Comment of the week

From my college friend Melon, about a recent post regarding health and fitness:

A) In some cases, the Obie reunion just came at a really good time - if it had been last year, I could have been your Fat Buddy (grad school sedentariness in a place where we needed a car for the 1st time, depressed job hunting, celebratory job-acquisition feasts, etc.), but it happened to be this year, when I've lost 40lbs.

B) You can do anything you actually, really want to, whether you hate change or not. It's got nothing to do with it. Change you start yourself isn't the same as change forced on you.

C) I totally wimped out of Couch to 5k - god, I hate running. But I like lifting weights! :)

As you might imagine, I particularly like point B.

The weight of the world

Since my last post, a lot has happened. I went to my college reunion, where I had the shocking realization that I'm one of those people who put on a significant amount of weight since college. I noticeably surprised at least a few former classmates, including one who pinched my abdomen and said, "What's going on here?" (I wasn't upset; he's a good enough friend that he gets to do that without incurring my wrath.) I walked around Oberlin in the muggy summer heat feeling like a big mound of fat. Many of my classmates seemed quite fit, and some looked younger than they had during college. I felt unappealing, regretful, and confused -- how had I let this happen to me?

Then I went to New York, where I began reading Frank Bruni's excellent memoir, Born Round. In it, the former New York Times food critic talks about his struggles with bulimia and compulsive overeating. I felt like I was reading my own story. In New York, I was walking a lot every day, much more than I do in Seattle; the same had been true in Oberlin. In both places, I had no other affordable transportation option. I huffed and puffed at times, but I survived. At the same time, I managed to eat more moderately than I had in many, many months.

The result: I lost weight. Even so, by the time I got to Virginia for an old friend's wedding, I once again felt fat and unattractive. It probably didn't help that Richmond was even muggier than Ohio and New York, and that the temperature was around 95 degrees. Also, weddings are a merciless indicator of how I'm feeling about my romantic prospects; in this case, I felt suddenly as though I'd be single forever unless I found a way to sustain my experiment in moderate eating. Being thin isn't the key to attracting a mate, but reining in self-destructive overeating would do wonders for my self-esteem (I know from past experience). In fact, I think getting a handle on my eating habits, and finding a way to exercise, would improve all areas of my life. Nothing can substitute for hard-won confidence.

I managed about five days of moderate eating after returning to Seattle, and then Shabbat dinner at the Kibbutz knocked me for a loop. (I wrote about this phenomenon recently for Jew-ish.com.) Carbs and sugar may not be the devil, but to someone looking to kick binge eating, they're diabolical enough. William Leith, in his food-addiction memoir, The Hungry Years, points out that carbs are many people's binge food of choice. Avoiding them entirely may not be practical or necessary, but cutting down, especially during communal feasts, is vital.

Focusing on fruits, vegetables, and protein has helped me feel healthier during the past couple weeks, and falling off the low-carb wagon last night was, well, instructive. I'm currently reading a book called 50 Ways to Soothe Yourself Without Food, and it helpfully addresses the black-and-white thinking that can doom a moderate eating regimen. People trying to change their eating habits make mistakes. There's almost always something to learn from them, provided you're able to spend a few moments not emotionally beating yourself to a bloody pulp.

As Bruni points out in his book, one screw-up can lead to the following logic: "Well, I messed up; might as well get it all out of my system with a nice, long binge! Then I can start my diet again in the morning." When this becomes a daily pattern, any hope of actually returning to moderate eating begins to fade. As I told my mother in Virginia, what I have trouble holding onto is that essential thing, hope, the intangible quantity that keeps people doing and trying, day in and day out. Wanting to give up? It happens. Actually giving up? A bad idea. In that spirit, I've enrolled in a "Couch to 5K" running class that takes the out-of-shape and gets them ready to run a 5K without stopping. The process takes six weeks. My ex-girlfriend Kelly is taking the class, and she looks and feels great.

I'm not much keener on running than on any other kind of vigorous exercise, but the gradualness of the Couch to 5K program appeals to me, as does the fact that it caters to people who, like me, aren't very fit. Also, the group runs will probably make it easier for me to handle the solo ones (the class involves homework). I thought about trying the program earlier this year, but going it completely alone, without a coach or fellow runners, was just too daunting. That's the thing about change: It's harder in isolation.

Dane likes to remind me that I hate change, and I've recently started correcting her more fervently. I don't hate change as much as I hate feeling worthless and ugly and empty. I just hate not knowing what to do to achieve the kind of change I want. I hate not knowing where to put my energy. And I hate being depressed, because it undercuts the part of me that loves change, that craves it, that desperately needs it to survive. When people learn how to change while being gentle with themselves, they love it. That's all I want, and I don't think it's an unreasonable goal.

Lexapro vs. everything else

Someone responded to my most recent post about antidepressants by asking whether I'd tried non-Lexapro meds. The short answer: Yes, I gave Celexa a whirl, and it seemed to diminish my verbal abilities. This was upsetting but not entirely unexpected, as I'd been warned many years before that some SSRIs have that effect.

Lexapro is ridiculously expensive at roughly $100 per monthly supply, but I'm reluctant to mess with other meds when this one has worked, on the whole, so well. I also know that my weight gain is almost certainly due to a variety of factors -- Kibbutz food, waves of mild depression that elude the drug, etc. -- so I'd be more likely to drop meds in general than to go searching for a "better" one. It probably doesn't get a whole lot better than this.

Antidepressants and weight gain

The other night at the Kibbutz's second-night seder, someone I know asked me if I'm on an antidepressant.

"Yep," I said. "Lexapro."

"I figured," he said. "That's no normal weight gain."

In the past I might have been upset, but he's right: I've gained a lot of weight since I went on Lexapro in October of 2008. Then again, my weight has gone up and down pretty dramatically throughout my life, and living at the Kibbutz exposes me to a lot of good food, and a lot of communal meals, where the social aspect of eating often gets the better of my willpower. Yet I do think that the antidepressant has something to do with my ascent to 225 pounds, possibly my highest weight to date.

While some Lexapro users attribute their weight gain to the drug's biochemical effects, I believe that, at least in my case, its psychological impact is just as significant. In the past, when I put on weight, I felt bad about it. I would eventually reach a point where I started feeling fat and unattractive, but I'd continue eating too much and not getting enough exercise until I finally snapped. Then I'd begin combating my overweight with a combination of exercise and self-deprivation, a tactic I learned as a teenager with anorexia. My weight would drop, and I'd feel better about my body on a superficial level, but I'd remain extremely afraid of relapse -- i.e., gaining the weight back. Since depriving oneself isn't a sustainable long-term strategy, I'd suffer the sad fate of many a yo-yo dieter: I'd end up even heavier than I started.

Even though unemployment is hard and I have a lot of work ahead of me if I want to attend Bastyr (for nutrition and health psychology, of all things!) in 2011, I'm thinking about going off Lexapro on a trial basis, to see how I feel without it. I'm unlikely to start losing weight simply because I drop the drug, yet I can't help but be curious about what would happen. Not freaking out about being overweight is a double-edged sword. It opens up the possibility of more fully accepting my body, flaws and all, which is something I'm eager and determined to do. On the other hand, overweight isn't healthy in the long run, and being too okay with it -- indifference isn't the same as acceptance, after all -- might not be such a good thing. I'll consult my therapist about it and do some soul-searching, but I imagine that if I go without the meds for a while and I feel the weight of the world return, I can go back on them.

I'm pretty pleased, all in all, that I've been able to use an antidepressant without taking an absolutist view of a complicated issue: the question of whether the positive effects of SSRIs outweigh their downsides. In my 18 months of use, I've decided that they help, but they alone are obviously not enough. And no, they don't steal your soul or make you an unwitting slave to the Man. If anything, people who aren't completely demoralized are more likely to stand up for what's right and fight against what's wrong. There are few simple choices in this world, and to inhibit serotonin reuptake or not to isn't one of them.

BBC article on the set-point theory of body weight

We talked about this concept a bit last quarter in nutrition class. Since my own body image is reaching an undesirable low point these days, I'm trying to build a little momentum in the direction of exercising, even if that means going back to the dreaded gym. The genetic explanation is somewhat comforting:

One expert, Professor Jane Wardle, believes there could be a genetic answer, through what's known as the FTO gene. Adults who have one variant of this gene weigh on average more than everybody else.

Prof Wardle believes the gene can influence appetite, leading some people to not know when they are full. Those without the gene, she thinks, find it easier to say no to food.

At the same time, I know that personal effort can make a big difference, at least for me. I've gone back and forth from unhealthy lows to unhealthy highs, rarely staying in the middle for very long. And even when I am in the middle, I'm generally moving fairly rapidly toward one dysfunctional pole or the other. I don't want to keep going like this. I'm starting dodgeball at the end of the month, but it's going to take more than that to get my weight under control. I also want to try to find a way to structure my eating -- to budget it -- the way I've done with money. Stay tuned...

Winter blues

I've been feeling blue for at least a couple of weeks now, and though I know progress isn't an upward slant but an upward-slanting sine wave, periods like this can be hard to ride out. I've got my wonderful community, of course, and my involvement with it still brings me joy on a pretty regular basis. But I feel stuck with regard to work -- no NWsource.com projects on the horizon, very few phone screens since I turned down two job offers a couple months ago -- and uncertain about my current academic path, such as it is. When people ask me what I'm studying, I'm more weary of repeating myself than excited to tell them.

I've considered the possibility that the antidepressant I'm on is contributing to my general sense of emotional flatness, but I wonder if I suspect the Lexapro because I've heard other people say that SSRIs can cause emotional flatness. The power of suggestion works both ways; it can make you feel like your meds are helping you, or it can make you wonder whether they're hurting you. I imagine the increasingly gray Seattle skies, my singleness, my overweight, the overeating that's sustaining that overweight, and the lack of exercise in my life are all contributing factors to this year's early-onset S.A.D. Last year at this time, the Kibbutz was still something new in my life, and New Year's Eve brought the beginning of a relationship that lasted longer, and became more emotionally significant, than I expected. This year, the Kibbutz is still meaningful but not nearly as novel, and I don't feel particularly confident about presenting myself to the world, whether in a dating context or just socially.

I think my #1 problem right now is sagging self-esteem due to physical inactivity. When I danced at the Moishe House Chanukah party the other night, it only took about 10 minutes, if that, to utterly exhaust me. I was practically wheezing, and I felt a desperate need to lie down. There have been times in my life -- my bar mitzvah, the year 2004 -- when I was so out of shape that I couldn't dance for very long. Here I am again, in the middle of one, only this time it happens to coincide with a unit on fitness in my nutrition class. Looking at all the toned models in the book's supposedly helpful pictures, I felt that the distance between where I am and where I want to be is vast. Even moderate fitness feels unattainable.

My main goal for 2010 is to make exercise a regular part of my life. I want to do on the fitness front what I did this year, with the help of my wonderful life coach, in the area of money management. Thanks to our work, I make a budget at the beginning of each month and am much more conscious of how and why I spend money the way I do. Prediction: If I can make the sort of progress with exercise in 2010 that I did with money in 2009, I'll be much happier by 2011.

221.8 pounds

That's how much I currently weigh, as of this afternoon, per the doctor's scale. According to the Body Mass Index, I'm obese. Then again, the BMI is a questionable tool, as a helpful Flickr set illustrates. Particularly effective are the images that juxtapose a confident, beautiful person with the "obese" label:

Cassie is "obese"
5'4", 175 lbs., BMI 30

He ain't heavy, he's my father

During my visit to L.A. last weekend, I looked at some pictures I'd never seen before -- old photos my sister Lore brought out for us to peruse together. In one of them, my father is surrounded by his three children from his first marriage -- my half-siblings, including Lore -- as well as his first wife, Patricia. What struck me immediately was how large he was. When I was alive, my father was big, but I didn't think much of it until my teenage years, when I went from overweight to anorexic via a self-deprivation plan of my own design.

When I was at my most deluded and paranoid, I looked at people who were overweight and thought: I'd rather die than end up like that. Seeing the old picture of my dad this past weekend really moved me, and helped me realize how far I've come since the last time I visited my sister in California -- 15 years ago, when I was deep in the throes of my eating disorder. In 1994, she weighed me daily during my visit, as my parents and the growing number of specialists following my case insisted she had to. I, of course, hated being weighed and watched and told to eat what was in front of me. These days I still struggle with eating and weight and body image -- during my recent physical exam, I found out I'm back over 190, which is what I weighed when I unsuccessfully gave Weight Watchers a shot in 2007 -- but I've probably never had a healthier, more even-keeled outlook on those interlocking subjects, and that's worth appreciating, or even celebrating.

What struck me about the photo was that my father must have struggled even more than I have with his size, since he clearly passed out of adolescence and into fatherhood at an unhealthy weight. He never did what I did; he never fled the problem of being too heavy with all his might -- with such fervor, in fact, that he overcompensated, went too far, and ended up with a different, no less dangerous problem. Also, all of his children are doing better today than he was in that picture, and that's a nice way of regaining perspective when I give myself flak for overeating or not exercising enough. I've told several people lately that I still can't quite grasp how others, friends and acquaintances of mine, can actually enjoy exercise. For me, the act of exercising is still weighed down, so to speak, with middle-school baggage (being the fat kid, failing to do even one pull-up, all the humiliation that accompanied that kind of failure, etc.).

This year, I hope to develop a better relationship with exercise by doing things I actually enjoy -- softball, classes, bicycling -- rather than forcing myself to pay for yet another gym membership I can't afford and will likely underuse, or never use at all. I guess my heart broke a little for my dad when I saw that picture, but I was also glad that by the time he became my father, he'd lost at least some of the weight he'd carried around as a younger man. And as I try to get a better sense of what he was like at my age, I imagine it's inevitable that I would start to think of him less as my infallible, all-knowing father and more as a human being, flawed and well-intentioned and funny and good. He's been gone for nearly six years, and it saddens me that he'll never see me get married or have children. But if old photos and stories I've never heard can help me get a better sense of him, I'll settle for that.