I turned 50 this year, and finally hit a point where I knew I needed to make a fundamental change in my health. I’ve been overweight or obese (mostly obese) my entire life. I’m tall (6′), and reasonably active (I’ve been walking at least 20 miles a week most of my adult life), so I “carried it well,” but this year, I’d hit a new high on the scale, and had some frustrating illnesses and injuries that, on top of all the other accommodations I made in my every day life to deal with being well over 300 lbs., finally pushed me to the point of considering either surgery or a medically-monitored weight loss program.
I researched the available bariatric surgeries, and decided I couldn’t go that route. I really do love good food, both cooking it and eating, so making the accommodations necessary to manage a post-bariatric lifestyle seemed almost as onerous to me as being overweight. I totally recognize that this may not be true for many people, but it’s the conclusion I came to. So, I opted for a medically-supervised diet through our Kaiser healthcare system here in Northern California. Two important notes about this plan: first, it’s actually open to anyone, not just people in the Kaiser healthcare system. If you are not a Kaiser member, you are given a temporary card for the run of the program so you can access the facilities and laboratory services that are included. Second, it’s not cheap. There is a $300 a month fee during the main part of the program, and you have to purchase the food as well. However, the flip side is that for the entire period of the program you won’t be doing any grocery shopping for yourself, and won’t be paying for any meals out for yourself. So, the net cost is not unreasonable, and the longer term benefits more than compensate.
Kaiser’s weight management program is a “meal replacement” program. Similar to a commercial program like Jenny Craig, you replace your normal eating with a strict diet of packaged food. However, this program takes it up a notch over the others. You have a choice of bars, shakes, or soups. Each meal contains 160 calories, about 20% of all the nutrients your body needs in a day, and you typically get to eat 6 meals a day; that means you’re on a 960 calorie-a-day diet. Although, because I was such a big guy, they started me at a higher 8-meal plan, so I began at 1280 calories a day.
On top of the meals, there are few other commandments that must be followed to maximize the opportunities for success. First, drink a lot of water; like over a gallon of water a day. The need for this is two-fold. First, most of us simply don’t drink enough water, and at any given moment, a chunk of the weight we’re seeing on the scale is because we’re retaining water that our body doesn’t want to give up because it fears it won’t get enough to be healthy. The first week I kicked up my water intake on the program, I lost 12 pounds. It was mind-blowing!
Second, because of the meal replacement, we end up taking in a lot less water than normal, because we’re not eating normal food anymore. Much of the normal food you eat each day has some water content to it, and by replacing it, we lost an important source of hydration.
Another very important commandment is to log everything you eat and drink. Apps make this really easy. I’m using the MyFitnessPal app from Underarmour, which allows me to scan bar codes to find the nutritional information on most packaged foods, or to search a database of info so I can build the numbers around recipes I’m trying. Of course, during the meal replacement phase of the diet, logging is really simple, since every day is pretty much the same.
And here I’ll get to one of the drawbacks of this particular meal replacement program: it’s boring. Really, really boring. There are five flavors of bars to choose from, and I only ended up liking one of them. There are three flavors of shakes to choose from, and while they’re… okay, they also taste like what you expect a beverage designed for nutrition first would taste like. However, they work pretty well for making cafe lattes, which has been a lifesaver (caffeine, in strict moderation, is okay on this diet).
And then there are the soups, which are… perfectly reasonable. One nice accommodation to variation is that most spices don’t have any calories, and can’t significantly impact the nutritional value of the soups, so over the course of the diet, we got very good at spicing up these meals (we usually eat the soups for dinner, since they’re the only savory food in the plan). Sadly, because the soups are relatively high in sodium, we’re only allowed to have them for one meal a day.
While there are other meal replacement programs like Jenny Craig out there, what’s highly effective about this one is how much impact you get out front. Rather than limiting us to 10% or 20% fewer calories a day over the long term to achieve sustainable results, this program puts us through what is effectively a weight loss boot camp. We’re on the above-detailed diet for about 17 weeks. They don’t like to do it for longer, because it’s not easy on our bodies. In my case, the net reduction in caloric intake was over 50% per day at the start (of course, as I lost weight, how many calories my body needed each day shrunk, so that got a bit smaller over time… until they reduced the number of meals I was eating). And all that is before adding in physical activity. For the program so far, on most days, I was using between 1,500 and 2,000 more calories each day than I was eating. That leads to rapid weight loss.
How rapid? After that first water-related loss of 12 pounds, weekly weight loss has ranged between 3.5 and 6 pounds each week. As of the time of writing this post, I’ve lost 78 pounds in 15 weeks. I’ve still got around 40 pounds left to lose, but that isn’t a daunting number at this point. And better, we’re about to move on to the “transition phase” of the diet, where we start to replace “product” with real food. We actually went grocery shopping this weekend for the explicit purpose of buying food that we will be cooking for ourselves next week, which is hugely exciting after three months of “open box, take out product, unwrap product, eat product.”
Over the 6 weeks of transition, we replace one of the daily product meals each week with a meal of real food that has close to the same, or slightly more, calories, and helps us bring natural sources of nutrients in for what we’re replacing. By the end of the transition period, we’ll be eating about 10% more in calories, but all as real food that we cook ourselves, and track the nutrients along the way so we get better educated on how to make and consume a healthy diet.
As we go through transition, and after we’re done getting back on normal food, we’ll still be losing weight, just doing it in a safe and sustainable way as we edge ever closer to our final goals.
Feel free to ask me questions in the comments, and I’ll do my best to respond. But there’s a lot more to talk about and I’ll be including more in upcoming Chronicles. First, as a geek and someone who works with data every day, I’ve been tracking EVERYTHING on this diet. And second, I’ve been learning a LOT that, even having done many, many other diets in my life, I didn’t already know. I’ll leave you with the following important piece of information that I’ll talk about more in the next edition of these chronicles: the BMI is terrible, and you shouldn’t use it as a gauge of your health!