BERKELEY, Calif. — Is the traditional nutritional mantra — burn fewer calories than you consume — useless on the individual level?
I am a veteran of weight-loss support groups and 12-step programs, in-person and online. So I know well that the only acceptable way to do this is to make my confession up front: Only by admitting our problems do we have any hope of overcoming them. And when it comes to obesity, there’s only one confession that anyone has any interest in hearing.
I once weighed 352 pounds.
Or 356. The trouble is I don’t really know my starting weight. When you cross over from merely obese to morbidly obese, it’s hard to find a scale in the bath part of Bed Bath & Beyond to accommodate your girth. Even many doctors’ offices don’t carry a scale large enough for the truly fat. This usually ends in a nurse whispering, “Well, how much do you think you weigh?” as if you, the nonmedical professional, were a better judge of this than anyone else — despite the fact that according to many medical professionals, you are lazy, unattractive, stupid and stubbornly unwilling to comply with treatment.
One thing about not knowing your starting weight: In those early days of weight loss, when you can reasonably expect the numbers to diminish rapidly, you may not have any accurate way of accounting for them. So you miss out on that Pavlovian spur to greater feats of diet and exercise when you need it the most.
Now that I’m merely on the chubby side of normal (size 12) and weight loss is considerably more difficult — an hour-by-hour grind of Zumba and deprivation, of parceling out each ounce and calorie on my constant companion, a chrome Cuisinart kitchen scale — the fact that I don’t get to put an accurate starting number on my MyFitnessPal weight-loss ticker prevents me from presenting my numerical value and virtue to the world.
“Virtue” may seem like an odd word here, but only because I haven’t quite reached my goal weight. When I do, I can imagine the praise that will come in. In MyFitnessPal Internet speak, “WTG!!!!11!!” In co-worker speak: “OMG, what’s your secret?” or “Congratulations on your achievement,” like I’ve just delivered a really superb Nobel laureate address. A quick scan of Amazon or the international reach of The Biggest Loser tells us that we revere people who manage to drop obscene amounts of weight, and the more housebound and disgusting to begin with, the better. These are tales of midnight binges and food combinations (Twinkies wrapped in bacon and dipped in guacamole) to make even the strongest stomach twist, and the grosser they are, the greater the moral redemption at the end.
Harmless encouragement, perhaps, but there’s a darker underside. If obese people who drop their excess poundage are to be commended and given book deals, those who can’t manage it — well, let’s regard them as the child rapists and five-pack-a-day self-destructive hedonists that they are. We need someone to hate, and smokers are a dying breed. Obesity, as every reputable news source has been reminding us for the last 25 years, is the new normal. Except that it’s still OK to hate the obese. In a perverse way, people like me make it harder for every fat person out there. If Formerly Fat X can do it, why can’t my morbidly obese sister-in-law?
This despite the fact that every shred of evidence available to medical science indicates that it’s nearly impossible to take off large amounts of weight and keep it off. That was largely the point of Tara Parker-Pope’s New York Times Magazine article from earlier this year, from which the main takeaway was that even a more than typically well-informed healthy eater and marathoner like Parker-Pope is 60 pounds overweight. And her experience is not unusual. Of the statistically minuscule number of people who ever manage to take off serious poundage in the first place, an even tinier number manage to keep it off in the long term. The article describes the complexity of metabolic changes that occur in dieting obese patients that seem to effectively convince their bodies that they are perpetually starving and should conserve every calorie consumed and burn fewer calories than most people would easily shed through normal activity or exercise. “A sobering reality,” writes Parker-Pope, “[is that] once we become fat, most of us, despite our best efforts, will remain fat.”
Parker-Pope personalizes that point through the story of Janice Bridge, one of the statistically small number of people qualified to join the National Weight Loss Registry, which tracks 10,000 people who have permanently lost a lot of weight. Bridge weighs her lettuce, eats 500 fewer calories per day than every means of medical measurement says she should be able to eat, and burns off another 500 calories in exercise. Medically speaking, she is nearly starving to death. In reality, she’s maintaining at a number that indicates that she is still overweight.
This is the story of my adult life. Bridge initially lost most of her weight by following what is technically termed a Very Low Calorie Diet (VLCD), or fewer than 800 calories per day, usually in liquid form. These diets are poorly studied beyond their implications for patients, say, with diabetes (the diabetes usually goes away), but anecdotally, they seem to work for a lot of obese patients who haven’t seen weight loss with other eating plans.
The blandness of that pronouncement can’t possibly describe the reality of actually being on a VLCD. Mine wasn’t medically supervised or liquid, and perhaps this made it harder than usual. Every morning I ate a packet of raspberries — an officially low-glycemic, low-calorie food — and drank three cups of coffee, because caffeine staves off my appetite. Then I’d go home at the end of the workday and eat exactly half of my dinner so that my husband wouldn’t realize what I was doing to myself and intervene. I knew that if anyone told me it was a bad idea, I would stop. Eating 800 calories a day and burning up about 400 of them on the treadmill at lunch doesn’t leave you with much will to resist. Brain function slows. Your entire life becomes about a set of numbers on a page. Was it only 758 today? Excellent work, but you’re still a fat pig. 811? You fat loser, you.
The desperation that drove me to such an extreme diet was a long time coming. Like Dara-Lynn Weiss’ daughter in the now infamous Vogue article, I was a tween dieter. I went on my first diet at 8 or 9: 1,500 calories and 20 fat grams and a lot of Healthy Choice hot dogs, which are truly and technically the worst food on the planet. When I was in middle school, my mother and I went on Jenny Craig together. She quickly got to her goal weight; I languished after about 6 pounds, lied to her about how much I was losing, and was eventually caught and ended up even more humiliated than if I’d just admitted the truth in the first place. No matter how long or faithfully I ate Jenny Craig food, I couldn’t lose the weight, and I was distractingly hungry every minute.
Weight Watchers was next because my mother thought it might offer more flexibility, but I clashed with our local strip-mall location’s staff, who found me to be belligerent and ill-suited to a group weight-loss support environment. I was 14, and I questioned everything. Why points? Why not just calories? Why calories instead of carbs? Why carbs instead of protein? Above all, why — despite playing organized sports and walking the dog two miles every morning before school and consuming my exact point tally — could I not lose weight? Why didn’t I get to bask in the warm collective and reinforcing praise of the Monday night meeting?
Throughout college, I tried all of the trendy plans to little or no avail. My bookshelves are littered with South Beach, Atkins and Zone manuals, Protein Power handbooks, and every form of the lie that the sensation of hunger is really just dehydration. (One month, I drank 5 liters of water every day. This must go on the record as my least favorite of any of the diet plans I tried.) Every time, the same pattern: about 10 pounds of initial loss, very quickly, great joy throughout the land, and then . . . nothing. Although I’d made no changes to my eating plan or introduced any new food, I would stagnate. I followed every rule to the letter but always got stuck.
And then, slowly, the pounds would begin to creep back on.
When I finally turned to the raspberries and coffee diet, I did it for less-than-stellar reasons. I was trying to flee a job I disliked for a competitive graduate school program just as it was becoming clear that a recession was a’coming. I felt out of control, and, like other anorexics, sought complete dominion over something clear and measurable. Five months later, I was still obese, but I wasn’t seriously worrying about fitting in an airplane seat anymore.
I (mostly) kept it off by staying on what other people would call a “diet” but what is just maintenance for me (1,500 calories per day, at least five days per week of heart-rate-raising exercise). But my ridiculous low-calorie diet had made some of my hair fall out, turned my skin dull, and rendered my life miserable. And, predictably, my weight plateaued again. So I tried vegetarianism for a year. Then I tried low-carb. Three years later, I finally began to consider surgery.
My beloved aunt, my father’s last living sibling, had just died far too young of obesity-related causes, the cascade of diabetes, high blood pressure and congestive heart failure that seems to kill everyone in my family. My future at my current weight looked bleak. Complicating matters, the present was pretty good. Continuous activity had kept my sugar levels decent, my cholesterol excellent, and my blood pressure on the low side of normal. I had none of the usual obesity-related complications to make surgery recovery difficult. In fact, I was at the perfect weight for surgery: fat enough that the insurance company wouldn’t deny the claim but not so fat that I had to lose massive amounts of weight even to fit on an operating table. Most of all, I was in my 20s. “You carry your weight well,” said my bariatric surgeon at the University of California, San Francisco, noting the difference between my (relatively) toned appearance and the actual numbers. He saw mostly older patients, and I could tell that he was looking forward to my surgery because it would be easy. “Are you ready to do this?” he asked. Without hesitation: “Yes.”
Bariatric surgery effectively puts one on a 600-800 calorie per day diet, at least to begin with, but supplements with vitamins and cuts away the hunger hormones that make this all but impossible for people with normal stomachs, let alone the enlarged ones of the obese. Naturally, I’ve lost a lot of weight. Fifteen months out, it’s starting to become harder. Most days, I engage in 90 minutes of exercise and eat 1,000-1,200 calories. Everything in my life is parceled out into packets, and I know the precise value of it all. An ounce of goat cheese has fewer calories than an ounce of Gruyère. My grandmother’s cookies have 114 calories each and must be a rare treat. Protein, protein, protein. Protein before everything else. Protein über alles or my hair falls out in chunks in the shower and my nails peel off the tips of my fingers.
I’m now at a weight where my daily life in the world has changed. When I was in my middle state of moderate obesity, I rarely got a nasty comment on my appearance. I used to think it was because I wasn’t all that fat. Now I know that, as with other bright, round objects, nobody wanted to stare directly at me. Men now feel comfortable approaching me in coffee shops to suggest that if I only lost 20, I’d be hot. Drivers who cut me off when I’m riding my bike shout “fat b——” with some regularity. I hate it and find it encouraging at the same time. Finally, my fat doesn’t make me invisible. It just makes me fat.
And, naturally, I’m starting to get solicited for weight-loss advice, but I refuse to provide it. Nothing about the way that I’ve lost weight was in the short term safe or healthy, if you define health as the pursuit of overall system happiness. Bariatric surgery was about the safest thing I’ve ever done for myself, in the sense that it was medically supervised and I got a special 24-hour-advice nurse number to call — and it involved five hours of getting cut open to have my intestines rerouted. Also, on this great wide Internet of ours, surgery is cheating. On a MyFitnessPal forum I follow, someone who was recently denied for weight-loss surgery because she’d been asked to lose 50 pounds before the surgery and managed it was now congratulated because now she’d have the satisfaction of “doing it on her own,” the virtuous way. As I stare down my post-surgery 90 minutes of aerobics and bike riding and my 178-calorie lunch ahead, I beg to differ.
The fact of the matter is: I don’t know anything about weight loss. Neither does anyone else. What is emerging from the best research is that the old nutritional mantra — burn fewer calories than you consume — is correct in the thermodynamic sense but useless on the individual level. You and I don’t have a clear idea of how many calories we’re actually burning up. Gary Taubes tells us that some calories count more than others. Michael Pollan says mostly vegetables. New York Mayor Michael Bloomberg thinks that putting our soda in two cups instead of one is the magic ticket. The federal government is so swollen with corn-industry money that I can’t even look at the food pyramid — old or new — without laughing. Absent these precise measurements or solutions, how can you look at someone who is obese and hold them personally responsible for each pound? Or personally virtuous for each pound lost?
Let’s say you had to starve yourself daily for bare maintenance of your health and physical appearance. Could you do it? Forever? And would you be happy? I doubt very much that you would. But still, it’s what I have to do.
Shannon Chamberlain is a graduate student at University of California-Berkeley and blogs at dofatpeoplehavesouls.tumblr.com.