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April 10, 2008
Does Anything Last Forever?
"Five years is a long time," said a mutual friend of ours over lunch today, in a totally different context. My best friend and I looked at each other and agreed. "Yes, yes it is."
We are right on the five year mark. Best friends, five years. It hasn't always been easy, and we've had our share of fights, but we've remained committed to working it out and making it work. At this point, I'm fairly sure that if we haven't killed each other by now, we're not gonna.
Sara points out in her comment re: Yvonne's statements that weight loss doesn't count as permanent if one hasn't kept it off for five years or more:
I agree with you, but I think another part of her argument was that it hasn't been five years for you yet, and they see five years as a magic marker. So maybe you could say something about that--like there is nothing magic about five years, and four years is a good amount of time... or whatever.
Do you know what is significant about the five year marker?
Note how it's cited for both cancer survival and weight loss.
So it must have some sort of import, wouldn't you think?
Yes, you would think. Or I hope you'd think. There is evidence that most of my readers think.
But you'd be wrong. There is nothing significant whatsoever about the five year mark. There is no magic that happens at five years. It could be four years, it could be ten years, it doesn't matter. Nothing changes biologically in the body of a person who has kept weight off for five years. Just like the legend of the seven year itch doesn't force people to cheat on their spouses at year seven, nothing forces people to gain back weight at or before five years.
It is completely arbitrary.
And for my next trick: the entry completely debunking the statistic that 98% of people gain back the weight they've lost. You'll have to wait for that though because I'm on the road all week without access to the relevant back up info.
And while Eris points out that it is quite silly that even those of us who are CR folk get sucked into feeling defensive about our weight (good point!!!), she also writes:
I think the fat acceptance people go too far in asserting that being obese is healthy. It's in response, however, to everyone else saying that being any degree at all above a certain weight is de facto, unhealthy. As for the five year mark, I hardly think that really refers to you, April (since, even at 137, you were never obese, just slightly overweight). With Robin, if she started out at a high normal weight, gained more weight through pregnancy, and then lost it, this is still not being morbidly obese. Such weight loss really should not be compared to those who are 100+ pounds over their normal weight. That's where the five year mark truly is hard to achieve - for those people. In fact, they not only gain back their weight, but put on even more. It's like a boomerang flying back to hit them in the head.
I agree that moderate weight loss is a very different animal from extreme weight loss of 100 pounds or more, but I'll also point out that Kate Harding doesn't make the distinction in the comments that Yvonne eventually referenced, or anywhere else to my knowledge (though feel free to point out if she does somewhere I haven't read.)
As Yvonne quotes Harding:
"If your lifestyle change involves putting restrictions on your food intake," she concludes, "you will almost certainly be fat again in five years."
That's just absurd. And Robin's point is that everyone on the national weight control registry is evidence that this is not a forgone conclusion. It may be true for some people. Those who go back to consuming more calories or exercising less or both.
I appreciate Yvonne's clarifying comments, and I will repost them here to save all the trouble of scrolling and clicking:
April--I didn't mean to imply, in my original comment, that you were above normal. Lord, no. Just that you were above where you personally wanted to be right now, which is the impression I got from your blog.
The CR-osphere and the fatosphere are divided between people who believe, and people who do not believe, that they can exert control over their weight long-term. Not their health, but their weight.
Fatosphere people have tried, often for many years, and failed. For them, doing what Katerina did didn't work--or at least not for long. If you read their narratives, there's lots of heartbreaking stories of initial triumph followed by a breakdown of the system (whether through an unexpected onslaught of extreme hunger pangs or an unexplained weight gain despite still following the system), partial or total re-gain, confusion, guilt, self-blame, an effort to get back on the straight-and-narrow, a harder time losing the weight this time, another and much greater re-gain, more self-blame, more efforts, the realization that they're in real trouble, and the painful beginning of letting go of the dream of weight control. After having been through all this, often over a period of many years, many fatosphere bloggers are understandably angry, defensive and cynical. Some discuss trying to recover from overwhelming feelings of shame and failure. Understandably, these vulnerable people lash out hard at anything that may seem like a judgment of them or their experience. Even if it wasn't meant that way.
CR-osphere people, on the other hand, have tried and (thus far) succeeded. The earlier in their trajectory they start blogging, though, the more likely it is that they'll end up falling off the wagon. Remember when April wondered where all the new CR blogs had gone? Remember when some of her friends felt guilty because they'd fallen off CR, and she had to reassure them that it was okay?
Both camps have strengths and weaknesses. In my opinion, the main weakness of the fatosphere is its overreliance on the blog "Junkfood Science" for "proof" that fat is Just Great! and we should all relax. (They can and do cite any source at all for evidence that 98% of diets fail over the long term, but for evidence that being fat poses no health risks, the links to Junkfood Science rise alarmingly. In my opinion, it doesn't matter whether fat is "healthy" or not--it just is, and most people have to live with it.)
The main weakness of the CR-osphere, imho, is its naive rugged individualism, its faith in its own efforts, and its occasional confusion of the power to eat healthy food with the power to affect the outcome of that choice (thinness, longevity, freedom from heart disease).
The fatosphere is more realistic about how things really are; the CR-osphere has great recipes and tips :) and has a wonderfully optimistic atmosphere.
When Robin scolded the fatosphere's failure to bow in awe at those who achieve a one-year weight loss, however, I felt impelled to speak up. Lots of people in the fatosphere *have* lost weight for a whole year, and often more. They have a long-term perspective which the CR-osphere sometimes lacks. I felt that that needed to be said, both for the sake of fairness and also clarity in terms of what we mean by "weight loss."
A few clarifications from me:
1. CRON is not a weight loss diet. Most people who start CR are not overweight, and certainly not obese, though some are. Most who started CR blogs were not overweight to begin with. They were interested in CR because it is the only method that has actually slowed biological aging in mammals. Not to lose weight. Weight loss is a side effect. Some people like it, some people don't. MR doesn't. He's love to be fifty pounds heavier. He's just not willing to risk an earlier death for it.
2. Doing long term CR is a whole different animal from long term healthy weight loss. See previous entry.
3. While there are many huge tremendous differences between weight loss achieved by those who lost moderate amounts of weight on CR and those who've lost 100 pounds plus, they do have a few things in common. Most notably that consuming fewer calories leads to weight loss.
Many folks have found the tools that CR people use to maintain their CR are also helpful to those looking to lose weight. For instance, that eating high nutrition food makes it easier to maintain a lower calorie intake than eating less nutritious food.
That being said, here is what really strikes me as problematic about Yvonne's attitude, and an attitude I see reflected throughout the fatosphere (which btw I think is a very clever name.)
In my opinion, it doesn't matter whether fat is "healthy" or not--it just is, and most people have to live with it.
Hmmmm. Two things.
1. I believe it does matter if fat is unhealthy. It matters a lot for those who are fat, and also for the future of our health care system. If people are becoming sick and dying due to a factor that is preventable or modifiable, shouldn't they know about it and have the option to do something about it? We educated about smoking and seat belt use. Some people still choose to smoke or not wear seat belts. But they know they're taking a risk. If the there are risks, but obesity is not preventable, then our health care system had better work overtime to prepare for the onslaught of those needing care.
2. If fat just is, and some people just have to live with it, then why are so many people fatter now than at any point in history? Did a genetic mutation occur in the last thirty years, or is it possible that people's lifestyles have changed? I don't mean to be flippant, actually. Some people do assert that people are just "naturally" fatter now. But most don't. Some blame the food environment, some blame the individual, but very few folks think that it just happened.
If the numbers of those addicted to drugs were to suddenly skyrocket, with demonstrable health consequences, would people state that drug addiction just is, and that some people just had to live with it? Or that alcoholism just is, and that alcoholics may as well accept their condition because alcoholism is after all genetic? There most certainly are genetic components to alcoholism, and likely to drug addiction too. But we don't just sit back and let it be: did anybody notice the "War on Drugs?" The stigma surrounding alcoholism I'd venture is even worse than the horrible stigma surrounding obesity. Very few people would argue that alcoholics should be protected by anti-discrimination laws, yet alcoholism has a firmly genetic component that some people just get and others don't. Yet... we accept that alcoholism and drug addiction are treatable. And that while it's really really hard to get over both, it can be done. Look at Eric Clapton for heaven's sake!
I'm not arguing that discrimination against those who are obese is a good thing: as all who have been reading for a long time know, I've written extensively against weight bias. But to say that people should be treated with dignity and respect is different from saying that people who are overweight or obese are doomed to remain so forever and must learn to accept it.
Many long term alcoholics don't get Korsakov's syndrome or chirrosis, yet an alcoholics' acceptance movement would be laughed off the internet. Why? Because the health risks of substance abuse are undeniable and well documented. So are the risks of obesity... they just take longer, in some cases, to manifest. Addiction to substances is hard to kick, but everyone knows it can be done, often with a great deal of treatment and support and sometimes with medical intervention. The same is true of obesity and I think that the attempt to turn it from a health problem into a cultural issue is both dishonest and dangerous.
Posted by april at April 10, 2008 2:11 AM
Comments
Maybe this is because I'm a fairly young Male with some all or nothing attitudes towards bad food. But this world that is portrayed seems so weird to me, How can folks that have the money(I understand economic conditions) have this health problem?
Don't mean to be insensitive but I really don't understand seeing people that are extremely obese just hurting themselves more: Is it really that hard to bring yourself not to eat gak? The reason why everyone I've ever seen diet fail is because people go back to eating food that is both unhealthy for you and high in calories(which besides your Lipids seem to go hand in hand). I assume these same people don't have problems with alcohol/drugs/buying too many massages even though these give a pleasant feeling?
There is a reason why many raw foodists are emaciated, have you ever met an obese raw foodists that has been doing the program for a while? It seems to me you want to cure these folks get some subliminal messaging going in their head that gak is poison.
With the fact that I cut out without exception all gak in my diet, forces me to do strict weighing CR. Otherwise I end up with horrible problems from weight loss.
When I was in weight gain phase from losing too much, I could just eat at a salad bar till I was about to throw-up(this includes eating olives to make sure I got fat and lean protein) and still not be gaining weight. I had to add in a lot of fruits(even some grains) and good fats to make sure I was gaining weight.
I'm sure it's my minor orthorxia talking, but it just amazes me people are so willing to make choices that harm themselves. Of course the amount of smokers and others out there in the past it shouldn't be a surprise.
Posted by: Chuck at April 10, 2008 11:43 PM
Hi Chuck,
I'm very interested in the research on food addiction, and how much it seems to be similar to addiction to drugs. While it's perplexing to those who aren't addicts to watch an alcoholic or drug addict continue to engage in behavior that is obviously harmful, it makes some sense because we understand that the substance gives the brain something that it's come to think it *needs,* more than it needs long term health. I expect that some people feel the need for excess food the same way that addicts feel the need for drugs. In the absence of an obesogenic food environment, where food companies intentionally pack "food" full of substances that trigger addictive responses, folks who are inclined to food addiction might never manifest the problem, just like children of alcoholics might well not follow in their parents' footsteps if they're not in an alcohol-soaked social environment.
I'm certainly no expert in food addictions, and I never had that kind of relationship with food. But I can see how if one did, the struggle to maintain a healthy weight would be much more difficult than it is for those who aren't addicted.
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Posted by: april at April 11, 2008 4:54 AM
As always, April, your thinking about these issues is so thorough and articulate.
I'll be looking forward to seeing your work on "debunking the statistic that 98% of people gain back the weight they've lost." I'll be interested to see if the distinction between "normal" and "obese" people crops up again--e.g., as you put it, the fact that "moderate weight loss is a very different animal from extreme weight loss" (and hence probably easier to maintain).
If you find that people can maintain moderate weight loss just fine, and most of the statistical trouble is coming from the extreme camp, then the fatosphere scores one, because the fatosphere has always been primarily of, by and for FAT people. The kind who "need" to lose seventy-five pounds or more. The kind who get yelled at by assholes on the street. Not plump, not zaftig, not middle-aged-spread-afflicted, not subject-to-euphemism people, but FATTTTT people.
And, increasingly, those plump and zaftig ones who find that intolerant assholes are defining them upward into the FATT category because their collarbones are not visible.
Posted by: yvonne at April 11, 2008 10:17 AM
For me, severe, unrelenting depression is connected to an addictive drive to alleviate the depression with a "food high". Now, before you say: why the hell doesn't she just STOP?!? Doesn't she realize how depressing it is to be so FAT!?! Let me say: of course I do. I have tried again and again to stop. I have battled this all my life. I once lost much weight. 100 pounds, in fact. Everyone was *sure* I'd keep it off since I did not go to extremes to lose weight, lost it slowly (it took 3 years) and did not end up skinny. 170 on a 5 ft 6 in person is definitely not skinny. Well, sadly, I did regain it all. I just went nuts one day and that started me off on a bad cycle I could not get out of. I feel very driven, very compelled to Overeat. Not always, oddly enough. But mostly. Shame increases this urge. It's like my body is fighting me every step of the way. For those of us who are "morbidly obese", losing weight is a horribly frustrating, struggle. The struggle to Keep It Off For Life is even harder. Can anyone understand that? I'm not a CRON. I can't even stand to do the Weight Watcher's point system, let alone what CRONS do. I wish people wouldn't judge me. I ran out of a luncheon today because I just couldn't take the stares and the coldness. I felt like a freak. I felt like dirt. But I'm not. I'm just as human as any thin person. I do Not like how the size acceptance movement prentends that obesity is harmless. It isn't. But I also don't like how doctors call a size 16 person "obese", either. Moderately large people can also be very healthy. CRONS may not believe it, but it's true. Only when you get to my size do you really start to feel the truly bad effects of obesity. As for "acceptance", it's not about that. It's about respect for basic, human rights. Everyone has the right to not be discriminated against. A CRON can control what he or she eats, so it may be hard to have much empathy. Still, even for CRONS, I don't think what you guys do is easy. I have fear that CRON is completely healthy, either. However, I also have respect and even much admiration for April and others. I see people honestly attempting to do what they think will bring them much health and longevity. Re - the Five year mark - I think Five Years is a guideline. If you can keep it off that long - and you have lost 100+ pounds - this is quite an achievement and not one that many Can achieve. If an obese person loses 100+ pounds and keeps it off, I think they are *constantly* fighting hunger. Most fat people can't do this, but some can, I think. I also wish food did not taste so good, in all honesty. I love all the bad stuff. All the luscious cakes and so forth. It would not bother me if I could control it better, though. I can, but then my drive to overeat wins out. Again. Yet to live with no food such as sweets or bread - well, I don't see myself being able to do this, either. I know it sounds terribly weak and is. I'm being honest, however, because I think it's better for everyone to work on understanding where we all are, rather than for us to hate each other. April's recipes really sound great, too.
Posted by: Eris at April 11, 2008 2:08 PM
I feel compelled to make the following observations:
1) Making a rational, non-malicious argument is not "scolding."
2) Asking others to acknowledge my existence is not the same as demanding that they "bow in awe" of me.
Yvonne, you usually play fair so I'm a little disappointed that you've chosen to exaggerate my comments to make your own point. Please don't mis-characterize what I said, and please don't put words into my mouth. I have not and never will expect anyone to "bow down" to me or anyone else.
Posted by: Robin at April 11, 2008 6:25 PM
Eris, I think it's important to remember that everyone's experience and inner reality is different. People react to things differently. What works for one person won't work for the next person.
There's no need for you to call yourself "weak." Doubtless there are factors which we don't understand yet that are involved in your overeating and intense cravings for certain foods. People used to think ulcers were the result of stress or drinking too much coffee. Turns out it was bacteria all along. Sylvia Plath was harshly judged for her rages and compulsive eating. People were sure it was a character flaw, although, to their great puzzlement, they did notice that it seemed to reach its peak right around her period. Shortly after her suicide, the spectrum of premenstrual disorders was identified.
We tend to blame negative things which we don't understand on the people who suffer from them. A horribly large percent of the time, we turn out to be wrong, and discover that we've unnecessarily added shame and guilt to the burden of people suffering from problems largely or entirely beyond their control. I feel that a lot of weight problems will eventually turn out to have physiological causes like hormone imbalances (all that dioxin we're absorbing ain't doin' us any favors), viruses, and the like.
I agree about the recipes :)
Posted by: yvonne at April 11, 2008 6:26 PM
Eris and April - Thanks for the interesting insights. My comment before was based on that fact that I had a bout of food addiction/obsession after being told I needed to stop CRing for a few months and eat freely and a lot to gain myself to a healthy weight.
Suddenly I felt free and all I though about/wanted to do was eat 24/7(as has been shown as being one of the effects of coming off of starvation(http://en.wikipedia.org/wiki/Minnesota_Starvation_Experiment)). But I suppose due to my orthorxia, this led to me going to all you can eat salad bars and binging on the dark green leafy vegetables till I literally felt extremely sick/about to throw up and felt like I didn't want to eat ever again. Going along with what I said before: even doing this crazy low-calorie vegetables binging continuous hour and a half eating(sometimes even longer), I still wasn't gaining weight.
It really seems to me like i said before, that if you could somehow manipulate people's mind into orthorxia like me and that getting a dirty/unclean/unholy feeling from eating GAK that this battle can be won.
Posted by: Chuck at April 11, 2008 9:50 PM
Why do i have to read about your personal life on the Methuselah Foundation's website?
Posted by: Nathan Hesley at April 13, 2008 8:06 AM
There are hormonal issues that I think make it harder for obese people to keep the weight off. Your body's going to fight a larger weight loss much harder than a small weight loss, and the leptin and ghrelin it pumps out are going to make you absolutely ravenous. But it can be done, and it has been done.
Posted by: Erin at April 13, 2008 9:17 AM
To Chuck I would say--it sounds like you're a male with a high metabolism. I eat a high-raw diet, and can certainly very easily gain weight eating avocados, nuts, seeds, olives, and dried fruit--or with just one of those things. Yes, they are more nutritious, but the calories in/calories out formula still applies. It sounds like it's difficult for you to eat more than you need, but I personally have always had a very good appetite,so I have recently gained weight overeating these foods. But it is true, if I had been eating SAD, it would have maybe been 30 or 40 pounds instead of 10 or 15. The latter is much easier to take off.
I would agree that people are addicted to "gak", though, I don't really understand it. I used to be crazy about fried foods and sugar, and have completely weaned myself off of them--and it's been more than five years ;) A person's tastes can change, is what many don't realize. I never used to like vegetables or natural-tasting foods, but I was patient enough to let the taste for real foods evolve.
Thanks for a great entry, April.
Posted by: Sara at April 13, 2008 11:06 AM
Hey Nathan,
Unless someone is holding a gun to your head, you don't *have* to read anything at all. And the beautiful thing about the internet is that if you see something you don't like, there are about a billion other things you can read instead.
Posted by: Robin at April 13, 2008 12:24 PM
Sara - Thanks for the reply, I guess it's also a volumetric issue.
This is a social issue I've just been thinking about more and more during my weight gain phase as I went to salad bar/buffet restaurants and see people who are obviously obese, eat small tiny salads and then huge bowls of rice, almost as if because culture says rice is a cheap staple food you need, you must eat it.
It bugs me out even more that people look at me like I'm an insane eater when I go and get multiple salad plates - but folks That fill multiple plates of non-salads are treated as just being normal.
I've always had poor taste buds/could eat anything and the physiological issues I've built up Via CRON(low calorie high nutrient is great) and my orthorxia with dark green leafy vegetables being the stuff of life: Makes me look at the dark greens like someone savoring chocolate.
Which goes along with what you said, you look at me 10 years or so back though in my early-mid teenage years, all I did was eat junk food/what made me feel good, didn't particularly like vegetables.
Nowadays, Literally eating a pound of Dark Green Leafy vegetables(with some cabbage inbetween to add crunch) is just as good for me as eating anything else. Which unless you are a nathans competitive eater, You are not going to be able to eat enough to gain weight, let alone even have a high carb diet. I mean we are talking 130 calories for more then 2 pounds of food here.
I'm basically just repeating myself here, but again: There just has to be some way to manpiulate Social normals/ people's mind to feel the same way about Turnip Greens as I do.
Posted by: Chuck at April 13, 2008 9:18 PM
Losing weight is very difficult for obese people. Yvonne's right, there are probably underlying physical conditions that help cause and maintain obesity. Right now I'm reading a book called "Thin" by Lauren Greenfield. (There's also a DVD). It's about Anorexics. I see some odd connections between obesity and Anorexia. I don't think CRON is Anorexia. The girls and women in "Thin" eat terribly. All they want is to be thin, and if they die: oh well. It's strange to think that not eating can be a compulsion, just like eating too much can be. I don't think bread or sweets are the culprit, really; plenty of people eat them w/no problem. I do, as well, when I don't feel driven to overeat.
Posted by: Eris at April 14, 2008 9:34 AM
