New Directions or What the heck am I doing?

This is going to be a long post. I considered breaking it up in several sections, but there never seemed to be a logical place to say “to be continued.” So you're getting it all in one dreary post.

It's been just over a week since I restarted the hospital weight loss program. I thought I'd write a bit about the program itself in more detail. I foresee that some of my future posts will include writing about my personal journey in this program. I wanted to give you all a glimpse as to what it is I'm actually doing and the support I get from the hospital as I go forward so you all have an idea of just what the heck it is that I'm talking about.

The New Directions program is designed, first and foremost, for the morbidly obese. It is not for those who have 10-20 pounds to lose. It is for those patients whose weight is seriously affecting their health.  There are risks, real risks, but those risks must be balanced against the risk of staying overweight. For me, there is the risk of becoming diabetic.  There is also damage being done to my heart because of my blood pressure right now, so getting the weight off is a very key component in stopping and possibly repairing that damage.

It is a low carb program. A patient starts off with 3 protein shakes a day, plus a lean meat and low carb vegetable for a meal (most choose supper). The goal is to stay below about 50 g of carbs a day. That is ridiculously low. But the goal is to get the body into ketosis.

Now, I don't claim to understand exactly what ketosis is, but I know diabetics avoid it like the plague It's when your body has used up most of the glucose in the muscles, the body starts burning the fat. It also starts burning muscle as part of the process, which is why protein is very important on this diet. The process also puts several different products in the bloodstream which, if unchecked, can damage the liver and kidneys.

(At this point, I am probably worrying my readers. Hang on...hear me out.)


It is important to drink 64 to 108 oz of water a day to flush the waste from the blood and keep the kidneys functioning. That, plus 2/3 of the glucose molecule is water, it means you're in the restroom a lot. The program makes use of the body's own process of using the fat stores but turning it up to eleven.

That's how I understand the process as it happens in the body. And I'm sure I have greatly simplified it.

Now, the program is done in the hospital. There is a health screening before one is accepted. It is directed by a nurse practitioner, overseen by a cardiologist/internist, and has a staff of registered dieticians (I prefer that spelling), personal trainers and two other nurse practitioners. Once a month the patient meets with a NP for essentially a health check up, just as one might see a doctor for a health and wellness checkup. Labs are drawn every month for 6 months to keep an eye on the kidney and liver. After 6 months, if there no indications of problems, labs are drawn every other month.

Now, to the meat and potatoes of it all, so to speak. Once a week the patient checks in. Weight and blood pressure is measured. This is when the patient purchases the shakes. The patient then meets with someone on the staff, usually the dietician, to go over the week prior. We review what we did for exercise and how often. We talk about problems encountered, feelings of success and failure, answer questions the patient might have and so on. It is also the time the staff asks questions geared to elicit information about the patient's general health and the director is notified if there is any change in health.

After the review, the patient attends class. These are real, in-depth classes covering nutrition, exercise, general health and emotional health. The last was always difficult because I feel the emotional connection to food is soooooo deep, it really can't be addressed in a group setting. Plus, the speaker has some woo woo ideas that I just couldn't always buy into, but more often than not was extremely helpful. Participation in the classes are mandatory if the patient wants to continue. However, some patients, like me, have been through the curriculum several times. These patients get excused from class if the director is comfortable that we “get it.”

Once the patient reaches his or her goal, maintenance begins. The patient works with a dietician to ween off the shakes and on to real food, using the lessons learned in class and specific work to the situations that arise. This goes for at least 6 months minimum. After that, the patient comes in for a checkup once a month for 6 months. If the patient is still maintaining the loss, he or she comes in once a quarter for a year. Then the patient is asked to come in twice a year after that.

Once you're in the program, you're in for life (or so long as the hospital funds the program). One can visit any class after the weight loss, purchase the products, meet with a dietician or nurse practitioner as needed or just simply call in if one needs a little encouragement.

I know some of you are skeptical of shake based programs. I was too. But the medical supervision, the educational component and the accountability has removed a lot of that skepticism for me. Eighty percent of their patients have maintained their weight-loss a year after meeting their goal. That was a statistic I couldn't ignore. If it hadn't been necessary for me to quit midstream last fall, I have no doubt that the transition to maintenance would have happened.

I'm NOT sure it would have been successful though.

I had a lot of work to do in self acceptance, self love and accepting & understanding emotional connections to food. In many ways I look at the last year as a time to work on these aspects without the stress of weight-loss I am much more confident restarting the program because of this work. And I have my readers and fellow bloggers to thank for that. I would not be at this point to begin anew if it hadn't been for your encouragement and understanding.

That's it in a nutshell.  Later I'll write about my personal adaptation to this program.  It isn't quite a severe as the description above sounds.

Ask me any questions you might have. I'm going to add a link to my email somewhere on the blog if you don't want to ask via a comment.  I believe in this program.  That in itself will take me a long way towards success.

Option 3

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I got out and ran today. I wish I hadn't. I really am too heavy and my ankles are screaming.

I came to a decision recently. I can wait for something to happen the rest of my life.  I can wait for something in my life to change and suddenly all this blubber will magically melt off and food will no longer have its powerful emotional connection.  But waiting isn't doing me a damn bit of good.

I could also do the hard work, count my calories, watch every morsel that passes through my gullet.  I can live my life thinking about food and making conscious decisions to limit myself.  And I can shame myself when I inevitably fail setting up another cycle of emotional sabotage.

Or, I can live my life as if I were already thin and healthy.  I can tell my body that we are where we are and I'm going to live as if we are already over there.  I have a feeling my body will come along for the ride.

I'm choosing option 3. And that's partly why I went out for a run today.  That's the sort of thing I've been waiting to be lighter to do and I have missed it.  Reality is settling in as I ice my ankles, but damn I feel good.  I will have to take it easy until reality catches up with this attitude change.  But I'm not going to stop altogether.

Having made this decision, the Itty Bitty Shitty Committee in my head is trying to veto it,  telling me that I'll treat this as carte blanche to eat what I want, when I want and eventually end up even heavier.  Not true. I will eat as if I'm already healthy and want to stay that way.  I've learned quite a bit about intuitive eating.  I have a lot to learn about emotional eating.I know this isn't a panacea.  This path will have its ups and downs, failures and successes. But I trust that this is a journey worth taking.

Something positive, something negative

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I am really struggling with this post.  I want to share a nascent change I've noticed in the last month.  I just don't know how to do it without giving a lot of backstory.  There's just so much to tell.  I'll try to keep it simple.


I recently shared about a financial situation that blindsided us.  Indeed, what I shared was rather negative.  And I can't stand here and tell you I faced that situation with complete happy optimism.  But I worked hard to keep a positive perspective.

Instead of thinking, "my god I have to put this on a cc and woe is me forever", I turned it to "thank god my credit limit is high enough that I can make this gap stop measure and get some breathing room before the next decision."  Instead of focusing on "there is nothing to be done, there is no help for us," I found myself open to the overtures of two CPAs who attend our church willing to sit down and go through our options.  And instead of thinking "I can't sit with them...then they'll know how ignorant I am when it comes to money," I thought "they are the experts; I can learn something here."


It wasn't easy, but I remained open to the chance that positive things could happen for us.  Indeed, I kept telling myself that positive things would happen to us even though I didn't always fully believe it.  Things turned out...ok.  None of the options available to us for absorbing this debt were any better than the cc.  Indeed, the current rate on this card is actually the lowest available to us, so the accountant friends gave it their blessing to keep it there until something else changes in our situation.

And now, on to the rest of the post....

Perhaps it is as simple as this: what you tell yourself to expect, that is what you find.  In everything. In your flaws, in your relationships, in your job, in your faith, in your finances.  Everything.  That is the power of Affirmations.  Whether that affirmation is positive or negative, it will have a profound effect on your responses to everything you encounter in life.

And that is the change I have found in myself.  I am floored how easily I calmed down after the initial shock.  I am shocked at how pervasive this new attitude is.  I do have a long way to go.  I have taken great strides in affirming myself as the great guy I knew I could be.  I have gone a long way to accepting that life will be painful, but positive opportunities will present themselves if I'm looking for them.

There is one place I still struggle with, though.  I hate my body.  I loathe it.  Right now my belly is so large and I feel so bloated.  I can't bend over to tie my shoes without holding my breath.  I struggle to get out of the sofa. I can feel the constraints of my clothing all day long.  I can accept my inner self so much easier than my physical self. I find myself thinking that maybe if I trick myself with faking positive affirmation thing as it concerns my body and it will respond even though deep down I hate it.  But it's not going to work.  As long as I affirm that I hate my physical self, my mental self will continue to abuse it and treat it as if were truly unworthy.

I love my fat self in as much as I have compassion for how I got this way--that I have used food to protect and soothe my emotions and that I am not a failure...but that is as far as I can get.  The flesh is much harder to love than the hurting person inside the flesh.

I have come a long way, my friends; but I have so much farther to go.  Thank you all for coming this far.

Counting vs Knowing

In my last post, I mentioned that I'm not going to count calories.  I'm going to "know calories."  That distinction is important to me.  I know that if I count calories to some predefined limit, I will chafe and rebel. I know that, once meet that predefined limit,  I will look at the rest of the day as depriving myself.  I know that when I cross that limit, I will not control myself but instead will say "what the hell, I blew it anyway.  Where's that bag of chips and, oh, how about just a pint of dip this time?"  I know myself well enough. It's one reason why points don't work for me either.

But, knowing what calories I've taken in makes a huge difference.  It's about being mindful.  It's about learning.  It's about paying attention.  It's a completely different mindset. And it works.  I'm learning about how the little bites of everything add up, and add up fast.  I'm mindful of what I decide to eat.  I plan ahead.

I know what is going on.

It's hard to describe in words what I'm experiencing.  A "rebirth" is much too dramatic.  A "revelation" is over stating it too.  I'm experiencing...growth.  I'm experiencing...control.  And it is rather exciting.  Sure I've already had days where I went way over what was healthy, but I know by how much I did and I can wrestle with the questions of why and, more importantly, if I really want to do that again. What's more, this approach seems to fit better with my personality and the way I process information.  It's putting things in a structure, a system, that makes sense (to me at least). 

I honestly did not know just how many calories I was putting into my body when I binge.  And now that I have that little piece of information, or know how I can go about finding it, I have something to make an informed decision with. Sure, I did read the nutritional guides on the sides of things, and that does in a pinch.  Using livestrong.com, however, brings it all in to sharp focus as it tallys and displays the information for me.  I do wonder if I will have the discipline to continue doing this.

So far, so good.

Kevin's Plan

I have a plan.

I plan to run a 5K on Jan 1.

I plan to train for that run.  And I plan to run it with my son and daughter.

I plan on tracking my calories and whatnot on livestrong.com

I plan on knowing my calories, not counting them.

I plan on returning to my program once my wife is healthy and back to work.

I plan to work diligently on mindfulness; to avoid negative self talk; to tell myself I am good and I deserve health.

I plan on staying on this journey through the good and the bad; to accept that setbacks are unavoidable.

I am a good person.

And you are too.

There are a few things in this list I want to write more about in the future, but for now, it's a plan.  Not a goal.