Cancer and obesity, plus my boring visit to the doc.

*Sigh* It didn't go so well at the doctor's, but it wasn't awful. I didn't realize that I'd lost so much weight since my last visit (in clothes/shoes). I was 103! two months ago, and 97 yesterday--six pounds in two months. I'm not complaining, mind you, but he wasn't happy. He asked me if I was still seeing my mental health people and I said yes. He replied, "That's good, except that they don't seem to be doing much for you." I told him not to blame them too much; that while my therapist was clueless, the psychiatrist was trying. I was the one at fault. He didn't say anything. He wanted to do a variety of blood work since I've been anemic for around two years
.
My blood tests showed that my electrolytes, while low, were still within normal limits, so I didn't have to go back on potassium. However, my continual anemia was much worse. He says that, plus excessive diarrhea, are probably the cause of my fatigue. He also thinks the malabsorption is responsible for some of my weight loss, which is logical. So I'm back on iron tablets for now (other stuff if it gets even worse again) and a med for intestinal trouble. He also thinks that one of the meds I take for my nausea from the chronic migraines could be causing the GI distress, so I had to go off that cold turkey. I sure hope something helps. I was nauseated all day without it, and had to dose myself with a migraine abortifacient twice today. Not pleasant--a painful day.

Otherwise, everything is fine. LOL. I know that all that was too much information, and not the most elevating of topics to boot (diarrhea), but if you want to know what poor nutrition will bring you, just look at my diet. I'll let Ice Queen, Karen, and Twix tell you about my hair, skin, and nails. What a mess.

Now for serious stuff.

An area I wanted to know more about was the constant mention of the relationship between obesity and cancer. I've known about the elevated risk in women for breast cancer for years, but was surprised at the constant reference to cancer as a generic disease as it relates to obesity in men and women. This is from Weight in America: etc.

"Overweight increases the risk of developing several types of cancer, including cancers of the colon, esophagus, gallbladder, kidney, liver, and prostate, as well as uterine. . . and postmenopausal breast cancer. Excessive weight gain during adult life increases the risk for several of these cancers.

. . .a gain of more than twenty pounds from age eighteen to midlife doubles a woman's risk of breast cancer, and even more modest weight gains are associated with increased risk. . . The IARC also asserted that obesity increases the risk of breast cancer in postmenopausal women by as much as 40%."

Other relative, but significant risks between obesity and cancer showed up in colorectal cancer among premenopausal women and all men; pancreatic cancer, especially those who had a tendency to gain abdominal weight, and AML (acute myelogenous leukemia). It's completely unknown how obesity would increase any risk, recurrence or mortality. Perhaps it's eating habits, such as a high-fat, high calorie, diet, or physical inactivity, that actually increase it. Thus one of the healthier obese people we've talked about, who eat a highly nutritious diet and are very active, wouldn't have the risk levels as the unhealthier ones.

One recent finding, off the subject, which has been intriguing me is the relationship between obesity and lack of sleep. It's felt that the hormone leptin, which regulates appetite, is reduced when there's a lack of sleep. Here are the stats: People who got less than four hours of sleep a night were 73% more likely to be obese. "People who averaged five hours of sleep had 50% greater risk, and those who got six hours had 23% greater risk of obesity." It doesn't hurt to get more sleep, and if there's the remote possibility that it can help dieters and maintainers to keep losing or maintaining, I think it's worth trying for. We all know the important role that sleep plays in memory, clarity of thought, alertness, and concentration. Isn't that enough to force us to go to bed earlier? (Apparently not. I never get enough sleep and my brain and memory can be quite fuzzy as a result.)

There's more, but I think you get the drift. Certainly some kinds of breast cancer are related to increased female hormones, which are elevated in obese women. But it doesn't say if the breast cancer they're talking about is estrogen/progesterone dependent or negative. Just as certainly, other environmental factors and genetic ones are at least as responsible for developing breast cancer as far as they know now. Since there are several different types of breast cancer, we can't make any leap until more information is gathered. However, it's a frightening and potentially lethal disease which we should try to avoid if at all possible. While lung cancer still beats breast cancer in mortality rates among women, that's primarily because lung cancer is deadlier at close to a 100% mortality rate, whereas breast cancer is around 50/50.

Let's be careful to recognize that these are statistical relationships only. No one is saying that obesity causes pancreatic cancer. However, the stats are highly correlated with each other, thus very much deserving of further inquiry.

Okay. I'm starting to get yet another migraine at this time of night--uncommon for me--so I'll sign off and just read. Eat nutritiously, sleep right, stick to your diet plans, and I'll see you tomorrow.

Quickie.

I see my FP today for a weigh in. He used to make me come once a month, but decided to let me go two months in between them. I've lost weight since I was last there. He will be displeased. The minimum he wants me at is 103 in clothes (100 naked at home). I got to that, totally freaked out, and began dieting to get it off, which I did. But now it's time to pay the piper. I just hope he doesn't make me start coming in once a month again.

I don't play any tricks with him. I could put heavy things in my bun (I have long hair), pockets, shoes, etc., and weigh in that way. I could drink a lot of water and hold my urine until after. I could do a number of things. But I don't with him. I could never disappoint him--he's the best doctor I've ever had, and he really cares about me. I can't lie to him, so I'll take it on the chin. We'll see what happens.

I got another book in the mail from Amazon yesterday. It's the one that was a penny plus shipping. It's in perfect condition, which I never expected. The title is Weight in America: Obesity, eating disorders, and other health related risks. It's full of graphs, charts, numbers, numbers, numbers, and statistics. I didn't expect that since it wasn't in the book description. I thought it would only be writing. But I've looked at the stats and think they'll be useful, so that's good.

I'm having some trouble at work with a coworker, as I may have mentioned before. I feel out of control over my job and whenever that happens, I don't eat in order to have control over something. I was very frank with him yesterday and the day before, and felt pretty good about it. I don't find it easy to confront people who are harming me, but I couldn't let it go. I doubt it'll work, but it helped me.

Okay. Time to go to work.

Ramblings.

I'm done with the Grilo book, Eating and Weight Disorders, and will be starting either The Body Betrayed, or Eating Disorders. I also ordered two more books from Amazon--one very expensive, and one only one cent, which kind of makes up for it--with good sections on obesity. In fact, one is only about obesity, I believe. I think I've discussed all that would be of interest to us in Eating and Weight Disorders.

I got a copy of last month's Scientific American magazine because the cover story was on obesity. There was nothing new in it except talking about support groups and behavioral psychology, most of which we know. With a third of Americans obese, they felt that the best way to attack the problem was with diet and nutritional therapy with a registered dietician (a multi-pronged approach), but with behavioral counseling, too. They stressed the importance of group therapy, however, which surprised me, and said that virtual group support was just as good as face-to-face group support. That's what our circle here is doing, IMO. We're all virtually supporting each other.

I don't know if they meant group support for all EDs or just obesity. I tend to think it would work well for anorexia, bulimia, binge eating disorder, EDNOS, and compulsive overeating, too. I know that when an anorexic is hospitalized, she's put into group therapy along with private sessions. That makes sense to me. I don't think group therapy is for everyone, nor for every psych problem, but I think it makes sense for EDs of all kinds.

I was really disappointed in the article because Scientific American is usually quite detailed about its cover story. It was only three pages long and mentioned genetics, neurotransmitters, and environment in passing. There wasn't any in-depth coverage or discussion of them. I expected more. I could have learned the same thing in Newsweek or Time, you know?

I hope Allan blogs more tomorrow. I like it when he does three entries. Guess I've gotten very spoiled! He's not blogging for us. I have to keep remembering that. He just didn't need to, or want to, do it three times today. But I sure miss it.

I'm up way too late this evening. I'll be sorry for it tomorrow, because I'll only get four hours sleep. Sleep tight. See you tomorrow.

Bariatric surgery.

I read about bariatric surgery today. The first surgeries for weight control in this country began in the early 1950's, with jejuno-colic bypass at the beginning, to jejuno-ileal (JI) bypass from 1954 through the 1970's. The initial surgeries worked through malabsorption. Many had to be redone due to the nutritional deficiences caused by the surgery. Along came refinements, and the Roux-en-Y gastric bypass (RYGB) was born. It and its variants are very successful, safe, and have fewer post-op complications. These surgeries are now done by laparoscopic surgery, vastly reducing recuperation, pain, complications, cost, scarring, etc. People return to their normal activities much sooner.

"Overall, studies generally report weight losses of roughly 40% of excess weight within six months of surgery with the maximum weight loss (roughly 50-60%) generally achieved by two years after surgery. In striking contrast to all other obesity treatments and weight loss methods, the weight loss produced by bariatric surgery is both substantial and highly durable over time."

Follow-ups at five and ten years post-op show around 50% are successfully maintained. That's incredibly impressive when compared to non-surgical weight loss methods. Patients have significant improvement or total resolution of co-morbidities such as diabetes, high blood lipids, hypertension, etc. The most interesting thing for insurance companies to get through their heads is that bariatric surgery for obese people saves huge amounts of money. There are "very substantial decreases" in long term health care costs of severely obese persons. There are also significant decreases in health care resource use, and morbidity, in those who have the surgery.

A megastudy which included 22,094 patients showed a complete resolution of diabetes in 76.8% of patients; hypertension completely resolved in 61.7%, and obstructive sleep apnea in 85.7%. It's interesting, however, that the improvement depended on the type of surgery in some obesity-related medical problems. "In particular, complete resolution of diabetes was observed as follows: 98.9% (for biliopancreatic diversion or duodenal switch), 83.7% (for gastric bypass), 71.6% (for gastroplasty, and 47.9% (for gastric banding)."

The RYGB had more weight loss and greater medical improvements than any other bariatric surgery. The "method is currently generally regarded as the 'gold standard' given its impressive clinical outcomes (weight loss plus broad improvements in co-morbidities) coupled with good safety record."

I didn't realize how different the results were among the various types of surgery, particularly percentage of weight lost. The band is the other one I have some idea about, since I've been reading a woman's website that's very well done. She didn't have all that much to lose, however, so it was a very good choice. You can eat a wider range of foods post-op with it than you can with RYGB, and the potential problems seem to be less severe, or more easily repaired, if you have them with either surgery. There's the whole filling thing to adjust the band to each user; I like that. But I also don't like that. In this woman's case, the port became displaced and is highly visible under her skin. As a matter of fact, they can erode the skin or stomach because they stay in. I doubt that happens much, though. Still, it's something to keep in mind.

This got me to thinking about under what circumstances I would choose bariatric surgery. At 200 lbs.? I don't think so. That's a low enough weight that I'd give dieting, therapy (cognitive, probably), exercise, etc., a good try or three. But 300? Now we're getting into serious weight. An RYGB is forever. I look at someone like Allan's success taking off nearly 200 lbs. and ask myself--do I have what it takes? Because all he's doing is following the bariatric surgery diet he'd have to follow anyway if he had the surgery. He's doing it without the surgery. It's such a marvelous decision (would I have thought of it?). . . However, it's truly not for everyone, nor even 10% of people. Will it have the same success rate as surgery, and for as long a time? It should about equal it, I think. Anyone can eat his/her way back up to 400 lbs. after surgery. Anyone. (Another thing I didn't know before I started reading about all this.) Surgery is (the cliche)--a TOOL. The patient did and does the work, just as if s/he was on a weight-loss diet, which s/he actually is.

My lovely friend here, who had RYGB done, was kind enough to explain her surgery and decision to have it in her blog. Now, having read her reasons, plus as much as I could about the surgeries, I think she made an excellent choice. I'm so happy the modern surgeries are available. I still think that researchers must get on board with finding a very safe drug to effect the same results. It's imperative, now that weight has become such an issue for so many people. Oddly, there are dozens and dozens of medications to help someone gain weight, some of them quite rapidly, such as the steroids and some of the older antidepressants (Elavil, in particular). Ain't that a kick in the head? Just what we need, eh? Not.

It won't help if you tell me it's a good thing that I gained weight. Really, it'll hurt--a lot. But I weighed 95.1 last Sunday, and 95.9 today, for a pound gained. All I can do is cut back this week and quit indulging myself. I should have known when I wasn't hungry all week that I was gaining. Too late now. I can only aim for next week.

Last night I asked DH what kind of bread he wanted me to make today, and he said he had a real craving for focaccia. That was about the last thing I wanted to make, but I did it, anyway. I had a piece and it was great. He'll take in the rest to work tomorrow.

I'm off to read now and decide what my menu is going to be this week. I have to lose this pound. It will be on my mind all week. Take care, people.

A sad, even scary, survey.

In 1961, researchers did a survey of societal stigma among a large group of children. They were to rate six things in order of desirability, from best to last. The things were: an average, normal person; an obese person; a person with a facial disfigurement; someone with only one hand; someone on crutches, and a person in a wheelchair. The order in which they were ranked by the children from best to last were: An average person; a person on crutches; someone in a wheelchair; a missing hand; a facial disfigurement, and finally, an obese person.

Children would rather be permanently disabled than obese, something which can be changed. In fact, they'd rather be facially disfigured than obese. These were remarkable findings, and the study became famous in sociology circles. The study was repeated with nearly 460 children in 2001, 40 years later.

Once again, they rated the average person as most desirable, but differed somewhat on the others. Second was a facial disfigurement; third, crutches; then a missing hand; a person in a wheelchair, and once again, someone obese was in last place. The results were surprising, in that a facial disfigurement, something permanent and highly visible, was rated as more desirable than being on crutches, which is temporary and heals itself. Obesity's scores were even lower than they'd been in 1961, while obesity itself had increased in numbers across the board, adults, teens and children--including those who participated in the survey!

Just when one would expect that negative feelings toward obesity should be dropping, it turned out that children had learned at a young age that it's worse to be fat than almost anything else. Even the obese children had internalized these negative images and outright hate of the obese, and were engaged in self-loathing.

This certainly must be worked on with people's kids, both at home and in school. Just as most intelligent people are doing with racism and other bigotry, we need to purge it from our country's culture of prejudice. We'll have the easiest time of it, as we do with any bias, by starting with children. But intelligent adults can change. We'll never get anything out of the stupid, so there's not much hope for them, but we haven't been able to change them about any prejudice they have. As far as I'm concerned, let them keep each other company. I have no need of them in my life. I have enough bright, funny, talented, and imaginative/creative friends. I don't need to waste time fooling around with morons.

So that's my rant for today. I apologize for disappearing for so long. Work just wore me out. No real excuse; that the explanation. I hope it gave you respite from my nonsense. :~)

See you tomorrow.

Nothing much to say.

I don't know if you remember or not, but I baked a loaf of Italian bread Sunday just to see how it would come out. It was braided, nicely browned, and covered with sesame seeds. I have a photo I'll put up once I get around to it. The flavor was exceptionally good. It's as light as a feather with a good texture. The crust is crispy but not thick. El husband said I could make it any time I feel like it and he'd be happy. His way of saying make it next week again.

Gained a pound since yesterday. See what I mean about drinking a glass of water and gaining weight? A pound or two, up or down, might just be an artifact of bladder or bowel activity, not fat mobility. Damn. I was so happy, too.

I'm having a good time reading NewMe's links to medically-based obesity websites. I got a little caught up in Dr. Sharma's and have to be careful about that, since I missed a class assignment because of it. Couldn't help myself. Once I start reading something interesting, I often can't stop.

He was talking about how the relationship between obesity and diseases which are commonly attributed to it isn't what common thinking says it is. He doesn't find obesity to be a cause of excess cardiac death, stroke, etc. I think he makes a point in some ways, and it's a theory I read many years ago in a good book on the fat pride movement. I agree that there's a healthier obese person and an unhealthier one. Certainly if you're obese and fit, and eat nutritious (but scrumptious) foods instead of crap, and have decent genes, you're in a whole lot better position than the person who doesn't exercise, goes to Taco Bell and whose parents died at 60 of diabetes complications. I disagree that there's no relationship other than a statistical one, however.

Obesity--even simple overweight--does indeed cause insulin resistance, and thus diabetes, which is an extremely serious disease. The thinking now is that while genes are part of the problem, most people have some point at which they'll become insulin resistant, even if it's farther down the road than others. To say that overweight doesn't cause it is simple denial. Many people who lose weight go back to a normal blood sugar without meds. They do have to eat a good diet and do have to exercise, but hell--we should all be doing that anyway. Unfortunately, the disease isn't always reversed that way. It's usually asymptomatic for several years before being discovered during a routine blood test, so it's worse than it might have been if one were getting regular checkups. (And seriously--who does that? Does insurance even pay for it?)

So to say there's not much evidence that obesity causes disease and early death is whistling in the dark. But it's not as though every obese person is going to drop dead in between dessert and the drive home. Not every smoker gets lung cancer and dies young. If they did, I sincerely doubt there'd be any smokers.

I'll have to keep reading his site, though. I didn't check his sources or citations, so right now I don't know how large the studies were, what the controls were, how the studies were designed, and all that jazz. If he has the evidence about things other than diabetes, I'm willing to change my mind or at least, follow his lead wherever it goes.

Here's the link to Sharma's website:  http://www.drsharma.ca/

I started a chapter in Grilo's book on bariatric surgery. I know extremely little about it, but want to learn. One thing I wonder is why someone would choose a Roux en Y over a band, or a sleeve, etc. Why a sleeve over a Roux en Y? I imagine that if one surgery were good for every patient, there wouldn't be so many different types.

I think the early bypasses, which worked strictly through malabsorption must have been grueling. I had a coworker who had one around 1978 or so, and he had a lot of complications. They finally had to go in and restore what they could. Several years later, he had another surgery--which kind, I don't know--and tolerated that one well. To the best of my knowledge, he had no problems and is still maintaining his weight.

A relative by marriage had her stomach stapled--remember that procedure?--and it helped, but she had to have the staples removed. Or, it could be that they're supposed to be removed after a certain period of time? See, I know nothing whatsoever.

I'm going to try to discuss the surgeries next time, as long as I get my reading done. I can't believe that I've heard people say that surgery is the easy way out. OMG, it seems to be far more difficult than any other way! Must be ignorance, that's all.

Anyway, that's for next time. Take care and sleep tight.

Interesting development of obesity.

There was a violent wind and rainstorm last night, so I was reading by candlelight. I love to do that, even though it causes eyestrain for me. It makes whatever you're reading more interesting. Seriously--candlelight makes you focus on the words more.

It was Grilo's Eating and Weight Disorders. He has some charts which show things like personality traits, common environmental factors, etc., where the research points to reasons for obesity's development. One is like a genealogy chart that goes step-by-step up a ladder: social and cultural factors; unhealthy dieting or weight control; psychological vulnerability; personality-tempermental vulnerability; personality-tempermental genes; obesity genes (vulnerability for bulimia nervosa), and finally, full-blown BN. It's interesting to me that he sees obesity as a stop on the way to mental illness, since he writes that obesity is primarily a physical illness, not a mental illness, whereas the reverse is true for BN.

Take the same chart to the personality-tempermental genes, then follow it with AN genes, rather than obesity genes, and you end up with full-blown AN. He writes that studies on the personality of BN sufferers shows "novelty seeking and impulsivity," while those with AN show "obsessiveness, inflexibility, perfectionism and harm avoidance." He says that the differences "converge with findings from molecular genetic research suggesting AN and BN [thus obesity] have distinctly different underlying biological (genetic) vulnerabilities."

Hmm. . . . There, I disagree. Why? All of the other research I've read says that the commonest mechanism leading to AN is the pursuit of weight loss on a reduction diet by an overweight or obese person, generally at a young age, but not always. Furthermore, about half of anorexics use binge-purge methods for weight loss in addition to restriction, thus overlapping with BN. The EDs are too close to have different genetic causes on a molecular level, IMO. Besides, our knowledge of molecular biology in this field--in almost any field--is in its infancy. Yes, we know lots, but to base hardcore theories of something as complex as obesity--and it's extremely complex--on it, is unwise. Again, IMO.

I won't rule it out, though, until I've read more about it. This will require a lot of digging. My training is in research, not psychology or medicine or biology. I say that to you guys, but not often enough. i should put up a notice here, and will.

But what do you think on this subject? 

Today is weigh-in Sunday. I'm going to participate from now on, or until I get too embarrassed and stop. This morning, with underwear and slippers, 95.1 pounds. I normally round up, and don't include tenths of a pound, because a glass of water or taking a piss can change that. But I want to join the crew properly. (You realize that Allan has shit out nearly two of me? lol.)

I have a braid of Italian bread dough rising now. Off to take a shower and wash my hair, then bake the bread. I hope it doesn't come out a rock-like mess like last time I made it--which was 30 years ago. I've topped the braid with sesame seeds, so it'll be pretty to look at, even if it turns out to be an inedible brick.

Two new books on EDs.

Can't keep my mind off obesity/EDs, food, eating, etc., and our blogs. Even at work, my mind wanders to blogspot, wondering if there are new posts. The self-revelatory entry I made is still up, and I decided this morning to stay brave and keep it up for a variety of reasons. The biggest one is your comments. They're beautiful, and I'll return to them when I need to read them. Thanks, guys, again.

I was crazily antsy about getting some more ED books, and studied Amazon for an hour or two trying to decide what to get. I already have one that I haven't blogged about yet, even though I've finished reading it, so I didn't need any, but chose two. They were just delivered ten minutes ago.

The first was two cents, plus $3.99 s/h. It's in nearly brand-new condition, too. I've decided not to get anything older than 2005 since there's so much new science in the field. If there's something good on the philosophy, politics, etc., I don't care if it's older, but science changes too rapidly to stick with old stuff.

Anyway, the first one is called, The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment, by Kathryn J. Zerbe, M.D. You'll notice that I emphasize women in my blog. Part of it is that I'm a woman and understand women's problems better. Another part is that all of the EDs, even obesity, have more women in them than men, although obesity is almost half-and-half. But the biggest part is that women comment here, and I think Allan is my only male reader. He's never sexist in his blog--he blogs for everyone. I started out that way, but until I get some male readers, it'll probably stay geared to women.

Zerbe is a staff psychiatrist at the Menninger Clinic, among other things. In addition to basic principles involving EDs, she's written chapters on "the impact of sexual and physical abuse, the relationship between eating disorders and chemical dependency, medical complications, the biology of nutrition, pregnancy, athletics...and much more." It sounded good, and like I said was only two cents. Couldn't pass it up.

The second one is the one I've been eagerly anticipating. It was recommended by Amazon itself based on my reading habits. Eating Disorders, by Pamela K. Keel. I paid a small fortune for it, and it's a skinny book, completely the opposite of the other one. But it looks well worth it. It's brand new, not second-hand, and is used as a graduate level college textbook, which explains its price ($30+!!). Just opened it and it went right to a page talking about "forbidden" foods and weight maintenance. It's discussing how it's probably easier to avoid whole groups of foods, such as desserts, than it is to eat them in moderation; that moderation may not be possible for those with an ED. I notice in several of the blogs I read regularly, particularly AGB, that's the thinking. Just don't eat the thin sliver of cheesecake to begin with, and you won't then eat the whole damn thing later that evening when you're alone. Makes sense to me, although many times I'm able to stop after that first bite. (Other times, not, which incites terrible fear; panic, actually. I want to run and run and run 'til I collapse.)

I'll be starting on the second book tonight: Eating and Weight Disorders, by Carlos M. Grilo. I have Post-Its stuck all through it to talk about. You poor people--more research papers. Well, no other blog I've been reading routinely addresses this stuff, so I guess I've found my niche.

Hope to see you later.

This anorexia episode.

I've had an ED all my life, since as far back as I can remember. Looking at photos from childhood, and medical height/weight measurements on report cards, I don't show any signs of overweight until I was 9 years old, when I was put on a low-calorie diet (inappropriately) by my mother. It was 1000-1200 calories a day with no change in eating habits and no increase in motion, although I was a pretty active kid. Placing a child on a calorie count like that is dangerous and would never be done today. She didn't know what she was doing, however, so she's excused.

She controlled my eating and weight, and my sister's, as long as I lived at home. She'd put me on a diet, then at some point say I was too skinny and force feed me, then say I was too fat and put me on a diet, again and again for a decade. By the way, I never reached that elusive "correct" weight. In her mind, it was always one or the other, fat or thin. There was never a day that went by that my eating was natural, happy, or otherwise uncontrolled. I was allowed no money, not even as a gift, so I couldn't buy any food if I was very hungry. I couldn't NOT drink her weight gain milkshake concoctions because my father would hold me down and she'd pour it into my mouth. It was easier to swallow than to choke and vomit, so after a while I simply acquiesced and didn't have to be held down anymore.

A little on the sick side? You bet. She was never in her right mind, and remains fucked up even today. During every phone call, she asks me how much I weigh. I lie. She then tells me the details of every meal she had during the intervening days between calls. Every meal, one by one. She's obese. Food is her life. She always talks about how little she eats, which is delusional. Obviously, she has a major ED, so it isn't any wonder my sister and I have them.

This episode of anorexia started, as is common, with a simple weight reduction diet. Probably people with a history of anorexia, or any ED, should only diet under medical supervision. I figured that at my age, there was nothing to worry about. I had to lose about 10 pounds, to get to 145, but wanted to lose 25, to get to 130. I lost exactly 60 in seven months. That's quite a feat when you're starting at 155, because the closer you are to normal weight, the more slowly you lose, as you know.

I've regained three pounds, up to 98 pounds. I'm now dieting to lose them as quickly as possible and get to 88 pounds. There. I've said it. It's out there. I don't want recovery. I want to be thin. I'm sure you can't imagine how fat I feel--immense. I feel as though I didn't even lose one ounce, and that's the truth. As I sit here, I can feel the masses of fat in my butt, waist, thighs, chin, everywhere. I can't stand to be this heavy. It's uncomfortable and makes it difficult to fit into bathroom stalls.

I sincerely believe I don't have AN. By my weight, regardless of how fat I feel, I should be thin, but I refuse to accept a diagnosis of AN. Some part of me accepts that I have an ED of some kind, but not anorexia. No way.

I decided to come clean in this post because of something PrincessDieter said in a comment. I talked about how open and brave Allan is on Almost Gastric Bypass. She basically wrote that we should all be that way, and that she'd broken herself of her fear to post photos, etc. I'll have to get a photo of myself at some point--just bought a cheap camera to do that. I owe a couple of people photos of me; thus I may as well put one up here.

So that's it. I might have to delete this at some point, but not tonight. Tonight it stays up.

Now for sure we're all in this together.

Almost Gastric Bypass, Part two.

I am no expert on how to get leaner, healthier, thinner or how to maintain a weight loss. I am an expert on how to get Fat.

Today, Allan published a photo of himself in which he weighed between 450-480 pounds. Let's be honest--it's unattractive. Very. I think I see desperation in his eyes, whereas the photo taken this morning, 180 pounds thinner, is just as attractive as the other is bad. There's a big smile on his face, too, and that bloom comes from within. He deserves our pride in him for such hard work and determination in fighting this ugly disease. It kills.

If you don't want to become a cardiac patient, go blind (or into kidney failure or get your leg amputated, etc.) from diabetes, get breast cancer, or any number of life-threatening or misery-inducing conditions, you have to lose weight. It's a simple as that. Make sure you don't go too far in the other direction, since it's even deadlier than obesity. The aim here is normal--normal as in waist measurement in conjunction with BMI. Yes, I'm a BMI believer. I've noticed that nearly all of the people who say it's inaccurate are overweight. If you're reading this, trust me: you're not a professional athlete. For us average folks, the BMI is a good, general indicator of where they stand on the anorexia to obesity scale. It's not the be-all, end-all, definition of weight. But it gives you a damn good idea.

450 - 480 pounds on me was not pretty, not healthy, and not something I wish on anyone. I could not breath well, I could not walk a block, let alone a mile. I was not happy, I ate whatever I wanted and whenever I wanted to. When I say I know how to be obese, I am not kidding around. When I talk about the plan I am on now, and how it has changed my life, believe that it has.

Doesn't that describe some of the suffering a morbidly obese person has during the tasks of everyday living? There comes a point when even walking is such a strain, movement is nearly impossible. The joy is stripped from life.

Most people don't get up in the morning thinking about what they're going to get to eat for supper. They don't think of food during every free minute of the day. They don't often dream of eating. Unless they're on a weight-loss diet, which makes you hungry, or you have an eating disorder, they aren't preoccupied with food. I think about food all the time. The menu, buying it, preparing it, and eating it. If I have a break at work, I think about eating something. If my mind wanders, it wanders to food. I wonder if I'll be able to squeeze lunch in today. A typical anorexic's daily intake is: take an apple, cut it into eight slices. Eat one slice for each meal, and five snacks. Eat as slowly as possible. That's it. Of course, bouillon accompanies it in winter (14 calories a cube), and water or diet soda in summer. There are bigger meals, but you get my drift. That's an ED, as is obesity. You'd better believe that I'm looking forward to that next slice of apple.

I have read alot of your blogs. I have read about the failures and the success, and I comment on my blog as I see fit. I have been picked on, ridiculed and laughed at. I have done nothing earth shattering except I eat less and move more. I can not run 5 miles, but I can walk/jog them without dying. I can walk from Penn Station to my office and back and enjoy it. I can grab little Al with two hands and take aim at any toilet I want to, or tree for that matter, and see his happy face without having to move a layer of belly. I can wipe my own ass without fear of missing a thing. I can sleep in my own bed without fear of not waking up from Apnea. I am not an authority on how to lose weight, but I am trying. If you want to come at me because I am a bully, then you are not reading with the back story told. I will never bully someone that is weak, or attempting to better themselves. I will always help that person. On the other hand, write a blog that comes off as a knowledge center, while you carry 200 pounds of excess shit on your body will cause me to jump ugly. Better yet, why aren't the rest of you crazed from diet advice from people that are obese?

How his life has changed! Simple, everyday tasks are manageable, like taking a piss. Can you imagine the joy it must bring? I'm sure Little Al is entertaining himself mightily, too.

The courage he showed by publishing the Big Al photo this morning is staggering. Very few of us have the stones to put it all out there. He does. While we're all affected to one degree or another by other people, his self-esteem comes from within and the opinions of people he trusts, not strangers on public blogs. We won't all get there. We don't even have to try. But it demonstrates what being a new, different person physically can do for your mental and emotional health. It's wonderful, and delightful to witness. I only hope that he considers continuing his blog once he's at maintenance level. That's a tougher row to hoe than losing the weight, actually. Once again, he blogs for himself, but he'd bring so many along with him that it would be a boon. We'll see what he does.

I'm asking you to buck up your determination, to follow the path to health, to live longer. I'm asking you to be honest, open, and even brave. I'm going to do my very best to do that. I think it helps others in the same boat, and that it can help the blog writer him/herself.

If you're still following along, I hope I haven't ranted too much here. That wasn't my original intent. We're all in this together, fat or thin, because we all have an eating disorder (or three). Let's learn more from each other, and maybe save some lives in the process.

Almost Gastric Bypass--Part one.

Ice Queen, of Fat Like Me, is a friend of mine from another board. When she gave me the URL of her blog, I began reading. On her blog roll was a place called Almost Gastric Bypass, written and edited by Allan Klein. http://almostgastricbypass2.blogspot.com/

Reading his entry of that day led me to older posts, which in turn made me read all the way back to the blog's beginnings. Then I read blogs on his blog roll. I was hooked, and that's how I got started with my little blog.

Allan's entry today piqued my thoughts, so I'm writing about it. Oh, I also want to give you some idea of his personality, but you'll do much better just to read his writing. He's extremely smart, as well as clever; wickedly funny; can rant like a Hyde Park speaker; generous to a fault; gentle as a kitten and as biting as a goose; loyal to an extreme, perhaps, but someone a friend could forever count on . . . I could go on. He's been called a lot of things besides those, primarily the word "bully," due to his no-nonsense, no bullshit, way of seeing things. He brooks no lies nor denial. I like this guy, and think it would be quite something to know him in real life.

Today is almost precisely one year since he began a low-calorie diet. He weighed somewhere around 480 when he started, and has lost 180 pounds this year. Yes, you read that right--nearly 200 pounds in one year. Breathtaking, isn't it? The diet comes from medical professionals with whom he works closely, and is the old standard: move more, eat less. He has many readers, but about 50 people (many dropped out) are following the plan with him in a major Challenge.

He has always insisted that he blogs for himself, and himself alone. However, he's a natural leader who inspires trust and motivates others to lose weight. All of the people are obese--many are morbidly so--but they're losing weight by leaps and bounds alongside him. It's magnificent to watch. He's done more for more people in this past year than most of us will do for others in a lifetime. The diet plan is literally saving lives.

He uses the metaphor of cancer to describe his morbid obesity. He says he has fat cancer. He watched his wife go through a cancer cure and knows what treatment entails. He knows he'll never be "normal"--that he'll always have to carefully self-monitor his food intake--and will never be able just to eat when hungry. That's because in his case, hunger can mean anything, rather than purely physical hunger. The signals got mixed up somewhere along the line (my vote is primarily genetic, with a very large dose of environment/behavior thrown in). He's willing to do that in order to live. He's in his mid-40s. At that age, and 200 pounds ago, he probably didn't have much longer to live.

Okay. That is a light overview of what he and AGB are about. The next entry will be a riff on his post today.

A new ED book, March 14, Part 2.

I ordered a new ED book from Amazon and it just came in. It's part of a modular course in clinical psychology, Eating and Weight Disorders, by Carlos M. Grilo. The first chapter has a macabre sense of humor: "Overview of eating and weight disorders: Bodies to die for."

It emphasizes obesity, anorexia nervosa, bulimia nervosa, and binge eating disorder.

The book was published in 2005. One statistic throws me for a loop. He writes that statistics show that roughly 25% of children between 6 and 11 years old, and adolescents aged 12 to 18 years old, are obese. I was shocked by that number. He didn't say overweight--he said obese. Wow. If you add overweight to that, I'll bet it's more than half of all kids between 6 and 18 need to lose weight. Does that surprise you as much as it surprises me? I've read in popular magazines, such as Newsweek and Time, that the number of obese kids is close to a third, not a quarter. Can this be true? If you add overweight kids into it, then we're definitely looking at greater than half of them needing to take off a lot of pounds. If we don't intervene while they're young, I think we're setting them on the path to a truly unhealthy--and unhappy--adulthood. 

But I'm more worried about adults, frankly. They're at higher risk for heart attacks, strokes, diabetes, joint damage, breast cancer, liver problems--you name it--because they've had the problem so much longer. Isabelle Caro, the famous anorexic who posed nude for the billboard attacking the fashion industry's promotion of unhealthy weights for women, died of her AN, just as she was beginning to think seriously about recovery. She'd come to realize that she really had a disease, and she needed treatment to cure it. But she'd been anorexic too long. Her muscles were wasted; her heart, damaged. It couldn't hold out, nor could her other organs, and she died of unknown causes at age 28 this past November. Essentially, she died because her body failed. She was 13 when her anorexia started, which means it took 15 years to kill her. How many years does it take to kill an obese person? It can happen rapidly, suddenly, over years, or in a slow death. But we do know that, just as in AN, the longer one is obese, the more dangerous it is. And death will happen.

I have my fingers crossed every day that my friends here and on Allan's blog have success with their weight loss plans, whether in the Challenge or using another method. I also hope that those of you who've reached a healthy weight stay there. Yes, it's hard. However, Ice Queen has a design to the right of her blog's name, which reads: Losing Weight is Hard. Being Obese is Hard. Choose Your Hard.

There's no debating that.

Just a quickie--blog entry 1 for March 14.

I've been meaning to post twice a day lately, but haven't gotten around to it. I will today. This blog keeps me sane. How odd that is. Is it the same for any of you? Some of you have written words to that effect, also how your blogs keep you on track with food.

My dear husband brought home a huge apple coffee cake yesterday. I ate a third of it, then had no supper. Aside from not taking in one bit of healthful nutrients, I felt like a thresher shark eating all that shit. I also had a piece of bread for breakfast. It was a starch festival. This morning, my waistband on my jeans was too tight. I don't think you can gain weight overnight, and certainly not on 2,000 calories when a normal person needs that to maintain their weight. But I feel as though I did, or at least am bloated up from it. Ugh. I'll make up for it over the next few days--also not a healthy thing to do.

I usually hate blogging about my personal eating, because I think it's of no interest at all to you. But I want to have a record of this in writing so that I don't forget. He wants me to gain weight, and knows that I've been craving sweets, so I swear he brought it home to sabotage me. That sounds awful, but I think it's true. I won't touch any of it today. If he doesn't finish it today, or at least put a big dent in it, I'm tossing it tonight.

I might delete this post. It's too boring. See you later, and have a good day, people.

Obesity is an eating disorder.

Ice Queen commented on one of my recent blog entries. The whole comment was good, but this part hit me like a brick:

"If the eating patterns that get a keep a person obese isn't disordered eating, I don't know what is."

Truer words were never spoken. There's great pleasure in eating, no doubt about it. But that's not why people become nor remain obese. Fundamentally, it's a highly unhealthy relationship with food. What most people don't know is that the painful feelings due to hunger can sometimes be pleasurable to an anorexic. Yes, sounds crazy, but anorexics aren't normal. There's a high to it. When we're dying of hunger, it means we're losing weight. That makes us happy. When we're dying of hunger and don't eat, we're showing we can control the most basic of desires a human can have. That means strength and control to us--a control we have nowhere else in our lives. I suspect that at least some of the time, it's as pleasurable as eating is to an obese person. But that's not why we become anorexic. It's disordered eating, just as it is for the obese.

That's why I insist that obesity is an ED.

It's also been shown that obesity frequently has crossover with the other EDs. As in anorexia, an obese person often feels she's not in control of large parts of her life. She can eat to comfort herself for that anger. They often binge; in fact, I'd say they all binge. That gives them Binge Eating Disorder. Not all purge, but a number do, making them bulimic, too. Binges are definitely self-medication. Compulsive Overeating Disorder is a frequent addition to obesity. I can't imagine that any obese person doesn't have COD. In fact, other than the anorexics, the people at OA meetings all discuss their COD.

So why isn't obesity termed an ED? I think it's because even today, not to mention two hundred years ago, it was seen as a moral failing by lay people (and was by medical and religious people, too), not as a mental illness. The obese are still seen as weak, lacking in self-control, normal but lacking in basic character, etc. I've known people--my therapist is one of them--who see anorexia that way, but nearly all people in the mental health field disagree. I'm seeing the tide turn with obesity in modern medical research of obesity. It's a physical, mental, and emotional illness, with genetic, neurological, and psychological aspects. There's no moral component whatsoever. As several of my blog entries have addressed, obese people are practically hated. It's crazy. I have some ideas about why that's so, and will probably post about that again later.

When reading so many of the weight loss blogs, if you do as I do, you'll see the bingers are everywhere. A few are bulimics and should be receiving medical care for that in rather than, or in addiction to, obesity, IMO. COD is rampant. That should be treated, too, or else the obesity will persist--once again, IMO. Oh, anorexics binge, too, but on a much lesser scale. A binge for an anorexic can be as little as 500 calories, or as much as 1,500 calories, nothing like the tens of thousands an obese or bulimic person will eat. Since a "regular" obese person won't purge, and obese people have more efficient digestive powers, that adds weight quickly. Bulimics tend to gain more slowly, and their binge/purge cycles are a little different. They can easily binge/purge a dozen times in one day, something an obese person will almost never do.

I know this is rambling all over the place and apologize for that. But one thing leads to another. What I'm essentially trying to emphasize is how much of obesity is wrapped up in the other EDs--so much so that ignoring that is a disservice to the obese, and why I think it's so difficult to treat.

You know, I haven't talked about people who are overweight in this blog, and only rarely mentioned them. I'll get to them in the future. I just want you to know that I'm always aware of them, and not ignoring their problems. Obesity and anorexia are life-threatening, however, so while the problems of the overweight are important, they're not dire. Anorexics have the highest death rate of all the EDs, but obesity isn't too far behind. They must come first.

As I wrote initially, I think we're all in this together: the obese; anorexics; those with BED, COD, bulimia, etc.; and all of the EDs. We have to band together and force the medical experts to see that obesity is treated the same way as the other EDs. We have to educate laypeople to understand that obesity isn't something to be hated, feared, or its victims to be seen in a terribly negative light. We really have to make laypeople--especially young women--not see anorexia as something desirable, a choice, and something to be aimed for.

Obesity is a sign of disordered eating, an unhealthy relationship with food--an ED. For real. It's not a choice. No one ever decided at age 5 to be obese. No one binges in an out-of-control way in order to get to 350 pounds. No one joins an obesity blog ring to get tips on how to gain weight. (Anorexia websites are filled with such people, as sick as that is, although it comes from pure ignorance.)

Fat is not disgusting. Thinness is not desirable. Normal is the thing to aim for. For the average person, that's a normal BMI. At 5'4", my range is 108 to 145 pounds, a very wide range. It's not 88 pounds, which is what I want to weigh right now. Oh, and when I get to 88, I'll want to weigh 85 or 83--that's the nature of anorexia. I don't want to die, just as an obese person doesn't want to die. Death is irrelevant in these diseases until the desire for health steps in and says, "No more. I'm getting off this road to death right now." Then, and only then, can recovery occur.

I hope I haven't bored you here, but this is very important to me, that the obese and those who are traditionally determined to have EDs get together and fight these diseases.

What do you think about this? I'm really interested in what you have to say.

Fat kills.

Allan K. talked about fearing a stroke or heart attack as his motivation for finally getting to a healthy weight and saving his life. This inspired me to write something about an old friend, Doobs, who died about 25 years ago.

Doobs was always obese, even as a little kid. So was his sister, and his mother was overweight. His father had been obese, and died young of a heart attack, leaving his mother a young widow with two small children. Doobs was thus pushed into the role of little man while still a kid.

His mother obviously had some sort of ED and stuffed her kids and any of their friends who came over. She was one of those crazy Catholics with pictures of the Sacred Heart of Jesus hanging around the house--you know the one with thorns around his ex-corporeal heart, dripping with blood, even one hanging in the kitchen. It didn't promote appetite in me, that's for sure.

Here I'm not kidding: a serving of mashed potatoes was a huge soup bowl piled high with about six or seven regular-sized servings in it, and cream poured on top! On the dinner plate was a whole chicken for each person, smothered in gravy. There were no vegetables unless it was something starchy like baked beans or corn served in another soup bowl, but there were several pieces of bread for everyone at each place setting. Binks put away the whole thing, thousands of calories, and that was just for supper. I believe she pushed food as a way of making up for a deprived life and as a means of control. She didn't allow her kids to do anything, and chose all of their friends. Yeah, she was nuts.

As an adult, he and his buddy often came to visit me. I had a set of those 50's chrome-legged table and chairs, and it wasn't meant to hold a 500-lb. guy. When he sat in it, the legs splayed out and the chair cracked in two, sending him to the ground. He didn't even blush, which I found odd, because I would have been humiliated. He was angry I had such cheap furniture. That week, I went out and bought a sturdy, solid-oak chair with upholstered padding, pretty expensive, which I was sure would hold his weight. It was over-sized, but it fit perfectly at the table. When he visited that weekend, I told him he had a new chair. He was insulted, and said he wouldn't sit in it. He sat in one of the set's chairs, and the same thing happened. Now I was down two chairs. I didn't have much money at the time, since I was unemployed and living on savings, but I went out and bought a whole new kitchen set so he wouldn't feel "different" from everyone else, but would stop breaking my furniture. That seemed to settle him and it worked.

Now I believe he had a small stroke when he was 24 or so. He'd been driving down the road and blacked out. When he came to, the car had hit a railing on the road, and while the car wasn't too bad, he'd hit his head against the steering wheel. He began having severe headaches and started missing time--short periods were bleeped out of his memory. He saw no specialist, just a very bad family doctor, who said it was a result of his hitting his head. But what had caused the black-out, I wondered? The doc was an idiot, and never investigated that.

He'd had trouble finding girlfriends, but when he moved to Florida after finding a job as a motel manager, he fell in love and married a lovely woman. They had a baby after they'd been married a year or so. Within  two weeks of his son's birth, he was dead of a heart attack, age 32, almost a duplicate of his father's death. When the autopsy was done, his heart was covered in fat, as were his internal organs, and his coronary arteries were closed due to cholesterol deposits. It had only been a matter of time.

He died of obesity, without experiencing the joy that many years of marriage can bring a man. His son never had a father.

His life was one of emotional deprivation, and his death was unnecessary. I will say this: he never tried to lose weight in all the years I knew him. I believe now that the thought simply terrified him, whether it was the fear of hunger, failure, or losing his protective layer of fat. While I knew on some level it was inevitable, it still took me quite a while to come to terms with his passing.

Make no mistake--obesity kills, and it often kills young. Whether the death is slow or rapid, it still kills. Please, please, get healthy before it's too late. People love you. People will never, ever, get over your death. You're not the only one losing your life. Those who love you lose a piece of their lives, too. Do it now.

Food addiction doesn't exist.

There. I said it. Food addiction doesn't exist in the real meaning of the word "addiction." However, if by addiction you mean behavioral addiction--a series of obsessions which lead to the compulsion to eat--then I agree it does. Confusing? Let's look at the word more closely.

I will be addressing weight reduction through diet, not surgery. I believe there are very real differences between the two such that they can't be addressed here, and I'm not educated in bariatric surgery, only what I'm going to write about today.

Traditionally, "addiction" means a physical dependence on something, most likely a drug such as opiates (morphine, methadone, heroin, codiene, etc.); nicotine; alcohol, etc. These are drugs which cross the blood-brain barrier and have a direct action on the brain. For instance, our brains secrete naturally-occurring painkillers and pleasure-giving substances called endorphins. They fit into places in the brain precisely, like a key is meant to fit into a specific lock. There are some drugs, however, which fit even better than endorphins, and the opiates are one of them. When introduced to the brain, they will sort of push the endorphins out of their home and take their place. Their key fits the lock better than the brain's own key does.

Opiates come in various strengths, with Dilaudid one of the strongest man-made drugs, and heroin one of the strongest "natural" opiates. (Actually, heroin doesn't exist in nature. It's created from morphine, but it isn't a completely lab-based drug such as Dilaudid is.) These drugs cause physical addiction, substance tolerance and behavioral (psychological) addiction. Withdrawal from them has consistent symptoms in everyone who does, including sometimes great physical pain and/or other mild-to-severe physical problems. Sometimes medications are given over a limited period of time to mitigate these difficult to tolerate symptoms. The goal is to never use the addictive substance again for the rest of the patient's natural life. Tolerance to certain drugs, such as nicotine, is never lost.

The second meaning of the word addiction is a tolerance which is built up over time. This is commonly called substance dependence. Many medical researchers argue that this is not true addiction, for a variety of reasons. It refers to a person's unwillingness to withdraw from the drug and while a physical tolerance is built up, that tolerance is lost when the drug is discontinued. This class of drugs includes cocaine, marijuana, hallucinogens such as LSD, mushrooms, and others. They are so pleasurable that the user finds it difficult to give them up. While there are some physical symptoms across the board on withdrawal, they aren't usually severe and can vary from person to person. The biggest symptoms are psychological, and they can be quite severe. Because of the strong psychological component, treatment must address mental problems and use therapy as part of the treatment, although it's often for a short duration, depending on the school of thought.

The user can't use the drug again or tolerance will again be built up and the behavioral components re-established almost immediately.

All of the drugs which cause physical addiction also cause substance tolerance. It's complicated, and I can't get into it here, but there are academically-vetted sources of information available (not Yahoo or Wikipedia) on the web. Try the Mayo Clinic, National Institutes of Health/Mental Health, etc.

Finally, there is "behavioral addiction." This is where the layperson's use of the term food addict comes in. Tolerance is not built. A food addict doesn't need increased amounts of food weekly or every two weeks in order to get the same high. As they age and get less physically active due to the limiting effects of obesity itself, they will gain weight. However, that is not usually due to greatly increased tolerance. Users don't have across-the-board symptoms on reduction of food intake, although hunger is always a component of it, and is decidedly unpleasant. However, reduced calories do not cause physical pain, nor muscle spasms, heavy mucous production, inability to sleep, terrifying dreams, or death. (Withdrawal from some drugs, such as the barbiturates, is life-threatening and is often done in a hospital.) There is no physical dependence.

Constant thoughts and dreams of food occur nearly 100% of the time. The person will often be restless, weep, and withdrawal can cause a true depression in a person who is already at risk. Fatigue and weakness may occur, but usually not if calories are kept at a moderate level such as 1100 or above, which prevents muscle deterioration and stripping of muscle tissue by the body to use as calories. Calorie reduction below 1000 over a significant period of time can do that. What is significant? At least a month, but the semi-starvation diets of 500 calories a day are always done under medical supervision and may last longer.

Because food addiction is obsessional and compulsive, and nearly always contains a component of Binge Eating Disorder (BED), the person will often find it difficult to maintain a diet unless cognitive therapy or other specialized therapy addresses the behavior. Some obese individuals have flat-out OCD, but the majority do not.

Summing up this part, we see three types of addiction. Physical, which also has substance dependence and behavioral components; substance dependence, which also has behavioral aspects; and behavior addiction, which has neither of the other two. That's why I say that food addiction doesn't exist, since the primary meaning of the term (medically) and tightest definition, oldest definition, and most accurate definition of the word addiction doesn't apply to food.

The reason why I bring this up today is because I read a blog yesterday where the blogger was insisting that the reason why s/he had a more difficult time losing weight than other people was because s/he was a food addict. It irritates me when someone cops a plea like that to excuse his/her unwillingness to dedicate him/herself to getting healthy by losing weight. No one is commited to getting unhealthy, or if already in bad health, to getting worse. Even suicidal people aren't addicted to it, if you want to say the food addiction is someone's way of commiting slow suicide. There are real addicts fighting even as we speak, who are dedicating today to suffering through severe physical side effects in order to get well. To say that losing weight is akin to their struggles disrepects their hard work and suffering. It also disrespects those who are struggling mightly to lose weight without pleas for extra sympathy due to their addiction problem. Yes, food addiction does exist, but again--only in the layman's definition of addiction, or when talking about the very real problem of behavioral addiction.

I'd like to see the term food addiction thrown out and something more accurate put in its place. Just the psych term behavioral addiction? Food dependence? Eating disorder? (My favorite, and one which I believe in completely.) Food mental illness? There are many things we could think up for this, sex addiction, computer addiction, and other such "addictions" which wouldn't cloud the medical definition of addiction.

I didn't write this to hurt anyone's feelings or to mock anyone. I wrote it to praise those who don't excuse their behavior because of their addiction. I wrote it to stop watering down the definitions of addict and addiction. Those words should be reserved for their traditional meanings. I admire the English language, too. But not as much as I admire the people in the Challenge, those who've successfully gone through and live with bariatric surgery, people who are devoted to getting healthy and having some control over their lives of an important aspect in it, and more.

I know I'll piss some people off, but I want them to do their own research and think a little about what they're saying and why they're saying it. I'll say it again: Food addiction doesn't exist, and yes food addiction does, but not in those words. Let's agree to disagree if you don't find that scientifically accurate, because after my research, I'm not about to change my mind.

Quick apology

Guys, I've been sick, so I haven't been able to post a few new things I found. It's not something I like to do--skip a day's writing--but I'll catch up tomorrow. I'll answer all of your excellent comments that you made on the last blog entry, too. Great stuff.

I also have to catch up on your blogs. I hate to miss anything you write about, because it's always so damn good. But I'll see you tomorrow.

A helping hand or not?

Sometimes, what looks like a helping hand is really a reaching out for help. Let's say that you see someone in need. They're in need of emotional support, love, a feeling that they're worth something, the strong need to not be alone, and so forth. So you reach toward them in order to help ease their pain. But it doesn't stop after a few times. A symbiotic relationship is set up, almost a parasitical living system. The helper feels terrific for doing a good deed, and the one who needs help, now has someone who cares enough about her that the helper will give up time and emotion, even food and money, to rescue the desperate one.

In the case of eating disorders, there's almost always going to be falling off the wagon by a dieter. She'll cry out for help. The readers will tell her she's a good person, don't hate yourself, everyone needs to break a diet now and again, get back on the wagon and start over. All very natural--the first two or three times. But with someone who's not invested in losing weight, the situation of need, rather than the weight loss, is what's wanted. So she reaches out continually. One by one supporters drop off, realizing that this is some sort of game the dieter is playing. Eventually, all who are left are those who play the game themselves. They are a living organism of pretty much eating whatever they want to, being "forgiven," and talking about how in the future--they'll name a date several days or weeks in the future--when they'll start the diet again. And the cycle repeats itself.

This thinking was triggered by one blogger in particular, but I've been reading a lot on the obesity ring and see that the game has other players. About a third of the bloggers on dieting aren't dieting to lose weight at all. They want to, but they won't do the real work it demands. Pleasure trumps health. Even when someone has had brushes with death, there's no change in behavior. It's baffling and irritating and sad, all at the same time.

The helpers are helping the dieter to kill herself out of their own need to be heroes. They also need to feel superior. Sound ugly? It is ugly. But it's the truth. It's like watching Maury Povich--you get to feel as though as bad as things are in your life, at least it's not the train wreck that's happening in others'. It's snobbery.

We have to learn when to pull back. You don't have to kick anyone in the ass, but you do have to stop saying it's all right to keep eating chips and chocolate for an afternoon snack. You have to stop saying that it was okay that she ate because her kid got sick, or her car broke down and cost a lot to fix, or her shoelaces came untied--any damn thing will do. Because eating won't fix it. You know the old saying: "If hunger isn't the problem, eating won't fix it." The only thing you've done when you eat a quart of ice cream because you're depressed is depress yourself further and make yourself feel like shit. You're basically saying that you're not worth losing weight, gaining health, gaining sexiness and beauty. Oh, yes you are! Sure, you might be awfully pretty, even though obese. But think how much more stunning you'll be at normal weight, most of all to yourself.

So the enablers have to stop doing that, and those who are playing a game of dieting have to stop allowing the enablers to keep them obese. If you truly can't lose--which means you really don't want to--join a fat acceptance group, stay fat, die young or live with blindness as your diabetes progresses.

I know this has been a rant, and rants usually aren't helpful. But I hope this one has added something to the dialogue. I know that it's changing my way of looking at this. I don't think I've ever enabled anyone, because I don't have the temperment, and don't interact with any of the gamers, just read their blogs. But it's a good warning sign to be aware of that all the time.

Selfish or helping?

Allan K. talked about enabling today. He essentially wrote that what seems to be support may actually be enabling, if it does nothing to help the person at risk. That if every mistake--particularly one made repeatedly--is forgiven, that person has no reason to change. I want to address this, although I'm not as clear or concise as he is.

I'm not talking about someone who's working toward their goal weight, and slips up every once in a while. I'm talking about people who, once a week or more, find themselves "having" to eat, trapped by recurrent thoughts of dancing burger patty melts. Then giving in. Night after night, or only twice a week. Whatever it is, they can't lose and will probably gain each week. An extra 500 calories a day, or 3,500 a week, translates into a pound of fat gained each week. Thus they're not only not losing, they're gaining--a lot.

The fact is that it's not difficult to slurp in an extra 500 calories, particularly for someone who's already obese. Maintaining 400 lbs. a day requires 4400 calories. That's an amazing amount of food, just to stay at the same weight. What's another 500 calories? Child's play. Anyone can do it.

If someone starts off their blog saying how they "cheated" all week (just who are they cheating?) and that they were "bad" (only children use the term that way, not adults), I know we're going to read a litany of overeating, usually crap. Crap tastes better than real food, for some reason. The same person who doesn't have the energy to walk or exercise indoors has the will to get dressed at 9 p.m., throw a coat on, then drive to a fast food place to pick up a four-patty In-and-Out Burger with double fries, and a maximum size cola.

Remember, this person has eaten like this all her life. She's thus given into her old habit, which is a hardcore neural pathway laid down by years of doing the same thing repeatedly. It's difficult to fight, very difficult. She feels awful: ashamed, guilty, sad, humiliated, and her self-esteem is in the toilet. Along come her friends to lift her spirits and help her to forgive herself. That needs to be done, at least the first few times. She's still learning how to set up new habits, such as how to fight the hunger, how to love herself enough to want to lose weight, how to lay down a new neural pathway so that hunger doesn't result in eating.

More to come. . .

Bring Your Own Crazy--Drazil's Friday Questions

Karen, owner of the Sunshine blog, turned me on to Drazil's Friday questions. They're to kickstart your blog if you're out of things to say, or just to help each of us know the other better. Just copy and paste the questions into your blog and let us see your answers.

1. If you could be a weather forecast, what would you be and why?

For the past week? Bright and sunny, turning to low clouds and overcast skies. Rain tonight, but sunny skies again tomorrow.

2. Would you break the law to save a loved one?

On a dime. Hell, I break the law every day over nothing but merely my wanting to (speeding). I'd surely break it to save a loved one, no questions asked, any risk taken.

3. If Happiness were the national currency, what would make you filthy rich?

To have my husband as healthy as he was 20 years ago.

4. Can you sum up your life in a six word sentence? (Example: My heart continuously expands in joy.)

Life is short: I am shorter.

5. Repeat question. Summarize your week in blogland and in real life.

I didn't blog as much as I wanted to--so many things unsaid. I enjoyed everyone who commented and appreciate their comments so very much. In real life, I had good news (a full time job starting next year) and a little down (my husband has been flu-ish and I'd rather it be me). Overall, everything balances.

Buddhist thoughts about food.

I was wandering around some of my favorite sites, and came across the Buddhist meditation on food:

This food I take
not for play,
not for fattening,
not for beautifying,
not for intoxication.
But only for the
continuation and
nourishment of
this body.
For keeping it unharmed,
for helping it to
lead a pure life.
Thinking, I shall
destroy hunger.
Thus will I be free
from bodily troubles
and live at ease.

It's beautiful, but you might be surprised to learn that I found it on a site for the EDs anorexia and bulimia. Yes, one of those infamous "pro-ana" sites you hear about. Now, I've been to them, but don't always like them. This one isn't what most people think it is, however. It's a support group for people struggling with these diseases. I can go two ways on it. It's mostly populated by teen girls, followed by young women in their early to mid-20's. Then there are boys of 16-18, and a very few young men.

They're all so desperate, and lonely. They talk of their families calling them "slimfast girl," "fatty-kins;" they speak of bullying by fellow students and older siblings (who are invariably prettier and thinner), and mockery by mothers, grandmothers, aunts, and other mostly female members of their families, who often have EDs themselves.

They need support, and they get it from each other. However, I get nervous about kids--and most are kids--in that mindset inspiring others to do the same. On another such site, I was in a chat with an older anorexic, and we were talking about recovery. We discussed threats by docs of involuntary hospitalization unless we'd eat or get our BMI's up to 17, 18, or so. A girl--I could tell she was very young--jumped on us like glue, begging us to tell her our "secret" of how to be so thin. She said she weighed something like 135 and would kill herself unless she got to 100. I told her she was a normal weight for her height (which was something like 5'3") and she should keep her weight normal, eat fresh vegetables, yadda-yadda, the whole nine yards. She became desperate--"Please, PLEASE, tell me what you do to lose weight. I need to know!" Finally, I just left the chat room after telling her the same thing several times. I couldn't take it anymore.

After I left, I wondered what happened. Did some young anorexic come in and tell her how to vomit efficiently? Did she give her the 2-4-8-2, or 2-4-6-8, or on-and-on diet? (Going from 200, to 400, to 800, and back to 200 calories a day.) Did they give her support to stay healthy and get even healthier, or did they "support" her in her dream of getting to 100 pounds?

That's what I mean about being of two minds about these places. You must let them come to their own decisions for them to accept who and what they are. However, they're still mostly children, and this can turn into eating-disordered children talking to other ED kids and getting into a world of trouble.

Just as I don't believe talking to obese people makes you obese, I don't think that a normal girl can be talked into anorexia. But a girl can learn how to fake out their doctor's office during weigh-ins; how to vomit easily; how to hide evidence of not eating from her parents (who usually aren't looking for it anyway), etc. So if they're on the path to anorexia or bulimia, they can be taught how to get there sooner and more efficiently.

I wish we were all like the Buddhist meditation, unattached to food. I wish we could all think of food as nourishment, and while it's a pleasure to nourish us, it's nothing more than that, like the pleasure of seeing a daffodil in spring. You recognize it and enjoy it, but you don't live for it. There are more important things to live for.

I haven't read my blogs today--it was a crazy one. I'll get to them by tomorrow, by hook or by crook.

All day hunger.

Potato chips were on my mind when I got up at 4:30 this morning. I didn't eat much the day before, so maybe that was it. I didn't eat or drink anything, except half a Coke, until after I got home at 3 p.m. For supper, half a cup of rice, half a cup of green beans, and a roasted chicken drumstick--no skin, average size or a little bigger. Not bad. Oh, forgot a full glass of ginger ale. Around 700 calories, give or take. Or that's my best estimate. I'll have to look up calories somewhere.

I have two cats who eat whatever they want. One eats wet food because he has no teeth from a hit-and-run driver. That's how we met. I picked him up off the boulevard and after nine surgeries, he became mine. Just what I needed, another cat. The other one, a tuxedo kitty, only eats dry food. Every once in a while she nibble on his wet stuff, but it's rare for her. She has become quite fat over the past two years. He, however, remains slender. She's more active than he is, and would love to play all day. He doesn't like it--he might not have played much before his extensive injuries, because he was very young, under a year, when he was hit. He's about 14 or so, right now.

So why is he slim when he's older and eats what he wants, including treats? Plus he doesn't exercise. And why is she fat (not obese yet)? I don't think they have eating disorders, a lack of self-esteem, or a feeling that they're not in control. I think this speaks to genetics, and probably environmental issues.

What do you guys think?