Corking The Bat

I am really tired of being fat.

When I was 20 and I was down to 10 lbs. of persistent leftover fat, I was tired of being fat. A year prior, I dropped from 275 to 175 pounds. After that loss, I hovered for a time. Then, it started to trickle back on. From age 20 to 30 I went back up to 230 pounds. I got into web design: long hours, fiddly crap, a learning curve that never ended. I got on the road to 260 lbs. by the time we had our daughter. The Dot-bomb era with the 9/11 chaser made it really hard to find decent tech work. I was manacled to my desk and came out of that era at an all time high: 300 pounds. I lost some, then regained to again. The waves of fattitude have continued and I got back to my max of 300 lbs. again. At all points in my life, I've been tired of being fat. Being tired of being fat is like being tired of being poor. Sure you can do something about being poor or fat, but some people succeed better at addressing those respective problems. Telling someone they should just lose the weight is akin to telling someone they can just be rich. It is very doable. It takes will. And, it's easier said than done.
November 2012 to January 2013 was harsh. I had a killer learning curve again. I made the mistake of doing some of it for crap pay (never do that). All I did was work. No exercise. No attention to my diet. I was able to go from an unacceptable 280 up to the painful 300. I said to myself that this had to stop. I came up with a plan. This is a plan that will take all of 2013 to execute.

  1. Stop The Overwork - I have been doing web design for 16+ years. I have seen trends come, go and come back again. I know web design backwards and forwards. Any crappy design I deploy happens because I make design gaffs or I am doing the work in response to a client's specific wishes. I can help others with their web design. I can come up with smart solutions that will hold water. In January, I quit one sub-contract. In February, I renegotiated another sub-contract so that I deploy a co-worker and take a management role to satisfy this. I took out most of the Consulting text from my company page. When it comes to consulting, we'll be aiding in prototype building. Through Drupal, we can come up with a speedy prototype for a start-up. I have some legacy clients who we are keeping, but I am otherwise going to focus on start-up prototypes and our own products.
  2. Change My Diet - I saw an endocrinologist (see below). When I saw her on my follow-up, she asked "how's the diet?" Asking me "how's the diet?" is like asking America, "Are you winning the War on Terror?"-- I have been on a diet of some form for years and it's been some variation on the diabetic diet. Any cheat sticks to me like glue. Did you have a hamburger last week? And if so, did you permanently gain 2 lbs. because of it? So, enough of all this. I have made some decided differences in my diet:
    • Less beef and pork with fish taking its place.
    • Almost no bread or flour. When I depart from that, it's sourdough (I discovered that yeast and flour is a bad combo)
    • Much less rice. When I eat rice, it will be in very small portions, basmati and prefably brown rice.
    • Learn to love the diabetic free list: peppers, onions, garlic, tomatoes, zucchini, green beans. When in doubt, I can work those into my diet in lieu of starchy foods.
    • Less egg yolks and more egg whites.
    • Less processed food (this is only hard because there is so little in our diet already).
    • Less pop. I was down to some Diet Coke but that is even going to go by the wayside in exchange for more tea (hot and cold).
  3. Exercise - This seems like a no-brainer, but you would be surprised how different my doctor and my endocrinologist felt about the impact of diet: my doctor said it had a modest impact and the specialist said it was a big part of the formula for weight loss. Personally, I am okay with exercise, but I have two chief problems: I need to exercise in excess of two hours per day everyday to change my weight. When I start with 50 reps of something, it has to be up to 150 reps in a couple weeks to give me the same level of exhaustion and burn. I also have to learn to push back: I make appointments for my clients. Now, I make appointments for my exercise.
  4. Vitamin D - Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success. An endocrinology study led by Shalamar Sibley, MD was quoted as saying, "Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around." There's correlation and coincidence, but look to the sun drenched tropics where there is lots of sunshine and Vitamin D synthesis-- there are also not a lot of fat people. The study attempted to determine whether baseline vitamin D levels before calorie restriction affect subsequent weight loss. On average, subjects had vitamin D levels that many experts would consider to be in the insufficient range. However, the authors found that baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship. Higher baseline vitamin D levels (both the precursor and active forms) predicted greater loss of abdominal fat. "Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss," Sibley said. Today, I got some sunshine. Every day since I started this regimen, I have taken 4000+ UI per day. I was advised to take 4000 and the cap for toxicity is in excess of 5000. In my diet, I have added as much salmon as is practical.
  5. Metformin - I called this piece "corking the bat" for a reason. In the 40 years of weight problems, I have never taken anything to lose weight. I have stopped eating. I have had diets of salad and more salad. I have walked for hours and hours per day. I have never popped a pill to help me lose weight. My endocrinologist suggested that one option for me was Dexedrine-- that's an amphetamine that also is used to treat adults for ADHD. So, I could lose weight and be more productive at work? No, nope. No. I did not want to give that a try. But the other medicinal option was metformin. Metformin is used to treat diabetes. I know should know: my family is full of diabetes. A couple friends are on it. The off-label side effect of metformin is massive weight loss. It doesn't make the fat disappear-- you need to practice a good exercise routine and a good diet. But up until now, I have been practicing good diet and exercise with no luck. I am hoping to use metformin to "cork the bat"-- to use drugs to get me to a place I could not get to otherwise.

Part of me feels like metformin is "cheating." This is the problem with obesity that I both rail against and buy into. So much of medicine is shaped by social norms. Homosexuality used to be considered a treatable mental illness. Left-handed kids used to be beaten until they used the "right" hand. If your kid is born with a tail, doctors would immediately plan to snip it off.
Look at pop culture: the dumb guy is usually also the fat guy. The guy with problems is fat. If you have fat, it's not a treated like a growth that needs to be excised in some way-- it's treated like an emotional problem much like PMS used to be considered hysteria. If you were tougher you wouldn't be fat.
If you have a big gut, it's a sign of moral weakness and a semaphor that you're lazy and probably stupid. A deficient person. A cure for obesity may be possible. There are many of them in the works. The ones that are launched are commonly meant to address mood and craving (the moral fiber approach). Imagine where cancer research would be if doctors said, "Oh, you get cancer if you're a bad person" and handed out Bibles instead of looking for treatments? The majority of people in North America are overweight or obese. Either this state is the defacto norm; and/or all of the affected people are faulty and can be fixed with mood altering drugs; and/or there's a very large problem in play; and/or there's something else going on than too many potatoes chips and too little ditch digging. There's a big picture problem going on and that's not my primary concern.
If I were tougher I wouldn't need to cork the bat by taking metformin to help me lose weight. The truth is: I am plenty tough. I'm also plenty fat. I'm using a pharmaceutical approach to address a medical problem.

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