Pre-Op Ramblings – Part Two

Over the next three months, while the Powers That Be decide whether or not my op is worth funding, I have regular appointments with a dietitian and a physiotherapist.

Last Tuesday I saw the Dietitian. She asked me questions about the food I eat, how often I splurge on takeaways and what I have if I do (still too much, too often… working on it). She seemed generally pleased with my progress and simply advised to keep on doing what I’m doing; logging calories in myfitnesspal, and keeping an eye on things with the Fitbit. She also put my mind at rest on the sticky issue of the funding decision. She said if I didn’t get funding it would be because the operation is not considered safe for me at this moment in time. However, it would appear things are looking positive and I should keep on keeping on until the next stage of the process is reached.

On Thursday I had my first appointment with the service’s new Physiotherapist. I had no idea what to expect having been through nothing of the sort in the past. Another new appointment, another assessment. This time a lot of questions which really brought home just how ruddy lazy I’ve been. The questions, and tests of my walking pace, ability to run (hilariously poor) etc were to establish a baseline, a point from which we can measure progress.

She then set me a daily exercise routine. Ten minutes, three times a day, when I would normally be sitting on my arse staring at my iMac. Since the appointment I’ve done these exercises twice.

I have to admit, exercise has always been a problem for me. And ten minutes of stepping and what-have-you seems like ten hours. The prospect of doing this three times a day does not fill me with joy. I know that if I’m to do this, I need help.

And, unfortunately for my metal-loving husband, that help is in the form of dance hits from the 90s:

And some unadulterated cheese from the 70s:

In my next instalment of pre-operative blether, I’ll share the first few days from my activity diary. Will embracing my inner English Disco Lover make any difference? I think it might. Blame it on the boogie.

Weight Loss – Sam’s Story

I have a file at our local hospital. There’s a big red stamp on the front advising anyone handling it to ‘look inside’. I assume the big red stamp points them to my weight and a comment “yes really, so be careful”.

“Have you always been big?” some folks ask. I tell them yes, and my arrival nearly killed my mother who still to this day walks like she’s lost her horse. Yes, my weight has been a problem for me as long as I can remember. My early childhood was marked with concerned aunties talking to each other over my head saying “it’s just puppy fat, it’ll go.” My teens were marked with bullying, exercise advice from said concerned aunties and, confusingly, a stepfather who couldn’t keep his cigarette-stained hands to himself. Early adulthood was marked with the desire to do whatever the hell I wanted and since I had it drummed into me that I was a lost cause from the get-go, I went for food and alcohol. Maybe heroin would have been less damaging (and at least I’d have a decent figure, eh?).

Things really started getting out of hand around 2003 or so. But remaining convinced I was a lost cause, I didn’t do anything about it. My logic was, food was delicious, my life didn’t amount to much, so if I clocked out early, it wasn’t any great shame.

There have been several attempts at getting well since. I stopped drinking in 2004, and stayed off the booze for almost 3 years. At the end of 2006, when Michael and I had moved 200+ miles to a new life in Devon, I started drinking again. In 2007, I joined Slimming World. I stuck religiously to their plan to the point of obsession. Any day where I ‘cheated’ was a day ruined. I became a complete pain in the arse, but I managed to lose 10 stone (140lb/63.5kg) in less than a year. By this time though, my drinking had become heavy and by 2011 I had regained every last ounce of that 10 stone weight loss with a few extra to boot. I was a chronically depressed, incredibly overweight alcoholic and to my mind I was in the middle of a ‘slow delicious suicide’.

I decided to try again to get well at the end of 2011. I gave up drinking in October, and I have been free of the booze ever since (some days more willingly than others). Around that time I also asked for a referral to the excellent obesity clinic in Exeter. I saw a wonderful psychiatrist and dietician, and decided that the best course of action for me was bariatric surgery. I was referred to Musgrove Park Hospital in April 2013, and I’m currently on the waiting list.

I signed up for MyFitnessPal in December, and when I used it (which wasn’t daily) it did a good job of keeping me in check. It wasn’t until Michael joined me in July, and bought the Fitbits, that things really started to fall into place. For me, having access to all the information on food intake and exercise has helped me to learn what works and what doesn’t. I have got a long, long way to go to get well, but with the help of MFP and fitbit, and with the support of my husband and fantastic friends, I will get there. Hopefully without surgery, but if I have to take that option I will.

Until then, it’s one meal at a time.

Losing Weight with MyFitnessPal and Fitbit

I’m fat. I could really do with being less fat.

Inspired by Sam, I’m working on it with the help of two online services and one little gadget. I’m a geek, so if the solution to any problem can involve wireless syncing and iPhone apps, it’s a good solution.

The eating side of things is tackled by a site called MyFitnessPal. It’s a terrible name, but a very effective online service for counting calories. The activity side is helped along by Fitbit, which is like a very clever pedometer that reports back to their online service. I’ve talked about the Fitbit before, so here I’ll concentrate mainly on MyFitnessPal, then update a bit on how I’m getting on with the Fitbit after more time using it.

MyFitnessPal

Counting Calories

The idea of a calorie counting site is fairly simple, and it is, ultimately, the key to weight loss. Burn more calories than you eat, and you should lose weight. Admittedly, as with so many things, it’s a little more complicated than that in reality, but that’s the basics. To do the job, a calorie counting service needs to know how many calories you’re eating, and how many you’re burning.

That means you need to tell it about everything you eat and drink. Everything. If you miss things out, they don’t get counted, and any figures you work on will be wrong. It’s absolutely vital to any such service that entering the food and drink you consume is as easy as possible. That’s where MyFitnessPal does really well.

Users can add items they eat, and enter the nutritional information. You can search for stuff that’s been added. You can also add your own, but with so many users adding things, it’s rarely necessary – I haven’t needed to add anything yet. Adding your own cooking can be a bit of a chore, if you add each ingredient separately. There are often pre-calculated ‘meals’, that you can use if you don’t mind being a bit approximate, and for the most part they should be near enough.

There’s An App For Fat

My favourite feature, though, is using my iPhone as a barcode scanner. Choose to add a food, pick a meal, tap the barcode button, and point the iPhone’s camera at the barcode. It does surprisingly well at reading barcodes at strange angles, and partly ripped codes don’t seem to be much trouble, as long as the rip has left at least one straight path through the code. It looks up the barcode online, and usually brings up the right item within seconds.

MyFitnessPal counts several other things along with calories, like sodium, fat, and protein. I haven’t taken too much notice of them so far, but I have noticed that quite a few user-added items have some of their information missed out. You’d probably need to double-check, and perhaps re-enter, quite a few things if you were trying to accurately track, say, your sodium intake. For my purposes it doesn’t really matter.

I’ve been using MyFitnessPal for over two months now, and haven’t knowingly missed out anything I’ve eaten, so it certainly seems to be practical enough for me to use.

My Problem, and MyFitnessPal’s Solution

I’ve come to realise that the key problem for me with weight loss is that I don’t tie short-term sacrifices in to long term gains well. The same problem means I’m not naturally good at saving money, or generally planning for the future, especially long term. I see a biscuit. I see a decision. The down side is a possible weight gain and reduction in health over years if I keep repeating the decision to eat the biscuit. The up side is I’ll be eating a biscuit that looks delicious. To me, the decision has always been easy. Nom. I ate all the biscuits.

And all the cheeseburgers. And at least some of the pies.

MyFitnessPal attempts to connect these short term decisions together. Because each thing you eat adds to today’s total, the biscuit reduces the chances of me hitting my target that day, or means I won’t be under by as much. It reduces my score that day. Immediately. The pay-off for not eating the biscuit has moved forward. It’s become somewhat arbitrary, about balancing some numbers, but it’s now. That makes quite a difference to me.

In addition to that, at the end of each day, when you close your food diary, it calculates an estimated weight loss over five weeks if you did the same every day. That connects the decisions I made today with a longer term event, but one that’s soon enough to seem quite real. If it tells me my weight in five weeks will be notably lower than it is now, I know that’s as a direct result of the things I decided to eat today. And the things I decided not to eat.

The weight loss idea feels more real, and more immediate, so I care about it more. Enough that it really isn’t difficult to turn down a cream cake, or to avoid adding ketchup, or to have less potatoes with my meal.

Sometimes, I decide something is worth eating anyway. I ate an entire tub of Ben & Jerry’s Cherry Garcia last night, and it was worth it. I’d done ok for the rest of the day, though, and it was the frozen yogurt version, so I still managed to stay within my calorie allowance. Win.

Calories Burned

The other half of the calorie equation is what you’re burning. Everyone thinks of the calories used in exercising, but most are actually burned just by your body’s basic functions. Breathing takes energy. Your heart uses energy to keep beating. All this stuff forms your Basal Metabolic Rate. MyFitnessPal can calculate a reasonable estimate of this, based on your weight and height, so it knows how many calories you generally use. It also asks you how much general activity you do – it makes a difference if you’re generally sedentary or if you have an active job. It can add these activity estimates on to your BMR to get a good idea how many calories you normally burn.

If you do more on a particular day, you can add exercise to MFP, and it can add this to its equations to work out your weight loss (or gain!).

Keeping track of how much you do each day, though, and trying to guess how much activity you’ve done relative to ‘normal’, can be difficult. That’s where Fitbit comes in.

Fitbit

I’ve written before about what the Fitbit is and what it does. The very short version is that it’s a clever pedometer that counts steps and ‘floors’ climbed, and wirelessly syncs the data with their online service.

I took a few steps today.

The interesting part for our purpose here is that their online service can be connected to MyFitnessPal, and will feed the same data to them. If you’re more active today than you normally are, Fitbit tells MyFitnessPal about it, and you get a credit for exercise added to your daily totals.

If you’re easily motivated by changing arbitrary numbers, as I am, it can really help you to get more active. I don’t mind popping down stairs for something as much when I know I’m going to get some ‘credit’ for it – even if the credit is just changing a number. Because of the way MyFitnessPal ties those numbers in to my long term weight loss, the number feels important and relevant. So I do more.

Working Together

Both of these services are useful, and could help on their own. The combination of the two, working together, is what makes them work really well for me, though. The Fitbit watches what I do, with very little effort needed on my part to make it work, and means I can compare activity levels on different days. MyFitnessPal uses that data to give it a more complete picture of your inputs and outputs, so it can calculate your calorie equations better. It does seem a little like it’s making a ‘game’ of activity and weight loss, but if it works, I’m all for playing.

If anyone wants to join me, I’m pigpogm on both services. Profiles here:

…or straight to the sites’ home pages: