Now another reason not to visit the doctor...

 I have not had the best of luck with doctors.  I have moved so often that I find it easier just to go to the walk-in clinic rather than bother with trying to find a GP in town that is still accepting patients (and good luck with that!).  As with any walk-in clinic, sometimes you get a good doctor, and sometimes you get a schlub. 

Speaking of schlubs, a recent study has revealed that doctors have similar levels of bias against people who are overweight as the general public.  Further, physicians are likely not aware of their own biases.

Previous research identified weight biases in doctors, but the new study found that their level of bias is similar to that of the public.  The study included nearly 360,000 participants, including 2,284 medical doctors. The researchers used a computer test designed to measure both explicit biases, of which people are aware, and implicit biases, which people do not recognize they hold.

Results showed that female doctors were less biased against obese people than male doctors. "Even though there was a slight difference, bias was strong among both men and women," the researches was quoted as saying. 

On the positive side, obese doctors were generally more sympathetic to overweight people, the study found. 

And that's not all.  There were also reports this summer about a GP in Worcester, MA, who made headlines after she went on record that she was no longer accepting patients who were obese.  The doctor said that her new policy (which applies to anyone who is obese and over 200 pounds, or someone with a BMI over 30) is a way to avoid injuries to health care providers and the subsequent loss of productivity.  I think it looks a lot like this is an example of the aforementioned fat-bias at work. 

I have to say that these results do not surprise me in the least.  My most recent interaction with a specialist involved a neurologist who was called in to consult on my carpal tunnel issues.  Without even examining me, the doctor told me that there was little point of doing anything to correct the carpal tunnel until I had lost weight, because my obesity was exacerbating the carpal tunnel. 

At what point is my obesity itself a health issue versus a contributing factor?  I would have to think that it depends on the condition.  I cannot think that my obesity would exacerbate an allergic reaction, or a cold/flu, but it would definitely affect knee or joint pain or lower back pain.  My mother has told me that fat affects all the organs in the body, so it may even be possible that obesity aggravates my carpal tunnel.

It is a fact that there are many obesity-related health issues that can get worse with time.  Type 2 diabetes is one such health problem that leaps to mind.  Heart disease is another.  Asthma is a third.  Delaying diagnosis and treatment of such conditions can negatively affect an individual's health. 

The issue with the Worcester doctor's position - - and my neurologist's position - - is that by fat shaming patients, it can cause patients to delay seeking medical care, explicitly or implicitly.  Either patients will be told to lose weight before they seek medical care, or they will undertake to lose weight on their own before seeking treatment.  This delay can be dangerous at times, depending on the condition in question. 

And fat shaming has impact.  I haven't gone back to that neurologist who would not consider treating my carpal tunnel, and I haven't visited the walk-in clinic in years.  I am pretty sure that I could use a checkup and physical, but I just can't stand the thought of being told that my conditions are all due to my obesity when I am working on that very problem.  Especially since it will take more than a year for me to reach a normal weight.  I just hope that nothing breaks in the meantime.

Here's a problem I haven't had in a while ... what dress to wear? (with photos)

As a person of size, my clothing choices in the past have largely been driven by the same considerations as those motivating military camouflage designers - - how to obscure and hide my shape as much as possible.  Dark colours were always my preferred go-to palette, with as many layers as possible to hide my various rolls and more abundant bits.

This year, though, I am trying to come out of my shell somewhat, and embrace a new, more confident me.  At least sometimes, situationally, when it is warranted.  I may wear black suits 5 days out of the week at work, but occasionally I get the chance to break out of that stuffy lawyer mold.  Next week is just such an occasion.

My firm is having its annual "non-denominational festive holiday party" next Friday, and, just like the cliche, I have nothing to wear.  You see, since last year's party, I have lost 75 pounds (yay!), and dropped 3 dress sizes.  Which is fine, except that the dress I wore last year, a size 26, will look like a tent on my new size 20 frame.  Not to mention the fact that the "girls" (ahem) would just fall out of that dress now - - not the lasting impression one wants to make at the firm party, I think you would agree.

Now let's not get thinking that I am skinny or anything - - at 258.9 pounds and a size 20 I am still one of the largest (if not the largest) person at my firm.  But I think that it is time to embrace my new body, and enjoy it for the shape that it is, rather than trying to hide it.

So I went out today and bought two party dresses.  In all honesty, I was in and out of the store in 10 minutes - I hate shopping - and these two looked like they would fit.  And they both fit, just fine.

 Option 1: the purple dress.  My first thought was "love the colour!".  Plus, the horizontal detailing and form fitting nature of the dress was very daring for me.  I love the colour with my eyes and my hair, and it will be a positive shock for most of the people at the office to see me in a colour other than black - any colour. 

The cons are that it really hugs my figure.  Not in a sausage casing way, as there is a lot of room in that dress for dinner, but just in the sense that it is cut in a way that hugs my curves, of which I have many.  I am used to dressing in ways that hide my curves as much as possible, so this is a major mental shift for me.  Plus, as a colour that is almost as far away from black as it is possible to get, this dress just screams for attention, which is a little intimidating for those of us (i.e. yours truly) who spend most of their time trying to blend into the background.  No blending with this dress, no way.

Option 2: the sparkle dress.  This picture does not do justice to the number of sequins in this dress.  Basically anywhere there is gold in the picture, there are sequins that catch the light in a really attractive way.

I was drawn to this dress because it is an A-line dress, and therefore immediately more camouflagey than the figure-hugging purple dress.  And the sequins really are quite pretty.  Plus, I like the amount of coverage in the top area (although I immediately saw I would need to pin the front of the dress together, as it gapes quite open when seated. 

As I look at the photo, however, I am thinking that I look a little dowdier in this dress than in the purple dress. 

Decisions, decisions!  I will, of course, change my mind multiple times between tonight and the night of the party, just because that is the way I roll. 

My biggest problem is that I am so unused to wearing clothing in my size (normally I wear suits 1 or 2 sizes too large), that I am very uncomfortable wearing clothes that actually fit me.  I am not used to clothes that fit appropriately, and are not hanging off me, and I feel self-conscious.  I need to get over that, and learn to love showing off my shape, like normal people.

The Nerd is no use at all, as he (wisely) has taken the position that I look lovely in both dresses.  He's no dummy.

Week 44 - 75 pounds lost! (with pictures)

Well it has been another great week of taking up the intensity of my workouts, and I am continuing to see great results.

Last week I stepped up the weights from 4 pound weights to 6 pound weights, and took the sets down to 2 from 3 (for now).

This week I added another 5 minutes of cardio on the elliptical, for 45 minutes x 6 days a week.  If I remember correctly, 45 minutes is the maximum cardio I ever did at one time when I was working out back in 2000.  For some reason, it doesn't feel as oppressive now as it did then - - I suspect that the difference is that now I am doing the cardio on the elliptical, while back then I did cardio on the recumbent bike and Nordictrac ski machine.  The elliptical is much more fun, and easy on the joints.

So what are the results?  I lost a further 2.2 (!) pounds this week, for a total of 75 pounds lost overall (!!).  My BMI has gone down to 38.2, from a starting BMI of 49.3 (for a change of -11.1).  I have lost 22.5% of my original body weight so far, or 44% of my total target weight.  I am, as you would expect, very pleased with all of these numbers.

I still have 93.9 pounds to lose, which is a huge number in itself, but give it another year and a half, and I will make it.  I have fewer than 10 pounds to go to reach the halfway point of my weight loss, and as they say, "it's all downhill from there...".

I was concerned that once I hit 270 pounds, I would stall a little bit.  I had made that target out to be such a big deal in my head, what with it putting me into Obese Class II (from Obese Class III), breaking 40 BMI, and being the weight that allowed me to register to be a bone marrow donor, that I was worried that I would get complacent and backslide a bit.  But so far, that hasn't happened.  I have religiously stuck to the 6-days a week workout plan, and have kept working on healthy eating every day.

The key to my success has always been consistency - - I have not missed a workout in 26 weeks.   And I haven't really plateaued in a while yet, either.  I think my last plateau occurred before I got the elliptical machine (in July 2012), in fact.  I can attribute part of my progress that to the fact that I keep dialing up the workouts - - adding weights, then adding sets, then adding time on the elliptical, then adding more weight ... repeated as required. 

I am constantly amazed at the things my body is able to do now.  For example, this morning my elliptical workout felt great.  I felt strong and it was almost effortless to increase my stride rate here and there.  I did 45 minutes non-stop, at a tension of between 8 and 10 (40% - 50%) most of the time.  I remember when I first got the elliptical machine and I could not go for 20 minutes without stopping for a rest.  And eventually working at a tension of 2 (10%) seemed like a big deal.  Let's not even think about when I first began working out, and could only manage 7 minutes of cardio.  On the recumbent bike. 

Those days are long gone, but I still look at the things I have accomplished and the things I can do without thinking now (like walk to the office), and I see how far I have progressed.  And when you think that I am only 44% of the way along this path, there are so many more good things still to come.

So today, in the spirit of celebrating milestones, I went and got my hair did.  I am never able to replicate the smoothness of what the hairdresser does, so don't get attached to photos of me with straight hair.  I am a curly girl at heart, but it's fun to play "manageable hair girl" for a day. For the record, the March photo was taken when I had lost about 18 pounds or so, and weighed about 315 pounds.  Today's photo obviously shows me down 75 pounds, at 258.9 pounds.

I am pretty pleased with the haircut, and with the photo.  I have been getting compliments all day.  Yay, me!

Week 42 - More Progress

Another week down, another 3.5 pounds down.  I blame stress, as I also lost 3.4 pounds the week previously, which is a little much.  Not that I am complaining - - I will take any weight loss and hug it to my bosom and cherish it. 

I now weigh 261.5 pounds, for a total weight loss of  72.4 pounds.  This represents a total loss of 22% of my pre-workout body weight, and 43% of my overall goal.  Slowly but surely I am chipping away at my weight.  It will be another full year, at least, before I come close to reaching my objective, but I am making good progress right now. 

I had a normal blood sugar reading this week, but only the one.  I am not overjoyed with my fasting blood sugar levels, but they are lower than last month.  Any overall decrease has got to be positive, right?

In the spirit of keeping things interesting I am going to step up the weights next week, and move up to the 6 pound dumbbells (rather than the 4 pound baby weights I am currently using).  I will start at 2 sets of 12 reps with the higher weight, and see how that feels.  3 sets of 12 using the 4 pound dumbbells is fine - - I feel the effort with the third set, but it is readily doable.  I am hoping that I will feel the same effects using the higher weight and lower sets. 

Week 41 - 9 months down (with pics)

Another month down, and another month of pretty good results.  I did not lose as much weight as I have in previous months, but I did have Thanksgiving, 3 birthday parties, multiple cake/cupcake occasions, and a business trip thrown into October, all of which made things a little challenging.  All in all, I consider that I did pretty well to lose 7.5 pounds last month.

First things first.  What do these people have in common?

 That's right.  We could all fight in the UFC's heavyweight class.  I finally reached 265 pounds for the first time in years as of last week's weigh in.  That puts me down 68.9 pounds overall (as of the end of last week), with exactly 100 more pounds to lose.  That represents a loss of about 7.6 pounds per month since I first began working out. 

Reaching 265 pounds was my next short term goal.  Although it sounds like a huge number, and still puts me at a weight heavier than 95% of the population, this represents huge progress for me, and is a major milestone. 

This month I managed to pass another milestone: I dropped below 40 BMI, which puts me in Obese Class II (rather than Obese Class III).  I now appear on BMI charts, whereas previously my numbers were so high I was just a suggestion on the far right hand tail of most charts. 

See below for my BMI data:

Last month I would not have even shown up on this chart which only goes up to 40.  This month, and every month from now on - - look out, here I come!

So let's look at the numbers for this month:

Metric	31-Dec-11	30-Sep-12	31-Oct-12	Change vs prior month	Change vs. Dec 2011
Bust	52.9"	46.5"	45.5"	(1.0")	(7.4")
Waist	48.0"	42.5"	41.0"	(1.5")	(7.0")
Hips	58.1"	52.0"	51.0"	(1.0")	(7.1")
Thigh	35.0"	31.5"	31.25"	(.25")	(3.8")
Calf	20.5"	19.0"	19.0"	---	(1.5")
Bicep	14.9"	13.75"	13.5"	(.25")	(1.4")
Total inches lost:				(4.0")	(28.1")

Once again I can see progress in terms of significant inches lost, so  I should keep doing whatever I am doing, because it seems to be working.  My current program is to do 40 minutes on the elliptical machine 6 days a week, plus 3 sets of free weights using 4 pound dumbbells x 12 reps 3 days a week.  I am finding that the 3 sets of weights are taking a lot of time, making my weight days tough ones so far as scheduling goes. 

But what about the face, I can hear you asking, what about the face?  Are these inches translating into a slimmer looking face? 

Yep.  The face definitely looks skinnier.  Not skinny, yet, and I still have only the merest hint of cheekbones, but the face has definitely lost at least one chin and some padding in the width.  My glasses look larger, because my face looks smaller. 

How about those fasting blood sugars?  I am frustrated - - I don't think I had a single normal reading this past month.  My sugars were consistently running higher than even in September.  We'll come back to these figures next month.  So far, things are looking up for November, as I had a normal fasting blood sugar reading this morning.  Fingers crossed this is the start of a positive trend.  I am still exercising every day, and eating well, so I refuse to let myself get discouraged by one bad month. 


In summary:

Pounds lost this month: 7.5
Total pounds lost: 68.9
Pounds still to lose: 100
Inches lost this month: 4.0"
Clothing size: US/Can 20 (plus size 20, down a size from plus size 22)
Average fasting blood sugar: we're not going there this month.  Nope.
Number of ankles: 0
Number of cankles: 2 (sigh)
Number of clavicles seen: 0 (but the merest hint of a clavicle was spotted this morning, suggesting that sometime soon these little guys are going to make an appearance).