We do have some kind of weird relationship with food. We are inundated with ads - big plates of restaurant food, bags of chips, ice cream, crunchy snacks, etc etc. We are also inundated with pictures of slim, beautiful people with rock hard abs and smooth blemishless skin (hello airbrushing).

I posted a few months back that food gets some kind of special pass in society. Eat it, it's yummy! Eat it, you deserve it! We aren't given carte blanche to indulge in other things just because they feel good (drugs, skipping work, sex with our best friend's boyfriend, etc etc). Why is food so darned special? Food is just food, it tastes good but it has consequences.

For me, the only way to lose weight and keep it off was literally step off the cultural path. No more fast food, no more "easy cook" meals from the grocery store, no more hitting vending machines. No more giant sodas, great big coffees, no more giant pastries with my coffee, giving up huge plates of food at restaurants. Every now and then, I get whiny about this. I want the easy, yummy, tasty, fast life that other people get to enjoy. Other times, I'm proud of my determination to get off that bus and be healthy.

I seriously laughed out loud over that. Excellent thought. But, see, most would say food does less harm than drugs (it can't wipe out the brain), skipping work (it won't cause us to lose our jobs), sex with our best friend's boyfriend (it won't ruin the relationship with said best friend), SO, in the eyes of most, food is harmless. I see where you're coming from, of course -- and I, too, agree that people do not see the risk or danger involved with overeating. Heck, a good portion of overeaters probably refuse to admit they have a problem just because they aren't binge eaters; they don't do it for emotional purposes; they don't have trigger foods; they just eat... a lot... too much.

Amen to stepping off that cultural path. I have done the same, as have a good portion of us here. I have to admit I DO get a tad bit jealous when I see a skinny, slim, thin, or "in shape" person frequently engaging in such habits, until I remind myself that she (I said she because I don't get jealous of guys ) probably is eating that pizza/burger/other crap and has most likely skipped breakfast, will have no snacks, or will skip dinner. Even if this is not true, those habits are not healthy and there is no way she could be feeling her best. I have a skinny friend and it seems like all she eats is fast food, pizza, and Coke. That IS probably true, BUT she eats something like ONE meal a day (she is a very good friend of mine... we spend lots of time hanging out... I get hungry frequently and she is like "eeh" unless it involves fast food), drinks Coke the rest of the time, hardly ever drinks water, and, well, that can't be healthy.

I really like this and find it exceptionally interesting because I have had drug addiction issues along with food addiction issues. And skipping work addiction issues and.. oh yeah, sex with my best friend's boyfriend issues.. Wow! You completely nailed it

I don't think it would do me much good to actually talk about unhealthy food and/or overeating like a drug in public, but for me really it is in the same boat. I will enjoy it temporarily and then it will have consequences. I need to be more mindful of this!

There are a lot of obese people who say "I don't know why I'm obese, I really don't eat that much." My dad is one of them. He constantly says "I don't eat that much" but he has been obese for 40 years. And you know what? He DOES eat that much! Kind of like how he refuses to believe that he snores even though he kept the whole family awake at night for years.

I was watching a show on one of those people who was so obese that they had to be excavated from their house to get to the hospital. One of those "1000-lb man" type shows. The person was saying "I really don't eat that much, it must just be bad metabolism." Meanwhile the film crew documented them eating something like 10,000 calories during just a single day -- a few chips here, a hamburger there, some sodas, etc.

I was in denial about it for a long time too. I though, I'm just eating what everyone else is eating, why am I fat and they are thin? But really I was eating more than everyone else, and more of the unhealthier foods, and not getting as much exercise.

That's kinda cool . Except, they should pay for both, of course.

I wonder how one draws the line. Paying for surgery seems like something insurance should obviously pay for.

Paying for my healthy foods seems like something they obviously shouldn't cover.

And there's so much in between. Gym memberships? For everyone, just for the diagnosed obese, what about formerly obese or at risk to become obese? Daily vitamins? Weight Watchers membership? Rice steamer? Resistance bands to use at home? Counseling for emotional eating? Dietician consults? Again, for whom? The diagnosed obese, at risk to be obese ...

I hear a lot of people say "I don't eat all that much, I don't know why I;m overweigh". Heck, I used to say it myself... then I added up a few days on The Daily Plate and discovered go to lunch meals with 1500+ calories, dinners with 2500+ calories, days of 4000-5000 calories.... I had to look back and say "I guess I do eat that much, no wonder." Turning that light switch on really started the lifestyle change for me. I realized I was eating terrible foods and sitting on my behind all the time so unless something changed I was just going to get larger and larger. I came here, and to other great reference sites, and educated myself so I knew how to live the lifestyle change.

So many people don't ever turn on the light - they don't know what they are eating or what they are doing to their body with their habits. They look for quick fixes like weight loss surgery or crash diets, then don't know how to maintain the loss so they regain. (I have two old coworkers who had gastric bypass, both regained to higher than they started out within seven years.) This is why our maintenance stats look bad, those are the people that get noticed!

I really wish the insurance companies would get on the boat of paying for some weight loss and maintenance programs - it would save them so much money in the long run... But, whoever above me said it is right - the companies figure that by the time you are having your serious weight complications there is a good chance someone else will be insuring you, especially with the way employers have to jump insurance companies every few years with rate increases...

I hope that over time more people see those who have maintained weight loss by healthy means like the great people here!

Re: "I don't eat that much" --
I used to say that, too. I DIDN'T eat that much in regards to quantity, but I ate the wrong stuff. I feel like I actually eat more FOOD now, along with much more frequent feedings. If you throw some oils, sugars, and creams on almost anything, it'll make it super fattening super fast. I went out to eat quite often, and even though I got a box or bag very often, just HALF of many restaurant meals still equals 800-1,000 calories. I'd eat the stuff, feel like I had rocks in my stomach, and think, "Oh, I ate a good meal" just to get hungry a few hours later. I didn't snack much, because I didn't want to be a pig, so I just ate more at dinner. *Rolls eyes*

A lot of people drink their calories, too, between sodas, juices, and so-called health and sports drinks. Those can add up quickly and get you very fat. As Shannon said, most people don't have any idea WHAT they are eating... and you can tag "no trans fat", "all natural", "gluten free", "100% organic", and "...salad" to almost anything to make it appear healthy.

Oh yeah, I forgot about the liquid calories... I had a Venti Soy Chai Tea Latte from Starbucks every single day, sometimes twice per day, and thought I was being healthy with the soy...

Hey Shane - congrats on the first place in your bodybuilding contest!

Very interesting and thought-provoking posts by everyone! I was trying to think if I know a single person who's lost weight and kept the majority of it off for any significant period of time IRL. I couldn't think of one person. Everyone else I know who's lost weight has yo-yo-ed and gained it back. Those people mostly did "programs" or fad diets (like weight watchers, Atkins), no wls, but they are still either "on a diet" or "off a diet". They don't get the concept of "lifestyle change".

My BF's immediate & extended family was visiting a few weeks ago for a week-long vacation. We ate a few meals with them and I was thinking as I ate that I still put more on my plate than this group of fairly skinny or "normal"-sized people - even now. I did have more salad on my plate than most, but I had more of everything. It's no mystery to me why I have weight problems. I will never say "I don't/didn't eat too much" because that's just a lie! I have accepted that in order to maintain a healthy weight, I will always have to eat differently (drink differently), and work out differently than the majority of people I know. However it's so true that a lot of people are just ignorant of proper nutrition. "Sugar free" doesn't mean calorie free, a true portion is a lot less than what one receives at a restaurant, etc. etc.

From what I know, cheap food hasn't been available to modern society on such a mass scale for more than about a half century. Revolutions in agriculture and technology have made food a lot cheaper and more readily available. Such an over-abundance of food is pretty new to us. Maybe as we get more "used" to having so much food available, we'll eat less...? I just watched a documentary on the History Channel about the rise of drugs in American society. It included the background of cocaine use, how it used to be in coca-cola, and was in all kind of tonics that were readily available to anyone who could walk in a drug store. Everyone was using it, and it wasn't thought of as anything dangerous. Finally people figured out that it was seriously addictive. Of course as someone noted food seems "safer" and of course one could live without cocaine, but not live without food. I know there's a big difference, but it's interesting to think about it from a historical and sociological perspective.

Maybe it's harder to behave healthily with food because we can't give it up, as one can give up alcohol, drugs, gambling, etc. (Please note I'm certainly not trying to trivialize addiction or how hard it is to overcome.) We need food to live.

I do have a friend whose insurance company would give her a discount for her gym membership. I can't remember what it was - full or partial reimbursement for membership fees, or just a discount on her premiums, but I believe there are a few plans that promote "healthy lifestyles". I agree that I think it's unfair many insurance co's will cover WLS, but not any other kind of weight loss or maintenance program. There are many valid options and should be given equal weight. With all the stats out there about how much $ obesity costs the health care system, you'd think insurance co's should want to promote any and all ways that might help people live healthier lifestyles!

I'd be bummed to be left out just because I exercise at home and on the street instead of in a gym!

Of course, no matter what insurance companies do, someone deserving will be left out and someone undeserving, so to speak, will be discounted. But I think they are only beginning (and some not at all) to address these things.

Megan, wanted to share this with you. It's part of one of our lessons from the Precision Nutrition Lean Eating Program I'm participating in, but it's a habit that many of us could use. I know it hit home for me....

The Okinawans are a simple people. They drink their water, they farm their lands, and they eat until 80% full. This last practice is known as "hara hachi bu." It's actually quite repulsive to do otherwise. Hara hachi bu is not a fad dietary suggestion, or about being a nutrition over-achiever, it's part of the culture. People who stuff themselves are gluttons. Many experts believe that this cultural practice, in conjunction with the traditional Okinawan diet rich in fruits and veggies, legumes, seafood, tea, and otherwise unprocessed foods, plays a major role in their leanness and well-being.

Hara hachi bu is an excellent practice for anyone who hopes to attain optimal health and body composition. Think of it as eating to a point where hunger is no longer present. This is compared to the North American way of eating until "full" or "stuffed."

When we eat until 80% full, we are ready to eat again in 2-4 hours (see previous meal frequency lesson). Not only that, but not stuffing ourselves allows the body to digest and process food without discomfort and bloating. Moreover, with a low level of hunger around at all times of the day, we know we are in fat burning mode. When hunger hits, and/or you aren't 100% full, don't think of it as an obstacle. Think of it as an opportunity. An opportunity to improve your health and body.

Eating until 80% full doesn't require a food scale, measuring cups or an encyclopedia of calorie counts. It simply requires YOU to figure out your hunger and fullness cues. It also requires that you pay attention to the food you eat at meals while allowing some time to elapse before drawing conclusions. If you've never paid attention to how you are feeling before and after eating, you have years of conditioning and circuits to re-wire. No time like the present.

At first, allow some wiggle room. It will take trial and error. Begin to understand the amount and types of food your body does well with. One of the most critical factors for eating until 80% full is allowing between 15 and 25 minutes to elapse after eating before deciding to eat more. If we eat a high volume of food in a short amount of time (say 6 minutes), we might get done and still have hunger sensations. This is because the signals from our gut haven't yet reached our brain to say, "slow the food cramming session!"

So pace yourself and understand that if you are truly less than 80% full in 20 minutes, you can eat more real food. It's about how YOU feel.

Another caveat with hara hachi bu is this. Real, unprocessed, whole foods tend to elicit the 80% full sensation better than processed stuff. You might be able to eat an entire bag of potato chips before you feel 80% full, which could set you back about 1500 empty calories. Meanwhile, a bowl of beans and broccoli could get you 80% full, which would contribute a controlled level of calories and lots of nutrients. When our options include completely natural foods, and we acknowledge hunger cues, overeating and gaining excessive body fat is extremely unlikely.

Think about the major signals you notice when you're no longer hungry and when you are hungry. They are different for everyone and we all have them. Our minds are actually designed with receptive machinery for optimal hunger and thirst regulation.

When you are hungry, you might notice shakiness, borborygmus (growling stomach), headache, an "empty" feeling, irritability, a craving for real food (e.g., veggies, lean proteins, and so on), etc.

When you are no longer hungry and have reached 80% fullness, you might notice a fuller sensation in your gut, no desire to eat real foods, contentment, minimal cravings, a good level of energy, alertness, etc.

Now, when we eat at home or when we bring meals with us, our food intake is under tight control. We simply bring the amount of food we do well with and then make adjustments as necessary.

However, at restaurants we need to think ahead. Take a look around at the portion sizes being served and ask the wait staff. Don't be afraid to start with a smaller order, as we can always get more. If the sizes are massive and you know that eating an entire plate would push you beyond 80% fullness, order a half serving. Or, simply order a full serving and box up half for a future feeding. You save money and get leaner. It's a win-win. And when you get your food, check in with yourself throughout the meal. How are you feeling? When you approach 80% fullness, don't be afraid to leave some food on your plate. Just because your friend, spouse or business associate ate a certain amount of food doesn't mean you have to as well.

Once our clients get the hang of this habit, they're astounded at how little food they actually need to feel good and meet their goals. Once you take up this habit, you'll feel much better during the day, have more productive workouts, sleep better, and get/stay lean. It's not always easy to eat the hara hachi way, since some cultures promote and advertise excessive consumption.

To make the "80% full" message a bit more appetizing, consider that quality may have a bearing on quantity. We know that at PN, the better the quality of the food we eat, the less of it we need to feel satisfied.

I do annoyed that insurance companies for the most part are not concerned with prevention or maintenance of health. It took passing laws in most states for insurance companies to cover the cost of mammograms, and even now ours covers the actual test, but not the cost of the radiologist to read it! I have worked places where the employer - not the insurance company - provided gym membership at a reduced "corporate" rate, and deducted it from your paycheck (if you wanted). My sister has a lap band, and that surgery was covered, along with all the counseling and support that goes along with, and of course her regular doctor visits, medications and her c-pap machine. Me, I pay for my gym membership, for any nutritional counseling I might want.... Grrr. BUt, it's worth it to me to go into my later years as a healthy active person.

I t will be interesting to see how and if insurance companies cover WLS in the future as this surgery becomes more and more popular.This is an elective procedure.And with its increase in popularity we are seeing more and more complications post-op in the hospital I work at.Just admitted a patient on Friday that has been admitted 6 times in the last 6 months with intestinal obstructions and her surgery was 7 years ago.Have seen many WLS complications this summer.So I imagine that insurances will begin to evaluate this over the next few years.

A couple things:
1) A comment about food
2) My meeting today with a nutritionist
3) Public Awareness Campaign Plan

Food:
I think it's so interesting about the very big change I've gone through over the years. I remember a key moment: when someone said they 'ate alot at lunch and would eat light at dinner'. It was a massive "who'd have thunk it?" for me. I never knew there was anything I could do. That was maybe ten years ago. Slowly over the years I have learned a lot about food and fitness, cut out poor nutrition behaviours, and added good nutritional behaviors.

Yesterday at a local pizza/sub shop, the kids and I ordered small subs with lots of veges. I asked for may on the side (pretty sure I wouldn't bother with the teaspoon scrapping--mostly as totally inadequate and not worth the effort). The guy have my a half cup of mayo on the side.

On the menu board, here's one of their very popular items: Seafood Platter with fried clams, fried shrimps, fried scallops & fried haddock, french fries, cole slaw, fried onion rings, tartar sauce, bread & butter. I felt like dying of a heart attack just reading it.

Nutritionist:
I made an appointment with a nutritionist through my PCP five months ago. I was thinking I'd need support near the middle or back end of my "diet" and want to check with a specialist. So, today's meeting was kind of weird. She was very nice but clearly puzzled after a few minutes when she realized I have a very good idea of my successful strategy so far and am near the end. What's the need? I was totally looking forward to this meeting because I wanted some kind of innoculation against gaining this weight back. I really had a secret wish that she might give something I can walk off with.

In the end, I just got a very nice pat on the back and a "keep at it" thumbs up. I did tell her about 3fatchicks.com, public policy support for maintenance programming, and Meg's post about that doctor who thinks surgery's the only answer. She raised her eyebrows and agreed surgery seems to be way too supported.

She asked if I'd be willing to speak with people about my success story. I said it's a bit early for me to grab a megaphone. I would be willing to sit on a panel with more experienced maintainers for:
1) sharing info to folks who are trying to lose weight
2) connect with other local maintainers for an evening
3) support past weight loss people who've regained
4) inform the friends, family and co-workers of maintainers (about NOT being a freak-of-nature, fanatic; why gifts of food are not appropriate; how to support; ways to enjoy this new maintainer and healthy life; etc.)

Policy:
I want to open a new thread for folks interested to promote maintainance. It will be housed within the maintainance forums. Interested people should watch for this. It will have discussion, action alerts, and information on current policies/practises that either support maintainance or work against healthy weight loss and maintainance. (I'm going to research a couple things then start the thread).

As opposed to a doctor who has something to gain from the original statement, the following study found pretty much the opposite.

Lifestyle Changes As Effective As Surgery For Obesity
http://www.realjock.com/article/1302

That's a pretty good description of how I try to eat too. I think it's good stuff.