Obesity and addiction

[lph]

Inspired by goldfinch's beautiful post, and some of the comments after:

I've been reading a thread lately on another bike forum, about obesity. It started off as a discussion around the use of surgery to limit the size of the stomach (don't know the medical terms well enough here), but veered into a general discussion of why people become obese, or why they don't. One brave man told about his journey from life-threatening obesity, via cycling to just being slightly overweight, and unfortunately, back. He was now well on his way back to being seriously obese, but not heavy enough to qualify for surgery or any other of the more extreme measures. He said himself that he knew how to fix it but just couldn't do it alone, he needed help. He also told about how his eating disorder probably was linked to a very traumatic childhood with a lot of violent abuse.

And I've had his story on my mind. Granted, his case is extreme, and I think very few people are unlucky enough to experience that level of psychic trauma. At the same time, his description of how incredibly hard it was to rely on pure willpower all the time, every day, to stay "normal" in a world where most people around him just... ate, was quite an eye-opener.

I've never been more than just uncomfortable stocky, but my point is that for me it just doesn't take that kind of willpower. I need good habits, like bike commuting, "clean" food in the house etc to stay at the weight I want, but basically I enjoy exercise, I enjoy being fit, most of my friends enjoy doing active things, and while I love food, I just don't think about it much unless I'm hungry. I think that may be the case for many people, that good habits and a love of physical activity is enough, so that willpower doesn't really play that big a role. But I do understand addiction, and I do understand mental imbalance, so I can easily see how food can mean much more to someone than just food.

Any thoughts? It seems to me that a discussion around obesity as a general problem in society isn't really worth much as long as one assumes that everyone has the same relationship with food. And from reading how easy, and how incredibly hard people find giving up even smoking, it seems obvious to me that addiction and/or habits can be incredibly strong and very individual.

[Crankin]

For many people, it's the same as substance addiction, cutting, or whatever else takes the pain and gives you comfort. Yes, trauma is involved in a lot of these cases.
Some people say they would rather take a pill than eat. For me, this is inconceivable. Food is a huge part of my life. In my case it's cultural, but still, it would be hard to think any other way.

[limewave]

I'll jump in and say that I am convinced that I am addicted to food. And I've struggled with obesity and weight gain my entire life, topping the scales at 320+ pounds. I was so big that I could not even buy clothes at Lane Bryant anymore.

Food is an addiction I still struggle with.

I hide food. I'll hide evidence of food I've eaten. Sometimes I'll eat an entire package of cookies, candy, icecream, bread, peanut butter, chips, (fill in the blank) . . . and then be so embarassed and humiliated that I run out to the store to replace the package before anyone finds out. Sometimes during those episodes I get the sensation of 'blacking-out.'

There are times I will eat and continue eating until it is physically impossible for me to put more food in my body. I eat when I'm tired, when I'm stressed, angry, sad, etc.

It's a comfort thing for me. A distraction. A way of shaming myself. Even a way to sabotage myself (I'm not good enough to succeed).

Finally accepting that this was an addiction and coming to terms that I would struggle with food every single day was a turning point for me.

I do have to write down what I eat and get on the scale every single day. When I don't do that, I relapse. Weighing in is about holding myself accountable, sort of like attending an AA meeting.

I've worked really hard to not let myself get obsessive in the other direction (anorexia, bulemia). I was afraid to have kids because of how being pregnant would affect my body. But, I did not want to be a slave to my food addiction--I didn't want it to get in the way of having a family.

This weekend I am going to Chicago. I have anxiety about eating away from home and not having complete control over my food. This is something I struggle with every time we are invited to a dinner party, take a vacation, have a pot-luck at work . . . I have to remind myself that it is okay. It is a vacation and I am allowed to enjoy myself. I can still make good decisions while I'm gone and even have a treat.

Cycling has been good therapy. I like training and working hard. I've learned how to eat a balanced diet and that food is fuel for our bodies. In other words, eating is not bad or shameful.

Now I have the challenge of teaching my children how to eat. The kids help with the meal planning every week. I talk to them about how food supplies energy to our bodies and keeps us healthy. I emphasize the importance of eating a variety of food.

It's a daily battle. Somedays more-so than others.

[lph]

Thank you, limewave, that was insightful.

I'm curious if cycling also helps by controlling your natural appetite? Or do you have to think equally much about eating the right amount? I ask because I know that in inactive periods (illness, injury, exams) my appetite just doesn't work right and i end up eating just because, without really feeling either hungry or full (and getting pretty pudgy in the process). When I exercise a lot I feel very obviously HUNGRY, and then I feel FULL. And I just read a study recently that showed that exercise does measureably improve appetite.. uh, "precision", for lack of a better word.

Do you find that people don't understand the way you relate to food, or do you feel that many people feel the same way?

Feel free not to answer if I'm being too nosy on a sensitive subject.

[limewave]

I'm curious if cycling also helps by controlling your natural appetite? Or do you have to think equally much about eating the right amount?

Yes and no. If I eat the right combination of nutrition during a ride, I find that I am able to maintain a healthy and appropriate diet. But there are times when I am ravishing, usually later in the day or even the next day. Part of that I think has to do more with wanting to satisfy or assuage the fatigue that I'm feeling more than satisfying hunger.

Exercise and cycling helps with increasing endorphins and reducing stress and anxiety. Being in a better mood, feeling strong and healthy does help control my diet. In that sense, yes it does help.

Do you find that people don't understand the way you relate to food, or do you feel that many people feel the same way?

I don't think most people understand.

I feel constantly judged. We just had Easter which meant lots of candy, big meals with families, lots and lots of food. Last night was a pizza party. I made a healthy dinner that I had before the pizza party and opted to not eat pizza--especially after all the indulgences over the weekend. You would not believe the number of people commenting and judging me because I wouldn't eat the pizza. I tried to be discreet about it, but people pay attention to what other people are eating We are very judgmental and concerned about what other people are putting in their bodies--both ways. We judge people for eating the wrong things and then we judge people when opt for a healthier option. It's just one slice of pizza!

[goldfinch]

I think that there are many factors that lead to weight gain but it is undisputed that one of the most predominate factors is your genetic makeup and other aspects of your biology. There are separated twin studies that evidence this factor. A genetic predisposition in a world of plenty can mean fat for a large number of people. I look at the women in my family history. My sisters are round. My niece is round. My grandmothers were round.

Parents of children whose family is fat should work hard to instill habits in the kids that will help them resist overeating and that it might be harder for them then it might be for others to keep weight off.

The drug addiction analogy has truth in it as well. There is evidence that brain receptors (dopamine receptors) which play a key role in drug addiction play a key role in responses to food as obesity approaches.

http://dept.wofford.edu/neuroscience...ing2006/o3.pdf
http://www.nih.gov/news/health/mar2010/nida-28.htm

Once you are fat and lose the weight it is extremely difficult to keep it off. Not regaining weight may be a fundamentally different problem from why you gained weight in the first place. The fat cells are still there, wanting to be fed. Research on hormone levels after weight loss is still in its infancy but there is evidence that even after a year hormone levels did not go back to the original pre-diet levels. Ghrelin was up (an appetite stimulant) and leptin down (a suppressant). You are driven to eat. There are metabolic differences between me at 103 pounds who used to be 160 and a person whose consistent weight for adulthood was around 103 pounds. If your resiliency is low, maybe your are depressed or injured, it can now become even harder to resist eating and the food itself is rewarding, making you feel a bit better when you are down.

As loathe as people are to admit it, weight gain, loss and maintenance are complicated biological and psychological issues. Where I have beef is when people make it a moral issue, a failing of personal responsibility, a failing of the power of one's will: People who are fat are lazy and lack motivation. This is a moral judgment and not based on any kind of scientific understanding of weight gain and loss. It is circular reasoning as well. I would bet that just about everyone who has lost weight are highly motivated to keep that weight off. Extremely motivated. But unfortunately, desire or "will" alone are not a recipe for success. We need tools.

For me behavioral approaches helped, good old principles of conditioning. For example, if you tend to eat meals when you watch tv you may get hungry just by watching tv. So, break that connection by eating only at the table with the tv off. Or, you may eat mindlessly when food is available. Make it difficult to eat mindlessly by having only food around that requires preparation. Based on data gleaned from the National Weight Loss Registry there are factors which are shared by many who successfully keep the weight off. Number one, they are exercisers. As in an hour a day of exercise. They also keep close track of their weight and what they eat. There are other factors as well. How they lost their weight seems to vary and does not seem to be a significant factor in keeping it off. So, I weigh myself every day an keep a running trend analysis so I can catch small weight gains early. I count and record my calories, even if they are high that day. I exercise religiously. For whatever reason, I don't have a properly functioning weight regulator so I need these tools.

People say it is a lifestyle change. Yes, I suppose it is. It is adopting a lifestyle that a naturally thin person would not have to adopt. It may include having a rigid set of rules about how and when you eat and how much you exercise. It is more than just eating healthy and getting exercise. I have said that you need to be a bit obsessive to go down this path and was criticized for it on Bikeforums. Those who lose weight and keep it off are pushing their bodies to places that is not the norm for them. Given that most people regain their weight a single-minded preoccupation with keeping it off seems necessary.

Whatever the factors that enter into weight gain and loss, I am done blaming myself. All I can do is educate myself on what has worked for other people and try my best.

[goldfinch]

I feel constantly judged. We just had Easter which meant lots of candy, big meals with families, lots and lots of food. Last night was a pizza party. I made a healthy dinner that I had before the pizza party and opted to not eat pizza--especially after all the indulgences over the weekend. You would not believe the number of people commenting and judging me because I wouldn't eat the pizza. I tried to be discreet about it, but people pay attention to what other people are eating We are very judgmental and concerned about what other people are putting in their bodies--both ways. We judge people for eating the wrong things and then we judge people when opt for a healthier option. It's just one slice of pizza!

Groups of people are tribal. You are not fitting in. My neighbor ladies at my fall and spring home are constantly pushing treats on me.

[Catrin]

...We judge people for eating the wrong things and then we judge people when opt for a healthier option. It's just one slice of pizza!

Wasn't there a study done recently that focused on this? Food is about more to the human mind than simply fuel, it comes wrapped in all different kinds of packages, some of which comes straight from our family/culture.

As a member of a quite diverse Greek Orthodox parish (many of us are not Greek), I am very careful what I eat before attending dinner at a Greek home (or immigrant household in general). It is very much about hospitality and to not partake of the food offered is an insult, I understand this and I am there for the relationships - not the food. Thankfully, there is a lot of healthy choices in Greek/Arabic and Eastern European traditional dishes - and I start out with quite small portions because I know I won't be allowed to leave the table without seconds...

As far as cycling and nutrition is concerned. My diet was actually pretty healthy for the last 5-6 years when I was still 50-70 pounds heavier than now. It was more about my totally sedentary lifestyle and the wrong percentages of fats/carbs/etc. I pay far more attention to what I eat now because in my weight-loss journey I've learned that if I do not then it becomes easier to justify old comfort foods. As someone else mentioned, once that weight is gone, that diligence has to remain to keep it off. Being older and without a thyroid or reproductive system just makes that even more important. I also am prone to low-blood sugar if I am not careful so, yeah, I will always need to be vigilant in both food choices and exercise.

It helps to not have anything unhealthy around to eat, and I rarely have the budget to eat out - which helps

Added: I love what cycling has done to my body (I've lost a LOT of weight since starting 2.5 years ago - most of it in that first year), and my moods. My depression has almost completely disappeared and I am much more positive about me and the world around me. In learning how to fuel for the bike, and reversing diabetes II at the same time, I learned a lot about nutritional choices. Now, if I can just avoid further over-use injuries...

[Bethany1]

Food became a problem when I was first married and we didn't make enough money to really eat. It was feed the kids first and then take care of yourself which pretty much meant I wasn't eating much. Then when we did have food it was eat as much as you can because you don't know when your next meal would be. That was about 14 years ago and the mentality is still here. It's a double edged sword on your physical and mental health.

Later when I was diagnosed with epilepsy and bipolar most of the drugs cause weight gain with Depakote being the worst offender. With the highs/lows of bipolar eating has it's own problems. If you are depressed, you either eat to feel better or don't eat at all. If you are on the manic side, you are too busy to eat and only realize it when it's dinnertime.

Cycling has brought it's own food issues and I get torn on continuing to cycle. If you don't have enough food/calories (with the right food) when you start, you bonk. It's a terribly sick feeling and intensely frightening. When I'm done with the ride, there's this overwhelming desire for food as you've just gone through all that energy. When I ride past the BBQ restaurant, I'm dreaming of ribs, mashed potatoes, salad, and corn on the cob and end up going back with DH to inhale food. I've gained weight instead of losing it. Cycling can be physically and emotionally overwhelming. My entire metabolism has changed and no book goes over cycling for heavy people.

On the other hand my blood pressure is down and I'm gaining some better definition on my body. My back and fibromyalgia can handle the ride and there is a sense of accomplishment once you are done. For the first time in years, I'm outside almost every day.

It helps with the depression/mania even though I still get pretty cranky because of my limitations. It's helped with the anxiety of leaving the house and once I realized that my biggest fear of cycling is being stranded, I've been able to work through it. It's made me more independent and more confident.

I just wish I could manage the intense food cravings after the ride. I think because I'm heavier my body's metabolism after a ride is different than someone who doesn't weigh as much. Every book on cycling/nutrition has numbers for skinny people. The caloric intake for someone who is 150 lbs is totally different for someone who is 220. Obviously the food after the ride needs to be as healthy as the food you eat before a ride.

[Trek420]

Cycling has been good therapy. I like training and working hard. I've learned how to eat a balanced diet and that food is fuel for our bodies. In other words, eating is not bad or shameful.

That ^. I think for some there is/may be an addiction to the couch, the screen, the remote, the ever larger big screen TV is like a siren song for some tempting them to the rocks ...

Some foods are addictive. I've seen friends struggle to give up soda. It's tough, like kicking a heroin addiction not that I'd have any way to know about that.

My thoughts about healthy foods especially here in these United States are complex. Maybe I need to write a cartoon novel or cookbook. I'll try to condense. I'm 56 years young, arguably obese, I used to think "fit but fat" but now really doubling down to lose the weight. I'm a former souse chef, have a love for good, local, sustainable, delicious foods. What I see a lot is this:

Ever been in the supermarket produce aisle or even a farm market and seen folks with that deer in the headlights look? Or had people stop you and ask "What can you do with that?" "Uh, a potato? Ok, here goes, you can ..."

We (and when I say we I mean most Americans) know we should eat food that's made from food but most don't know what to do with it. The food industry (let's call it an industry) has us so removed from food that many don't know what to do with a pear, fennel and a walnut. We don't know how to prep, how to be creative, how you can make quick, fast, easy, affordable meals from real food.

We're losing the kitchen counter lessons of our families. I'm not saying mothers should be home cooking, My dad cooked too. We're losing the lessons of our cultures. Those need to be passed down from family and community, up from the kids, all around.

And let us not forget that many areas of this great country are food wastelands where produce simply is not available. People there are largely poor, busy, working class and there's your friend fast food "gotta buck, you're in luck". Fast food bills itself as the friend of the busy and working poor. Those need to be erased.

The only thing I'd change is the title. It needs to be "Teach everyone about food"

http://www.youtube.com/watch?v=go_QOzc79Uc

[SadieKate]

And I've had his story on my mind. Granted, his case is extreme, and I think very few people are unlucky enough to experience that level of psychic trauma. At the same time, his description of how incredibly hard it was to rely on pure willpower all the time, every day, to stay "normal" in a world where most people around him just... ate, was quite an eye-opener.

Like you, I've never been where he is but I do think it might help him to realize that those folks around him who "just... ate" may be also struggling with their willpower and habits. I know many people who've lost a significant amount of weight and you wouldn't know unless they told you.

It's like seeing a person use a handicapped parking spot and thinking "they don't need it!" Just how do you know they don't?

Yes, his case might be extreme but perhaps he should realize that few people "just eat."

[VeganBikeChick]

People say it is a lifestyle change. Yes, I suppose it is. It is adopting a lifestyle that a naturally thin person would not have to adopt. It may include having a rigid set of rules about how and when you eat and how much you exercise. It is more than just eating healthy and getting exercise. I have said that you need to be a bit obsessive to go down this path and was criticized for it on Bikeforums. Those who lose weight and keep it off are pushing their bodies to places that is not the norm for them. Given that most people regain their weight a single-minded preoccupation with keeping it off seems necessary.

What a wonderful post, goldfinch! So insightful! I am in awe in all that you've accomplished, and if I can take just a piece of that knowledge, it would help me so much. Thank you.

[Wahine]

I just wanted to thank lph for starting this thread and for all of your thoughtful contributions.

As someone who deals with overweight people regularly, this thread has given me a lot of insight. It's hard for me sometimes to not get frustrated when I know that a person's back pain/knee pain/hip pain would be so much better, if not disappear if the individual lost some weight. Hearing very candid accounts from your position, will help me help my overweight patients.

Thank you.

[goldfinch]

Like you, I've never been where he is but I do think it might help him to realize that those folks around him who "just... ate" may be also struggling with their willpower and habits. I know many people who've lost a significant amount of weight and you wouldn't know unless they told you.

It's like seeing a person use a handicapped parking spot and thinking "they don't need it!" Just how do you know they don't?

Yes, his case might be extreme but perhaps he should realize that few people "just eat."

Yes, you don't know other people's struggles. And maybe few people just eat. But very few people go from morbid obesity to normal weight and keep it off. Everyone who does that successfully is an extreme case. That struggle is significant and I feel it should not be minimized by saying that everyone has their issues. The physiology of the ex-obese person is different from someone who has always been normal weight and maybe deals a bit with five, or ten extra pounds. I do not even think it is out of line to compare it to drug addiction.

So, my opinion is that it is likely not helpful for him (or for me) to realize few people just eat. I am sorry, but mentally roll my eyes at that kind of statement. Instead, he can acknowledge that his struggle is significant and different and substantially harder than the efforts of those who were never as fat as he was.

This is my opinion, fwiw. I do tend to have rather strong opinions.

[limewave]

Yes, you don't know other people's struggles. And maybe few people just eat. But very few people go from morbid obesity to normal weight and keep it off. Everyone who does that successfully is an extreme case. That struggle is significant and I feel it should not be minimized by saying that everyone has their issues. The physiology of the ex-obese person is different from someone who has always been normal weight and maybe deals a bit with five, or ten extra pounds. I do not even think it is out of line to compare it to drug addiction.

That is my big fear! I've managed to keep off 160-170 pounds for 10 years now. But I feel like I'm one misstep from being morbidly obese again. I did go back up to 200 pounds when I was pregnant with my son (that's 200 pounds after I gave birth to him). It was a real struggle to lose weight a second time. My goal now is to get on the scale every day and try to maintain. If I go up 5 pounds, I can correct it before the extra 5 pounds turns into 10, 15 . . . 30.