Monday, July 30, 2012

Review: Intuitive Eating, 3rd Edition


Intuitive Eating, 3rd Edition, by Evelyn Tribole and Elyse Resch


Note: I did not buy this book. A review copy was sent to me at my request.  


Recently, I heard an interview with Elyse Resch on Koren Motekaitis's great podcast, and everything Resch said made sense to me. After so much time in the weight blog community, I'm really coming around to the idea that dieting doesn't work.  I kept thinking that my failure to achieve long-term success with Weight Watchers or other programs I have done was a personal weakness. But enough other bloggers have the same struggles that I know it's not just me.

This isn't my first time around the block with Intuitive Eating. I read one of the older editions of this book and somehow misunderstood the concept. I thought it was basically "eat whatever you want, whenever you want." When I do that, I gain weight like crazy. In theory, I believe in accepting a wide range of body types but I really didn't (and honestly, don't) want to give up on the idea that weight loss is possible for me, and I feared even more the idea of continuing to gain. As bad as dieting felt, this distorted version of IE felt even worse. I also hated, hated the idea that I would always be expected to sit and eat without any distractions (an Intuitive Eating "rule" echoed by Geneen Roth). Sometimes I enjoy having a snack at the movie theater, or glancing through the news with my breakfast. I didn't want to give that up either.

There were also other gurus of Intuitive-Eating-like strategies that hinted that once you became an intuitive eater you would never again eat sugar or, for that matter, anything but vegetables, lean proteins, and whole grains. I like those foods, but I also want to be able to have a piece of birthday cake or a margarita once in a while. Life without bread doesn't sound like freedom to me.

This new edition makes it clear that IE is not "I eat whatever I want, and as much as I want, whenever I feel like it!" The whole point of the process is to tune into the body's signals of hunger and fullness. They also addressed my concerns about distracted eating. They say that many others have taken this perceived rule to heart but remind readers that, "Intuitive Eating is not another diet with rules to be broken."
They also reject the idea of "good" foods and "bad" foods, steering readers instead toward "gentle nutrition," quoting a Julia-Child-led task force on nutrition that concluded, "In matters of taste, consider nutrition and in matters of nutrition, consider taste."

Before readers consider nutrition, though, they need to put weight loss and nutrition "on the back burner" and start to discover a saner relationship with food that honors their own preferences and their signals of hunger and satisfaction.  Even when not dieting, most people walk around with a system of food rules in their minds.  Rules against eating fat, or carbs. Rules that say that vegetables should always be the first choice or that snacking is bad.  Observers, even strangers, are likely to chime in if we violate these rules. The authors explain how to politely challenge the food police and how to turn internal negative voices into allies.
The thing that stunned me about this book is how much it called me out on what I thought were my own personal neuroses.  They understand that for readers who have been pinning all their hopes for a better life on reaching a perfect weight, this strategy could represent a loss. The inability to use food just as a distraction or numbing agent is also going to feel strangely sad.  I know from experience that both of these can happen. When I was at goal weight the last time, I remember feeling unsettled and not knowing what to think about.  Their discussion of obedience and rebellion reminded me of my Weight Watcher days, when I felt an alternating need to "be good" and to tell everyone, especially the weighers who commented when I gained, to stuff it. There is also a discussion on pseudo-permission. I remember the last time I tried IE, I only gave myself pseudo-permission to eat what I wanted. I immediately rescinded even that when the scale started to creep upward.

Unlike HAES, there is not the ultimate prohibition on weight loss as a goal, just a nudge to put it on "the back burner" and to get rid of scales and other "body-checking" devices. It seems likely to me that most people, I would have a natural weight that is lower than my current weight. I'm not completely confident that I can chuck the diet voices out of my head and find my inner Intuitive Eater, but after reading this book, I really want to try.

Though I only skimmed them, this edition has new chapters on "Raising an Intuitive Eater," and "The Science of Intuitive Eating." I'm not a parent and I have read plenty of research on diets. There is also a new free online community for people who still have questions after reading the book or who want to connect with other would-be Intuitive Eaters.

This review only scratches the surface, so I encourage readers to check out the community and the articles and see if this book might help them find their inner food wisdom. I'm hoping it will help me. Even if I am one of those people who can't lose weight, I'm ready for some sanity around food.

Tuesday, July 24, 2012

Rehab for Writers: The Artist's Way


I have been following The Artist's Way program for six weeks now. Author Julia Cameron describes her program as recovery for injured artists. I am finding this book extremely helpful.

How do artists get injured? Lots of ways. I can point to some discouraging moments and even incidents of humiliation in my own life that sent me into my shell, but I think the greatest injuries are self-inflicted. That blaming voice that asks, "If you are such a serious artist, why aren't you writing?" at the same time that it screeches that there is no time for such foolishness when there is money to be earned, real work to do.  The same voice screams that if you dare to write a word down on the page, someone will read it and laugh at you. If this sounds all-too-familiar, you could probably benefit from this book, which is not intended to just be read, but asks you to make a commitment to it by reading each week, writing your "morning pages" every day, and treating yourself to an "artist's date" every week to refill your creative well.

I have been doing the program but have not done it perfectly. I missed almost the whole week I was in Toronto. I haven't been great about treating myself to the artist's dates every week.  Ordinarily, the fact that I haven't been doing this perfectly would be a great excuse to put it aside until I can do it "right." But I decided that the exact point here is to do it as well as I can and not let that impulse to quit when it's not perfect.  I had to copy this quote into my journal: "Perfectionism is not the quest for the best. It is the pursuit of what is worst in ourselves, the part that tells us that nothing we do will ever be good enough." I also underlined, "The perfectionist never says, "This is pretty good. I think I'll just keep going." It reminds me that I can't please that voice. Best to brush past it.

The nasty voice has also been hissing at me lately that the journal work I'm doing isn't "real writing." It isn't working toward a project or a book. I have written some ideas in my journal, but I'm not pushing myself just yet. An injured athlete who is in physical therapy doesn't decide to jump into a football game to see if he is any good yet.  Getting tackled would just set him back.  That's where I am right now.

This blog has also been exceedingly helpful to me. I put my stuff out here, and even when I get nasty comments or ones that suggest that the reader didn't get what I was trying to say, I survive. I feel like it's a gift just to have someone reading.

When I finally get around to writing, I'm not going to be too worried if what I am writing is "literary" enough like I did when I was in my MFA program. I'm going to write the stuff I would enjoy writing, and would enjoy reading, and hope that others might enjoy reading it too, if I publish it. I have gotten a lot of enjoyment out of my watercolor painting and colored pencil drawings, and I haven't felt any pressure to prove I'm a serious artist by selling them. Maybe it will be the same for writing, or maybe I'll self-publish. Who knows or cares at this point.

As when I was doing races, I have a "goal ladder" -- multiple, tiered goals. My first goal is to just write.  The second goal is to enjoy it and want to keep doing it. My third goal is to write for an audience, however small. My fourth goal is to have people enjoy what I write.  Publishing, if it happens, is way up the ladder. I have plenty of "real writer" friends who have published books, and it didn't change their life. It was a nice thing that happened, and sometimes it brought in some extra money, but it didn't usually allow them to quit their jobs or become world travelers.  Thinking of it that way, writing itself has to be the goal, and not whatever rewards might result if I hit the lottery and got someone to publish my book and pay me for it. As Julia Cameron says, "Art is an act of faith, and we practice practicing it."  That's really all I'm asking for here, to feel good enough to practice practicing again.

Monday, July 23, 2012

Medication update

For those of you who read my "Medication and Weight Gain" post with interest, I thought I'd provide a quick update. I will post something more interesting tomorrow, I promise.

I saw my allergist today and we are going to try dropping the hydroxyzine. It seems to be more of a sedative for me than anything else. The nurse practitioner didn't say whether she thought it might be related to weight gain, but she did say I shouldn't be feeling as groggy as I was when I woke up.

She also thought that some of my symptoms may actually be reflux disguised as a lump in my throat and a cough.  I am going to be trying a short course of meds to see if that helps. I mentioned the idea of food sensitivities and she said there is no reliable test for them but that I should keep notes of what foods seem to give me trouble. Since DietSNAPS allows notes and journal entries along with food and exercise journaling, I figure it's a good way to streamline the whole process. This will help motivate me to journal more effectively.

As I said, I know there is no magic, but I'm still hopeful that I can make things a little easier if I get the medications straightened out.

Sunday, July 15, 2012

Hello, my name is Jen, and I'm obese

My discussion with my endocrinologist has on my mind since I posted, especially since I spent time around my family the last couple of days. Most of us struggle with our weight, and it is almost second nature for most of us to seem to be apologizing to everyone for taking up too much space. One of my cousins mentioned a visit to the doctor where she got lectured for being in the "obese" category. I told her that I am also in that category right now (with a BMI of just over 30). Then I told her about my own doctor visit. 


I don't think that when people hear a statistic like, "Overall, more than one in ten of the world’s adult population was obese [in 2008]," they are picturing people who look like me. Ditto "More than one-third of U.S. adults are obese." I think they are probably picturing the contestants on "The Biggest Loser" (who are generally in the morbidly obese category).

Part of this confusion may be that the definition is somewhat arbitrary. The change in 1998 in the definitions of "overweight" to a BMI over 25 and "obese" to over 30 seems to reflect a desire to settle into nice round numbers.  The stated reason at the time was to help motivate people to make changes, but since our national weight has continued to climb since then, I don't think it worked.  There is also plenty of controversy over whether these numbers actually represent an increase in risk. The change in numbers certainly made certain groups richer (diet drugs, weight loss companies, obesity researchers), but they did little to actually help people deal with their weight problems.

The food industry launches misinformation campaigns against any attempt to make changes that would help create an environment that made it easier to lose or even maintain weight. Yoni Freedhoff characterized this response as "because single sandbags don't stop floods, don't bother with sandbags and instead focus on proven to fail swimming lessons." Blaming us for all becoming lazier and more gluttonous is easier and doesn't interfere with any corporation's bottom line.

I'm not holding my breath and waiting for a better world, though.  I think the average person like me should, instead of asking him or herself, "how much weight do I want to lose," should reframe the question. "What changes to my lifestyle am I willing to make in the long run?" would be a more appropriate one.  I know that I could lose a lot of weight by never eating bread again, for example. But that isn't a change I'm willing to make for the long haul, so why bother to make it in the short run?  I am, however, willing to cook most of my meals at home and plan on one of those meals being mostly vegeables. The picture here is my lunch, mostly veggies from our Community Supported Agriculture (CSA) subscription supplemented with a few things from the grocery store. Eating like this makes me feel happy, not deprived. Going for a run, taking a yoga class, doing an early-morning swim -- these are things that make me feel good.  I think it is possible for me, even with my bum genetics, to lose at least some weight by focusing on the things that I know are good for me and feel great.  At the very least, I'd like to lose the five or so pounds that would drop me into the merely "overweight" category, no matter how arbitrary it might be.




Friday, July 13, 2012

Not what I wanted to hear: Visit with my endocrinologist

I had a visit with my endocrinologist today. I was stressed out for several days before the appointment that he was going to give me a big weight lecture, so I went ahead and brought it up first.  He went back through his notes for the two years I have been a patient.  He looked at my weight (which, despite my conviction that it has gone steadily upward over this time, had actually stayed fairly stable). He looked at my blood pressure, which has been good. He looked at my doctor notes from the other doctors in the Toledo Clinic system, since they can all share data.  He looked at my labs.

He told me something that wasn't quite what I wanted to hear, but in my heart I think he's right. "There is something to be said for accepting the reality of your genetics." He said that I am actually doing well. He told me about a Danish twin study that found that adopted children resembled their birth parents, not their adoptive ones, in weight.  He said that it was no excuse to give up on my efforts to be healthy, eat right, and exercise. He said that chances are, if I wasn't working this hard, I would have gained instead of staying within four pounds of my weight two years ago.

It was all very kind. He said that of course, I could "become obsessive about it" and beat my genetics but it would be difficult and probably not very fun.

I guess the question is how much more I am willing to do. If I'm willing to do more to maintain a thinner weight, I can. If I am happy with my current lifestyle, this is probably the way I will look.  I can work at being more active and more consistent with my planned exercise. I can regulate my diet a little more strictly. But I do want to be able to have a splurge now and then. I have been telling myself that I should focus more on my behaviors than on my weight on the scale. It's probably time to really do that. For real, and not just "I'll pretend I'm not paying attention to the scale and see if that works."

I am getting a higher dose of thyroid medicine. I am also cleared to fill it as a generic instead of taking Synthroid, which costs 6 times as much, because the latest studies show the name brand has no proven benefit over the generic.  He didn't think any of my other meds -- the birth control, the allergy meds -- were the problem. I am still going to talk to the allergist, but I'm less hopeful that will be the magic bullet.

I was telling my husband about this, and said that "I guess what I really wanted for him to do was say, 'Oh, you really want to lose weight? Let me get the magic pill I keep in the storeroom. I was just waiting for you to ask.'"

You mean there is no magic? Rats!

Thursday, July 12, 2012

Review: Culinary Adventure Company

Super-boozy display at TTS
When I was a kid I was the world's pickiest eater. I wouldn't even eat spaghetti with tomato sauce -- my Italian grandmother loved me enough to overlook this flaw.  As I got older, I consciously decided that being picky was boring, and I gradually got more and more adventurous. Now, I love food and I'll try almost anything if it seems to be prepared with care. Good thing, too. I wouldn't call myself a foodie, but I have really learned to love trying new things.

My husband and I just got back from a trip to Toronto. He was going to cover a track meet for an online web service, and I came along because I love the city.  Since he had plans last night, I made some of my own with the Culinary Adventure Company. I heard about it on Trip Advisor and decided to give it a try so I wouldn't have to eat alone.  I did the Chef's Tour of Little Italy.  Because Chef Scott had an Escape the City event that night, I ended up with a private tour with Chef Shahir. It was fun and relaxing not to have a whole group to deal with. It was Chef Shahir's first time as a guide and he was a perfect host.



TTS drink menu
TTS appetizers
The evening started out in a little unmarked club called the Toronto Temperance Society. Apparently their approach to temperance is to buy all the booze and keep it in this little hideaway.  I couldn't decide among all the interesting offerings on the cocktail menu, so I gave the bartender a few clues about what I liked and ended up with a really refreshing burbon drink called the Darjeeling Limited. It was a hot day, and this really hit the spot. We also had some nice appetizers to get us started. We had some halibut cheeks, which sounded odd but were just little nuggets of perfectly fried fish, and a nice board of cured meat and cheese. I paced myself knowing that there was a lot more food and drink to come.



Acadia salmon creati

Acadia drinks (and my host)
The next stop on our tour was Acadia, which as the name suggests, had a French Canadian/New Orleans vibe. A new chef was just hired away from a very fancy restaurant, and so our two choices were the traditional (and delcious) shrimp and grits, and a very fancy (maybe too fancy for me) cured salmon dish that had pea shoots, grated foie gras, pea shoots, some kind of powdered butter thing... it was tasty, but I'd stick to the shrimp and grits if I went back.  I also had another sweet/tart bourbon cocktail, this time with strawberries and balsamic vinegar.



Poutine

One of the most fun stops on the tour was Hogtown, because I tried two things I had wanted to try for a while but never had: Oysters and poutine. Poutine is a French Canadian specialty made with fries, cheese curds, and gravy. To be honest, it always sounded a little disgusting to me. It was so good that I had to consciously limit myself because I knew another stop was coming. I had about six or seven fries with the cheese and gravy. It was a shame to leave the rest but we knew they wouldn't taste good cold.  The oysters were very refreshing and it was nice to have something a little lighter after all the heavy fare. I liked them plain, with lemon, and with a little grated fresh horseradish.  Both the poutine and the oysters were perfect paired with a local lager.
Pizza Margherita at Taverniti
Finally, of course, I couldn't have a tour of Little Italy without some Italian food, could I? We went to Taverniti's for a traditional red-sauced pizza and a Chianti. This was where I had to call it quits on the food. No clean-plate rule on this tour -- it would have been impossible. I couldn't leave the pizza so we had it boxed up.

After all this food, we met Chef Scott at Chef Shahir's home base, Teatro, where he and his fellow chef Dave decided to try to kill me with gimlets.  I really learned not to try to keep up with chefs when it comes to drinking. I'm not a high-tolerance drinker and I had some trouble realizing how strong the drinks were because they tasted so good.  Luckily, my husband met up with us. He helpfully polished off the pizza and escorted me home. I don't remember much about the walk home except saying that I thought my liver might be broken.  I got up early, slammed several glasses of water, and then went out and found a coffee shop near the B&B. Luckily I had time to sleep on the train home.

Two kinds of oysters
How did Chef Scott make money on this tour when I was only charged $150 (and was too drunk to think of buying a round or at least paying for my husband's drinks)? He didn't. I'm sure he lost money.  I lucked into a real steal.  Normally with a larger tour, he can work out deals with the restaurants, but since I was solo, he said he thought he would just make sure I had a good time.  I did, and more.  I thought that was a very generous and classy move.

My husband and I plan to go back and try that Escape the City trip next time we are in Toronto. It's a paddle out to the Toronto Island Park with a gourmet picnic.  It looks amazing.

Obviously, this adventure was a splurge for me in terms of money, calories, and my poor aforementioned liver.  I don't do things like this often.  I worked up an appetite with the hours and hours of walking I did in the city just to get around (even with public transit, there is plenty of walking involved) and was more moderate for the rest of the trip.

I wouldn't recommend this trip for the super-calorie-conscious, anyone with dietary restrictions, or a super-picky eater. It's not called Culinary Safety Company, it's called Culinary Adventure Company.  If you are willing to throw caution to the wind for one night, you can have a lot of fun.

Monday, July 09, 2012

Medication and weight gain

I have been on prescription allergy medicine for about two years now. Around that time, I also started taking Synthroid for my thyroid condition. The Synthroid was supposedly going to help me drop some of my extra weight, in addition to making me feel more like an alive person and less like a zombie.  I feel better, but I haven't lost weight.  In those two years, my weight has gone up about 15 pounds.

I was trying to wean myself off my allergy meds because I have been getting allergy shots and was hoping to reduce the number of pills I am taking. I have also read that antihistamines in general, and my drug in particular, have been known to cause weight gain, not just from water retention but also from increased appetite. With my family history of diabetes, I can't afford a 7-pound-per-year weight creep.

And it worked! Check out the chart below. It's even more dramatic than it looks because the diamonds, not the red line, represent the data points, and the red line is the line of best fit.






Unfortunately, at the same time I tried this experiment, I also got bronchitis. I didn't go to see a doctor, because all my sources suggested it was probably viral and all the doctor would do is suggest rest, fluids, etc. I also took Mucinex to help clear the congestion in my lungs. Friday night, I realized that I should also go back to my normal dose of allergy medicines in case my little experiment was contributing to my problem.

Guess what? I instantly felt better and saw the weight start to creep up on the scale.  Apparently my choice is between being thin and being able to breathe?  I have to breathe.  I already have the size-14 clothes.

I have an appointment to see the allergist in a couple of weeks to discuss this issue.  I am hoping they will take the issue seriously.  It seems a silly thing but, again, I like having both my legs and in my family, fat people get diabetes.  That's no good either.

I wonder how much of our "obesity epidemic" might be able to be chalked up to the side effects of various drugs.  I find it frustrating that this effect was never discussed with me. It is on the patient insert when I go to the pharmacy, but wasn't mentioned by my doctor.

Tuesday, July 03, 2012

DietSNAPS review



Note: This is a spontaneous and uncompensated review.
I have been trying for a long time to find my food-diary groove. I did really well with Weight Watchers the first time around, tracking on paper in a three-month journal. It didn't take me long for my enthusiasm for the program (and my weight loss) to slip away. Since then I have been trying various things without much success. I tried Weight Watchers again, several times, with paper, online, and smartphone journaling.  I tried LoseIt!, and that worked okay for a while, but I tend to stop journaling right around the time I need to do it most. I tried posting my food pictures to twitter, which just made me self-conscious and defensive. I tried Intuitive Eating, but intuitively, I seem to just eat like a lumberjack.
I'm trying something new. I heard about dietSNAPS through the appSmitten newsletter.  It is a $1.99 app (at least currently) that lets you track your food, exercise, and mood through a photo journal.  One of the nice features of this app (for me at least) is that the photos do not go to the iPhone camera roll, so when a friend is looking at my photos they don't get treated to a view of my menu for the last week.  It's also nice not to have them end up in my photostream.
Using dietSNAPS is simple. For each entry, you choose an entry type (Breakfast, Lunch, Dinner, Snack, Water, Drink, Exercise, or Journal Entry).  You also need to provide a time (though that field is helpfully populated with the current time and date, you can always change it. Then, of course, you take the picture (though a picture is not required for every entry).  ;You can crop the photo, enlarge it, or make it smaller.  You have the option to add a picture from your camera roll or media library, too, in case you already have a picture of a similar item. You can add a note (in case you want to track hunger level, effects of the food on your body, or just give a brief summary of what it was).  Individual entries can be posted to twitter or facebook.
So far I am liking this app. Taking a picture is a lot simpler than typing in a bunch of foods.  I had heard before about Meal Snap, a $2.99 competitor app that tries to guess calorie counts, but I don't like the idea of some person in the developing world being paid pennies to guess at the calorie counts of my photos. It seems too exploitative.
So I am using photos and words but no numbers this time.  I could, of course, do my own calorie counting and put it in the Note field, but I'm trying something different: Instead of focusing on calorie counting, I'm trying to focus more on being reasonable and moderate with both food and portion sizes. It's funny, but seeing the food in the picture helps me reflect on what I'm eating. I'm not sure if this will work, but I'm willing to give it a shot.   It takes some getting used to, though, because sometimes I will be well into eating before I remember to take a picture -- I have a few photos of empty plates.  I have also thought I was saving a photo and managed to delete it instead. I think that as I get more used to journaling I can get better at remembering to take photos.
The fact that the photo is not required is nice for situations where it would be inconvenient or embarrassing to take a picture, like a business lunch or a party.  It would be easy to just describe the meal in the note.  The journal entry option is nice, too, for tracking things like mood, or events that happened during the day. Because you can add a photo there, you could include progress photos or even take a picture to signify an important event that day.
The dietSNAPS app has a monthly view, for browsing old entries, and a daily view. You can export your journal to send it to your trainer or your diet buddy, but the reviews in iTunes would seem to indicate that the formatting gets messed up and all of the pictures are dumped to the bottom. It would be nicer if the journals could be exported as a formatted web page to be posted to blogs or other websites or sent as an html-formatted message.  The iTunes site says there is an update "coming soon," though how soon is anyone's guess.
If you have an iPhone and you're interested I'd definitely recommend giving DietSNAPS a try. It can be used with any food plan, or no food plan at all.  At $1.99 it's a bargain, and the price may go up as functionality is added. It's fun and easy, and it may just be the thing that works for you. I'm hoping it will be for me.          

"Count your calories, work out when you can, and try to be good to yourself. All the rest is bulls**t." -- Jillian Michaels at BlogHer '07