You Can't Go Home Again

When you go on the Optifast diet, if you follow it and do not cheat, it is like being in a nice secure bubble. You are insulated from all the bad things that you were doing that turned you into a Thanksgiving Day float. But eventually, you have to leave the bubble. The rest of the world doesn't live in there. That's when your time comes and it's "fly little bird, fly!!" It's time to do the hard work. It's time to look at the real world and address all the things that contributed to the XXL or XXXL person who walked through that door on day one.

At week 12, I hit 219 lbs. I had now shed about 60 plus lbs of ugly fat. 12 weeks is an incredibly fast time to lose that amount of weight. It is weird in that you just seem to be hitting stride and now it is time to think about managing your life OFF the diet. My original goal as set by the doctor was 215. My personal goal was 205. I was basically where the doctor thought I should be. Next week, we would talk about adding another meal to the daily plan. As I have said, I was on three shakes per day plus one carefully measured dinner meal. I now had to consider a diet that was 100% real food. The Miriam Hospital program, in my opinion, excelled at showing you how to manage your eating like a normal person. Strike that. Our country is now comprised of a population where over 50% are considered overweight, obese and morbidly obese. This condition is becoming the 'norm.' So this program was teaching us how to eat within the boundaries of a normal human body, not at the levels we have become accustomed to as a society.

To do this, the education program in broken into behavior and dietary management. I have said this over and over, but the diet management was the most valuable to me. I am going to cover some of the topics in the next few blog entries.

A man of 210 lbs burns about 2000 calories per day. If you want to lose weight over a long term, you should restrict your intake to about 1600-1800 calories per day. Exercise plays an important role. First, you need to have enough energy to exercise. Second, you can burn a large amount of calories depending on how much exercise you are doing. On my diet I was taking in 900 calories per day. I was burning about 2000 normal calories and about 400 exercise calories. The exercise calories came about from my speed walking which I did daily. On weekends, in addition to the walking, I would mow the lawn etc. I was running a daily 1500 calorie deficit. The weight, at this tempo, comes off at a speed that has been reflected in my progress.

Start to think about your sex, height and weight. Look at a chart that will show you your normal calorie burn. That is what you work with daily. The most important thing you need to know now, coming off of Optifast, is how many calories you are burning on average daily and how much you are taking in. We could go into the detail about the type of calories but let's keep this real simple. My 'off-diet' calorie intake should be about 1800 calories daily. I could manage this because I had decided that I would exercise 3-4 days per week and figured I was burning around 2400 calories per day. That number gave me some leeway for any small indiscretions. We aren't perfect and we aren't robots either. So that's my number 1,800.

One of the most astonishing things I learned in the education classes was how many calories I had been ingesting. I had absolutely convinced myself that, before this diet, I didn't consume that many calories. The day it really came home to roost was the day our class covered the "Dining Out Guide." This is a compiled list of meals and their calorie content from some of the most known restaurants in the United States. If you are serious about losing weight, you should go out and buy "The CalorieKing Calorie, Fat & Carbohydrate Counter 2009" by Allan Borushek. If you eat out even one night a week, you should just take this little baby with you. It lists the calories in most foods but it also has a section like our class "Dining Out Guide," only even more extensive. It tells you just how much you are stuffing into that chubby little frame when you eat out in restaurants. You won't believe it. I didn't .

Here are a few examples. As an appetizer (the meal hasn't even arrived yet!!), an order of fried Calamari (3 cups)....1,037 calories. That was more than my diet allowed ALL DAY! Here are some more appetizers. Ruby Tuesday's low carb Spicy Buffalo Chicken Wings with dressing...1,090 cals. That's right football aficionado's, don't even try to tell me that you limit it to one serving either. Especially during the playoffs and on Super Bowl Sunday. Don't rationalize this one...the restaurant doesn't matter! Check out TGI Friday's Buffalo Wings...1,010 cals. Whew!! But you may actually be making a relatively HEALTHY choice! Check out these! Stuffed Potato Skins with sour cream...1,260 cals. The Bloomin' Onion with dipping sauce (because it tastes awful when it's plain)...2,130 cals. Here is the all time show stopper appetizer, Cheese Fries with ranch dressing...3,010 cals. Make sure you have the diet-cola!!

Here is something you figure out pretty fast using these guides, and take it as a tip. The appetizers listed above had more calories than the entrees. They also have more calories than dessert! The golden rule, SKIP THE APPETIZERS and SKIP THE DESSERT. If you are going to eat the meal, an appetizer could multiply your calorie intake by (depending on choice) a factor of 4!! Add a dessert and multiply that intake by 6!

I could cover this forever. Go and buy the book. It will be the best education and investment you can make. Go and find a chart of calories you burn daily, print the number in BIG BOLD CHARACTERS on a sticky label, and put that label on the cover of the guide. If you are serious about weight loss, you may never have another appetizer OR dessert.

Other major thing to consider in restaurants:

(1) Watch the alcohol. It is a source of empty calories and makes resisting the dessert and appetizers hard. You will thank me when you get the bill and see the difference between the cost of two Brown Ale's and two Ice Water's with Lime.
(2) Watch how the meal is cooked. If it says "fried" or "baked", ignore it. Go for grilled or steamed. Watch the sauces. Go light. Pick "marinated in juice" over "marinated in butter."
(3) No pasta and no starch. Go double veggies always with your protein.
(4) If all else fails, go with the Grilled Chicken or Fish Salad.

My pre-Optifast life was one of excess. Absolutely. No exercise. Much food. Much drink. I was King of my castle. My castle of fat.

The walls are down and it's time to live like a person who hopes to see the finish line. It IS possible. But...you can't go home again. You don't want to anyway.

Next: Stay with the new life plan, don't listen to them!!

Selfishly Selfless

I go through life with a different perspective (I think) than most. I take a lot of things in this life seriously. I view those things, however, with a sense of humor that reflects society’s response to those same things. I do this because I have grown to realize that I live in this grand fishbowl with about 6 billion people and my view has about as much a shot at carrying weight as I do of winning the Powerball lottery. So in my small mind, levity is very important. I always write this blog with that in consideration. That said, today is not one of those days.

While the act of going on a diet is funny, and being on the diet is a laugh, and watching others on THEIR diets can be hysterical, my reasons for going on the diet are not funny at all. I took this diet with the utmost seriousness. The conditions that I experienced, leading up to my decision to go on this diet, were conditions that way too many people experience every day. They are conditions that, if ignored, can end your life.

Consider the fatal diseases that obesity (and while I was two tiny classification points from that term, I still put myself in that class) can cause. Congestive Heart Failure. Ever heard a real big person wheezing as they type on a keyboard? It’s not really an activity one would call exercise…so that person is dying. Enlarged Heart, from pushing the massive body around. Pulmonary Embolism, a blockage that can be caused by clot, or fat, or clumped cells and fluid. The circulatory instability can cause death. GERD, more commonly known as Acid Reflux, when untreated, can cause esophageal cancer. You get GERD (many people) from a gut that hangs so heavy in front of you that it actually bends your esophagus enough to break the natural seal between it and your stomach. When that happens, stomach acid backs into your esophagus and over time, can cause cancer. Fatty Liver Disease. Chronic Renal Failure. Skin Infections such as Carbuncles and Cellulitus. Stroke. Many types of Sleep Apnea. Get the picture? These are just the ones that can kill you. There are many others that just make you feel like crap. All the time.

So what did I have? Let’s see. GERD. Back issues with two cervical areas. Sinus issues (which happen when your immune system is overloaded). Edema (swelling that could lead to Lymph edema). Varicose veins. Yes, I know. It’s a real pretty picture. Not to even mention the way I could sweat through clothes just from a stroll around the neighborhood.

Let’s talk about some other items. Ever broken furniture? I have. Lots of it. Everything from wooden dining room chairs to outdoor lounges. Ever had a resin chair just shatter from under you? I mean so many pieces you need a broom to pick it all up? Ever been to a theme park where you couldn't fit on the ride? I have a funny story about that, but not today. Ever been to an old stadium like Fenway Park in Boston? It was made in the early 1900’s when people were not as big on eating for ‘entertainment’ as they are today. Try squeezing your ass in between the metal handles of a circa 1900 ballpark seat. Good luck. Is the picture a little more clear now?

Some have a good sense of humor about this. I did. I can laugh at myself and my shortcomings. I especially could when it was about my weight. I think it was because I always had in the back of my mind that I could lose it if I wanted to. I have been big most of my life but have lost a large amount of weight enough times to feel like it was a matter I could control. 95% of all overweight and super-overweight, do not have that feeling of confidence and control. That said, it is my opinion that when you make the decision to do something about your weight and for whatever reason drove it, that you should go at it with the seriousness that it merits. Something pushed you to that point. Don’t forget what it was.

I have a 13 year old daughter and an 11 year old son. I hope someday to be there to walk her down the aisle. I want to be able to go sailing and hiking alone with my son and maybe even share a beer (when he is old enough) and laughs with him. I want to be able to play with my grandchildren someday with the same enjoyment that I played with my own two kids because even though they are still young, I miss that time more than I can say. The diseases that go with obesity are fatal. They are in my way. They are in yours.

My very first class for the Miriam Hospital Weight Management Program was shocking. The subject of the meeting was how to live your life around people who just “have to feed you and won’t take no for an answer.” Seriously. How to exist around people who make foods “just for you” and think you should “just try some.” I listened to this being discussed by several women until I chimed in. I felt funny because this was my first class. I had lost zero pounds at this point and was the new person. But I jumped right in.

“I just need to clarify what I am hearing. Are you saying that you tell people you don’t want the food? You tell them that you are on a diet. And they still stick it in your face?” I said confusedly.

“Yes”, she said.

The behavior specialist said, “There are nice proper ways to handle this situation.”

I jumped in, “why?”

“Why what?” she said.

“Why be nice?” I responded. “Look, take a good look around this room. This isn't a game. I have listened to many of you today. You are here to remedy a situation that is jeopardizing your health and taking away quality years of your life. This is a hard thing for all of you. I haven’t lost weight yet on this diet but I have dieted successfully before. When someone asks me if I want food, the first time, I am polite in declining. When those offers continue and become taunts, being nice goes right out the window. I have no obligation to be nice anymore. The second time, they will get an appropriate glare from me. The third time, my response will be unforgettable for them and I guarantee it won’t happen again. You are doing something that will be positive for you and everyone else around you…and you better start being selfish about it. If you don’t, this diet is going to be long, it will hurt, and it may not be successful.”

The meeting ended shortly thereafter. I don’t know if any of them got my message. I know this though…I went into that diet to win. I went into it to be healthy and more importantly, to stay that way for the first time in my life. I hoped everyone understood. The months to come would tell me that some did understand but, unfortunately, many didn’t. I hope, if you are reading this, that you do.

More to come.

Blogger's Note: The photo above was taken by a very talented photographer friend of ours, Judith Laliberte.

Next: I am supposed to drink this stuff?

Orientation aka Futurestate

"Good Morning, Miriam Hospital Weight Management Clinic. How may I help you?"

If ever there was a loaded question. How may you help me? If you could SEE me, you wouldn't even ask. "Yes, a friend of mine referred me to your program...I guess you do some kind of orientation...I would like to get in there as soon as I can."

"Ok...the next orientation is in three weeks, do you want me to schedule that one for you?", she said chipperly.

ASAP, kept running through my mind. This was obviously not a sales organization. These guys are not really understanding the whole 'get them while they're hot' concept. "Uh, I was really hoping for something sooner."

"Sorry, there are a lot of people trying to get into this program and there is a big wait."

McDonald's is going to go out of business, I thought. "Fine, let's make the appointment please, thanks."

I don't know about you but when I make up my mind to do something, I really feel the need to do it right now. Not tomorrow. Not three weeks from now...RIGHT NOW. So I waited. I watched Ray in the cafeteria walking around in his new slim body. I can do this just like him. Just not right now, apparently. I was really anxious, this damn program better be good.

The day finally arrived sometime in June and I went after work. The directions were terrible and I ended up in the wrong building. By the time I found the right one, I was 5 minutes late. I knew there was a group of people already in the room and there is nothing I hate more than being the 'interrupter.' I signed in at the desk and went down the hall to the room. The door was closed and I could hear someone talking inside...great, "hey everyone, stop what you are doing! Look at me, I'm fat and need help!"

As I opened the door and walked in, I entered from the front of the room. About 25 people were facing me, and every single one of them heard a loud gasp escape from my mouth. I couldn't believe what I was seeing. Whoever set this room up had placed the chairs touching each other side by side. NORMAL chairs mind you for NORMAL sized asses. It had been a pretty hot day and many were in shorts and short sleeve shirts. Here I was, standing there staring at an ocean of flesh. These people were wedged in and flowing all over each other. When one moved, they all moved, like one big wave. Before you think I sound awful cruel, I was about to join the group and become the next wave in the ocean. I sat on the end and tried to make myself look as small as possible.

I could not NOT stare at this group. So many were really really huge. Some were smaller than me, maybe 5 or 6 of them, but most were bigger. I couldn't get the thought out of my head that, if I didn't do something, I was looking at my future. I knew there was a cost to this diet but I made up my mind then and there that it would have to be a really big number for me to walk out that door and not participate.

The program was covered partially by my medical plan. That was good. There were going to be doctor visits every two weeks which would mean a co-pay (but the visit was covered by my plan). There was a fee to use the facilities and cover the education classes (not covered by the plan but, in hindsight, the real value to the plan was buried in these classes). There was a cost to the food. OK, this had to be the real burden here right? They warned us, this could be expensive. The diet, and I was on something called 'modified fast', consisted of three shakes per day and one very tightly defined meal. The shakes cost $86 for a case of 24 pre-mixed shakes...so about $3.60 per meal. By my count, I would go through 21 of those shakes per week. The cost of the program with the medical coverage would end up being about $800 plus all the co-pays, plus the meal costs. OK, it was somewhat expensive...until I started adding up my food costs. I chalked up the $800 to years of stupid eating and bad decisions. Penalty fee. Believe it or not, if I was 'real' with myself, the cost of the meals would actually be a cost savings! I hadn't built this ocean liner of a frame on Lean Cuisine snacks...I had spent a small fortune destroying my health.

They then discussed the shakes. Perfectly balanced little shakes in Chocolate, Vanilla, and Strawberry. You could get pre-mixed or powder and whip them up yourself. Oh, and they were 160 calories each. Huh? Wait, three shakes a day at 160 a pop comes to...18, carry the one, 480 calories per day??!! What is in the other meal, a Whopper? A Big Mac? The shakes are called Optifast 800. Now I knew why. 800 calories per day.

"Don't worry though, after the first couple of days you won't be hungry", they said.

"And how is that?", I asked. I was looking for some kind of encouragement here.

"Because you will be in starvation mode."

"And that differs from actual starvation, how?"

"Don't worry, we have had tremendous success here and we will explain it all to you, today is simply an orientation."

Ok, I got it, they would take care of me. "So when do we get our shakes?", I asked.

"Oh that won't be for at least three weeks...you have to set up your appointments. Physical exam, exercise screening and psychological evaluation...all that stuff."

Three weeks? Three MORE weeks? Are we actually going to lose weight sometime soon at the Weight Management Program? And a psych eval??!! What the heck was going on here?

I would soon find out.

Next: A Psych Eval...really?