So, what are you eating?

That's what most people ask when they realize I've lost weight. Having tried so many times to lose with no success, it would be my question, too.

I read the book 20/20- Lifestyles; Metabolic Cure by Mark Dedomenico. Dr. Dedomenico works at a local gym, offering the book along with a full program of exercise, nutrional support, and counseling. I just read the book. I ordered it from my all-time favorite used book shop, www.betterworldbooks.org. I actually scoffed at the plan at first. A friend was trying it and I thought it looked like just another route to the usual diet catch-22. Starve myself, lose no weight, then gain some more once I eat heartily. No thanks.

But then she lost two clothing sizes and I thought I'd better read the book all the way through.

The book suggests following several stages in your eating. I was already eating a very low carb diet, so I chose to begin at the stage just below what I was accustomed to.

For breakfast, I have a protein smoothie, made with plain Jarrow whey protein (from Amazon), frozen bananas, other fruits or flavors, and skim milk. The program recommends using berries only, which is what I did at the outset. For variety, I have tried frozen mangoes (especially good with raspberries, which tend to have the worst seeds) as well as a tropical fruit medley my grocery store offers. I've tried the chocolate flavor, which is especially good with decaffeinated coffee ice cubes and low-fat cottage cheese. I occasionally make a vanilla smoothie with vanilla-flavored powder I found locally. I use an extra half-banana and plain ice in that one.

Lunch is almost always a mixed-greens salad with homemade dressing (balsamic vinegar, evoo, garlic, and a smidge of honey and mustard which helps it emulsify). I add 4 to 6 ounces of very lean protein--usually steak tenderloin--and a few other veggies, such as grape tomatoes, cucumber chunks, chopped peppers, olives, and so on. Dessert is a cup of fresh raspberries.

Most dinners consist of a grilled meat and steamed vegetable. Occasionally I'll make a recipe like Beef Stroganoff without the usual noodles. If I choose a dish that involves more than simply grilling some meat, I try to choose low-fat ingredients, but for the most part I strive for portion control. No more than 6 ounces of very lean protein, lots of vegetables.

And I always have about an ounce of dark chocolate afterwards.

About once a week, when I'm either really hungry or low on supplies, I'll eat some cheese (Beecher's Flagship) and water crackers, which satisfies that need for crunch and cream that is so missing in the world of dieting. Another snack I enjoy from time to time is a Honeycrisp apple with a tablespoon or two of chunky Adams peanut butter.

And of course, I occasionally fall off the wagon. Yesterday we were invited to lunch with Dave's parents. I happily enjoyed a bowl of cream of potato soup and half of a ham sandwich and half of a turkey sandwich. I didn't turn down the delicious dessert. I find I can do that now and then with no consequences. But I suppose doing it daily would be a problem, especially with the dessert.

The other big change to my diet is that I can drink an adult beverage from time to time. Ten years ago I was sure I'd tasted alcohol for the last time. Today I can drink a glass of wine with dinner or have a cocktail (gin and vodka still the safest) with friends. I think the meds make it possible, and that the mouth-guard also makes a difference. I still try to have as much water as alcohol shortly afterwards.

Today's Discoveries

At the end of sixth period, my carryall fell over, and two pencils flew out, rolling to a stop under a desk. I frowned. Crawling under that desk would *hurt*. My sore knees would shriek, my heels and ankles would ache, and I'd probably break into an embarrassing sweat. Rising back to my feet would be worse than crawling under the desk. Rats.

I took a deep breath, made sure my blouse covered the waistband of my now-too-large-jeans, and dropped to the floor.

And didn't feel a thing. I grabbed up the pencils, stood back up, and wondered where all the pain had gone.

In terms of weight, I've lost 25 pounds.

In terms of limitations, I've lost a lot more.

Twenty Pounds

I did something in the final months of 2016 that I haven't ever been able to do (without medical intervention).

I lost twenty pounds.

Did I discover a miracle diet? Maybe. I'm following the Pro Club's Lifestyles 20/20 diet (I bought the book from a second-hand bookseller), and it's a good one. But I don't think that's the whole answer.

I think I'm finally losing weight for two reasons: I've gotten a mouth guard for my sleep apnea, and I've been taking probiotics for ten years.

I should back up a little.

I’m a life-long dieter. At first, diets worked, sort of. And then I'd gain it all back. And more. The problem wasn't willpower or an inability to love myself or any of those things you read about in women's magazines. I took my food diaries to doctors, exercised so energetically that I injured my Achilles tendon, tried taking weight loss drugs. Nothing worked.

And none of the weight loss advice made any sense to me. As a child, I was underweight. My pediatrician patiently explained to my mother, a war refugee, that four-year-olds didn't eat the same quantities as adults. She gave me less food, and I was still a picky eater, but my diet included whole milk, real butter, lots of meat, gravy, and potatoes, and regular desserts. I ate high-fat and high-sugar foods and was the skinniest kid on the block.

When puberty hit, and my body gained the geography of womanhood, angry red stretch marks split across my thighs, my breasts, and my bottom, and  I was sure I was fat. I was taller than most of my friends and wore larger clothes than they did. I had to be fat. I started watching my weight, as they say, drinking diet soda and eating iceberg lettuce with salmon, dressed with straight vinegar. As an adult, eating lots of fresh veggies and yogurt and avoiding fat in all its forms, I ballooned up to well over two-hundred pounds.

Was it pregnancy? I had a hard time losing weight after my first child, despite pushing her stroller mile after mile after mile. I lost some weight nursing the second, but once nursing stopped, the weight returned.

Weight loss drugs worked, but after two years, my doctor declined to continue the prescription, and the weight returned with a vengeance.

I concluded that there must be more to the standard equation of CALORIES IN - EXERCISE = WEIGHT. I didn't know what it was, but I felt certain there was something.

I learned of one possibility a few years ago, when I read a NY Times article about gut bacteria and obesity, with its suggestion that gut bacteria could contribute to excessive weight. Although I was and still am totally willing to swallow a capsule filled with the fecal bacteria of a skinny person, availability is a long way off. I was already taking twice-daily probiotics for my irritable bowel syndrome, and hoped it would be enough to change the chemistry in my stomach. (I tried kombucha and found it disgusting. I adore sauerkraut, but it's hard on my stomach.) As I read more articles on the subject, I realized that I began to gain weight in my twenties, the same decade in which I took antibiotics on several occasions. Could those antibiotics have changed the microbes in my belly sufficiently to have caused thirty years of weight gain?? I don't know for certain, but until I have proof to the contrary, I'm continuing with the probiotics.

The second possibility is a more recent phenomenon. My husband had begun complaining that my snoring kept him awake. During those wakeful hours, he also noticed that I stopped breathing. I greeted this helpful information with ridicule. HE was the one who snored and stopped breathing. He was the one keeping ME awake! At the time, I was serving on the Board of our State PTA and had occasion to share hotel rooms from time to time with other board members. They confirmed my husband's accusations concerns, and encouraged me to have a sleep study done.

So I did.

The study found that I stopped breathing fifteen times each night.

Once I got the mouth guard that promised to help me sleep at night, I sat at my computer to research the connections between sleep apnea and my litany of annoying conditions.  I typed, "sleep apnea and migraine." They are linked. One article even suggested that migraines are simply a side effect of sleep apnea. In any case, if you have migraines, I urge you to ask your doctor about sleep apnea.  Second search: "sleep apnea and depression." Bingo. The CDC says that sleep apnea is associated with depression. Next I checked for a connection with asthma. Yup. Obesity? Of course. And IBS? Yes, there's even a connection with IBS. Could this goofy mouth guard really help me with all those conditions?

So far, I think it has. I need to have another sleep study done, to verify whether the mouth guard keeps me breathing all night, but I am waking up more readily these days and feeling generally much better.

And losing weight. Twenty pounds, in fact.

Dieting and Me

Short Version: I've lost 18.5 pounds.

Long Version: I've been on a diet since approximately 1977. I was a senior in high school, and it was kind of fun. Avoid fat and sugar for a week, drop five pounds. Considering I weighed a whopping 130 at the time, five pounds was 4% of my entire self. I felt successful.

Unfortunately, my success led to a thirty-year bad habit: I didn't continue counting calories and writing down every morsel I ate, but I did continue drinking diet soda.

Fortunately, I was in college by this time, and it was easy to take a PE class each quarter to stay in shape.

My next serious diet commenced in 1985, after a day of shopping when I noticed I looked terrible in everything. At home, I weighed myself and I discovered I'd surpassed 150 pounds. For some reason that number clanged an ominous bell in my head, so I signed up for aerobics class and started buying 1% milk. For lunch, I ate a yogurt and maybe a piece of fruit, and for dinner I stuck to salads and avoided meat. I got down to 135, and felt pretty good about myself.

It seemed odd to me that I'd gained weight in my early twenties. I was living with my husband, and we ate a low-fat, high-fiber diet. We avoided meat, enjoyed pasta at least once a week, ate cereal for breakfast, and seldom had any dessert. It was a stark change from my childhood diet of meat, potatoes and gravy, and vegetables drenched in butter. In my mom's kitchen you'd find whole milk, ice cream, butter, and eggs. Yet as a child, I'd always been underweight.

The other big difference in my life during my twenties was that I had a string of awful colds. I'd get so sick that I'd miss two and three and four days of work...for a cold. When I asked my doctor what I should do, she prescribed antibiotics. I got to the point where I'd visit the doctor as soon as I felt the first signs of a cold, knowing that the antibiotics would help prevent the infections that made me so sick. I also had bladder infections. It took a while to figure out that the spermicide used with my diaphragm was killing off all the good bacteria; until then, I took more anti-biotics. I've read that the gut flora of slender people is different from those who are heavy. It resonated with me, because before my antibiotics era, I was able to lose weight with minimal effort. But after my twenties, it became virtually impossible.

I had my first child when I was twenty-seven. I gained a horrifying 35 pounds, but everyone said nursing would help me lose it, so I didn't worry.  I should have. I couldn't lose an ounce, despite joining a gym and pushing my daughter's stroller around my hilly neighborhood for what must have been thousands of miles.

And then I got pregnant again. Again, I gained over 35 pounds. After I delivered this one, I weighed over 200 pounds.

By this time, I didn't much care about my weight. I had two small children, a demanding job, and a busy life. I continued my "good" eating habits during these years, never buying any butter and using so little mayo that even the smallest jar would dry up and get crusty before we finished it. I steamed veggies, sauteed meat in the smallest amounts of oil possible, and if I wanted a snack, I stuck to popcorn or pretzels. Yet the pounds kept creeping on.

In 1996 I quit my demanding job and decided losing weight would be my top priority. Every morning, I took the kids to the bus and went straight to the gym to work out. I did a circuit of weights and then walked on the treadmill for an hour. On the weekends I'd walk a 2-mile loop in the hilliest part of the neighborhood. I recorded everything I ate, each bowl of Cheerios with 1% milk, each carton of yogurt, each ounce of chicken. After six months I'd lost nine pounds.

So I took my food journal to the doctor and asked her what I was doing wrong. She gave me a prescription for phentermine, a drug that suppressed my appetite and boosted my metabolism perfectly. I quickly reached my goal weight and felt terrific. I bought an wardrobe of new clothes. It was heavenly.  Unfortunately, you can't take an amphetamine for too long, and she ended my prescription after two years.

It was as if I'd never lost the weight at all. Looking back, I wish I'd weighed myself daily so I could quantify how quickly it returned. All I know is that in virtually no time at all, I gained it all back, plus an extra twenty or so.

I concluded that losing weight wasn't for me. Up until this point, every time I'd been successful at losing weight, I'd not only gain the weight back, but also gain a few bonus pounds. It was as if my body anticipated imminent starvation. Both of my parents faced severe food shortages in their lifetimes. Had I somehow "inherited" an unusually high need to pack calories away for the future? My doctor convinced me that genetic changes take far longer to show up, but I can't help noticing that all of my relatives on my dad's size are as heavy as I am. I also had a baby that weighed over ten pounds at birth. I wondered if my body was carefully socking away enough fat to support the growth of another ten-pounder.

As my kids got older and I got heavier, I decided that my worth as a person had little to do with my weight, and stopped worrying about it. I worried much more about the migraines that plagued me, and after some stomach issues--likely caused by my Aleve habit--I started examining my food triggers. After a good deal of trial and error, I eschewed most anything that came in a package in favor of fresh meats, fruits, and vegetables.

But then my husband started worrying about his weight. And he learned different habits than I had. He read books about avoiding carbohydrates instead of fat. He read books about eating bacon and eggs, but not the toast. Eventually we both ate very low-carb diets. I gave up the sugar I'd always had in my tea, something I never expected to be able to do. I stopped eating cereal entirely.

Sleep apnea and migraines?

This week I picked up my custom-fitted mouth guard, which should help my sleep apnea. Sleep apnea is a common migraine trigger, so I'm hoping for improvement on that front as well. In fact, one article I read suggested that the apnea is an underlying CAUSE of migraines. Really??

Hmmm. Is there a relationship between sleep apnea and gaining a ridiculous amount of weight all your life even though you don't eat that much. Why, yes, there is.

What about depression? Do people with sleep apnea tend to have chronic depression? Yes.

OK, so what about ADHD? I have that, too. Is it relate--holy cow, that's related too!

But I bet the IBS isn't related. How could it be? IT IS.

Holy cow.

Healthy AND Easy

Many of my friends look skeptical when I talk about eating only fresh meat and fruits and vegetables.  One of their concerns is that eating this way takes too much time and talent in the kitchen.  Well...I do have talent in the kitchen...but it's not necessary for grilling a piece of meat and steaming or sautéing some veggies.

Recently I made this recipe from Taste of Home, and it wasn't much faster than opening a can of Navy Bean soup.  I chopped a few vegetables and cut up the ham.  It was quick, and it was delicious.  Given that it called for so much cubed ham, this recipe is one of the few where I'd suggest using low-sodium broth rather than the good stuff.  The final result was saltier than absolutely necessary.  Otherwise, this recipe is a keeper.  Had I been able to find a ham hock in the grocery store, I'd have begun with dry beans, which really isn't that much more complicated.  It just takes longer...and you need that ham hock.  They can be hard to find in the Pacific Northwest once Thanksgiving and Christmas are over!

Doing well with the Wellbutrin, but upped my nightly dose of Nortriptyline to 20 mg a while back.  I still get breakthrough headaches, but most respond to meds and caffeine in time for work.

Twenty Laps

The YMCA was closed for a week for cleaning and repairs and I missed my swims.  Today I got right back into the habit with twenty laps.  I don't want to brag or anything, but I can swim twenty laps in under an hour.  Whew!  So fast!!  Twenty laps, incidentally, is two-thousand meters.  I think.

Did I mention I swam twenty laps?

The XR version of Wellbutrin is continuing to give me very mild headaches.  These are the type that I can ignore as I go about my day, and they may well cease once I'm back on a strict regimen of waking at the same time each day.  I've read lots of feedback from other patients online, and many of them say the headaches do taper off, so I'm willing to continue with it.

I've eaten lots of carbs in the past few weeks, mainly in an attempt to curb the headaches.  It doesn't really help, so I'm going to stick more closely to the low-carb eating for the rest of the summer.