Reading the Charts

As my surgery date approaches and I realize I have not lost a single pound, I think to myself: what could I have done differently?

One thing: I could have logged more faithfully.

Second thing: I could have printed out the logs I did have and try to analyze them to see what I've been doing wrong. That's the thing...it's not just about writing it down. It's also about being honest about what you ate and then trying to figure out where the problem is. If charts and numbers are boring, this is the point to sail on to another blog.

Okay, so I went back and looked at one of my worst weeks. This is how it averaged out:

Where Did My Calories Come From in August??
Total Calories = 1780
	Grams	Percent	% Total
Fat	84	755	43
Carbs	177	641	37
Fiber	16	0	0

The first thing I saw, to my dismay, was that I wasn't getting nearly enough fiber as I thought I should have been! It doesn't even show up as a percentage. What about all the wonderful fruits and vegetables I was eating? Unless...I was taking in too much fat, that was very clear. Where was it all coming from?

I took my food diary and looked at it. I wish there was a way to import the entries over here but I can't do that anymore unless I buy a kit and I don't want to do that. I got my daughter's help to create a table and it's taken me the last couple of hours to get one day's menu down:

What I Ate Today
Food Name	Servings/Size	Cals	Fat	Carb	Prot
Vegetable Salad (no meat)	3 cups	39	1	8	2
Ken's vinaigrette	1/3 cup	192	14	17	0
Cabot's cheddar cheese	4 oz.	440	36	0	24
2% milk	3/4 cup.	91	4	9	6
chicken breast	5 oz.	277	11	0	42
Rice	1/2 c.	103	0	22	2
mixed vegetables	1 cup.	107	0	24	5
Glucosamine	3 pills.	18	0	6	0
Cinnamon Toast Crunch	2 c.	347	9	64	3
Totals		1623	76	150	84

Well, right away I can see one major problem. Cheese has got to go, especially cheddar cheese. That hurts because I love it so much! Still, the cost is too high!

I'll be back later with another day's breakdowns. I have to rest my fingers!

One thing I'm wondering: where did all that extra space around my tables come from?????

Insurance Coverage

I was curious to see what kind of assistance the family can get with weight loss counseling, nutrition, and fitness.

There are 2 nutritionists with the plan -- well, what I mean is that they're willing to give a discount to members with our insurance. The trouble is they are both like a 2 hour drive away.

The customer service rep (CSR) advised me the only other thing I could do was go to an organization affiliated with Global Fit and we would be able to receive discounts in gym memberships and in programs like Weight Watchers. Well, okay, that's better...at least these places are more convenient to get to.

The CSR asked, "Are you considering like a lapband or gastric bypass?"

Not really. I have concluded the surgery's not going to help me unless I make permanent life style changes and get my priorities reordered which is what I told her.

She seemed confused.

Surgery. Is that the answer du jour nowadays so that CSRs don't get another concept?

I want to get to the maintenance level on Weight Watchers. WW has worked well for me before but I never got to maintenance. If I can get the weight off and keep it off by rewiring my brain I would have more success than by trying to rewire my body!

Fries & Cancer

The article that caught my eye said California AG Wants Warning Label on Fries. Ah, so are they going to address the problem of frying and how it can clog the arteries? I wondered.

But no. This is about the possibility that you might be ingesting some carcinogen when you eat french fries and potato chips. Who's going to listen to that? These days, you can get cancer from eating or drinking just about anything -- including fresh foods (sprayed with chemicals).

I read a little further, past all the scoffing by the companies that make french fries and potato chips. The chemical in question, Acrylamide, was originally thought to come from processed packaging. It's also used, ewwwww, to treat sewage. It turns out, though, that this toxin occurs in low levels when you fry certain starchy foods...like french fries and potato chips.

Ah well. It's not like these two things are on my menu list anymore anyway.

I just wonder if a warning on the label would really be a deterrent? After all, how many smokers even look at the AG's warning label on a pack of cigarettes?

Will Surgery Help?

I have been doing a lot of thinking about my upcoming breast reduction surgery and the possibility of having a lap band afterwards. I see the benefit of the reduction although I worry I won't wake up from the anesthesia.

The lap band is another story. I've been reading some articles about how bariatric surgery won't solve all my problems. Yes, I would lose some of my weight, enough so that my blood pressure and other risk factors would go down. I've often wondered, though, what about the emotional baggage I'm carrying around in the first place?

I am an emotional eater. I've been working hard on it and I think I've come a long way. Last year at this time, I was sending TB out on nightly trips to Wawa for a pint of ice cream or a bag of candy. I put the brakes on that but I've substituted. Instead of ice cream, I have a bowl of Cinnamon Toast Crunch or some cheddar cheese and grapes. I'm eating so much better I was sure the pounds would start melting away, especially when I began exercising again.

Well...they haven't. I weigh about the same now as I did last year when I was eating all that ice cream. I tell myself, yeah, but if you werestill eating Ben & Jerry's you'd probably have gained at least 25 lbs. I bet that's true but it's still discouraging.

So...if I had this lap band, everything would miraculously change, right? Obviously I would be very limited in how much I could eat. Obviously I'd start losing a lot of weight, right? I read an article a couple of days ago about a woman in Britain who had a gastric bypass and lost a lot of weight. Soon after, though, she was back to eating the same unhealthy stuff she'd eaten before the surgery. Sure, she was suffering the consequences but she just couldn't seem to live without the junk. She isn't an isolated case I bet.

You have to be in your right mind for it to work. I mean, I could have this surgery but if I don't have a healthy substitute for my comfort food then it won't help me that much will it?

I read an article called Weight Loss Surgery...the End or the Start? and there were several points made that addressed the worries I have.

Bariatric surgery - including several kinds of operations that reduce the size of the stomach and may also change the way food is digested - can be a great weight-loss tool, but patients still need to deal with the behavior and emotions that made them heavy in the first place.

"The psychological thing is that they have to come to grips with the fact that they've chosen a complete change in lifestyle," said Gus Slotman, who does gastric-bypass surgery at Our Lady of Lourdes Medical Center, in Camden. "I tell them they're like recovering alcoholics. They're always going to have that fat person in their head." ...

While the dramatic weight losses and substantial risks associated with the surgery get much of the attention, it's also important to think about the psyche and emotions before and after shrinking the stomach, say surgeons and psychologists. Yes, they note, the operation creates a tiny stomach that makes patients feel painfully full after eating more than a couple ounces of food, and yes, it seems to depress their appetites.

But most of us know that we don't eat just because we're hungry or stop eating when we're full, and that radically changing the way our bodies look and feel is bound to have emotional repercussions. ...

Mann and other surgeons want patients to realize that losing weight won't solve all their problems. Many are depressed - often at least partly because of their weight and the social isolation it can cause - but sometimes their problems go deeper.

"There is a sub-segment of this population where their life is so messed up and dysfunctional that you can help them lose 100 pounds and you're really not helping them," Mann said. "This is not going to make somebody's life great if they're otherwise miserable. It will make their life better if weight is the central issue."

Surgeons and others who work with the patients say that many patients whose weight levels off early don't follow doctors' orders. Unfortunately, to succeed in the long run, patients have to do what they were unable to do before surgery: eat small amounts of food - up to about 1,200 calories a day - and exercise. That's a huge behavioral change for people for whom food has been comfort, celebration and fun, and who often have little interest in exercise. ...

After the weight starts dropping off, patients often feel ecstatic. Their other medical problems generally improve quickly. They have more energy and endurance.

But, therapists and patients said, they need to understand that losing weight can upset the balance of all their relationships. Stories are common of couples who got divorced after one partner had surgery. Patients often become more assertive, and not everyone likes that.

A patient told Cathy Reto, a psychologist who works with a bariatric-surgery program in San Diego, a story that Reto thought was especially insightful in explaining how people and relationships change after the surgery.

"I liked you better when you were fat," one of the patient's acquaintances told her.

"I probably liked you better when I was fat," the patient replied.

This isn't to say I'm turned off the surgery now. However, I think I do need to figure out what's going on in my head for it to be a successful procedure. Lots of "food" for my thoughts...

The Rates Just Keep Going Up & Up

Report: Obesity Rates Up in Most States

By KEVIN FREKING, Associated Press Writer

WASHINGTON - Like a lot of people, the nation's weight problem is settling below its waistline. The states with the highest percentages of obese adults are mostly in the South: Mississippi, Alabama, West Virginia, Louisiana and Tennessee.

In the entire nation, only Oregon isn't getting fatter.

Some 22.7 percent of American adults were obese in the 2002-04 period, up slightly from 22 percent for 2001-03, says the advocacy group Trust for America's Health, citing data from the Centers for Disease Control and Prevention.

Alabama had the biggest increase. There, the obesity rate increased 1.5 percentage points to 27.7 percent.

Eight states came in under 20 percent: Colorado, Massachusetts, Rhode Island, Connecticut, Vermont, Montana, Utah and New Hampshire. But their figures were all rising. Oregon held steady at 21 percent.

Hawaii was not included in the group's report Tuesday.

While certain regions of the country fared worse than others, particularly the Southeast, the organization said that no state met the federal government's goal of a 15 percent obesity rate for adults by 2010.

An adult with a body mass index of 30 or more is considered obese. The equation used to figure body mass index is body weight in kilograms divided by height in meters squared. The measurement is not a good indicator of obesity for muscular people who exercise a lot.

"Bulging waistlines are growing and it's going to cost taxpayers more dollars regardless of where you live," said Shelley Hearne, the organization's executive director.

Why the geographic patterns? Experts don't have any one clear answer. Some suggest that urban sprawl plays a role. Others say it's easier to find a burger and fries than apples and asparagus in poor communities.

If you're on a limited or tight budget, you have to try and make your money stretch. No, I would not go for burger and fries...but I might opt for beans and macaroni, cheap foods that feed more mouths. The good, fresh stuff is expensive. I buy it because I have the money but I well remember the days I didn't!

Dr. Delia West, a professor of public health in Arkansas, said demographics play a part. The South has a larger percentage of minorities, who have shown an increased risk for obesity. She said Southerners also tend to lead a more sedentary lifestyle than their counterparts in states such as Colorado or Oregon. People will find fewer jogging trails in Little Rock than in Denver, she said.

Also, the Southern diet probably plays a role, said West, a professor at the University of Arkansas for Medical Sciences.

"We know the difference between purple hulled peas and speckled butter beans," she said. "But we make them with bacon fat or salt pork, so even though we're getting the micronutrients, it often comes laden with these extra calories."

Hearne said the United States is stuck in a "debate limbo" about how to confront obesity. She urged government action on several fronts, such as ensuring that land use plans promote physical activity, that school lunch programs serve more healthful meals, and that Medicaid recipients get access to subsidized fitness programs, such as aerobics classes at the local YMCA.

It'd really be helpful if the school day included recess! Anyone else notice that recess periods are getting shorter and shorter? At high school, there is no recess. I remember in Maryland a kid didn't even have to take PE after 9th grade!

I like the idea of subsidized fitness programs...I think it would definitely cut down on the amount of money the government has to spend on obesity related complications, especially among poor people.

Radley Balko, a policy analyst at the Cato Institute, said he was wary of the call for more government action on obesity. The institute is a think tank that prefers free-market approaches to problems.

"I think obesity is a very personal issue. What you eat and how often you exercise, if that comes within the government's purview, it's difficult to think of what's left that isn't," Balko said.

Health policy analysts maintain that obesity increases the burden on taxpayers because it requires the Medicare and Medicaid programs to cover the treatment of diseases caused by obesity. The report issued Tuesday said taxpayers spent $39 billion in 2003 for the treatment of conditions attributable to obesity.

Balko said it's not clear the government really knows how to persuade people to make better decisions. He said open-ended entitlement programs, such as Medicaid and Medicare, don't provide much of a financial incentive for people to watch their weight. The government just picks up the cost of treating diseases for those patients, regardless of the amounts, he said.

He prefers that the government give Medicaid and Medicare recipients an incentive to open medical savings accounts, which would allow them to save money when they do not access the health care system.

"If they knew they only had so much to spend, or what they did not spend could be saved, then maybe you could instill a certain sense of responsibility and ownership," Balko said.

Tiny Dorm Rooms

Moving in day for my son in upstate NY 

Well...if ever there was an incentive for my kid to lose weight, it's his dorm room! See the above picture? You can see just about the whole room -- and 3 guys are supposed to live in that teeny little room! It's located in the basement ... there's no elevator and steep stairs down. Billy should get plenty of exercise going up and down those stairs, particularly if there are no elevators in the whole building. He brought his bike, too, and riding around campus will provide lots of exercise for him.

As for me...I'm still working on it and sticking to my food plan. As you can see by the picture, though, I don't seem to be losing anything. :(

It Figures

With all the concern about the increasing childhood obesity and the health risks involved for overweight adults and kids, you'd think that after creating this new food pyramid the government might invest some of their money toward subsidizing the healthier foods? After all, they already subsidize farmers for growing grains. Many of them sell their grain to other farmers as animal feed. We get the milk, eggs and meat we need as a result of that but we also get cheap stuff used in processed foods.

Subsidies encourage an abundant supply of corn, wheat, rice and soybeans. Much of the corn and soybeans is fed to livestock. Some also is turned into nutrition-poor ingredients in processed food for people. For example, toaster pastries contain partially hydrogenated soybean oil that gives them a flaky texture, and they contain high-fructose corn syrup to sweeten their fruit filling. That translates to lots of calories, lots of artery-clogging fat and little or no fiber.

That's not what we need and yet there are no subsidies given to farmers growing produce.

Know what that means? Junk food is cheaper; the healthy food is expensive. Using the above example of the toaster pastries, it's cheaper to feed your family buying a package of those things than it would be to get the whole grain bread and fresh fruit.

What if you are on a fixed income? How can you go buy a cartful of fresh fruit and vegetables that will take a big portion of your check and not last as long as the cart full of processed food?

And now again: the Department of Agriculture subsidizes the lunch programs in our schools. Which types of foods do you suppose they are going to provide, even though they recommend more fruits and vegetables?

Agriculture Secretary Mike Johanns has begun a series of "listening sessions" across the country to gather input for the next farm bill, which dictates how subsidies are distributed. But the department doesn't write the farm bill. Congress does.

I see what I need to do. There are big lobbies that work to keep things the way they are. Maybe I can't change a thing but at least I can speak up and use my vote.

Read the full article here.

A Scare

We had a pretty good scare this weekend. My hubby TB, who is diabetic, hurt his toe somehow and on Friday evening he showed it to me. It was swollen, bright red and blue and the nail was coming off. We went straight to the emergency room. I knew that it was infected and felt that they'd send him home with a strong antibiotic. Imagine my shock when the doctor said he had to be admitted!

TB's sugar was running high and had been for a while. He needed to have one of his prescriptions filled and we'd put it off because of a lack of funds. Also, he hasn't seen an endocrinologist in over a year (same reason...and distance).

Well, this was a wake up call.

He is home from the hospital now and we've put the prescription in. If another bill doesn't get paid, so be it. This is much more important. So is going to the endocrinologist and getting on a better nutritional program.

Thank God he is okay ... but we can't get complacent again!

Kids' Waist Sizes and Later Health Problems

All 3 of my kids are overweight. I try not to beat myself up too much about it but I have to admit that I feel very guilty in spite of the fact that there are a lot of big people on my side of the family. I'd like to say it's all genetics, but let's not go there.

I went a couple of rounds with my younger stepdaughter about genetics and obesity when I cautioned her against giving her baby soda in a bottle and sweet treats. "You don't want him to become predisposed to sweets and get fat," I warned. She weighs as much as I do, just looked at me, and said, "Well, if it's genetics we can't help it."

I don't agree with that and said so ... but on the other hand, what kind of example have I set?

Okay, anyway, after my first husband died, the 3 kids and I must have gained about 400 lbs -- almost the whole man at the time he passed. I "woke up" to the severity of the issue in time to put the skids on the youngest becoming severely or morbidly obese. She also grew a couple of inches in height and so I would say she is, at most, about 25 lbs overweight. My older two kids are in the same morbid boat as me and it upsets me to no end.

As it happens, doctors are now looking into ways to predict if and how kids will develop serious health problems later when they start out as obese kids.

doctors are on the lookout these days for a group of risk factors known together as metabolic syndrome.
They include excess weight, high blood pressure, high triglycerides, low levels of HDL or so-called good cholesterol, glucose intolerance, and elevated insulin levels.

They want to see if simply measuring a kid's waist can be a predictor of future problems. It would be nice if it was that simple, eh?

The researchers analyzed data from 84 kids aged six to 13, of whom 68 were overweight or obese. They found children with abdominal obesity determined by a waist size above the ninetieth percentile of the study group had increased metabolic syndrome risk factors such as high blood pressure, insulin resistance and high cholesterol. The researchers say abdominal obesity may be an especially important risk factor for insulin resistance syndrome in children.

It would be very important to have that information. I know my kids need diet and exercise. If these measurements had been taken when my kids were younger maybe I would have been more aware and actively involved in their eating habits. I would like to think I would have been.

There was yet another reference to smoking and belly fat:

The study, in the journal Circulation, found that six percent of teens aged 12 to 19 had metabolic syndrome, and that the numbers increased with exposure to tobacco smoke. In kids who were overweight, the numbers increased even more. Although it's not understood how tobacco smoke might contribute to metabolic syndrome, obviously we cannot forget the important effort to prevent kids from smoking and to protect them from second hand smoke.

The whole article is here.

Smoking and Belly Fat

I am not an advocate of cigarette smoking but I was always under the impression there was a link between it and weight loss -- or, at least, not gaining weight. After I lost all that weight when I was 17, I took up smoking. I know, I know...it was a dumb thing to do. Sometimes I'd gain 10-15 pounds but always managed to get the weight off quickly.

When I was 32, I got pregnant with my son. I'd been smoking (almost 2 packs a day) about 15 years by then. I decided I was going to quit because I knew smoking would be bad not only for me but for the baby. The doctor was very supportive and said, when I gained 80 pounds, better to gain than to smoke.

I used to like to blame my weight on the fact I quit smoking...it's easier to blame something like that than your age or poor will power.

Well...think again!

When I saw this article I was sure that it was going to talk about a link between smoking and losing belly fat. Imagine my complete surprise to read that these doctors feel that smoking contributes to metabolic syndrome, particularly in kids 12-19.

Whaaaaat?

I'm not sure I buy it. The percentages aren't that high and I'm thinking that other things must have a greater impact ... like sedentary lifestyle, poor eating habits and so on.

It's a great argument to use to try and keep kids away from cigarettes though...maybe. Used to be we'd say, "don't smoke, you'll get cancer." No kid thinks he or she is ever going to get cancer...not now anyway. But if you say to a kid, "don't smoke, you might get fat" ... would that make a difference?

Hmmm.

No More Soda!

I love Diet Coke and Diet Pepsi. Sometimes when I felt hungry, a glass of diet soda made me feel more full than several glasses of water. I enjoyed the taste of different flavors: cherry, vanilla, and now lime. Earlier, I read a connection between drinking soda and gaining even more weight that alarmed me. Could it be all the sodium in soda? The study seemed to think not -- it seemed to have something to do with triggering a hunger response.

Eh, I thought, that doesn't happen to me. Until we hit a tight financial patch, I continued to drink a lot of diet soda. For the last week or so, though, I've restricted myself to water and gradually seem to be losing the craving for soda.

Today, there was another article about diet soda and gaining weight. This was more ominous to me and I think I will have to give up my beloved Diet Coke and Diet Pepsi. According to this article, researchers are linking a sweetner used in diet drinks to replace sugar with messing with your body's metabolism. The sweetner is fructose and what might be happening is that it causes your body to store more fat. Geez, that's the last thing a person wanting to lose weight needs!

To prove it, scientists conducted a test with mice, all beginning at about the same weight. They were split into groups: some were given all the water they wanted, some were given a diet drink, some all the water they wanted flavored with sucrose (regular sugar) and some all they wanted flavored with fructose.

The mice on the fructose didn't take in as much calories. I guess they felt 'full'. Still, the scientists saw that they gained a lot more body fat over the weeks than the other groups did.

The other new tidbit of information I learned from the article is that in the last 30 years, soda manufacturers have switched over from using sucrose to fructose. Now, I don't know why they did that. The studies show, though, that soda drinking Americans have been gaining more and more weight ever since.

Is there fructose in diet soda? I don't know ... but I think it would be better to stay away from it until I find out!