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Post-hoc reflections on long-term obesity recovery after a 12-week VLCD (very low calorie diet) program

Posted in health, and personal

I’ve recently completed a second full phase of the 12-month obesity treatment program called PfHW, or Partners for Healthier Weight. (I’ve summarized the details of my first year’s experiences here and my second year’s experiences here.) At its core, the program inducts up to 20 participants per group who all agree to meet for 3 hours per week for six months, then 3 hours twice monthly for six more months. For a 12-week period during the first quarter of the year, participants replace all of their food and drink with Optifast, a nutritionally-complete liquid meal replacement/food-like substance manufactured by Nestlé.

This is not a natural diet, to put it mildly. It is also not sustainable or well-advised for the long term. For me, being on this program meant that I twice spent Christmas through Easter on MR (Meal Replacement), consuming nothing but water and 900 calories’ worth of chocolate meal replacement shakes. Those who can remain fully compliant with the program without eating anything on the side can lose huge amounts of weight: a fat-burning, ketogenic state is quickly induced with so few calories being taken in each day. Losses of more than 70 pounds in 12 weeks were not unheard of. Several people lost more than 15% of their starting body weight in only 3 months. After my second period of MR, I was convinced that there was no more effective, rapid and relatively painless way to lose a significant amount of weight. After two cycles within an 18-month time span, I ended up losing well over a hundred pounds. (Insert “results not typical” disclaimer here. —ed.)

Aside from the weight loss itself (which admittedly was wonderful), there were several side benefits that accrued during MR. It felt like I had boundless physical and mental energy. There was a newfound clarity to my thinking each day; I actually experienced a higher degree of mental acuity. I had significant, positive mood shifts, decreased feelings of stress, and a noticeably increased feeling of empowerment for having finally taken control over my eating habits in such a dramatic and effective way. My wife coined the term “OptiFast-Induced Hypomania” to describe my wide-awake, creative mind during that period. I called them “Superhero Moments,” although thankfully mine never strayed far enough into the delusional so as to inspire any roof-jumping or anything.

I was able to ride the high associated with such drastic weight loss for several months. When I was invited to perform as a guest soloist on tenor saxophone with a local jazz orchestra, I bought my first Calvin Klein jacket and shirt for the event. I was literally awash in compliments from dozens of people about how I looked, and a photo I posted of myself from the evening on Facebook accumulated a few dozen “likes” by the end of the day. For an outgoing extrovert like me, it’s hard to think of any downsides to an experience like that. I felt truly blessed to be showered with so much positive attention and love.

And it was only natural that I should think these benefits were there because I had successfully lost so much weight. I mean, God forbid that that positive attention has anything to do with who I am or what I do as opposed to how I look, am I right?

Of course, everyday life is not the Constant Positive Reinforcement Shower I just described above. I was a stay-at-home dad to three young kids and all of my strongest stressors were still in effect, despite my acute-onset euphoria and weight loss. Once again, I found myself returning to some of my favourite emotional comfort foods to get myself through the most stressful parts of my day.

It’s worth spending some time unpacking this whole practice of emotional eating. I’ve had to do a lot of journaling and self-reflection in order to understand when, how and why I appear to need the most emotional comfort each day. If you’re pretty enlightened, you might happen upon the root causes of your overeating quite quickly. But even if you do, you’re left with a big, glaring question:

What am I going to do to deal with my frustration in this moment if I don’t eat something right now?

That begs all sorts of questions I’m not used to asking myself, and not many of them are comfortable or easy questions to answer. The questions all have something to do with a fundamental thing inside of us: it’s how we deal with disappointment in our life. Do we face it fully in the moment, or do we avoid it by eating? And if we avoid it by eating, WHY? What is it we are avoiding that is so terrible we think that eating an entire jar of peanut butter is going to solve the problem? (Not that I’ve ever done that.)

It has taken me this long to figure out that the way out of this feedback loop is to change the way I think about this, instead of trying to change the way I behave about this. Now I’m confident that if I can successfully change my wrongheaded thinking and beliefs about this, then my behaviour will follow along naturally as a result.

some new rules

  • make my primary nutritional focus to be on learning and listening to my body’s physical cues for hunger and satiety (these skills were massively underdeveloped in me as a teen and young adult)
  • eschew the practice of following any sort of prescribed eating or activity program that has losing weight for its own sake as its primary objective (see above!)
  • cultivate a sense of inquisitiveness and nonjudgment about why I eat for emotional comfort, and consider how else I might be able to handle my life’s daily stressors without first turning to food
  • discover physical activities that I genuinely love to do—things that I actually want to do and even look forward to doing each and every day
  • explore new recipes and ingredients that I know from experience are healthful, nutritious and delicious (i.e. make real food for our family that doesn’t come from a cardboard box or a cellophane bag)
  • be totally open and honest with myself about what my TRUE needs and wants are (i.e. am I leading a life that’s genuinely being guided by my most important values?)

some old rules

  • eat 4-5 servings of fruits and vegetables each day
  • drink 8 glasses of water every day and limit my consumption of coffee and alcohol
  • go to the gym 5 days per week for a 20-min cardio workout and a 30-min strength training routine
  • stop eating any food that contains sugar or refined white flour products
  • don’t consume anything but clear liquids after 8:00 PM

I feel optimistic, positive and excited when I read through the first list. It contains practices and activities that I know in my gut are going to help me recover more fully from three decades of emotional eating habits. If I can attain any measure of success with any number of those items, I am very likely to curtail my overeating and will eventually return to a normal weight for my size.

I feel queasy, depressed and lacking when I read through the second list. It contains a set of rigid rules that may well conform to common wisdom, but that also set me up for immediate failure the first time I break one of them. Which, knowing me, I’m likely to have done by 11:00 or so tonight.

My intent is to master that first set of practices right now. And in so doing, I’m striving to attain what the fine Dr. Yoni Freedhoff defines as my Best Weight, which is whatever weight I can reach while living the healthiest life I can honestly and realistically enjoy. For the more disciplinary-minded among us, that may sound like moving the goal posts. But I now know from extensive personal experience that I will never “succeed” at this by following any kind of prescribed diet or exercise regimen—at all. Not unless it’s the natural one prescribed by my own body’s actual cues for hunger and fullness.

Postscript: In the absence of regularly-scheduled, in-person meetings, the next best thing for peer support and guidance is available online through e-mail forums and Facebook groups. I personally owe a debt of gratitude to groups such as the private forum moderated by the US-based disordered eating treatment expert and psychotherapist, Karen R. Koenig. That and other groups have provided me and many others with a helpful forum to work through our hangups about moderating our feelings with food.

3 Comments

  1. Cecilia Das Gupta
    Cecilia Das Gupta

    Great article Dustin. Just read it all here in New Delhi, where I have to every day remind myself of what I achieved with the progran and what I need to do to maintain this weight. It is hard work but I’m trying and I’m doing OK, I think, no wait, I AM doing OK. So many temptations…it’s really a very challenging task, but I try to balance, if I have a big dinner coming up I try to compensate with more healthy and lighter lunches and, miracle of miracles I’m walking so much I can for sure say it is definitely helping. But it is so nice to walk here, shops and shops and shops, it will be harder when I go back home.
    Thanks for writing this. It helps me. Cecilia

    Thu Feb 27th 2014
    |Reply
  2. So I just started the PfHW about 2 weeks ago and ran across your blog. Its been supremely informative, so allow me to thank you for that.

    In regards to “In the absence of regularly-scheduled, in-person meetings,” I wanted to let you know of two other, low cost, obesity meetings in Halifax you may find useful:

    ~Over Eaters Anonymous: This is the one that I am most likely going to attend. They treat Over Eating as an addiction, along the same vein as PfHW. They run every Thursday, 7pm at St. James Church Hall. More information at http://www.oa.org/.

    ~TOPS: They use the food exchange system that PfHW has mentioned. Low cost membership. Not religiously minded, like Over Eaters Anonymous. More information at http://www.tops.org/ and http://www.tops.org/TOPS/FindAMeeting.aspx

    There are a bunch others I am sure you’re familiar with. These two I only stumbled upon after research and thought it may have flown under your radar.

    Wed Sep 24th 2014
    |Reply
    • Thanks so much for your comments, Kait, I appreciate hearing from you. I also appreciate the hat tip to TOPS, which I’d never heard of before now. I just recently learned of the Halifax OA chapter too.

      Best of luck with your program!

      Wed Sep 24th 2014
      |Reply

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