I am busily visualizing a nicely shaped, mature bonsai tree  as part of my process of just hanging on to this project.  Because, as is probably typical for most of us, progress is occurring, but slowly.

Here’s the rundown: my weight seems plateaued. Meaning I’m about the same as a week ago, roughly six or so pounds lower than at the start of the project, but far from the dramatic 12 or 15 pounds I wish I had lost by now.  So on one level, it could seem like nothing much is happening, certainly nowhere near as much as the many “weight loss stars” seem to accomplish.  (You know, the ones who promise to make you lose 2 or 3 pounds a week, or who report such dramatic results themselves.)

And it’s possible I could be doing much better.  I know I need to cut back some on carbs (meaning “white food”).  My diet isn’t really super heavy in, well, anything, and I almost never (except on those weekend splurges) eat stuff like big burgers on big white buns and pizza and dessert.  But I have generally been eating a few hundred calories a day more than I absolutely have to, nutritionally speaking.  (Example: I am determined to avoid high fructose corn poison and fake sweeteners that turn to formaldehyde in my system, so instead I toss some unnecessary plain old white sugar in my coffee.  Another example: higher fat varieties of cottage cheese and such than I perhaps need.)  So even though I almost always come in within my allowances on my CalorieKing software, the pounds aren’t dropping.

And of course, that’s frustrating!  Not horrible one week, but if it’s the third week and it’s still stuck, especially if that weight is 3 pounds higher than my best-so-far weight… well, that sucks.

Of course, there is a big, big “on the other hand” argument here.  For one thing, my measurements.  Blood sugar is generally great.  My blood pressure is much improved and holding — not dropped enough that I could consider dropping a medication yet, but it’s in a good range and that’s consistent.  Resting pulse continues to be much better than when I started the project.  (Not yet Lance Armstrong, but in a really good range.)

More important: measurements and muscle strength are good.  I lost another half-inch on my waist this week; still not perfect and I still look a little bit pregnant, but the tape measure doesn’t lie.  Chest is same, but then I’ve been doubling and even tripling my upper bod reps on my chest/pecs, just because I have felt I need more upper body strength.

And my capabilities in the gym are improving steadily, as well.  Big muscle groups in particular, going up at best in the double – digit percent improved range in a few areas.  I can lift more weight  more comfortably, and this gets better constantly.  Aerobic conditioning is also clearly improved; at least on good days (when I’ve gotten good sleep and not messed up my blood sugar), I can do more, go faster, sustain intense bursts with better comfort and respiration than in the past.  It’s all good.

Which brings me back to the bonsai tree.  I love the art of bonsai, mostly as a spectator.  (Used to go to the Minnesota State Fair bonsai club exhibit  and man! they are spectacular!)

The thing about a bonsai is that it’s something you tend, change, shape very gradually.  Over time you make consistent, tiny, almost invisible little changes.  You may snip a small bit of a branch or a few leaves or needles from the tree.  You may shape a branch with a piece of wire ever… so… slowly, making teensy little adjustments very patiently.  It generally is a project of many years.

But then you have this amazing thing.  This beautiful tree that seems to have brought all the latent potential of the original tree out, and made it perfect.

I think that’s what this project really is about.  Make little tiny changes.  Go to the gym and maybe the only thing I do on a particular day is push myself just a bit longer, get my heart rate up into my aerobic zone just a half-minute longer than yesterday.  Or drink maybe just the first cup of coffee in the morning without sugar, even if I “cave” after that.  Just don’t replace small improvements with small bad habits in other areas!

And look for little evidences of change.  Because if my weight is the same on the scale but my waist is smaller, even a little, and I’ve added five more pounds to what I can do on the leg press and that’s more than I could do a week ago… something important is happening.

What do you think?

Yesterday I ate too much, and today I can still feel it.  I don’t think I really enjoyed what I felt after we had our large pizza and the cheesecake dessert we brought back from our “foraging” trip later in the afternoon.  And this brings up an interesting topic — the idea of giving yourself a “splurge day” every week as part of your weight loss plan.  There are pros and cons to doing this.

Pros of having a splurge day

The basic idea is that if you are working on a diet plan as part of a weight loss effort, that you may sometimes find it easier to maintain your plan if it doesn’t mean you’ve got to give up your favorite foods for the rest of your life.  You like chocolate cake, you miss chocolate cake, you don’t think you can possibly do without chocolate cake forever… so you tell yourself that you’ll have it, if you can only hold out until Sunday.

There are some good scientific theories behind “splurge days.”  

• Limits of self-control.  Some psychological researchers suggest that there are limits to our abilities to deprive ourselves.  Their research suggests that self-control seems to operate like the batteries in your laptop or cell phone: eventually you need to recharge them.  The thinking is that if we try too hard to deprive ourselves or control our behavior in too many areas, or sacrifice for too long, we may actually weaken our ability to control ourselves.  So the theory goes that if once a week you splurge, it’s like a much-needed rest period. 
• Avoids “starvation mode.” This is based on the medical research suggesting that our bodies have built-in “famine detector” systems that react to prolonged caloric reduction by going into an energy-saving mode. In other words, if you cut back your calories constantly, you find that you’re less able to burn off fat.  The bod says “no.  Un uh.  I need this fat.”  So a day of splurging is a way of keeping the body’s famine detection system off guard…. so you can keep losing weight.  You eat a few extra cookies on Sunday and on Wednesday you may find you’ve lost more weight than you would have if you’d skipped the cookies.  (This only works occasionally, of course — cookies every day doesn’t have the same effect.)

Cons of having a splurge day

• How it feels.  Sometimes your splurges may just not feel all that good.  When you generally eat a lot of heavy foods, sugary foods or whatnot, you may feel less good than you might feel if you ate healthier instead of splurging.  And the more you are used to healthier eating, the more you’ll notice the effects of your once-weekly splurge.  I think this was part of my feeling yesterday: despite looking forward to a pig-out meal and a great dessert, the fact is I didn’t feel all that great after I ate.  I used to eat like that daily; now I seldom do.  So I felt stuffed and frankly, got kind of sick of eating the pizza and dessert we’d bought.  Ick.  
• Health effects.  Being diabetic, I have to plan carefully and adjust my meds if I am to eat a lot of carbs or sweet desserts or the like.  High blood sugar means having that “sleepy stupid” feeling that other folks mainly associate with the after-Thanksgiving feast.  It’s not healthy, though.  And even if your health is generally great, a pig-out meal stresses your bod anyway.
• Psychology.  I mean, here we are, working not just to “get thin” for a few weeks, but trying to modify our general sense of ourselves.  Part of your sense of “self” is the stuff you do, the stuff you say, the stuff you think.  As Kurt Vonnegut once wrote, “you are who you pretend to be.”  So if I want to be a thin, healthy, athletic guy (my mantra), what is that guy doing eating like that?  

What to do?

I think the upshot of this is that like most weight-related issues, there are complex, one-size-fits-one answers here. My current thinking, for me, works like this:

• Having a splurge day is fine, but I’ll try to have a balanced, more reasonable approach to it.  It’s fine, for instance, to make that a “splurge meal” instead of a whole day.  A big brunch or nice dinner should suffice, instead of following an “anything goes and eat like you’ll never see food again” strategy. 
• Even at that, using some portion control and picking healthier treats is generally better, though I won’t lose sleep over it if I am not “perfect.”
• Trying to get some exercise on splurge day is probably a good idea.  It happened that I also was on my “no gym” day (which is usually Sunday).  But a walk in the woods would have been good to have had.
• Getting single-servings of things would be better than buying larger quantities.  Neither my wife nor I really want big slabs of pizza and slices of cheesecake during the week, but we bought a large pizza and a couple of cheesecake desserts that are now sitting in the fridge.  (Actually, we didn’t realize we’d have as much left over as we do.)  It’s hard not to eat that stuff later in the week, ya know?

I’ve been lazy about blogging for about a week, which sort of matches how I’ve been feeling about the Project.  This is fairly normal, actually, though I wish it weren’t so.  

Some psychologists speculate that we have a sort of natural limit or quota in terms of how much “self-control” we may be able to maintain over our behavior. The idea is that if you spend a period of time resisting a temptation or sticking to a hard task, you sort of run the self-control batteries down.  So the thing you have to do is give yourself a bit of time and some outlets for not being so perfect, while your self-control battery “recharges.”  Then you may be ready to get back to whatever you’ve been working on.  

For instance, if you’ve ever known anyone going through treatment for substance abuse problems, you know two things: 1. just about everyone, it seems, in CD treatment seem to be smokers (though less now than years ago), and 2. the general rule of thumb in most treatment programs is don’t try to quit smoking while you’re busy trying to quit drinking or using drugs or whatever.  It just seems to be too hard to start controlling everything in your life at once.

This past week I’ve had actually a great week in maintaining my workouts, and their quality (and my strength on the weights, aerobic conditioning, etc.) is improving.  Fell down over the weekend on the food diary, but was partly derailed by reading some articles and suggestions dealing with changing diets to a less carb-based, more plant/protein/legume diet.  Have to look at that some more, but part of the many suggestions were to give yourself one day a week to cut loose, eat whatever.  Not sure how much I agree with that, though we sort of let ourselves do it over the weekend.  And somewhere in there (along with the weight gain last week) I think my energy for food recording and blogging flagged a bit.

But that happens.  The real key, of course, is to get back in the saddle.  You fall off the horse, get back on.  You have days you don’t want to do it, get back to it the next day.  Breaks aren’t all that bad, as long as they aren’t permanent.  I find it helps to keep the “big picture” in mind — if I imagine looking back, maybe in a year or two, after getting to my target weight goals, I’ll very probably have a bunch of lapses, periods when I cut back, vacations where there was no gym, parties and dinners out and days when everything will have gone to hell.  

But the general, overall trend should be that every time, I got back to the plan, and that most of the time, I did an adequate job of sticking to the program.

Today is my weekly weigh-in day, and I have mixed news to report.  My scale says I’ve gained back five of the 12 pounds I’d lost since beginning the project.  Rats.

Of course, this is a fairly common situation in any weight loss project.  Since we generally place a lot of stock in our scale weight, a bounce up can feel like a total failure and even a disaster.  At this point, many people just stop trying to lose weight.  That isn’t always done as a “big decision,” but rather you just “kind of start to forget” to keep track.  Motivation sags and pretty soon a year has gone by since you’ve been back to the gym or written down what you’ve eaten.

Clearly, the mental game of weight loss is key at times like this.  So I am thinking, what to do?  And I realize, the real key is to analyze the gain as best I can.

First of all, not to panic.  Five pound variations in weight are actually within the normal range for anyone.  I’ve had readers tell me that normal monthly hormonal shifts could account for even more weight gain than that — one person commented that she had a regular seven pound gain once a month.

So my five pounds might be partly just random fluctuation.

Second, I should look at other measures.  For instance, my blood pressure is slowly dropping again, after a brief tendency to rise a few weeks back (never to the pre-program level).  And my resting pulse is generally running ten beats per minute lower, and is steadily improving.  This says something important about my overall conditioning — that it is improving significantly, and continuing to improve. Likewise, my blood sugars are generally or always in a good range.

Then there is the tape measure.  While my pounds are up a bit, my waist and hips have shrunk about an inch this week.  Chest is the same, but therein may be part of the explanation for some new weight.

About 2 weeks ago I decided that my legs don’t need much more by way of weight training.  Partly due to genetics and partly due to hauling a lot of weight around, I have always had strong legs.  My calf muscles are huge and bulging and it’s pretty much all muscle down there.  The recent program gave me a leaner, less puffy lower leg look, and so I felt all I needed was maintenance.

But my upper body has never been super strong.  I lift a laptop and books most days, not tools and lumber and cinder blocks.  So I decided to add 10 minutes to my upper body workouts, which amounts to 20 more minutes a week of upper body strength building (a full additional weight workout a week), along with pushing myself a bit more to increase my strength.

I doubt I’ve actually added five pounds of muscle all of a sudden, but I probably added some.  I know I’m stronger, more able to do more in the gym with less sense of effort.  Muscle is heavy.  The fact that my weight is up but my body is slightly thinner does suggest some new muscle.

In terms of diet, I’ve been under my calorie limits most days, but was away on the weekend at relatives’.  So it’s restaurants, both on the visit and during the trips to and from.  Plus generally I’ve felt I’ve been a bit slack a couple of days, and did have two or three days of being over my calorie allowance (like last night,  when all the extra working out and the fact that it was “free cone day” at Ben & Jerry’s in Vermont, led me to a bit of overindulgence.  Guilty as charged.)

In general, then, I can break this extra poundage into a couple of causes: some is probably new muscle, some is last night’s heavy meal (I’ll verify that tomorrow), and some is a need to tweak the diet a bit.  I need more veggies anyway.

The main thing is: if you keep records, you can make sense of seemingly “random” weight fluctuations.  This is never 100% — our faith in having total control over nature is never completely justified.  But some of it is.  And the more sense things make, the less likely we are to just give up in despair.

Because we just can’t.  Ever.

I’m visiting out-of-town relatives over the weekend, in some hilly, sidewalk-deprived suburb of Connecticut.  This means having to find some other way to maintain my exercise program, and having to adapt to different food choices and routines.   Getting away and seeing folks I like is nice, but if I don’t want to have a traumatic “weigh-in day” experience on Wednesday, it’s important to not undo in a long weekend visit all the things I’ve been working for all week.

Since I generally take one rest day a week, I took yesterday off from any kind of workout.  But that meant that today was exercise day.  Being a few hundreds of miles from my gym, I had to improvise.  I decided to go out and walk the hills.

I’ve always loved walking — being outside in the fresh air, seeing the rolling hills or the woods or the ocean or the sights of a different city have always given me a lot of joy.  And walking generally feels good to do — I find running hard on my knees.

My concern has been that walking is sometimes a rather “lite” exercise in terms of the calories one burns.  While a runner can burn as many as thirty or more calories a minute, the burn rate for walking may be much slower — as little as five calories a minute, according to my reference information.  Meaning that I may get much less bang for my buck, calorie wise, strolling around than I do back home on the elliptical.

The key seems to be pace.  Faster means more calories expended.

I put on the monitor and a pair of too-worn running shoes (they work fine in the gym, where my feet are fairly still in the treads of my elliptical machine), and hit the hills.  After a couple of minutes of slower, warm-up walking, I did jog for about a minute, until my heart rate was in the top of my so-called training zone (somewhere from the mid-120s to the low 140s.)  Then I just adapted my walking pace as best I could to keep it mostly there.  It went sometimes much higher on hills (into the 150s or a bit more), but that’s still a reasonably comfortable pace for me for brief periods and from my own calculations is a good zone for me to go into for briefer periods of higher-intensity work.

It was a great walk.  I got blistered a bit on one heel, but otherwise no harm done.  Got a great cardiac workout and my legs appreciated a nice rest with a novel after 55 minutes up and down the hills.  Perfect day for it.

Being outdoors puts you in a less predictable exercise situation than working out in a gym.  It’s kind of like switching from weight training machines to free weights — it may be better for you, but you also have much more variability in terrain, conditions, and even safety issues to cope with.  While many days, and in cold or snowy weather, I prefer the comfort of an indoor workout, there is still a part of me that seems to call me out of doors, even if it’s wet or cold or nobody in Connecticut seems to have considered the possibility that someday, someone might appreciate the chance to get out of their car and take a walk on a sidewalk.

I’ve written before that perhaps the best exercise for weight loss is the one you’ll actually stick to — the one you’ll do.  I wanted to talk a bit more about that today.

One of the biggest hurdles to successful weight loss is the need to actually get up and out there and do something physical every day, or most days anyway.  Yet, many overweight people tend to get far too little exercise, which probably accounts for a great deal of weight gain.  In fact, many times, overweight people have always tended to get less exercise than they need — even back in childhood.  (And nowadays, the number of children who spend way more time with their laptops and video games than being outdoors engaged in active activities seems to be the highest in history.)

If you want to reverse this kind of pattern, you know — and have heard for years — that you need to be more active.  But how to do it?

Let’s face it, there are probably several good reasons why you don’t do as much as you should physically:

• Inertia: You are used to your more sedentary lifestyle.  It’s comfortable.  You maybe work in a sedentary job, sitting in a cubicle or at a desk; then you drive home, eat dinner, and want to mostly sit and watch TV or read or something.
• Biological programming: Our bodies are programmed to be energy hogs.  For most of pre-recorded history, survival was a matter of burning fewer calories than we consumed.  If you don’t know where the next handful of fruit or carrion is coming from, not burning off too many calories is literally a survival imperative.
• Physical discomfort: Exercise sometimes “hurts.”  Maybe not in a major, pulled tendon way.  But hard work is subtly “painful” in its own way.  Plus there are discomforts such as getting sweaty and “overheated” and huffing and puffing.  If you really focus on these sensations, many times they don’t feel all that great.
• Mental discomfort: Fat people in gyms often feel out of place.  Overweight kids feel ostracized, and may even be mocked or bullied or teased in gym class or locker rooms.  Even as adults, formerly heavy kids often carry the memories of those jeers in their heads and so tend, mostly unconsciously, to avoid “going there.”  (Even as an adult, I remember doing some jogging with my first wife across a parking lot in our neighborhood and some adult woman laughing, at us, saying “you’ll have to run faster than that if you’re gonna lose weight!”  Stupid kids grow up into stupid adults.)

So how to make yourself exercise more?  Probably the most pleasant way to do it is to look for a form of exercise that you really enjoy.  And one key to enjoyment is finding something that you can lose yourself in, that gives you pleasure, that you find interesting, that can trigger a sense of what psychologists call “flow.”

The concept of “flow” is one of the most useful ideas in psychology.  The term was coined by psychologist Mihály Csíkszentmihályi, who identified several things about an experience that help it to feel really good.  In a state of flow, we feel absorbed in an activity.  It is interesting, even mesmerizingly fascinating to us.  We get some kind of pleasure from it.  It is generally something that we find challenging, but not too challenging or overwhelming.  We feel energized and involved.

Some kinds of exercises may trigger more “flow” in you than others.  For instance, while you may find running or jogging to be painful (because maybe it is too difficult), you may find biking to be engrossing.  Or, you may find weight training to be boring, but yoga is interesting and something you enjoy.

In my own experience, I’ve enjoyed the “flow” in several kinds of exercise activities.  For instance:

• Martial arts: I used to enjoy taekwondo classes quite a bit, and I enjoyed learning and practicing new kicks and forms.  (I didn’t enjoy sparring, though — probably because I needed a more gradual introduction to it than my school provided.)
• Kayaking: Being out on the rolling waves of Lake Superior, feeling the kayak roll up and over waves that were higher than I expected, but then not tipping over, was incredibly exciting; being out on the beautiful lake in the sun added much to that feeling.
• Biking: when not in too-busy traffic, I’ve always loved the experience of biking.
• Elliptical machines: It’s not kayaking on big blue lakes, but I personally enjoy the experience of being on a good elliptical trainer.  Maybe it’s cuz I’m an introvert writer type, so I can spend 45 minutes getting my heart rate up to a comfortable but not overwhelmingly high level and get a bit lost in planning an article or blog post or rewriting the morning’s bit of my novel.  For me, ellipticals are much less painful than running can be, so I do enjoy the experience.

If you have a sense of “flow” in an exercise, it makes a huge difference.  You will actually look forward to doing the thing, even on lazy-feeling days.  That may be one key to regularly exercising that didn’t get taught to you in those awful high school gym classes, that may help reverse a long slide into laziness.

Today is weigh-in day, which I do on Wednesdays so as to minimize the “weekend weight gain” effects.  The news this week is mixed.

As you can hopefully tell from the picture, my weight is up a pound and a half.  This is the first real increase since I started the project (the other “rise” on the graph was merely a recovery bounce from a week of stomach flu and dehydration).  I’ve also re-grown a half-inch on my waist and hips.  Not good.

I say it’s a “mixed” week, though, because some other key indicators still look good:

1. My blood sugars are generally running well within normal ranges, even with a gradual decrease in my insulin doses
2. My blood pressures are continuing to be considerably lower than a few months ago, now running more often in the 120-something over 70-something ranges; not ideal or enough to cut out any meds, but a great improvement nevertheless
3. My body fat percentages seem to be generally running a percentage point lower than they were just a couple of weeks ago when I first got the monitor.
4. My general sense of conditioning at the gym — how hard I feel I’m working, how much weight I’m lifting comfortably, etc., are gradually improving and are the best they’ve been in a long time
5. Most important, I’m continuing to get to the gym regularly and continuing to monitor my calories/food intake daily; I’ve had NO misses on any of that in weeks or maybe even a couple of months now (except when ill with the flu.)  And I almost never eat more calories than my software recommends for a day; almost always, I come in a few hundred calories under (which I think is probably okay — the software seems to overestimate how much I need.)  Finally, I pretty much never walk around feeling deprived or hungry, even with all this exercise and diet control.   This is really excellent.

These latter are really the most critical changes — they are all indices of overall health, which is fundamentally more important than belt size.

Nevertheless, anyone who is working on weight loss will instantly realize that it’s always disappointing when the “most important measures,” your scale weight and belt sizes, don’t keep going down.  It feels even worse when they go up a bit.  (And of course, in the long run it might also be argued that the only really good way to improve my health is to really knock them pounds off.)  And in  a sense, the fact that I am actually sticking to the program might even trigger more anxiety: “Even THIS isn’t enough???”

So what do you do when things bounce up instead of going down?  I’m focusing on a couple of things.

First, keep things in perspective. Occasional rises in weight and even “bad weeks” are entirely normal.  If you assume that this is a long-term project, one that will last at a minimum 12 months and possibly twice or three times that long, a week or even several weeks of weight increases or plateauing are entirely predictable.  In that sense, things are really going “according to plan.”

That doesn’t make it easy to take.  Some of my readers have written about how discouraging it was for them to see themselves go up instead of down on the scales as they worked on their programs.  But, they pointed out, you stick with it, and things will eventually turn around.

Second, assess what you’ve been doing right — and what you need to change. I actually predicted that this week might not pan out so well, because of the Easter holiday.  I didn’t get to work out so much on the weekend (just a half-hour on the elliptical on Saturday because with all the holiday laziness I got there late, just before closing time.)  Plus, there was a big family get-together Sunday, and so after we had a late (and slightly large) lunch, we ended up being at a large dinner in the evening.  (I really maxed out my calories on Sunday — the one exception to my “I’ve been good” summary all week.)

From this I know that I basically made a few bad calls over the weekend, which I suspect is human but which I also don’t generally do.  I also have noted the other day that I’m needing to increase my vegetable servings… which will be one good way to help balance my diet and probably cut out some of the less-good calories.

So this week I have lots of reasons to feel optimistic, and a few things to work on (veggies, keeping up the workouts, which I’ve been wanting to tweak upward a bit in intensity. But just a bit.)

Let’s see what that yields next week.

Yesterday I wrote about the problem we face when confronted with medical reporting on weight-loss related matters.  Part of what I discussed was the tendency of the media (and of unethical entrepreneurs with their eyes on your money) to make too much of premature medical findings — the kind of thing where one study suggests some important discovery, but where either the area needs much more research, or where there really aren’t any clear ways to make use of the results yet (and there may never be, for all we know.)

I could go on about the problems with much medical research on obesity that makes the headlines, but it might be more helpful to cite a few things that do seem worth reading and knowing about.  Today I have two articles to recommend — one on diet, and one on medical care.

News on diet

First is a report on a study on healthy diets, which was recently published in the Archives of Internal Medicine.  Researcher Andrew Mente, Ph.D., and his colleagues at the Population Health Research Institute did a thorough review of fifty years of research on various diets that supposedly are healthy.  They found that for the most part, there isn’t enough evidence to recommend many diets.  However, there is one exception: the so-called Mediterranean Diet.  This one seems to be really heart-healthy.  This study strongly suggests that the key to healthy eating is not just “eating plenty of” veggies and such.  Rather, it involves organizing your entire diet around these things: fruits, vegetables, legumes, nuts rich in monounsaturated fatty acids (such as walnuts), fish, whole grains, and cheese or yogurt.  (The difference is important: if you continue to live on burgers and bacon, it probably won’t help much to add the occasional salad to your diet.  What you have to do is — gradually but not too gradually — change your entire diet to something different.  Probably something you did NOT grow up with.  Possibly something that most of your friends or relatives don’t eat.  We’re talking low-meat, high fish, high veggies (like five to ten servings of vegetables a day!), and getting your protein from stuff like fish, soy, nuts, other legumes (soy is a legume), cheese, yogurt, etc.)

The power of studies like this is in their size and consistency: when one study finds something, that’s information that may or may not pan out eventually. But when study after study points in the same direction, and when different kinds of research keep showing the same findings, from experiments with lab animals to studies of healthy populations to experiments where people change their diets — then it’s really “news you can believe in.”

I believe this one.  And it reminds me, personally, that I do need to crank up the veggies in my diet more.  (I mostly avoid meat and such, but know there’s a gap between the number of vegetables I eat per day and the number of servings — probably seven to ten — that I should eat.  The problem with calorie counting as your main dietary “guide” is that it doesn’t care if the calories you ate yesterday were based on a few servings of asparagus and lettuce and spinach and broccoli, or marshmallow “peeps.”  But your body cares.)

Getting good medical care

Another recommended reading is a discussion in a recent NY Times article on the issue of patients’ need to really understand their medical conditions, and the role doctors can play in this (or that they may fail to play.)  The article makes the point that it’s important for medical personnel to take the time to help patients understand their conditions and the recommended treatment.

I agree completely, but I don’t think the article goes far enough, in two respects.  First, there is often a big gap between teaching patients about their medications and how to treat their conditions (which the article focuses on), and the bigger issues of teaching both prevention and life and health enhancement.  When a doctor tells me I have high blood pressure and so starts talking more medications, I feel a bit depressed.  The message, in my head, is: “This won’t go away, so it’s time for still one more medication that I’ll now have to take for the rest of my ever-shortening lifespan.”

I don’t know about you, but I don’t like that message.  It triggers a subtle form of depressed thinking — not a clinical depression but a feeling of “nothing I can do will make a difference.”  And when people feel that, they tend to care less, try less hard, and so medically, they are at risk for deteriorating faster.  (Depression, if it does go to the clinical level, is a strong risk factor for earlier cardiovascular disease and death, too.)

What I prefer in a doc is information about how to restore health.  And also encouragement: someone telling me that this or that symptom or issue can be made to shrink or vanish if I can manage to, say, lose some of that weight.  (The best medical news I ever got along those lines has been docs saying that if I could lose my excess weight, I’d quite possibly be able to eliminate all my meds and such.)

So doctors who can point toward health are most appreciated.

Of course, having been to some extent on the other end of that kind of medical interaction (as a psychologist for many  years), I also know that getting that kind of discussion going with patients isn’t always easy.  Some patients are too poorly educated to even recognize that you are discussing something that is life-threatening, or to understand how or why to follow recommendations. Some are already too depressed to be able to process the “this can improve!” message you’re trying to send.

Others may just not have much frame of reference for understanding how to use this information.  It is easy to overestimate people’s abilities to actually make small changes.  You may say “eat vegetables” to someone who has absolutely no experience knowing what vegetables even are, other than maybe having a vague idea that lettuce is a vegetable and they hate lettuce.  Knowing how to plan, manage portions, shop for good veggies (not canned peas?), or cook palatable veggies, is really not that uncommon a set of problems.  (I’ve mentioned using calorie counting software, for instance, but recognize that many patients might not have the faintest idea what that means… presumably, if you’re reading a blog on the internet, you’re not one of them.)  So doctors and other medical personnel have to be ready to take the time to really talk with their patients about this stuff — to assume the role of teacher, mentor, and supporter.

(The fact that insurance won’t pay for that kind of time with a doc is all the more reason to get active in working for a better health care system.)

But patients also have to overcome natural psychological hurdles to getting good medical information.  Even though I’ve worked side by side with physicians through my career, and even had physicians as my patients in psychotherapy, I recognize that when I get into a medical setting my own anxieties and vulnerabilities kick in.  I get less active, don’t always find asking questions to be very easy, forget things, leave without realizing that I don’t really understand the instructions for that medicine.

Those of us who battle being overweight have need for the best diet, exercise and medical information we can get.  That means keeping up on the best research (and reading it with a critical eye), and getting the best medical advice — and support — we can.

A weekend editorial in the New York Times mentions the recent news about so-called “brown fat” that apparently burns calories a zillion times faster than ordinary white fat in the adult body, and notes that this fat seems more active in lab animals when they are put into very cold conditions.  The possibly tongue-in-cheek advice is to drop the temp in your house to 61 degrees.

Of course, this is a fairly common kind of news article, and so perhaps it’s a good time to talk about one of the minor hassles of working on weight loss: the abundance of junk science, bad advice and just plain stupidity that we have to put up with.

There are really two different kinds of things you’ll see in the news and on internet ads that flow from early hints of medical findings.  The two more or less fuel each other.  On the one hand, there will be about fifty thousand articles on the “brown fat discovery” (“!!!!!”) that will be published this year.  This is publications trying to be trendy, and knowing that readers are always hungry for big news about their weight loss concerns.  Basically, any news, however useless, is good filler.  (And most important to editors, it sells magazines — and so gives them advertising revenue.)  Whether or not the news is actually useful, or even accurate, is of lesser importance.

The second major result of these things will be premature quack cures and recommendations.  Odds are high we’ll be seeing books on “the brown fat cure” that involve freezing yourself every day or God knows what kinds of weird recommendations.  Somebody, somewhere, is surely trying to figure out a way to claim that their magical protein supplement drink (basically soy milk, probably) “may increase brown fat — the kind that burns calories fast!”  Even while you sleep, somebody is out there trying to pick your pocket.

This kind of thing is far from new.  Two thousand years ago the Greek physician Hippocrates, often called the “father of medicine,” wrote an essay called “On ancient medicine.”  In it, he complained of the same thing happening in the medical practice of his time.  Namely, people would get a little bit of fact and spin wild theories around it.  Then they would base their practice (or nowadays, self-help articles, sales pitches for supplements, and editorials in the Times) on these theories, made mostly of empty air.

The problem, Hippocrates pointed out, was that the theories may be wrong, wrong, wrong.  Or even lethally wrong, wrong, wrong.  Until you actually try things out, gather data, look to see if something actually helps, you don’t know anything.  And you are foolish to think you do.  (Which was why, even 1800 years after Hippocrates,  George Washington was almost certainly hastened to his death by well-meaning physicians who continued to use ancient methods based, literally, on ancient theories of “bodily humors,” such as by “bleeding” him profusely after he caught a chill while riding on a cold, wet day.)

The field of weight control and health recommendations are rich in this kind of mistake.  Not many years ago, for instance, diabetics were being advised to go on high carbohydrate, low fat diets.  The reason was not based on research (at least, not research on how that diet actually affected diabetics), but on the theory that carbs were good for people and fat was bad.  So dieticians around the country dutifully had diabetics cutting fat and increasing grains.  Until it was found that this was just about the worst thing you can do for blood sugar control.  In fact, it was found, a bit more fat might give you better control over your blood sugars, and that diets heavy in even whole wheat bread can lead to blood sugar surges.

My advice for now on the brown fat issue: ignore it.  Every article you read about that stuff is five minutes you could be using to take a walk or write down what you ate for breakfast, or just enjoying the sunshine.  An essential psychological strategy for weight control projects is to keep focused on the few things that will give you the best results — then live your life to the fullest with the rest of your time.

Taking the day off.  Enjoy your bunnies and peeps.

Just write down how many you eat.