In her terrific, informative comment to yesterday’s post, Mary wrote, “The scariest part of all is why do so many people regain weight? It can’t all be willpower because well over 90% of people do regain. Studies suggest it is the hormonal signals the body starts sending out once we lose a significant amount of weight.”
I haven’t read the studies and I can’t speak about all overweight people, but Mary’s absolutely right. In my case, overeating and being obese wasn’t about willpower or the lack of it. It took me a long time to understand that compulsive overeating is a disease with the emphasis on compulsion. Suffering from it did not mean that my will was weak. Ask anyone who knows me well and they’ll tell you that I am extremely strong-willed. When you have a disease, you can’t will it away. You need a treatment plan and tools to combat the illness.
I don’t know if anyone understood this about the disorder when I was a kid. I’m not sure people really got it about alcoholism and drug addiction decades ago either. I know I heard a lot of admonishments that I needed to have better or stronger willpower to lose weight.
Sure, you can gut it out on willpower for awhile, but eventually I always stumbled and went back to my regular way of eating. Will power? I have it in abundance and it helped me stick to some really extreme diets over the years. I’ve been on some doozies in my life including one where I drank only this horrible liquid protein stuff and didn’t eat anything at all for almost a year. I lost over 100 pounds on a plan where I ate no more than 9 oz of protein (usually chicken) and a cup of salad a day.
Optifast and variations of it offered by different hospitals, Weight Watchers, Atkin’s, Pritikin, one that didn’t have a name but included shots of human placenta. I’d do great for awhile — gutting it out with willpower — but sooner or later, I’d fall off and game back all of the weight.
When I started going to OA I was also seeing a therapist who was the first to talk to me in terms of compulsive overeating. That therapist was also in the program, although not at the same meetings, so she walked the walk and talked the talk. I attended meetings three to four times a week and, in the beginning, kept waiting for someone to give me the diet I was supposed to follow. Then I realized that everyone else talked about their different individual food plans. Some abstained from all sugar or white flour products, or from sugar and white flour. There were low carb and no carb plans. I didn’t know what I needed. The therapist helped by suggesting we look not so much on the individual food choices, but instead focus on how I ate — the actual behavior of eating.
We designed a food plan that was pretty simple. The guideline was that I could eat whatever food that I wanted but only in the way that I pre-decided that morning and I had to write down the plan and commit. I can still remember her saying to me, “If you decide in the morning that you’re going to consume an entire pizza for dinner, that’s okay. However, if you commit in the morning to two slices for dinner, then that’s all. No compulsively reaching for additional slices.”
As outlandish as that “entire pizza is okay” sounds, setting up my food plan in this way and sticking to it relieved a great deal of stress, anxiety and shame. Each day that I successfully stuck to what I’d committed in the morning meant that on that day I’d abstained from compulsively overeating. Abstinence fueled more abstinence.
It was not a matter of willpower, of clenching my fists and fighting my cravings. This was about being conscious, aware, and clear-headed about food and eating behaviors.
When I am in a good place in my head about food and the eating disorder, I can make healthy choices. Quite often, the choice has nothing to do with what foods I eat. Instead, it’s about whether I eat compulsively or don’t. That’s still the choice that I need to make today, even with the weight loss surgery. My food plan is to eat six times a day, mostly protein followed by veggies or fruit, with carbs last and in a small amount if at all. This does not mean that I can graze and graze and graze, eating small amounts of anything and everything throughout the day. There are days when I set myself up and consciously make the choice to deviate a little — permit myself the piece of chocolate or a couple of bites of a dessert.
I know for some people it’s hard to understand the distinction. Sometimes it’s a very subtle difference between operating on willpower and making conscious choices, but I get it and that’s what really matters.
Mary also mentioned the hunger hormone in her comment. Again, I don’t know how much it affects, or doesn’t, different people. Likewise, I don’t understand why some people reach the point of satiety before others or how someone without weight loss surgery could be happy with a few small bites. I guess I don’t understand it because I was never one of those people of light appetite. Until now. I don’t get the same hunger cues that I used to feel. The area of the stomach that secretes the hunger hormone was removed in the surgery. I do not physically feel hungry unless I’ve made the mistake of skipping one of those six meals. Some folks who’ve had surgery tell me that this will change and I’ll start to feel hunger sooner. I’m not too concerned at this point. Even if I experience hunger, I do have the tool of a greatly reduced stomach so I am satisfied with relatively few bites. As long as I continue to be conscious and aware of my choices, I should keep doing fine.
Weighty Matters 
Mary, I’m glad my comment was useful to you. I see what you are saying now about compulsive overeating. I think my concern is people who are responding to biological cues and assuming it’s their lack of willpower. I dislike seeing people beat themselves up over behavior that is normal.
Egads
There’s a Mitch Hedberg joke about alcoholism that seems apropos.
“Alcoholism is a disease, but it’s like the only disease that you can get yelled at for having. “DAMMIT, OTTO, YOU’RE AN ALCOHOLIC.” “DAMMIT, OTTO, YOU HAVE LUPUS.” One of those two doesn’t sound right.”