss from exercise than others.
The “Times” article had a quote that made me go into fist-pumping mode. “In general,” says Eric Ravussin, a professor at the Pennington Biomedical Research Center in Louisiana and an ‘expert on weight loss’, “exercise by itself is pretty useless for weight loss.” The article sums it up this way: “The newest science suggests that exercise alone will not make you thin, but it may determine whether you stay thin.”

With the understanding that there may be some exceptions to this rule, I couldn’t agree more. I often use a particular slide when I give talks about weight loss. It looks at multiple complete studies which compared weight loss via diet alone with weight loss via a combination of diet and exercise. In nearly every case, the addition of exercise did not cause additional weight loss. In some studies, those who did not exercise did better than those who did. This might reflect a phenomenon that I often see clinically, the tendency to eat more when one is exercising. In some people, this may come simply from the mistaken belief that exercise gives them a free pass. But the “Times” article suggests a more intriguing explanation. It references a study in which exercise caused increased hunger hormones in women (not in men). So we might conclude that women are sometimes made hungrier by the act of exercising itself.

Other studies have shown that young men might have their appetite blunted by working out. This data would also support what I see clinically. Most of my patients are women. In general, men lose weight faster and seem to get a greater benefit from exercise than women do. This leads me to the following recommendation: Do whatever you can exercise-wise that allows you to follow your chosen diet plan without deviation. Keeping calories low is paramount for weight loss, so if exercise is derailing you, you are likely doing too much of it. As I’ll talk about in a moment, exercise becomes much more vital in the maintenance phase. Imagine the exercise portion of your weight loss period as a lead-in, a kind of practice, for maintenance.

This brings up an interesting question. Why should exercise have a stronger impact on maintenance than on weight loss? After thinking about this all weekend, I had a Eureka! moment. We always say that weight loss and weight maintenance are two different things, but what we usually mean by this is that they take two different types of psychological focus. We’re probably not going far enough. It occurred to me this weekend that weight loss and weight maintenance REALLY ARE two completely different things. They seem to be continuums of one another because they are controlled by the same levers, diet and exercise. But they’re not.

As I’ve said before, weight loss is all about forcing your body to do something it is not genetically comfortable with: giving up stored fat. The body behaves as if it’s ignoring that fat, working with whatever you give it to eat and adjusting to those ingested calories, no matter how low. Exercise doesn’t appear to change that equation much. It is only when you consistently convince the body that the food shortage is serious enough that it must burn fat that it will open up its fat flood gates.

Maintenance, on the other hand, is about energy storage, not fat breakdown. Now we are dealing with an entirely different system, the one I’ve called the IBM (Intake Balance Mechanism) . NOWs have a smoothly oiled auto-balance or IBM. This bodily system sends food either to be burned or to be stored. In NOWs, the system makes the correct decision no matter how many calories or how much exercise is added in. POWs gained weight when their auto-balance gets stuck on “store”. For the POW, daily exercise appears to unjam this broken system, giving it a chance to run again. POWs will remain vulnerable, but will be vastly aided by exercise.

The “Times” article talks about an animal study that supports this view. After a group of rats that carried a genetic tendency to gain weight were purposely fattened, they were then dieted. Once they had lost weight, they were put on a maintenance diet and assigned to either run on a treadmill or remain sedentary. After eight weeks, they were allowed to eat at will. Sedentary rats ate heartily and regained their weight. “But the exercising rats metabolized calories differently. They tended to burn fat immediately after meals, while the sedentary rats’ bodies preferentially burned carbohydrates and sent the fat off to be stored in fat cells.” In other words, exercising animals burned rather than stored. Their auto-balance was restored, at least temporarily. We might conclude from this study that exercise oils the auto-balance enough to get us past periodic periods of diet indiscretion. I believe that’s true. But I’ve seen enough regain in 20 years to know that it takes only a moment for the levers to jam again and for fat to start accumulating. Thus, exercise, controlled intake, and proper food choice must be on the menu 80-90% of the time.

Well, I’ve gone on and on…as I always do…on this topic. There were other interesting tidbits in the “Times” this weekend. More on those in the next post.
http://refusetoregain.com/refusetor...on-goes-on.html

Here is the article Barbara Berkeley is referring to:

Quote:
Weighing the Evidence on Exercise

By GRETCHEN REYNOLDS
Published: April 12, 2010

How exercise affects body weight is one of the more intriguing and vexing issues in physiology. Exercise burns calories, no one doubts that, and so it should, in theory, produce weight loss, a fact that has prompted countless people to undertake exercise programs to shed pounds. Without significantly changing their diets, few succeed. “Anecdotally, all of us have been cornered by people claiming to have spent hours each week walking, running, stair-stepping, etc., and are displeased with the results on the scale or in the mirror,” wrote Barry Braun, an associate professor of kinesiology at the University of Massachusetts at Amherst, in the American College of Sports Medicine’s February newsletter.

But a growing body of science suggests that exercise does have an important role in weight loss. That role, however, is different from what many people expect and probably wish. The newest science suggests that exercise alone will not make you thin, but it may determine whether you stay thin, if you can achieve that state. Until recently, the bodily mechanisms involved were mysterious. But scientists are slowly teasing out exercise’s impact on metabolism, appetite and body composition, though the consequences of exercise can vary. Women’s bodies, for instance, seem to react differently than men’s bodies to the metabolic effects of exercise. None of which is a reason to abandon exercise as a weight-loss tool. You just have to understand what exercise can and cannot do.

“In general, exercise by itself is pretty useless for weight loss,” says Eric Ravussin, a professor at the Pennington Biomedical Research Center in Baton Rouge, La., and an expert on weight loss. It’s especially useless because people often end up consuming more calories when they exercise. The mathematics of weight loss is, in fact, quite simple, involving only subtraction. “Take in fewer calories than you burn, put yourself in negative energy balance, lose weight,” says Braun, who has been studying exercise and weight loss for years. The deficit in calories can result from cutting back your food intake or from increasing your energy output — the amount of exercise you complete — or both. When researchers affiliated with the Pennington center had volunteers reduce their energy balance for a study last year by either cutting their calorie intakes by 25 percent or increasing their daily exercise by 12.5 percent and cutting their calories by 12.5 percent, everyone involved lost weight. They all lost about the same amount of weight too ~— about a pound a week. But in the exercising group, the dose of exercise required was nearly an hour a day of moderate-intensity activity, what the federal government currently recommends for weight loss but “a lot more than what many people would be able or willing to do,” Ravussin says.

At the same time, as many people have found after starting a new exercise regimen, working out can have a significant effect on appetite. The mechanisms that control appetite and energy balance in the human body are elegantly calibrated. “The body aims for homeostasis,” Braun says. It likes to remain at whatever weight it’s used to. So even small changes in energy balance can produce rapid changes in certain hormones associated with appetite, particularly acylated ghrelin, which is known to increase the desire for food, as well as insulin and leptin, hormones that affect how the body burns fuel.

The effects of exercise on the appetite and energy systems, however, are by no means consistent. In one study presented last year at the annual conference of the American College of Sports Medicine, when healthy young men ran for an hour and a half on a treadmill at a fairly high intensity, their blood concentrations of acylated ghrelin fell, and food held little appeal for the rest of that day. Exercise blunted their appetites. A study that Braun oversaw and that was published last year by The American Journal of Physiology had a slightly different outcome. In it, 18 overweight men and women walked on treadmills in multiple sessions while either eating enough that day to replace the calories burned during exercise or not. Afterward, the men displayed little or no changes in their energy-regulating hormones or their appetites, much as in the other study. But the women uniformly had increased blood concentrations of acylated ghrelin and decreased concentrations of insulin after the sessions in which they had eaten less than they had burned. Their bodies were directing them to replace the lost calories. In physiological terms, the results “are consistent with the paradigm that mechanisms to maintain body fat are more effective in women,” Braun and his colleagues wrote. In practical terms, the results are scientific proof that life is unfair. Female bodies, inspired almost certainly “by a biological need to maintain energy stores for reproduction,” Braun says, fight hard to hold on to every ounce of fat. Exercise for many women (and for some men) increases the desire to eat.

Thankfully there has lately been some more encouraging news about exercise and weight loss, including for women. In a study published late last month in The Journal of the American Medical Association, researchers from Harvard University looked at the weight-change histories of more than 34,000 participants in a women’s health study. The women began the study middle-aged (at an average of about 54 years) and were followed for 13 years. During that time, the women gained, on average, six pounds. Some packed on considerably more. But a small subset gained far less, coming close to maintaining the body size with which they started the study. Those were the women who reported exercising almost every day for an hour or so. The exercise involved was not strenuous. “It was the equivalent of brisk walking,” says I-Min Lee, a researcher at Harvard Medical School and Brigham and Women’s Hospital and the lead author of the study. But it was consistently engaged in over the years. “It wasn’t something the women started and stopped,” Lee says. “It was something they’d been doing for years.” The women who exercised also tended to have lower body weights to start with. All began the study with a body-mass index below 25, the high end of normal weight. “We didn’t look at this, but it’s probably safe to speculate that it’s easier and more pleasant to exercise if you’re not already heavy,” Lee says.

On the other hand, if you can somehow pry off the pounds, exercise may be the most important element in keeping the weight off. “When you look at the results in the National Weight Control Registry,” Braun says, “you see over and over that exercise is one constant among people who’ve maintained their weight loss.” About 90 percent of the people in the registry who have shed pounds and kept them at bay worked out, a result also seen in recent studies. In one representative experiment from last year, 97 healthy, slightly overweight women were put on an 800-calorie diet until they lost an average of about 27 pounds each. Some of the women were then assigned to a walking program, some were put on a weight-training regimen and others were assigned no exercise; all returned to their old eating habits. Those who stuck with either of the exercise programs regained less weight than those who didn’t exercise and, even more striking, did not regain weight around their middles. The women who didn’t exercise regained their weight and preferentially packed on these new pounds around their abdomens. It’s well known that abdominal fat is particularly unhealthful, contributing significantly to metabolic disruptions and heart disease.

Scientists are “not really sure yet” just how and why exercise is so important in maintaining weight loss in people, Braun says. But in animal experiments, exercise seems to remodel the metabolic pathways that determine how the body stores and utilizes food. For a study published last summer, scientists at the University of Colorado at Denver fattened a group of male rats. The animals already had an inbred propensity to gain weight and, thanks to a high-fat diet laid out for them, they fulfilled that genetic destiny. After 16 weeks of eating as much as they wanted and lolling around in their cages, all were rotund. The scientists then switched them to a calorie-controlled, low-fat diet. The animals shed weight, dropping an average of about 14 percent of their corpulence.

Afterward the animals were put on a weight-maintenance diet. At the same time, half of them were required to run on a treadmill for about 30 minutes most days. The other half remained sedentary. For eight weeks, the rats were kept at their lower weights in order to establish a new base-line weight.

Then the fun began. For the final eight weeks of the experiment, the rats were allowed to relapse, to eat as much food as they wanted. The rats that had not been running on the treadmill fell upon the food eagerly. Most regained the weight they lost and then some.

But the exercising rats metabolized calories differently. They tended to burn fat immediately after their meals, while the sedentary rats’ bodies preferentially burned carbohydrates and sent the fat off to be stored in fat cells. The running rats’ bodies, meanwhile, also produced signals suggesting that they were satiated and didn’t need more kibble. Although the treadmill exercisers regained some weight, their relapses were not as extreme. Exercise “re-established the homeostatic steady state between intake and expenditure to defend a lower body weight,” the study authors concluded. Running had remade the rats’ bodies so that they ate less.

Streaming through much of the science and advice about exercise and weight loss is a certain Puritan streak, a sense that exercise, to be effective in keeping you slim, must be of almost medicinal dosage — an hour a day, every day; plenty of brisk walking; frequent long runs on the treadmill. But the very latest science about exercise and weight loss has a gentler tone and a more achievable goal. “Emerging evidence suggests that ~unlike bouts of moderate-vigorous activity, low-intensity ambulation, standing, etc., may contribute to daily energy expenditure without triggering the caloric compensation effect,” Braun wrote in the American College of Sports Medicine newsletter.

In a completed but unpublished study conducted in his energy-metabolism lab, Braun and his colleagues had a group of volunteers spend an entire day sitting. If they needed to visit the bathroom or any other location, they spun over in a wheelchair. Meanwhile, in a second session, the same volunteers stood all day, “not doing anything in particular,” Braun says, “just standing.” The difference in energy expenditure was remarkable, representing “hundreds of calories,” Braun says, but with no increase among the upright in their blood levels of ghrelin or other appetite hormones. Standing, for both men and women, burned multiple calories but did not ignite hunger. One thing is going to become clear in the coming years, Braun says: if you want to lose weight, you don’t necessarily have to go for a long run. “Just get rid of your chair.”



Gretchen Reynolds writes the Phys Ed column for the magazine. She is writing a book about the frontiers of fitness.
http://www.nytimes.com/2010/04/18/m...ml?ref=magazine

Last edited by Demi : Tue, Apr-20-10 at 15:28.
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  #138   ^
Old Sat, Apr-24-10, 02:06
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April 23, 2010

Sugar. Cholesterol. JAMA. Finally.

by Barbara Berkeley, MD


Scientists are supposed to be curious. Weren’t they once the little boys and girls who peppered their parents with a zillion questions about how the world worked? Didn’t they once want to solve the riddles of the universe?
But then the scientists grew up and like all the rest of us, they became less open minded. Perhaps they were influenced by powerful figures. Or perhaps they became so immersed in their own hypotheses that they stop looking at others.

In no area has this been so true than in the reluctance of researchers to look at the negative role of sugars in our modern diet. In 1980 (coincident with the start of our obesity epidemic), Ancel Keys, a professor of physiology from the University of Minnesota, published a study that would change science for decades. The Seven Countries Study was a research project that looked at diet and heart disease throughout the world. It concluded that there was a strong association between the amount of saturated fat people ate and their cholesterol levels and subsequent chance of developing heart disease.

The Seven Countries study has arguably been one of the most influential forces on our modern American diet. Keys was a big, loud voice in the scientific community. Beginning in the late 60s, he had begun convincing much of America to start eating more polyunsaturated fats and fewer saturated ones. It was around this time that my mother banned the Breakstone butter tub from our table and substituted that fabulously healthful product--- margarine---made completely from corn oil. Americans stopped frying in lard and started consuming tons of vegetable oils instead. With the advent of the Seven Countries Study, things got more confused. All fat became the enemy and the fat free craze was on with a vengeance. Carbs good. Fats bad. Dutifully, I switched to a diet of vegetables, grains, pasta, and bread with fat free Entenmanns cookies for dessert. It was all completely fat free. But, for the first time in my life, I started to gain weight as if it was going out of style. I chalked it up to being 40. My diet was obviously pristine

But holes began to appear in the Seven Countries Study. (For more on this, see Gary Taubes’ book, “Good Calories, Bad Calories”) Critics noted that Keys had omitted data from countries in which results contradicted his preferred hypothesis. At the same time, Dr. Atkins popularized a diet which had pretty much no carbohydrates. Cholesterol levels fell on this diet. How could that be if fat raised cholesterol? For years, people like Weston Price who studied the anthropology of diet had noted that the inclusion of large amounts of carbohydrate in native diets was linked to modern disease. Yet science refused to be swayed from its single-minded pursuit of fat as villain. Clinicians who spoke out against sugar and starch consumption, and those who wrote about it were sidelined as kooks.

Despite the fact it is clinically obvious that cholesterol falls when patients are placed on low carbohydrate diets, other doctors still look at me as if I’m nuts if I suggest that sugar has anything to do with lipids. Even more importantly, we now know that our levels of total cholesterol are only one, very generalized, piece of the puzzle. Equally, if not more important, are the types of lipids we have. We’ve gone beyond just the “good” cholesterol and the “bad” one. We now know recognize vital subtleties.


Bad cholesterol turns out to exist in two forms: a light, fluffy, innocuous form and an irritating, small, dense and dangerous form. Dense LDL predisposes us to coronary disease. Standard lipid tests do not say anything about the size of LDL particles, but doctors can guess if we have them by looking at levels of two other lipids, triglycerides and HDL. If the ratio of these two elements is above 3.8, that is a strong indication that there is small, dense LDL. We call this type of lipid profile “dyslipidemia” and it is highly correlated with vascular disease.
Are these changes entirely brought about by the fat we eat? Absolutely not.

On April 21, 2010, with absolutely no fanfare, the Journal of the American Medical Association published an uber-important study. JAMA Study. Here is how the authors introduced it:

Dietary carbohydrates have been associated with dyslipidemia, a lipid profile known to increase cardiovascular disease risk. Added sugars…are an increasing and potentially modifiable component in the US diet. No known studies have examined the association between the consumption of added sugars and lipid measures.

Isn’t it incredible that with all the research on diet and heart disease that has been going on for the past 30 years, this is the first study to even consider the possibility that sugars impact lipids??

So here’s what the study showed. It looked at 8,495 US adults over the age of 18 who were part of our ongoing national nutritional survey (NHANES, 1999-2006). Excluded from the study were those on cholesterol medicines or diabetics---so two of the populations that theoretically might have shown the greatest correlation of lipid levels with sugars were not considered. The study also looked only at the added sugars people consumed, in other words, the extra sugar, high fructose corn syrup or other sweeteners that were included in the foods they ate, not at the total carbohydrate composition of their diets.

Results: Good Cholesterol levels, which should be high, fell as the consumption of added sweeteners increased. Triglyceride levels rose significantly, meaning that the ratio between the two went up (suggesting more dense LDL) as sweetener use did. In women, total LDL (bad) cholesterol rose with increased sugars as well.

Interpretation: Sweetening agents directly affect cholesterol and triglyceride levels (or at least are highly correlated with them). If this study is correct, eating more sugars increases your risk of vascular disease. Finally, It’s not just about fat anymore.

How much added sugar do we consume? On average, about 16% of our calories are coming from this completely unnecessary source. Recently, the American Heart Association jumped on the anti-sugar bandwagon with the recommendation that women consume no more than 100 calories in added sugar per day (150 calories for men). How likely is this to happen? Well, 1 can of coke has 140 calories from sugar. A Starbucks Blueberry scone has 460 calories, 96 of which come from added sugars and a small pack of M&Ms has about 130 calories of added sugars. Eat any one of these and you are done with sugar for the day and that doesn’t factor in the hidden sweeteners that are added to restaurant foods, canned foods, and just about everything else. How many sugars should we truly eat? In my world, the answer would be: just the sugars contained in natural foods.

Finally, this study just skims the bare surface. It opens the door to the thought that too many sugars can be just as dangerous for your heart as too many of the wrong fats. But the name of the game is gestalt—or totality. If we get bogged down in running after sugars as we’ve gotten bogged down in running after fats, we will find ourselves at the end of another blind alley. Each and every one of these studies confirms the very same priniciple, that the further we depart from the diet that was original to man, the more we mess things up. Clumsy attempts to “correct” the problem only reveal our ignorance. Remember that margarine my mother switched to? Turned out that it was full of corn oil, which is high in omega 6—or pro-inflammatory—fats. Also turned out that margarine was just a tub of trans-fat, one of the most dangerous substances for the heart. And all of those Americans who switched to vegetable oil? They vastly raised the ratio of omega 6 to omega 3 fats in their diet, putting them at risk for inflammatory problems. Is it such a fringe idea to suggest that we need to revamp our entire idea of diet to bring it back into line with what kept us healthy in the past? I certainly don’t think so.

But for today, I will celebrate the JAMA study and be glad that science has started to expand its view. Maybe I’ll try re-reading it while eating the peculiar concoction that I’ve recently been enjoying for lunch: some sardines mashed up with a good mustard, a salad, and an avocado. Lots of omega 3, completley Primarian, and not a sugar in sight.
http://refusetoregain.com/refusetor...ma-finally.html
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Old Thu, Apr-29-10, 09:22
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April 28, 2010

I Can’t Want To. I Can’t Like That.

By Lynn Haraldson-Bering


“Hello, it’s me. I’ve thought about us for a long, long time.” Todd Rundgren

It’s been two months since my last RTR post, and believe me, I’ve missed it very much. While I’ve still been writing on Lynn’s Weigh, I’ve also been dealing with some physical issues that are leading me in a new direction on the maintenance road. Uncharted territory, actually.

My thanks to Barbara for picking up my slack and for writing so many thought-provoking blogs in my absence. She’d do fine blogging without me, but she assures me my voice is still needed here. I told her that in tackling my knee and shoulder problems, I felt I had nothing relevant to contribute to the maintenance conversation. They are two separate issues, I said, and I could only focus on one at a time.

Then I went back and read the first blog I posted on Refuse to Regain – a piece outlining my “green house philosophy” in which I liken my body to the actual green house in which I live. Although the imperfections I referred to in that blog were stretch marks and loose skin, the same philosophy applies to the imperfections of my bones and cartilage, ligaments and tendons. Even as my body becomes more imperfect, it remains a body in maintenance, and because I only get one body, the imperfections and maintenance must learn to coexist, and like rivaling siblings, learn to to live under the same roof.

As I come to terms with the degeneration of body parts, my goal is and always will be to maintain my weight. This will require some finesse and fine-tuning, though. Out are my 7-hour-a-week workouts and in is the philosophy my 2½-year-old granddaughter lives by:

Me: “Claire, go potty before we leave.” Claire: “I can’t want to.”

Me: “Claire, try a bite of asparagus.” Claire: “No thank you. I can’t like that.”

(For the record, in the photo Claire's not sleeping, she's doing her Jackie-O impersonation.)

What the medical professionals and I have learned is that, due to hypermobility, lifting weights injures the tendons in my shoulders and arms, so I “can’t want” to do that anymore. Therefore, I traded my hand weights and barbell for Thera-bands. And since there’s no simple solution to removing the bony benign tumors growing in my knees, I “can’t like” biking 20 miles or hiking on steep inclines or ballroom dancing anymore. Can I still bike and hike and dance? Yes, just not the way I liked or wanted to. So my new mantra for physical activity is “compromise and improvise.”

Same goes for food.

I see maintenance as a tightrope secured by exercise on one end and diet on the other. Since I have less exercise to work with, I need to also work with less food in order to keep the tightrope straight. Can I still like chocolate? Sure, just not as often as I do now. Can I still want to roast a potato? Heck yeah, just not more than once a week since. Sadly, a few studies show nightshade plants like tomatoes and potatoes can make inflammation worse. *tear*

Along with a reduced 3- to 4-hour-a-week workout regimen, my strategy is to push the limits of my limited caloric intake and maximize those calories with beneficial anti-inflammatory foods. Shouldn’t be too much of a problem since I love berries, green leafy vegetables, apples, red onions, soy and turmeric. I’ve also decided to take several of my doctors’ advice and take fish oil supplements, even though I’m a vegetarian.

This next component is, to me, the most important. Without it, I’d probably not step out on to the food-and-diet tightrope.

Unless you’re Philippe Petit, you’ve got to have a safety net. Those of us in maintenance AND on the road to maintenance need that crowd to cheer us on when we succeed and hold its breath and offer support when we slip. Writing and posting here has been my safety net for two years, and while it’s been a few months since I’ve written, I’m back. Maybe not with the same frequency, but please know that your participation here in the form of your comments and emails help me and all the other people reading RTR feel the security of the net beneath us as we walk that tightrope of maintenance.

Some days I feel like a 15th century sailor adrift somewhere in the Pacific with an albatross around my neck. I want to trust what I’ve learned in the last five years, but honestly, I’m a little worried that these ligament/tendon/joint issues might call out the old me who’s MO was to give give up, give in and stop focusing when she couldn’t walk and chew gum at the same time. I don’t feel like and certainly don’t think like that person anymore, especially since I’m more attuned with my body. God knows I want more than the old status quo.

But still the question lingers: What if?
http://refusetoregain.com/refusetor...-like-that.html
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  #140   ^
Old Sat, May-01-10, 05:43
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Demi Demi is offline
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Plan: Muscle Centric
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April 30, 2010

Less Food, More Quality

by Barbara Berkeley, MD


I am always hesitant to voice my true opinion on how much we need to be eating in order to stay healthy. My trepidation revolves around the fear that I will be perceived as subourning anorexia. Let's get that out of the way immediately: I am not.


But what I do find is that a healthy, efficient body needs far less food in order to run than is commonly supposed. When the conversation turns to eliminating foods or cutting back on eating frequency, my tentative suggestions are usually met with horrified gasps, "But how can that be healthy?"


Just today, for example, I met a lovely young lady for a cup of coffee. She was consulting me because all of her efforts to lose weight had only caused more pounds gained. Because she was still in her 20s, with an active metabolism, I suggested simple elimination of starches and sugars. Going to a Primarian (or ancient) eating style has worked very well for a number of patients and friends who needed 20-40 pounds of weight loss. However, the young person in question was skeptical. Where would the fiber come from? What would prevent her from being hungry? How could her body run on just fruits, veggies, proteins and low fat dairy? It simply wasn't enough food!

Just prior to her arrival, I had been reading my daily copy of the Cleveland Plain Dealer. In it was an interview with Evan Lysacek, the Olympic figure skater and gold medalist (currently featured on Dancing with the Stars). He happens to be in town with an ice show and was doing the requisite pre-performance publicity. Lysacek was asked about what he ate when he was training for the gold medal. Here is his answer:

"I was on a strict diet: five servings of fruit and two eggs in the morning; protein shakes to get through the day; five servings of vegetables and some protein at night---before 6 o'clock--so my body would digest it. After I won the Olympics, I felt like, 'Yeah, I'm free, I can eat whatever I want.' I did that for a few days, but then I started craving fruits and vegetables again."

I pulled this out and showed it to my friend. Here is a guy who is training for one of the most vigorous performances in the world: a men's figure skating program at the Olympics, and he is eating---what for most Americans----would be very little. Also note that there are absolutely no modern carbohydrates, added sugars, starches or grains in this training diet.

If you return to the video I posted a couple of weeks ago from Jack Lalanne, you will also note that the diet he recommends is quite spartan and very Primarian. At the same time, you can see that Jack is very lean and has excellent muscle mass.

Eating foods that don't meld well with our bodies leads to free radical formation and other stressors. Yet we have been conditioned to believe that we need lots of food to be healthful. Health is not a matter of amount. It is a matter of quality. One of the tasks of maintenance is figuring out how to maximize food value. Once you design your diet to rely on foods that are largely "high test", you will need far less fuel to get you where you are going. You will also burn cleaner and produce fewer harmful byproducts. You and the vehicle in which you travel, your body, will not only find a harmonious partnership--- you will also last a whole lot longer.
http://refusetoregain.com/refusetor...re-quality.html
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  #141   ^
Old Fri, Jun-11-10, 04:20
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Demi Demi is offline
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Plan: Muscle Centric
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June 10, 2010

Less Guilt Dear Maintainers

by Barbara Berkeley


I am on a campaign to lessen the guilty feelings of dieters and weight maintainers.

There must be some sort of hormonal "guilt" response that accrues with each fat cell we add. Over the years, the patients I've cared for are among the guiltiest group of people I know. What are they guilty about? I probably don't have to tell you. If you are reading this, you are only too familiar with the whole cycle. But just to reiterate:

Overweight people are guilty because they feel weak, powerless and out of control. They are guilty because they have done damage to their bodies that may not be reversible. They are guilty because they have repeatedly broken promises to themselves. They are guilty for not being better role models for their children. They are guilty for not excercising more or for the fact that they dislike exercise in the first place. They are guilty about eating junk food. They are guilty that they have blown their diet. They are guilty for losing weight and regaining it all.

In short, it is a guilt-fest.

If you read this blog regularly, you know that I believe that all this guilt is misplaced and damaging. Overweight people have physiologies that are particularly susceptible to the SAD (standard American diet). Unless they are taught or can figure out appropriate strategies for getting out from under, the food environment will quickly swelter them. Guilt only gets in the way of finding objective solutions. It personalizes a problem and puts the blame on the wrong side.

In this regard, I found Lynn's last blog kind of interesting. Should we feel for guilty for comparing ourselves to people who are still eating destructively? This is a complicated issue. Those who change their habits for the better will inevitably feel somewhat judgemental about those who haven't done so. That's life. When we succeed or win at something, it gives us a boost, a feeling of superiority. It may not be completely pretty, but it's human nature. But that feeling of being on top gives us another opportunity to feel guilty, and as we've said, those who have struggled with weight are good at guilt.

In my book, I actually make the suggestion that maintainers cultivate a mild sense of "food superiority". It's probably quite important that those who've opted out of the SAD are looking at the shopping carts of those who haven't. We need to be aware of how far we've come, and because we are human, we may necessarily have feelings about those who haven't been as successful.

When I started playing tennis at the tender age of 56, I learned alot about competing to win that I never understood before. I learned that in many ways, it's easier to lose. When you win, you have to deal with staying on top and with what other people expect of you. You also have to deal with the discomfort (and fun!) of feeling prideful. None of us wants to feel that we are looking down on another human being, but when we compete and win, there is always a little of that factored into the mix.

I think it's important for maintainers to get comfortable with a feeling of pride in their accomplishments. If this occasionally takes the form of feeling "better" than someone with a cart full of ring dings and fried chicken, it's ok to forgive yourself. Disabling guilt is a vital part of moving forward.
http://refusetoregain.com/refusetor...aintainers.html
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  #142   ^
Old Fri, Jun-11-10, 06:41
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Judynyc Judynyc is offline
Attitude is a Choice
Posts: 30,111
 
Plan: No sugar, flour, wheat
Stats: 228.4/209.0/170 Female 5'6"
BF:stl/too/mch
Progress: 33%
Location: NYC
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June 07, 2010
The Plank In My Eye
By Lynn Haraldson-Bering

Quote:
Originally Posted by lynn
"Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye?” Matthew 7:3

A 2-liter bottle of Diet Dr. Pepper fell over the plastic divider separating my groceries from the groceries belonging to the man next in line. The cashier grabbed it and scanned it before the man could set it straight, and I said, slightly panicked, “Oh no, no! That’s not mine! I don’t drink soda!”

I don’t drink soda? Where did that come from?

Prior to this misunderstanding, I’d watched the man unload his cart onto the conveyor belt: four Tony’s pizzas, two boxes of Honey Nut Shredded Wheat, two boxes of Fruit Loops, a bag of frozen pierogies, four bottles of diet soda, a can of ravioli, et al.

‘Not a single fruit or veggie,’ I sighed. ‘Just instant food.’

In October I wrote that these “cart observations” were sincere and not judgmental. “I assure you,” I wrote, “my attitude is not holier than thou.” Not holier than thou? After yesterday’s soda freak-out, I realized, ‘I’ve got a huge plank in my eye.’

Just as quickly as I thought, ‘How could the cashier think that I – with my beautiful, near-perfect food choices – would buy a bottle of soda?’ did I realize, ‘Oh my god, I was once that man in line.’ His was MY cart six years ago. I bought Tony’s pizzas. I bought bagged pierogies. I bought sugary cereals. And, more importantly, I would have thought that the skinny person ahead of me with her fancy veggies and fruit and yogurt and beans was judging me and my pierogies with her “I don’t drink soda!” outburst.

And 300-pound me would have been right. The skinny person ahead of the man with the pizzas and pierogies yesterday was judging.

Sometimes I do behave as though by not drinking soda or by filling my cart with veggies rather than processed foods I’m a better person. And why? Because sometimes – not all the time – I hate being reminded of who I was. This is particularly true, I’m slowly realizing, when I’m most afraid of gaining weight.

For instance, I’m facing surgery in two weeks along with two or three months of rehab. I’ll be laying around, exercising less, and thus eating pierogies and gaining 100 pounds, right? *eyeroll* Irrational, I know, but a fear nonetheless and one that’s best examined than ignored.

As Barbara so poignantly reminded me in her last blog (“The Sea Within Us: The Oil We’ve Spilled”), all living things are the same. My meditation teachers instruct, “We all want to be happy; we all want to not suffer.”

The last thing I want is to cause someone else to suffer. I wish I could tell the man with the sodas that I’m sorry I judged him. The next best thing, I guess, is to tell the me I was that I’m sorry I judged her. To her I say: As a maintainer, I find myself fighting like hell against the forces that be, both inside and outside. “I don’t drink soda!” No, I don’t. But that doesn’t make me any better than her, the man in line or anyone else.


I get all of Barbara's blogs but not Lynn's....hmmmmm.

I wonder if I do feel guilt when I judge the contents of carts at store. I've actually begun to try to figure out if they are vegetarians by what they have there.
The people who's carts are filled with processed crap upset me the most. I maybe judging them....but I think it is coming from a place that is more about feeling sorry for them because they haven't gotten "it" yet. But I also now know that its not my job to help them see the light.
A few eeks ago, I was doing a small fillin shop. I bumped into my next door neighbor. She was filling a bag of bread rolls and when she saw me, her eyes went right into my cart and I don't even have to tell you what she saw in mine...I'd caught her. She is an x Atkins girl who was doing Atkins 6 yrs ago when I started out and now is back to her old eating habits and is once again, morbidly obese. I tried to make it so that it didn't seems as if I noticed what she was filling her cart with....I just walked by quickly as I said hi to her.
Was that judging by her or by me when we spotted one another? She knows better but choses to not make them...at this time. I feel very sorry for her. I can only guess what she felt about my choices.
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  #143   ^
Old Mon, Sep-06-10, 12:21
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Judynyc Judynyc is offline
Attitude is a Choice
Posts: 30,111
 
Plan: No sugar, flour, wheat
Stats: 228.4/209.0/170 Female 5'6"
BF:stl/too/mch
Progress: 33%
Location: NYC
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http://refusetoregain.com/refusetor...se+To+Regain%29

Quote:
Originally Posted by Barbara Berkeley
September 06, 2010
A Group Project
by Barbara Berkeley, MD

Within the next couple of weeks, I'm going to be starting a new project. For years, I've wanted to develop a maintainer's group that would look very different from the standard weight loss meetings. To do this effectively, I'd love to have your help.

My office practice has given up on groups. Over the years, we've found that patients who must pay out-of-pocket for treatment prefer the convenience and privacy of individual visits. When we've tried to start groups so that we could offer a low-cost alternative, they have fizzled.

But I've remained convinced that a group setting can work---and in fact might be more effective---for maintainers. One of the principle obstacles to maintenance is the fact that it must be done alone. Few maintainers know anyone else who has achieved what they have or who is living their life. After the oil spill in the Gulf, I started using this analogy:

Our food culture is like the oily water of the Gulf. There you are, swimming away, in what looks like chocolate. Everyone is splashing around in there telling you how much fun it is. One by one, though, you notice that people are starting to struggle or are even disappearing. You are determined to be different. You clearly see the danger. In the distance is an island. With enormous effort, you swim to the island, pull yourself up on unpolluted ground and clean off all the oil that clings to you. As the sun dries your skin, you feel an incredible rejoicing. But when you turn around, you find that the island is deserted. You are going to be living there by yourself, and a lonely future awaits you.

In truth, we are not alone, but are part of a growing community of maintainers. It's just that our numbers are still small enough that we still have trouble locating each other. We are spread out over that island, but rest assured: we are there. This is exactly why I believe a group is so important. At least once a month, it's helpful to have contact with our peers. We need to know that other people are living the maintenance life successfully and that we are not the cultural equivalents of Bigfoot, living an odd, solitary existence while crouched over a bowl of nuts and berries.

Maintenance is an evolving enterprise. There is no information about it. The field is wide open. That's both frustrating and great. We find ourselves in a dark room unsure of what dangers await or how to move. On the other hand, there are no preconceived notions to get rid of. This fun house is ours and ours alone, so let's have a good time with it.

In an earlier post I wrote about my starting points for the new group. Here is the charter I envision:

1. The group is for those who have undergone a life conversion or for those who seek to achieve that goal. In other words, you must not only have lost weight, but support serious changes in your life to be part of this enterprise. The changes you've made do not reflect the fact that you were weak, lazy or misguided in the past. They reflect the fact that your eyes were opened to the dangers of our food environment and physical culture and that you've now realized that you must live on a kind of island to avoid them.

2. We want to build the population of our maintenance island. As working maintainers, we commit to spending some time each month working on community initiatives that will allow us to share what we've learned and help throw a life preserver to those who are going under.

3. We want to develop something. Our mission is to teach others how to maintain while we teach ourselves. The group will remain creative, open to new ideas, and willing to experiment. We will generate materials for other maintainers from those elements that succeed.

Ultimately, I am hoping that our experiences in this group can lead to a workbook for new maintainers or to other tools that might be used by those who want to set up similar groups.

As readers of this blog, you are all part of our extended family. Your input is vital and I hope you will be interested in helping to create the direction of this project. Here is how you can help:

Consider these questions:

1. When you were just beginning the maintenance phase, what were the things that you had to figure out for yourself? In other words, what were the basic principles of maintenance that you discovered? If you could pass these on to someone else who was just starting out, what would they be?

2. Are there any readings or resources that have helped you?

3. Are there any daily practices that you would recommend? For example, does keeping a food record help you? Do you journal your maintenance experiences? Do you keep formal track of your exercise? Do you wear any tracking devices (pedometers, calorie monitors, etc..) and if so, can you recommend ones that have proved reliable and helpful?

4. What have you found to be an effective amount of exercise to keep weight stable? If any of you are limited physically, I'd like to know if you can maintain with less strenuous forms of exercise like walking, basic yoga, tai chi, and so on.

5. If you could have been in a maintenance group (or if you are already in an effective group) what would you have liked the group to offer?

The answers to any or all of these questions would help me greatly. Pick the one that most interests you or make your own comments. I thank you for any input you can provide!
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  #144   ^
Old Fri, Oct-22-10, 12:01
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Demi Demi is offline
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Plan: Muscle Centric
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Quote:
October 22, 2010

Smoke, Fire, Inferno: Are You STILL in the building?

by Barbara Berkeley, MD


Picture this. It's a grey fall morning in Northeast Ohio, the kind of morning when the nip in the air prompts people to get out the mittens and the knitted hats. There's a peek of sun now and then; a few moments of lucent optimism. Each time the light glows, the leaves flash irridescent orange and red. But it doesn't last long. The clouds quickly reassemble and cover the sun. Unlike the leaves that still cling to the branches, the leaves that litter the ground are brown, wet, and dead. Winter is just a moment away.

From the corner seat in our local coffee shop, I'm blogging and watching life go by. The first guy who comes in from the street has a prominent belly that's hanging way over his belt. He orders a coffee, a doughnut and a blueberry muffin. He pours sugar liberally into his cup of joe.

The pastry case looks tempting. There are five different types of muffins, multiple slices of pound cake, rice crispy treats, cookies and scones. If you ask for coffee, the smiling staff has been trained to ask, "Anything else for you today?". They appear to be slightly offended--mildly shocked--- if you don't get something sweet.

I flash back to a story from Don's medical school days. He was assigned to take an eating history from a very overweight patient. She reported that she usually ate cake for breakfast. He came home and told me this and we were so shocked that the story was repeated for years. That was 1980. Now I sit and watch as the majority of people in our town leave this coffee shop with a bag full of cake for breakfast. Actually, they've probably already had breakfast, because it's now 10 am.


A vertical rack offers a selection of newspapers with their front pages tilted forward attractively. Bold headline, above the crease on USA Today: DIABETES CASES MAY DOUBLE BY 2050.

The pace of our sugary dissolution is apocalyptic, frightening. Why are we all becoming diabetic and why doesn't anyone care? Smoke in our house, flames licking at our feet. Sometimes I feel like I'm a lone voice shouting FIRE. It's like a bad dream. The one in which you try to call someone with an urgent message, but your feet stick in the sand, your fingers turn to rubber when you try to dial the phone, the line is dead. Over and over.

Last night we held our second Refuse to Regain Group. Eleven maintainers showed up, all so anxious to learn from each other. Many in our group have lost over 100 pounds and one person has lost over 250 pounds, but the tasks of maintenance remain the same. In order to maintain, in order to beat off the world of illness, fat and diabetes, we must find a way to live outside the sugar and starchy American norm. How we do this was the subject of heated debate. Can we eat whatever we want, but just have three bites? The National Enquirer reports that Kim Kardashian eats a bite of dessert and pours champagne over the rest to ruin it, perhaps the ultimate demonstration of our wasteful, profligate society and our search for ways to have our cake and avoid it too.

At the meeting, there was a clear division between those who had maintained weight for years and those who were just getting started. The newbies were still wrestling with the Kardashian solution. Surely there was a way to continue to "play" with pasta, potatoes, grains, bread, cereal and sweets. Maybe on the weekends? Maybe with steely self control? Maybe by keeping a food diary? Please, please let there be a way!

The more experienced maintainers had long since made their peace with the elimination of sugars and starches. They ate by consistent rules and had discovered certain non-triggering treats (NTTs) that worked for them. Their diets relied on large amounts of fruits and vegetables, lean proteins like poultry, fish and low fat dairy and some nuts. When their weight went up a bit, they eliminated their NTTs temporarily.

What is causing our obesity and diabetes? The honest answer is that no one knows. Perhaps we've simply exceeded the amount of stress our insulin systems can tolerate. Perhaps epigenetic changes that occurred in utero, in wombs that were exposed to much higher levels of sugar than earlier generations, have left us vulnerable to these foods. Or, there may be new obesogens in our environment, chemicals that disrupt the normal ability of our insulin to choose whether sugars should be burned or stored. We store everything and become fat and increasingly sugar intolerant. (And please remember that all starches are sugar too, including whole grains).

It doesn't much matter, because the short term answer is clear. Eat a diet that is consistent with your ancient genes and one that avoids as much starch and sugar as possible. This removes the stress from an insulin system that is busted...either by overexposure or by some unknown obesogenic cause.

The tsunami is gathering. The fire is already raging. We are facing an untold epidemic of overweight, diabetic, atherosclerotic Americans. You are in the line of fire. I'm telling you the answer. I'm shouting that the roof's about to cave in. But so far, there aren't many people running for the exits. They are still staring, glassy eyed, at the pastry case and pondering the Kardashian compromise.
http://refusetoregain.com/refusetor...e-building.html
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  #145   ^
Old Wed, Oct-27-10, 03:01
Demi's Avatar
Demi Demi is offline
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Plan: Muscle Centric
Stats: 238/153/160 Female 5'10"
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Progress: 109%
Location: UK
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Quote:
October 26, 2010

We Are Artists

By Lynn Haraldson


“On 7 August 1974, shortly after 7:15 a.m., (Philippe) Petit stepped off the South Tower and onto his 3/4" 6×19 IWRC (independent wire rope core) steel cable. He walked the wire for 45 minutes, making eight crossings between the towers, a quarter mile above the sidewalks of Manhattan. In addition to walking, he sat on the wire, gave knee salutes and, while lying on the wire, spoke with a gull circling above his head.” From Wikipedia

Philippe Petit is a “high wire artist.” His walk between the twin towers of the World Trade Center was documented in the awesome 2008 film “Man On Wire.”

I was born one day and 14 years after Philippe Petit. The only thing we share in common other than we’re both Leos is that we know something about balance. God knows I’m terrified of heights, yet I’m mesmerized watching him walk across the sky on a thin cable, light as a feather, as natural as if he were walking on sand. As a weight maintainer, his artistry makes sense.

The longer I maintain my weight, the more I see the balancing act for what it is. Things change day to day. Our bodies need more, then they ask for less. Our minds revert, then they move forward. We need props to keep us balanced.

In my latest blog on Lynn’s Weigh, I reveal a part of my non-blogging life that will be a central player in my weight maintenance balancing act. My husband, Larry, and I are separating and I am moving to Pittsburgh next week. These stressors won’t derail me as a maintenance artist, but it will change the canvas for sure. Larry and I are committed to our friendship and to being the best grandparents we can, but he is also committed to keeping his status as my maintenance balancing prop. He has seen me through all of this – the gain and the loss – and has lost and maintained 25 pounds himself. I’m very glad he’s part of my maintenance posse.

One of my props that I thought was its own is exercise. Since knee surgery in June, I’ve discovered that this maintenance “yin” has a “yang”: exercise at one end and food at the other. I was concerned about weight gain because I knew I’d not be able to work out the way I was used to. What I’ve learned is that when I start losing my weight maintenance balance, I tilt the food side just a little and presto! I’m in perfect symmetry.

This isn’t to say things haven’t shifted. My weight is up a few pounds due to extenuating circumstances (can I just get another period, please?) and my middle is where I accumulate weight first, but I’m not concerned. I was for awhile (concerned, that is), but the hand that holds the props is trust.

Living life as a weight maintenance artist requires as much physical balance as mental, and trust is crucial to that balance. If you doubt yourself, doubt what you’ve learned, doubt that what you’ve accomplished is real…that’s OK. Just don’t forget that what got you to where you are in the first place was trust in yourself…that you could do it this time.

You. It’s your most crucial balancing prop. You are who holds it all in place. You will not forsake you. You are the Philippe Petit of the weight maintenance world. If you trust that and believe that, you will not fall.

I truly believe that.
http://refusetoregain.com/refusetor...re-artists.html
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  #146   ^
Old Mon, Nov-15-10, 08:31
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Demi Demi is offline
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A thought provoking post by Barbara Berkeley over at the Refuse to Regain blog today. I've also posted it on the Media forum here.


Quote:
November 15, 2010

Should We Accept Our Size and Forget All This?

Barbara Berkeley, MD


For most people who have struggled with weight, there is the persistent, nagging suspicion that permanent body change may be a fiction. When we look around, we see very few people who have lost weight and kept it off...yet every magazine cover proclaims the ease of bodily reconstruction. Just walk off the weight! Lose 33 pounds by Christmas!.... As author Gary Taubes once famously asked, "What if it's all been a big, fat lie?"

Way back in 1959, obesity expert Albert Stunkard published a seminal paper which showed the dismal failure rates of programs treating overweight people. Stunkard demonstrated that, in multiple clinical settings, very few people lost weightand practically no one maintained the loss. In a 1983 commentary on this work, Stunkard recalled, "This study grew out of an attempt to resolve a paradox--the contrast between my difficulties in treating obesity and the widespread assumption that such treatment was easy and effective." Any reflective professional who deals with obesity will tell you that they often feel like Sysyphus, rolling an endless boulder up the mountain only to see it tumble back to the sea. Dieters feel the same way.

If we have been lied to, if it is in fact impossible to get rid of excess weight in any permanent way, we may want to circumvent the frustration and simply accept ourselves. We may even want to rejoice in the size we've been dealt. This outlook is attracting a growing number of people and has come to be known as Size Acceptance. If you are unfamiliar with this viewpoint, you might want to take a look at websites like Big Fat Blog or the writings of Linda Bacon, Phd.

The growing size acceptance movement together with the very real failures of conventional weight loss treatment have given me quite a bit of food for thought. As always, I can only give my own opinions and I remain respectful of those who disagree. Here are some of the questions raised by size acceptance as I see them:

1. Is long lasting weight loss unattainable?

2. Is overweight unavoidable for some?

3. Is overweight unhealthy and if so, do we bear any responsibility for keeping ourselves healthy? Can we be healthy and overweight?

4. What is causing us to be obese? Who are the potentially responsible parties?

For me, here are the answers:

1. Is long lasting weight loss attainable? Yes. Long lasting weight loss is possible. There may be periods of relapse or regain, but increasingly I see people who have been able to engineer permanent change. This is not to minimize the profound nature of this change. It is not for everyone. But I do think that we are getting better at figuring out how to do this and at creating connections between those who have. I am also hopeful that the FDA will finally approve medications that we can use during the early phases of weight maintenance. Drugs that blunt appetite would be very helpful is allowing Maintenance Juniors (Just Reduced) to get used to a new eating style. They might also bridge the period when hormones and brain chemistry are altered following the starvation-like period of dieting.

2. Is overweight unavoidable for some? Yes. Likely there are many people for whom weight gain is unavoidable in our current environment. These people may have more sensitive responses to modern foods or may have been so metabolically damaged by modern eating that weight loss is too great a task. However, I believe that there are fewer of these people than we might think.

3. Is overweight unhealthy? Unequivocally yes. There have been many critiques written that cast doubt on the veracity of reported health consequences of overweight and obesity. As a physician, however, I must say that the degree of ill health that comes directly from weight is utterly convincing and completely astounding. How can I be sure that these problems are coming from weight? I can be completely sure because I am able to watch them dissolve and disappear as weight is lost. I am able to watch them re-occur as weight is regained. In addition to the obvious big killers: high blood pressure, atherosclerosis, diabetes, high cholesterol and an increased risk of cancer, there are the things that make life miserable like gastric reflux, gout, arthritic pain, shortness of breath, sleep apnea, fatigue and depression.

Do we have a responsibility to choose healthy habits? That depends on your world-view. America has never been a society that has looked down on those who chose to race motorcycles, smoke, or drink. Those choices have always been the personal business of the individual. However, the choices of individuals become more profound when they are part of a sweeping health epidemic. There is no question that the societal costs of treating the panoply of obesity related disease are staggering. Perhaps we finally do have some social responsibility to attempt to curb these costs.

Can we be healthy and overweight or obese at the same time? We can certainly strive to be healthier at any level of body size, but certain realities remain: we cannot make up for the fact that our heart has to chronically power a body that is 30 to 100 pounds larger. We cannot make the loading on our back and joints disappear if we remain overweight. We also know that intra-abdominal fat is viewed as an invader by the body and causes a brisk inflammatory response which goes on internally. While we can try to be healthier, we cannot be sure that we do not remain chronically inflammed: a state which leads to diabetes and vascular disease.

4. What is causing us to be obese? This is the sticking point. While it is completely legitimate to say, "This is who I am. I choose to accept it", I remain troubled by one major thought. Suppose this is NOT who you are? Suppose you are only this way because you have been manipulated, brain-washed, culturally drowned, poisoned or otherwise hurt? You can still choose to accept and enjoy your size, but the landscape suddenly looks alot different. I can't be sure that obesity has skyrocketed because of the way our culture has accepted and promoted food. I can't be sure that we don't all have a virus or haven't succumbed to an environmental toxin. It may be a combination of the two, but nevertheless, a healthy skepticism about the SAD and an unwillingness to participate in it, seems to be the pre-requisite for making complete bodily change. We see the same phenomenon in those who have gastric bypass surgery. The surgery initially causes withdrawal from the SAD. Eating modern foods causes the patient to feel sick. Once a year or two has passed, some patients become able to tolerate SAD foods again. Those who succumb regain weight. Patients who remain SAD-free also remain lean.

Having said all of this, I find that a big part of my job is convincing some patients that they should accept their size. Torturing oneself with failed weight loss attempts, hating oneself for perceived inadequacies is no way to live. Many of the people who come to my practice are charming, accomplished, lovely people who simply can't get past their weight and can't accept that losing weight is not in the cards. That unhappiness is a tragedy. Thus, it seems to me that there are two equally legitimate strategies for personal overweight. One is to fight the fat...but with the knowledge that the fight is infinitely more difficult than we've been led to believe. The other is to accept it and try to remain as healthy as possible at any given size.

The best advice I can give as a practitioner is this: Rather than wedding ourselves to absolute beliefs about size, perhaps we would do better to periodically re-evaluate our positions. We may want to attempt weight change now only to find that we accept ourselves at a larger size later. We may be happy eating the SAD today, but decide that we want to trade in for better health as time goes on. The one thing that we should never do is use our belief to hit someone else over the head. Obesity and it's cultural roots are way too complicated to allow them to divide us into angry camps. Like other ethically challenging decisions, the decision as to whether to accept size or continue to work against it remain deeply personal and should be respected.
http://refusetoregain.com/refusetor...t-all-this.html
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  #147   ^
Old Tue, Nov-30-10, 05:36
Demi's Avatar
Demi Demi is offline
Posts: 26,664
 
Plan: Muscle Centric
Stats: 238/153/160 Female 5'10"
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Progress: 109%
Location: UK
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November 27, 2010

Refuse to Regain Gives Birth

by Barbara Berkeley, MD


A very happy post-Thanksgiving to you, dear readers! I hope you were able to fend off the advances of pumpkin pie, mashed potatoes and stuffing and arrive at the other side of Turkey Day weighing about the same as you did going in. Now let us get ready for the big guns! Just as we let out a sigh of relief at having made it through Thanksgiving, we can expect to be blasted by much heavier artillery. Returning home to Cleveland today, Don and I found the city fully engaged in the Christmas season. Food, food ads, food smells and emotional appeals to eating abound. Cookies and candies seem almost to dance in the atmosphere. I wish everyone the best of luck as we go into the toughest stretch for weight maintainers.

But more of that another time. Today I wanted to make an announcement: the birth of a new blogsite. As you know, several months ago we started a Refuse to Regain group in Cleveland. As part of our discussions in the group, I encouraged members to consider blogging about their maintenance challenges and experiences. Several of them have now decided to do so and their blog can be found at www.refusetoregainmaintainers.blogspot.com.

Since becoming a blogger myself two years ago, I have been impressed with the power that the internet holds. It is a wonderful means of expression and a terrific conduit for connecting people and ideas. I hope you'll support our maintainers by reading their posts and interacting with them. I also hope that those of you who have considered the idea of expressing yourself on the web will be inspired to give it a try.

Once again, a joyful and most importantly---a healthy----holiday season to you all!
http://refusetoregain.com/refusetor...ives-birth.html
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  #148   ^
Old Thu, Dec-09-10, 08:22
Demi's Avatar
Demi Demi is offline
Posts: 26,664
 
Plan: Muscle Centric
Stats: 238/153/160 Female 5'10"
BF:
Progress: 109%
Location: UK
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December 09, 2010

Maintenance Mind Over Matter
By Lynn Haraldson


I’m cautiously optimistic about the cortisone shot I got in my left knee a few weeks ago to help ease the pain of my torn medial meniscus. I’d prefer not to be scoped, at least not before the holidays, and thankfully the pain has subsided. But every once in awhile it reminds me it’s still there, in a misplaced step or standing in one position too long.

I’ve never torn my meniscus before. So I asked my doc, “How will I know when we need to do something else?” And he said, “When your mind no longer conquers the matter.”

I’m reminded time and again how weight maintenance requires the tenacity of mind over matter. I call it Maintenance Mind, the one we develop and hone and polish after finally realizing (perhaps after dozens of failed maintenance attempts in the past) that life in maintenance is not like any life we’ve led before. Every day we must make the decision that today we will stay on plan despite the bombardment of food marketing and processed food convenience, despite what others think or how others behave, and sometimes despite our inner demon (in my case, my former fat girl) telling us one bite of that won’t matter or one less week at the gym won’t hurt anything.

It’s not easy, per se, but it’s certainly not impossible, despite the odds against us or articles such as the one I read last week in Nutrition Action Newsletter. In an interview with Eric Ravussin, an obesity researcher and head of the Nutrition Obesity Research Center, some of his comments might lead people to believe weight maintenance is impossible, particularly what he said about people who lose weight are constantly hungry. (Really??)

He also said that obese people develop a resistance to leptin similar to a diabetic’s resistance to insulin, and he explained leptin’s effects that occur in the hypothalamus: “With weight loss, the body’s fat stores shrink and therefore produce less leptin. The hypothalamus responds by shifting several body systems into starvation mode. It results in urges to eat more and expend less energy, making it difficult to maintain the weight loss. Other changes, such as increased stress response and weakened reproductive and immune function, cause their own set of problems.”

I can attest to the weakened reproductive function, having struggled for nearly four years with amenorrhea (see “The Mystery of Aunt Flo”), but the other stuff left a big question mark in my head, so as usual, I ran to Barbara for answers.

“Is leptin yet another deterrent to maintenance?” I asked.

Barbara’s response: “It’s well known that obese people become resistant to leptin. Leptin is a ‘no’ hormone, meaning that it discourages eating. Obese people have high leptin levels, but they don’t do what they are supposed to do.

“In terms of what happens after weight loss, I think that’s all speculation. It’s certainly true that the body goes into a starvation mode during dieting, which means that it burns as few calories as it can in order to survive the ‘famine’ and encourages eating and food storage. No one knows exactly what happens after refeeding. We do know that people who exercise have been shown to have a return to normal metabolic rate (for their new size) after a couple of months. This may well be the reason that exercise is important in maintenance.

“As far as saying that people who have lost weight are hungry all the time, I don’t agree. There are people who fit this description, but I have many, many maintainers in my practice who don’t have any more hunger than the next guy. I personally don’t find myself to be excessively hungry. Only if I depart from my usual diet plan!”

Everywhere we’re reminded how fragile maintenance can be. Our metabolisms are against us, we lack brown fat, our hypothalamuses go nuts and our bodies go into starvation mode. These things make up the “matter” our Maintenance Minds conquer. It sounds impossible and yet…we maintain. Day in and day out, we do what we have to do to fight the powers that be, the things inside and around us that – for all intents and purposes – fight against us.
http://refusetoregain.com/refusetor...ver-matter.html
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  #149   ^
Old Thu, Dec-09-10, 08:55
Judynyc's Avatar
Judynyc Judynyc is offline
Attitude is a Choice
Posts: 30,111
 
Plan: No sugar, flour, wheat
Stats: 228.4/209.0/170 Female 5'6"
BF:stl/too/mch
Progress: 33%
Location: NYC
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Thanks for posting this latest blog by Lynn!

I think that I enjoy her posts more than I do the doctor's. But I also think that she makes this maintenance thing sound close to impossible. This has not been my experience at all. Truth is, the longer I do this, the easier it seems to get, for me anyway.
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  #150   ^
Old Fri, Dec-10-10, 09:27
GlendaRC's Avatar
GlendaRC GlendaRC is offline
Posts: 8,787
 
Plan: Atkins maintenance
Stats: 170/120/130 Female 65 inches & shrinking
BF:
Progress: 125%
Location: Victoria, BC Canada
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Quote:
Originally Posted by Judynyc
Thanks for posting this latest blog by Lynn!

I think that I enjoy her posts more than I do the doctor's. But I also think that she makes this maintenance thing sound close to impossible. This has not been my experience at all. Truth is, the longer I do this, the easier it seems to get, for me anyway.

Ah, but Judy, don't you think that's because we didn't lose on a starvation diet? I certainly don't believe that my body went into starvation mode - if I was hungry, I ate and I still do. The difference now is that I need less food than before to be satiated. I'm sure I would have a great deal of difficulty maintaining on a low-calorie, low-fat regimen.
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