"Observe due measure; moderation is best in all things."
Based on weighing myself yesterday morning, I've reached a milestone of sorts. My weight is now approximately the same as it was during my senior year in high school, down about 20 pounds since February. I was overweight in high school, no doubt. So there is still quite a way to go to reach my ultimate goal. Yet that high school weight itself varied quite a bit and, indeed, having a sense that my weight was out of control contributed to the depression I experienced in 10th grade. A diet of sorts followed a period where I got counseling for the depression. The diet was aided by medication to reduce my appetite. That worked for a while and I did take off some pounds. But after the diet ended, I reverted to my old ways. That issue remains with me now. I also sense that the distribution of my weight in my body is different than it was in high school. Not surprisingly, the abdomen is larger. The arms, with a geezer's sagging skin, are smaller. Humor may be found by contemplating the changes in some of the impossible to observe internal organs over this time period.
I will give a brief background of my weight's trajectory since high school and then provide a rationale for dieting now. That is meant as background for the purpose of this piece, which is about the thoughts I need to make the dieting work and the various compulsive acts I'm prone to engage in that make that thinking more of a challenge. It is further about whether an old dog can learn new tricks via this sort of reflection, which is what I hope for, or if the bad habits are so imbued that they will evidently return, once the diligence from the current dieting regime is in the past tense, which is what I fear.
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My sister and I took a drive trip to the National Parks (e.g. Yellowstone) during the summer between high school and college. I lost about 10 pounds during that trip. In my time in college I more than made up for it. During sophomore year at MIT, where the depression I felt in high school had returned, I had some eating binges. I don't recall doing that once I had transferred to Cornell, but I know I developed a taste for beer then as well as Black Russians, on occasion. Also, there were the various indulgences that college kids did at the time The effect of this on my weight surely was there, but now I can't parse one cause from another about what happened then. The upshot is that when I graduated from college I was about 15 or 20 pounds heavier than I was in high school.
After returning home from Ithaca, before heading to Northwestern for graduate school, I went on a crash diet. The motivation was to improve my amorous life, which until then had gone nowhere. For about two and a half months I had only one meal a day, dinner, with no seconds. I lost about 50 pounds in that brief time span, enduring the feelings that sustained periods of low blood sugar will generate. At the other end of the tunnel, I appeared normal and not overweight. Other than one couple who were friends of my sister and hosted me while I looked for an apartment, I didn't know anyone else at Northwestern and they didn't know me, so they had no knowledge of what I was like at Cornell. Though normal in appearance, I still had the mindset of a fat person. That in itself was a big deal. Maybe I'll write about it in a future post.
The relevant point here is that I stayed at approximately the same weight for the following 16 years. There would be a little drift upwards as winter came, mainly because I exercised less. Then I'd shed some pounds during spring and early summer. So there was a bit of a sine curve in my weight, but no trend either up or down. I ate and drank normally (for me) during this period. I also got a reasonable amount of exercise. I had been playing tennis since I was a kid and continued to do that some. Golf was something new I got into as an assistant professor at Illinois. And I started to do jogging regularly. I had reasonable balance between the exercise and my food and drink intake. I wish I could have sustained that until now, but I didn't.
Our first child was born near the end of August 1992. Parenting was a wonderful experience. We liked it immensely. But it did include sleep deprivation and with that impulse control is less. The usual weight increase during the winter months wasn't offset by weight reduction the following spring and summer. I began what proved to be a long upward climb in my weight, ultimately with more than a 100 pounds weight gain.
But I still had golf and jogging, which helped to provide balance, though the former became too time consuming to do regularly. A few years later, after our second child was born, I made a career switch from economics to ed tech. That matters here regarding work stress and how it is managed. Both types of work had some stress to them, but with the ed tech work I was much more visible on campus. And some of the ed tech work meant overseeing online applications that instructors used in their teaching. There was much stress related to that. Humorously, the first inkling I had of such stress was when we stopped supporting PacerForum, as the company that made this application went out of business. We had a group of hard core instructors who were quite attached to PacerForum. They did not care one whit about the business side in supporting the application. Some of them had become friends of mine. Nonetheless, I got quite a lot of grief from them for making what was evidently a Hobson's choice.
For about 5 years there was a moderately slow upward drift in my weight. I don't have a chart of that time to recall the pattern exactly, but maybe I reached a weight about where I am now at the end of that interval. Then, around 9/11, I stopped jogging because my knees were shot and simply hurt too much to do it. I made a grievous error after that. I didn't find alternate exercise for quite a while. Ultimately, I took up walking and then using the exercycle, which we used to have in the basement, during the winter months. But for quite a while there was no exercise and the stress really started to pile up. I put on a lot of weight then. The peak occurred about 5 years later at my brother's 50th birthday party in Ann Arbor. I had a bad fall and ruptured all the tendons in my left leg between my quads and the knew. I was out of commission for a couple of months. This was a wake up call that I needed to do something about my weight. I had switched jobs (from the campus to the College of Business) during the time when I was recovering from the fall. I retired about four years later. By then, I was about 35 pounds lighter, a definite improvement though still much heavier than I am now.
Now let me note a different factor that complicates matters some. In fall 2009 (I retired the following summer) for the first time I experienced pain in my leg merely from walking. As my dad had sciatica, I assumed that's what I had as well. That proved incorrect. I was diagnosed with arthritis and bone spurs in my lower back. On occasion that would pinch a nerve, which was the cause of the pain. The rheumatologist recommended exercise as the main way to cope. I did increase the amount I walked after I retired as a consequence. But, obviously, while a good solution, it was not perfect. So, even though my stress level dropped considerably, I drank pretty heavily most of the time. It did conceal the pain, if only for a short time. And the habit was pretty entrenched. My dad was quite a drinker too.
The obesity and the drinking can each individually cause high blood pressure. I began to take medication to control that. Sometime later I became aware that the drinking can cause high pressure in my eyes as well. As I'm now being treated for glaucoma, that is something to be avoided, if possible.
Sometime in 2014, well into retirement, I started a period of no alcohol. I can no longer recall what motivated that effort, but it must have been something health-wise. I lost a good deal of weight then, getting to a few pounds less than I am now. I recall taking a lot of clothes to Goodwill, most if not all of the stuff I had that was labeled XXXL. But I did go back to drinking after that and my weight drifted upward as a consequence. Less than a year later, when I turned 60, I was about 5 pounds heavier. Three and a half years after that, when I was treated for prostate cancer, I had gained more than 30 pounds. Further, aside from my lower back, there had been episodes of pain elsewhere, in my neck and in my feet.
The neck pain I have since been able to control with medication. The foot pain, which I believe has multiple causes, oscillates in its intensity. The lower back pain and right hip paid has gradually gotten worse. In March 2019 I saw an orthopedist who said I was a candidate to get a hip replacement. I found that recommendation unsurprising, but I opted to put off doing it for a while. In 2012, I had rotator cuff repair in my right soldier. The procedure went okay, but about 6 weeks later the wound started to ooze and upon inspection by the doctor I learned that it was infected. I ended up spending 5 days in the hospital, with 3 trips to the OR to scrape out the gunk. I found that experience excruciating and would really like to avoid a repeat in the future. Further, my mom had her hip replaced more than 10 times. Each time it would get infected, so they'd have to do it again. Eventually they removed all the bone and she became completely wheelchair bound. It seemed to me that the risk of infection from getting a hip replacement, with the risk increasing due to being overweight, provided justification for putting off the procedure.
So, the weight loss regime I'm now on is there either to lessen risk of infection or to lessen the pain enough so I don't feel hip replacement is required. But, as this story has made it agonizingly evident to me, one of the reasons to write this post, I need to think through how to avoid my historic pattern of having the weight drift up after a period of weight loss. Unless I solve this issue long term, I don't really have a solution at all, even if I can get down to a normal weight in the not too distant future.
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When I was a teen my mom, who was a native German speaker, would call me a fresser. She was a fresser too, as was my sister. For whatever reason, my brother was not. Using English, you might call me a gourmand or a foodaholic, with motto - to eat is good; to eat more is better. Only it really isn't. It's better in the present. It's worse for it's impact on the future. I want to note here that I'm not prone to excess consumption in other things. For example, the car I drive these days (with decreasing frequency) is a 2008 model. Having it sit in the garage most of the time may be almost as environmentally friendly as buying a current electric model.
The lack of impulse control with food and drink may seem to belie my rationality.
I interrupted the writing after completing the above sentence to go for an appointment with my eye doctor. It began with a visual field exam. With my glasses off and one eye covered with a patch, I stare into a machine with the other eye and am told to focus on the bright orange light that is approximately in the middle of the screen. When the test starts little flashes of white light appear at different places around the screen. I'm holding a clicker and am told to click every time I see such a flash. But I'm also told to keep my focus on the orange light. And the technician kept telling me to do this throughout the exam. Yet it is very difficult not to move the eye to look at where the the white flash appeared. I'm supposed to use only my peripheral vision for that. I wanted to do the test as instructed, but I felt that I was cheating some while it was going on. When the doctor reviewed the results with me, he said I did pretty well in focusing on the orange light. It occurred to me that this visual field test provides a great metaphor for having difficulty with impulse control, one that those who have never struggled with their weight could identify with. Instinct sometimes trumps thoughtful intention.
Indeed, given my formal economics training and general preference to think things through as fully as I can, I'm probably more rational than most people, academic friends included. Yet as behavioral economists have taught us, none of us is fully rational, even well trained and very accomplished economists. According to Daniel Kahneman, a Nobel Prize winner, there is Thinking, Fast and Slow. It is the slow thinking that can be associated with rationality. Fast thinking is more impulsive. One of Kahneman's core hypotheses is that slow thinking is fatiguing (except, perhaps, when the person has achieved Flow). Once fatigued, the person reverts to thinking fast. Understanding that, ahead of time one might put in place incentives to minimize the damage created by the inevitable impulsive behavior.
Such an incentive is called a Nudge. I understood the idea intuitively before I ever heard of behavioral economics. When I was single and of normal weight, I would never buy ice cream to keep at home, which I might otherwise consume in the evening after dinner, going out for ice cream then being too much of a schlep. Though I much prefer married life to being single, marriage requires making compromises on decisions of this sort. So, I needed to find other nudges that can work under the circumstances. Some of those will be described in what follows. Yet the nudges are, of necessity, incomplete. What is required in addition is to develop new habits that are healthier and abandon old habits that seemingly provide pleasure but are in fact self-destructive. Much of the learning I want to consider is in regard to habit formation of this sort.
I tend to do my initial thinking in my head without writing things down. Subsequent written reflections, such as this blog post, happen much later. So, in what I say here about initial goals, please understand that these weren't quite as well articulated up front. That said, I wanted to reduce my drinking. I wanted to change my eating so a good deal of it was fruits and vegetables and comparatively little of it was starch - mainly bread and pasta. I also wanted to mainly eat at mealtimes. And if I snacked, I wanted those to be healthful. One of those things I implicitly knew at the outset is that sometimes I snack to satisfy an oral fixation rather than because I'm hungry. Chewing on a stalk of celery can satisfy that want, though most people wouldn't consider it snacking.
I also knew two other important facts. My impulse control varies with the time of day. It's much better in the morning and not so good in the evening. Then, alcohol weakens my impulse control substantially. If I'm going to lessen my drinking overall, it has to happen by going cold turkey over some time period, then resuming to drink for a while, followed by another interval of going cold turkey. Over time doing this, one might compute the average amount drunk per day. Seemingly one would get the same results by having that average amount, and no more, on a daily basis. The quote that begins this piece seems to recommend that approach. But that won't work for me, at least not yet, because with that initial drink I'm very likely to consume another. Further, I'll do snacking of the foods that I'm otherwise trying to avoid. So, I knew going in that my approach would have periods of no drinking and sticking with the diet and other times of indulgence that couldn't be considered dieting at all. If it is two steps forward and one step back, that's still overall progress. That's what counts.
Let me describe some of my nudges. As I have a sweet tooth (who doesn't?) I needed some way to indulge it that was still manageable. So, I moved to a regime that when I am dieting I will have a sweet baked good, whether intended to be consumed with the morning coffee or as dessert for dinner, to be eaten only in the morning. I would have it first, before the rest of my breakfast, usually with the second cup of coffee. That satisfied the craving without wanting even more. The second nudge is to have a quasi-plan for both breakfast and lunch (the fruit which served as a dessert for lunch would typically be melon, a relatively new thing for me) where my wife and I would eat entirely different things for those meals. And we've reached the point for dinner where maybe two or three times a week a good meal is made with plenty of leftovers. The rest of the time we each "scrounge," so have individualized meals then. I do allow myself an afternoon snack, typically an apple or some other fruit, which is before dinner but in some sense serves the purpose of having dessert. The third nudge is the biggie. I try to go to sleep very early, which now that the sunset is before 8 PM isn't as hard as it was earlier in the summer. This nudge is facilitated by one of my medications, which tends to make me drowsy. Taking that at the appropriate time encourages me to want to go to sleep. The idea behind this nudge is to not allow the lack of impulse control to take hold. I've already gone to sleep before it can work its evil ways.
I'm pretty sedentary much of the day, but I do try to get exercise on a daily basis by walking on the treadmill and then doing some light weightlifting as well. I discovered a few years ago that while walking outside will cause the lower back pain to flare up (nowadays after only walking 1/4 mile or so) walking on the treadmill and bearing some of my weight with my arms takes the pressure off my back. I try to do that at a sufficient pace so there is some aerobic benefit. It's not nearly as effective that way as the jogging I did 20+ years ago. But it is real exercise. To relieve the tedium of the treadmill I watch some show on the TV. (I'm currently in the middle of season 4 of Star Trek the Next Generation, which is on Netflix.) It also helps as a timing device of sorts, to let me know how much I've worked out. Sometimes I overdo it and am in pain afterwards as a consequence. And on some days I've got pain (perhaps from a cause unrelated to the exercise) so I won't do my workout at all that day.
Physical pain is one of the big reasons while I will drink that evening. It's a bit of feeling sorry for myself and a way to numb the pain. I confess it's not the only reason. Another reason is a sense of fatigue. I get up in the middle of the night several times to go to the bathroom - old man's disease. The issue is whether I can get back to sleep or not. If I don't, I feel drained the next day and then want to pamper myself. Going off the diet is a kind of pampering. Then, like many others, I have bouts of anger about our national politics and the stupidity of many in not getting vaccinated. Drinking is surely not a healthy response to that anger, but it is a response of a sort. Last night I had some drinks to celebrate reaching the milestone with my weight. Kind of ironic, wasn't it?
I've learned over time that sometimes it isn't even two steps forward and one step back. I might drink for several days in a row. It takes some near-term plan to stop that and get back into the diet routine. A big part of the learning is to accept that these failures will happen. The goal, I've discovered, is not to eliminate these episodes. Trying to do that, I believe, will ultimately have me abandon the dieting altogether. So, I can't punish myself after the fact too much. Instead, what I need to do is manage these episodes so that overall there are more steps forward than there are backward.
There are aspects of my personality that make this a challenge. It will probably not come as a surprise to my friends and former colleagues, but I do have my compulsive side, which now has me weigh myself a few times a day. There is a learning aspect to this, about understanding the cycle of one's weight over the course of the day and whether there is a downward drift overall or not. Sometimes, what appears to be an upward drift can motivate me to stop drinking. But it is also clearly neurotic. I don't do anything like this when I'm not dieting. One weighing per week is probably more than sufficient then.
I've also learned that there can be other rewards, ones I hadn't anticipated, from losing the weight. My clothes started to seem baggy. The shirts and jackets I had been wearing were all XXL. The shorts too. I had XL shirts that I kept from an earlier time. Lo and behold many of them fit. That felt like victory. (I also discovered that across brands there is substantial variation in the XL and XXL boundary.) This sort of reward does make me want to persist to where I can experience wearing shirts marked L, though then I will need to purchase them.
And I have learned that there needs to be experimentation along the way, not a completely fixed plan. Some of this is simply to match the circumstances. My wife in her retirement has taken to gardening big time. Episodically there is a bounty from the garden and somehow I try to incorporate the bounty into my eating plan. How to do that requires experimentation. And as too much repetition gets boring, there needs to be different foods to try or some variation in the routine, just to keep things interesting. This includes, for example, how much to eat at a meal as well as how fast the weight should come off. Having that memory of the crash diet I did when I was 21, the frequent weighing now does suggest the idea to eat less than I've been doing, even when on the diet path, to speed things up. I do wish I was 21 again, but that's not going to happen. My rhyme yesterday was about slow and steady winning the race. Rationally, I do understand that. Alas, there is thinking fast and being impatient. Economists refer to it as HRTP (high rate of time preference). Somehow, I have to deal with that as well.
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My original weight goal was to return to the weight I reached during those 16 years when I was normal in appearance. Now I'm thinking I have to overshoot some, so I can experiment with approaches to keep the old pattern of upward drift in my weight to return after the dieting has concluded. The ideal, of course, would be to truly embrace the quote at the top on a daily basis. But I'm beginning to see another possibility, which is that my pattern while dieting becomes the pattern for the rest of my life, with the forward steps and the backward steps more or less equalizing out. We're not there yet and I don't want to get too far ahead of myself. But I do normally make conjectures about this sort of thing. The conjecture here is that if I can get my exercise level up then I can achieve moderation in eating an drinking. But, if not, there is an alternative that might still be effective for me.