The hardest week yet

So the quick calculations have me at 27 days in to an 84 day process and complete 33%!  That means 108 Optifast down and 228 to go.

Weeks 1, 2 & 3 were a relative breeze. Week 4 was horrible. Saturday and Sunday were miserable. I spent the whole time napping. 4 naps in 2 days? A bit much for me.

Temptation has been everywhere and my desire to eat isn't waning. I'm craving salt - it almost seems like I can smell salt. To the point where I wouldn't make good choices. The salted cucumber I craved in week 1 has been replaced by a desire for potato chips.
The consistency is helping, and there is weight loss. But looking back over the last 3 weeks it doesn't seem worth the effort.  If  rate I'm losing doesn't increase my 12 weeks fasting will have a total impact of:

1. reducing my activity level,
2. losing some of my positive habits around exercise, 
3. increasing some of my bad food cravings,
4. missing my kids and stressing my husband, and
5. losing on average 2lbs a week.

Would 24lbs be worth it?  Would 50lbs?

Is it worth running slower, feeling weaker?  Missing family meals?  Giving up an extra evening a week that could be spent exercising, being with my kids and giving my husband a break?

Right now the answer is a big fat IF.  This is only worthwhile IF it gives me a higher longer quality of life.  And my confidence about that is falling.

Not something I can answer yet, but at (what I hope is) the end of the worst week yet, it's hard to be positive.  But it's not impossible.

There are others out there

Just got a lead on a new to me blog.  I'll be following along with http://optifastblog.wordpress.com/.

Running Large: Running Again

Today I start back to a Running Room clinic. John Stanton is going to be able to retire on what I've spent on the For Women Only program, Learn to Run program and 5km Program. (To be fair, I probably made back what I've paid when I was a co-instructor for the 5k.)

My latest foray into Learn to Run was reasonably successful. I worked my way up to 10&1x2. So I'm moving up with most of my clinic to the 5km program.  I can already do the time, I tried it out a couple of weeks ago.  10&1x3 is doable. At my speed there's not much distance covered.

On the Partners for a Healthier Weight program during the 900 calorie OptiFast phase I can't increase my exercise. But since I've dropped a few other activities because summer is over, it should be fine.

The goal for this clinic is to keep moving. Based on my runs over the last 2 weeks I'll continue to lose speed from my super-slow speed walker pace to an even slower elderly-strollers-will-pass-me pace. Luckily there's a running buddy at my speed who keeps me at a reasonable starting pace. Looking forward to seeing her tonight.

Lesson 2: There is a choice

Taking away choice is - at the moment - a relief. It removes the stress of debate. Sometimes the choices should have been easy: greek salad vs cheesies. But sometimes they were more challenging: greek salad vs garden salad. Plus there was always a debate about enough of the right protein.

When someone else made the food, I was never confident what to pick. When I made the food the debate just happened during the preparation.

Other times it didn't seem like there was a choice at all.

As ridiculous as it sounds, to me it seemed my body was demanding a cinnamon bun. With certainty that a fortune teller would envy, I could predict that after drinking the water and eating the healthy snack I was still going to have the cinnamon bun.

But now I see how that was my choice. And it's a little scary. Because there's a slippery slope.

Friday there was a trip to Costco and the sample tables were out  My husband spotted and went for onion dip on ripple potato chips. It actually went though my mind... three chips can't be many calories, maybe I can have one. (I didn't!)  

But the next thought was, maybe that's why I'm still struggling to lose weight. Those little blts (bites, licks, tastes and snacks) over years must add up. If my weekly trips to Costco included 250 calories of samples, that alone could help me gain 1/2lb in one year.

Now that I know I can, the task will be to choose to skip those taste tests in the future.

Lesson 1: What you control

Choosing to participate in 12-weeks of a medically supervised liquid diet teaches you a few unexpected lessons. The one that hits home right now is:

1. you control what you control and nothing else.

Remember just a few days ago when I was worried over my weight loss?  It wasn't much worth worrying about. Because I'm certainly not worried about my weight gain.  Yes, you read that right, my weight gain.  I'm back up 2lbs.

Just so you know, I'm 100% faithful to the program to date. Not a morsel, calorie free or not, has passed my lips.  My water intake fluctuates between three and five litres a day. So on 900 calories of a perfectly balanced meal replacement, my body can still gain weight.

Oddly, I'm not worried or frustrated.  It's a relief.  It's never seemed believable that hormones and water might make me gain weight. Weight can be gained even if I'm on track for balanced calorie appropriate meals and exercise!  I have proof.  I can only control what I can control.

Next I need to take that discovery and turn it into action.  The number of pounds I weigh on any day is just a number.  It can help me know when the trend is going the wrong direction.  But what's really going to matter is:

1.  making good choices as often as I can, and 
2. not getting demoralized.

The number is just a number. It's a solution to an algorithm with too many unknown variables to calculate. It's as opaque to me as calculus. So I'll focus on what is clear.  How I:

1. fuel my body, and
2. how I use my body. 

Partners for a Healthier Weight: Week 3 Homework

The 3rd weekly meeting was focused on emotions & behaviour and led by our team psychologist.  It was heavily influenced, but not identical to, the material provided by Nestle as part of the OptiFast900 program titled "Taking charge of your attitude".

We discussed the A-B-C Model of Emotions and Behaviour. It's about how an Activating event leads to a Belief or attitude that is often destructive and the Consequence.  In some cases the consequence becomes the next activating event and a destructive cycle begins.  If I understand it correctly, it might go something like this for me:

• Activating event: Headache
• Belief: Food is going to provide comfort
• Consequence: Weight gain and a sense that I might as well give up

Next in the model is introducing the Disputing thought and Effective new philosophy.  So next would be:

• Disputing thought: Food doesn't provide comfort and it causes long term challenges
• Effective new philosophy: Food doesn't solve problems.  Think about what else can help.

I'm sure I've seriously misunderstood these.  Because I'm not making any progress with my homework.  I need to fill in an A-B-C-D worksheet.  But I'm not sure how or about what.  

My weight issues are still external to me, despite lots of evidence to the contrary.  Somehow I need to first recognize that I am part of the problem.  That being 100lbs when I was 8 doesn't mean I have to be overweight for life.  That I contributed to the weight gain.  That living a life more healthy then many doesn't mean I deserve to be healthier than they are, just healthier than I was.

So any advice for filling in my worksheet?

A: Activating Event - What were you doing and with whom?

B: Beliefs/Thoughts - What was going through my mind just before I started feeling this way?  What does this say about me?  What am I afraid might happen?  What images or memories do I have in this situation?

C: Consequences - What emotions am I feeling?  What are the behavioural consequences to how I'm feeling?

D: Disputing thought - If a friend had this thought, what would I say to them?  Is there an alternative way of thinking about this situation?  What is the evidence that supports my thoughts and what is the evidence that does not support it?

Should I be worried the weight is coming off too fast?

It doesn't seem possible, but it's true.  Today it took a calendar to figure out how far into the Partners for a Healthier Weight program I am.  Nineteen days on the program, 12 days on the liquid diet.  That's 7% done the liquid only phase.

This may come back to haunt me, but right now, it's not that hard.  There's a lot of stress involved in deciding what to eat, when to eat, when to prepare the food.  Opening up a package of powder and mixing it with ice and water is easy.  And knowing there's no decisions is eliminating a lot of the worry that goes into my normal eating habits.

What have I noticed after nineteen days?

Most of my pants are too big.  Unusual for me, but my bra size is holding steady.  The inches seem to be coming off my butt, thighs, hips and the area you work out as the obliques.  Spanx are still exercise to put on.  The stubborn above the belly button fat that usually shrinks with diet and exercise isn't budging.

I am tired.  There's a bit of brain fog.  It's difficult doing exercise that used to be easy.  My 2x10&1 run was a flop on Sunday.  Today walking to the car seemed like an effort.

Oh yes, and it's not easy to get blood work done in the HRM during the afternoon.

To me, my weight is coming off a bit too quickly. I am concerned that I'm losing muscle mass.  Including the time on 1200 calories and OptiFast 900, it's been about 12 lbs lost in 19 days.  My exercise is scaled back already and I'm following the plan exactly, so I notified the team in Halifax about my concerns.  Sounds like they'll have questions next time they see me. But they're not worried.

Next steps:

1. Wake up every morning and stay on plan for the day.
2. Make sure the team is ok with the weight loss.
3. As my current exercise program ends, replace it with one focused on building muscle probably at the Sackville Sports Stadium.

Partners for a Healthier Weight - Day 11

I`m still trudging along on the Partners for a Healthier Weight.  No taste or food has passed my tongue except for the vanilla or chocolate Optifast 900.  In the first 4 days on a liquid diet there have been a few moments I expected to be challenging.

1. My family met with my sister and parents on an outing that included a picnic.  They were great and didn`t offer me any food, but did push a bottle of water on me.  (Not such a bad thing).
2. Attended a birthday party with snacks, cake and ice cream.  Saying no the first round was easy, but I did have to get up and move away from the leftover cake.
3. Helped my husband prepare the kids food for supper.  He was taking care of diapers, pasta and cooking.  So I pitched in to slice up cucumbers, cheese and ham.  It went ok... but I`m upstairs typing instead of downstairs with them because the smells were tempting.

Today I`m actually hungry.  Maybe because breakfast was late? Maybe because my back hurts and that makes me want to eat?  But I don't want anything sweet.  Cucumbers have become an over powering smell for me.  (I love cucumbers with salt).  I would trade a days worth of packets for tuna and cheese or just about anything with salt (especially cucumbers).

The idea of going without real food is still baffling to me.  Right now the approach is get up every morning and try my best for the day.  Celebrate how far I've come already.  So when I go to bed tonight, I'll be 5% done the liquid diet phase.  Down to 80 days.  In moments by myself I'm still too near tears about the fact that this is what it's taking me to lose weight, that I couldn't manage it by myself.

But I am losing weight, and I am trying to keep habits that kept off the weight from my first weight drop from near 280lbs to between 220 & 230lbs.  So I log my food.  (Silly, right?  The same thing 4 times a day).  My water is all logged, too.  I weigh myself everyday, but don't get worried about it.  Interestingly I did gain weight at least one day on the program.  Keeping my exercise up is a challenge.  There's a little lack of energy and also a nagging back pain that started the same day as the liquid diet.

Let's see how tomorrow goes.

What is Partners for a Healthier Weight?

To quote some of their welcome package, Partners for a Healthier Weight is a "medically and psychologically supervised" program that "uses a meal replacement called Optifast which provides 900 calories per day.  The meal replacement is 12 weeks in duration and is followed by a 6 week transition to food.  Regular physician/nurse assessments and blood work are all a mandatory part of the medical monitoring.


The meal replacement will certainly help you lose weight; however it is the weekly facilitator-guided sessions that are essential to your long-term success!"

Before the program starts there needs to be a referral from your family doctor, an initial fasting blood work, and an extended online survey.  The results from the blood work and survey are the basis for the meetings with the nurse, dietician, and psychologist.  They all assess you for your likely success, review the survey and have some questions of their own.  Plus there's a bit of a physical with the nurse.

Week 1 was a welcome and introduction where the nurse, dietician, psychologist and physiotherapist are all present.  Because of the pre-work I'd already met the nurse, dietician and psychologist.  There was a meet and greet to get to know some of the other participants.  Once we'd done the meet and greet the group was divided in half with half starting with a walk test and half starting with weighs and measures.

The weighs and measures were much what you'd expect.  Waist measurement, a body comp analysis and an extended blood pressure test.  I've forgotten the waist measure and blood pressure, but I have the Tanita Body Composition Analyzer TBF-310 results.

Height 5'5"
Weight 226.0
BMI 37.6
Impedance 422
Fat % 45.8
Fat Mass 103.5 lbs
FFM 122.5 lbs

The walk test was a bit of a surprise to me.  They suggested comfortable clothes and sneakers.  It turned out to be the 10 M Shuttle Walk Test.  I was kicked out at level 11 for not making the time.  After it was over I regretted not wearing my sports bra - it was nearing a full out run for me.  Unfortunately my course was shared with another who went even farther than I did.  I probably went out because of the pressure on my back and hip of always having to turn left and the dizziness.  Wish it could be done again and there would be an option to turn left or right on demand!

Most of the rest of the night was caught up in signing away waivers, quick talks and getting an intro to week 1.

Week 1 was a 1200 calorie diet with a strict measure of tracking.  Each day there were:

• 5 70 cal servings of grains and starches (only 2 could be bread, corn, potato, turnip, squash)
• 3-4 65 cal servings of fruit
• unlimited vegetables
• 2-3 90 cal servings of milk or alternatives (milk, yogurt)
• 6-7 75 cal servings of meat or alternatives (1 oz) includes cheese, eggs, peanut butter, legumes
• 3 45 cal servings of fats
• 2-4 condiment servings of 20 cal

The first few days I struggled to get to 1200 calories.  I was out and about and didn't have the reference with me.  By the end of the weekend, knowing it was your last time in a long time to chew food, it was really hard to stick to the program.  There is a cupcake splurge I must admit to being the lone participant in.  There were also many of my favorite healthier foods - spinach, corn, raspberries, and apples.

The first week had a high level of anxiety for me.  The idea of not eating was just so far out of my realm of possibility it was stressful.  There were nightmares and random feelings of being completely overwhelmed.

It's actually been less challenging to be on the liquid diet than to think about being on the liquid diet.

Partners for a Healthier Weight - Day 9

More details to come later on the Partners for a Healthier Weight Program.  But I wanted to share that I am enrolled and doing my homework.

What that means today is that I`ve just finished day two of 84 days on a liquid diet of 900 calories.  That means only 328 (of 336) more drinks to go.  And then, presumably, I get to crunch something.

The liquid product is surprisingly disgusting.  The OptiFast 900 in Canada is only available in vanilla and chocolate.  Both flavours taste vaguely like cake batter.  Cold seems to improve the taste some.  Made with ice in a blender and using a straw to minimize time on the tongue works best for me.  I`ve also gone well past the recommended amount of water to dilute the taste.  Both flavours of OptiFast 900 taste better when I`m hungry - but with four packets a day - I`ve only been hungry when out longer than I expected.  (Wishing for other flavours or chewing, but not actually hungry).

Odd side effects have been minimal.  Behaviour changes are a bit surprising.  I`m brushing my teeth constantly. Not certain if that`s to rid my mouth of the flavour or because the toothpaste introduces another taste.  The dry(er) mouth is noticeable, but not problematic.  My lips have also dried out so there`s an increase usage of lip balm.

My early speculation is that the nasty taste for me - and the almost gagging response to the last few mouthfuls - is not dissimilar to how I feel about many proteins (especially powdered), bananas and yogurt.  Might explain the low iron that`s plagued me through life.

As for the running, it`s still going.  I finished the learn to run clinic with a slow 3k.  This week I got in a couple of 10 & 1s on Sunday, Thursday and Friday.  Thursday was about 2.7 in 24 minutes, Friday was 2.5k in the same 24 minutes or so.  Not fast... but still moving.