Thursday, August 21, 2014

How to Maintain: FAQ

I'm fasting for my annual checkup blood tests, which includes HbA1C, cholesterol & triglycerides, all indicators of my cardiac risk and of how well, on the whole, I've been controlling my blood glucose levels. I had my physical exam last week and all was well. It's been 7 years now that this has been the case.

Seven years of controlling my Type II and CVD risk factors with nutrition and exercise. Seven years with numbers in the "normal" range or better. And yes, seven years at my target weight.

Sometimes folks ask if it is "as they say" harder to maintain this weight (and really, I guess, that means healthy habits too) than it is to lose the weight or make the needed changes in the first place. I have a clear answer: no. It's way easier. But that's just one of the questions I get asked about weight loss. I usually try to change the subject to the broader category of healthy behaviors. Because I really never set a goal of losing weight, it was just a means to the other end of getting healthy and getting to a place where I didn't need to take medication to control my risk factors.

But I know folks want to know about losing weight and maintaining weight loss. are some other questions folks sometimes ask, presented with short answers. If you have others, feel free to ask and I'll answer them too.

About Me & Losing Weight

Q: So how much weight did you lose, anyway?
A: About 70lbs. I was 230 at my heaviest. For the last 7 years I've been within a few lbs of 160 with zero exceptions.

Q: How long did that take?
A: About 9 months. Apart from the first week with some water weight loss, I didn't drop more than about 1-2 lbs per week.

Q: Did you hit a "plateau?"
A: I didn't graph it, but I do recall weeks with losses less than 1lb. But otherwise it was pretty steady.

Q: So, how did you do it? Diet? Exercise?
A: Both. I did 45 minutes of vigorous exercise 6 days a week. I counted carbohydrates and calibrated my intake to achieve a normal steady-state blood glucose level between 100-140 mg/dl, with the high number being less than two hours after eating.

Q: Yeah, but what was your diet?
A: No restrictive diet. Just counting everything, watching what the food did, then adjusting portions, timing, and choices to get the BG results I wanted. I still ate (and still eat) everything.

Q: So you still eat sweets and stuff.
A: Oh yes.

Q: Wait, so did you count calories?
A: Nope. Because all calories aren't the same. (try getting fat eating celery; pandas can do it, but you can't).

Q: So did how did you set a goal weight?
A: I didn't really. I eventually got to a place where my other numbers - the ones I was really monitoring like BG, A1c, etc. were normal, and that determined it. Now, somewhere between 160 & 165 is what I try to stay at, but only as a shorthand for the other things.

Q: Ok, so then how do you figure out how many carbs equals the right amount?
A:  That took a while. But you can only do it by monitoring your BG.

Q: So about this *exercise*...what did you do to lose the weight?
A: I've written a lot about this, so I'll keep it simple. I rode my $300 7-speed comfort bike on an $150 indoor trainer. I did structured workouts consisting of short, intense intervals and varied these each day. I did it all while watching inane sports talk shows.

About Me and Maintaining Weight
Q: So what do you do now? is it the same?
A: No. I eat a little more and exercise a little more, on average, than before.

Q: How much more do you eat?
A: Not much. Roughly 1 more carb unit per meal per day than when I was trying to lose weight. That amounts to 2-3 units for breakfast, 3-4 for lunch and 3-4 for dinner and usually one 2 unit snack somewhere during the day too, depending on how active I am that day.

Q: How much more exercise?
A: About 6-12 hours per week. On the high end of that range in warmer weather. At least half and sometimes more than that is vigorous exercise (heart rate above 75% of max.)

Q: So why more exercise?
A: Just for fun.

Q: Oh, so that's not all for keeping weight off?
A: No...for that I'd need only about 75 minutes of vigorous exercise per week, or 150 minutes of moderate (less than 60% of max hr).

Q: So this HR this important?
A: Only as a measure of intensity. Your body will only adapt to exercise that is a challenge. If you do the same thing over and over and never challenge yourself, you won't cause change. Bodies are amazing at adapting to things. The cool thing, though, is that intensity is better than duration for causing adaptation. So a little hard exercise can be as good for you as lots and lots of moderate exercise. (so stop reading on the treadmill).

Q:  But you are some kind of cycling freak now, right?
A: Kind of, yeah, but that's not required. It's just fun for me. (although when you burn 9,000 calories in a day you *can* pretty much eat whatever you want)

Q: So you are now, like, normal? I mean no diabetes or anything?
A: Clinically yes. Normal numbers. I'll find out if that's true still next week when my latest tests come back. But I've had an A1c near 5 for the last 7 years. So far, so good. And much better.

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