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TFL Key #5: Nip It In The Bud: Break The Relapse Cycle

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Old 02-06-2005, 02:45 PM   #1
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Default TFL Key #5: Nip It In The Bud: Break The Relapse Cycle

Key #5: Nip It In The Bud: Break The Relapse Cycle

Key #5 addresses an incredibly important issue for both losers and maintainers alike: how do we stop the dread weight regain? As we all know too well, losing weight really isn’t the hard part – it’s the keeping it off that’s oh so tough. Take me, for example – it’s embarrassing to admit, but I’ve probably lost hundreds of pounds in my life. Hundreds! I could have gotten to goal years ago, probably five times over, if I had been able to keep the pounds off. It turns out that my problem wasn’t losing weight but that I sucked at maintenance (it’s a long story why, probably stemming from my refusal to Accept The Food Facts (Key #4).

Is there anyone here who thinks that they can’t lose five pounds? Nope, I think that’s something we all feel is do-able. OK, how many times have we lost the same darn five pounds over and over again? I’m guessing it’s a lot! Losing the five pounds isn’t the hard part; keeping it off is where most of us run into trouble. And that’s what this chapter is all about – how to keep off the weight that we’ve lost.

It doesn’t matter if you’ve lost one pound and still have 99 left to go … or if you’ve lost 100 and are maintaining. Each and every pound lost is precious! We NEVER want to go back and re-lose any of them ever again! It makes me sad when I read a post from someone here at 3FC who is ready to throw in the towel because they *only* lost, say, a pound last week. ‘Only a pound’ equals 52 pounds in a year and 104 pounds in two years. That sounds a whole lot more impressive, right? Well, only if you keep it off!

The book’s answer to preventing regain is to ‘nip it in the bud’ – in other words, to deal with it while it’s a little problem and not allow it to become BIG and overwhelming. Like we just talked about, probably everyone here can see themselves being able to lose five pounds. But the picture looks a whole lot different if you change that to losing 100 pounds. Right? So the answer to preventing regain is to deal with it on a ‘day-by-day and meal-by-meal basis' (p 153). Never let weight regain spiral out of control, even for a day. Take care of it NOW, while it’s small.

So what do you need to do not let regain get out of hand? You have to mentally set an upper limit for regain – an actual number of pounds. This is your line in the sand that you will not allow yourself to cross under any circumstances. The vast majority of masters (80%) stop gaining before they put on 5 pounds; most others allow themselves no more than 10 pounds (another 14%) (p 154). In other words, 94% of successful maintainers refuse to allow their weight to go up more than 10 pounds before taking immediate action. The book cites reversing weight gains while they’re small as THE single most important maintenance skill.

If we’re mentally setting a number of pounds that we’re not going to exceed, then obviously we’ve got to keep tabs on our weight. Personally, I know that my times of greatest weight gain were when I refused to weigh myself. I could happily live in the Land of Denial if I never stepped on a scale. Since I’m never going back there, I’m a daily weigher and so are 40% of NWCR members. 75% weigh themselves more than once a week and 90% weigh themselves at least regularly (pp 154-155) Of course, there are alternate ways to monitor your weight – how your clothes fit or how you look in the mirror. The lesson in the book is to pick a monitoring system and use it faithfully.

We’ve set our upper limit for weight and we’ve been monitoring regularly and - oops – we hit the high number. What do we do now? The next section of the book says Have A Set Plan Of Action If You Hit Your Upper Limit (pp 157-160). When the masters hit the top of their weight zone, they DO something about it: They don’t harp on it, feel sorry for themselves or stall around, and within a short time their weight is back down to the lower end of their comfortable range.

The book lists eighteen examples of different strategies that maintainers use to deal with regains (p 158) – such as increasing exercise, weighing and measuring portions, writing down food etc. When I scanned the list, it looked to me like it’s pretty much going ‘back to basics’ – going back to the things that worked to get the pounds off in the first place (which makes sense).

The next section of the book is key: Don’t Let A Lapse Become A Relapse (pp 160-161). There’s a significant difference between the two concepts: ‘Lapses are single events of slipping, doing something unplanned that is not ideal for weight control’. Relapses are accumulated lapses (p 160). You’re not going to put on much, if any weight with a single lapse; it takes a relapse to cause significant regain.

Let’s stop right here and acknowledge that we’ve ALL had lapses and that we will all continue to have lapses for the rest of our lives. None of us is perfect and we’ve all experienced unplanned eating. It’s going to happen! You’re only setting yourself up for failure if you vow that you'll never slip up and make mistakes. It WILL happen and how you deal with the aftermath is going to determine whether you stop at a lapse or end up face-down in the gutter of a full-blown relapse.

So many of us professional dieters are black and white thinkers – we’re ‘good’ or we’re 'bad', we’re 'on' the diet or we’re 'off' (often way, way off). We’ve got to give ourselves a break and look for the shades of gray. A lapse doesn’t mean that we’ve blown the day and ruined the diet and that we’re weak, miserable failures (so we may as well stuff ourselves ). Put a lapse in perspective – make it a learning experience – and then pick yourself and keep right on going the very next minute. Not the next day or week or month.

The next section of the book sets out A Plan For Preventing Relapse (p 161) for both losers and maintainers from researchers who studied successful maintainers versus regainers:
Quote:
The maintainers were significantly more likely to respond to a gain in weight by using coping strategies such a treating it as a small mistake, losing the pounds again, increasing exercise and watching food intake more carefully. The regainers, on the other hand, were more likely to say that they’d react to weight gain by feeling terrible and going off a diet. (p 162)
There are four skills in the plan to prevent relapse:

1. Identify your potential high-risk situations.
2. Prevent high-risk situations the best you can.
3. Effectively deal with high-risk situations when they do occur.
4. React constructively after high-risk situations (what went wrong? could I avoided the situation altogether? how can I handle it better next time? what can I do to make up for the lapse?).

Then put any lapse behind you and move on!

The chapter concludes with a section on Learning to Set Realistic Goals (p 167-171) and the guidelines are worth repeating:
  • Steer clean of ‘never’ 'always’ and ‘everyday’ goals.
  • Set ‘just for today’ or 'just for this week’ goals.
  • Replace 'I will be' goals with ‘I will do' goals.
  • Set specific rather than vague goals.
  • Base goals on where you are now, not where you want to be down the road.
  • Avoid ‘should’ and ‘have to’ goals.
  • Set flexible goals and be ready to change them.

Realistic goal setting is important for long term maintenance because it allows you to experience numerous small successes – small wins – and these accumulated successes have been shown in studies to carry maintainers through times of great personal crisis. They become ingrained habits and a reservoir of success to draw on when life gets stressful.

The most significant part of the chapter for me was the emphasis on distinguishing lapses from relapses and keeping lapses from turning into relapses. One lapse really isn’t going to make me regain 100 pounds; in fact, one lapse probably won’t make me regain even two pounds. The only way that I’m going to regain all the weight I’ve lost is to let a lapse turn into a series of lapses, which then becomes a major relapse. In other words, it’s going to take a whole series of bad choices and decisions for me to regain the weight. A lapse isn’t a catastrophe worth beating myself up about – but it IS worth stopping to figure out what went wrong and how to keep it from happening again.

Losers and maintainers, let’s talk about lapses, relapses, and regain!
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Old 02-06-2005, 04:59 PM   #2
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OMG Meg, this is me, you are me!!!!! This is exactly me!! What a relief I'm not the only one like me. This is so informative and such good ideas to stay at or get back to our goals. I have not read the other chapters yet and don't have the book but this chapter is so like me.
I've been on a lot of lapses this past month and so a big relapse. I have lost 2# this week which were partly water weight I'm sure. I am almost back to my high goal. I've learned a lot this past month and am going to keep in mind what happened. People telling me how good I looked, some telling me I was thin enough and hanging out with those saboteurs. Is that a word? We went on a weeks vacation to the ocean and the other 2 couples are way overweight. We had desserts and so many snacks we couldn't begin to eat it all. I pigged out on licorice, desserts, mixed nuts, chips etc. You get the idea. I was so sick and had GERD so bad I had to sit up to sleep. Now is that sick or what?
Anyway, this info was so helpful and I will remember it. Maybe for you and me it will always be learning to keep it off!!!
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Old 02-07-2005, 08:43 AM   #3
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Learning to keep it off will be a lifelong learning road to success for me I have that in my head now, and I will not let it go, EVER!!. It will get easier, so the real masters say, and I am inclined to believe them, after all they've kept it off for 3 years +.....

I've had MANY lapses in the last year, but not many relapses, where I didn't nip it in the bud within a few hours of the lapse. I always tell myself " I am only 2 hours away from the next healthy meal " and I DO have a healthy meal the next time around, because I usually feel physically cwappy from the junk food ...

My personal line in the sand is 2#, because I know if I go over to 5# it WILL turn into a relapse... During the holidays it was 4#, I was honestly almost in a panic.... the first time I got on the scale and saw this, I literally yelled : "NO!!! " Other than that moment of fear I didn't let it get me down (much)... Used ALL the positive self talk I could think of and plugged away, one foot in front of the other, one step/one bite at a time ...

One thing I have stopped doing is beratting myself and I never look at myself and call myself names .... this is completely out of my self talk vocabulary ... and this has helped me in not only in weight loss but in other areas of my life...

Well that's it for now for me.... GREAT work Meg !
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Old 02-07-2005, 02:55 PM   #4
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When my numbers were moving upward my line in the sand was very flexible. It would always be "well, it has gone up but at least I do not weigh more than (insert proper multiple of 5)." When I went over it would just adjust upward to the next multiple of five. So I can really see her point about drawing a line in the sand and sticking to it.

It took a while to come to grips with the lapse/relapse issue. Now I know that I will have a lapse every once in a while, and general if I accept it for what it is I can rescue the day. In the past I would see it as an excuse to ahev a "free day" or to give up. I guess it is all part of realizing that every decision is important for itself.
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Old 02-08-2005, 03:04 PM   #5
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It's so true but probably not usually thought of in this way. Almost anyone can lose weight, but keeping it off is a whole other story.

I have a definite line in the sand that I will not cross, period. And I know that if I ever get to that point I will go straight back to strictly following the plan that allowed me to lose the weight in the first place. I think this is one of the most important aspects of successful maintenance. I, personally, weigh daily. This is part of my routine and I use it to keep tabs on how I'm doing with my maintenance. I want to know as soon as there is a sign of true weight gain rather than the normal everyday fluctuations. And I know that if I've eaten badly and see the scale jump up a few pounds then I need to watch my food choices and portions more closely and perhaps up my exercise a bit.

I have definitely had lapses but I think I've got a good handle on how not to let them turn into a true relapse. I've certainly discovered that I can't think of being OP as an all or nothing thing, like I've done so many times in the past. Sure, we're gonna mess up, but the trick is to get right back on track at the very next opportunity rather than allowing it to blow your whole day or week. It is so important to remember that we are not going to put all this weight back on overnight. We absolutely have the power, knowledge, and tools to prevent a significant weight gain. And we are the only ones who can keep it from getting out of control again.

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Old 02-08-2005, 04:59 PM   #6
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Okay. Now you've done it. I am definitely going to have to buy this book and read it. Thanks so much for taking the time and trouble to read and give very detailed and well thought out summaries of the chapters. This chapter, in particular, was so helpful to me at this time in my life. I have been struggling with the "lapse" issue - feeling like if I broke down and ate a few fries or a piece of pie, that would spin me out of control. Your summary of this chapter has given me a "Eureka" moment and real insight into what maintenance is about.

I now feel that I do not have to be a "slave" to the scale or to calorie counting. The one thing I knew would destroy my new found thinness would be getting just plain old tired of a lifetime of depriving myself. But this has given me confidence that I can, on occasion, just let go and enjoy myself and not spiral out of control as long as I have my line in the sand. What a great insight to gain. I had already drawn that mental line at 5 lbs and now reconfirm that line. It is a solid, double yellow line that will not be crossed.
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Old 02-10-2005, 05:30 AM   #7
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Quote:
Originally Posted by boiaby
We absolutely have the power, knowledge, and tools to prevent a significant weight gain. And we are the only ones who can keep it from getting out of control again.
Wow - that's it right there in a nutshell - the motto of the Maintainers Forum!

It sounds like we've all found that the 'line in the sand' concept is key to maintenance. As Lawshark put it so well: it's a solid, double yellow line that will not be crossed. I had to at the mental picture of Ilene yelling NO! at her scales but it's really what we have to do: get on the scales regularly, face the music, say that this is IT, and go back to what works, one day at a time. Just think what would have happened if you had given yourself a 'vacation' from the scales during the holidays, Ilene? Where could you have ended up by January 1? Ten pounds up? Much, much better to stop any regain while it's small and deal with it right then and there.

Along those lines, during the holidays, an Internet diet expert urged her readers to take a vacation from dieting during the holidays (as she so eloquently described doing herself) and get back on plan after the first of the year. I was aghast at this advice, since it went against everything that I've read and found to be true personally. Haven't we all discovered how EASY it is to regain and how HARD it is to re-lose? How EASY it is to get off track and how HARD it is to re-start? Study after study has shown that weight gained over the holidays is never lost, despite New Year's resolutions. Isn't it so much better to keep on track and keep monitoring all year long? I'm curious what you all think? Are the holidays a reason to cross the line in the sand?
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Old 02-10-2005, 07:54 AM   #8
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Quote:
Originally Posted by Meg
Are the holidays a reason to cross the line in the sand?
Heck, no!! What an idea!!
Even though I know I'll most likely have a few slip-ups during a holiday, I make every effort to stick to my plan. If I was to go right off plan, there's no telling how much I'd pack on! Easily 10 fatty pounds in a week.
When I continually remind myself of what's "right and what's wrong" to eat, I'm more likely to only gain 1 or 2 pounds.
I DO accept that losing is not an option over Christmas; though, and go into the holidays with the hopes of maintaining.
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Old 02-10-2005, 08:24 AM   #9
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I also go into the month of December with the thought that I will maintain for that month... I up my exercises considerably too ... When the party is over it's over for me too till the next party ... I NIP IT IN THE BUD the day after with less calories, more water, more exercise...

I had read that article too Meg somewhere and shook my head !! NOT a good idea at all...

Off to work TTFN...
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Old 02-10-2005, 08:56 AM   #10
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I read that too, and thought "Oh boy! There's a recipe for disaster!" I picked a few occasions when I knew I didn't want to stick to plan (Thanksgiving dinner, Christmast party, Christmas dinner, New Years Eve), ate moderately at the "event", and really cracked down between. Each event was a momentary blip on the scale, but overall I was down. I found it very easy to hold a conversation in any setting hold a water bottle instead of a glass of egg-nog. Bringing a vegies tray and shrimp platter to parties was just as much appreciated as any calorie-laden dip or dessert. Maybe more so, from the speed at which they disappeared!

When I read that article, I wondered how many unhappy people would be facing reality in January after their "diet vacation", up 10, 12, 15 or more pounds....I know a vacation would become a revelry for me and gaining 15 pounds in a month and a half would be very doable. That's a much wider line in the sand than my usual 3 pound! and at the rate I lose, it would take me nearly 3 months to take it off again. Worth it? NO WAY!

I'm currently seeing the effects of that kind of thinking at the gym. Several of my clients who worked hard to get themselves into really good physical condition by November lost a lot of their dedication through the holidays. Too many demands on their time...shopping...lunches...school and business commitments...family celebrations and holidays.... All important, all fun, all involved food and alcohol. And in mid- to late January, most of them came back, toting 10 pounds of fat, having lost a lot of the conditioning for which they'd worked so hard in the previous months. Now they are looking forward to spring break bathing suit vacations and are in a panic. My biggest job is to try to get my clients to see that health and fitness is a year-round lifestyle, not a series of connect-the-dot dates on the calendar when they have to fit into a size 8!

Oh, the subject was lapses vs. relapses
These days I mostly have planned lapses. Maybe that sounds a little like the aforementioned "diet vacation", but they only last 1 meal or 2. For example, although I'm still bloated from it, I planned to eat off plan at a SuperBowl party. I'm regretting the decision, but I planned it and was back to clean eats Monday morning. I plan to make a Valentine's dinner that won't be strictly diet friendly, and have a few bites of dessert. I plan to be right back ON PLAN with the next meal.

I don't ever want to outgrow my current wardrobe, feel stuffed to the point of pain, or be angry with myself again. It's not worth it.

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Old 02-10-2005, 09:01 AM   #11
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This section certainly hit home for me. After being in the low 120s since early fall (I think) the scale has been creeping slowly upwards since late Dec until I hit 124, my line in the sand, when I stepped on the scale after my mil's 2 week visit.

But, I have to credit habits learned over the past 10 months as the reason the number hasn't crept higher. Even while I was eating all kinds of junk and rarely denying myself a treat I wanted, I was eating a healthy, moderate breakfast every day and a healthy, moderate lunch 6/7 days, so that my junk eating was not nearly as bad as it has been in the past. And running 3X per week has not been optional, regardless of the weather. (I guess I should also give some credit to my 12 month old dd who lately seems to think I run an all night buffet for her dining convience.)

And it's been easier that I expected to jump back into losing mode this week; once I saw the scale hit that magic number and felt my jeans getting tighter, I resolved to stop the upward trend now. This week I haven't even wanted to eat excessive amounts of junk. (Of course, I haven't baked cookies this week either.)
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Old 02-10-2005, 10:22 AM   #12
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Quote:
Originally Posted by Mel
My biggest job is to try to get my clients to see that health and fitness is a year-round lifestyle, not a series of connect-the-dot dates on the calendar when they have to fit into a size 8!
That's a really important point, Mel ... if this is going to become a lifestyle - and it HAS to be to work long-term - then there really isn't room for diet vacations (which doesn't mean no room for planned treats - more on that later). To me, a diet vacation implies days or even weeks of off-plan eating, with some date in the future circled on your calendar when you intend resume on-plan eating. That's NOT a lifestyle - it's a diet. And we all know how often 'tomorrow never comes' when you're talking about re-starting a diet and exercise plan.

Data from the National Weight Control Registry shows that successful maintainers practice their eating and exercise behaviors 24 hours a day, 7 days a week, 365 days a year. Taking days, weekends, whole weeks, or the holiday season off is associated with weight regain. Them's the facts, folks.

As for planned treats versus lapses - Thin For Life distinguishes the two. Anne Fletcher isn't calling a planned treat a 'lapse' - she reserves that for 'doing something unplanned that is not ideal for weight control'. A planned treat is something you decide to do ahead of time (like 'I'm going out to dinner on Saturday'), you have an idea of what the treat is ('I'll have a glass of wine and dessert'), and it's limited in time (one dinner). So I don't think that your Super Bowl party and V-Day dinner even count as lapses, Mel. They're a pre-planned part of those days and you return to your eating & exercise plans the minute that the event is over. That's what makes what YOU do a lifestyle - simply put, it's how you live your life every day.
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Old 02-10-2005, 01:17 PM   #13
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Quote:
I don't ever want to outgrow my current wardrobe, feel stuffed to the point of pain, or be angry with myself again. It's not worth it.
I'm still dealing with my lapse that became a relapse, and headed down the highway at great speed, so that I caught it only 62 pounds later! When I "came to" I was so angry with myself. A year of WL and 2 of maintenance undone. I finally had to face the fact that it would take longer than a couple weeks for me to get back into my low-weight clothes and packed them up. I can see the box, but at least the clothes themselves are not hanging in the closet mocking me and feeding my anger. Since I grabbed hold and began to reverse the relapse I have not eaten to that "stuffed to the point of pain" level, and did only have planned off program meals at the holidays rather than a free-for-all. In fact I've not had many lapses at all. I have gotten back to exercising regularly (lack of exercise played a big part in the relapse).

I'm enjoying reading TFL again, and hearing what y'all have to say about it and about your experiences.
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Old 02-10-2005, 01:34 PM   #14
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Pat, I don't mean to be nebby or nosey (so feel free to ignore me ) but would you mind talking a little more about what happened while you were regaining the weight? You said you finally 'came to' - what was it like when you were regaining? Did you recognize what was happening while it was going on? Was it denial (like not weighing yourself)? Or just not caring? Or stress eating?

Like it said, this may be way too personal, so there's no need to respond. I'm asking because the dread regain is my biggest fear and I'm looking for any and all insights into how to prevent it from happening.
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Old 02-10-2005, 03:34 PM   #15
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Oh, no problem. You may recall that while I started losing before my DH was diagnosed with cancer, much of the hard work came while we were dealing with the stress of that, including living away from home for 8 months. For WL purposes, it was perfect - no friends, family or social events, so complete control of my foods; no job, so lots of time for exercise; lots of stress to work off. I got to a weight I could maintain, and a size I loved! We came home in Aug 2000. I continued to exercise a lot, plus I had a job as a PC tech, which required me to be all over an old 3 story building, with only 1 slow, inconviently located elevator, so I was getting lots of exercise at work too. This went on for the next year, and I maintained well. Then in the summer of 2001 2 things happened. Our local gym closed, which didn't affect me in the summer, as I was running and I prefer that outdoors anyway. The second was that while I was at a conference at UC Santa Cruz, which is a very hilly campus, I developed PF. I'm sure in retrospect that it was from wearing Birkenstocks to go up and down the hills to the meetings, meals, etc. I ran most of the days I was there too (very cool, to run in the foggy mornings, and meet the deer who lived on the campus) but then of course, I had good supportive shoes on. Anywho, still continued to maintain til fall, but my exercise program slowed way down - couldn't run w/o pain, gym was closed. I still had the job-required exercise until October, when I changed to my current job. I'm now a library director, which is a fairly sendentary job. Plus we were still going through some stuff with DH's health, and frankly what it was doing to our marriage. This time, however, I turned to eating to alleviate the stress. Sigh. I guess I just kept thinking I'd deal with the weight issues "next week," or "next month." I had my head in the sand until I realized that I had nothing that fit. Of course, I had to buy new clothes - in a larger size! Wouldn't you think that would alert me? No, apparently not.

To prevent this from becoming a novel, just let me say, that since about late 2003, I've maintained at this weight (I'll tell anyone, I have maintenance down - I just need to do it at a lower weight ). In April 2004 our gym reopened under new management, and I've gradually gotten back into exercise. I rode my bike a lot this past summer, and hope to again this year, enough to be a genuine cardio workout! But I began weight training in October 2004, and upped my cardio to a level more conducive to weight loss. Since I'm 60, on HRT, and Lipitor, my WL tends to be s-l-o-w.... But it is happening, and I feel much better, both physically, and mentally.

And I should also ask, that DH is coming up on his 5 year anniversary of his bone marrow transplant (a very good remission for his cancer ), and our marriage has weathered the storm and is very strong. He usually joins me at the gym, and frankly can run further than me!
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