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Reflections after my first year on a medically-supervised obesity treatment program

Posted in health

On our care and feeding during Maintenance

During Maintenance, we were instructed to eat a balanced diet of solid food which was planned and portioned according to standard food exchanges. For my weight and body composition, the dietician prescribed an 1,800-calorie-per-day diet comprised of various numbers of grain exchanges, dairy exchanges, meat and alternate exchanges, and fat exchanges. I was given a guide to describe the typical weight and/or portion size for each type of exchange, and I was instructed to plan and prepare my daily meals using those food types and portion sizes. The goal of Maintenance was exactly according to its name: we were simply to maintain as much of the weight loss as possible that we had experienced during MR. To the chagrin of many participants who had become accustomed to seeing a falling number on the scale each week, we were now instructed not to lose any more weight at all for the following six months.

In addition to all of the learning we had experienced so far, there were two key elements of Maintenance of which we were made aware. First, we were instructed not to consider any particular foods as “forbidden.” Part of the path towards developing such maladaptive eating habits was tread by our placing undue or inaccurate judgments and evaluations on our food choices. The reasons for avoiding the very idea of “good or bad foods” were evident to all of us with a repeated history of “falling off the wagon” from so many diets in our lives. Deep down, I knew I could derive no further benefit from that way of deciding which foods I would eat. Instead, I had to live in the real world—the non-diet world—and work out a way to get through all sorts of social situations and my own home life while eating an ordinary, nutritious diet that didn’t involve me gorging myself mindlessly on calorie-dense, emotional comfort foods.

Second—and perhaps most importantly—we were told to expect to gain back a certain amount of the weight we had lost during MR. This was considered entirely common and natural. If we could maintain a 10-15% reduction in our total body weight since the outset of the program, our participation could be considered successful. My own firsthand experience proved this to be true. After an initial rapid weight gain of about 10 pounds during the early weeks of Maintenance, I was able to maintain the rest of my weight loss for more than four months. However, with two months left in the year-long program, I found myself reverting to some of my former habits. These were mostly focused on eating in secret, either at drive-thrus on my way home or simply by overeating more frequently—especially at home, late at night.

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5 Comments

  1. juanita eisan
    juanita eisan

    dustin, you are in inspiration to me , thank you for letting me read about your struggle, and best of all your determination to lose the weight ….. sincerily marie eisan

    Sat Jan 19th 2013
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  2. Jerry Katz
    Jerry Katz

    I appreciate hearing the ins and outs of this journey. The main thing I see is that you seem locked into the new relationship with food. That’s inspiring to anyone struggling with a psychological challenge. And that would qualify you to inspire, encourage, teach, and lead others who know that have to re-build their lives of eating.

    Sun Jan 20th 2013
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  3. Cecilia Das Gupta
    Cecilia Das Gupta

    Great piece Dustin, very inspiring and very, very useful to read right now for me. Thanks.

    Sun Jan 20th 2013
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  4. Cathy White
    Cathy White

    Thank you for having the courage and honesty to share details of your voyage through the program. I have been hounded by my poor relationship with food throughout my life. I tell people that I am a food addict and have cravings for food like others would crave alcohol or drugs. I think the philosophy of this program mirrors my own thoughts and, having read your piece, I am more determined than ever to follow up on this.
    Kudos to you for your efforts!

    Mon Apr 1st 2013
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    • Jill Peapell
      Jill Peapell

      Dustin – Thank you for your honesty. I am waiting for the next intake of participants and have now been told it wont be until September. This means we will be on the liquid diet over Christmas and in my case over the three weeks I am in the South in January/February. I was pleased to see that you went away and stuck to the liquid diet when you were away. My husband suggested we should cancel our holiday but I need to live in the real world so feel I will reap the benefits of the sun if not the food! Hope your second year is proving to be as beneficial as your first!

      Thu Aug 1st 2013
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