And the Fat Wars Continue...

I blogged about a post on obesity over at Alas, a Blog yesterday, and went back tonight to read the comments section, where I left a pretty long comment of my own.  I decided to post a version of it here as well, because I think that it touches on a couple of really critical issues about body image and eating.

I am not sure of whether to cry or  laugh at the well-meaning prescription of large amount of exercise and food intake reduction for obesity. Gee, why didn't I ever think of that?

I invite you to my life. I invite you to contemplate starting an aggressive exercise program when getting out of bed seems daunting. I invite you to eat less when you have a wild beast prowling around your blood stream, a beast called "plummeting blood sugar." I invite you to restrain your appetite not just a few isolated times a day, but EVERY WAKING MOMENT.

No one has enough will power to live that way. No one.

Now, I have lost over 123 pounds in the last 23 months eating a very healthy, high fat, low carb plan that works very well for me. I have been thinking a lot lately about will power and this plan, and why it works for me when other ways of eating did not.

There is a thing our bodies seem to have, called an "appestat." (Whether we "have" one or not I don't know - perhaps this is just a metaphor.) It's like a thermostat on a heating or cooling system, but it regulates our perception of being full or hungry. In many of us, it's broken. Thin people, when put into clinical studies where they are required to eat more food than they want to, find it hard to do. They might gain some weight, but as soon as the study ends, they rapidly lose it and return to previous intake of food. They have normally functioning appestats.

But if your appestat is malfunctioning, the reality is, it's very hard BIOLOGICALLY to realize you've eaten enough, or that you aren't hungry, or that you need to eat. The connection between a physical need to eat and other prompts to consume food, such as boredom, loneliness, or just the desire to taste something, has been disrupted. ALL your decisions are being made under the constant influence of blood sugar fluctuations (which are biochemical but have effects that feel emotional) or cravings (ditto!) or a sincere inability to recognize if something is or isn't "hunger." What IS that odd feeling in your tummy? Who the hell knows, when the whole system is busted! Are you thirsty? Tired? Stressed? Do you have ANY idea?

People with functioning appestats most likely DO know the answers to these questions when they consider them. Those of us whose appestats are not working honestly don't. It's like that pathway in our brain is just not going where it's supposed to be going.

What Joe in the comments section at Alas, A Blog seems to be saying is that we have to decide intellectually what we are going to eat and how much and what kind of exercise we're going to get, and not deviate from that, regardless of how our bodies respond. That is the key to the "willpower" or "decision-based" responses to eating problems.

But let's be real. Who among us can, literally every moment of every hour of every day, rely on strength of will and our intellect and our previous decisions, and NEVER deviate from them? Who doesn't get tired or stressed, or forget to plan a meal, or run out of money to pay for whatever it is you're SUPPOSED to be eating? None of us.

And when in situations of stress, or fatigue, or when rushed or sick, we don't tend to make our best decisions no matter who we are. And for people with eating disorders and serious weight problems, all issues around food become even more emotionally-charged and stressful, which just perpetuates a negative emotional state. So inevitably, we falter, we fail, we backslide, we mess up. Which also feeds the downward spiral.

This is why my particular plan works so well for me: It restored the functioning of my appestat and removed the 95 percent of my problem with food that was biochemical rather than genuinely emotional. My "decision-making ability" and "will power" (which are formidable) were able to handle that 5 percent, probably could have handled even more. But they simply weren't enough, and couldn't possibly have been enough, to overcome the 95 percent that was biochemical. No one is that strong, and no one should have to be that strong when other strategies will work better than the exercise of willpower.

I can fight a craving for a few hours. I can fight a couple bad days a month around my period. I can get through a normal amount of stress, and a few crises in a year. What I can't do is resist cravings and hunger and a complete lack of feedback from my body as to whether or not I'm hungry, full, whatever, every waking moment of my life. NO ONE can do that. It's impossible.

Having gone from having no functioning appestat to almost overnight having one, I am excruciatingly aware of the difference. This is not about will power or decisions, at least, not about being able to use them as a weight control strategy. It's doomed to failure in all but the most extraordinary of individuals.

As long as I eat this way, which I find very easy and satisfying, my willpower is sufficient to handle the minor emotional impulses to eat and the PMS factor. I can use tools like certain supplements that make cravings less, like chromium, and I can check the amount of fat in my diet and increase it, knowing that makes me feel less hungry.  I can stay in a range where the demands on my will power are modest and don't overwhelm me.

But I couldn't live with each meal being a battle. I couldn't go back to my life before this change. I couldn't bear it if every day was like the day before my period, when there is a beast in my gut demanding to be fed.

And that is the reality for most people who either do not benefit from the plan that helped me, or who don't discover a plan that works for them for whatever reason. And no amount of sanctimoniousness on the part of someone else (including me), can change that.

Comments

[Nancy]

Super-charged subject, isn't it?

I wish I could trade places with some people. I wish that they could be made to understand what it is like to be me. There are two ways a person will respond to critism, positively or negatively. Not exactly rocket science. But it's also not so cut and dry.

Those that respond positively exercise, eat "right" for them, and live their life. Those that respond negatively, over exercise, eat right but hate every bite, binge/purge, or simply refuse to eat, they also spend their time looking in the mirror criticizing the image before them, real or not. Some even shell out thousands of dollars for boob jobs, butt lifts, tummy tucks, nose jobs, collagen lips and other invasive, mood altering, image changing surgeries. That's all okay, but the minute someone talks about a gastric bypass people get condescending.

Then there are people like me. People tend to view my "problem" through their own eyes and experience. They think that my over-eating is just like their once a month splurge on overdrive, that I can just stop and all will be well. They figure that if THEY can control themselves and have a workable exercise regimen, then *I* can, too. Look, if it were that easy, I would have DONE IT!!!

I think about food ALL THE TIME. When I'm not eating I think about what I can eat. When I'm driving I think about what I can eat when I get to where I'm going. When I'm sitting at the computer I'm thinking about what is in my cupboards and fridge. If I don't have what I want I will go to the grocer and get it. After breakfast I'm planning lunch and dinner. I'm OBSESSED with food. I hate exercise (except swimming). I cannot eat a handful of chips, I eat the whole bag. I cannot limit myself to 12 crackers, I eat the whole box in one sitting. I can't eat just a piece or two of pizza, I eat a half of a large or a whole medium. I don't stop at a piece of bread, my husband and I split a loaf (mmm...fresh baked bread).

FOOD IS MY DRUG.

Eating heathy isn't like giving up illicit drugs. You can live without drugs, you can't live without eating. Can you imagine telling a marijuana smoker, "you just need to have some willpower, dude. Just one toke, dude, you don't need the whole joint." Or the heroin addict, "don't shoot up so much, just small amounts friend, you don't over do it."

As a former cigarette smoker I can tell you that giving up cigarettes was one of the easiest things I have ever done. I simply don't smoke.

I can't simply not eat.

I'm looking for my appestat. I honestly think it's either broken or I just don't have one.

So here I am. Anyone know a repairman? ;-)

[Christie]

I think that it's very true that people who don't experience this really, really don't understand it. They just don't. They have NO IDEA.

And that's an enormous disconnect between them and us, that I have no idea how to bridge. And they keep on with their ridiculous and completely useless recommendations of eating more, exercising less.

Dude, I'm fat, not an idiot. Knowing what to do IS NOT THE PROBLEM. Get a clue.

[Michelle Bernard]

Interesting Christie, I would have never know. I guess we all have our food crosses to bear. I am not overweight nor do I crave food all day, but I do have difficulty with sugar which leads to a more deadly craving for alcohol. I have tried numerous things to work through that. Maybe one day I'll find the right combination.

Thank you for sharing.

Michelle