Weight Report and Some thoughts on Depression

IMG_20150913_070233When I returned to my program, on September 6, 2015, my weight had gone back up to about 278 lbs. (about a 23 lb. increase, with most of it after rotator cuff surgery). I remember it being within a pound or so of that, but didn’t take a photo. Part of the reason for not taking a picture is that I wanted to get back into fat burn and properly hydrated before reporting my weight. The reason for waiting until properly hydrated over several days is because (as I reported in the past) my weight will differ by as much as 5-7 lbs. Inflammation, as joints and organs hold water to maintain proper function adds weight. There is also the additional weight of a full bowel—sorry to share that.

This past Sunday (September 13) I weighed in at 266.8 lbs. This might seem like a large drop for just one week—which it is—except that it likely includes additional loss for the above reasons. However, I usually lose very fast on this program, at least for the first few months. After several months my metabolism will slow down to compensate for the long term calorie count. But in the first few months my body happily burns major fat.

A couple days in, I stopped feeling any hunger pains. There was the occasional grumbling tummy, but that will come and go any time. After three days, I was in fat burn and my energy levels were back up. My motivation is high and I am very pleased with the program. This actually brought up some thoughts about another time I tried to go back on program.

Last spring, for various reasons I decided to go back on program and, a week or so in, I became terribly depressed. It really came on suddenly. It was also quite extreme. That is one of the reasons I dropped off the radar blog-wise. It got bad enough, that I thought I might need to seek help. I’ve used traditional and over the counter methods for years to counteract depression, and they usually work very well (I’ll share some later). This past spring nothing seemed to work, except for dropping off of program. Even that only brought me out of “the deep dark”, into the “not as deep and dark.” I was still fairly depressed. There was an element of it that continued until recently. This helped me to figure out what happened.

Low Carb diets can affect our serotonin levels and cause lowered moods—and for some even a depressive mood.  I don’t want to say it can cause depression, because depression is something medical. If you suspect depression, see the doctor. I can talk about moods and recommend ways to improve those, but really am not offering advice on depression. I am only offering what I have learned about myself. Please take it in that spirit.

I went back on program right about the same time that there were some new stresses in my professional and personal life. Those stresses and the program joined up with it being the time my doctor lowered my testosterone dose by a third to see if my body would make up for it. It didn’t. Instead I got very low on T-level, and only recently found that out by my latest blood tests (I’ll share some of what I’ve learned about testosterone later). The doctor recently raised my dose back up and confirmed this as the cause of my symptoms.

One problem with health, and trying to return from an unhealthy state, is that there are so many different factors. One thing good for you can actually compound with something else. These together can have an undesirable effect. Throw in three or four changes together and your world can seem to come apart. Take things slow. Don’t try to improve everything at once. We want everything to be undone immediately and to return right away to that healthy young man or woman we once were. The thing is, I didn’t get to be over 400 lbs. with all the health issues I had overnight. It took decades to get there. I hope it doesn’t take decades to fix it—especially since I am not so sure how many decades I have left. The thing to remember is that my goal may be total health. But that is long term goal over the distant horizon. My goal today is to be healthier than I was yesterday; healthier than I was last week; healthier than I was last month; healthier than I was last year…

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Renewed Determination

The five months since my last post have been full, interesting and educational—and some of it depressing. You may have noticed that I dropped off the radar, blog wise. Actually, I’ve had many things going on and several reasons for not posting on this site. Well, I’m back. I have a specific reason for coming back. One thing important is that I’ve learned much about maintaining weight and the difficulties of going from unhealthy to healthy.

In April, I dropped off of program. It wasn’t intentional. My first plan was to lose the weight, which I did pretty well through Medifast. I lost the weight quickly and learned a great deal about myself. Then I switched, in the fall, to lifting weights to build muscle mass—to continue the weight loss from the other direction, gaining muscle to increase fitness and metabolism.

My job changed in ways that made it difficult to get to the gym regularly. This was more of an excuse. Had I truly wanted to make it, I could have. Of course, there were two reasons for not wanting to make it to the gym. One was an issue with my testosterone level (which I’ll address further down page) and the other was arm pain—not only when lifting, but constantly. Having spent several years in the military, my instinct was to just work through it. This had worked in many other situations. But, no matter what I did the arm only deteriorated.

So, I thought if I laid off a few weeks my arm would get better and I could just go back to it. Instead, I discovered that it didn’t get any better—it continued to get worse. During this time I lost the habit of going to the gym. A good habit must be reinforced just as strongly as a bad habit must be resisted. If you don’t go, you develop the habit of not going.

In June, I received confirmation of what I suspected. I had a torn rotator cuff. I had learned a lesson too late. That lesson was to always always always (perhaps I should say ‘always’ a few more times) lift with proper form. If you’re not going to take the time to learn and use proper form, then don’t lift! On June 23rd, I had corrective surgery to fix the rotator cuff and remove a bone spur from my shoulder. I have been in recovery since hen—I suppose physical therapy is a form of gym, right? It really stinks going from lifting weights in the quest to build muscle to working with pulleys and bands trying to regain the ability to raise my arm above my waist. If you haven’t had rotator cuff surgery, please take it off your bucket list. I assure you it isn’t fun.

During the first few months, even without the gym, I maintained my weight with little effort. Some habits were easy. I still avoid most sugars. I try to limit carbs on most days, but allow myself splurge days. I also avoided those foods which are simply not good for maintaining health (notice the past tense in that sentence). This will bring up another lesson learned, later.

I kept telling myself I was going to go back on program later and I’d go back to the gym as soon as my arm was good enough. This morning (Sunday, Sept 6, 2015), because of how my shirt no longer fit, I said to my wife, “That’s it! I’m back on program right this minute!” I went in and ordered more supplies and notified my coach. Fortunately, I have enough Medifast supplies stored to tide me over until the new shipment comes.

The issue of my testosterone was less of a lesson and more of a discovery. Early in the year my endocrinologist tried lowering my testosterone lower than ever. I was doing well, with lots of energy and motivation. This all changed with the new dosage. It took me several weeks to put the lower dose and my newly acquired lack of energy and motivation together. Then it was a couple months until my next round of tests. A couple weeks ago my doctor found that my low levels matched my symptoms and raised my dosage back up to the higher level. We did an MRI to see if there was a pituitary tumor causing problems. This showed my pituitary gland is fine. The doctor and I agree that the problem is that I still have too much body fat (more on this and testosterone in a later post). I should have continued with the Medifast to continue reducing fat and waited to start weight training. Lessoned learned.

Now with my T levels adjusted and my renewed intent, it’s time to get going back on the path of healthy choices. An important part of this will be this blog. The blog gave me accountability. When facing decisions, it helps to consider what I’ll report in this blog—good news, bad news, success or failure.

If you have dropped off your program of health, get back on program. Don’t let anything keep you from it. “When it comes to health, tomorrow never comes and later is a lie.”

Ending the Year, Continuing the Journey

Before

Before the Journey

Well, it’s been a while since I posted anything on this site. That is my oversight, as I have been very busy with changes at work, and with some new projects in the works. This week is the end of my annual goal of making healthier choices. I’ve had many victories, some failures, and quite a few lessons learned.

I thought I would post the changes that have happened. I am also going to come back to discipline myself to post about lessons learned. This post will concentrate on the changes. Future posts will concentrate on the lessons learned—those learned in the past, or new ones as they are learned.

My weight is the biggest change—but not the most significant. My lifetime high was 425 lbs. Of course, I’m not sure if that is the actual highest. That was my weight when visiting my sleep specialist for the first time. He was the only one of my doctors with a scale high enough to measure me. It was still several months of bad eating, and poor choices after that visit before I actually did anything to change, so I may have weighed much higher.

After

After a year on the journey

My first step was going on meds for my pre-diabetes under doctor’s orders. Supposedly this medicine would also cause weightloss. I started taking it, almost expecting a magic bullet effect—“Take this daily shot and get healthy and skinny.” Of course, there is no magic bullet. I lost weight down to about 385 lbs. but stopped there. Nothing else happened. I knew 385 was not really healthier than 425, so I resolved it was time to rethink my whole outlook on food, exercise, health, etc.

The rest of my journey is described elsewhere on this site, so I’ll skip to today. Starting at 385, I am now down to 258 lbs. today. My clothes are very different. I was wearing size 56 pants at my largest. I just bought my first pair of 36 waist jeans today. My shirts were 5X a year ago. Today they are XL.

The C-pap is gone. I sleep unassisted and, according to my wife, don’t even snore. I am no longer pre-diabetes. As a matter of fact, my doctor has described my A1C, cholesterol and heart rate as ideal. I now take only one pill a day for blood pressure—but we have not fully dialed in the dose yet, so this might change. My back problems have all but disappeared.

I am anxious to see my blood work this coming Wednesday. I was on Testosterone for so long that my doctor says my Pituitary became virtually non-responsive. She lowered my dose to see if my body starts creating hormones again. I pray my pituitary kicks in and I can stop taking the shots.

In the coming posts I’ll describe the lessons learned and what I plan to do for the future.

Pi$$ Poor Prior Planning

We’ve all heard the saying, “failure to plan is a plan to fail.” In the Army we referred to The Four P’s: Pi$$ Poor Prior Planning. Today at the gym I found myself thinking about the importance of having a plan in striving for health and fitness.

Since I’ve switched from weight loss to mass gain I am doing less cardio, more weight training and eating larger portions to fuel the gains which are my current goal. When I started out in the gym I found the easiest way was to go to a line of machines and do a full course from the first in that line through the end. This is easier since the machines are usually laid out to work one muscle group and then the next. It was easy because I knew where to start, where to go next—and very important—when I would be done. This latter point is paramount when just starting a workout routine and not being in the habit of hitting the gym.

Now, because I kind of reached the limits of where the machines would take me, I am moving more to free weights. The reason for this is core conditioning and practical strength issues. While the machines are great for concentrating on a specific muscle or muscle group, they work only those muscles and usually hold your body fairly stable. Free weights are very different. While working one muscle group you must also use others to support your body and maintain proper form. In this way you work on the muscles you target but you reap the benefit of strengthening the surrounding areas.

The problem with doing this though is a lack of a plan. The machines were laid out in order: start here, go here, finish over there, and go home. The free weights are a jumble of steel and benches often laid out haphazardly. There is no direction, no actual plan built into the area. This means I can either wing it, doing whatever I feel like at the moment, or I can lay out a plan ahead of time. If I don’t take the time to plan, it is too easy to get discouraged, bored, or side tracked. It is especially hard since, unlike the machines, the weights have no little picture telling you what to actually do. Without a plan the favorite things get worked on and everything else gets neglected. Before long, discouragement creeps in and you fall off the fitness bandwagon.

These thoughts came to mind today while talking to a friend about her health and weight and thinking about my own experience. One major help for success is having a plan. Too many approach their health and their weight with the mindset of “I’ll try this and see what happens; then, I add this; perhaps I’ll do that.” We trade the food buffet for the fad diet buffet. Someone tells us the answer is Apple Cider Vinegar so we add that. We are told “Juicing is the answer.” Others claim, “You will never lose weight without (fill in the blank).” One nice thing about a plan is that we can tell people “I’m on a program and will stay with it. Thanks for the advice but it doesn’t work with my program.”

I had people tell me, “You don’t need a diet! You just need to watch how much you eat.” To which I responded, “Isn’t that what a diet is?” You see a diet or a weight loss program is a plan for how to go from heavy to light, from fat to slim, from unhealthy to healthy. It is a roadmap. It is not a master. It is a guardrail keeping you from falling off into the abyss of another failure.

Can you lose weight without a plan? Yes, you can. You can also lose weight without even trying, but how many of us can rely on that fact to get healthy. A plan (a formal program, if you will) helps in the following ways:

  1. It allows you worry less about each step.
  2. It allows you to think long term without getting discouraged by what is right in front of you.
  3. It allows you to know the path to the goal—where you are going is useless information without knowing how to get there.
  4. It allows you to be more disciplined.

This last is very important. One of the things I did was set a reminder on my phone for every time I was supposed to eat. This way I always knew when to eat, but also knew when not to eat. If I just wanted something I could say, “Nope. The alarm hasn’t gone off yet.” I could also look to see just how long until my next meal. Resistance is easier when you know it’s only three hours between meals (part of the plan). It is also easier to be disciplined when you know what your next meal is going to be (the plan, again). When you have planned it ahead of time, and maybe even done the largest part of the cooking ahead of time, it is easier to not eat just out of convenience—“I need to eat something but have nothing prepared, so I’ll pick up a hamburger just this once.” One thing I did was to cook a whole roast and portion it out for meals so each day I could just grab a piece of roast and add some proper green veggies to have my meal if time was short. No temptations from convenience.

The first point about knowing the next step is also important. Do I need to eat 30 grams of carbs, and then some protein this meal? Did I have too many carbs in the last meal? Did I get enough protein today? All of these can be a problem without proper planning. A good program takes care of most of these things for you. Forget about the fads your skinny friends will all regale you with and find a clinically studied and prepared program that works for your health needs.

My program was Medifast meals on the Take Shape For Life Program. It worked for me. I recommend it highly to anyone. Does this mean I believe this is the only program? Of course not! There are others. I want to encourage you to make a plan, to chart a course to health. For many, like me, the best course is one that many before have taken.

Concentrating on Your own Positive

Since changing my goals and concentrating on gaining muscle, I have been in a Carb Cycling macrocycle (meaning more than one day per week consuming higher carbs and lifting weights). I find myself wanting to get my scale weight down. But I can’t build muscle and worry about the scale at the same time. Building muscle can push weight up, since muscle actually weighs more than the same volume of fat. I have to keep reminding myself that I have an end goal to reach. I want to raise my lean body mass and then lower my fat content down to reach a specific BMI.

One reason for doing this is my testosterone. When I was at my heaviest, my weight and sleep apnea all worked together to create a perfect storm against my endocrine system. My body was making so little testosterone that it was practically useless. On top of that, the testosterone I was making was of no use. Fat cells around the abdomen actually convert testosterone to estrogen. My sleep apnea reduced the production of testosterone, and then my excess fat took what was produced and converted it to a hormone that would do even more harm to my system.

Losing weight has helped my sleep apnea. I am no longer using my C-PAP. My testosterone levels are great, but not perfect so the doctor has started reducing my weekly dosage—which is nice because it is a painful, self-administered shot and the lower the dose, the less pain.

I decided to concentrate on weights and muscle gain in order to increase my natural testosterone production. The problem is that I spent so many months thinking about the scale and looking for lower numbers, it is hard to see the scale make no changes in over a month.

I have to remind myself of my current goal—get off the T-shot, and increase lean mass. This means looking at the tape and skin pinch more than scale numbers. I have increased my chest by around 3 inches. My calves have increased from 18 inches to 20 inches. My thighs have trimmed to 27 inches at the widest and tightened considerably. My waist has stayed almost the same. My shoulders are expanding and widening. All of this in about a month and a half. Funny thing is that my shirts had gotten down to XL size, but these are now too tight in the chest and I need to move back up to XXL. Of course this is much better than the 5X I used to wear. My chest was 56 inches back then. It went down to 44 inches (I list 12 inches of fat around my chest)—the smallest I remember it being since high school. It is now up to 47 inches.

I have to keep in mind the goals that matter are mine. Others would look at my scale number and say, “You have to get that down.” They don’t know anything about my actual lean mass (which is heavier than what the traditional BMI chart says should be my healthy weight). They don’t know about the need to gain muscle to increase T production. Worrying about what someone else thinks you need is useless. Set your own goals and work towards them. If others can’t support the goals you set for yourself, don’t talk to them about this area of your life. Even after all this time on program, I still have friends whom I know not to speak to about my weight or health. I know their contributions are useless, so I protect the friendship by ignoring the stupid advice and silly statements. I try to concentrate on my own goals and remind myself constantly of what I am working towards. Since my weight is unchanged but my muscle mass has increased, this means I am “exchanging” fat for muscle—a positive. Concentrating on the positive is always helpful.

New Weight and an Italian Dinner

IMG_20141017_075717I haven’t posted anything in a while on the blog. I haven’t gotten bored, neither have I given up, nor have I “fallen off the wagon.” Things have been pretty busy career wise, and I’ve had to put more emphasis in some new directions there—which leaves less time for other endeavors. Of course, one of the biggest improvements to my career has been losing weight. I now have the energy to match my drive giving new joy from my work.

There are several differences over the last few weeks. As I said before, I transitioned off my earlier program onto a different one because my goals have changed from losing weight to building muscle in order to impact my lean mass to fat ratio from the other side.

I’m on what Roman Malkov calls a macrocycling rotation in his book The Carb Cycling Diet. This means I am doing more than one day a week working to build muscle. One or fewer days per week on weight-lifting (a regiment concentrating on weight loss and cardio) is referred to as microcycling.

Here is what I’m doing now:

Monday: Weights—high resistance, low repetitions; higher carb; higher calorie.

Tuesday: Cardio—one hour on the treadmill; low carb; low calorie.

Wednesday: Weights—high resistance, low repetitions; higher carb; higher calorie.

Thursday: Cardio—pool workout; low carb; low calorie.

Friday: Weights—highest resistance, low repetitions; higher carb; higher calorie.

Saturday: Rest—no cardio or weights; moderate carb; moderate calorie.

Sunday: Rest—no cardio or weights; moderate carb; moderate calorie.

Each day I have a protein shake for a meal replacement and on weight lifting days I have two. I still eat six times a day and try to get half my body weight in ounces of water per day.

The scale results are not nearly as impressive as they were on Take Shape for Life and Medifast, but I am looking for different results. My weight is down to 262 lbs. This is a loss of about 4 lbs. over the last month. It’s about 10 or 12 lbs. under the rebound weight that I recorded shortly after changing over. My most important measurements are with the tape. My waist is down two inches and my chest is up about 3 inches. The other day my daughter asked me to print something for her on my computer. I sat down at the desk without a shirt with her standing over me. She looked down and said, “Dad, your abdomen goes down straight from your chest while seated and I can see the muscles in your shoulders.” She was shocked. She didn’t know me as a young soldier—she was born after I got out of the Army and had gained a ton of weight. She had always seen me fat, and was shocked at the transformation.

Keep in mind that transformation is the goal. If the need is to transform the numbers on the scale then concentrate on those. If the goal is other transformations then don’t get worked up over scale results.

I want to share some lessons gleaned from the book Mindless Eating, which I’ve referenced here before. On my weight lifting days I get higher carbs, and can even allow myself carbs that I would previously have passed on. My wife and I love Italian food. One day, a weight lifting day, I decided to take her out to an Italian restaurant—a treat I hadn’t allowed myself in months. I won’t name the restaurant, since they aren’t paying me.

Restaurant meals are usually larger portions than anyone actually needs—unless you are eating at one of the pretentious, sanctimonious, hoity-toity eateries, which my wife and I wouldn’t be caught dead in. Besides large portions, the restaurant we went to, like most, would serve in courses, so I would make decisions about multiple courses. Thanks to Mindless Eating, I’ve started doing such meals like this:

The meal would include several course options:

Bread

Beverage (Could be alcoholic, or sweet, or neither)

Appetizer

Salad (Keep the dressing in mind)

Entre (high carb, or low)

Dessert (Sweets, fruit, etc.)

Mindless Eating recommends you take such a list and pick three or four. I did a form of this, but adjusted volumes and options by carb content of each choice.

I would only consider Italian food on a high carb day, but I still had to watch it. Carbs would be the driving force behind my choices. My entre was going to be higher carb—we had already decided to split a pasta dish. This meal would give me more carbs, but splitting it with my wife kept the carbs and calories down. One point on pasta: from what I’ve read, if cooked properly pasta has a lower glycemic index than other wheat products because ungelatinized starches are trapped in a web of gluten if cooked al dente. While the GI is low, one still has to keep down the amount to avoid a high glycemic load.

Since my meal was higher carb (and contained wheat) I decided to have no bread. I also chose to refrain from an appetizer because all of the options were breaded and fried. I also did this so I could have a bit more freedom on my choice of salad dressing—I wanted Ranch, and some places add sugar to it. I also wanted to allow myself to have a few of the croutons with my salad.

For beverage, I chose unsweetened tea (my go-to drink in restaurants). Had it been later in the day, I might have had a vinaigrette dressing and ordered a glass of wine. The alcohol can disrupt the system as it switches from burning fat to metabolizing the alcohol to clear it from the system. However, once the alcohol is clear it quickly returns to burning fat. Like most things moderation is called for, but when trying to lose weight moderation usually means abstaining. You make the choice. Now, if I were on a low carb day, wine would not have even been an option, but of course we would not have considered Italian food either. On weight lifting days I am not trying to burn fat or lose weight. On those days I’m trying to build muscle. However, keep in mind that even on those days excessive alcohol can be a problem because your system uses testosterone and Human Growth Hormone in the muscle building process and excessive alcohol can reduce testosterone production—sucks huh? Allowing yourself a glass of wine is one thing. Allowing yourself a bottle of wine is totally different.

Some might look at this and think, “That’s just too much to think about!” The point is that one of the biggest problems with our health is eating with little or no thought. If we just eat without any thought we eat too much, too often, too imbalanced and just too wrong. That might be acceptable if you have the health and metabolism to handle it. The problem is that when we get out of balance and our health deteriorates thoughtless eating just makes things worse.

Slaying the Scale Monster!

The scale can be a real monster sometimes. Using it to know where you are and if you are going in the right direction is helpful. However, it can also be a real kick in the shorts when you are sure everything is doing well, you step on the scale and it attacks—giving you a number far above what you expected. It is hard to not get worried. There are so many things that can cause a scale fluctuation—inflammation, dehydration, etc. But one can still get quite scared and even emotional when that scale doesn’t say what you want it to say.

To prevent this, you can weigh infrequently. Rather than weighing every day you could pick a day of the week to weigh. If that day, you happen to be in a small scale fluctuation it is likely to be after a week of weight change so even a number higher than it should be will be welcome. This is a good method when doing the same thing over a period of months and you are confident it works. When you are weighing like this, you aren’t trying to figure out if your plan is working. You are just checking to see where you are. This isn’t as helpful when transitioning or changing things up. During these times, it may be necessary to weigh every day—as I have been doing over the last few weeks.

Recently, I transitioned over from trying to lose the maximum amount of weight in the shortest possible time, to trying to build muscle. I reached one goal and now have set another different one. Because of this I transitioned over from MediFast on the Take Shape for Life program (which saved my life and set me on a good path), to using Carb Cycling with a combination of weight and cardio days. Unlike the earlier program, in which everything was so well laid out and easy to follow, the new program takes a lot of study, practice and learning to know what to do. This means there are more chances of screwing up. Since this program means eating more carbs, and I have a history of carb cravings, there is a great deal of apprehension when adding in new things, and watching the scale helps to tell if I am going the right direction, and weighing each day has become part of this.

To handle this I adopted a practice similar to a skill learned in the Army. In the Army I served as an Infantryman for eight years. One skill that you learn is calling in artillery on a target. Artillery is an area target, meaning that you aren’t trying to hit a target on the nose. You are trying to get a special projectile within a certain distance of a target (within the effective area). In the days before laser guided and smart munitions, you began by calling in initial coordinates; then, the gun bunnies fire a shell; the observer sees where it hits, calls in corrections and then another shell is fired. The observer tries to walk the shell impact onto the target with a technique known as bracketing. For example, the first shell lands 100 yards north of the target. Call in a correction and the next shell lands 100 yards south of the target. Correct the next shell back to the north for 50 yards and see if it hits.

When I use the scale I have an area that is acceptable: “If I weight between A and B, then everything is fine.” I also want this area to slowly move down. I notice over time that the lower number of my acceptable range slides down and the upper number is lower and lower. This way, scale fluctuations are built into the expectation. If I am supposed to weigh 260, then anything between 255 and 265 is acceptable. Slowly over time this becomes 250 to 260. For some it might be a ten pound spread. For others it might be five.

In my new program, big week to week changes in the scale just don’t happen—this really makes me miss being on the full TSFL program. Seeing that big drop of pounds each week was nice. However, my goal now is muscle building and changing my body fat percentage by both reducing fat and raising lean mass. One thing that helps to monitor now, is regular tape measuring. For example, my weight hasn’t changed much over the last three weeks. However, my clothes are loose. My muscles seem to be tightening. In my arms and legs I can start to see some new definition. Now I still weight regularly, but I find a tape measure a far more useful tool. Besides measuring various locations, I like to give myself regular tape tests. I use the military tape test because it is the easiest. I know it is not the most accurate, but it gives me a good picture of direction and change that the scale may not see. I found an app for my phone so I simply enter the measurements and it gives me my range.

Even though my scale hasn’t registered any big changes—just a very gradual movement—the tape shows a different story. According the tape I am now out of the obese range and into the acceptable range. This means I am not yet “fit” but would pass a military tape test. That is progress. If you are working and working but not seeing change where you expect then look somewhere else. Are the scales not moving? Well, are your clothes looser? Are your body dimensions changing? Have things disappeared? For example, one day it seemed I wasn’t making progress until it dawned on me that my “moobs” were gone. Yesterday, I realized my “love handles” were gone. One day I looked down and realized I could see the bones in my knees. The fat that usually surrounded them was just not there.

There are health targets to shoot for other than numbers on a scale.