On Health and Diet (and Moobs)

On Friday, I had yet another followup appointment with the Doctor. It went about as well as I could have hoped…but wait, let me back up a little bit first.

It’s no particular secret that my body has made the (probably accurate) determination that I am a absentee landlord/slumlord and has largely given up trying to support my hedonistic1 lifestyle, but in the past several months it has gotten to the point where I really felt like I had to do something I tend to avoid doing…I went and saw a doctor.

Now, it’s not that I specifically have a problem with doctors. I recognize that I’m not immortal and that they serve a very necessary purpose in my life, but I maintain this knowledge while at the same time having precious little real desire to go see one for trivial things like flat feet, insomnia, tendonitis, or weight gain.

So, around three weeks ago, I took my flat feet, insomnia, tendonitis, and weight gain to a local doctor that I met when taking my daughter to her office. We have a good rapport and she seems smart, trustworthy, and not liable to be entirely aghast at my shenanigans. Some orthotics were prescribed for my flat feet, some cortisone was injected into my elbow for my tendonitis, and we started what was to become multiple rounds of blood work to establish the cause of my recent rapid weight gain, my inability to lose any weight regardless the circumstances, and my inability to sleep for periods of time longer than 4 hours.

My weight became something of a concern almost two months prior to the visit, when I decided that I’d finally had enough of a break in my schedule to do something about my massive weight gain. After spending two weeks recording my food intake (and doing little else), I decided to cut my caloric intake by 1000 calories (from an average of about 3200/day to 2000-2200/day) and add walking 2 miles each of two to three times per week.

I nailed it. Over the course of about six weeks, my highest intake day was just under 2400 calories, and that was the only day that it was over 2200. Most days I was under 2000. I missed only one complete week of walking during that time, but every other week walked my 2 miles at least twice, averaging around 30-35 minutes per trip. I went in for my follow-up expecting to see a nice, gentle 2 pounds down per week (I’d have been happy with 1, but I secretly hoped to see 3). The grand total I lost after what amounted to a fairly extenuating change?

Can I get a drumroll!? (And if you don’t see where this is going, I’m awfully disapointed in you.)

I lost a grand total of -1 pounds. That’s right, I was a pound heavier than when I started. Well, technically speaking, 0.9 pounds, but you catch my drift.

The Rich Get Richer, the Fat Get Fatter

Needless to say, I was annoyed. My bloodwork showed very mildly elevated liver enzymes and NOTHING else. My cholesterol was great, my blood pressure was great, my fasting blood sugar was fine, my iron was okay—everything was peachy. So we sat down and we went over my diet. During the time we were discussing, I wasn’t excessively carb heavy, but I didn’t limit my carbs. I don’t really do sugar, so there were no sweets to speak of. The fat content of my daily intake was within the range we discussed most days (generally in the middle of the range). I’d even started eating three meals per day at more regular intervals than in the past.

“Wait right there,” she said, “explain ‘started eating three meals per day’ and ‘more regular intervals than in the past’ for me.”

So I explained. I explained about how generally I’m not hungry in the mornings, so I rarely eat breakfast. Around lunch time I’m pretty hungry, but usually busy, so if I eat, I don’t eat a ton. I explained about dinner time, and how when it rolls around I’m usually starving, so I eat a TON. I explained about how I often eat again later because I’m still hungry. Throughout the telling, she inquired about various things, and I labored to answer as fully as possible given how little attention I’ve always paid to such things. In answer to what percentages of my daily food intake I thought took place before noon, before 8 and after 8, I guessed 20%, 40%, and 40%, roughly?

She immediately interjected, “Hold on, so if you were eating 3000 calories, that means you were eating only about 600 of them in the morning, and at night, after 8pm, you were eating 1200 or more calories?”

I acknowledged the accuracy of her math, and we discussed the factors that could be contributing to my weight. As she described it, if she were to explain to someone how to best gain fat as quickly and efficiently as possible, she would basically describe my lifestyle (only she would add cheesecake, an amendment I heartily endorse): limit sleep as much as possible, work a sedentary job, add a ton of stress, and load as many calories as you can as late as you can and in as few meals as you can. It’s the Jer Diet, guaranteed to boost your weight or your money back!2 My metabolism, as she put it, no longer metabolized; I had essentially made it dormant by keeping it in a sustained fight-or-flight food hoarding frenzy through stress, starvation followed by binging (alas, no purging though), and torturing my body with exhaustion. Food came in, and my body screamed out “MINE!” and resolved to let as little out as possible since I was constantly tricking it into thinking we were starving to death.

Fair enough, but what about the six weeks wherein I didn’t do that? What gives?

She opined that my metabolism, after nearly a decade of such abuse, might need a lot more to kick back into normal gear. So we developed a new plan.

The Plan

She said that I needed to pull three areas of my life together. First, I needed to start sleeping. Perhaps I wasn’t the sort of person that needed 8 hours per day, but obviously I need more than 4 or I wouldn’t survive on caffeine and sarcasm (probably just the sarcasm). She put me on an anti-depressant (whose name escapes me) that, as she put it, “is not a very good anti-depressant, but makes a pretty good sleep aid.” More importantly, she felt that with the way my sleep issues manifest and the fact that I’m a recovering drug addict, this was my best bet for some much needed sleep.

The second area: stress. She reiterated back to me the list of things to which I’ve whittled my responsibilities and pointed out that it was still a lot. Quite a lot. I agreed. My doctor and I both agreed that since I was unlikely to cut MUCH more from my plate, what I had to do was actually schedule relaxation and stress relief. She wants me to get a massage (and sure, money permitting, I’ll get right on that…I’m guessing insurance won’t cover stress relief massages), do a relaxing hobby, spend time with friends and family—all on a schedule. The premise being that if I schedule this time, it’s time into which I can’t schedule other things, so I’ll be forced to relax some. We shall see how that works, but I’m game to try.

Finally, there was my diet. I simply had to get my metabolism going. To do so, I had to schedule my meals better, consume less carbs (not a low carb diet in the Atkins or South Beach sense, but low carb in the “only one serving per meal and make it a non-white carb if possible” sense), and eat much more protein. I looked at Tim Ferris’s Slow Carb Diet (or 4 Hour Body), and while it intrigues me and is close to what my doctor prescribed, it is dissimilar enough that I want to wait until I’ve given her program a run before I diverge. In order to kick-start things metabolically and supress my appetite some, she gave me a prescription for phentermine once per day in the morning. While I’m on that, I’m not doing energy drinks so as to minimize the chances of some of the more heinous potential side effects.

So, for about the last week, that’s what I’ve been doing: trying to relax, taking my go pills in the morning, taking my stop pills shortly before sleep, and concentrating on fixing my eating. So far, I feel great (but when in the history of dieting has the first week ever not been the best week, eh?). Last night I slept an uninterrupted 7.5 hours and I feel really good today. After getting over the initial hump of taking phentermine (when taken on an empty stomach, it makes me feel unpleasant and drug-trigger-y), that is settling in. I’m still consuming 2000 calories or less per day (closer to 1800, atually), but now it’s pretty close to even across all three meals, and there’s no second dinner. I’m consuming at least 40 grams of protein within a half hour of waking up to get things moving (a big protein shake is really helping there) and am making my meals pretty carb-light and protein heavy. The upside is, I generally feel more full despite the fact that every night this week I’ve noted that I’ve fallen short of my caloric goal by around 100-200 calories.

Moving Forward

Will this work? Who knows. The only real diet that I’ve ever been on in the past was when I was lifting and trying to get more muscle definition. At the time, it worked great. At the time, however, my principle caloric load was beer and protein—heavier on the beer than the protein. That said, I was a super lean 185 and very, very drunk. I forsee a very different result here. Ideally, I would like to end up having dropped 80-90 pounds. When I was under 200, I looked emaciated. I think 200 to 220 is a good weight for my frame, but I have a fairly long 75 to 95 pounds shed on the way there. What I won’t be doing is daily updates on my social media feeds. I hate seeing it, and while I know that it is supposedly meant to breed accountability, the fact is that I don’t feel particularly accountable to you guys and gals, no offense. I have one friend that does it ‘right’ by my reckoning: she has lost something like 100 pounds and periodically she’d just point out that she was up or down X pounds. It was like a normal status update; like it should be. That’s what you can expect, normal Jer-like lamentations about how I want to make sweet love to a Double Whopper while eating a (different) Double Whopper or how I’ve gained 2 pounds and am going to go slice off a moob3. Perhaps, if we’re all lucky, you’ll get notices about how I’m losing weight like crazy, looking all buff, and sending pictures of my weiner to interns…but now with SHIRT OFF! You know, business as usual…

[Updated 11 Sep 2011]: If you’re interested in how it’s turning out, there is a follow up here.

1 For a loosely-defined version of “hedonism” that basically consists of swearing, petulance, energy drinks, and leering.
2 Not a diet. There is no guarantee. You’ll get no money back. You probably won’t even survive it. Do at your own risk. Unless I hate you…then, fire away!
3 Moob: Man Boob. If I shaved them, I could probably get off to pictures of them.