I’ve been meaning to write this up for some time but just haven’t gotten around to it. Frankly it’s more than a single blog post, it could be a book but time doesn’t allow for that so I’ll start with this.
As many of you may know I’ve spent the last year plus working with a metabolism doctor. Dr Emily Cooper is both a genius and an incredible scientist. I’d call her a miracle worker but that would insinuate that what we’re doing isn’t science and frankly, unlike all the other doctors and diets I’ve been on, this is the first science I’ve actually been a part of when it comes to my weight and metabolism.
You see, when you go into Dr Coopers office you spend time doing blood work and can actually SEE what is happening in your body, how you’re body is responding to what you’re doing, why things are working (or aren’t as we’ll get to here) and how to fix it (which is her role). Everyone else just sells you a bunch of pop science nonsense. Yes, “calories in, calories out” is nonsense. The scientific community has known that for a very long time but the diet industry makes a lot of money from it (it’s a multibillion dollar industry) and keeps pushing the myth. After all if that weren’t true and every person’s body were actually different you wouldn’t be able to sell that one size fits all workout or nutritional plan. In a bit I’ll post a blog that has links to medical articles (eventually) though if you really want to educate yourself just read Emily’s book which you can find here.
So a bit of background without going into it too much. I went to Emily because I’d gotten to the point where I couldn’t lose weight no matter what I did. Throughout my past I’d gotten to this point. Indeed just yesterday I drove past a place where I’d had my metabolism tested years ago. At the time I was working out 2-3 hours a day, 5-6 days a week. I was being very careful and counting my calories. Sure, I RARELY ate more than my allotted calories but I wasn’t binging. What did my test show and what was suggested by the guys at the CrossFit gym (this was at the start of that trend)? I just needed to work out an hour or two more a day. An hour or two more a day. An hour or two more… You know, like quit my friggin job so I can work out 5 hours a day?!? I’m sorry, but that’s not normal. No one should have to do that to lose a few pounds. And yes, I was overweight… I wasn’t one of those people trying to lose 5 pounds so I could fit into a size 000… I was trying to fit into something smaller than a size 14.
Anyway, years later I had started riding my bike all the time. Planning for a trip to Europe I couldn’t afford, I determined that it would help me get in shape, lose weight and save money (my gas guzzler was costing me $200-300 a month in gas) to ride my bike everywhere I could. That meant commuting from February (yes, even in the pouring rain) through October. That meant carrying all my groceries up a gigantic hill every evening. That meant climbing Phinney every evening. And it even meant riding all over the city to get to appointments. Indeed the only time I’d drive is if I had to carry stuff I couldn’t carry on my bike and I do mean COULDN’T… like 2x4s or cheesemaking supplies for a class I was teaching. Heck, I even tried to figure out how I could do that since I had hauled the 3 gallons of milk up that huge hill on my bicycle but the pots along with everything else was just too much stuff to fit on the bike.
Anyway, I was also watching what I ate. I made casseroles and broke them into 400 calorie servings. I’d eat four of these a day to make 1600 calories and then give myself another 200 ish calories. When I didn’t lose any weight I began going to the gym after riding my bike home. And yet still nothing.
It was pretty crazy at that point. Yet again I was at the “I really can’t do any more” stage. I couldn’t eat less and still cycle everywhere. If I tried to do so I literally wouldn’t have the physical energy to get anywhere. I needed some fuel to get my body to function. I couldn’t exercise more as there simply wasn’t time in the day.
So I went to Dr Cooper after hearing about her from a friend. And after the first round of bloodwork we found why I wasn’t losing weight and why what I was doing (a lot of exercise) was actually worse for me. I had insulin resistance. Essentially the thing that comes before pre-diabetes. Exercise was making everything worse because my body already thought I was starving (I could see this with my leptin levels) and the more working out I did the more my body really wanted to hold onto weight… after all I was obviously about to die. Except that I wasn’t…. I was still quite overweight.
Anyway, flash forward a bit. I’ve lost quite a bit of weight working with Dr Cooper. I’ve lost it eating WHATEVER I want. I mean that. Cake, cookies, you name it. I just want less of that than I did (I’ll get to that). I literally never count calories or think about what I’m going to eat.
More recently however I changed my meds (most insurance programs won’t cover drugs for insulin resistance or pre-diabetes… you have to let it progress to full blown type 2 diabetes before they’ll approve medication. Gotta love our medical system eh?). The new meds were… different.
Before I get to the science of what was happening let me tell you what I experienced. With my old medications several things happened. First, I stopped wanting to eat a lot of food. Indeed I went from consuming a ton of food at any sitting to eating very little. It wasn’t some sort of self-control and I wasn’t stuffed or full really. I was simply done eating. It was truly bizarre.
Never before (well, not in a long time) did I have the desire to stop eating before I was really full. I could mentally tell myself to stop but having my body and my motivation to eat just shut off? That was completely foreign. I just didn’t want anymore. Anyone who knows me knows that now I eat precious little food. My body knows that I’m overweight (see Leptin) and doesn’t want as much food as it did. Before it thought I was starving and wanted me to FEED IT. Now it’s fine with a lot less and really won’t let me eat too much.
Second, and this is a big one, I didn’t crave sweet stuff. Let me say that again, I didn’t crave sweet stuff. For anyone who knows me this is a huge thing. First, there was never anything that was too sweet before and now, a lot of stuff sounds sickeningly sweet. Second, while some sweet things sound good, the motivation to eat them or go get them is rarely there. I’d often choose a mint over ice cream as an after dinner desert now. That would have never happened before.
To be clear, before I would have almost killed you for something sweet. No really. I would get almost shaky wanting sugar. There’s a very good reason for it. We’ll get there.
So anyway, my meds changed and a few things happened. My partner and I go out to eat on occasion (more often than not right now as I’m prepping my house to sell) and I noticed that food I wasn’t able to eat in its entirety I could now. How the heck am I eating a whole burrito? What’s more, since I was used to my body telling me to stop when it was done I kinda assumed that I must simply need more food… I must just be more hungry.
And the sugar cravings were back. Now I was thinking about desert after dinner, concerned about what it would be and making sure there was something in the house whereas before the “something in the house” often went bad before I got around to eating it. My favorite gelato actually got freezer burn because it just never sounded appealing to me before.
What was going on?!
Of course it was time for my appointment and that meant a blood draw. Multiple blood draws actually. Your doctor has not done this for you most likely. You’ve not been tested for insulin resistance. To do so you have to have a fasting blood test and then you have to eat and be tested again several more times on a half hour interval. Usually the test takes about 3 hours with 5+ draws. It’s worth it (and that’s coming from someone who has veins that are hard to find).
When I went in my symptoms were right there in the blood science. First, my insulin resistance was back. That meant that in about an hour after I ate my blood sugar was dipping very low (this is why the typical fasting blood test won’t work… it doesn’t show this hour after sugar dip). Why was I craving sugar? Because my body ACTUALLY NEEDED it. I was crashing after eating… but well after eating at exactly the time I started getting hungry for something sweet.
But why was I eating more too? Again, the blood told me. My MSH, which had been better with the older drugs was now gone. It didn’t show up on the blood test at all. My appetite was through the roof because the hormone that regulates it didn’t exist in my body.
So now I’m back on the old drugs and working to a different drug that hopefully my insurance will cover. Eventually I’ll likely be able to get off the prescriptions but it will take a while. The other option is to not treat the problem and go into full blown diabetes and obesity as so many other Americans do. All because we refuse to recognize that our hormones affect our cravings for sugar and salt and control our appetites. We actually think it’s a willpower thing. Is it that people who don’t have a weight problem feel the need to feel better than others?
Or more likely, having never had an issue with the body’s responses to food they simply can’t understand why someone would overeat or crave sugar.
When my body is functional now it’s so incredibly night and day from what it was. I honestly rarely think about sugar. No really. In fact last week I purchased some M&M’s and I have NO IDEA where I put them. Some of you know how truly bizarre that is. Really, where the heck did they go? The funny thing is that I forgot I bought them. Forgot.
If you’re craving sweets all the time, if nothing is “too sweet”, if you can eat until you’re stuffed and don’t want to stop until that time it’s not you. Well, it is but it’s not some character flaw. It’s not something lacking in your motivation. It’s very likely something screwed up in your body.
But, you say, “I don’t work out like you did… I just can’t motivate myself. I don’t want to”. What do you think motivates you? Yup, hormones. Indeed you can make mice lazy by screwing with their hormones too.
People want you to believe that you’re a bad person. They want you to believe this because it makes them rich and hugely because they don’t understand the more complex science behind metabolism. There’s a lot of reason for that. It’s not easy is the big one. But it’s not you anymore than my cravings for sugar or eating too much was me. It was a system that was malfunctioning.
We assume our bodies are machines when it comes to weight loss (calories in, calories out) and discount their more complex systems (hormones) when it’s convenient to blame people but we’re more than willing to discount the machine answers (malfunctioning metabolic systems) when the science shows that it’s not a character flaw. Why do we discount solid scientific evidence simply so we can blame people and push pop science that hasn’t worked and indeed has made us more and more sick for years? Are we really so mentally ill that we can only feel good about ourselves by holding on to pop science to put others down? More and more it seems the answer is a resounding yes.
And yes, I know that this is simply my personal experience and to believe that alone would be committing an anecdotal fallacy however with a ton of science behind it and a whole lot of other people having the same experiences we have to question why our current paradigm isn’t working and why I can see the science on my blood tests. Further we have to really question why no other doctor ever bothered to check some of these basic tests to see if there was something bigger going on and why no one is checking the majority of people out there before telling them to simply eat less and exercise more, especially when that isn’t working and the problem is getting worse, not better.
Dr Cooper has started a foundation to do more research into the work she is doing. Sadly very few doctors are doing good science around this (though it’s changing… slowly). You can learn more here: http://www.diabesityresearchfoundation.org/
There is a section for practitioners. Send your doctor there assuming they’re up for learning new things. Not everyone is. Many already know it all. If nothing else that’s another thing I love about Emily… she’s always gathering more information and doing more research. Isn’t that what we should expect from our doctors!?
Finally, I wrote this up very late at night and haven’t had a chance to reread it. I may change it a bit to make it flow a bit better so if you come back and it’s a bit different forgive me. If I wait to make it perfect I’ll never get this posted!