There Is Less Of Me, But Can I Sustain This?

There is less of me than there was not so long ago. 

I have lost about 50 pounds in the last nine months in a doctor supervised weight loss program through Kaiser Permanente with the help of some diet drugs and more conventional means (diet and exercise). 

My diet has been basically a pretty strict low carb diet, assisted by drugs that change the way that I metabolize food and make me pay with GI discontent if I eat any meaningful quantity of cereals like bread or oatmeal or rice or popcorn or pasta, and a couple of different appetite suppressants that makes me sometimes forget to eat meals and strip away the desire to have larger portions or seconds.

Ironically, after year after year of having New Year's Resolutions to lose weight (in various permutations) or to exercise more, my only New Year's Resolution in 2018 was to eat more empanadas (a resolution that I totally nailed in the first three months of the year)!

I also reconstructed my weight history from journal entries going back to January 1, 2004 (I have several journals older than that but didn't note my weight in them). I'm not yet all of the way to my all time low in that time period, achieved in another concerted dieting effort quite a few years ago, but I'm within a few months of striking distance from that point and weigh about 12 pounds less than I did on January 1, 2004.

I know what I weighed from I graduated from high school in 1989, about 189 pounds at the six feet, one and a half inches of height that I have remained at, a BMI of 24.6 which is within the "normal range."

But, I gained a lot of weight with unregulated food service dining in college and law school, combined with a less active lifestyle than I had had when I was in high school, so I have been at least "overweight" (193 pounds or more) pretty much continuously since I was 19 years old, and I am sure that I have been somewhere in the "obese" range (231 pounds or more), where I continue to be, pretty much continually, at least since I completed my higher education in 1994, although I would like to go back through my medical records to reconstruct that some time (not that there are all that many of those, because health young men don't go to annual checkups very often).

Still, while I am still in the obese category, losing 50 pounds has done wonders for all of the various body chemistry measurements that they make to assess the health problems caused by being obese, so my health risks have declined considerably. There are several circles of hell when it comes to obesity and I am in a less dire one than I was when I started.

It turns out that when you lose weight, the weight that you lose first is the fat in your internal organs which is most harmful to your health, which means that the weight loss isn't very visible at first (which is discouraging), but means that your body chemistry measurements start to show improvement before your clothes start fitting any differently.

I could say that I have so much energy and vitality, but if I did, I wouldn't be telling the truth. Honestly, I don't "feel" very different at all. Really the only clothing measurement that I've really noticed any difference in is my neck size with my older smaller neck size dress shirts that were starting to get uncomfortable not being so tight anymore. Maybe if I lose any more weight, I will, and this has to, at least, make exercise programs I engage in easier than it would have been on me before I lost 50 pounds.

Going into 2019, the question is whether I'll be able to continue to lose weight at anything approaching the rapid pace that I have so far (with some periods of faster than average weight loss and other periods of plateaus or minor setbacks), and if I will be able to maintain a lighter weight in the long run. The holidays have been a bit of a plateau, but that isn't horrible considering that I usually gain a lot of weight from Thanksgiving to New Year's and then lose some of that holiday weight by late summer. It wouldn't be inconceivable for me to have lost 60 to 65 pounds by the time I've been on this regime for a full year.

But, it isn't easy. For someone like me who considers baking artisan bread to be one of his hobbies and loves all sorts of high carb foods, the diet has been a real drag (I can't even drink beer, which is basically liquid bread, now) and figuring out a sustainable compromise will be a challenge. And, getting into even the kinds of exercise habits that I had before I hurt my back will also be hard.

A back injury a number years ago (cause by a squashed disk in my spine as a result of trying to move a piano I had bought without hiring piano movers in my SUV) seriously impaired my ability to exercise or even move around for a long time, which contributed to my weight gain. At its worst, even with opioid pain killers and a cane (and anyone telling you the NSAID drugs like ibuprofen can come even close to opioid pain killers in terms of relief is crazy), it would take me twenty or thirty minutes to make it from the surface parking lot where I parked my car downtown to my 20th floor office (by elevator) across the street from the parking lot, with one or two sit down breaks to recover included along the way. I needed a handicap tag on my car for about six months and needed to use the electric wheelchair shopping carts while grocery shopping and a cane when walking for at least a year. And, even as I was starting to recover, it was a struggle just to drive to the Washington Park Recreation Center, swim during free swim, and return home by car. 

Now that I have that under control after back surgery, therapy and steroid injections, my back condition is fine, so long as I don't lift anything too heavy (to the ire of my colleagues when we have to carry a lot of things into court for a trial; honestly, even a heavy laptop or a couple of jugs of milk at the same time, is close to my limit) and as long as I don't do anything to jarring (one relapse was triggered by the jerking around that occurred in the very early days of teaching my son to drive stick shift). 

But, as I get more active, I'm also reminded of an ankle injury that I incurred on a law firm rafting trip near Grand Junction, Colorado in about 1997, which I didn't go to have treated at the doctor at the time despite the extreme pain involved and despite the fact that I had decent health insurance. I suspect that I fractured a bone that didn't set quite right, although I've never had it X-rayed. Ever since then, my ankle provides me with weather reports and long hikes or running aggravate it so that I can't continue very much.

These restrictions seriously limit what I could do in a hard core exercise program, but, since even modest low impact exercise would still be a huge improvement at this point, I don't have to worry about that too much yet.