"Lifestyle Changes Without Surgery Don't Work"
 

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. :carrot:

Meg:

What a thought provoking post. Thanks for your insights. I agree!

Cheers,

J

:cp: Thanks for your post Meg!

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 :D

Edit: Meg, do you have the name and contact info for that surgeon? I would LOVE to share my thoughts with her :devil:

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!! :carrot:

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.

Thank you for your post.

While I'm not to the point of maintaining (YET!!! :D), 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.

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.

Such an interesting thread!

Such a fascinating thread.

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.

How irritating. What is so out of the norm about eating healthy, getting regular exercise, and being accountable to yourself?

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.

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.

Meg: I'm all about this! Count me in. Give me a podium and I'll talk to them for hours. :devil: 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." :rolleyes:

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. :hug:

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.

BRAVO Meg,
What a great post! We know it can be done with effort, YOU are EXHIBIT A & many of us are exhibit B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V, W, X, Y and exhibit Z! It can be done and many of us are living proof!
Lets hear it for us maintainers- hip, hip hoorah!

Thank you Meg. I have been around here on and off since around 1998- the very early years. I had weight loss, as I had in the past, but I had no clue about maintaining. I come to the Maintainer's area to see how you do things, because really what you do is what I need to continue to do every day to get to goal and then stay there. The women here are incredible. Knowing that it is and will continue to be a daily priority is something you hear, but when you see it in action it makes a difference. I am also impressed with the healthy eating that the maintainers do. I see women around me who maintain their weight, but the thought of a tasty meal or a vegetable is a low priority. I can't live like that, and I do not think it is healthy. A book with the daily healthy recipes of the big maintainers here, along with their stories, would be a big seller. Hello!- are there no publishing house editors here?

QFT! And thank you, Lydia, for being one of those role models! :carrot:

Meg, great post! And I think "obesogenic" is my new favorite word.

Count me in as one of the people who had no idea that "maintenance" existed before coming to 3FC. If my story can be called a success, it's thanks to 3FC.

It makes me angry that that doctor would say that non-surgical weight loss is impossible. What are we, chopped liver? (Of course, they would probably look at me and say, you gained back 15 lbs, you don't count. :p) And what about the people who have WLS only to regain anyway?

I've heard the depressing stats about weight re-gain, but I am hopeful that it doesn't always have to be that way. And that a place like 3fc can be instrumental in better success rates!

Meg says it all the time -- the industry is about weight LOSS, not MAINTENANCE. I think that if more people hear about successful maintenance strategies and incorporate them, then maintenance rates would increase. It will never be 100% -- and may never be really high, but I KNOW we can do better. I believe knowledge IS power!!

Thanks for a great post, and a great thread!

From what I've been reading, doctors have NO IDEA whether weight loss surgery is successful in the long run, meaning 5 years or more. Supposedly they define "success" as losing 50% of excess weight and keeping it off for 5 years, but I can't find any numbers showing how many patients are actually successful. Meg, anyone, do you have information?

Surgeons tend to gauge success by whether everything got put together right and the patient wakes up from the surgery. They aren't so interested in what happens after that.

Jay

The proportion of people keeping it off is very low, so it's easy to argue that wls has 4 to 8 times the success rate of dieting alone - but it seems to me completely illogical that there are primarily only two options for obesity treatment. Self-directed behavior change or wls. Why aren't there more treatment options in the middle (and why aren't they more affordable)?

It would be a bit like if treatments available for alcoholism and substance abuse were self-help groups (like AA) and brain surgery/shock treatments. What about the "middle?"

Our hospital has an amazing comprehensive weight loss program that includes education classes and appointments with the doctor, dietitian, and personal trainer, a gym membership and group and individual counseling. AND it's housed in a YMCA building partially funded by the hospital (the gym facilities also are a fully-equipped and accredited physical therapy program).

Virtually no insurance companies will pay for this program, but will pay for wls.

The argument is that these programs haven't been proven as effective as wls (but they're not really given the chance to, because it's rarely an option in most communities - and where it is an option, insurances not covering it does affect people's ability to choose it, and therefore the number of people interested in it).

Finding a supportive community, I believe is one of the factors that contribute
to successful weight loss and maintenance (even of wls this is true - the patients who continue to attend the support group meetings tend to be the most successful in the long-term), and yet finding that support can be difficult when a person doesn't know where to look (or is ashamed to look).

There are so many possibilities for non-surgical intervention, that have not been explored, and I wonder why, as a culture, we're willing to make the huge leap from "diets" to surgery - why aren't the intermediate possibilities explored more?

If I had had insurance that covered it, I would have gladly entered a "rehab" style treatment for obesity. These programs do exist, but unless you can pay out-of-pocket, they're not available to most people.

It just seems to me that in the field of obesity treatment, there's a huge gap in treatment - there's little to no middle-ground. Certainly there has to be more options "in the middle," less invalsive than wls, yet more comprehensive than a typical "diet" program.

If the insurance company is looking for proof, they're talking about studies. The number of people interested in a program in a community and whether they can afford a program really have nothing to do with whether a program is or ever will be considered proven by an insurance company. The proof doesn't come from giving a program "a chance" in a community, it comes from a study. At least, that is all that insurance companies are looking at.

And I think the insurance companies are not so interested in what works as in what they can find an excuse not to cover :). The long-term benefits of weight loss & maintenance don't mean much to insurance companies, who figure by then someone else will be insuring the person and benefiting from the investment of the earlier insurance company.

I'm so thrilled by today's discussion. Very exciting. I would just echo most messages above so I can get to another thought.

I'm hearing folks say in today's thread that they are interested in advocacy. Right? I happen to be a professional public policy advocate who works at the grassroots level for community change. Currently, I work in a municipal health department with a great program that has had lots of success promoting "active living" with public policy changes to the environment to support lifestyle changes. Finally, I am applying to a Public Policy PhD program (to start 9/2010).

I would like to propose, for those maintainers interested, a separate thread for advocacy about (any or all of the following):
1) maintenace is possible after weight loss
targeting: media, weight loss magazines, govt officials
2) need programs to support maintenance
targeting: govt officials, insurance, gyms, others
3) 3fatchicks is an awesome place
targeting: general media, weight loss magazines

These are my thoughts. Folks interested to consider working on promoting our thoughts might expect to:
1) write letters to editors,
2) email/call/write elected officials,
3) attend local meetings around health issues
4) follow a group email community network
5) share some/all of personal weight loss/maintenance story

What do you say? I would be very happy to participate, assist the group to brainstorm ideas, and such. If we pinpoint our message and have a consistant strategy, we will likely see our efforts pay off with more attention to 3fatchicks, potentially seeing more maintenance programs, and an increased public belief that there is life AFTER weight loss.

I wouldn't feel comfortable (as a new chick cracking out in to the maintenance area) being too far out there since I'm just too new. However, I do very strongly agree that there are NO SYSTEMIC support for successful maintenance.

Anyone interested?

Great thread!

As I've said before - I always wanted to diet for a short time and then eat normal. I did that for 20 years! It took me 20 years to realize that my "normal" made me fat and I had to change normal. Once I hit that mind set, I can honestly say it has been easier than I ever imagined (not that there haven't been challenges).

*blows a raspberry at that bariatric surgeon*

Yep! I'm interested. :) Let me know specifically how I can contribute. Anyone else?

Good luck with your PhD program. :D

Re: insurance - I find it very interesting that my insurance plan does not cover WLS, but it does cover you if you sign up for the Dr. Ornish Spectrum Program for a year. And that is all about prevention.

Too bad they won't pay for a gym membership LOL!

Mine will pay for a gym membership if you meet certain BMI criteria, but once the weight is off, they stop paying for it. Cause we know once you lose the weight, you don't need to exercise anymore, right?

iaradajnos, I am VERY interested!

Meg, that is an excellent post.

I find it appaling how many people seem to think surgery is the only option. Heck, I have a friend of mine who is going to get liposuction (not morbidly obese, would never qualify for "the surgery" -- she is just overweight by maybe 20 pounds) because she truly believes there is no other option. She would like to be around 50 pounds lighter than she is. I told her it's not THAT tough, if she is willing to be dedicated and PASSIONATE about losing the weight and keeping it OFF. We ALL know it's about finding something you can stick with forever.

See, most people in my life think I'm extreme. I WAS extreme for around half a year, as I was preparing for a bodybuilding contest (July 18th -- I did well, placing first in my weight class and second overall, but I will NOT do it again; I don't think it was healthy for me physically OR emotionally), which really put things into perspective for me. I was working out two hours in the morning, two hours in the evening, and on a CRAZY diet eating practically nothing but chicken, almonds, egg whites, olive oil, and green veggies. My ordinary lifestyle change was (now is, that I am back on it) not extreme at all. So what if we count calories, eat clean, and work out every day? That is not extreme; that is our responsibility to our bodies in order to maintain healthy lives. I think people just turn away from the only thing that works (eat less, move more -- how you get there is up to you :)) because it is not the easy way out. As I've said before, I've been asked all the time how I did it. Before wasting my time, I always ask them if they REALLY want to know. The other day, someone said, "I know you are just such a fitness freak because you're afraid to gain the weight back. And you probably would, because you most likely have a slow metabolism." At first, I was offended, then I thought, "Wait, the metabolism portion of that statement is BS, BUT SO WHAT if I don't want to gain my weight back? GO ME! :D"

Seriously, GO US. We're a minority. American culture easily promotes obesity with its grab 'n go lifestyle. There is SUCH a lack of healthy options from anywhere but Mother Nature. Once upon a time, going out to eat (or any other type of grab 'n go) was a TREAT, now it's just normal. Restaurants fight each other for who can serve the most food for the less money. And we buy into it, as a country, thinking we are getting a good deal. Despite this, we're more obsessed with being thin than ever -- on the surface. I believe if we REALLY wanted to be so-called thin people, we would change our lives and stop being ignorant as a whole. (This was not meant to be delivered in an insulting fashion; the media FEEDS this ignorance with all its diet product propaganda.)

Ahhh, it's time for me to step off my soap box!

I think your last statement sums it up. I believe that people really DO want to be slim. They are innundated with visions of slim people in all the media--slim, happy people who are shown chowing down on mountains of fast food, who are depicted as having a great time drinking beer and eating all kinds of unhealthy stuff. So they see it as some kind of personal failure when they gain weight on the same type of diet! I really beleive that if people truly understood how many calories those foods have, and what effect that has on their bodies, that many people would make different choices.

And yeah, it's amazing to me that insurance companies will pay for WLS but won't pay for a dietician, or for an extended obesity-treatment facility. It kind of reminds me of the days when Medicare would refuse to pay for a screening mammo, but would pay for the breast cancer treatment once you had advanced disease.

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.

:lol: 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 :lol:) 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 :lol:

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 :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.