Refuse To Regain

Shields Up! The Hunger Advantage

By Barbara Berkeley

What if you could cloak yourself in a defensive shield that warded off disease and extended your life? Would you do it? Would you take a pill that could do it for you? Many of us are already trying to, by swallowing tablets of antioxidants and resveratrol, swigging acai and pomegranate juice and downing loads of vitamins of uncertain benefit. But a growing body of research suggests that the solution may be as seamless and elegant as nature itself. It’s possible that we can activate just such a defensive shield this very moment...simply by eating less.

As readers of this site know, I am especially interested in the role of food choice in life extension. I am also deeply convinced that the hormone insulin is the central “superhormone” which mediates fat storage, obesity, inflammation and longevity. Whenever you read any research about overweight and its related conditions, you will find the fingerprints of insulin all over it. I also believe that a broken or poorly functioning insulin system is the reason that the vast majority of us develop modern disease. We don’t need to have diabetes or even elevated blood sugar to have a struggling insulin system. Defects in insulin signaling can be going on for years before we can detect them. This doesn’t mean that our bodies are not suffering.

Now, in a paper that is due to be published in Nature, German scientists have shown that we have a second defensive system which acts independently of our classic immune system. When we go without food for awhile, this system switches on. Surprise, surprise…the hormone which is responsible for flipping the switch is insulin. Once the system is activated, cells produce proteins which are capable of destroying harmful microbes and defending us against invasion from the outside. According to the the study director, “This happens every minute every day. What is fascinating about this is that a function of the immune system directly depends on how much and what we eat.” In other words, slightly stress your cells by making them hungry and your shields will go up.

This, and other research studies, provides a great deal of non-caloric food for thought. We know that obesity and the diseases it spawns lead to increased inflammation in the body and can result in reduced life span. We also know that uncontrolled inflammation is bad. Might it be that the habit of affluent societies to eat continually results in a chronically lowered defense system? If more invaders are able to penetrate our outer barrier, we would likely respond with aggressive inner defenses, in other words: inflammation!

One of the strategies for weight maintenance that I suggest in my book and that I continue to suggest to patients is that we spend parts of each day in the non-eating state. This allows insulin levels to fall. We now know that these lower levels can active the FOXO transcription factor; the messaging system which turns on defense genes.

So put up those shields and rethink that grazing habit. As those of us who are maintaining weight know, the body does best on small amounts of highly nutritious foods. Our miraculous physical plant is finely tuned and we may be best off if we stop trying to second guess it with pills, potions and manipulations. More and more, we are coming to know that a return to simple basics and a realignment with our genetic priorities is the only way to put nature to work for us.

No Winter Maintenance: Travel At Your Own Risk

By Lynn Haraldson-Bering

Some of you know from my post, “Four Little Words: A SAD Remedy,” at Lynn’s Weigh that I suffer from Seasonal Affective Disorder and that this year’s been killer.

Winter weight maintenance is more difficult with SAD. While my food intake is relatively stable (except for the worse than usual carb cravings), there are days you can’t pay me to exercise. Yesterday, for instance, after one – just one! – set of four back strengthening exercises, I quit. And nothing – no meditating, coaxing, promise of reward – was getting me on that elliptical, either. I just didn’t have the mental mettle.

Within this deep emotional hollow, I could do little more than stare at my computer and come up with excuses not to go to the birthday dinner Larry and I were invited to that evening. I knew I’d feel worse if I didn’t go, but you know how you get so emotionally drained with depression that you don’t know what the hell to think? For hours I vacillated between “You promised to be there! You can’t let your friends down!” and “How can you fake happy for three or four hours? You’ll be the most dismal person there!”

I had a hair appointment at 3:00. Cut and color, the anticipation of which usually perks me up. Instead, I hemmed and hawed until finally at 2:30 I washed my face, brushed my teeth and put on normal clothes (I was still sitting around in my under-utilized workout clothes). After throwing on some extra moisturizer (the cold is brutal on the skin, isn’t it?), that little voice in the back of my head said, “Put on some makeup. You’ll feel better and you’ll be glad you did.” Ugh. I can never seem to shut that thing up. But I put on makeup and I went to my appointment. Two hours later, I felt a little less sad and a little more capable of being a sociable human being and one who wouldn’t plunge head first into wine and birthday cake.

The party, like most anticipations, wasn’t as difficult as I imagined. In fact, it was a lot of fun. I reconnected with old friends and I met a new one – a woman who is maintaining a 25-pound weight loss! Thing is, we didn’t talk about weight. We talked about SAD, among other things. She – as well as our hosts – understood SAD. They deal with it every year. My new friend told me about a passage from “The Book of Disquiet” by Portuguese poet Fernando Pessao, a quote she said doesn’t evoke who she is, but resonates with her. That’s what SAD is: not who we are, but merely a part of our experience.

No winter maintenance. I’m determined to not let this be my mantra.

The sun was out today – a rare occurrence in winter in western Pennsylvania. It was 36 degrees, and after a full workout, I went hiking with my husband in one of the most peaceful places I know, Cook Forest. The hemlocks, the running water of Tom's Run, along with the air and sun cleared my head, and another day of SAD was laid to rest.

I’ll leave you with Pessao’s quote. Like my friend, it doesn’t define me, but it explains a part of me.

“The mere thought of having to enter into contact with someone else makes me nervous. A simple invitation to have dinner with a friend produces an anguish in me that’s hard to define. The idea of any social obligation whatsoever – attending a funeral, dealing with someone about an office matter, going to the station to wait for someone I know or don’t know – the very idea disturbs my thoughts for an entire day, and sometimes I even start worrying the night before, so that I sleep badly. When it takes place, the dreaded encounter is utterly insignificant, justifying none of my anxiety, but the next time is no different: I never learn to learn.”

Overweight Top Doc: Yes or No

By Barbara Berkeley

Well, what say we start off the New Year with a really contentious topic? Is it OK to have a surgeon general who is overweight?

President Obama recently named a new top doc, Dr. Regina Benjamin. Dr. Benjamin is an obviously dedicated, talented family practitioner who has been a voice for the underserved population in her home state of Alabama. She has provided an enormous amount of free care and has been a staunch advocate for her patients. Furthermore, she focuses on preventable illness. For more on her background, click here.

But Dr. Benjamin, who is 52, is overweight. By her own admission, multiple members of her family have died from preventable illness including HIV, lung cancer, diabetes and hypertension. The New York Times’ Well Blog recently solicited comments about Dr. Benjamin’s weight as it relates to her status as chief physician.

I found the comments to be both fascinating and instructive. I didn’t agree with most of them and I wondered what your take might be. We have a unique population on this website so I am very interested about your opinion. In case you don’t feel like scanning all the comments, they fell into a couple of broad categories:

1. How dare we use weight to judge someone’s fitness for a job.
2. Criticisms about weight would never be leveled at a man.
3. Dr. Benjamin is preferable to someone who looks like a bikini model. She can understand what we’re going through.
4. Dr. Benjamin’s weight “enhances her credibility.”

You will read my comment below, but before you do, I would like to add that I doubt that male wellness advocates like Dr. Oz would be taken very seriously if they were overweight. I do believe that he would be looked at critically if that were the case, just as Dr. Phil was when he suggested he was an expert in weight loss.

Here was my response to the Times:

“It’s hard to address this without sounding petty, but this issue is not as simple as it might seem.

"Obesity and the costs generated by its related medical conditions are the crux of our current national struggle with health. As we go into the future, the battle with obesity is certain to intensify. Johns Hopkins University, for example, has predicted that 86% of Americans will be overweight by the year 2030. Our health care system cannot survive the onslaught of diabetes, hypertension, cancer, heart disease and the like which will be generated by such figures.

"While it may be comforting for people to see a physician who looks like other Americans, Dr. Benjamin’s weight suggests that she herself has not found a good answer to the obesity dilemma. At this particular moment, we need someone who can be inspiring on this issue. We need a leader who doesn’t just struggle with the problem, but who has figured it out.

"Many of the comments above proclaim that size is predetermined. It is not. Our size comes from the interaction of a genetic predisposition with an unhealthy food environment. There are thousands of people who have been able to work this equation out, have lost weight, and have kept it off. A doctor who has made such a change and has been able to sustain it would have been the perfect candidate for surgeon general at this particular time. Over the years, scores of patients in my weight loss practice have complained that they have been unable to seriously consider lifestyle advice from doctors who smoke or are overweight themselves. While commenters above suggest that they can be more open, real life experience tells me that Dr.

"Benjamin’s solutions for weight loss will be a hard sell. At this critical juncture – and as far as obesity is concerned – we need an inspiring medical leader, not necessarily an understanding friend who looks like we do.

"I was also troubled by something Dr. Benjamin said in the appended video. When asked what she would do to curtail smoking, she spoke of getting individuals to quit. She was then pressed as to whether she would take on the tobacco folks. Here she backed off, leaving most of the responsibility for control to smokers themselves. I hope that this does not foreshadow her approach toward obesity. We have put far too much responsiblity and blame on those who are overweight and have done far, far too little to control the overstimulatory environment and uncontrolled food production which is causing the problem."

I’m curious as to what you think. Feel free to let me have it if you disagree.

Emotional Transformation and The Skinny Girl

By Lynn Haraldson-Bering

In her last blog (Transformational Thriller), Barbara wrote about the physical transformation from obese to thin and how thrilling it is to be “noticed” and in essence rewarded by the accolades of others (and ourselves) for the ways in which our bodies have changed. For some, there is a subsequent let down when people get used to seeing us as we now are, and therefore their comments end and we’re left wondering, What’s next?

I enjoyed the compliments for the most part as I was losing weight, but I admit I was pretty happy when the hubbub died down and I could be just Lynn again and not That-Woman-Who-Lost-All-That-Weight. What has the potential to trip me up once in awhile is not so much the physical transformation as the emotional transformation. I’ve said many times since reaching goal that I finally feel like the outside me and the inside me finally match, but the longer I maintain, the more I think that descriptor may be a bit premature. In many ways, my inside is still catching up.

The emotional transformation from obese me to maintaining me is perhaps even more astounding than the physical transformation. It’s just not as apparent. The transformation began the moment weight loss “clicked” five years ago. Most people who successfully lose AND maintain their weight had an “aha!” moment – that realization that things are different “this time” as opposed to all the other times they tried to lose weight and failed. For me, that moment was followed by an avalanche of changes, not just in the way I ate – that was the easy part – but in the way I related to food and, even more important, how I related to myself. I began to demand from myself respect, forgiveness, and understanding – three things I rarely asked of myself or others. I often hid in my fat or other emotional insecurities and believed I didn’t deserve to be treated fairly.

Physical transformation is, for the most part, finite. We can sculpt our bodies through weight training and surgery, but if we remain the same weight, we pretty much look the same. Emotional transformation is infinite, an evolutionary journey.

I know many of you don’t like the word “lifestyle” to describe the way we live life as maintainers. But lifestyle is a choice, and I choose maintenance as a way of life, just as I choose to be a writer and I chose to become a mother. It’s living within this choice where the emotional transformation evolves, and that has had the biggest impact on my relationship with myself and with other people.

Because I no longer put myself or my needs last, my relationship with my husband has improved – not because I’m thin, but because I am more confident, which in turn has made me a better partner. My relationship with my children is stronger because I’m a better communicator. Sure, Passive-Aggressive Lynn comes out now and then, but like I said, this is an evolutionary process.

Where I see this process jammed up a bit is in my relationship to people I’m not related to. For instance, life before 300 pounds, I was the queen of parties. Threw them, went to them, loved them. Not surprisingly, I became somewhat of a hermit when I got to the top of the scale. What is surprising, to me at least, is that I’m still a hermit. This is the thing I meditate on the most, the part of my emotional transformation that has me the most confused right now.

Is it because I really don’t like large gatherings that I don’t go out much, or is it because I’m tired of defending my “lifestyle” and prefer the company of like-minded people? More times than I can remember I’ve been at a party or out to dinner and have heard, “What’s one meal? Eat!” (Heck, I even get that from strangers on my blog!) To me that’s like telling an alcoholic, “What’s one drink?” or an ex-smoker, “What’s one cigarette?” What most non-maintainers don’t get is that one meal of food I no longer choose to eat would not only cause me great gastrointestinal distress, but it would take me a good week or two to get it off the scale. Say that to food pushers and I’m suddenly Debbie Downer. I’ve tried the “I don’t care what you eat. Why do you care what I eat?” approach, but that usually doesn’t work, either.

Food is perhaps not a good example. Emotional transformation is an attitude that goes way beyond food choices. I’m still learning how to respect myself and my boundaries, both in terms of food and the way I am comfortable moving within and thinking about the world. Things I said yes to before I say no to now, and vice versa. Things I tolerated before I no longer tolerate. I’ve met some incredible people since getting to goal three years ago, largely because I’m no longer afraid (or at least entirely afraid) of what they might think of me. Some friendships have deepened and some have fallen away. But for the most part I don’t sit in regret, not like I used to when I was in the habit of gaining and losing and gaining and losing, not understanding the permanent change that must take place in order to reach and maintain a goal, any goal.

My outside is pretty much where I want it. I’m confident the inside will catch up in time. As long as I stay outside the cycle of self-abuse, self-loathing and delusion and live in a state of emotional transformation, I’ll continue to be more self-respectful and, hopefully, not social inept.