You are not alone!
As a physician I have the privilege to speak to people about their innermost struggles. I am often struck by the amazing bravery and forthrightness of some of my patients. On occasion, after barely an introduction has been made, eyes become quickly moistened, tears are expressed, and the most personal of information is shared. Some of it can be shocking and terrifying. I hear stories of abuse, trauma, betrayal, regret, and self-destruction. Some of it is self-inflicted, much of it is not. Some of it is inherent in the human condition.
People are struck with catastrophic illness or face eminent death. There is a lot of loneliness, despair, and disconnection. There is great fear. There is bitterness and resentment against the world. Far too many people ask themselves if life is worth living. They want to become extinct. They don’t want to remember any more.
Out of a pit of nihilism some seek to take revenge against the world and God by punishing His creations, by inflicting pain, suffering, and death. They would rather destroy than create. They want to be remembered for going out in a ball of flame and a hail of bullets.
Many people feel that they are drowning in a stormy sea without hope of rescue. They are constantly overwhelmed and anxious. They tell a story of powerlessness, fear, loss of control, self-loathing, and desperation. They are crying for help but don’t know where to turn or how to express it. They are looking for an outstretched hand.
These people are all around us, but we just don’t know it. We all have egos that cover over our innermost selves from others and even ourselves. We want others to know but at the same time we don’t. We fear peer rejection and vulnerability above almost anything else. We keep others at a safe distance from our true selves so that we can’t possibly be hurt or helped. We fear frailty and death.
My interactions with people have taught me that we are not alone and that someone’s apparent outward composure does not always correlate with their level of inner composure. All of us have things about ourselves that we despise and feel powerless to change. We push up against a wall that will not budge. We may have lost hope and given up trying. We may feel a lack of purpose or meaning. We may be bored with life.
Many try to cope with these negative feelings by seeking immediate relief, immediate gratification. The substitutes or stand ins for negative feelings can come in the form of substances, behaviors, or food. We can also try to hide from these feelings by retreating or withdrawing out of society. We can sleep too much, work too much, or exercise too much. These are all attempts at avoidance and distraction. They are attempts to avoid self-responsibility. They are ultimately self-focused and selfish. They are a refusal to bear our own cross and carry it up the hill. They are focused on losing or having less of.
I have experienced many of these same feelings around many areas of my life. One of these areas that I have been pretty open about is my struggle with compulsive eating. I have personally lost several hundred pounds over my life. In two stints I have lost more than 80 lbs. And like nearly everyone else who has tried to lose weight I have gained the weight back on many occasions.
I was 155 pounds when I got married right before medical school. I was pretty physically active and played a lot of sports. During medical school I exercised less and ate poorly. I experienced more stress due to the rigors of school. I unconsciously resorted to eating as a way to cope with negative emotions and stress after a long day. When I got to residency and started having children the stress only got worse. During my medical training my wife and I dealt with some pretty trying circumstances like surviving hurricane Katrina. Eventually, during a particularly harrowing portion of my residency I ballooned up to 240 lbs. I experienced a lot of self-doubt and became depressed about my weight which began to have a significant impact on my health. I developed sleep apnea and significant anxiety. I worried a lot and felt overwhelmed.
Somehow, I came to a place where I had had enough. I was tired of feeling crummy and I resolved to make a change. It was around this time that I had begun to research the Ketogenic diet which is now popular but at the time was not well known. Over a whole year I lost about 80 pounds with this diet. I tracked my carbs, fats, and calories diligently. I tried to stay at about 1000 calories and for the most part I stayed committed and consistently lost weight. I felt great and my physical symptoms disappeared. I did feel better about myself, but I still had negative feelings that arose due to life circumstances. This, of course, is unavoidable.
Then, I made a mistake. I subconsciously wished, like many people do, that I could just go back to eating like a “normal” person, that I could eat naturally only to satisfy hunger. I thought that I could in a sense return to a point in the past where eating did not fulfill other wants, needs, or desires. It is almost like I wished that I could once again return to a state of innocence and to have never partaken of the forbidden fruit. But just like an alcoholic who can never expect to go back to drinking like a regular drinker so a compulsive eater cannot expect to do so either. Once the apple has been eaten it cannot be uneaten.
Eventually, the memory of the pain of what it felt like to be significantly overweight faded and it became easier to rationalize going back to eating like I had previously. I had become focused on loss, the loss of food choice and the loss of pleasure of eating.
In a way, I longed for weight to not be a challenge anymore. I suffered weight loss mental fatigue and got tired of fighting. I just wanted to be able to relax. As a result, I began to seek food more as a source of comfort and a relief from inner distress. I would binge eat frequently. I relaxed, took it easy. I indulged. I was focused on self.
The result of this is that in relatively short order I lost control of eating and regained all the weight that I had lost. I was right back to 240 pounds within about 1 year or so. Like the proverb says I was “as a dog” that “returns to his vomit” or like a pig, that is washed, that returns to wallowing in the mud.
It wasn’t until I started my own medical practice in 2015 that I started working on losing weight again. Since my previous weight loss, I had since gathered hundreds of peer reviewed articles about weight loss and various diets. I was and continue to be very fascinated with helping people become stronger physically rather than enabling their compulsions with medicines. I wanted to help patients by sharing my research about diet and weight loss, but I couldn’t effectively convey how to lose weight from a practical standpoint when I was still very overweight.
Once again, through sheer determination and will power over the period of about 1 year I lost about the same amount of weight in about the same amount of time and using the same diet. I also incorporated intermittent fasting and long fasts into my routine.
I have since continued to struggle with weight. I have gone up and down 10-20 pounds and still binge eat on occasion. This is largely due to the fact that I have at times let my guard down and indulged in my previous habits. I have found that inertia is incredibly powerful. It is much easier to continue eating healthy once you get in a groove and vice versa for satisfying unhealthy compulsions.
Because of my struggle losing and maintaining weight loss I have also invested a lot of time researching “weight loss maintenance” which is the least successful part of weight loss programs. The evidence that I discovered was not only not encouraging, it was bleak. Only about 2-3 percent of people that lose a significant amount of weight manage to keep the weight off over a 5-10 year period. Most of the others gain it all back or more.
Many people have repeated the cycle I had repeated over and over again. They despair and may eventually give up as I have been tempted to do on many occasions. They may take long weight loss sabbaticals until the physical and emotional consequences becomes too much to bear. They may then find the will power to make yet another attempt to lose weight out of a reaction to this suffering and pain.
Unfortunately, by this time weight loss has often become simply a means of escape. There is often a lack of sufficient vision or purpose. It is like an inmate being let out of prison only to find that out they are much more comfortable with the familiar controlled circumstances of prison life than the uncertain and unrelenting challenge of making their own way toward a higher life. In the short term it is sometimes easier to stick with the pain you know rather than the pain you don't. But the paths are not equal in their sum total of pain and joy.
So if you struggle with weight what can you do?
To escape this revolving door in regards to our compulsive behaviors requires a shift in our vocabulary and our approach. For example, I don’t like the term “weight loss.” It implies a deficit and that something is missing. Nobody likes to lose anything. We like to gain. I like to focus on what someone is gaining when they make a significant change in their life.
The proper vision of “weight loss” in my view is the increased physical, emotions, and spiritual capacity someone gains from proper health choices that helps them serve themselves, their families, and the community to the highest degree possible. It is a commitment to love rather than fear. It is a commitment to serve the highest meaning and purpose, to walk the road less traveled, and to help others along the same road.
The change in vision also starts by acknowledging with honesty that you have been powerless to control your eating and all the efforts you have made have been unsuccessful. It means acknowledging that you need help and that will-power is not enough. It means that thinking about how to lose weight or reading more self-help books is not enough otherwise you would have figured it out by now. It means when it comes to weight loss you are figuratively lost and will not find the way out by yourself.
Ask yourself. If you were the CEO of your own weight loss company would you fire yourself? Ask yourself. Who is my higher power? Is it food or some other substance or behavior? You can know who your higher power is by what you think about or what indulgence in when you are stressed or have negative emotions. Your God is what you believe will give you comfort and relief. It is where you put you trust. It is safe and secure and reliable. It is your deliverer. For an alcoholic it is the bottle. For a compulsive eater it is binge eating. It is Don Corleone. It is a deal with the devil and the road to unhappiness and regret. It is a shortcut.
To get the necessary strength means to have the correct lens to look through. It starts not by focusing on how to lighten your burden but on how to strengthen your back. It starts by writing down with real commitment and purpose what the ultimate vision for yourself is. Ask yourself if you could visualize the ultimate version of your self what would it be and how would you go about transforming yourself into such a person? If you still cannot come up with a vision of your future potential self then think about a potential future version of yourself that if you met in person you would be in awe of or you would be strongly tempted to worship. That is the person you should be but are avoiding.
Focus on your future self. The God of compulsive behavior is to desire immediate relief and to avoid responsibility for the future potential of yourself and that of others. It is a lack of faith in your future potential. It is a life ruled by fear rather than love. It is self-rejection, self-hatred. It is a self-condemnation of your value. Will you sell your birthright and your soul for a mess of pottage? I certainly have at times and you may have done so as well.
The true God represents the highest way. The way that sacrifices the short-term fix of today for the transcendent future for you and humanity. It means letting go of earthy pleasures, the search for power and prestige, and the desire to remove the hard realities of life such as pain and death. It means letting go of resentment and bitterness about the reality of the situation you are in. It means letting go of blaming others. It means being honest with yourself and that you need help beyond yourself. It means letting go of your ego and being vulnerable and acknowledging your weakness.
Once you have realized this then there is potential for real magic to happen. The key for me has been to realize that out of the greatest suffering comes the opportunity to help others will similar suffering. Be a true hero. Transcend your greatest weakness and you can help others transcend theirs. Walk the path of strength and you can strengthen others. Have sufficient love to stick out your hand to all those that are suffering who you could help. Offer them hope and a way out.
Rely on a greater power and greater vision than yourself because you will set your sights to low. Love yourself and others. Make a covenant with your vision of a higher power and to your future self and to others that you will do everything it takes to accomplish this vision and that you will leave yourself no outs. As Yoda from Star Wars famously said: “Do or do not, there is no try.” Ask for courage. Say the serenity prayer.
Don’t focus on hunger as a loss. It is a friend, not a foe. It is future strength. Don’t focus on the loss of not being able to eat junk food. Focus on the strength that will be gained from eating the right foods. Be thankful for the blessings you have received as a result of other’s contribution to alleviating your suffering and making your life easier. Choose to live in abundance and not in depravity.
Trade your expectation for a “normal” life for an appreciation of the potential and opportunity of a “celestial” life, one that is hard won.
This is where real meaning and purpose arises. Want to know how to help others and to not feel alone? Make amends for those things that you have done to hurt others. Seek out those that are suffering as you have suffered and give them hope. Help show them the way. Strengthen their feeble knees. Let them know that they are not alone. Be the light in the darkness. Draw people closer to you with your own outstretched hand and lighten their burdens. Love first and love will be returned. Be and do what is seemingly impossible and you will inspire others to do the same. Don't seek for a finish line, rather seek for a new starting line to a land of greater possibility and capacity. Invest in yourself everyday because you are worth it and others need your help.
Start today by taking these action steps. First ask yourself what your ultimate meaning, purpose, and mission is. Then ask yourself that if you could become the person you dreamed of and that you were meant to be what would that person be doing now. Feel it, breath it, and visualize it. Write it down. Then post it on your bathroom mirror and fridge. Begin every day by focusing on the abundance this vision holds for you, your family, and to humanity. Finally, create one action step that you can and will repeat every day that will take you a little closer to becoming this person. Post it next to your vision. Forget perfection and focus on progression.
For me losing weight and keeping it off once seemed impossible. I have now become the impossible in my own mind and in reality. I am as healthy as I have ever been not by accident but because I purposefully invest in my health every day. You can do the same. Be the impossible in your own life and health!
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