The Expertise of Experience

I finally made time to get my hair cut yesterday, something I do every 2 – 3 months and really should do every 4 weeks. At my local hair salon, my normal hairdresser was off for the day, so I got placed in the care of someone new – a friendly, chatty mother of four who wanted to know what the inkpot-and-quill tattoo on my forearm represented.
“Oh, I am a writer,” I said as modestly as possible.
“Really? What do you write about?” was her interested query.
“Health issues, mainly.”
And, with that, we were off to the races. She wanted to know about high-protein diets. (Yes, with appropriate nutritional supplementation.) About avoiding kidney and liver damage. (Drink more water, and try to cut out soft drinks.) About which was the truth: fish is good for you because of fish oil, or fish is bad for you because of mercury. (Both, really, but if you really want just the oil and not the taste of fish, just take a fish oil supplement.) I talked more during that half an hour than I probably had in the 8 hours preceding it. (Sorry, Lor!)
It was very interesting to discover how much confusing information is out there in the general public pertaining to dietary health. This intelligent woman, trying to look out for the health of her family, had so much conflicting data that her dietary planning was at a standstill. All of the hard-won experience Lor and I have earned in the past few months, involving radical surgery, major lifestyle changes, and thousands of dollars in medical bills should be available to normal people without having to suffer through the costs of morbid obesity, right? So, how do we go about getting this info into the hands of our friends and neighbors?
Talking about it seems to be a good starting point. Most people, when they hear about my surgery, want to focus on the procedure. But most people I talk to don’t need bariatric surgery. They could get positive results from making a few of the changes that Lor and I have made, without having to go through all of the “other” stuff that went along with our treatments for morbid obesity and diabetes. It is entirely possible that I need to begin shifting my focus when interacting with people on the subject. Like, “Yes, I had to have surgery, but you can have positive results by exercising, avoiding processed foods, and focusing on hydration.” It is an interesting focus shift that I hadn’t really considered previously.
As my haircut wrapped up, my hairdresser commented that, instead of being a writer, I really ought to be a nutritionist or dietitian. I laughed and thanked her, then mentioned that I had a dietitian, and that it was a very technical position requiring many years of education and training.
My hair artist looked me over, and said: “You? What do you need a dietitian for?”
If I Wasn’t Married, I Would’ve Kissed Her,
– Hawkwind

The Psychology of Obesity

Photo Credit: theearlofgrey via Compfight cc

An awfully pretentious title for early on a Friday, right? But today will be my first visit to a psychiatrist in many years, after a couple of very bad patient/doctor relationships – and telling myself to not worry about the visit today has got me thinking about why it is that a person becomes obese in the first place.

The Background of Obesity

Visit any forum or message board dealing with obesity these days and you will find a few trolls – those individuals who have taken time out of their day to drop in and tell us that we are only “fatties” due to a lack of willpower. If we only had some self-control (as, presumably, these individuals believe they do) we would not suffer from this problem. To them, the condition of obesity is a product of nothing more than laziness. Running into an especially obnoxious troll post can infuriate me for hours afterward – which tells me that something inside that post has resonated with me. Apparently, I believe at least in part that if I had just tried a little harder over the past 20+ years, I would not be obese.

And here lies the problem with obesity, in a nutshell. The vast majority of us thinks that we alone are responsible for our condition. But, other than being fat, where is the evidence? The majority of us go to work, we raise families, we practice religious devotions, we do chores around the house – we do a hundred things a day that prove that we are not lazy – and yet we accept that the state of our bodies results from a failure in willpower.

Obesity sits in the same corner with drug addiction, alcoholism, and depression – conditions that a person who has never suffered from will never really understand. These afflictions of the mind are easy to marginalize and make fun of because they are invisible to the naked eye. A person on crutches wearing a cast is accepted as having a broken leg. But, in our culture, obesity is not accepted as a sign of a broken mind.

Rejection by Society

A few years back, Lor and I stopped by a local gym to check into monthly rates, thinking maybe we could get this thing moving on our own. The young and heavily muscled twerp behind the counter took one look at the two of us and suggested that maybe this wasn’t the gym for us. We couldn’t afford it anyway, so I just let it go. But I guarantee you that I went home and ate something afterward. “Healthy” society had just rejected me and made me feel bad. So, I went home and ate, which made me feel good.

Now, which activity do you think I return to most often? It is called a conditioned response – your mind drives you towards those things that feel good. The mind associates things which are good for itself (eating, sexual response) with pleasure, and things which are not good (being cast out of a social group, hitting oneself with a hammer) with pain. This is Mother Nature at work here, trying to secure the continued survival of a species. What Mother Nature did not count on is that we’ve now developed a cycle:

  • There are so many things to eat which cause pleasure.
  • Overeating develops obesity.
  • Obesity causes rejection by social groups, which is painful.
  • One retreats from the pain of rejection, by embracing the pleasure of eating.
  • Back to step one.

This is, of course, a vast over-simplification – and I am no psychiatrist. But the logic is clear: why would I endure rejection and exercise (which is initially painful as well) when I could instead feel good by eating? Eating is a short-term pleasure, of course, but there is always another Quarter Pounder or Snickers bar just around the corner. I am not only eating things which are bad for me, then – I am also eating them more often.

See where this is heading?

The Final Rationale (Rationalization?)

I am not looking forward to bariatric surgery because the smaller stomach size will force me to eat less. I am looking forward to bariatric surgery because I will finally have the chance to look for “pleasure centers” that do not revolve around food. Weight loss will allow me to finally seek endorphin-releasing exercise. It will enable me to live a life where I am not constantly in pain. It will enable me to have a normal sex life. And, yes, it will enable me to interact with other people without the prejudice against obese people working against me. I am willing to have the majority of one of my internal organs removed and THEN go through all the normal work of weight loss, just to reset my association with food as the sole source of pleasure in my life.

It may seem unfair, but there it is. I have to live in the world as it is, not as I wish it to be.  I can only hope that my psychiatrist today agrees with me, and does not instead want to turn me into a multiple-year case study or something. Wish me luck!

Still Looking For Endorphins That Don’t Make Me Fat,

– Hawkwind


Dietary Thinking is Painful

Photo Credit: Rachel Cogyddes via Compfight cc

Last night’s experiment with a slow cooker, a package of “Buffalo Chicken sauce” and 12 chicken thighs has left us with 3 pounds (no, really – I checked) of shredded chicken and no idea what to do with it. This is after we created buffalo chicken salads for dinner last night, mind you. Surfing through all the different web pages on how to use shredded chicken, I am struck by how many of these recipes are totally not suitable for our current diet. (So far, 100% of them.) Which has me thinking even more about how difficult this transition from “obese eating” to post-surgical diet really has been.

Take breakfast, for example. Used to be we could pour a couple bowls of cereal, maybe top with a little fruit, and call it done. If we were feeling really ambitious we would assemble all the materials for breakfast burritos: you know, tortillas, potatoes, peppers, eggs, chorizo or bacon, shredded cheese, a little salsa. Half an hour’s work for pure breakfast bliss.

Nowadays we look in the fridge, completely perplexed. And frequently just settle for cottage cheese with fruit or yogurt for breakfast, because thinking in the morning is so hard. Bagels, toast, English Muffins – all the easy solutions are barred to us unless we want serious carb restrictions for the rest of the day. Scrambled eggs, you say? Scrambled eggs are just so…meh.

The problem with eating just yogurt for breakfast is that you are starving to death (or, at least you think you are) an hour later. But snacking creates some problems of its own. Firstly, snacks aren’t regulated very well and are an easy way to slip back up into high-calorie eating. But the real problem is drinking. We’re supposed to wait an hour after every meal before drinking again. If we are eating every couple of hours, we have very limited windows for fluid intake (remember, no gulping, only sipping.) And trying to fit 64 ounces of water in every day is tough enough without reducing the amount of time we have to drink.

Lunches, at least, are easier. Our go-to lunch nowadays is deli meat, block cheese, and nuts of some kind, along with a piece of fruit. We had been doing fruit and vegetable smoothies for lunch every day but were “corrected” by our nutritionist. “Don’t drink your calories!” has become a familiar refrain during our nutritional visits. I still think we were getting a greater nutritional benefit from all the fruits and vegetables we were putting into our smoothies, but I am not the one with all the fancy letters after my name, so I am forcing myself to pay attention and be a good student.

But dinners…oh, man, dinners are a stumbling block. Used to be multiple times a week Lor and I would look at each other and simultaneously decide “I don’t want to cook!”. And then we would be off to the closest fast-food joint, ordering (super-sized) value meals and soft drinks. And then wondering why we were hungry again an hour before bedtime.

The era of the value meal has passed. As long as we have planned carefully, everything is ok. But on the days where we forget to plan, dinner time is a furball of frustration, as we attempt to figure out what in the heck we are going to eat when nothing has been thawed out and no meal plan exists. Salads seem to happen a lot. Sounds healthy, but is awfully boring. Not to mention the pile of dishes every single night. (Our dishwasher broke just in time for us to start cooking at home 90% of the time. Of course.)

Don’t tell Lor, but I am soooo looking forward to the all-liquid diet around my surgery. For 4 glorious weeks, I won’t have to think about food. She is very concerned about getting bored with the constant repetition of vanilla/chocolate/vanilla/chocolate. Me, I couldn’t care less. I will be so delighted to not have to plan – it will be like a return to the days of instant gratification at the drive-through window.

Just, you know, liquid. And chocolate or vanilla.

Wondering How To Make Chicken Enchiladas Without Tortillas,

– Hawkwind