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.