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Old 11-02-2008, 12:23 AM   #1
AnneWonders
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Join Date: Oct 2004
Location: Tucson, AZ
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Default Refuse to Regain

I’ve just finished reading Refuse to Regain! 12 Tough Rules to Maintain the Body You’ve Earned! by Barbara Berkeley, M.D. Berkeley is an internist who runs an obesity specialty practice (which includes the Optifast program), and is a 5 year maintainer of a 20 lb weight loss and seems well qualified to write a book like this. My very long review follows along with some questions for discussion to those of you who've also read the book.

First, a summary of the book. Refuse to Regain is a book designed to provide a weight maintenance plan to new maintainers, who Berkeley calls Maintenance Juniors (after Just Reduced, J.R.) to enable them to beat the often-quoted long odds on maintenance. The book is divided into four major sections. The first is Ten Foundations which introduces the challenges of maintenance and lays out the social, biochemical, nutritional, and emotional environments that maintenance must successfully navigate—the facts on the ground, so to speak. This includes an extensive discussion of an eating style Berkeley calls Primarian, which is essentially a Paleo diet with the addition of low- and non-fat dairy and a few modern “treats.” The second section is a discussion of the 12 Tough Rules themselves, and the steps to take to understand and implement them. The rules are as follows.
  1. Be Tough, Not Moderate
  2. Commit yourself to a 3 Month Opt out Period
  3. Weigh yourself every day
  4. Reverse small gains immediately
  5. Eat Primarian 90 percent of the time
  6. Eat one major meal a day
  7. Perform a daily “Scan & Plan”
  8. Stop eating at 8 pm
  9. Eat from a limited menu
  10. Have one acceptable treat per day
  11. Have a love affair with exercise
  12. Maintain with support and support others
Section 3, Five Lives in the Balance, gives several successful Maintainer’s stories, and Section 4 provides Primarian meal plans and recipes.
Berkeley’s plan is very heavy on her Primarian approach, so named so that Maintainers can give name to a diet of conscience, and their choices will therefore be respected similarly to those following, say, vegetarian or Kosher diets. The description of the diet, the reasons for avoiding all “S foods” (starches and sugars—including whole grains, tubers, and legumes) make up a large portion of the book.

I ordered this book after finding the Refuse to Regain blog (co-authored with Lynn Haraldson-Bering), which discusses many of the issues associated with maintenance, with interaction from readers, and thought provoking questions and issues. I was surprised to find that the book and the blog were completely different beasts. The book is a prescription on how to maintain weight loss, and a detailed plan is given to the reader. If you do this, you’ll maintain the weight loss. No thoughts on how to create your own plan, or what to do if something about the prescription doesn’t work for you, just be tough, do this, and you’ll keep that weight off. I did find two places in the book that acknowledged that people have to find a way that works for them, and if something in the book doesn’t work, discard it, but I had to look hard for that, and there were no answers on how one might go about finding that something that would work instead.

I found the Primarian eating approach a bit strange. I do find the Paleo diet concept interesting and logically somewhat compelling. People did not evolve in an agricultural world where grains and milk were readily available and it makes sense that the addition of these foods to the diet in large quantities could potentially cause people issues including weight gain, and moving closer to this primitive diet could improve health and well being. However, Primarian isn’t Paleo in that it allows dairy as well as non-starchy modern foods like sugar free Jello, Lean Cuisines, or diet Coke. But it doesn’t make sense to me either to outlaw all grains, including whole, low glycemic load varieties and preparations, just because wheat can also be used for cake, and corn can end up as gummi bears. I just don’t believe there are that many of us that got fat, stayed fat, and got fat again because we ate a portion-controlled bowl of oatmeal in the morning. I was also a bit put off that I was being asked to tell my friends that yes, I was following an ancient diet of conscience called Primarianism, so don’t question my refusal of your whole grain bread, and could I have a diet Coke with that. Huh? But it is hard to argue that eating lots of fruits, vegetables, and lean protein sources is bad, and avoiding junk food is the right thing to do, and if you can get past the grains/tubers/starchy legumes thing, it doesn’t appear to me that this is an unhealthy plan, just one that is hard to live with in our culture. And, yep, I’m a 6 year maintainer come December, if not a perfect one (who is?), and I eat carbs and lots of them, trying to get whole grains as much as possible and limiting added sugars. I know a lot of us have issues with carbs, and we should respect that, but Primarian eating is not a one-size-fits all approach.

There is a list of other disagreements I had with the book, including its assertion that counting calories is essentially useless and no one does that anyway (I know lots of us do here), arbitrary rules like don’t eat after 8 pm, and the notion that somehow after a year that you just kind of get Maintenance and it gets easier (graduating from a JR to a SLIM, Senior Level Maintainer).

My last major issue was that the book had no footnotes, for fact checking, monitoring changes as time passes and such. It did have an extensive bibliography, but footnotes are better for those of us who actually go to the original literature from time to time. Yes, I’m a geek.

The Maintainer stories were nice, but not especially compelling (perhaps because of the Maintainer’s board here at 3FC where we have living examples), and I just don’t do recipes so Section 4 was wasted on me, but probably useful if you want to give the Primarian thing a go.

There were several things I liked about the book, including the fact that there is a Maintenance book out there. The book emphasizes the difficulty of the task, the need for planning, the difficult food culture (think marketing) that we live in now, and other tidbits like sabotage by friends, family and coworkers. It also called out the need for support and exercise as very important, but didn’t spend a lot of time with either of these factors.

So would I recommend this book? Maybe to someone who didn’t want to put much thought into their Maintenance plan and wanted a lot of guidance, and a switch from the plan that got them to their goal weight. But probably not to most people. I believe that what we need to do to have long term success is something that we all have to figure out for ourselves and not something that can be handed to us. 3FC has shown me that without a doubt, we have common threads, but we are all doing this differently. While the book has a few interesting ideas, and the occasional good point, it does not include the tools for making that individual plan and the strategies that support it. Personally, I probably follow about half of the rules. I have a handful of books I return to (including the excellent Thin for Life) and Refuse to Regain won’t be on that shelf in my library. My recommendation is to bookmark the excellent blog, and leave it at that.

I would love to hear from the other Maintainers here.

How many of the rules do you follow?

What do you think about the low-starch (low carb?) approach of Primarian eating?

Do you, and if so, how do you control “S Foods,” starches and sugars in your diet?

If you’ve read the book, was there any particular idea that really resonated with you, perhaps an “aha!” moment?

Do you feel like you are a Junior or Senior Level Maintainer and why?

Anne
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Long enough have you dream'd contemptible dreams,
Now I wash the gum from your eyes,
You must habit yourself to the dazzle of the light and of every moment of your life.
-from Song of Myself, Walt Whitman
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