Wednesday, 6 November 2013

Fat Woman and the difficult equation

Fat Woman has a favourite doctor. The doctor won Fat Woman's love and respect when she said: "I don't know. Let me look it up." This same doctor once said in front of Fat Woman: "After all, no fat people came out of Belsen." Fat Woman likes this quotation and has even said it back to the doctor, who had forgotten the context in which is was originally said and was rather shocked to hear the words coming out of the mouth of a fat person. Fat Woman had a naughty little moment of glee at that :-) Fat Woman has also pointed out to her doctor that it is actually easier for a very fat person to lose weight because just moving around means they burn so much more. Fat Woman quite misses the days when an hour on the rowing machine would net her a burn of 1200 calories.

As a result of getting to know Fat Woman and her realistic and sometimes shockingly accurate grasp of her health and situation, Fat Woman's doctor is sympathetic and treats her clinically i.e. according to how Fat Woman says she feels, not just as to whether her blood results are within the lab range. The doctor also lets Fat Woman have thyroid blood tests every two months to try and help her out of the loop where she loses weight easily because her blood is right, then suddenly her dose is too high and she puts on pounds within a week, and then is the right dose for the weight she is now. The year Fat Woman has lost the same four pounds at least five times. After June Fat Woman changed her mantra to "Don't stop!" because it is too heart breaking to focus on weight loss when she is doing everything right on paper and yet her body is working against her. A week of weight loss costs Fat Woman at least five hours of exercise, plus twice as much in preparation and travel, plus the same again in food shopping and preparation. To have that disappear in a blink of an eye is massively disheartening.

The one thing that Fat Woman and her doctor have always agreed on is that if calories consumed are fewer than the calories burned you will lose weight. It's simple physics, for goodness' sake. Metabolic disorders make this rate slower, but you could in theory simply reduce the amount of calories until you started losing weight. Unfortunately this comes with side-effects such as having no energy, feeling sick, being in pain from digestive problems, being barely able to walk etc etc. Fat Woman admits that she thinks far too much of herself to follow any eating plan than leaves her hurting and unable to function when the alternative is to be functional and fat. Fat Woman is defensive of her need to eat as she has had quite enough experience with people thinking that because she is fat she shouldn't be allowed to eat at all. For anyone who is not entirely clued up on such things, food is a human need and having food is a human right. In fact Article 5 of the Universal Declaration of Human Rights says: "No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment." Fat Woman considers the suggestion that fat people be denied food on any grounds let alone the idea that having fat on your body is somehow morally offensive to be at the very least degrading as well as in violation of Article 25: "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food". It took a very long time for Fat Woman to get her head around the idea that she deserved to eat, even if she was fat.

Fat Woman counts herself lucky that she made it past 35 without developing an eating disorder.

Fat Woman lost weight for the first time as an adult when she learned about the Basal Metabolic Rate calculator in 2007. This was the first scientific evidence Fat Woman had even seen to suggest that weight loss plans could be anything more specific than "eat 1500 calories a day". For what it's worth, Fat Woman can lose weight on more calories than most women need to maintain their weight. Fat Woman uses the number of calories she would need to consume if she were completely sedentary and subtracts the 500 that make up a loss of a pound a week (a pound of fat being 3,500 calories) and then doesn't eat any more food even though she does a fair amount of exercise. This means that when Fat Woman follows her eating plan and has all her hormone levels in the right places she can log up to 2lb weight loss each week.

Fat Woman had been making fitness progress including putting on muscle but had not lost any weight for a while. Fat Woman had a review of her priorities and decided that although losing more weight wasn't her first (or even second or third) priority she would find it useful for it to happen, so she returned to first principles, which meant keeping a food diary. Fat Woman has the private opinion that anyone who claims they want to lose weight but who won't commit to writing down what they eat and how much so it can be compared against their BMR is hoping for some dieting magic. This is of course what a lot of diet clubs prey on. Fat Woman hates the idea that dieting is "hard". It's not fucking hard if you've got a basic understanding of adding up. With MyFitnessPal you don't even have to do the maths. What is the issue with putting food on the scales before you cook it, or reading the side of the packet? Fat Woman suspects this wilful ignorance is really a refusal to face up to the fact that people are eating more than they should be. As Fat Woman spent years being fatter than the amount she ate meant she should be she has no sympathy. People should go to therapy and deal with their issues.

Fat Woman is quite clued up about nutrition and has learned many good practises such as swapping carbohydrates for fat and knows that low Glycemic Index carbs make you feel fuller for longer. When Fat Woman is on plan she has a food diary that not even Personal Trainer can moan about (apart from the bread - Fat Woman will not give up bread, she did it for three months and it made no difference, and it still rankles with Personal Trainer). Fat Woman prides herself on being able to create a filling and tasty meal within her allowed calories and has learned lots of new recipes and cooking techniques since she overhauled her diet. Thin Husband only had one comment about the regime inflicted upon him and that was that he liked having so much steak.

So Fat Woman started her food diary again in a determined effort to make further change and move forward.

Personal Trainer has a knack for smelling weakness where Fat Woman is concerned. Sometimes this means he wants Fat Woman to make him a cake, but where he seizes the advantage is when it comes to their area of contention: nutrition. Fat Woman thinks she is perfectly fair in saying that if Personal Trainer brings her two peer reviewed papers, one establishing the principle and the other confirming it, she will apply the findings to her diet. Personal Trainer finds it annoying that whatever he recommends Fat Woman will go off and research until she understands what is being talked about instead of blindly trusting him. Fat Woman has been told by too many medical practitioners that she should eat starvation levels of food in order to lose weight so she doesn't trust ANYONE on the subject of nutrition. Also, Personal Trainer once made the mistake of saying to Fat Woman that soy was a fat burner when it is in fact an emulsifier, and the resounding argument lasted four days, ending with Personal Trainer denying he ever said it. Fat Woman does not believe that she imagined it or that Personal Trainer went on to offer the excuse that he got the tip from someone who was ripped so it must be true (arrrgh!). Fat Woman also eschews fat burners (dangerous to very fat women), zero carb diets (same, less chance of a heart attack, more chance of depression), green tea extract (shown to be ineffective in women over the long term by more than one study), and the idea that the calories you eat late at night are more fattening than those you eat in the morning (please see previous references to the laws of physics). That's not to say that Personal Trainer has suggested these particular ideas to Fat Woman, but they float around every gym.

This time Fat Woman found herself hoist onto the petard of her belief in calories in versus calories out. Personal Trainer has reviewed Fat Woman's nutrition several times and made helpful suggestions such as swapping some carbohydrates for fat. Fat Woman thinks this was a perfectly sensible suggestion, unlike when Personal Trainer suggested taking out some of her cereal and replacing it with nuts or seeds. Fat Woman looked at the relevant nutritional information and found that would actually decrease the protein value of that meal and increase the calories and pointed out to Personal Trainer that she wasn't paying £4 a box for granola for no good reason. Instead Fat Woman took out some cereal and replaced it with a protein shake. Personal Trainer will not shake his belief that unfuelled cardio is beneficial, although Fat Woman has refused to try it on the grounds that to maintain her weight she needs to be fuelled 150 calories per waking hour, and that by eating 400 calories for breakfast she is technically well unfuelled by the time she meets Personal Trainer at 11am. Personal Trainer then suggested that Fat Woman could have a lower-carb breakfast. Fat Woman wanted to know just how low Personal Trainer thought low carb was, as her scrambled eggs on toast had just 20g of carbohydrates in and that was low by anyone's business. Personal Trainer acknowledged this but then said in that case perhaps Fat Woman could try not eating carbohydrates before training.

Fat Woman flicked through her mental database for reasons why she shouldn't eat a zero carb breakfast on training days and found none. Fat Woman found herself agreeing that she would refrain from eating carbohydrates before training.

Fat Woman has been back on a calorie-controlled diet for the last ten days, and admittedly the sightly higher than usual number the scales showed that motivated her to restart serious calorie counting could have been a little inflated due to things like water retention, but she has dropped 10lb in ten days. Fat Woman is worried that either she she is in the sweet spot before she tips over into overmedication for her underactive thyroid (it's a bit like being on speed apparently) or she is going to have to admit to Personal Trainer that despite the lack of scientific proof his suggestion has worked.

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