Friday, May 13, 2016

Why I Love the Always Hungry Diet: Obese, Post-Menopausal Woman on the Journey to Being "High Normal"

I've been a fat person for nearly 50 years, an obese person for nearly 33 of those years, and a morbidly obese person for about 3 of those years.

With bad cholesterol, high blood pressure and the like, I've known I needed to be a thinner person for a long time.

Ever since I was very small, I always preferred processed carbs and protein. Didn't like any vegetables except for potatoes (of course), carrots and corn. Not a fruit lover either.  Major junk food fanatic.

Usually I was a kid looking at the camera, but here I am at about 5, staring at a friend's birthday cake.

But I really didn't get fat until I was about 9. The year was 1966, Twiggy was the major role model and being thin was more than in.  By the time I was 11, I looked more like this.

Being a fat girl in high school in the '70s was a miserable experience.  I was harassed about my weight every single day.  But I kept on eating, kept on feeling depressed and angry, and hated gym class most of all.

I decided to go as far away to college as I could afford.  That would be about 550 miles - from central Massachusetts to southwestern Pennsylvania and Carnegie Mellon in Pittsburgh.  By the time I got to college, I'd started reading science fiction and hanging out with science fiction fans.  Fans were much more accepting of people of all sizes.  I understood I  should accept myself no matter my size and not be a self-hating fat person.  And I met & fell in love with Jim Mann who was a fan who loved me back.  So, we got married, had a daughter, worked hard in the computer industry...and, over 20 years, I ate my way up to 255 pounds, even though I was happy most of the time.  Should note - I only gained 20 pounds when I was pregnant, but while I lost 15 pounds right away, I gained most of the baby weight back.

I did periodically diet a little and would sometimes lose 20 pounds...then gain back 25 pounds.  I lost weight when Leslie was a toddler and had to chase after her, but gained 30 pounds in a few months when I went to work full time and was sitting at a desk.  And we had pizza a lot in those days.   But I really hated dieting as I was hungry all the time and still didn't like most vegetables, though I would sometimes eat salad and had learned to like cooked broccoli and tomatoes that hadn't been turned into sauce.

Here I am at my 20th high school reunion, the time you want to be exceptionally thin.  I was close to my all time high weight (I might have weighed as much as 260, but I didn't have a scale in those days).

I was torn.  On the one hand, I honestly believe we should like ourselves and never hide ourselves away no matter our weight.  We shouldn't harass fat people. Being fat is not inherently bad or mean that you're lazy, stupid, non-sexual or have a character defect.  But...being fat can be unhealthy.  My blood pressure and cholesterol were already creeping upward.  I wasn't particularly active. 

It wasn't like I woke up one day and started eating better and exercising.  Very gradually over the next few years, I started doing simple things like parking further away when I went places.  Trying to eat a little less and a little better. Having a little less junk food in the house.   And I finally bought a scale.  By the time I was 40, I was down about 15 pounds and noticed I could stand longer and walk a little more.

So between the ages of 40 and 55, I continued working on a very gradual weight loss and activity increase. But by my late 40s, my cholesterol had gotten bad enough that I went on Lipitor. Later, I had to add a blood pressure drug.

In my mid-40s I developed severe insomnia.  I want to note that I was down about 25 pounds from my all-time high weight, was walking more, and when I finally had a sleep study I did not have sleep apnea.  Women in my mother's family tended to have insomnia from about the age of 45 until they were through menopause.   I wound up going on Ambien.  That gave me about an extra half hour of sleep a night...and, an odd side effect - Ambien depressed my craving for carbohydrates.  While on Ambien, I lost about 5 pounds a year.  However, Ambien stopped working as a sleep aid after a few years, as it inevitably does, so I went off it and the renewed carbohydrate craving, combined with going through surgical menopause, led to a 5 pound weight gain overall.  Not horrible, all things considered, but kind of depressing.

As I was generally unemployed due to my lack of sleep and we'd moved out to the country, I took up walking more seriously in 2012.  I started walking 2 miles a day and the next year 3 miles a day most days.  But, being post-menopausal meant my weight would rarely budge.  When we traveled, I would always gain a little weight, and when I got home, I would get back to the pre-vacation weight pretty quickly...except the weight wouldn't go any lower.  Here are Jim and I on a Game of Thrones tour outside of Belfast in August 2014.  I weighed about 220 in this photo.  During a 3 week trip to the UK that year, I walked 75 miles but gained 12 pounds.  I lost 10 pounds pretty easily when I got home.  When I got back from that trip, I realized there was a Diabetes Prevention Coach working in the same building as my doctor.  Given my weight issues and the fact that there have been a number of type two diabetics in my family,  I started going to see Joellen Brewton.  It was helpful to go and talk about food issues, weight issues.  She encouraged me to avoid juice (which I was able to do) and avoid carbohydrates (which I wasn't having as much luck with).  While I wasn't working, I was doing a huge volunteer project in 2015, which meant I didn't walk as much as I'd hoped and I often found myself snacking.  I was also achy and generally not feeling very well even after the volunteer job was over.

In late 2015, realizing 2016 would mark 50 years of being a fat person, I felt I had to make changes.  I decided I would walk at least 1,000 miles and would start dieting very conscientiously, on January 1.  And I did, but I was having the same problem I always had when I dieted - I was always hungry.  

In early January 2016, I was listening to the radio and heard Dr. David Ludwig, an endocrinologist, talking about dieting.  Yes, he had a new diet book out and it was called Always Hungry?.  Everything he said sounded extremely reasonable. Hmmm.  I think I ordered the book from Amazon before the show was over.  What did I have to lose?

In early January, I started tracking my eating and lost 2 pounds the traditional way--eating less of everything, being hungry all times and craving carbs a lot.  In mid-January, I got the Always Hungry? book and leapt into it (it encourages you to take a week to read the book and clean out your pantry).  Suddenly, I was eating eggs and full-fat yogurt and making shakes and not eating bread.  Aside from its Phase 1 which is pretty strict, it encourages you to adapt the diet to suit your likes, so long as you avoid processed carbs (bread, pastas, cookies, alcohol and also potatoes).  By following Phase 1 very strictly, I stopped craving breads and chips almost immediately.  Eating more full-fat foods and more vegetables (learned to like roasted cauliflower!!) made a huge difference.  And the recipes, developed by Dr. Ludwig's wife chef Dana Ludwig, were mostly excellent.

During January, I lost 7 pounds.  Yes, I know some of that was water weight.  But still - 7 pounds without feeling constantly hungry or wanting crackers.

I found a weird but good way to keep exercising even in the winter.  I walk 2-4 miles outside almost every day.  When it was too cold or rainy to walk outside, I'd walk around the rooms of the house.  It took about 21 minutes to walk about a mile in the house.  I'd also climb up to the second floor at least once a mile.  I've been able to keep walking 100 miles a month that way, well on the way to walking 1,200 miles this year, even more than I'd planned.

After 2 weeks, the Phase 2 of the diet encourages you to start re-adding whole grains and the like.  One food Always Hungry? recommended a lot was steel-cut oatmeal.  I found quickly that nothing, and I mean nothing, makes me crave more carbs as badly as steel-cut oatmeal does.  This diet encourages you to listen to your body about cravings, and I did.  So I stuck to either having eggs, a yogurt berry shake or a fritatta (more eggs) for breakfast - no oatmeal, cereal, or my longtime traditional breakfast of a piece of whole wheat toast, Smuckers all-natural crunchy peanut butter and a glass of skim milk.  We haven't had skim milk in the house since January which is very odd, but I don't generally drink whole milk either.  I've generally been drinking kefir (a yogurt-based drink) or water.  And generally one Diet Coke a day.  While the diet discourages artificial sweeteners (and there are some people who are quite fanatical about that), I like my Coke and appreciate having a little bit of caffein every day since I can't drink coffee.

Other cheats for me - some crispy-burnt hash browns when I have an omelette in a restaurant, small pieces of crusty cibatta bread, a few whole wheat crackers occasionally with peanut butter.  Generally limit alcohol to trips, and try to stick to prosecco but still enjoy a beer, red wine or Moscow mule from time to time.  But I was surprised by how well steamed cauliflower and white beans mashed together will substitute for mashed potatoes. And some of my favorite foods like unsalted peanuts and cheddar cheese are not cheat foods!

I've lost 17 pounds over 19 weeks.  Now, granted, that's not a huge amount of weight, it's slightly under a pound a week. My BMI is still in the obese range at 31 but it's getting closer to the merely overweight range all the time.  But as a post-menopausal woman who does, admittedly, cheat on this diet, it tells me I've finally found an eating plan I can live with and lose weight.  I'm down a total of 57 pounds since 1996, without gastric surgery.  I'm finally learning how to eat and exercise most of the time.  We travel some and I love to go to restaurants.  There I will eat and drink things I avoid at home.  I generally come home a couple of pounds heavier.  But I go back on Always Hungry Phase 1 diet pretty quickly, the vacation weight goes away in days and I go back to losing about a pound a week overall.

The thing I particularly like about Always Hungry? is that the carbohydrate cravings are gone.  Most afternoons, I can have fruit or cold (but cooked) cauliflower with hummus. Yes, I do sometimes get hungry between meals but mere hunger is much easier to deal with than carb cravings.  My diet counselor says that's a clear sign that my insulin resistance is in good shape.   And the second most important thing is that my cholesterol  and blood pressure are both better.  And...I still like food.  Dieters tend to view food as the enemy.  We need to eat and I'll eat unapologetically.  But I'll eat better and move more most of the time.

Most people report a lot of physical changes improvements from dieting.  I couldn't say the Always Hungry? diet made me feel better or sleep better.  In fact, I've felt like crap most of the last year.  And then I realized - a common side effect of Lipitor is body aches.  Maybe, even though I didn't have body aches the first 11 years I was on Lipitor, maybe I was getting them now?  So I took myself off of Lipitor...and the body aches went away over a week.  At the end of June, I'll ask my doctor if I can have another cholesterol test to see if the dieting is keeping the cholesterol low enough without medication.

So thanks, Dr. Ludwig and the Always Hungry? diet book for finally helping me to find an eating plan that will help take me from being an obese women to being a more normal weight.  And thanks to Joellen Brewton for providing excellent counseling over the last two years.  My goal is to get down to about 150.  I will probably still look a little fat at 150, but, technically, that's "high normal."  I haven't weighed 150 since college.  I will generally avoid processed carbs.  And any time I reach 160 pounds in the future, I will go back to eating Phase 1 of the Always Hungry? diet.

Laurie Mann, 5/13/16, 5'7", 198 pounds