Three, count ’em, Three meals a day!

NurseBob_1
Well, as of last evening, my cohort has progressed to three “actual food” meals per day, with consideration regarding the meal replacements, which can also be included depending on need.
For me, I’m still including a couple of the chocolate shakes (320 calories total per day) in my meal planning. They are convenient, and while not absolutely “tasty,” they are better than a mere “OK.”
Since I am hoping to continue to lose weight for awhile, I’m targeting a total of 1200 calories per day, and the old carpenter in me seems oddly attached to 3-4-5 (a handy right triangle for determining if a corner is “square” – 90 degrees). Of course, I need to adapt that to my current situation: Weight loss, and the multiplier of 100 for each digit. Thus, the reality of my plan is actually… Breakfast – 500 calories, Lunch – 400 calories, and dinner – 300 calories. However, I’ve broken away from the traditional “three meals per day” and am back to what I did as a child – grazing my way through the day. The variation? Now the first six hours of the day will be breakfast and a mid-morning snack – the first 500. Then lunch and a mid-afternoon snack that combine to the the next 400, and finally dinner and an evening snack that complete the plan with the last 300 calories for the day.

Perhaps the most significant change to my diet behaviors (this is, after all, a behavior modification program), has been to break free of my “addition” to milk, half and half, and white sugar. Like an alcolholic, I always made sure that there were sufficient supplies of all three on hand. And “sufficient” could be read as “lots.” I’ve not touched the unholy trinity for over four months, and attribute most of my weight loss success to that simple change. I do, at times, really miss the cream in my coffee, and that “white” concoction sweetened excessively. Happily, while missed, it’s not missed to the level that I can’t wait to get back to the pattern. Surprisingly, I really am OK for the vast majority of the time with keeping the new status quo – coffee “whitened” with unsweetened almond silk, then sweetened with a touch of stevia. While it tastes nothing like what I used to drink, it is surprisingly acceptable. And on those days when I need something more, I do a mocha instead, using the soy-based chocolate shake – though that does add 160 calories. The silk adds at most 15.

I’m off on a five day trip to Death Valley with my best friend. The challenge on the trip will be to make appropriate menu selections from the restaurant fare. I believe my friend can be easily recruited as a supporter for my continuing goal.

Well, time to post grades for my RN students, then pack and prepare for my 04:00 departure tomorrow. If all goes well, there should be some photos, and maybe a video or two, to share. Fingers are crossed; there’s a report of another “super bloom” in Death Valley. I had the good fortune to see a similar event in 2005.

Stay Well,

Bob

T Minus 45 and holding…

Bob at 240#

Bob at 240#

Well, if your memory of “T Minus… and Holding” has you recalling NASA’s missions to land a man (uh, person) on the Moon, then you’re likely in my age cohort. If not, well you’re likely a bit younger than I.
Then again, from my current perspective the phrase has nothing to do with Space, NASA, or astronautical adventures. Once again it’s a weight reference. In this moment it’s my hovering around 193 lbs (87.72Kg or 13st 11Lb – I LOVE Scotland and the Scots!!!), which is a couple pounds away from 50 pounds lost. Fifty is neither my goal nor a magic number, but has become significant since I’ve been feeling stuck.

What’s up? Well, I’ve been hovering at that weight for most of the last week. And, “Why stuck?” you ask… Well, I’m struggling to stay on plan; struggling to increase my level of exercise from sedentary to not sedentary. Did I mention struggling to stay on the plan and not exercising enough?

’nuff said. The short, insight-less vision: some weeks are harder than others. This week has been one of the more challenging. In my last group meeting we were all to select a partner we could confide in. While there is an individual I would like to add as an understanding “sponsor,” he’s out of town. Hell, he’s out of country in Patagonia. So, I’m opting to use my other connections as part of my support network. Those would be all of you on FB, Twitter and Linked-in. I appreciate all the wonderful expressions of support I’ve received from all of you. While I may not always adequately acknowledge the support and comments, they are deeply felt and appreciated. Setting out on a more beneficial and insightful path, I have come to realize it’s time to use other additional resources and help. This is not something easily accomplished in state of emotional or social isolation, which is where I tend to go in times of stress.

Thus the work continues. Currently my greatest food/feeding challenge is when I have engagements that have me traveling in the greater Bay Area during business hours. I find I’m near OCD in my newfound desire to eat in places, and have dishes, I don’t normally care much about at all.

Where do these near-overwhelming urges and desire originate? Who knows? Is it just my physiological being, my body, saying, “Eat More! I need FAT! I need SUGAR! Oh, and a bit of protein would be OK too. Then again, is this related to my gut bacteria, my microbiome , calling the shots? Who’s in control, or out of control, here?

Short answer: I don’t know. All I “know” is, at times I am very hungry, and if I’m out and about, the temptation is overwhelming. On the other hand, and perhaps most importantly, I know you are out there on my side; rooting for me; and whether I want it or not, reminding me of the goal.

So, the story, and challenges of my weight loss journey continue, but not without a massive “Thank YOU!!!” to you all. You have no idea of how important and effective your support has been, and will continue to be… 🙂

Stay Well,

NurseBob

Medical Weight Management

NurseBob_1

My self-directed and self-managed attempt at a ketogenic diet this time last year was successful until… my wife and I traveled to Santa Fe, NM just after Christmas for just a week.  While on the road I went off my diet after having lost 20 pounds; upon our return home I was unable to resume the resume my plan, and, as happens to many, most? I had a “rebound” experience and gained back the 20, plus 5.  Argh!!!

I came to the conclusion that I could not do this on my own, and that my best bet was to enroll in a medical weight management program.  Last week I started in earnest with a Kaiser-based program. The program has demonstrated good results in the past, and I know from a personal contact who successfully did, and remains on, the program (officially 82 weeks, but apparently, a life membership for support meetings), that long term success is possible. Though a KP member, this program is outside of the KP benefits, so it’s out of pocket, about $800/month for the first four months, which includes weekly meal replacements.  After that initial period the cost drops significantly, but having not reached that point, I’ll hold off on any cost estimate for now.

My long term goal is to lose about 70 pounds. I have, in the first week, dropped 12 pounds.  Now, much of this is likely to be water, so I expect this weekly number to drop pretty rapidly to a more realistic 1-2 pounds per week.
Since weight loss tends to be physiologically sexist, I do expect to experience a more rapid rate of loss than most of the women in my cohort.  For now my diet is 960 calories daily, with a less than wonderful menu of two shakes, two soups and two nutrient bars per day.  To the credit of those at KP who designed the program I’ve not been starving, just had moments of elevated hunger.  I know that to get to sleep I need to have that last nutrient bar in the last hour before bed.

I will see if I can manage a weekly update on both the experiences and, I hope, successes of the experience.

The numbers:
Height: 5-10 – Hoping/expecting this won’t change over time… 🙂
Starting weight: 241 lbs
This week: 229 lbs
Goal: 170

Stay Well!

Bob

20 down, 40 to go

It’s been about six weeks since I decided a major lifestyle change was in order.  I mentioned that over the years my weight had increased by some 60 pounds over what matches my height and frame.

SOAPBOX ON
I’m not a fan of “fad” diets.  I’m careful to explore the basis for lifestyle changes, and especially in regard to diet.  There is such an overwhelming abundance of dietary advice and products, which in my view are mostly focused on generating profits for companies preying on the ill-informed, desperate, and unhappy segments of our population, which is a very, very sizable percentage.  Sadly, sound evidence-based, scientifically valid information is pretty much overwhelmed by the noise created by these unscrupulous purveyors of pseudo-scientific or mystical solutions to the real problems affecting many of us.  Further, on a similarly sad note, the level of education in this country leaves much of the population unable to see through these scams.
SOAPBOX OFF

However, someone I know and trust had recently experienced great success with a medically supervised Very Low Carbohydrate Ketogenic Diet (VLCKD).  Not only in successfully losing some 80 pounds, but also managing to make a lifestyle change in terms of diet for the long term which should aid in keeping those excess pounds off.

Given that, I decided to explore a similar diet.  Mine was started after an email consultation with my MD, and some six weeks ago I cut out all refined sugar, processed foods, and starches.  My goal:  under 20 grams of carbohydrates per day, and a target of 1000 – 1100 calories.  I’m basically on a moderate protein, higher fat and near zero carbohydrate diet.

The results so far: I’ve been steadily losing weight; I’m now 20 pounds lighter than when I began.  While I’m only about 1/3 of the way to my target of 160 – 170, I’m feeling pretty successful.

The experience:  To my surprise, and in truth, wonder.  I’ve rarely felt excessively hungry.  I do try to have a bite of something satisfying every 4 – 5 hours to forestall any sense of extreme appetite, but interestingly I’ve not had cravings for what I have cut out of my diet. And, believe me, I did like a lot of sugar in my coffee and cream, loved breads, chips, tortillas, pasta, etc.
Further, I’ve been sleeping better, have generally been in a better mood, and seem to be more stable in regards to mood swings (not that I experienced extremes)

Finally, I have a reasonable wardrobe which I’ve not been able to wear for the last several years.  I’m looking forward to having a “what’s old is new again” moment as I am once again able to pull some of those items from the closet, and hang them on me instead.

So, the experiment continues. As of this morning I’m on the cusp of transitioning from “Obese” to “Overweight” in the BMI table.  More in the future as I have more experience, and as I delve further into the physiology of this all.

Stay Well.

Bob

Other interesting resources:

Low Carb Dietitian:
Lipid Changes on a Very-Low-Carb Ketogenic Diet: My Own Experience

My Thoughts on Low-Carbohydrate Ketogenic Diets

My Thoughts on Low-Carbohydrate Ketogenic Diets, Part 2