• Dieting Makes You Fatter

    In previous posts I’ve covered lots of evidence that there’s not much you can do to change your weight. In the midst of all that, it turns out that there is one reliable way to make yourself fatter.

    It’s called “dieting”.

    I wrote before about Traci Mann and the analysis of 31 long-term dieting studies. Mann and the other researchers found that the majority of dieters regained their lost pounds and then some. She said:

    We concluded most of them would have been better off not going on the diet at all. Their weight would be pretty much the same, and their bodies would not suffer the wear and tear from losing weight and gaining it all back… Diets do not lead to sustained weight loss or health benefits for the majority of people.

    Janet Tomiyama, a co-author of the study, said:

    Several studies indicate that dieting is actually a consistent predictor of future weight gain.

    Oops.

    A couple of years back, headlines everywhere reported on a new study that showed that all diets work about the same, and if you just keep eating fewer calories, you’ll do okay. It turns out what the study actually says is that while all diets work about the same, they all suck about the same, which is what every other study says, too. Want to know happened this time that the articles don’t report on? All participants started regaining weight after a year. At two years, about half weighed more than their starting weight. On average, at the two year mark, participants were eating fewer calories than they had been eating at the 6 month mark when they were still losing weight.

    Let me repeat that.

    They were eating FEWER calories yet weighing MORE than when they had started.

    In a different three year study of almost 15,000 preteens and teens, the ones who dieted gained more weight than the ones who didn’t diet. The differences in their weight gain did not relate to initial weight or differences in calorie consumption. Other studies show the same causal relationship between dieting and weight gain.

    I ran across a great phrase while researching this: “physiological defense of body weight”. When you try to go messing around with your weight, your body fights back. In The Last Supper Syndrome, Michelle talks about that big meal you inexplicably eat as soon as you promise yourself you’ll eat “better” next week. She points out that by telling yourself that you’re going to eat less, you are threatening yourself. And your body has your back! Your body responds to that threat with protective measures. Various physiological processes kick in to help you eat more and make the most of what you eat.

    Some studies suggest that the metabolic changes caused by dieting stick around for a long time.  Dieting may alter the body’s metabolism in order to reset its set point in preparation for future restrictions. If you’re hungry now, there might be more hunger later, and your body is getting you ready for that.

    The body is so good at what it does that for most people dieting CAUSES weight gain.

    Diets. Don’t. Work.

    And just for the record, when we’re talking about diets and weight loss, what are we talking about? Here’s another great phrase I ran across: “cognitively regulated eating style”. If you’re plotting and planning and thinking and calculating what to eat, how much to eat, or when to eat it, it’s a “cognitively regulated eating style”, also known as a diet:

    Weight Watchers. Jenny Craig. Crash diets in bestselling books. Programs at commercial diet centers. Doctor-led plans. Meal substitutes. Fat-free processed foods. Restricting calories. Cutting carbs. Eating only whole foods. Reducing fat intake. “Portion control.” ‘Eating right and exercising.” SlimFast. South Beach. Nutrisystem. Paleo.

    If you’re doing it to lose weight, it’s a diet, and it won’t work.

    Kate Harding worded it well in Diets Don’t Work, But…:

    Diets do not lead to permanent weight loss for the vast majority of people.

    Not even if you call them “a whole new way of eating”. Or a “lifestyle change”. If your if your lifestyle change involves putting restrictions on your food intake, you will almost certainly be fat again in five years.

    Fatter.

    {Edited 4/17/13 to add: Please note that this post contains some creepy fat-hate in the comments that I didn’t go very far in smacking down or rebutting. Proceed with caution.}

    If you are looking for a fat acceptance community for friendship, fun, education, and activism, come join us at GLORIFY.

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27 Responsesso far.

  1. Jo says:

    I frequently tell my diet obsessed friends that this was true for me (lost weight then gained back twice as much), and what I now do (even thought I don’t… I just say I do for comic effect)… is

    “pretend” I used to be 240, lost 50 and I’m “down” to 190 and I’m THRILLED as I haven’t been this thin in years. LOL Because the fact is, if I lose 50, I will likely gain 100 and be that 240, so I might as well just pretend I was there to start with and WOO HOO LOOK AT ME NOW.

    All tongue in cheek of course. And the dieters don’t get it. There is no talking to them, however you never know. I might get through to one of them someday.

  2. Joshua says:

    And this is where the rare person who did lose weight and keep it off for more than a year or two comes out and acts like their existence disproves your entire point.

    • Issa says:

      That person can STFU!

    • Lee says:

      I liken that person who comes out with a claim that they hear god, or that prayer worked, or that the dog that gives them orders made the right decision – take the rhetoric away and what you have is a person who either was on the ‘fortunate’ side of circumstance/small genetic disposition or they are liars.

  3. Wendi says:

    Is there any difference in any of the studies or reports for people who start a new “diet” just to be generally healthier? I’ve started serving portioned out meals at home, to an amount of about 2000 calories a day, just because no one in my house knows what a healthy portion of ANYTHING even looks like, and half the people in my house do not know what hungry or full feels like.

    Actually, I’m pretty sure that their hungry/full “switch” was disrupted when they were children and forcibly put on diets, but that’s a whole different ragefest for me.

    But, basically I’m wondering that since the goal of this dietary change isn’t weight loss, but just to retrain our visual cues, does that count as “dieting”? I’m not changing what we’re eating in a significant way, but instead of making a large pot o’ food and letting people get their own, I’m cooking a meal for four people and serving it on the table.

    Of the four of us, two tend to overestimate portion sizes, and two underestimate, so it’s definitely a problem for everyone – mostly because none of us really know what we’re eating in that respect. And certainly I’m not the food police, if someone’s still hungry they can make more food without bitching or passive aggressive bullshit or “helpful” suggestions. But for those of us who are thinking that a pound of meat is “a serving”, by doing this whole meal changing thing am I putting them at risk to gain weight because they’re “dieting”?

    I mean, have any of the studies addressed that issue, and is there any information you’ve found on it?

    • Joshua says:

      One thing that stands out to me about your comment seems to be the assumption that there is a single correct portion size for all of the people, and that that portion size is defined as 2000 calories a day. I think these assumptions really deserve examination. Everybody has different metabolisms and nutritional needs.

      • Wendi says:

        Yeah, there’s a lot of family dynamics with our household and eating disorders and not singling out one particular member of my family that I didn’t go into. Those assumptions in the last comment are basic baseline starting points. I don’t expect our relearning how to eat will *end* with 2000 calories a day of food pyramid food.

        My brother in law has been on enforced yo-yo WeightWatchers his entire childhood. His current morbid obesity is obviously vastly unhealthy and I’m very, very worried for his health. He has freely admitted that he *does not know* what a portion or serving of *anything* looks like – which means he’s not even able to read the labels and calculate what he’s eating, how much he’s eating, or how it breaks down nutritionally.

        I can’t in good conscience enable his current eating habits by cooking a huge pot of food where we all take a portion and he finishes off what’s left, *regardless of how much it is*. Serving bowls are not the same thing as pasta bowls or cereal bowls.

        I’m not going to control his food; if he wants to get up and make another meal, he’s welcome to do so. I’m not the damn food police, and I’m not his mother. If he really wants to get up and make himself a 5 pound lasagna for dinner, he’s welcome to do that. I just have this very, very strong feeling that by making food with plans to have leftovers, and then there’s never, ever any left, that I’m enabling his eating disorder, and that’s really not okay with me.

        I also know what our lifestyle is like (which is unhealthily sedentary!) and I sincerely doubt anyone in this house actually needs 2000 calories a day. I did figure that, since we ALL need to relearn how to eat a healthy diet, that it would be a good, non-scary place to start that wouldn’t trigger him into “oh god not another diet!” mental state.

        What I expect to learn from this is to balance out who needs more protein and who needs more carbohydrates (and we ALL need more vegetables) as I observe who eats what, and who has cravings for which types of foods when the meal is over, and I’ll adjust accordingly. What I’m *hoping* will happen is that my brother in law will discover that he can be satisfied with less food.

        I’m really hoping he will discover that he doesn’t need to hide in his room to eat; that meals don’t have to be a source of shame and fear and guilt. I do know that singling him out is A Bad Thing. I do know that controlling his diet rigidly is A Very Bad Thing. I do know that focusing on his weight is A Very Bad Thing. I also know, as he and I have talked extensively about this, that he does want some help with healthy eating.

        I know that weight loss diets DO tend to result in rebound weight gain.

        I am worried that, given the studies Issa has cited, that no one has covered a lifelong change in diet from eating prepackaged crap high in processed carbs and fat and salt to something healthy and how THAT affects weight gain, and I was wondering if maybe she’d run across something I’d missed.

        • Joshua says:

          I know that Issa intends to respond to your questions directly, but hasn’t had time yet. I think your heart is in the right place, and there are a lot of things you’re doing right. I don’t think you’ve managed to sidestep all of the pitfalls of our fat-hate culture, though. One thing to consider is that, the larger a person’s body weight, the more calories they must consume to maintain that weight. Issa weighs 225 lbs and, the last time she tracked her calories, she needed 2,800 calories a day to maintain her current body weight. And she was basically totally sedentary at the time, so that’s not counting any exercise. (I just used her numbers, with her permission, because she remembers them from the last time she tracked calories, and I don’t remember mine.) It’s totally reasonable that a person weighing in the range of 3,000 calories would need in the range of 3,500 or 4,000 calories a day, just to maintain their current body weight. This is often overlooked when people see a very obese person consuming huge amounts of food and conclude that they are fat because they eat a lot.

          • Joshua says:

            It’s totally reasonable that a person weighing in the range of 3,000 calories

            Sorry. I meant 300 lbs.

            • Wendi says:

              Right, but we are talking about something *significantly* over 300 pounds that is actively hampering normal mobility. I’ll emphasize again the part that my goal isn’t to “make him” eat less. It’s to make him *aware* of what he’s eating. It’s not even to “make him” lose weight, although I think his health would improve if he could get down to 350 pounds. (For reference, he’s about 6’6″.)

              I would like to see him eat less cheap pasta and refined white bread. I would like to see him walk even 50 yards a day. Frankly, in his current condition, I think asking him to walk more than that might be actively dangerous.

              I do know *exactly* why he’s fat, and it’s a combination of genetics and the abuse he received with food as a child. It’s not because he’s lazy, it’s not because he’s stupid or bad or weak or because he’s necessarily eating too much.

              The main problem I’m seeing, honestly, is the *way* he eats. Reflexively. Find the biggest plate or bowl in the house, fill it to capacity, take it to his room if possible, and eat it as quickly as possible. I know that part of his indoctrination leads to a famine syndrome: If he doesn’t eat it all as quickly as possible and at every opportunity, someone will take it away and he will have NO food.

              I honestly cannot even COUNT how many things are wrong with that. I find it utterly obscene that that was inflicted on him. It’s completely horrifying to me that that was done to him.

              It’s something I cannot be a part of, and after a couple of years of watching the patterns, by just cooking unstructured amounts of food and leaving everyone to just grab whatever, I’m thinking I’ve been a passive enabler on it.

              I also want to emphasize again that he and I have specifically discussed what he wants, and ways I can help him, and ways I refuse to “help” him. I refuse to be the Food Police under *any* circumstances, and he did find that to be a relief.

              If his metabolism requires more portions per day, I have exactly zero problems with that. The problem I’m having is him thinking that a one pound box of pasta is a portion. It’s not; that’s eight portions. Since he judges everything he eats with the same mentality, he’s also not getting the right *proportions* of food, I suspect, and he doesn’t know how many calories he needs. A portion of pasta has, what? 250 calories? I’d need to check the box; but the point is that kind of misjudgment leads to eating 2000 calories and *thinking* it’s 250.

              And, to be completely honest, he’s not the only one with a food problem. His is just the most obvious. I tend to eat once a day (not good), I tend to think portions of some things are larger than they actually are, and I definitely need to expand my diet out from basically meat, carbs, and fat. My daughter tends to eat too little, from an entirely different set of food issues, although she’s the healthiest of us dietarily. Scott’s diet is limited to a degree that is commonly seen with people who have autism or Aspberger’s Syndrome. He was pretty badly traumatized in the same family dynamic that produced his brother’s obesity, with some interesting long term effects.

              And I think one of the reasons I’m posting this here is to leave an anecdata example that food issues of all sorts are incredibly individual. There are so many ways to fuck up your kids with food that it’s not even funny. Force feeding kids is a horrible thing to do. Forcing diets on them, rather than teaching healthy eating habits, is a horrible thing to do. Telling kids things like “you’re not tired, you’re hungry” or “you don’t like/want that” teaches them to not *listen* to their own bodies. And then in 20 years you wind up with situations like ours, and it’s Not. Okay.

              It’s *especially* thrown into sharp relief when, as an adult, you try to do some research on “healthy diet” and everybody and their brother has the This Diet and the That Diet and FSM help us all that damned food pyramid that promotes diabetes by not differentiating types of starchy carbs, and wherever you turn BY GOD YOU’RE DOING IT WRONG! OR YOU WOULDN’T ALL BE FAT! YOU’RE A BAD WIFE/MOTHER/HOMEMAKER BECAUSE YOU DON’T COOK THE WAY I TOLD YOU TO!

              And then you wind up being out of fucks to give, because you just can’t fucking win. So if you’re reading this, and this remotely sounds like you, you’re not alone and it’s NOT just you and there is no One True Way. And it’s okay to ask questions. It’s okay to say “well, that didn’t work; let’s try something else” as long as you’re trying it sanely, instead of converting to the Next Big Thing the way some people convert to an evangelical religion.

              • Joshua says:

                Right, but we are talking about something *significantly* over 300 pounds

                I think you may have missed my point. If he’s significantly over 300 lbs, then his daily caloric needs (just to maintain his body weight) are probably even higher.

                If his metabolism requires more portions per day, I have exactly zero problems with that. The problem I’m having is him thinking that a one pound box of pasta is a portion. It’s not;

                Are you sure? A pound of dry pasta is about 1,600 calories. Depending on his weight and his BMR, that may be only 1/3 or 1/4 of the daily caloric intake to maintain his current weight. It may be the same as you or I (assuming a 2000 calorie budget) eating a small McDonald’s hamburger, a small fries, and a small Coke. Okay, I’m stretching a little bit, because it’s unlikely his BMR is in the 5000-6000 calorie range, but it’s not out of the question, depending on his weight.

                • Wendi says:

                  Actually, I had not realized that his BMR could require *that* much difference in caloric intake. I did know there were some variations, and that I’d have to adjust things as we go, but I didn’t think that 4000 calories a day might be necessary. Thank you for pointing that out; it gives me a new direction to research with him.

                  I would be a lot happier with and for him if his hungry/full trigger hadn’t been damaged when he was a child. Then saying “just stop eating when you feel full” would have some meaning, and some relevance, and I wouldn’t have to worry about it.

                  I’m also absolutely certain that a pretty significant segment of the American population has the same problem. Many of us have been indoctrinated to eat at a clock time because it’s *time to eat*, not because we actually feel hungry. We have been indoctrinated to stop when the plate is empty, rather than to stop when we feel full.

                  • Issa says:

                    You can use this site to get a rough idea of caloric needs. A 450 pound sedentary man might need 6300 calories a day. He could eat two boxes of pasta and two pounds of meat and still need 1500 more calories.

                    You’re right that many people’s hunger/full signals are all messed up. But eating is a sensual, bodily process, and you can’t “math” or “portion” your way out of that. You definitely can’t calculate someone else’s way out of it.

              • Issa says:

                “…my goal isn’t to “make him” eat less. It’s to make him *aware* of what he’s eating… I would like to see him eat less cheap pasta and refined white bread. I would like to see him walk even 50 yards a day…The main problem I’m seeing, honestly, is the *way* he eats…”

                This just sounds like a bunch of… none of your business? Why do you have goals about what someone else eats? What he puts in his mouth is his business. This sounds like some seriously inappropriate boundaries. If you’re the one responsible for the household cooking, and you want to cook all salads and wheat bran, then more power to you. But the “way he eats”, how much he walks a day? He’s 100% in charge of that.

        • Issa says:

          One more comment and then I’m down for the night:

          “His current morbid obesity is obviously vastly unhealthy”

          That word “obviously” does not belong in that sentence. Weight and health are not the same thing. Period. Some “morbidly obese” people are the perfect picture of health. Some “normal weight” people are not. BMI is a ration of height to weight. That’s it. It doesn’t tell you anything about a person’s health. And if an individual fat person is also unhealthy, that unhealthiness is a separate concern than weight.

    • Issa says:

      I think some of the issues and questions you raise are really important, and I want to give them the attention they deserve, but I’ve gotta wait until sleeping baby time. :-) More to come!

      • Wendi says:

        Take your time, Issa. This is an inherently complicated issue, and not only does my train of thought resemble a Spirograph drawing at times, there’s just so damned much to cover. Hell, it took me, what, 3 comments? to bring out everything behind a pretty basically simple question: Does changing one’s eating *habits* produce the same rebound weight loss as *dieting*?

        It’s days like this I miss my Adderall, LOL.

        Anyway, I look forward to your thoughts, but please don’t feel rushed. I’ve got email notification turned on, so whenever you post it, I’ll see it. :)

        • Issa says:

          Yeah, there’s so much I want to write here, I may have to make it into whole posts on it’s own! I’m so passionate about this topic, and finding the difference between healthy eating and dieting is a really great question in particular.

          In the meantime, I ask that you please not make any more comments about your brother-in-law. I’m uncomfortable with some of the ways you’ve talked about him, which are common to how we talk about fat people, but that I think are problematic. I’d like to add some perspective on those things, too, but I don’t want this comment thread to get too far into that.

          • Wendi says:

            No problem. I’ll just close it out by saying that there’s absolutely nothing I’ve said here that he and I have not *explicitly* discussed; this is not a behind his back issue. Everything posted about the way he eats and what his issues are comes from *him* in our discussions. I’m not sure it makes a difference to you or not in this case – I just wanted to explicitly state for you and the comment thread that these things I’ve said are pretty damn specific to the conversations he and I have had.

            I’d like to ask you to, at a later time, specifically address what language made you uncomfortable, but that can wait.

            • Issa says:

              I hear a lot of judgement (processed, refined, “the way he eats”, the size of the bowl, etc) about the food choices of another adult. What another person puts in his mouth is none of my business. His health is none of my business, even if I could determine it, which I probably can’t.

              I’m especially upset at you saying that you don’t want to cook more than a certain amount of food, because then he’ll eat it. That’s so insulting. People need to eat. Even fat people. Fat people need to eat MORE. If your brother is 300 or 400 or 500 pounds or whatever, he needs a lot more calories than 2000. If that’s how many you’re telling him to eat (by not “enabling” him to eat more), OF COURSE he’s eating really fast while hiding in his room. He’s got THOUSANDS of calories to make up somehow.

              It’s hard not to be defensive about this, because *literally denying fat people the right to eat* is an actual, serious issue facing fat people in our culture.

              • Wendi says:

                Okay, first, thank you for the well-deserved, gentle smackdown. I slept on it, and thought about it, and you’re dead right.

                As to the above responses about control, and whether or not it’s my business to be involved in that, I can only say that I was specifically invited, by him, to take an active role in helping him change his eating habits. I can see now that he and I need to sit down and do some research together, and reformulate a plan that he’s comfortable with based on much better information than he and I had at the time.

                I don’t think I actually have it in me to apologize for simply being wrong, but I certainly can and do apologize for making you uncomfortable. I can absolutely admit that I was wrong, and I was blind to the language I was using and the misconceptions I had.

                The eating really fast in his room thing started when he was about eight years old, and has continued into his adult life. I’m pretty sure I’m not responsible for that one. I also know it causes him great emotional distress. When he and I discuss his eating/weight/health/mental state about food, I do take a lot of my cues from the things he says, and the language he uses. I slept really hard on that too, and I think I’ve figured out one of the things that has had me so emotionally invested in his eating.

                I’m angry.

                I am furious beyond belief.

                I’m not angry with him. I’m angry FOR him.

                I’ve seen the baby pictures when he was six, when his grandmother first put him on WeightWatchers. I’ve known him for about six years now, as an adult man. I’ve seen pictures of his father, and that gives me a good idea of what he should have looked like if his metabolism hadn’t been altered when he was a child.

                No one had any business putting him on a diet when he was a child, even by the standards of the time (the mid 80′s). That child was not fat. His current weight, which from the pictures and other physical cues is more than he was genetically designed to carry, is something I view as a disfigurement – much like a child with a face scarred from parental beatings. He was, genetically, never going to be a “thin” person, but from the pictures I’d guess that the yoyo dieting he was forced into has led him to carry an extra 200 pounds than he was meant to. For someone to fuck with this is something I view as torture, and it’s absolutely obscene. For someone to then turn around and instill in him that it was all his fault is even worse.

                I love my brother in law, and I am very, very worried about him. I’ve already found four specific studies in the links of the other post you’ve left after a bit of clicking through that I think he and I need to read, and then sit down and decide what he wants to do and what help he wants with that. His emotional health isn’t good (and that’s possibly the biggest “Thank you, Captain Obvious!” statement of the century), and his physical health is very not good. I really am worried he’s going to die. Soon, I mean.

                He and his family have been very focused on his weight as the major health issue, and I did get pretty well sucked into that – I find it’s a lot easier to do when the person in question is the one saying “the weight is the problem”, and I’m a little embarrassed to have fallen into that mental trap and drank the Kool-Aid along with him. I do think his weight is contributing to some of his health problems. His body mechanics aren’t good, and his breathing can be pretty labored at times, and his feet are swelling. The standard medical advice he and I have been looking at have indicated that weight loss will fix those problems.

                The links you’ve pointed me at, and the link lists I’ve found there, and the things you’ve said here, have led me to realize we’ve been going about this from entirely the wrong standpoint. Standard medical advice says it’s dangerous for him to start an exercise program, which is further compounding the issue, because he does want to get more mobile, and to not be winded coming down half a flight of stairs, which again is easiest to bring back to the “weight loss” solution, rather than one that’s actually going to give him the results he needs – the results of good health. Again, obviously more research is definitely in order. At least he and I are both vehemently opposed to any sort of gastric surgery, so I don’t have to worry about talking him out of that. Now we just need to find a level of light exercise that he’s comfortable with, and I’ll ask him what kind of support and coaching he wants with that – if any.

                Thanks again for the kick – I definitely needed it, and I have to say it was possibly one of the gentlest and most effective smacks I’ve ever gotten.

                • Issa says:

                  I’m glad the smackdown was gentle… that’s always tricky, to say what I need to say but not be too much of an ass about it. Let me also add that it’s great that you care about your brother-in-law, that you don’t blame him for his fat, and that you care about helping him in a way that’s not about dieting or shame. I thought of a couple more things to add about your situation.

                  One is that you’ve said that he wants to change things, wants your help, etc, and I think you should be cautious about that. For one thing, we fat people tend to buy into our own oppression. Of course he says he wants things to be different – that’s what he’s supposed to say. It may be more truly beneficial to him to say no – “No, I’m not going to participate in acting like you need to be “fixed”. If he’s got all these problems that arise from a history of obsessive pressure about weight and food, they probably aren’t going to get resolved by… a whole new set of pressures about weight and food. That’s why I like articles like The Fat Nutritionist one on permission. What a lot of fat people need is to just. let. go. of weight/eating/food as this huge focus in our lives.

                  I’d also like to suggest that you think about moving your anger away from his specific situation. Yes, you’re angry at what happened to him, but it’s too easy to then make him the center of solving that anger for you by solving him. What if you directed that anger more outwards, towards our culture as a whole? Use that anger to bring changes to the narrative as a whole? Channel it into research, use it to confront ignorant statements from doctors, think about how to provide counter messages in your community… I don’t know what form that might take for you, but make the anger… larger… instead of a laser pointed at your brother-in-law’s life.

                  I can recommend tons of good blogs on any aspect of fat acceptance, fat health, and fat activism, if you want any more reading and let me know what direction to might be interested in.

                • Hunter says:

                  Exercise…
                  There are definitely different levels to that.

                  I think, in a lot of situations, exercise is assumed to be *aerobic* exercise (heart rate in a certain range). This is not always true. There is value in moving without hitting that target range. There is value in working on gaining muscle even if you never hit that target range. In the idea of goal-setting, just go with *improvement*. (Is walking 50 yards excercise? It certainly is if that is near your limit of distance.)

                  Also, water is a very gentle environment.

                  • Joshua says:

                    I don’t think anyone is disputing that there are benefits to exercise–benefits other than long-term weight loss.

                    • Hunter says:

                      It is more the idea that I saw that:
                      He needs to exercise.
                      But…
                      An exercise regimen would be too dangerous.

                      The only way he’ll get more mobile involves moving.

                      Moving –> Exercise.

                      Catch-22.

                      In case I’m still being too oblique… Just moving around counts as exercise and should be helpful for increasing mobility. Set the bar for exercise as something attainable. If that starts out with walking to the mailbox, so be it. I used to count a trip to the grocery store as physical therapy. [Cardio exercise for him might well be dangerous. Walking to get the mail... hopefully not.]

                      [Personally, I'm a little too familiar with the medical catch-22. At some point, I mostly decided to say 'fuck it' and pick and chose a set of constraints that didn't contradict itself.]

    • Issa says:

      I just replied to this first comment of yours, Wendi, in a new post: Can You Change Your Diet Without Dieting?

  4. [...] a post on my regular blog about dieting making you fatter, a commenter replied with some seriously creepy and controlling comments about her fat [...]

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