Heard back from my NUT - made me cry - article attached
So, Katie at TWH emailed me back regarding my calorie intake versus my working out. I have been wishing to get to 131 pounds, to make it into the Century Club, but have been sitting between 134-139 since April (i hit 139 last October, and my lowest of 134 in April 2012). This note made me cry.
Hi Kelly,
You have done amazing and I think you may need to let go of that 100lb goal as that may just be too low for your body. Have you heard of the set point theory? I've attached an article so have a read and let me know what you think. I think that if your body is fluctuating between 134-139 this is likely where it wants to be. Take a deep breathe and spend some time reflecting on all that you've accomplished over the past 18 months. Hopefully you will see that the number on the scale means very little compared to all of your other accomplishments.
Take care,
Katie Warwick, RD
Bariatric Dietitian
Toronto Western Hospital
416 603 5800 ext 6145 press 4
[email protected]
For more info on the TWH Bariatric Surgery Psychosocial Program
http://www.twitter.com/TWHBariatricPsy
And here is the article she mentioned;
Set Point: What Your Body is Trying to Tell You
By Donna Ciliska, R.N., Ph.D.
Why is it that when you are trying to lose weight, the rate of weight loss usually slows down, stops, and often weight starts back up again, even if you are still following the recommended program? This nearly universal reaction is very discouraging to those trying to be thinner. You think, "There must be something wrong with me. I must need to cut back more in order to lose or maintain the weight loss." When the next plateau arrives, you think, "Why bother trying any more?" The deprivation no longer produces the desired result, leads to over-eating (maybe even a binge) and weight is quickly regained.
Determining body size by set point
The human body is able to adapt to situations of excess or insufficient energy intake (food). Several studies have shown that not only eating habits, but also genetics determine adult body size. For adults who do not consciously try to control their body size, weight is remarkably stable over time. These three factors together have led to the description of a "set point" - a reference point around which the body tries to keep a weight stable. An example of another set point is body temperature - if temperatures go above or below 37oC (for example, from infection or exposure to a cold environment) there are a variety of physical mechanisms that "kick in" to try to get back to, and maintain normal body temperature.
Each individual may have a genetically determined set point for adult weight. If weight is gained it has been shown that some people experience an increase in metabolism (the rate at which calories are used) so that excess energy is wasted. Following this period of weight gain, it is relatively easy to revert to the previous set point weight. However, trying to go below the set point weight has the opposite affect. Metabolism can slow down as less food is eaten or exercise is increased. This leads to a slow down in weight loss, a plateau, or even weight regain on few calories. This is your body's attempt to keep your weight stable.
Maintaining weight loss
These mechanisms have been used to explain why few people are able to maintain any weight loss following a reducing diet. Those who do maintain a lower weight were probably above their set point when they started the diet. They lost weight down to their set point and were able to maintain at their set point without constant restriction.
However, for those already at their set-point, but above "average" weight, a reducing diet attempts to get them below set-point, resulting in slower metabolism and quick regain on few calories, as the body attempts to keep the physically "normal", but culturally "high" weight. Your set point, unlike your brain, does not care about current fashion. You may say that a weight of 70 kg is too high for how you would like to look, higher than the height/weight tables tell you to be and, indeed, higher than your family doctor tells you to be. However, it may be exactly what your genes are telling you to be. This creates a real conflict. Fashion models are now 23% thinner than the average North American woman (see "Body Shame" article). A very small proportion of the population is naturally that size. The rest of us fight a "no-win" battle if we try to achieve that ideal.
Measuring set point
One frustration with the concept of set point is that there is no direct way to measure it. You cannot say that your set point is 65 kg. You can only estimate that you are at set point if you have been eating "normally" and participating in moderate exercise for about a year. It is estimated that it takes that long, free of dieting, to allow your metabolism and weight to return to what is normal for you. Of course, this applies to adults. The concept cannot be applied before growth has stopped. One other observation to make is to look at your family of origin. What size were your parents, their siblings or their parents? Predisposition to be a certain size "runs in the family" and ignores the current fashion!
There is controversy about what alters set point. Pregnancy, for example, increases the amount of body fat as well as weight. It is an area of research interest, looking at why a group of women revert immediately to their pre-pregnancy weight, and other women never do. Some researchers say that factors such as repeated dieting or certain drugs permanently elevate the set point, meaning that you will likely stay at this new higher "natural" weight. Others say that you are "artificially above set point" and will revert to your "natural" weight in time. At present, there are more questions than answers.
Healthy weights
So what does this mean? Does this mean you can never be thin? Does it mean that you can eat whatever you want and never gain weight? You can lose weight; you can gain weight. However, the implication of the set-point concept is that the farther you get from your set-point, the more difficult it is to continue, and your body will try to revert to your "natural" weight. Allowing your weight to remain stable, at your own set point, is healthier than the diet-regain cycle.
It means that you should consider weight as you consider height. Just as people have the genetic background to be short, average or tall, they have the genetic predisposition to be thin, average or large. There are many positive activities to do instead of focusing on counting calories, eating "diet" food or exercising for weight loss. Choose activities that increase your sense of self-worth and efficacy. These may include fulfilling long time and long delayed desires, dreams and aspirations.
To summarize, there is good news and bad news. The good news is that you do not have to keep beating yourself up for being "weak-willed" or "lazy" as reasons for your inability to maintain weight loss. The bad news is that we are living in a culture which highly values thinness in women. We need to learn to accept ourselves and others at whatever they natural weight and to challenge the notion that thin people are necessarily happier, smarter and have more fun.
Hi Kelly,
You have done amazing and I think you may need to let go of that 100lb goal as that may just be too low for your body. Have you heard of the set point theory? I've attached an article so have a read and let me know what you think. I think that if your body is fluctuating between 134-139 this is likely where it wants to be. Take a deep breathe and spend some time reflecting on all that you've accomplished over the past 18 months. Hopefully you will see that the number on the scale means very little compared to all of your other accomplishments.
Take care,
Katie Warwick, RD
Bariatric Dietitian
Toronto Western Hospital
416 603 5800 ext 6145 press 4
[email protected]
For more info on the TWH Bariatric Surgery Psychosocial Program
http://www.twitter.com/TWHBariatricPsy
And here is the article she mentioned;
Set Point: What Your Body is Trying to Tell You
By Donna Ciliska, R.N., Ph.D.
Why is it that when you are trying to lose weight, the rate of weight loss usually slows down, stops, and often weight starts back up again, even if you are still following the recommended program? This nearly universal reaction is very discouraging to those trying to be thinner. You think, "There must be something wrong with me. I must need to cut back more in order to lose or maintain the weight loss." When the next plateau arrives, you think, "Why bother trying any more?" The deprivation no longer produces the desired result, leads to over-eating (maybe even a binge) and weight is quickly regained.
Determining body size by set point
The human body is able to adapt to situations of excess or insufficient energy intake (food). Several studies have shown that not only eating habits, but also genetics determine adult body size. For adults who do not consciously try to control their body size, weight is remarkably stable over time. These three factors together have led to the description of a "set point" - a reference point around which the body tries to keep a weight stable. An example of another set point is body temperature - if temperatures go above or below 37oC (for example, from infection or exposure to a cold environment) there are a variety of physical mechanisms that "kick in" to try to get back to, and maintain normal body temperature.
Each individual may have a genetically determined set point for adult weight. If weight is gained it has been shown that some people experience an increase in metabolism (the rate at which calories are used) so that excess energy is wasted. Following this period of weight gain, it is relatively easy to revert to the previous set point weight. However, trying to go below the set point weight has the opposite affect. Metabolism can slow down as less food is eaten or exercise is increased. This leads to a slow down in weight loss, a plateau, or even weight regain on few calories. This is your body's attempt to keep your weight stable.
Maintaining weight loss
These mechanisms have been used to explain why few people are able to maintain any weight loss following a reducing diet. Those who do maintain a lower weight were probably above their set point when they started the diet. They lost weight down to their set point and were able to maintain at their set point without constant restriction.
However, for those already at their set-point, but above "average" weight, a reducing diet attempts to get them below set-point, resulting in slower metabolism and quick regain on few calories, as the body attempts to keep the physically "normal", but culturally "high" weight. Your set point, unlike your brain, does not care about current fashion. You may say that a weight of 70 kg is too high for how you would like to look, higher than the height/weight tables tell you to be and, indeed, higher than your family doctor tells you to be. However, it may be exactly what your genes are telling you to be. This creates a real conflict. Fashion models are now 23% thinner than the average North American woman (see "Body Shame" article). A very small proportion of the population is naturally that size. The rest of us fight a "no-win" battle if we try to achieve that ideal.
Measuring set point
One frustration with the concept of set point is that there is no direct way to measure it. You cannot say that your set point is 65 kg. You can only estimate that you are at set point if you have been eating "normally" and participating in moderate exercise for about a year. It is estimated that it takes that long, free of dieting, to allow your metabolism and weight to return to what is normal for you. Of course, this applies to adults. The concept cannot be applied before growth has stopped. One other observation to make is to look at your family of origin. What size were your parents, their siblings or their parents? Predisposition to be a certain size "runs in the family" and ignores the current fashion!
There is controversy about what alters set point. Pregnancy, for example, increases the amount of body fat as well as weight. It is an area of research interest, looking at why a group of women revert immediately to their pre-pregnancy weight, and other women never do. Some researchers say that factors such as repeated dieting or certain drugs permanently elevate the set point, meaning that you will likely stay at this new higher "natural" weight. Others say that you are "artificially above set point" and will revert to your "natural" weight in time. At present, there are more questions than answers.
Healthy weights
So what does this mean? Does this mean you can never be thin? Does it mean that you can eat whatever you want and never gain weight? You can lose weight; you can gain weight. However, the implication of the set-point concept is that the farther you get from your set-point, the more difficult it is to continue, and your body will try to revert to your "natural" weight. Allowing your weight to remain stable, at your own set point, is healthier than the diet-regain cycle.
It means that you should consider weight as you consider height. Just as people have the genetic background to be short, average or tall, they have the genetic predisposition to be thin, average or large. There are many positive activities to do instead of focusing on counting calories, eating "diet" food or exercising for weight loss. Choose activities that increase your sense of self-worth and efficacy. These may include fulfilling long time and long delayed desires, dreams and aspirations.
To summarize, there is good news and bad news. The good news is that you do not have to keep beating yourself up for being "weak-willed" or "lazy" as reasons for your inability to maintain weight loss. The bad news is that we are living in a culture which highly values thinness in women. We need to learn to accept ourselves and others at whatever they natural weight and to challenge the notion that thin people are necessarily happier, smarter and have more fun.
Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!
Kelly,
I'm still pre op and am sure it's easier said than done but I agree you should be so PROUD of what you have accomplished already! I understand you want to see that 100lb loss mark, but try to look at all the things you have accomplished that aren't related to the numbers.
Hang in there!
Jenn
I'm still pre op and am sure it's easier said than done but I agree you should be so PROUD of what you have accomplished already! I understand you want to see that 100lb loss mark, but try to look at all the things you have accomplished that aren't related to the numbers.
Hang in there!
Jenn
referral: fall 2010, orientation: march 2011, nut/psyc: fall 2011, nurse: jan 2012, tests: march 2012, pre-surg class: Sept 2012, surgeon, Sept. 2012. Surgery: Nov 8, 2012
Thanks! It's something I have to wrap my head around for sure.
Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!
I'm going to try. Here's what i'm proud of. I can run 10k!! I can eat a proper diet. I can climb MANY flights of stairs without stopping for a breath.
Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!
Kelly I think you have a fabulous reply from her that says so much...
I wish I could wave my magic wand and just get you to that 100lbs lost for even a day but what then... The struggle to maintain it. The 5 lbs fluctuation you have is wonderful and just how it is suppose to be...
I hope you can take the article to heart and work from there.
Shell
I wish I could wave my magic wand and just get you to that 100lbs lost for even a day but what then... The struggle to maintain it. The 5 lbs fluctuation you have is wonderful and just how it is suppose to be...
I hope you can take the article to heart and work from there.
Shell
Dr Sullivan VSG Jan. 8th, 2013!
Lost 100 lbs in a year post op with a VSG.
Thanks. It's just a silly number, I do know that. I always feel like I didn't do enough. The article has helped me a bit, and I will refer back to it on occasion.
Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!
Kelly Kelly Kelly
Have we talked about "Mal"? That's the name I give to scales. In spani**** means evil.
Look at all you have done. You can run, walk, eat well, eat healthy.
You are focusing on a number of less than 5 lbs. That's dominating your thoughts.
and it's because of "Mal".
I think you should celebrate by THROWING MAL out the window!.. he isn't your friend you know. He is your enemy. Look at the emotional ride you're on because of him.
I would be so proud to be where you are... Your NUT is right. Listen to her.
And more importantly, listen to your body. It's happy. Unwind those old tapes and toss "Mal" to da curb!@
Have we talked about "Mal"? That's the name I give to scales. In spani**** means evil.
Look at all you have done. You can run, walk, eat well, eat healthy.
You are focusing on a number of less than 5 lbs. That's dominating your thoughts.
and it's because of "Mal".
I think you should celebrate by THROWING MAL out the window!.. he isn't your friend you know. He is your enemy. Look at the emotional ride you're on because of him.
I would be so proud to be where you are... Your NUT is right. Listen to her.
And more importantly, listen to your body. It's happy. Unwind those old tapes and toss "Mal" to da curb!@
Growing old is mandatory. Growing up is optional.
ICK!! Not sure that I could!! I will try after my next shrink session! :-)
Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!
I get it... Oh I get it.
I lost 78 lbs... not 80... 78... and I hang onto that but boy I cried when I got stuck there...
The problem is I didn't embrace it and I allowed myself to be put in situations that caused re-gain...
You've done so incredibly! Embrace it.... I honestly hope to lose about 95lbs... If I lose that and no more I am good. If I lose more... so much the better.
Shell
I lost 78 lbs... not 80... 78... and I hang onto that but boy I cried when I got stuck there...
The problem is I didn't embrace it and I allowed myself to be put in situations that caused re-gain...
You've done so incredibly! Embrace it.... I honestly hope to lose about 95lbs... If I lose that and no more I am good. If I lose more... so much the better.
Shell
Dr Sullivan VSG Jan. 8th, 2013! Lost 100 lbs in a year post op with a VSG.
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