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Thin For Life/The National Weight Control Registry

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Old 10-19-2004, 10:18 AM   #16
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Default NWCR Facts

Recently I received my second annual questionnaire from the NWCR and they included a fact sheet in the packet that I thought was interesting:

NWCR Facts
  • 80% of the Registry participants are women and 20% are men
  • the average woman is 45 years old and currently weighs 145 pounds, while the average man is 49 years old and currently weighs 190 pounds
  • Registry members have lost an average of 66 pounds and kept it off for 5.5 years
  • these averages, however, hide a lot of diversity:
    • weight losses have ranged from 30 - 300 pounds
    • duration of successful weight loss has ranged from 1 year to 66 years!
    • some have lost the weight rapidly, while others have lost the weight very slowly -- over as many as 14 years
  • we have also started to learn how the weight loss was accomplished: 45% of the Registry participants lost the weight on their own and the other 55% lost weight with the help of some type of program
  • 98% of Registry participants report that they modified their food intake in some way to lose weight
  • 94% increased their physical activity, with the most frequently reported form of activity being walking
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Old 10-19-2004, 08:49 PM   #17
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And here they simply returned my first questionnaire as incomplete. They highlighted one line and asked that I complete and return it. The line was:

"How often do you use low fat or fat free salad dressings". My answer was ALWAYS. The next question was "How often do you use no salad dressing". And I failed to answer it. ::sigh:: LOL!
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Old 10-20-2004, 08:29 PM   #18
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Default Research Findings From The NWCR

I was browsing through some of the published studies that have come out of NWCR surveys and thought you all might want to see some of what the researchers have discovered about maintenance:

1. Gorin AA, Phelan S, Wing RR, Hill JO. Promoting long-term weight control: does dieting consistency matter? International Journal of Obesity and Related Metabolic Disorders. 2004 Feb; 28(2):278-81.

The present study examined whether long-term weight loss maintenance is enhanced by maintaining the same diet regimen across the week and year or by dieting more strictly on weekdays and non-holiday periods than at other times. National Weight Control Registry participants (N=1429) indicated on an eight-point scale whether they dieted more strictly on weekends than weekdays, adhered to the same diet regimen throughout the week, or dieted more strictly on weekdays. Participants responded to a similar question about holiday and vacation eating. Participants were then followed prospectively to determine whether scores on these questions were related to self-reported weight regain over the subsequent 12 months. There was a linear relationship between scores on the dieting consistency questions and weight change over the I-y period (P's <0.01), with smaller weight gains in those who reported more consistency. Participants who reported a consistent diet across the week were 1.5 times more likely to -maintain their weight within 5 pounds over the subsequent year (OR=1.58, 95% CI: 1.2-2.2) than participants who dieted more strictly on weekdays. A similar relationship emerged between dieting consistency across the year and subsequent weight regain. Dieting consistency appears to be a behavioral strategy that predicts subsequent long-term weight loss maintenance.


2. Wyatt HR, Grunwald OK, Mosca CL, Klem ML, Wing RR, Hill JO (2002). Long-Term Weight Loss and Breakfast in Subjects in the National Weight Control Registry. Obesity Research; 10:78-82.

The purpose of this study was to examine breakfast consumption in subjects maintaining a weight loss in the National Weight Control Registry. A cross-sectional study in which 2959 subjects in the NWCR completed demographic and weight history questionnaires as well as question-about their current breakfast consumption. All subjects had maintained a weight loss of at least 13.6 kg (30 lb) for at least 1 year; on average these subjects had lost 32 kg and kept it off for 6 years. A large proportion of the NWCR subjects (2313 or 78%) reported regularly eating breakfast every day of the week. Only 114 subjects (4%) reported never eating breakfast. There was no difference in reported energy intake between breakfast eaters and non-eaters, but breakfast eaters reported slightly more physical activity than non-breakfast eaters (p=0.05). Eating breakfast is a characteristic common to successful weight loss maintainers and may be a factor in their success.


3. Klem, M.L., Wing, R.R., Lang, W., McGuire, M.T., and Hill, J.O. (2000). Does weight loss maintenance become easier over time? Obesity Research, 8: 438-444.

For several health-related behaviors (smoking cessation, alcoholism, weight loss), risk of relapse seems to decrease over time. The purpose of this study was to examine, among registry members, the relationship between duration of weight loss maintenance and the amount of effort and attention required to maintain a weight loss. Registry members who had maintained weight losses for longer periods of time reported using fewer weight control strategies and indicated that less effort was needed to stay on a diet and to maintain their current weight. Members who had maintained weight losses for both shorter and longer periods of time derived equal amounts of pleasure from exercise, low-fat eating and maintaining their weight losses. Thus, as duration of maintenance increases, the effort required to maintain seems to decrease. This shift may make it easier to continue maintaining the weight loss.


4. Klem, M.L., Wing, R.R., Chang, C.H., Lang, W., McGuire, M.T., Sugerman, H.J., Hutchison, S.L., Makovich, A.L., and Hill, J.O. (2000). A case-control study of successful maintenance of a substantial weight loss: Individuals who lost weight through surgery versus those who lost weight through non-surgical means. International Journal of Obesity, 24: 573-579.

Surgical treatments for obesity produce large, well-maintained weight losses as well as improvements in psychosocial functioning. It has been suggested that large weight losses achieved through non-surgical means may produce adverse changes in psychosocial functioning. The purpose of this study was to compare psychosocial functioning and weight maintenance behaviors in registry members who lost large amounts of weight through surgical versus non-surgical means. Both groups reported that weight loss had led to significant improvements in many areas of life, and members who used non-surgical means to lose weight were no more likely than surgical patients to report symptoms of depression or disordered eating. The surgical group reported eating a diet higher in fat, and were much lower in physical activity, than the non-surgical group. Thus, while both groups are functioning well and maintaining significant weight losses, they appear to be using very different behaviors to maintain the weight losses.


5. McGuire, M.T., Wing, R.R., Klem, M.L., Lang, W., and Hill, J.O. What predicts weight regain among a group of successful weight losers? (1999). Journal of Consulting & Clinical Psychology, 67, 177-185.

This study evaluated factors related to long-term maintenance of weight loss by following registry members over a one-year period and assessing changes in weight and changes in weight-related behaviors. Of 714 individuals followed for a one-year period, 59% continued to maintained their weight, and 35% gained 5 pounds or more. Individuals who gained weight had reported, at their entry into the registry, more recent weight losses, larger initial weight losses, and higher levels of dietary disinhibition (more difficulties controlling food intake). Over the one year of follow-up, weight regainers also reported greater decreases in physical activity level and greater increases in fat intake. Thus, these results suggest that several years of successful weight maintenance will increase the probability of continued successful maintenance, and that weight regain is at least partly due to a failure to maintain changes in eating and physical activity.


6. Wyatt H.R., Grunwald G.K., Seagle H.M., Klem M.L., McGuire M.T., Wing R.R. and Hill J.O. (1999). Resting energy expenditure in reduced-obese subjects in the National Weight Control Registry. American Journal of Clinical Nutrition, 69, 1189-1193.

Some researchers have suggested that a successful weight loss may be accompanied by a larger than expected reduction in resting metabolic rate. If this is true, this reduction (also called "increased metabolic efficiency") may be the reason so many people find it difficult to maintain weight losses. In this study, we measured the resting metabolic rates of 40 registry members and a group of weight-matched control subjects. Resting metabolic rates for the two groups were not significantly different, although registry members had a respiratory quotient (RQ) slightly higher than that of control subjects. We found no evidence of increased metabolic efficiency in registry members, suggesting that this phenomenon is not an obligatory consequence of successful weight loss. The observed difference in RQ may have been due to either registry members consumption of a low-fat diet or to a reduced capacity for fat oxidation.


7. Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., & Hill, J.O. Psychological symptoms in individuals successful at long-term maintenance of weight loss. Health Psychology, 1998, 17, 336-345.

Prior studies have shown that individuals may be genetically predisposed to become overweight. Based on this finding, some researchers have suggested that attempts to lose weight (to drop below ones genetically determined "setpoint weight") will inevitably lead to intense psychological pressures to regain the lost weight. In this study, we examined the level of psychological symptoms among registry members, all of whom have successfully lost weight and who are therefore likely to be below their "setpoint weight." Levels of depressive symptoms, general emotional distress, binge-eating and self-induced vomiting in registry members are considerably lower than the rates of these behaviors seen in psychiatric samples, and similar to rates seen in random samples of the general population. Thus, we found no evidence that successful maintenance of a weight loss is associated with clinically significant levels of psychological symptoms.


8. McGuire, M.T., Wing, R.R., Klem, M.L., Seagle, H.M., & Hill, J.O. Long-term maintenance of weight loss: Do people who lose weight through various weight loss methods use different behaviors to maintain their weight? International Journal of Obesity, 1998, 22, 572-577.

Among subjects who used a commercial program or professional assistance to lose weight, about 30% participated in programs that utilized a liquid formula diet. This study looked at weight maintenance strategies used by registry members who initially lost weight either 1) on their own, 2) through organized programs, or 3) through programs utilizing liquid diets. Participants who used liquid diets were more likely to be women, older, currently heavier, and to have a history of health problems. All three groups are currently maintaining their weight losses by eating low-energy, low-fat diets and engaging in regular physical activity. Thus, despite using very different methods to initially lose weight, individuals who lost weight on their own, through organized programs, or with liquid diets are all using similar strategies to maintain weight.


9. Shick, S.M., Wing, R.R., Klem, M.L., McGuire, M.T., Hill, J.O., & Seagle, H. Persons successful at long-term weight loss and maintenance continue to consume a low calorie, low fat diet. Journal of the American Dietetic Association, 1998, 98, 408-413.

About half of registry members report that they initially lost weight on their own and the remainder used a formal weight loss program or assistance from a health care professional. This paper sought to determine if these two groups (on own versus assisted) report any differences in their current dietary intake. This paper also compared the dietary intakes of registry members to intakes reported by people in the general U.S. population and to Recommended Daily Allowances (RDA) for selected nutrients. Registry members who lost weight on their own do not differ from those who used programs in regard to total energy intake, percent of energy from fat or intake of selected nutrients. Both groups are meeting RDAs for most nutrients and, compared to the general population, are consuming less energy and a lower percentage of energy from fat. Among this sample of successful weight loss maintainers, maintenance of weight loss is associated with continued consumption of a healthy low-energy, low-fat diet.


10. Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., & Hill, J.O. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition, 1997, 66, 239-246.

The first article ever published about the NWCR, this paper provides an overview of the study design, as well as a description of the first 784 participants. Individuals were enrolled in the registry if they had lost at least 30 pounds and had maintained a weight loss of at least 30 pounds for 1 year or longer. Despite extensive histories of overweight and failed dieting attempts, registry members have lost an average of 66 lb and maintained the required minimum weight loss of 30 pounds for an average of 5 years. Nearly every participant used diet and exercise to initially lose weight, and nearly every subject is currently using diet and exercise to maintain his/her weight loss. Registry members report that weight loss has led to significant improvements in self-confidence, mood and physical health. Surprisingly, 42% of participants report that maintaining their weight loss is less difficult than initially losing the weight. Future studies will examine in greater detail the weight maintenance behaviors of these individuals and identify factors which influence continued maintenance of weight loss.
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Old 10-20-2004, 10:06 PM   #19
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Meg, thank you so much for sharing this -- it's fascinating! I'm thrilled to hear of the future studies, and I found their findings regarding resting metabolic rates particularly interesting. I'll be interested to hear the feedback of folks (like you, Mrs. Jim, and more) who've been living this.

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Old 10-30-2004, 04:53 PM   #20
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Default Second Annual NWCR Questionnaire

I recently completed my second annual questionnaire for the NWCR. It came in two parts - the first part was an exhaustive and detailed survey of what I eat (and don't eat - more on that later). There were long lists of foods, broken down by category (like fruits or breads), and I was asked how many times per day, week, or month I eat them and in what amounts. About half the foods listed were things that I never eat, like fried chicken or sugar soda. Some were foods that I rarely eat, like desserts. And then a few were the foods that I seem to live on, like chicken, fish, oatmeal, apples, salad etc (hey, there's a day right there! ). It made me realize that in the great big world of food, there's very little variety in my diet. I don't know if that's a good or bad thing.

The second part was a 23 page survey of what I do to maintain my weight loss and how I deal with stress and emotions. This year there was a series of questions about eating disorders - I don't remember that from last year so perhaps it's new. The questionnaire started off asking about my current weight and if it's within 5 pounds of what I weighed a year ago (yes - isn't that amazing!!). It then went on to ask if I wanted to gain, lose or maintain. The next section set out a series of diet strategies and asked if I'd used them in the past year and how useful they were - like keeping junk food out of the house, tracking food or exercise, increasing contact with friends who exercise, weighing myself on a regular basis etc. It asked if I used a formal diet program (like WW), another kind of program or aid (like hypnosis or a personal trainer) or was maintaining on my own. It also asked if I had bariatric surgery or was using a liquid formula diet.

The following section asked how difficult is it to maintain my present weight, whether it gets easier over time, and what makes it hard (like illness, vacations, or stress). It asked how much weight I would have to regain to become concerned and then asked what I would do about it - exercise, diet, journal etc and whether I had slacked off on any of those things over the past year. Then there was a series of questions about whether I follow my eating and exercise plan every day or take days or weekends off.

Next were three pages about exercise - the kinds and amount - and how much TV I watch (hmmm ... is there an inverse correlation between the two?). Then three more pages about food - do I eat breakfast? do I eat pasta? do I use mayo?

The next section was T/F questions about behavior -- "When I feel blue, I often overeat", "Sometimes when I start eating, I just can't seem to stop", "I usually eat too much at social occasions, like parties and picnics." Then two pages about how often I feel certain things (like helplessness or optimism), any major life changes this year, general mood, and any binging behavior.

Next was a section about ordinary life functioning, like paying bills on time and taking care of my car, and how much pleasure I get from ordinary activities, like reading or taking a walk. After that were questions about my overall health. The last section was two pages on how I deal with stress and whether I would do things like seek help and advice, make excuses for regaining weight, use food to make myself feel better etc.

Whew! It took quite a while to get through all of it but I think it was really worth the effort. As far as I know, the NWCR is the only study of what makes a successful maintainer tick. Any information that we can figure out to help people keep off the weight they've worked so hard to lose is well-worth a few mintues of my time.

As always, I'm intrigued by the questions and wonder where they're going with them. Hmmm ...
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Old 10-30-2004, 06:57 PM   #21
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Wow, thanks for sharing this Meg. I am interested in knowing the types of questions they ask and how long and detailed it gets since I just signed up this week and hope to get the packet in the mail soon. This week marks the 1-year anniversary for hitting my goal weight of 150 lbs. I was wondering though, since I've lost a little more since then, should I have waited until I've maintained my current weight for at least 1 year? Or do you think counting the time from hitting my goal weight is still appropriate?

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Old 10-30-2004, 07:13 PM   #22
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Congratulations on your one-year anniversary, Beverly, and I'm so glad you've joined the study! Do you still have those "pinch me" moments when you still can't believe that you made it to goal? I do.

In answer to your question - you don't even have to be at goal weight to join the study. Some people continue to lose slowly over the years that they belong to the NWCR. All the NWCR asks is that you've lost at least 30 pounds and kept it off for at least a year. Guess what? You sure do qualify!!

I'd love to hear what you think about the questionnaire once you get it.
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Old 11-16-2004, 08:00 AM   #23
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Default More News From The NWCR

This was in my local paper this morning - the bold face emphasis is mine:
Quote:
Low Fat Beats Low Carb, Weight Loss Study Finds
Tuesday, November 16, 2004

By Marilynn Marchione, The Associated Press

LAS VEGAS -- Regardless of how they shed pounds in the first place, big losers stayed that way by limiting fat rather than carbohydrates, according to new research that could add fuel to the backlash against low-carb diets.

Dieters already have been turning away from Atkins-style plans as a long-term weight-control strategy, and the new study gives them more reason: Low-fat plans seem to work better at keeping weight off.

"People who started eating more fat ... regained the most weight over time," said Suzanne Phelan, a Brown Medical School psychologist who presented results of the study yesterday at a meeting of the North American Association for the Study of Obesity.

The study used the National Weight Control Registry, a decade-old effort to learn the secrets of success from people who had lost at least 30 pounds and kept them off for at least a year. The registry is run by doctors from the University of Colorado in Denver, the University of Pittsburgh and Brown University in Providence, R.I.

They studied 2,700 people who entered the registry from 1995 through 2003. Their average age was 47, most were women, and they had lost an average of 72 pounds initially. Doctors compared their diets to see whether one type or another made a difference in how much weight they had lost and how much they had regained a year later.

All reported eating only about 1,400 calories a day, but the portion that came from fat rose -- from 24 percent in 1995 to more than 29 percent in 2003 -- while the part from carbohydrates fell, from 56 percent to 49 percent.

The number who were on low-carb diets (fewer than 90 grams a day) rose from 6 percent to 17 percent during the same period.

The type of diet -- low-fat, low-carb or in between -- made no difference in how people lost weight initially.

But those who increased their fat intake over a year regained the most weight. That meant they ate fewer carbohydrates, because the amount of protein in their diets stayed the same, Phelan said.

"Only a minority of successful weight losers consume low-carbohydrate diets," she and the other researchers concluded.


Colette Heimowitz, a nutrition expert and spokeswoman for the Atkins diet organization, noted that the study considered 90 grams to be low-carb, while Atkins recommends 60 grams for weight loss and 60 to 120 for weight maintenance.

She said that for many of the dieters studied, "the carbs aren't low enough for them to be successful." They also should have replaced carbs with more protein rather than fat, she said.

Dr. Thomas Wadden, a University of Pennsylvania weight loss expert who had no role in the study, said it is too soon to say which approach is better. Several longer-term studies of low-carb and low-fat dieters are in the works.

But he said: "I do think that people who are keeping the weight off are eating a low-fat, high-carb diet."

The dietary establishment has long been skeptical of the long-term safety and effectiveness of low-carb diets, and consumers increasingly are losing their enthusiasm for the glut of low-carb products that overloaded grocery store shelves as the diet became a fad in the past few years.

More than half of Americans who have tried a low-carb diet have given up, according to a recent survey by the market research firm InsightExpress. Other published survey information suggests that the number of Americans following such a diet peaked at 9 percent last February and fell to 6 percent by June.

The American Institute for Cancer Research used those trends to issue a statement in September urging dieters to "come back to common sense."

"Eat a balanced diet weighted toward vegetables and fruits, reduce portion sizes and increase physical activity," the institute said.
http://www.post-gazette.com/pg/pp/04321/412351.stm

In addition to the findings about low-carb vs. low-fat, how interesting that the average daily calories for a NWCR participant are about 1400! That's about what I eat, but every calorie calculator out there - and many diet 'experts' - tell me that I should be able to eat a LOT more and still maintain. It makes me feel better that there are other maintainers who are in the same place with calories as I am. But hats off to anyone who can eat more and still maintain - I'm envious ! It's a matter of figuring out the calorie level that allows our own unique bodies to maintain.
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Old 09-24-2005, 07:00 PM   #24
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I just got my packet for a one year follow-up from the Registery. It starts off with your weight last year then this year then asks if it's due to anything in particular...ie: pregnancy. But after that, I feel like I'm wading through muck trying to continue answering. How do you answer these questions when you're pregnant and due yesterday? Like what do you consider an acceptable weight gain? And what would you do if you gained more than that. I dunno! I'm pregnant!
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Old 02-13-2006, 10:58 AM   #25
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Quick question -- I know the NWCR is for people who have lost at least 30 lbs and kept it off at least a year. My question is can I sign up for it on the one year anniversary of when I had lost the first 30 lbs, or does it have to wait for the one year anniversary of when I reached my goal weight?
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Old 02-13-2006, 11:08 AM   #26
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As far as I know, it's the one year anniversary of losing 30 pounds and maintaining that loss - which you certainly have! I don't remember anything about goal weight, especially since 'goal' is so subjective and individual to each of us.

From the NWCR web site:
Quote:
If you are at least 18 years of age and have maintained at least a 30 pound weight loss for one year or longer you may be eligible to join our research study.
Go for it!
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Old 02-15-2006, 08:36 AM   #27
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Thanks for the bump, you guys! Seeing this here reminded me to get my packet sent off, after a couple of months of procrastinating on finding appropriate before/after pics.
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Old 01-28-2007, 03:23 AM   #28
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Meg, thanks for posting the article about Low Fat beats Low Carb. I feel better about switching now to watching my cals and fats. I know that the LC plan helped me take the wt. off. It just didn't end up being what I wanted to do for a lifetime. I actually felt like it was causing a lot of my chronic stomach problems. I simply couldn't get enough fiber and had to resort to unnatural methods to try to control constipation. My stomach was a mess. I really was in fear that I'd end up with another bowel obstruction.(You can only imagine how fearful I had become that I'd end up with a colostomy). I felt that changing my way of eating was in my best interest. I know there are others are on Atkins that aren't having as much trouble as I was. It makes sense, I've had multiple surgeries and I need the fiber. Taking fiber tabs, laxatives and enemas is no way to live. I was fearful to leave the house for when one of these methods might finally kick in. I have found that the increase in dietary fiber is helping greatly. Much better than anything else I was doing for the problem. For some reason, chewing 16 grams of fibertabs a day doesn't work the same as eating 24 grams of the fiber in your food.

As for LC foods on the grocery shelves. They are super difficult to find. I do most of my shopping at walmart and I couldn't ever find any Atkins products. I think a lot of stores have gotten away from carrying them. I had even called health food stores in my area. They had lots of low-cal/low fat options, but not low carb. I totally felt like I was existing on meat, cheese , eggs and salad.
The premise with Atkins was that as you moved through the phases, you could increase your carbs slowly and lower your fat and protein. This didn't work for me. I never got above 35 carbs really. I tried adding in a 1/2 of a baked sweet potato and started gaining. I hated feeling guilty and off-plan if I succumbed to eating a banana, apple or an orange. I wanted and needed the fruit. I can't understand how a person eating 90-120 grams of carbs a day is really doing Atkins. What could you eat? If my carbs were that high on Atkins, I would have put back on every lb. I've noticed the last few days that my carbs were 150-188 for each day. This is with watching fat and keeping cals around 1400.

It took me a long time to be ready to make the change, but I am so thankful for the support and guidance that I've received. I'll probably ask a lot of dumb questions so I hope everyone will have patience with me.

I read the Thin For Life book a few months ago. At the time , a lot of it didn't really pertain to me as it didn't seem any of the losers were doing LC. I'm going to read it again and I'm sure more of it will strike me as interesting this time.
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Old 01-28-2007, 12:56 PM   #29
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I am no where near my goal weight, but until I started on this site I have kept off 42 pounds since 2003. I signed up with them, and can't wait to get started on the surveys & what not.
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Old 01-28-2007, 01:01 PM   #30
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Awesome!!
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