I’ve been considering trying to tackle the issue of why I struggle with my weight so much for ages, it’s something I’ve always avoided as I know the response will be “just eat less and exercise more fatty” which is the current mind-set around weight management. Don’t get me wrong I’m fully aware that to lose weight I need to eat less and exercise more, I get that but the issues are way more complicated than that.
Tl:dr – I can’t do this myself but thenhelp I need isn’t available.
I just want to clarify at the beginning that at no point am I passing the responsibility onto anyone else. I am responsible for what I eat and drink, for how much exercise I do and for my weight. This is to show the history of the behaviours that I now have rather than look to shift the responsibility. If at any point you think I’m trying to blame someone else, you’d be wrong and come back and read this section again. If it still looks like I’m trying to blame someone else then tell me where so I can rewrite that bit.
Mostly I’m writing this to help me, its part of a process.
I have been overweight, obese or morbidly obese all of my adult life, I was overweight as a child as well but I’m going to focus on adult life. In my late teens I was working 2 jobs (a horrifically badly paid engineering apprenticeship and also at blockbusters) clocking 60-75 hours a week. On top of that I was training in Tae-Kwon-Do twice a week, going to rugby training once or twice a week and playing at least one, if not two matches. I was around 14 to 15 stone then and still growing across the shoulders. This was when I had the knee injury that became a real setback, I had taken a few weeks out of training as I’d been elbow dropped in the back during a game against the Old Lemingtonians colts team and I thought Tae-Kwon-Do would be a better place to start back rather than rugby. During the session I was doing a sparring drill that was designed to increase speed. My opponent would throw a technique, not looking to connect and I then answer with a technique of my own as quickly as possible. The drill had evolved to jumping kicks, so we were all bouncing up and down trying as hard as possible to get the next kick off. I attempted a jumping turning kick but when I landed my foot planted and the rest of me rotated for another 180 degrees about the knee. I’d really not recommend this, it doesn’t hurt as bad as you’d expect but it does really screw your knee up. I was able to drive home, grade that weekend (even without being able to put much weight on the leg) and was back at work on the Monday. It wasn’t until a few weeks later I saw a doctor, and then a specialist and then (thanks to the marvel of private health care) was under the knife quite soon after that. I had snapped my ACL and tore up the inside of my knee pretty good, they cleaned the knee up but left me without an ACL and provided my with woefully inadequate physiotherapy. Despite several attempts to get back into training (including a short stint of aikido that resulted in a dislocated shoulder, destroyed ligaments and a permanently displaced collar bone) my knee would never hold up.
Between the end on the 90’s and 2003 I made some choices that had some negative effects on my health. I did no exercise outside of clubbing, I ate far too much, I drank far too much, I smoked and may have spent too much money on recreational party supplies. Within 6 months of the knee injury I was over 18 stone and my weight pretty much stayed there (with some fluctuations) until the end of 2004, but I’ll come back to that in a bit.
As a child born in the late 70’s I was taught that good eating was finishing what was on your plate. This started very young where finishing all my food, and even having more was rewarded with praise. Food was also used to celebrate any significant event, achievement or anniversary. On top of that my parents very clearly demonstrated that socialising and celebrating was all done with alcohol. This is what has helped develop some of my feelings and behaviours around food. To me satisfaction from eating is achieved from either the feeling of taking a large mouthful of something, or the almost painful stretched stomach feeling of overeating. I really like that feeling, I have learned to associate it with pleasure so the feeling itself is pleasurable. This is my big issue though, the need for that pleasure response in the brain. I get it when I eat, I get it when I drink, or smoke or other activity that creates selfish instant gratification. I get it when I do something new and extreme or when I spend money on toys. I get it when I get the thing I’ve been chasing but the reward usually does not last long enough to justify the time spent chasing. Usually this can be managed by stopping one thing but then doing more of something else. I stopped drinking for a few years and I managed that by smoking and taking more drugs. I then stopped the drugs and smoking but my eating increased.
So this is the behaviour I need to break, it wasn’t a drink problem, or a drugs problem and it’s not really an eating problem. It’s a needing that feeling problem, it’s about needing that thing in my brain to fire off and give me that feeling.
So let’s just jump back to 2003 near the beginning of the year I’d finally had my ACL put back together (and my first experience of Morphine, wonderful stuff) and was starting the course back to being able to do sports again. Everything changed for me at the end of the year when I had both a big break up and my first American Football training session. I got sucked into football in a big way, it would become a key part of my life for the next decade and was when I really started to work on my weight. I think my heaviest playing weight was around 24 stone, and my lowest was under 16 but with the exception of the times I was deliberately trying to gain weight I started on a cycle that has never stopped.
I make the decision to lose weight and start with sorting a diet (calories in vs calories out, keto, low carb, weight watchers, IIFYM, and many more) and exercise (usually set around lifting heavy but has also included running or other cardio in the past) plan. Sometimes it’s a really strict plan involving lots of training and harsh dieting and other times (like now) it’s gentle with slow weight loss and gradually increasing exercise to help make it stick. Whatever I do it usually means massively reducing or stopping getting my rewards, that mental gratification that I talked about earlier. The time I was most successful was when I was in an unhappy relationship and was living in a new place with very few friends. All week I’d work, diet and training then at the weekend visit my girlfriend and not worry about the diet too much. This balance worked, I’d have a controlled amount of whisky most nights during the week and then get my gratification from food, drink, drugs or other things at the weekend. The balance worked until the relationship fell apart, I met my wife and my behaviours all changed. The 20109/10 weight and form is what I’d love to get back too, 20%ish body fat, strong and quick, but without the loneliness and horrible relationship. To achieve it I was in the gym about 2 hours a day, sometimes more. Then I’d either be coaching or at home, that was my life. And this is one of my biggest stumbling blocks to consistent weight loss, I don’t want that to be all there is too my life. I work hard for a while but eventually the lack of that gratification, the not getting my addiction met just become too much and I fall off the wagon. Then usually within a short amount of time I’m back to my old weight, quite often heavier and I can’t see the point of trying again. I then get upset about my weight and try again, and thus the cycle continues.
Over the years I’ve spent a lot of time reading about diet and exercise, I’ve read books, websites, scientific studies and anything else I can. I’ve talked to professionals and other athletes. I’m fairly sure I’ve a good strong understanding on nutrition and weight loss, I’ve helped other achieve their goals. I’ve developed lifting plans for myself and others that have (mostly) been really successful. Like everyone else I’m influenced by fashions and trends and I’ve followed a few silly ideas being convinced they were the way forward (I’m looking at you crash diets and exercise fads) but mostly I think I’ve a good handle on it all.
There is one more element to include at this point, which is a health condition that makes it harder for me, in mid-2015 after several years of arguing with doctors and mostly being ignored it was finally recognised that I suffer from low levels of testosterone. This has many symptoms of which I’ve had most to some level or another but the few that are relevant are that it means you gain weight faster and lose it slower than if you had sensible T levels. You also find it harder to make strength gains and your strength leaves you far quicker than other people. (Guess how much this sucks in a sport where strength is really important). This can be caused by a whole host of things, head injury, recreational drug use, drinking – pretty much my early 20’s and I don’t know when it really started to drop but things have been a lot tougher during the last 5 years. T levels naturally drop with age but mine fell off a cliff. Whilst I am now getting treatment for it the specific treatment chosen by the NHS as the best one take about 13 injections before you get close to an average level and with one injection every 12 weeks I’ve still a long way to go until I get there. If I didn’t have my negative behavioural issues around eating than this wouldn’t be such a big issue, but I do so it is.
Since I spent some time working as a behavioural specialist you’d think I’d be well equipped to tackle my behavioural problems myself but it turns out that I really can’t. I had to accept a while back that I really can’t do this myself. Anyone that truly knows me knows that I will put myself through hell to help someone else and can endure a lot for the right reason, but for some reason that all falls apart when I try to tackle my weight. So I did the sensible thing and I asked for help, I’ve been to my GP several times (most of which have resulted in being told to go away they can’t help). I’ve even talked to the head of commissioning for Berkshire, I’ve asked and have been offered two things.
The first was Eat4Health, it’s supposed to be a tier 2 intervention for fattys but it was built on the assumption that the issue we were overweight was a lack of knowledge. I had to sit there and be told that crisps were bad and vegetables were good. It’s was horrifically like the Little Britain sketch, it was also so badly organised that by the time it got to my turn to have my blood pressure measured it was about 20 points higher than usual. If someone wanted to craft an experience tailored to killing me through high blood pressure this is exactly what they would have created. The poor person who was running the course was so out of her depth. She really cared and was really trying but she didn’t really understand the subject. She had been taught to regurgitate the course which unfortunately contained a lot of outdated and incorrect (well probably more incomplete) information and she couldn’t answer any questioning at all. For the people the course was aimed at I can see it helping them make positive changes that will have positive outcomes, and in health and social care it’s about how you can spend the smallest amount of money to make the largest amount of change. It didn’t go well for me though, after several weeks of huge amounts of stress from not wanting to call her on her rubbish in the class (as it wouldn’t have been helpful to the others) and having to walk out several times rather than lose my temper I felt it wasn’t helping. This wasn’t the course for me. It did result in me having a long meeting with the person who commissioned the course which has hopefully resulted in some improvements but I’ve no intention of going back to find out. The other option was overeaters anonymous which operates the same plan as AA used for drugs and alcohol but since it’s based on the idea that you put your faith in god and has been proven to be really unsuccessful I’ve not given that one a go.
So now I’m at a point where I know I can’t do this myself, the level of diet and exercise required to get a big enough result are unsustainable. Taking things slower means a I last a bit longer but don’t get the results. The reality for me currently is to be fat or to be unhappy, even thinking about going through the rest of my life no longer able to get those moments of gratification makes me unhappy. Going for long periods without them at all is something I have yet managed to master.
I just want to point out that I have a really good life, I’m really lucky and have lots of things that make me really happy. I love my wife who is awesome and I have an amazing family and brilliant friends. Things are really good and that means I’m much better able to cope but it still doesn’t mean I can master this issue.
I reached the point recently that I would ask for help again, this time a referral for bariatric surgery (a gastric band would be my preference) because I had been lead to believe that this was the only option left. It turns out that in Berkshire there is something I have to do first (unless I jump up 10 points of BMI, which I could probably do in a few months if I tried) which is what they call a tier 3 intervention which is a multi-disciplinary team that looks at your nutrition, exercise and behaviour and then support you in the way you need. This sounds perfect, for me but despite all my struggles, despite my understanding of the issues, despite the fact that not doing this is probably going to cost the NHS a lot more money in the future there is a really good chance I won’t get it. As with all things it comes down to money and the fact that I need the support is not enough to ensure that I get it. Since my weight is not causing me any significant health problems (well if you ignore the massive amounts of pain I suffer all day every day) then I will probably get turned down.
So I’m not sure where that leaves me, maybe I’ll be wrong and they will give me the funding (if they don’t I’ll be doing a lot of letter writing and complaining to see if that helps). I really hate being fat, it sucks so much. I need to drop about seven stone just to be able to buy trousers from a normal shop again. What doesn’t help though is the current environment of fat shaming, and everyone being taught it’s as simple as eating less and exercising more, when it’s way more complicated than that.