Ask the guy who's doing a medically supervised fast

Miscellaneous and Personal Stuff I Must Share
1

That’s me, SoulBro. Been fat just about all my adult life. I wasn’t a fat kid, but I grew a beer belly as soon as I started drinking beer. Became a cook and got fatter, stayed around 210-220 (I am 5’5’’ and thickly muscled, Italian-peasant styley) until I hit age 35, whereupon I more or less instantly added 30, putting me at 250, or officially morbidly obese.

And there I stayed for a good while. Got sober in 2001, briefly dropped down to 225 or so, and then started to pile on the pounds. Somewhere, I can’t pin it down time-wise, I really started to eat like a fat person. One candy bar wasn’t enough, had to buy three. That kind of stuff.

Continued to spiral out of control, eating-wise. Plain old stopped eating vegetables and salad, every meal had to be crazy heavy/fatty/delicious, ate more and more fast food… Diagnosed with diabetes in 2004, at that time weighed about 300. Yow.

Got scared for a little minute, stopped eating sugar and fast food, dropped down to 265, and then went on a merry-go-round ride with eating. Every time I broke down and ate sugar I went on a run, just like I was doing drugs. It would take weeks to stop sugar. Then I would go a week or two, maybe three, then I would break down again and go on another sugar run. Also continued to eat like shit overall, eating out, especially Chinese food, all the time, stopped cooking for myself and my wife… it was awful. Got close to 300 again and my diabetes was getting worse. (Used oral meds to control it, but was going to have to switch to insulin.)

Then… I’m not sure what happened after that. My doc had mentioned at some point that Kaiser had a med-supervised weight loss program specifically for folks who had 100+ to lose (a little less for the ladies), entailing Optifast meal replacement (960 calories a day) and a weekly support group. I sniffed around it for a minute then forgot about it.

At the end of November last year, all of a sudden I find out how much it cost, that I could pay for it on time, that a new session was starting up in the second week of December, and that if everything worked out just right I could get in for that session. Somehow at the beginning of November without a real understanding that I would do this I had stopped eating sugar again and dropped some weight. I had to go through a battery of tests to make sure I was up for the drastic reduction in calories, passed them all, and on December 10 started the fast. 6 Optifast products a day, 160 calories each, for 15 weeks, and then a gradual transition back to actual food.

I am on week 18, and I have replaced 2 Optifast products with two small meals for a total of around 1050-1100 calories a day. Some of my numbers when I started:

Weight: 280

Fasting glucose: 247 (very bad, people without diabetes test 100 or below, this is with a lot of medication too)

Hemoglobin A1C (another diabetes-related test, normal is 4.6 to 6.0): 8.0 (again very bad)

Cholesterol was good because of meds, although the level of fat in the blood (trigylcerides) at 219 was in the dangerous (coronary artery disease) level.

I lost 15 pounds the first week, mostly water I guess. They put us on the body fat monitor scale.

Weight: 265
BMI: 44.1
Fat %: 48%
Fat Mass: 127 pounds
Fat to lose: 93 pounds

On to today’s numbers:

Weight: 205
Fasting glucose: 88 (normal)
Hemoglobin A1C: 5.5% (normal)
Trigylcerides: 92
BMI: 33.8
Fat %: 30%
Fat mass: 63.5 pounds
Fat to lose: 27 pounds

I could keep writing for hours about this fucked-up incredible journey, but I’ll stop here to let anyone who wants to ask any questions at all do so. Have at it good Dopers.

2

What’s their long-term success rate for people who have transitioned out of the fasting part of the program? I ask only because it seems like it would be pretty tough to go from meal replacement mode back into trying to figure out what to eat daily. (Easy to fall into old bad habits, etc.)

That drop in A1C is freaking fantastic. Good for you! (Literally.)

Are you doing an exercise program as well?

Do you find that you’re having trouble with food cravings? What’s been the hardest part of this so far?

3

Congratulations! I went on a similar program in 2005 and lost 150 pounds, of which 130 have stayed off.

Do they have a follow-up maintenance program? That is absolutely critical, I would not have been able to keep the weight off without the maintenance program.

Does the program include nutritional education? Again, absolutely critical to maintenance of the weight loss. I thought I knew something about nutrition, but I only found out how ignorant I was.

May I recommend Kessler’s book “The End of Overeating” to give you an idea about how much the general food environment is against you? It’s good information to arm yourself with as you go out into the world again, once your fast is over.

I wish you the very best of luck,
Roddy

4

What are the two small meals you’ve started adding? Are they prepared by you or are they prepackaged in some way? Have you had to use the interim time to educate yourself on nutrition, calorie counting, and general knowledge on how to integrate proper eating to your life?

And, congratulations! How do you feel?

5

Congrats on the weight loss.

Here’s a book I’ve been suggesting to people a lot lately: In Defense of Food by Michael Pollan

There is a lot of really good information in there to be had. There’s been so many books and articles about what and when to eat that it gets confusing. I think Mr Pollan does a really good job of breaking down the information. His opening really does nail it: Eat food. Not too much. Mostly plants.

Congrats again!

6

How do they control for hunger? Do they do anything to help with the cravings besides group?

7

Thanks all. To answer in order:

Kaiser does not have enough data to project long-term success, but Optifast has been doing this for 20 years, and they say-- half the people keep off half the weight they lose. Not very encouraging.

I am doing exercise as well, somewhere between 250 and 450 minutes a week of brisk walking. I had gotten too fat and sore to get much exercise at all, so it took me a little minute to start, but when I did, the commensurate weight loss was a great spur to keep going. They gave us a cool lil pedometer which tracks steps, miles, aerobic steps, calories, fun to have and use.

For those who are familiar with sobriety/recovery terms, I had reached my bottom for reals, so I did not suffer much from food cravings, although I was very hungry for much of the first few weeks. Nothing had tasted good to me for a while before I started, it was all bad craziness and compulsion. I would eat something and it just wasn’t satisfying me, but of course I would eat it all anyway.

Congrats to you Mr. Femm. Great encouragement for me. My goal is about 100-120 pounds total. Kaiser is really good at education/preventive stuff, and this class is no exception. Tons of education plus tons of cognitive therapy kind of stuff to help get your head around the idea that this is a lifestyle change and a big one.

Many of the folks in the class (most of whom are middle-aged women) have been trapped in the Jenny Craig/Atkins/Nutrisystem lose and regain loop for much of their lives, so a lot of time has been spent planning and talking about how to continue the exercise/food journal/weigh-measure-counting calories stuff after the transition.

This is an 82-week program-- 30 weeks intensive, and then an additional year of weekly and/or monthly meetings plus weekly phone calls from the group leader, a dietician/weight coach. Our group is really tight, only lost one member, when more typically several will drop out over the intensive part. And lots and lots of truth-speak, it helps that we are in Oakland/Berkeley for that. People talk about their real stuff. It’s been a huge help.

I also have been to OA a few times, just to check it out, and while I don’t feel like I need it right now, due to AA and the Kaiser group, if I do find myself struggling I will not hesitate to go again.

One great thing I got from OA is the concept of ‘trigger foods,’ those foods that when I eat them start me off on a run I can’t control. The idea is to stay away from the first bite of those ‘trigger foods.’ For me they are sugar, obviously, plus chips and other junk food, fast food, and fried food in general, especially Chinese-y stuff. Right now anyway I am OK with the idea of staying abstinent from these foods. I’ve had my share and someone else’s too.

The two small meals I’ve added are thus-- the first week I subbed 4 oz protein and 1/2 cup cooked veggies for a meal replacement. The second week, where I am now, you add 1 cup dairy (I’m doing yogurt which I make myself, I mix it with my morning shake) and 2 more oz protein plus 1 fruit exchange (1 small banana or apple, 1 orange, 1 1/4 cup strawberries). I am eating 1/2 cup of nonfat cottage cheese mixed with strawberries at lunchtime in place of a shake. Tonight I had a chix thigh marinated in Pickapeppa sauce, steamed, and cauliflower that I tossed with garlic slices and a bit of dried thyme soaked in water, then roasted. It was good.

As to hunger, there isn’t a lot you can do except drink a lot of water. Out of all 18 of us, I am the one who has suffered the most from hunger. They told us our bodies would adjust pretty quick and most everybody’s did. I stayed pretty hungry, but in some perverse way I dug it, hungry like the wolf, ya know? Isn’t as if I ate the way I did because I was hungry anyway…

Think that covers it so far.

8

You payed money to stop eating?

9

And another apt poster-name/post combination.

Soul Brother #2, sounds like Kaiser has it covered. I only wished I had known about these kinds of programs earlier. Hey, we’re right across the bay (I’m in SF).

And please, call me Roddy.

10

Great job, keep it up!

Do you ever worry that your obsession with food will head towards the other end of the spectrum (i.e. undereating/anorexia/bulimia)?

Are you married? If so, how is your spouse dealing with it? If not (and also if so, anyhow), how are your family/friends dealing with it? I have read that sometimes family/friends/spouse start to discourage the weight loss or try and sabotage it.

Do you find that food tastes different, especially now that you’re incorporating real food back into your diet? Do you savour your food or eat fast?

11

I spent 6 months on Optifast last year. I lost 55 lbs, in that time. I’ve gained all of it back since I finished.

12

Nothing to ask, SB#2, just wanted to throw a congrats your way; you’ve definitely developed the insight you’ll need to see this through. Best of luck.

And thanks to Roddy for the book recommendation; I can’t wait to read it.

And to may_be_ignorant…consider changing your username. Just eliminate the first two words.

13

Hi guys. Running off to work, so won’t reply to anything til tomorrow. Thanks again for all the well wishes and support.

14

Hi again. To answer in order:

I do not worry about the other side of eating disorderdom. Why I can’t really say, beyond the fact that body image seems to be a big part of those things, and I haven’t ever really struggled with that concept. There is always the future, though, and I appreciate you mentioning it, EmAnJ. I will keep it in mind, and even bring it up in group next time.

Friends have been supportive. Some people in my group have continued to socialize with friends at restaurants and such; not me. I ain’t goin’ near a restaurant until I hit my target weight and hang out there for a bit.

My family is 3000 miles away, and my mom and dad are masters of the backhanded undermining comment, so I haven’t even told them. They have been very very worried about my weight for years, and I can’t wait to walk off the plane this summer to see the looks on their faces. My old man has been fit and trim his whole life and it is his oft-expressed opinion that if I just had some got-damn self control I wouldn’t be fat, or a drunk and a dope fiend, and I know he loves me painfully, so there is a lot of crazy conflicting emotion there. Better for me to just wait and show up down 90 pounds or so (hopefully.)

I am married, and Ms. Two is my biggest supporter, and my weight and failing health have kept her up at night for way too long. She has cooked for herself more these past months that I can ever remember, and it has been really nice to eat dinner with her these last few days. She will eat what I am eating and be fine with it.

She is not overweight but could lose a few; she gets little exercise since she stopped martial arts a few years ago, which makes a big difference. A lot of discussion at group last time about the article stating that women of a certain age need an hour of exercise a day to just maintain their weight. It does seem the case with her as she has never been a big or unhealthy eater.

As to how food tastes, it has been, well, complicated. I fully expected a taste explosion my first meal (steamed turkey breast and carrots). What a disappointment it was. Bland as fucking hell.

I then realized that a) there is a decent amount of sugar and natural/artificial flavoring in the Optifast stuff (side note: it tastes just fine, I was worried that it would be yucky and artificial tasting but not the case, the flavors [vanilla, chocolate, cinnamon, tomato, et al] are muted but nicely balanced and natural-like), and also I been chewing a lot of highly flavored fruity Trident and eating sugar-free Altoids, so it wasn’t as if my palate was on the Bataan death march or anything.

As to savoring vs. wolfing, one thing that helps is not doing anything else while eating, no reading or surfing, just sitting at the table. I was/am a wolfer of the first degree, and I struggle with this. I actually note how fast or mindfully I ate in my food journal. Mindless eating, just mechanically cramming shit down my piehole, was a big part of getting sodamnfat.

picunurse, I am sorry to hear about your weight gain. Unfortunately, stats-wise, your story seems to be very common. Did you do the fast by yourself or in a program like Kaiser’s?

Oh yeah, it has definitely come out in group that family/friends have tried in various subtle or un ways to sabotage my companeros, from dragging them to buffet after buffet in Vegas to bringing huge pizzas over and eating it in front of them, plus the usual psychological mind game bullshit, which seems particularly prevalent in mother/daughter relationships. And sisters who are pissed that now they are the fattest one in the family. So it goes…

15

Soul Brother Number Two, I was in a program. It was my third time. the previous times I was successful in keeping the weight off for several years. The first time, around 1985, I lost 80 lbs and kept it off for about 5 years. I then had a difficult divorce. In 1992 I lost 65 lbs, keeping that off until my son passed away in 2000.

This time the only real difference was my age. I lost less per week, stayed on the fast for twice as long, lost only a small portion of the weight I needed to lose. Before I went to maintainance, the phychologist told me I should have my ADD treated before I left the program. I tried, but couldn’t get a psychiatrist to order the meds I needed.

As I’ve gotten older, my impulse control has gotten worse.

I didn’t mean to rain on your parade.

16

I did not view your comment as precipitation in any way, picu. I’m sorry you’ve struggled so, and your struggles really typify what so many of us go through.

17

Indeed. My health insurance doesn’t cover lap banding, but I think that will have to be my next option.

Good luck, keep up the good work.