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Sam’s monthly check-in: What’s up, what’s down, the September version (CW: some discussion of weight loss)

    Bright red maple leaves against a blue sky. Photo by Unsplash.

    What’s up…

    Here’s the fun, easy thing. I’ve started swimming lessons and I’m excited about that. I love learning new things though I feel like I have been learning to swim my whole life! And maybe that’s okay. We’re working (so far) on breathing and kicking. I feel like I am learning lots, I’m not hopeless, and I feel like someday I might be able swim lengths of the pool again. The lessons are semi-private and the other student is a 4th year undergrad, an international student, hoping to learn to swim strokes. The instructor is also a senior undergrad and we’re all having fun. The lessons are short–30 minutes–but twice weekly and I can come early and stick around after for extra time in the pool. This weekend I’m shopping for a second fitness-y, swimming pool type bathing suit and new goggles. Woohoo!

    Here’s the thing that’s hard to talk about, doctors and weight loss. I met with a family doctor with some experience/expertise in the area of weight loss. Why? Well, less knee pain is the short answer. But also better surgical outcomes and quicker recovery if I go that route. I also stand a better chance of avoiding knee surgery until the inevitable knee replacement many years down the road. I know doctors recommend weight loss for everything but in this case–I’ve read a bunch of the journal literature–I think they’re right.
    I don’t think it’s a case like this.

    So in my case I’m not being extra active in order to lose weight. I’m trying to lose weight to preserve my level of activity. There’s nothing magical on offer. The best diet is the one you can live with. I knew that going in. Weight loss is tough. Read Everything You Know About Obesity is Wrong if you want to know how tough. But with my active lifestyle which I love up for grabs, I have to try. The odds aren’t great. I know that. Given my size and the knee problems, I qualify for weight loss surgery. I declined. I also qualify for appetite suppressing medication. Again, for now, I declined. I might try it later. Instead I’m using MyFitnessPal and tracking all the things, trying to find a lower calorie life I can live with. I like this, from Yoni Freedhoff,

    Now, you should know that I too have a weight-loss agenda. It’s fairly easy to describe. In a nutshell, I don’t believe that there’s one right diet to suit everyone. In my clinical practice, as well as in my book, I embrace the fact that there are dozens, if not hundreds, of factors that influence an individual’s chances of long-term success. Low fat, low carb, keto, paleo, intermittent fasting, vegan, Mediterranean, meal replacement, whatever – there are success stories out there with each and every diet that exists.

    While I’ve seen proof of this in my own clinical practice, you don’t have to take my word for it. Instead, look no further than the National Weight Control Registry for evidence that, when it comes to successfully keeping weight off long term, everyone’s different. The massive database established in the 1990s tracks why and how over 10,000 people have managed to keep an average loss of 67 pounds off for over five years. And there, as I’ve described, there isn’t one answer.

    The one thing successful dieters have in common is that they reduce their calories on their new diets and like their lives and diets enough while on it to sustain its adoption for good. So, while it’s true that you might be able to lose more weight, or to lose weight faster, with one diet versus another, unless you keep living with it forever, that weight’s coming back when you head back to the life and diet that you actually liked before you lost.

    To put it even more succinctly: If you promote the notion that there’s one right way to lose weight or live healthfully, you’re part of the problem. The more weight you’d like to permanently lose, the more of your life you’ll need to permanently change. And, when it comes to something as pleasurable as food, merely tolerable lives just aren’t good enough. What’s best for you is undoubtedly worst for someone else.

    I reviewed his book, The Diet Fix, here. I’m seeing a family doctor, who as part of his training did a placement with Yoni Freedhoff.

    In the photo below, Aric is on the left and Yoni, on the right. They’re both proponents of evidence based medicine and I like that neither downplays how hard it is to lose weight and keep it off.

    At no point have I felt like I’m not believed about what I eat and my current level of activity.

    Where am I? I started at 240 lbs for my all time winter high and I’m down to 225. I’d like to get down to 175, which is still solidly in the ‘overweight’ category for my height. But I’m pretty muscular and the normal range 121-158 lbs are weights I haven’t seen since elementary school me! I’ve been keeping my weight loss updates to the monthly check-ins, complete with content warnings. Tracy and I are pretty committed to keeping weight loss talk to a minimum. But I’ve been writing about it at all because it’s very closely tied to my desire to stay active.

    Two different knee surgeons say that no matter what I’ll never run again and though weight didn’t cause that (lots of skinny people have osteoarthritis–it’s not caused by my size) if I want to keep walking, hiking etc I need to lose weight. You can read about my left knee here. You can read more about it here.

    Given that it’s tied to me having an active future, I feel like I want to write about it. The content warnings should help people avoid it, I hope.

    Why is it so hard to write about weight loss? Why?

    I know what’s hard about it for me. For years I’ve been happy and active at a larger size, sharing the message that you don’t need to be thin to be fit. I’m not throwing that message out now this larger body isn’t serving me so well.  There are so many imperatives to lose weight. See Wishing for weight loss. Looks, caring about pay and teaching evaluations even, and so many medical arguments that aren’t true. So many reasons I reject. But then there is this one, pain. It’s awful and urgent and I want it to stop.

    Wish me luck. 

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