So it's Sunday morning and as always, I'm on the elliptical in Ballys. I'm watching one of the news talk shows and a bariatric surgeon is being interviewed about the obesity crisis and she makes the statement:
"Lifestyle changes without surgery don't work."
Not "usually don't work" or even "rarely work". She flat out said that permanent weight loss is impossible without surgery.
I understand that she's a bariatric surgeon so is coming at this from the perspective of dealing with failed dieters, but wow! I felt like jumping off the elliptical and screaming at the TV but -- not a good strategy. So I stayed on and thought about this for a while.
Clearly lifestyle changes can result in permanent weight loss, though even I have to admit that it doesn't very often. There are those of us here at 3FC who are living, breathing examples of lifestyle changes working, often for many years and still counting. But anyone who has spent time here at 3FC or heck, in the real world knows that most people who set out to lose weight typically don't -- and those who do lose weight most likely will put it all back on. We have 85,000+ registered members here who are looking to lose an average of 100 pounds. How many lost it and kept it off?
Does this reality mean that the medical profession is right to completely give up on non-surgical weight loss? My PCP has been practicing for more than 25 years and she tells me that I'm her only patient who has lost and kept off a substantial amount of weight. These days she routinely sends her obese patients for surgery. When I asked her why, she said that she used to spend a lot of time counseling patients about diet and exercise only to have them ignore the advice and continue to gain. Her view is that none of her patients want to do the work of weight loss. So she now sees surgery as their only realistic option.
The implication of this to me is that fewer and fewer health care dollars will be available to support non-surgical weight loss and maintenance. If the default medical position is to automatically send obese patients for surgery, no resources will be available to someone trying lifestyle changes. I've talked before about how the local medical school has a program called "Life After Weight Loss", with nutritional counseling, plastic surgery for excess skin, psychological counseling -- all services I -- as someone working to maintain a 122 pound weight loss -- would love to access. The problem is that it's only available to patients who have had weight loss surgery. Try finding a program for someone who's lost more than 100 pounds without surgery -- it doesn't exist. We really are the orphans of the medical system.
Are we really freaks, as a doctor once called me? Are we so rare and unusual that we should just be ignored? Is what we do to lose weight and keep it off so "extreme" and "obsessive" that normal people can't be expected to do it?
This country is in a tragic place regarding obesity. We live in a toxic, obesogenic environment. People are getting fatter at an exponential weight. Health costs due to obesity are spiraling out of control. And now it seems that the medical establishment has concluded that the only solution is surgical weight loss.
More than ever, I feel that we at 3FC are making a statement to the world. Yes, lifestyle changes can result in permanent weight loss. Yes, it is possible to lose huge amounts of weight and keep it off forever with diet and exercise. Yes, we losers and maintainers live happy and fulfilled lives, filled with joy and purpose. More than ever, we need to support each other and offer a helping hand to anyone who’s struggling. The motto of 3FC has always been “Because we’re all in this together” and it’s truer than ever. For too many members, there's no support from the real world but at 3FC there always will be a shoulder to lean on and a hand to pull you up when you fall.
My dream would be if every one of us succeeds in our goals. All 85,000+ of us. How incredibly cool would that be?! Let’s join together to fight the stereotypes of lifestyle changes not working. Let's turn the medical establishment upside down! Let's show the world that yes, we did it and so can you.
I think that is one of the reasons that I still hang around 3FC. I honestly believe that lifestyle change alone IS enough to keep my weight off - forever. And, I feel that I need to help as many people as I can "see the light".
I got my paperwork for the NWCR yesterday. Hopefully, the alarm will sound out there in the research world that - indeed - there ARE successful folk that chose the non-surgery route.
I'm more determined than ever to help as many folk as I can understand that with commitment, knowledge, planning, community, and accountability - this journey can be a joyous and successful one
Edit: Meg, do you have the name and contact info for that surgeon? I would LOVE to share my thoughts with her
Last edited by CountingDown; 08-16-2009 at 03:09 PM.
Meg, thank you for your post. You are right on, as usual. I see that the experts at weight loss surgery, fail to mention that even those who lose weight by surgery sometimes regain. I can think of several celebrities who had weight loss surgery to great fanfare. Unfortunately some of them have regained weight. I am quite happy that I have lost a significant amount of weight and have maintained for 20 months, all by dieting and exercise. My son has lost over 200 pounds by diet and exercise and has had no surgery. He has maintained for about 3 years.
I didn't catch her name but she's associated with the University of Pittsburgh Medical Centers so I'll do a little research and see if I can figure out who she is.
"Commitment, knowledge, planning, community, and accountability" -- that's a great summary of what it takes to make weight loss a reality!!
Bargoo, I know how successful you've been but had no idea about your son. Wow! Please let him know that we here really can appreciate what an amazing accomplishment he's living.
My family weight loss total is about 237 pounds (DS = 70, DD = 45, me = 122) and your family total is even higher!!
I honestly don't know how rare it is for people to lose a big amount (over 75-100 pounds) and maintain it for years, because "common knowledge" and the media constantly hammer home the message that it's not possible, that most people regain it, etc. Is that true? If we take your doctor's statement as fact, then it probably is true.
But I wonder what our rate of success here is on 3FC? I can name a handful of successes off the top of my head, and I hope to one day be listed in that elite group. But I also know that I sometimes go back and read old posts from several years ago and I see names of chicks who seem successfull, who have lots LOTS of weight--but they are not here anymore. Have they kept it off, or regained? Sadly, I do not know. I'd like to think that they were here, lost, learned how to maintain their new, trimmer figures and rode happily off into the sunset. I imagine them to be too busy running, skiing, coaching kids' soccer to be posting here but I fear that many have fallen back into their old habits.
I feel that 3FC is a different world, almost. It's a world where my fellow chubby and used-to-be-chubby sisters understand me, can celebrate with me when I achieve a victory like passing up carrot cake. The rest of the world doesn't understand, support, and cheer on that victory, but my sister-chicks here do. And that is the kind of support we need in the real world. We don't need negative messages that pound into our heads, "But of COURSE people who diet and exercise can't keep it off long-term!".
Is it just our American culture? If so, it doesn't make sense because this has historically been known as the land of opportunity, the place where hard work and dedication means success.
Thanks for the thought-provoking post, Meg. I look forward to hearing everyone else weigh in on this!
Windchime, like you say, it's really hard to say how many long-term success stories there are here at 3FC. I personally know big losers here who have regained all their lost weight and are too embarrassed to come back, no matter how much I try to assure them that there's not one single person here who wouldn't be compassionate and understanding. Who of us hasn't walked in those shoes?
But regardless of numbers, I believe we here at 3FC have something unique to help members keep the weight off permanently and that's the Maintainers Forum. Here in the Maintainers forum, members can get a look at the realities of maintenance and hopefully realize that there's very little difference between the processes of weight loss and maintenance. Maintenance takes as much "commitment, knowledge, planning, community, and accountability" (love that, Counting Down!) as does weight loss but that's a message you'll rarely hear outside of 3FC.
While I'm not to the point of maintaining (YET!!! ), I hit my highest weight 3 years ago, and have steadily gone down since then. I've ended each year with a loss - some more than others. But still a loss. Lifestyle changes DO work, as long as you make it a lifestyle change for LIFE. Not just a few months/years or whatever.
Windchime, like you say, it's really hard to say how many long-term success stories there are here at 3FC. I personally know big losers here who have regained all their lost weight and are too embarrassed to come back, no matter how much I try to assure them that there's not one single person here who wouldn't be compassionate and understanding. Who of us hasn't walked in those shoes?
Oh, I WISH they would come back, I really do. They would have such a wealth of knowledge to share with the rest of us, and we would be able to encourage them because, as you say, we have all walked that path before.
I am a long way away from maintenance--well, wait. Am I really? I will hopefully reach my current goal sometime around Christmas or New Years, so I guess that's only about 4 months away. Anyway, I find the Maintainer's Forum to be a really good place and I read everything here, because I want to be successful at this. I don't want to have to lose this weight again, and I don't want to go back to feeling sad and unhealthy and heavy, and I don't want to go back to being invisible to men and upset about wearing big, unshapely clothing. I don't want that, and I think that hanging out with the Maintainers is one way that I can avoid that.
I don't even remember where I read this recently, somewhere on 3FC, there's a theory out there that we have a self-control "muscle" that can only be used so much and then we can't use it as effectively and therefore make poor choices. I don't believe that at all (it was not a theory promoted here, I think it might have been part of that Time exercise article). Certainly other "muscles" (real or simply behavior habits) get stronger with practice.
Why are some maintainers successful? Consistent excercise and movement choices. Certainly the context of our lives can enhance or cause resistance to these choices, but they are choices none-the-less. We do live in a culture that is ripe with fertilizer for obesity (I LOVE the word obesigenic!!), and our own bodies can work against our success, what with the changed metabolism that is common to the formerly obese, plus the fact that we are only getting older, and as women, our bodies' tendency is to lose lean mass. We are salmon swimming upstream. We can control some of the forces against us with planning, accountability & community (yeah, CountingDown!), but there is social resistance nonetheless, and we all have to deal with that in our own ways. I love both the practical tips and lifestyle choices here in Maintainers, but also I love the themes that come up over and over.
My own NWCR consent forms are on my desk as I type. We need to make ourselves heard, and the NWCR is a great way to get our stories out there.
I take a lot of comfort in the fact that other maintainers are out there across the country and the world, everyday, doing the work of maintaining. I know that Monday morning will start with a thread by Meg, incorporating her exercise and foodplan into her day, her week, and so it goes, month, year, and so on.
The irony of maintaining is that it is both simple and complex at the same time. But the power of maintaining is that I control my path at this time. Sometimes it is easy and sometimes it is not, but there is no question in my mind that it is worth it.
But regardless of numbers, I believe we here at 3FC have something unique to help members keep the weight off permanently and that's the Maintainers Forum. Here in the Maintainers forum, members can get a look at the realities of maintenance and hopefully realize that there's very little difference between the processes of weight loss and maintenance.
A very important point! Without 3FC, I would not have even known that maintenance was part of the process, let alone that there were strategies for maintenance that I could incorporate into my life. The honest posts by our maintainers have been invaluable for me. I learn from everyone's successes AND struggles. My maintenance looks very different than I thought it would when I began my journey - and everyone here has had something very important to teach me. I was such a "sponge" when I started - reading the posts in fascination, and slowly absorbing what I needed to add to my own plan.
Quote:
Originally Posted by midwife
The irony of maintaining is that it is both simple and complex at the same time. But the power of maintaining is that I control my path at this time. Sometimes it is easy and sometimes it is not, but there is no question in my mind that it is worth it.
I so agree! Vigilance is one of the key concepts our maintainers taught me. My future is 100% in my hands. No one else's. My choices and my actions are the difference between my success and failure at maintaining my goal weight.
I KNOW that it is possible for me to gain the weight back (I've certainly done it before). The realization that it is NORMAL to stay vigilant, to check my weight regularly, to continue to plan my eating, to exercise regularly, was oh, so important for me.
Staying "on plan" and continuing to do those things that have brought me successfully along the path thus far has become my "normal". I'm not sure I would have embraced that concept at the inception of this life-style change, but now I am absolutely thrilled that I have the knowledge and the keys I need to truly maintain my current weight.
Last edited by CountingDown; 08-16-2009 at 08:58 PM.
Let's turn the medical establishment upside down! Let's show the world that yes, we did it and so can you.
Meg: I'm all about this! Count me in. Give me a podium and I'll talk to them for hours. Seriously though. Thank you for posting your thoughts on this topic.
It is entirely possible to accomplish major weightloss through lifestyle changes but my thought is that these changes are not often incorporated all at once. Rather, there are a lot of little changes built upon the successes and failures of our previous attempts.
Each time we try this we learn something new that we apply to our future attempt. I think the frustration can be that it doesn't happen fast enough, people become confused about what is the best way for them to reach their goal and when those little gains occur they don't understand the mechanics of why it occurs. (Not always because you ate more than you expended that week) They consider their attempt at weightloss a failure and scrap the whole idea for their prior habits.
Education about the process is important as the support. Role models are vital as well. I NEVER would have been able to accomplish my loss the year I put my nose to the grindstone without reading about you and Mel. I dove into this realizing what I needed to do during and after the loss to make this real. This is something else that the medical community does not provide.
This summer I had the opportunity to do a weekly seminar with a group of women for one month. I shared my story and EVERYTHING I could possible cram into an hour and half about what I knew that could assist them. The underlying message from me was this, "If you no longer want to look like everyone else, you should no longer treat your body like everyone else."
Lifestyle changes are tough to hear. "If it came in a box or a bag you probably shouldn't eat it" (exception being frozen broccoli) "Exercise most days of the week with REAL intensity." "Learn how to lift weights and go HEAVY." etc. "Select dumb bells that say TROY on the ends instead of Campbells..."
It is an epidemic and it makes me sad, angry and scared. There are a lot of other variables in this mix as well. The food industry making foods that develop foods that trigger cravings. The availability of food on every corner 24 hours a day. The endless variety of cheese powdered carbs in the center aisles meant for our kids.
While obesity has significant preventable medical risks, it is too large for the community to address. Especially for the primary care physician. (Shoot, many of them are so freakin' oblivious beyond their routine it's dangerous. I had to point out to my own doc that I lost 70lbs and that it was time to wean my blood pressure meds.) Dork looked at my chart and then said, "Wow, you have lost more than a 1/3 of your bodyweight. Congratulations. (It should be noted that I see him every 3 months for blood pressure readings so it's not like he didn't see me often enough to know who I am but yet every time I walk in I have answer the same lifestyle questions Do you exercise, "Yep, six days a week. Lift weights too." "I'm the one who lost weight a few years ago and became a certified personal trainer so it's kind of like my job to be fit."
People who are relying upon their general practitioner for weight loss support don't have a chance in these circumstances. I'm not really sure that it's their role to even provide weightloss support although so many of us see them as
the authority in our general health and look to them for this guidance. Really though, they are the front line and can only refer to other programs that provide assistance that is really needed.
Unfortunately, I never have found any of the advice I've gathered from my physicians to lead me to my current path of fitness. I really had to seek this information out myself and take a leap of faith into a world that was completely unknown to me on every level. ~sigh~ Just me and my iPod and a big old scary gym.
This is something that needs to be addressed by a whole other entity. Right now, the information, support, accountability, and role models are available only to those who seek the mentors in a grass roots kind of effort such as these forums. So, after my rant and ramble here, let me just thank and praise you Meg and all the other role models who are here to lead the way.
THANK YOU SO VERY MUCH FOR ALL THE TIME, KNOWLEDGE, EXPERIENCE, SUPPORT, and INSIGHT YOU ALL PROVIDE. What you are doing impacts the lives of so many of us on a daily basis.
A very important point! Without 3FC, I would not have even known that maintenance was part of the process, let alone that there were strategies for maintenance that I could incorporate into my life.
I consider this the single most important thing I have learned on this forum. It seems so obvious, that I would have to stay vigilant, continue on plan, and stay aware after I get to goal....but that's not what I did last time. For some reason, I just kind of went back to my old ways and went unconscious or something.
But now I know better. I don't think we can count on doctors to give us advice on this; most of them either can't remember who we are between visits or have given up preaching the benefits of exercise and a sensible diet, because they know that the vast majority of their patients will not heed it. So I'm glad that I have 3FC to tell me how to go about losing and maintaining; it would have been really, really tough to keep going for 8 months without the support and knowledge that I have gained here. Really, really tough.
"Lifestyle Changes Without Surgery Don't Work"
Thanks for your post Meg!
