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Old 07-10-2007, 05:05 PM   #1
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Join Date: Sep 1999
Posts: 9,160

Default Topic 10 - We're Different!

First of all, please accept my apologies for getting behind in our Rethinking Thin book discussion. I was traveling last week and everything has just gotten away from me. We’ve pretty much discussed everything written in the book but I’d like to finish by focusing on some areas not discussed in the book and your overall assessment of the book’s message.

Many posters have pointed out that a glaring deficiency of Rethinking Thin is its failure to discuss successful weight loss and maintenance, perhaps because it doesn’t dovetail with the book’s message that long-term weight loss is pretty much impossible. So it’s up to us to discuss the ramifications of the physical and psychological changes caused by weight loss and their implications for maintenance.

In an early discussion, Heather/Wyllenn correctly pointed out that one of my favorite weight loss statements is: we’re different! When I say that, I mean that those of us who have lost a significant amount of weight are very different -- biologically and psychologically -- from “normal weight” persons who have never been overweight. As Dr. Rudolph Leibel said to me when I had the opportunity to discuss weight loss with him: “You may look like a normal person on the outside, but on the inside you’re very different.”

The book agrees that physically we’re different:

Fat people who lose large amounts of weight may look like someone who is never fat, but they are very different. In fact, by any measurement, they seemed like people who were starving. (p 114)
What’s remarkable to me is that, even five years after reaching goal, a simple blood test would reveal my status as a reduced obese person according to Dr. Leibel. Like the dieter quoted on page 6 of the book said: “I am a fat man in a thin man’s body”. Change the gender and that’s me and many of you.

In addition to the long-term physical changes caused by weight loss, the book also points out some psychological consequences of weight loss called “semi-starvation neurosis”, when people obsess about food and become anxious and depressed. (p 115).

These physical and psychological changes associated with weight loss led one group of researchers to conclude that:

… the removal of obesity by means of caloric deprivation led to behavioral alterations similar to these observed in the starvation of non-obese individuals. It’s entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved non-obese individuals. (p 115)
So what do the physical and psychological changes caused by weight loss mean for maintenance? The book concludes that weight loss success is virtually impossible, but it’s safe to say that we here at 3FC refuse to accept that conclusion! We know it’s possible – but we know it’s difficult. And sadly, long-term success is not very common.

So are we semi-starved? Are we neurotic? Is normal weight actually abnormal for some of us?

The book dismisses those who have maintained a substantial weight loss as making semi-starvation their life’s work:

Eventually, more than 50 people went through the months-long process of living at the hospital and losing weight, and every one of them had these physical and psychological signs of starvation, Hirsch reports. There were a very few who didn’t get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and always counting calories and maintaining themselves in a permanent state of semi-starvation. (p 114-15)
OK, I’m a mod here at 3FC and became a personal trainer. Did I make weight loss/maintenance into my life’s work? Is it yours? Must it be one’s life work in order to succeed?

And … how can we sustain the motivation?

(Describing one of the Penn dieters meetings) One man finds the words to ask the unspoken question that underlies all the talk about willower and keeping temptations out of the house. It is one thing to resist Krispy Kreme doughnuts while you are losing weight, or to tell yourself that celery – celery – is a snack. But how, he asks, can you live this way for the rest of your life?

“This is what I don’t get about weight loss and dieting,” he says. “How do you get the reasons why you want to lose weight to be important enough to maintain that self control forever?” (p 128)
What do you think works for successful maintenance? What separates the 95% who regain all lost weight from the 5% who maintain? Does acknowledging that we’re different make it easier to keep the weight off?

Do you agree that we're different? If so, what does this mean for weight loss maintenance?
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