Tuesday, June 26, 2012

Cogito, Ergo Edo

I think, therefore I eat.

That's pretty much the philosophy by which I lived my former life. These days I am still thinking a lot about eating, but as the old Apple Computer campaign would have put it, I "Think Different." 

For starters, I think that I want to eat more. But I don't.

As I have often said--I do extreme behavior well--it's moderation I find challenging. During this very well defined period of rapid weight loss (and to some degree self-deprivation) it is clear to me why and how I would resist the temptation to eat more. And I know, I know I'm supposed to be living in the now, but I can't help but wonder how well this behavior will translate to life back on food.

I used to graze so delightfully (?--you may not believe this but even I had occasional pangs of guilt and self-loathing) throughout the day. Food pellets were handy and plentiful. I even rationalized (some) that they were healthy and appropriate mid-morning and mid-afternoon snacks. (Depending on how many handfuls of pistachio nuts, or whole wheat bread sticks and hummus fit into the definition of healthy and appropriate.)

I also made extremely healthy salads for lunch--probably enough for a family of four, but extremely healthy! Well, let's not get dragged down in the litany of eating abuses. The point is--now I am in absolute control. I am practicing absolute control. Even when I tiptoe over the boundaries of the rigid program, I have done so with a high level of consciousness and sufficient control to border on responsible moderate behavior.  That's what gives me hope. 

I'll leave it at that.

Tuesday, June 19, 2012

Halftime Report

We’ve reached the end of our eighth week of this Kaiser Permanente Medical Weight Management Program with eight more weeks to go before we start transitioning from “food replacements” to “real food.” I’ve lost about half the weight I figure to lose, although the ultimate goal is only an approximation that, as I approach it, I suspect will be re-fined and de-fined by my body rather than my mind. Anyway you look at it I am at or nearing halftime in the rapid weight loss stage. Time for a breather? Probably not. Time for a pep talk. Definitely! 
In recent days I am finding myself increasingly weary of the same ol’ same ol’. It may be less boredom with the bars and shakes and soup and more simply some cravings for a real meal. Surprisingly I’ve also felt something akin to hunger more frequently, although I suspect that is more mental than physical.

I imagine that the entire process—all eighteen months of it—will focus a good deal more on the mental and emotional aspects than even the physical. That is where the true challenge lies. For the most part this period of depravation is pretty simple. There is essentially little or no choice regarding eating. That makes it a lot easier than when the all-the-junk-you-can-eat buffet of our society is back on the table.

The lure of real food only creeps in occasionally. I’m not keeping a food journal yet, and I’ve pretty much toed the mark, so I don’t have any data to analyze about when these cravings are most prevalent. I can, however, clearly describe the most recent, given that I just walked into the house after a 15-mile bike ride that was fraught with the most challenging of cravings.

A Tough Ride
About halfway through the ride, blissfully rolling beside the baylands on the paved Steven Creek Trail, I sensed some fatigue setting in. I had eaten my four o’clock protein bar not long before I left, so I should have had enough nourishment to sustain an hour-and-fifteen-minute jaunt, but I regretted not being able to reach into a pocket for some raisins and nuts or a Clif Bar. I drank water. Still I felt a bit weak. “Do I need to eat?” I wondered. And then my mind not only wondered, it wandered. In another few miles, if I were feeling too weak to continue I knew I would pass a taqueria. Or maybe pass is not the right word. Maybe, just maybe, I could rationalize the need for “nourishment.” Maybe I’m burning so many calories on this ride and maybe if I have just one chicken taco (and a diet-Coke of course) and skip my 160-calorie soup scheduled for seven o’clock…. The mind kept this banter up for miles with a growing sense of expectation.

Just two days ago, on Sunday, I did a rigorous 45-mile ride with folks from Hazon—from Mission Dolores Park, through the Presidio, over the Golden Gate Bridge in brutal fog and blustery cold wind, up and around the hills of Tiburon seemingly facing headwinds in every direction of travel, and back. Based on my experience on the big Hazon ride last month I stocked up with various cycling nourishments, freely stoking the furnace the entire journey. That seemed easily justified. But this. Fifteen miles of flat terrain hardly qualifies as justification to take liberties with the program. Oh, but a taco! The thought of that savory delight passing my lips! A taco! I could taste it more with each stroke of the pedals. I’m going to do it! Sure I am! I can handle it. Can’t I? Should I? Do I need to call a sponsor? Do I have a sponsor? If I call Matt, a “classmate,” will he talk me out of it or into it? If I call Debbie will she help me stand firm or sympathize with my plight? Am I really hungry? Well, maybe no stomach growls per se, but I was feeling tired, remember? I need this! Oh it will taste so good! That’s it. That taco is mine! Just one taco! I can do this! Oh, but I want so much to hit my next weight milestone—just a pound away. Would this delay it? Am I giving into my old habits too quickly? Can I resolve myself to get through this, and then feel even better about achieving that milestone than I would have about eating the taco? Nah. Drink some more water.

I exited the Stevens Creek Trail and started heading home through Mountain View. Oh boy, I’m on California Street and I know exactly where that taqueria is on California Street—not far ahead. What will I do? I don’t even think it’s a choice. I sense that some other power is in control of me, and I will just have to wait and see whether I stop there or not. I’m getting closer—only a block away and a creeping sense of disappointment starts to set in. I’m getting the feeling that after all my joyous anticipation of that taco that something is going to carry me right past it. I can’t believe it! Should I be cheering or booing? I don’t know. In a sudden state of blindness I ride right past the place without even seeing it—truly! Did it suddenly disappear? I know it was there when I rode this route last week. How did it suddenly vanish? How did I not eat that revered and much anticipated taco?

In class we talk about finding other things to do when we think we want to eat at an inappropriate time. I guess blogging will have to be one of those things for me. Not only did I somehow elude the siren call of the taco, I somehow found a way to fill the entire three-hour interval between “food pellets.” Time for soup! When I return, I’ll share a few thoughts about portion control and rewards!

Portion Control
Advanced Health Systems Peppermint Cocoa Crunch Bar Artificially Flavored
I may have mentioned in previous blogs that amidst the day-to-day unfolding of this program I get these occasional sparks of clarity and insight into what I am doing. I guess it’s called consciousness—a rare but delightful state of being. What hit me recently was an idea that seems so simple to say and yet so hard to really get. Here it is. Are you ready? Before I eat, when I look at a serving of food, I invariably overestimate the amount that will satisfy me. Another way to say that is when I look at what is truly an ample portion—it looks way small, much too little to meet my appetite (or as my papa used to say, “My eyes are bigger than my stomach”). What I am slowly beginning to understand is that smaller is adequate, that when I eat my little 160-calorie protein bar slowly—granted typically with some bubbly water, for better or worse—it eliminates my hunger and provides me with all the nutrition I need. Isn’t that what food is supposed to do? Conversely, when I eat a plate of tacos along with a couple of baskets of chips and salsa, and a diet-Coke or two my mind says, “Yippee, this is exactly what I wanted!” until my body catches up, about the time I start staggering toward the door feeling, “Oh no, I’ve done it again.”

I know it takes the brain 20 minutes or so to get a signal that one has eaten enough. By then I’ve usually eaten too much. This is something I think I can really learn and remember and act on!

We were given a book to read that apparently will provide the foundation of our work in the months ahead.[i] One of the skills is to give oneself some rewards along the way. I found it difficult to imagine what I would reward myself that would be of any help. I have everything I need and most of what I want. I realized very quickly that the one reward that has been consistently of value is simply watching decreasing numbers on the bathroom scale. Nothing has given me greater satisfaction. Perhaps that was the subconscious deciding factor in bypassing that taco stand. I can’t wait to see another lower number on the scale and that taco could very well have been an impediment. 

A few days ago we got a card in the mail from a charity asking for used clothes. Most of the time Debbie asks me what I have to donate and I begrudgingly cough up a ratty old T-shirt. Not so this time. With great exuberance I went through every drawer and pulled every hanger down, tried on virtually all my clothes and cheerfully filled up a large garbage bag with clothes I hope never to fit into again. Moreover, I dusted off a bunch of suits and pants, sweaters and shirts that I had long since outgrown and now can wear with delight. (Some of them may even have to be taken in!) If that’s not a reward, I don’t know what is. Oh, I suppose a taco plate at a big milestone still sounds good. Do you think?

Go Team!
Halftime is about over. Time to get back into the game. None of this rises to the level of a Knute Rockne locker room speech, but there are a few nuggets to take away. At the half I’m down by over 30 (pounds, not points, so that's a good thing). I demonstrated some inexplicable inner capacity to overcome temptation this afternoon. Maybe that spiritual connection I sought to infuse in the program is taking hold. I’ve recorded a few insights along the way that I trust will be even more meaningful later in the journey. Whenever I get lost thinking about all that lies ahead Debbie reminds me to stay focused on the present. (As they say in the post-game interviews, “We just gotta take it one game at a time.”) So I guess it’s time “to go out there with all I've got and win just one for the Gipper”     
P.S. A day later, I just stepped on the scale and indeed hit the milestone! Would one taco have made a difference? We'll never know, but I'm pretty pleased with how it all turned out.

[i] Living Smart, Five Essential Skills to Change Your Health Habits Forever, Klapow & Pruitt, DiaMedica Publications, New York City NY, 2008

Friday, June 1, 2012

Sixteen Weeks

I dream of food—literally. Not every night, that I recall, but I do dream of food. I have found myself chomping down on some delectable only to freeze with a sudden realization that I have mindlessly and inadvertently “gone off plan!” Then, fortunately, I wake up. I had a different sort of food dream this morning. I was striding quickly toward the stairs leading to an elevated train platform alongside a woman who I sense was providing the fare for me. She handed me her purse and I remarked about her trust in a complete stranger. I must also have made some remark about her need for a cigarette, although I don’t remember that exactly. Something elicited her retort, seemingly in defense of her habit—how was her smoking different than my eating hot dogs! That woke me up—literally— perhaps, figuratively as well.

Was this a proverbial “wake up call?” I pondered her sentiment. How is eating a hot dog like smoking a cigarette? Well I don’t eat two packs of hot dogs a day, or even a month, but if I broaden the definition to include the class of foods that contain high amounts of fat, salt, nitrates or any number of other specious ingredients, foods that I eat out of habit, or from an uncontrollable impulse to comfort rather than to nourish myself—that could include a lot of metaphoric hot dogs. Eating a hot dog is the gastronomic equivalent of hammering nails in one’s coffin one cigarette at a time. I was about to argue that at least poor eating doesn’t impinge upon the health of others, but I had to stop myself. I am guilty of exhaling into the faces of others the excitement of pizza and tacos and pastrami and ice cream with as devastating effects as blowing secondary smoke into a baby’s crib.

But, but, but…you can’t go “cold turkey!” You can never quit eating. Well, no, you can’t swear off food, but one could swear off junk food. “No! No!” my inner addict shouts, “Don’t even suggest that.” Well, it is a thought. Isn’t that what sixteen weeks of food replacements is trying to teach us? Well, that—and a bunch of other stuff I am sure.

For instance there was that morning, as I was innocently walking through our family room, when I had one of those sudden bolts of consciousness. It hit me that one lesson in the “sixteen weeks” was an awareness of the difference between “eating to live” and “living to eat.” Not that I yet am a convert from the latter to the former, but at least I get a sense of what that is like. I dutiful eat my 160-calorie meal replacements at 3-hour intervals in a methodical process of providing myself sustenance. With only a minimum of eager anticipation, I perform this ritual far more out of necessity than in response to desire, gluttony, emotional self-medication, camaraderie, or a half dozen other inappropriate motivations.

I also learned, or at least I’ve started to develop an awareness, that having set times and menus, and exercising a commitment to maintaining this schedule, affords me the opportunity to experience hunger without feeling compelled to immediately eradicate it. That may not seem like much to some people, but that is a biggie for me. The behavior of eating whenever one is hungry is especially challenging when one has difficulty distinguishing between true physical hunger and its many psychological imposters. I have often tried to discern whether my march to the refrigerator was a response to the needs of my body or of my mind. The beauty of this plan is, it really doesn’t matter—that is not if one no longer feeds oneself at the first sign of every real or imagined pang of hunger. Now I say, “Hunger is my friend. I will live with it for an hour until it is time to eat.”

The power of these sixteen weeks is great. I may not yet have fully discovered all their lessons. I imagine it is like other rehab programs—an opportunity to clean out the system from addictive substances, an opportunity for a fresh start. I have occasion to wonder about the effect of going off plan in the midst of this period. As I last reported, during the long fundraiser bike ride, I had a clear physical need that I addressed. I chose the ride over the plan and ate a bit of real food. Tomorrow night I will be at a family wedding, and I have chosen, during a weekend of catered events, to make another isolated exception to the program. I decided—rightly or not—that to eat food replacements at the reception dinner was a distraction to the joy of the occasion—perhaps more so for my fellow guests than even myself. I argued that to be fully present to and engaged with the sacred ritual I would make this one exception and sup with others at the wedding dinner. I will not partake in the tempting Korean barbecue Friday night. I will not partake in the cocktail hour hors d’oeuvres. I will not eat the likely rolls and butter or the inevitable dessert (well, maybe a bite). But I will have the porcini dusted chicken, roasted corn, bell pepper, Swiss chard, wild mushroom succotash, Meyer lemon beurre blanc & saffron oil with crispy sweet potato hay rather than, as I did on the bike ride, bring my oversized mug of chicken flavored food replacement soup to the table and go into the whole song and dance about why I don’t have a plate of food like everyone else, incurring their pity and provoking their self-consciousness, nervousness, or shame.

I talked at length with our dietician/instructor about how to approach this meal in a way that will provide the best chance of success, including portion control and some of the limitations listed above. Still I wonder: am I shooting up in the midst of rehab? Will this make me stronger or set me back? I suppose I will be able to make that determination in a few days. Meanwhile I am hungry. The sky is growing light, but I am hours away from my prescribed first “meal.” I will drink some water and go back to bed, perchance to dream…of food.
The salad was tasty, too!

Epilogue: The dinner went easily. I remembered my instructor's words--what if someone says "you've got to taste..." The idea was that I would "just say no." Nonetheless, since the bride herself made just such a recommendation, and since I had a rigorous 4-hour hike earlier in the day to Wapama Falls at the Hetch Hetchy Resevoir, I had a few pretty fairly healthful hors d'oeuvres and enjoyed them. I also learned that the grilled elk loin option on the menu had less fat than the chicken and swapped my chicken for the elk with pomegranate port wine reduction, white truffle-chive mashed potatoes, sautéed spinach & rainbow Swiss chard, garnished with fried shallots. The elk portion was much smaller than the chicken so that also helped ease the portion control aspect. I left some potatoes on my plate and did not even have a taste of dessert. Bottom line--I lost 2 pounds this weekend!