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Embracing Physical Pain

Have you ever thought your chronic pain can only be relieved by taking ever-increasing chronic pain meds? Yeah, me, too. But, in this second of a series of posts on dealing with your life’s pains, I’ll tell you what I found out. If you will apply the P10 Principle to relate with your pain, instead of just using drugs to avoid it, then you can manage your pain with a lot less pain medication, a lot less harmful and/or addictive pain medication, or may be no pain medication at all.

Pain has three components; Suffering from pain ignores them; Relating with pain embraces them.

Each and all of what we call physical, mental, or emotional pain are comprised of each and all three physiological, psychological, and emotional components when it comes to perception of and response to a pain stimulus. The physiology of pain is the signal transmitted from stem to stern and around about through the central nervous system that “something is wrong and we need to do something about it.” The psychology of pain is the interpretation or meaning we give to that pain signal. And that interpretation of pain is created, viewed, and perceived through the often abraded and/or opaqued lenses of our emotions.

Suffering, if one choose’s to allow it, results from ignoring or, worse, denying one or more of the physiological, mental, and emotional components of pain and negatively and reactively responding to one’s pain instead of positively and proactively relating with one’s pain.  Relating with both temporary and chronic pain involves understanding all of such pain’s three components and differentiating between the actual pain and the suffering it causes, and focuses on achieving relief from that suffering.

Suffering from pain flows from thoughts such as: “Why is this happening to me?!” “This isn’t fair!” “It’s horrible!” “I can’t stand it!”

Relating with pain flows from thoughts such as: “Why is this happening in me?” “This is a physiologic process.” “I can physically, mentally, and emotionally work with this.” “I CAN handle this!”

Using the P10 Principle can move you from suffering from pain to dealing with it.

Proactively want to reduce your pain using better resources than medications.

Perceive your practically perfect performance of dealing with your pain; your present quite imperfect way of dealing with it; and your life’s precious resources of self, time, effort, energy, emotion, intellect, property, and people that you can use to deal better with it.

Plan how you can use your life’s precious resources to deal affirmatively with your pain as best as you can.

Prepare your resources.

Practice your plan.

Persist by continuously monitoring the quality of both your practice and your results, and improving your planning, preparation, and practice.

Promote your Practically Perfect Performance as much as you feasibly can.

In the next post of this series, I will discuss in more detail how to apply the P10 Principle to specific examples of pain.

In the meantime, Go Out There Today And Be Great! All The Time!

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Are Fat People Just Food Addicts?

Do you ever wonder why those of us who are as fat as we are are as fat as we are? Yeah, me, too. And the answer to that question is even more complex than that question is worded.

Truthfully speaking, however, we do not really know the answer to the question of why we let ourselves get as fat as we do completely. Why we do what we do, both in general and concerning our eating habits, continues to vex us as much as a mystery inside a puzzle inside an enigma.

Almost nothing about obesity is easy to explain fully and completely with a high degree of certainty. Why? Because obesity, as a disease, has several causes for its onset, development, and persistence.

One theoretical cause of obesity scholars have recently advanced includes the idea that obesity results from food addiction behaviors. Some studies show a link between mood and dietary patterns including specific nutrients. The upshot of all this appears to be we eat highly palatable food because it both tastes good and makes us feel good.

Apparently, tasty food tastes so good and makes us feel so good that recent research also shows highly palatable and energy dense (high calorie) food may have addictive potential. People who chronically eat more of some foods in than they need despite knowing it is bad for them do so because they have lost control of their food behavior. In fact, research shows a 40% of obese people seeking bariatric surgery show signs of food addiction.

Alot of current research indicates there seems to be a potential relationship between food behavior and being fatter than one desires. In fact, the research seems to conclude highly palatable food may be as addictive as common drugs of abuse.

Why do we get addicted to eating tasty food to excess? Because somehow, someway, somewhere in our life our hedonic eating (eating more tasty food than we need just because we like it) started tickling a particular region of our pleasure centers in our brains called the nucleus accumbens, which makes us feel good, and we like to feel good, thus, we reinforce the behavior of overeating tasty foods.

We like the good feelings we get when our nucleus accumbens gets tickled from eating so much that it almost seems like we may be addicted to this hedonic eating of highly palatable food. Now, when we look at the actual structure of the nucleus accumbens in many fat people, it appears that fat people are more susceptible to this addictive reward-enforcing response to tasty food because they have fewer structures in their brains called D2 receptors, which process dopamine.

When you have fewer D2 receptors, you process less dopamine in your pleasure center, which means the excess dopamine then tickles your nucleus accumbens more and better and you reinforce the habit of eating tasty food more than regular weight people. And all this science seems to indicate that fat people continue to pursue this “eat-and-be-happy” cycle over and over again despite the negative social, financial and, health consequences that occur as a result of their being fat and getting fatter.

Despite scientifically learning all of this “food addiction” stuff, however, we must keep in mind that we don’t know a whole lot more than we do know about food addiction in obese people and there is no easy anti-food-abuse drug out there that we can take and immediately stop loving excess amounts of tasty food.

Not everyone exposed to palatable food environments develops obesity. Knowing the biological and/or behavioral motives or reasons why people eat highly palatable foods could help explain the susceptibility or resilience with respect to obesity. Thus, we need to continue to study why people begin to eat these kinds of food so we can design appropriate “personalized” treatments to lessen overeating and combat obesity.

The Palatable Motives Eating Scale (PEMS) discussed in an earlier post is a validated and robust scale to identify motivations for eating highly-palatable foods. The scale allows detecting motives for eating tasty food. Those motives include:

  • Social (e.g., to celebrate a special occasion with friends),
  • Coping (e.g., to forget about your problems),
  • Reward enhancement (e.g., because it gives you a pleasant feeling) and
  • Conformity (e.g., because your friends or family want you to eat or drink these foods or drinks).

So, it’s not just what you eat, but how, when, where, and with whom you eat that affects how much you eat.

All that being said, we have much more to do and discuss.

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19 Reasons We Eat Tasty Food More Than We Should

Have you ever looked down at the half-eaten piece of foot-high chocolate-chocolate cake you are scarfing for dessert and asked yourself, “Why in the heck am I eating this?” Yeah, me, too.

People who study eating call eating huge, sugary desserts after a more than full meal like this hedonic eating. Hedonic eaters eat not because they are hungry or have a metabolic need for nutrients, but rather because their neuroendocrine systems linked to reward drive them to do it. This translates down to hedonic eaters eat more than they nutritionally need because it feels good to eat food that tastes good and somehow makes us feel good.

Researchers (Burgess, et al) have come up with 19 different reasons we hedonically eat highly palatable foods that, in more than small quantities, usually make us fatter than we would like to be. Burgess and some other University of Alabama Medical School (“Roll Tide!”) researchers compiled these 19 reasons into a quick test called the Palatable Eating Motives Scale (PEMS), which is used to help hedonic eaters realize why they eat so much of what they eat when, where, and how they eat it.

Examples of such palatable foods include:

  • Sweets like chocolate, doughnuts, cookies, cake, candy, ice cream, other desserts.
  • Salty snacks like chips, pretzels, and crackers.
  • Fast foods like hamburgers, cheeseburgers, pizza, fried chicken and French fries.
  • Sugary drinks like soda, sweet tea, milkshakes, and sweet coffee drinks.

This fixation with fattening foods may have something to do with Bama’s mascot being an elephant, but I digress.

Burgess and the Bama Docs asked people, “Thinking of all the times you ate these kinds of foods/drinks, how often would you say that you ate/drank them for each of the following reasons?” and had them pick a frequency level list of

  • Almost never/Never
  • Some of the time
  • Half of the time
  • Most of the time
  • Almost always/Always

The reasons (20 here, but 1 was omitted from the tool) the people thought about comprised:

  1. Because your friends want you to eat/drink them
  2. So that others won’t kid you about not eating or drinking these items
  3. To fit in with a group you like
  4. To be liked
  5. So you won’t feel left out
  6. To forget your worries
  7. Because it helps you when you feel depressed or nervous
  8. To cheer up when you are in a bad mood
  9. To forget about your problems
  10. Because you like the feeling
  11. Because it’s exciting
  12. To get ‘‘high-like’’ feelings
  13. Because it gives you a pleasant feeling
  14. Because it’s fun
  15. Because you feel more self-confident and sure of yourself (omitted from study)
  16. Because it helps you enjoy a party
  17. To be sociable
  18. Because it makes social gatherings more fun
  19. Because it improves parties and celebrations
  20. To celebrate a special occasion with friends

If you go back and analyze these reasons carefully, then you may notice that many of them say similar things. Actually, these reasons can be categorized in four different general themes:

  • Conformity
  • Coping
  • Enhancement
  • Social

When you label each reason with its respective one of these themes you can see we hedonically eat for four general reasons.

2 Conformity Because your friends want you to eat/drink them
8 Conformity So that others won’t kid you about not eating or drinking these items
12 Conformity To fit in with a group you like
19 Conformity To be liked
20 Conformity So you won’t feel left out
1 Coping To forget your worries
4 Coping Because it helps you when you feel depressed or nervous
6 Coping To cheer up when you are in a bad mood
17 Coping To forget about your problems
7 Enhancement Because you like the feeling
9 Enhancement Because it’s exciting
10 Enhancement To get ‘‘high-like’’ feelings
13 Enhancement Because it gives you a pleasant feeling
18 Enhancement Because it’s fun
3 Social Because it helps you enjoy a party
5 Social To be sociable
11 Social Because it makes social gatherings more fun
14 Social Because it improves parties and celebrations
16 Social To celebrate a special occasion with friends
15 Because you feel more self-confident and sure of yourself Question 15 was omitted from the analyses due to poor factor loading, consistent with a recent validation study of the DMQ-R

We eat to conform to peers, to cope with life, to feel better, and to be sociable. Why do we eat for these four reasons? Because somehow, someway, somewhere in our life we discovered hedonic eating makes us feel good and we like to feel good.

Now, knowing this, how can we get better control of our hedonic eating?

You can learn more about the PEMS here. Burgess, et al, Profiling motives behind hedonic eating. Preliminary validation of the Palatable Eating Motives Scale, Appetite 72 (2014) 66–72, accessed on February 27, 2017 at https://www.researchgate.net/profile/Mary_Boggiano/publication/257204266_Profiling_motives_behind_hedonic_eating_Preliminary_validation_of_the_Palatable_Eating_Motives_Scale/links/559d7a8108aeb45d1715cb20/Profiling-motives-behind-hedonic-eating-Preliminary-validation-of-the-Palatable-Eating-Motives-Scale.pdf

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Final Report: The 5-Day MRB Crash Down Weight Loss Nutrition/Activity Plan

Have you ever read someone else’s series of blog posts and asked yourself, “Yeah, but what’s the freaking point?!?” Yeah, me, too. And several subscribers have asked me about why I am dieting so publicly this week.

“What are you trying to prove?” they’ve asked.

First, that, yes, if we can seize and maintain control of what we eat and do, when, where, how, and why we eat and do it for a finite course of time, then, we can crash off 5% of our body’s fat mass in a week. So, the MRB Weight Loss Plan is just as good as all the others advertised on TV.

Second, that, yes, just like my darling, soon-to-be board-certified in obesity medicine, wife informs me, a person can get along just fine for at least a week on food bars. Though, in this case, I only did it for a work week.

Third, that, portion-controlled, balanced meal plans, sufficient to support a fairly active adult human, can be obtained easily and inexpensively for the amazing low-low price of $6.00 a day — not including drinks, mind you, but decent water is free in most of the civilized world.

Fourth, that, yes, I can do the first and second of those things using the third and feel very good, both physically and mentally.

All that being said, however, it is not the way I would like to live out the rest of my life.

While there are some good things to say about it, eating nothing but a third of a food bar, even good ones like mine, every waking hour for a work-week is not as “fun” as letting my culinary muse soar in the kitchen thrice daily and sharing my bounty with family and friends in exchange for social contact and affirmation of my Greatness! putting food on the table. (Though the time spent with my best accountability partner this week was a good as it always is).

The next challenge is to figure out how to eat real food of a reasonable variety, in reasonable amounts, at reasonable times, for a reasonable cost and keep losing at least some weight each day until I get back done to my ideal BMI of 25 at 155.

On Monday, I’m starting the 3-Day Real Food Tapas Crash Down Weight Loss Plan based on hourly 100-calorie tapas of tasty salads, loaded with vegetables, fruits, seeds, nuts, cheese, eggs, fish, and meat.

See you here next week.

 

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Data Is Nonjudgmental

Have you ever stepped on the scale, seen you gained the same pound today you lost yesterday, and felt yourself an absolute failure? Yeah, me, too. Until a wise one taught me, “Your data is not judgmental of you because of the data and neither should you be judgmental of yourself because of your data. Just study your data, learn from it, and react to it appropriately.”

A reader asks, “What’s the benefit of micromanaging weight loss daily vs. the negative psychological effect of failing to drop weight for one or two days?”

First, I reject the premise of the question. There should be no psychological effect of failing to lose weight daily. The daily data is just data. We don’t judge actors based on data. We just analyze data and prior actions and other factors that caused the data to fluctuate as it did to discover the cause of the deviction from the expected result and correct our inputs in order to get better results going forward.

We use data such a daily weight to exercise CONTROL over our actions by Correcting Ourselves Nicely To Repair Ocassional Lapses.

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… and Move Your Fat Ass More

Have you ever heard the instruction,”And all you have to do is A and B, and then, you’ll get what you want” and thought, “Well, heck, anybody can do that,” and you start to knock the leather off the A ball, and while your smiling like a mule eating briars thinking about taking your lap around the bases and unexpectedly the pitcher knocks the snot out of you with the B ball? Yeah, me, too.

If you followed that introduction, then you’ll enjoy the rest of this post.

Continuing with the idea of Eat Less CRAPF (the P is silent and so is the processing) and Move Your Fat Ass More, we covered using meal replacement bars to eat less. Now, however, we need to discuss how eating less does very little good if you don’t move your fat ass more.

Growing, losing, or maintaining body weight is all a matter of energy intake and use balance. If you eat no more calories than you use, then, all other factors being equal, you will maintain your body weight. There are several factors that shift this input/output balance equation to one side or the other, but they are beyond our scope here and now. But one factor that we are concerned about is the factor that when you rob your body of energy input, it responds by slowing your metabolism to conserve energy.

So, if you only eat less CRAPF and don’t move more, you are not going to lose as much weight as you could if you moved more and you won’t be able to keep it off either. So, how much less should you eat and how much should you move?

The US government researchers say 55-60-year-old men who are not overweight should eat about 2,200 – 2,600 calories a day, depending on their level of activity and metabolism. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans, 8th Edition, December 2015. Available at: http://health.gov/dietaryguidelines/2015/guidelines/ (Accessed on April 25, 2016).

If you are overweight or obese, however, then you have to eat much less than this to lose weight. Why? Because a pound of human fat cells (adipocytes) store about 3,500 calories. So, to lose a pound of fat in a week, you have to have a 3,500 calorie energy debt that week. But, if you just starve yourself for 3,500 calories a week (500 calories a day), then your metabolism is going to slow to preserve your fat.

Therefore, to compensate, you have to get and keep your metabolism ramped up to have the maximum weight loss beneficial effect of eating less. For the past two days, while I have been dropping from 186 to 178.4 pounds by eating only 5 food bars containing 270 calories each totaling 1,350 calories, I’ve been doing an hour of intensive exercise first thing each morning and burning about 2,000 extra calories a day.

(This 2,000 calories of exercise is the figure that shows on the Free Motion Cross Trainer I’m using. I have no idea how accurate it is, but I am working up a maximum pulse rate of 150-160 beats per minute for most of the hour. My maximum training rate should only be 80% of (220 – my age of 57). 220-57 is 163 and 80% of 163 is 130.4. I hope I don’t kill myself trying to get that average healthy BMI of 25.)

Regardless of what the energy intake/use numbers are, eating the meal replacement bars and doing a maximum effort hour of exercise a day has helped me drop 4.1% of my high starting body weight in two days. It would not have happened just by eating the food bars without increasing my exercise. I know this from many cycles of gaining and losing these 30 extra pounds a few times over the past three years.

I’m not recommending anyone do exactly as I do. Talk to your own doctor first before making any sudden change to your eating, drinking, exercise, and other health issues.

Nonetheless, do not just eat less and expect to lose weight. You have to move more at the same time.

Check in next post to see if we have three good weight loss days in a row.

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Is It Time for a Meal Replacement Plan?

Have you ever wished you could just avoid preparing and eating meals and just get all the nutrition your body needs in one delicious (preferably chocolate flavored) pill you can take once an hour while you keep on working on more important things all day? Yeah, me, too. So does my wife, the board-certified family physician who is about to get her results for her American Board of Obesity Medicine results (we all believe she passed). Turns out, medical research supports the idea. And I’m about to apply it for at least a couple of weeks.

First, how did we get where we are today? In February of 2014, I was 155 pounds. I looked great and felt awesome. Then, I let life get in the way of my maintenance of that state of Greatness! Over the past 36 months, I have let 31 of the 75 pounds I lost in 2013 re-accrete in my abdominal viscera and I find myself halfway back to a less healthy hell and I now need to make some changes to get back down to a BMI of 25 again. Thus, I am about to shock myself with an easy, inexpensive weight loss plan I call the Clif Builders Bar plan.

Anyone who knows me knows, my mantra for RightSizing your body can be summed up as Eat Less CRAPF (the P is silent, just like the processing) and Move Your Fat Ass More! Mean as it sounds, this is just a catchy restatement of the scientific fact that eating more calories than you use each day results in increased fat mass. There is no two ways about it. If you eat more calories than you use, you store the excess calories as adipose tissue and get fatter and fatter each hour that you do it.

Having studied for Susan’s obesity medicine exams for all of 2016, I know there are lots of different dietary plans one can follow. The DASH diet, the Paleo Plan, the Adkins Plan, the Mediterranean Diet, the Asian Diet, Weight Watchers, Nutri-System, Slim-Fast, Hi-Pro, Hi-Fat, Low-Fat, No-Fat, and the North-South-East-and-West Beach Diets; more choices than at which you can shake a stick. Like many doctors tell me, “The best medicine is the medicine you are ready, willing, and able to take over the long term,” the best “Eat Less CRAPF” diet is the one you are ready, willing, and able to follow for an effective period of time.

My choice to readjust my dietary navigation in life is the dead reckoning idea of eating nothing but meal replacement bars for a sustained period of time. Hence, the Clif Builders Bar.

There is plenty of scientific support for meal replacement bar plans. Most people’s biggest dietary problems are macronutrient and micronutrient balance and portion control. Meal replacement bar plans (assuming you pick the right meal replacement bars) are a good way to overcome those problems. And the best MR Bar I’ve found is the Clif Builders Bar.

Most nutritionists recommend a macronutrient trilogy of 50% carbohydrates, 30% fat, and 20% protein each day. I prefer a bit more protein than carbs and the Clif Builders Bar hits my sweet spot (in more ways than) one with 43% carbs, 29% fat, and 28% protein. The fact that I can buy their chocolate-covered goodness for $1.05 per bar at Sam’s Club or BJ’s and eat five of them a day (1/3 of a bar every hour on the hour for my fifteen waking hours) for $5.25 a day (less than one max-fancy venti Starbucks latte) is an awesome bonus.

So, here’s the plan. I’ll be taking five Clif Builders Bars, cutting them into thirds, and eating one of the thirds every hour from 5:00 am through 8:00 pm each day. This will allow me to trickle into my body a balanced flow of 90 calories per hour. I did this yesterday after starting at a weight of 186 pounds yesterday morning. After a 1-hour, 3-mile, max-incline, max-resistance on my sister’s Free Motion cross trainer, today, I weighed 180.7. Yeah. I don’t believe it either. But, I checked it three times just to be sure.

I’ve recruited a mutual accountability partner to work with me for at least these next two weeks. The same one I had back in 2013. He’s agreed to do the same MRB program with me. I won’t say his name or his beginning weight. But I will nag him here if his progress wanes. He can, and should, start his own blog if he wants to nag me about mine.

Until the next time.

 

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Why?

imageHello, everyone. I hope you are enjoying Ken’s discussion of Changeology. Even he admits his chapter-by-chapter posts don’t give you the full flavor to savor. So, remember to go to Amazon through the link on his blog page to get your own copy of it. In the meantime, I thought I would chime in with a question and comment of my own. Let me tell you the first question I ask patients when we start discussing bad habits they may want to consider changing. It’s, Continue reading “Why?”

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Say Yes to Food- In Moderation

Say yes to foodAs I have often stated regarding most things- Moderation is the key.

With that in mind, let’s explore the newest nutritional guidelines just released (January 2015) by the US Department of Agriculture and the US Department of Health and Human Services. Those two entities release updated guidelines about every five years and are intended to mirror the latest evidence-based science about nutrition.

Before we dive into these recommendations, remember these are just GUIDELINES and not the final word. In fact, many organizations suggest the recommendations aren’t complete enough. But, they are certainly a place to start and a way to begin focusing on improving your lifestyle.

So here are the official guidelines. Continue reading “Say Yes to Food- In Moderation”

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Helping Sufferers Suffer – Part 2

In Part 1 of this series on how to best help people in your circle who are suffering, I explained turning toward the sufferer in as meaningful a way as possible. In this Part 2, I’ll show you how to refocus and reclaim a sufferer’s suffering to obtain as much value as possible from it, as strange as that may seem to you now.

Refocusing and reclaiming suffering enables sufferers to reconnect with what is important, meaningful, and generative in their lives. People who are suffering can always move forward.

Rather than merely coping with the suffering, both the sufferer and the person seeking to help him or her should seek the following things:

  • Adaptation
  • Confidence
  • Clarity concerning their values and aspirations
  • Connections with family and friends that are deep and meaningful
  • Wholeness
  • Gratitude

Refocusing and reclaim is not an easy, quick-fix patch to suffering. It is hard work and requires the following steps:

  • Attentive listening
  • Recognition of ambiguity, incompleteness, and contradictions
  • Gentle challenging of the sufferers self-perceptions
  • Encouraging consideration of alternative views
  • Providing hope that some of what really matters to the sufferer is achievable, if only to a limited degree
  • Developing new productive relationships
  • Driving from passive suffering to active engagement in managing the cause of the sufferer’s suffering
  • Thriving despite adversity, disease, disability, or impending death

Taking a holistic approach to suffering is a radical departure from how most “helpers” and sufferers try to “make it better” or give up and bear the pain.

It is, however, the essence of Greatness!

[reminder preface=”Tell me your thoughts on this issue.”]When was the last time you engaged someone who was suffering? What happened.[/reminder]

In the meantime, remember, you GOTTABGATT!, so go out there today and be Great! All the time!