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Effective weight loss: a wake-up call and a personal story

I was talking to an old friend recently and I remarked on how well he was looking.  He said he had lost two stone in weight and his waist circumference had gone down from 42 to 34 inches.  Wow!  I was very interested to hear how he had done it and he very kindly agreed to write his story:  

A Wake-up Call 

Salman Rushdie "Those who do not have the power over the story that dominates their lives - the power to retell it, re-experience it, deconstruct it, joke about it, and change it as times change - truly are powerless because they cannot think new thoughts."

I'm sitting on a zafu and it's a Saturday, day four of a 12-day retreat when I feel a thump in my chest, well it might have been a missed heartbeat I'm not sure. Then another one and another, I start to count them. They settle at one every 30 seconds, what is going on? What is going on is I have an irregular heart beat that by the next day is going to be one every 6 seconds and prompts me to leave the retreat and seek medical advice. Google enlightens me on the train North and I read...

An irregular pulse could be a sign that you have an abnormal heart rhythm. Atrial Fibrillation (AF) is one of the most common forms of an abnormal heart rhythm and a major cause of stroke; it is commonly caused by among other things high blood pressure.

This makes sense; my weight has been slowly but steadily climbing for a couple of years and with it my alcohol consumption and my blood pressure. I've been ignoring these warning signs and at 67 pretending they are all side effect of getting older. I get home and my GP arranges an immediate referral to the heart-monitoring unit at the Royal Infirmary at Edinburgh and a battery of blood tests. The good news is the arrhythmia is of the benign type the bad news is blood pressure is 145/95, cholesterol 6.1 and weight about 2 stone more than is good for me, with a waist measurement of 42ins. Waist measurement is really important for men because we accumulate visceral fat around our internal organs and this is not good and is almost certainly not helping my misfiring heart. The choice the GP offers is simple, either I start a course of statins and beta-blockers or lose weight so I opt for the latter.

I adopt the technical approach and start gathering information. I learn that if you can lose 10% of your current body weight you are a success story, if you can keep it off you are a hero. It is all about calories which equal energy. Key in this battle is my base metabolic rate and calorie intake balanced against exercise. As I lose weight my base metabolic rate will fall, this is hard wired into my physiology. The body is protecting itself against what it believes is a failed harvest and a period of enforced starvation. Aerobic exercise will counter this to a degree.

A pound of fat equates to 3500 calories. A reasonable rate of weight loss is between 1 and 2 pounds a week. I opt for 1.5 the middle way. This means I need to be 750 calories a day under my base rate.  The good news is I like to ride my bike, which is my preferred aerobic exercise, and an hour on the bike at a moderate pace is going to burn 600 calories, so on the days I ride I have a bit of wriggle room for an occasional treat. This I know is going to be important to keep my motivation level high.

Information is power so I buy a set of scales that is going to give me key information. I will have a read out of my metabolic base rate, the percentage of my body weight that is fat, my hydration level and my BMI (body mass index) and it will also tell me my weight.

I am not delighted to find my BMR (Basal Metabolic Rate) is only 2250. BMR reduces as we age which is one of the unfair tricks that nature plays on us. You need to eat less or exercise more just to maintain weight. So my calorie intake is going to be only 1500 per day if I am to lose 1.5 pounds a week. My BMI is at 24.6 a tiny bit under the magic 25. This is the official definition of overweight. A level of 30 is the obese level and a shocking 25% of men in UK are classified as obese and 65% are either overweight or obese. The ideal BMI range is 18 to 23 so I'm going for the mid point of 21.  My body fat percentage is 22.5% and a reasonably fit male should be around 14% to 17%. I decide to go for the low end of this and set a target of 15%.

So now I have the information I need I just have to work out the diet and the key word here is simplicity. I decide that I will do all the hard work of calorie counting before I start and then this will make the day-to-day eating easier. The old adage of breakfast like a king, lunch like a prince and dinner like a pauper is the route I decide to follow. I know this works for me from my experience on retreat. On retreat the routine is a substantial breakfast of porridge and hot fruits nuts and yoghurt. This has a low GI rating and gives a slow carbohydrate burn during the morning. I allocate 500 calories for breakfast. Lunch on retreat is around midday and is a mixture of vegetables with some form of protein, salad and fruit. I allocate 400 calories for lunch. Very little is eaten after midday on retreat, usually a cup of soup or alternatively two pieces of fruit around 5pm. I allocate 200 calories for this and that leaves me 400 calories for snacks and the occasional treat. A stick of liquorice or a square of dark chocolate is my favorite. My experience on retreat is that I always lose weight on this routine and after the first three days that are difficult my stomach will have shrunk and it becomes an easier diet to follow.

It is really important to stop the glucose level spiking and so having some calories in reserve for snacking is vital.

A bottle of red wine is 600 calories so I decide not to drink while I am losing weight. This will also help my blood pressure. I know that in the evening I will be struggling without a drink so I concoct a delicious alternative that is one third slim line lemonade, two thirds slim line tonic water ice, lemon and angostura bitters.

It is now six months since I started and here is a progress report.  I started on December 5th 2012 and it is now late May 2013. I weighed in at 12 stone 11 pounds and I now weigh 10 stone 8 pounds. I am at the bottom end of the healthy weight range for my height but there is a reason for this decision. Reading the research literature on weight loss it is not losing weight that is the real challenge it is keeping it off where the long-term challenge lies. So I have built in a wriggle factor. My long-term goal is to remain below 11 stone and I now have room for some motivating treats along the path.

Looking back over the records I kept the weight loss was not a neat linear drop. There was an initial quite rapid loss that I was expecting. This is normal and is usually mainly water. Then there was a fairly steady drop at 1.5 to 2 pounds per week and then a  de-motivating plateau around the 6 week mark. This lasted for about 3 weeks and then the weight loss recommenced but at a lower rate around 0.5 to 1 pound per week. I have no idea why this happened but I suspect it is the drop in metabolic rate that naturally occurs when engaged in a calorie restricted diet.

Reflections on the journey are positive. My blood pressure is now 115/75 and my cholesterol has dropped 2 points. I am still not drinking but the desire to do so has dropped away and I see no reason to start again despite social pressure to do so. I am much fitter and my yoga practice with a 34-inch waist is much improved. My bike is carrying 2 stone less and goes much quicker. Will it all last? I don't know but for now I am enjoying the experience and in August I'm going back on retreat and this time I am confident I will be able to stay for the full 12 days. That will complete this particular journey.

 

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