One of the first things you see when looking at weight loss stories or advice/tips/tricks from professionals is that it isn’t “all about the number”. People commenting on my posts on FB have echoed that advice too — reminding me to also look for success indicators that are not tied to my weight scale. What some experts call “off-the-scale” or “off-scale” success. These “other” indicators become not only philosophically important, moving you from a technical definition of obesity tied to your weight or Body Mass Index to a more functional definition of fitness, but also psychologically crucial if you bust your ass between weigh-ins and yet the needle doesn’t move because you’ve hit a plateau.

And with my typical analytical zeal, combined with my love of all things performance measurement related at work, I adapted my approach to take into account these “other factors”. I also used my research time to look at various milestones to give me way stations along the journey, markers to tell me I’ve achieved some arbitrary measure of success, something other than the obvious 157 little milestones for each pound lost or one big milestone at the end.

So with a bit of extra zeal, here are the first three sets of indicators for my journey.

A. Weight-loss milestones

While these are still “weight-based”, they are more about specific milestones. With my overall weight goal of going from 342 pounds down to 185, i.e. a drop of 157 pounds, that number is too big to be much motivation on a short-term basis. Instead, I broke it down in 10% increments…10% of 157, 20% of 157, etc. This gives me 10 clear targets between my start and finish. I have also added in 5 other weight targets, mini-objectives that fall between those 10% increments (1 each between 20 and 30%, 30% and 40%, 40% and 50%, 60% and 70%, and finally 90% and 100%) based on another more psychological total, numbers that are symbolic to me. Which means, for those doing basic math at home, I have 15 weight-related milestones to focus on.

Progress so far:

My first milestone was Level 1, the loss of 10% of my full goal. This worked out to 15.7 pounds, and would take me to 326.3. Back in Week 17, I hit below that number for the first time — 319.8 on October 10th. LEVEL ONE ACHIEVED!

Next goal: 310.6 (20%)

My next working target is 310.6, or 20% of my overall target. I’m at week 26 this week and the last 8-9 weeks have been frustrating on this front as I have hit a plateau, which goes hand-in-hand with finding it hard to regain my original commitment and momentum to be eating the way I’m supposed to be each day.

B. Body measurements

One type of indicator that most weight loss programs use to track non-scale success is measurement of various parts of the body. The premise is simply that you may be still making progress, but muscle is denser than fat, and you might be getting “leaner” without getting “lighter”, or you might be moving/shifting weight around on your body. If the goal is to be fit, not simply “lighter”, those shifts and changes may indicate forms of progress that your simple weight scale won’t pick up. It’s also one of the reasons why so many people hate BMI as a measurement tool — people with the same overall weight and height have the same BMI, yet they could be in two totally different sets of proportions and degrees of fitness. Scales, and the BMI, can tell you one story, but not necessarily the whole story.

Awhile ago, I had helped someone with a diet program and their program used a bunch of measurements. I was shocked by two things. First and foremost, that the numbers were not as precise as I expected. Measuring my own neck, for instance, can give me widely different numbers (shifting as much as 5%) just by slightly altering the angle or how tight you pull the tape measure. It is, regrettably, incredibly imprecise. Secondly, I discovered that all those ads on TV where someone lost 14 inches in one week, etc. was incredibly misleading. I never really thought about them, I assumed they meant around the waist. In some cases, sure, but in other cases it was some misleading math — two inches off their chest, four inches off their waist, two inches off each leg, etc. until it added up to a “loss of 14 inches”. Really? REALLY? Hmm…not even sure that qualifies as legal, but it is certainly misleading.

Anyway, regardless, I went through a whole bunch of websites that talked about these types of measurements and came up with a list of 16 areas of my body to measure and track progress. I do the measuring, which isn’t that effective, and Jacob does the recording on a sheet of paper, every two weeks. He then takes three pictures of me in my non-stylish, least flattering gray shorts: first straight-on and then right and left profiles.

I’ve been looking really hard at the measurement data, and the only solution I can come up with the random fluctuations each week between my shifting it a slight half-inch or pulling a bit tighter or looser than last time is to average them out. Perhaps a three-measurement average. Over time, those “effects” should, I think, cancel each other out a bit. If the average goes down, it should indicate progress not controlled by vagaries of measurement. I guess. I honestly don’t know, I just know that the measurements are wonky, not static/stable. Equally, if I take the marketing approach and add everything up, it will iron out glitches in individual measurements even more i.e. if there is a “net change” overall, I’m making progress.

Progress so far: 1 inch

If the mathematical approach is to add up all the “inches”, I guess I’ve lost an inch overall. However, given that I don’t really know what my “goals” are for each of these areas, my real progress is that I have done the measurements four times (the Seinfeld Method for consistency of measurements, yay me!). Since I do the measurements two weeks apart, the rolling average of 3 basically means “over the course of the last four weeks” i.e. a monthly measurement, updated biweekly, which sounds about right.

But here is the completely wonky part. I know the math doesn’t make any sense to add up all the measurements, not really, just in a generic sense that if the overall totals go down, you are “smaller”. Or if one specific area is something you are targeting, sure. And while I know all that, the fact that all of it adds up to an overall loss of 1 inch, 1 measly inch, is encouraging. As I said, I plateaued a few weeks ago, so I’ll take any progress I can find. Even ones of dubious lineage.

Next goal: ?

While I’m hoping the numbers change overall, I don’t really have specific numerical goals for each part, except perhaps my pants size. I have a 30 inch inseam, and I’d like to get to the point where I could wear 30″/30″ pants. I vaguely remember being in pants at the 28/30/32″ range and I know someone I consider reasonably fit who is also 30″. I feel like 34″ would be too big, but I really don’t know. I guess I’ll fine tune this as I get close. However, in the meantime, I’ll track it. Maybe it will show movement when I’m stuck on a plateau, like now.  A friend really likes the idea of dropping a “dress size”, but since that doesn’t really work for men, the pants size is about the best I can do for now.

C. Qualitative Indicators

I mentioned above that I researched the heck out of various websites and other resources to find “other” indicators that I could use to mark progress, and as I did so, many of them were completely irrelevant to me. Some of them were lifestyle issues that I don’t have, or choices that are not part of my mindset, or involved specific types of partnerships that I don’t have or don’t want. Which left me picking and choosing from a laundry list of possible indicators to come down to some that are applicable to me. My final list is a mish-mash of some 40 items and it looks chaotic even to me. Some of them I’ve already achieved, so it’s not as bad as having 40 still out there, but I feel like they need a bit of a framework to help me understand them, let alone explain them to others. This is what I have come up with.

Progress so far: Multiple items

I don’t know if those six categories are the right categories exactly, but they’re good enough to get going. And, as you can see from the list, I have made some progress already:

– Commit to the journey
– Announce goal
– Get professional help
– First weigh-in
– First pound
– First set of measurements
– Discussed it with Andrea and Jacob
– Discussed it with professionals
– Discussed it with friends and family last week (family gathering)
– Have received an unsolicited compliment that someone noticed a change
– Andrea finds it “easier” to hug me now, not quite as big around as I was

Next goal: Complete Tier 1

The big hold-outs for me in Tier 1 is mainly around getting going on the fitness. I had hoped to meet with the kinesiologist soon to get some help with that, but with some scheduling issues, that won’t happen until January. In the meantime, I will get started on my own. Which requires a crapload of work in the basement to get it all arranged properly. But that’s why I took the time off, right? 🙂

And that’s a wrap for almost all of the measurements/indicators. If you know of others, I’m happy to consider them!

Next week, I’ll blog about taking ALL of the measurements, turning them on their head, and going hard-core on 18 unique ones.

Last week’s post was the scariest one for me so far, me alone with my numbers and photos. After that, I was originally going to talk about metrics and other reporting this week, but I decided to go a bit sideways and instead talk about who I’ve brought along on the journey from an external professional standpoint, the team that I’ve put in place to help me survive the journey.

For overall context, I feel that in most areas of my life, I am pretty self-sufficient on the psychological front. Most things I can either handle on my own, or I know how to figure out how to get help / who to seek help from in order to handle it. When my mother passed away, grief was kicking my ass about a year after her death. The efforts to settle her estate kind of delayed part of the impact, and then when that was done, grief came flooding in unexpectedly. At the time, I couldn’t figure out why none of my mental processes and analytical functions were working to help me figure things out, but I dismissed grief as a likely cause. I felt it must be something else because she had been gone for a year already, but I didn’t realize that grief often manifests itself as a wet blanket over top of everything, dampening things down, lowering energies so that when I asked myself if it was “grief” that was bothering me, my internal diagnostic came back as “no”. In fact, EVERYTHING I tried came back as “no”. I needed help.

So I decided to give our Employee Assistance Program at work a try. I called, told them I wanted to talk to someone about stress and depression (I was mentally run down), they asked me politely if I was suicidal or going to harm anyone else, I said no, and so they referred me to a counselor in my neighbourhood. I was offered two or three to choose from, I chose one, and they authorized three initial meetings with an option to do up to eight.

The woman I went to see is named Shirley, and she’s a retired social worker who used to work at the Ottawa Children’s Treatment Centre, now part of CHEO. She is almost the perfect choice for me…some of what I wanted to talk about included Jacob, and how I handle things with him, and she has 20+ years of dealing with kids and parents of kids with Cerebral Palsy (which is similar to what Jacob experiences). I had no need to go into the basics, she knew EXACTLY what I was talking about. She’s a social worker by training and practice, not a psychologist or psychiatrist, although she works under the supervision of an overall psychologist for the purposes of the business model. We did the first three sessions, I extended it for five more, and between us, we got me back on track. A mental tune-up, if you will.

A few years later, I wasn’t feeling quite right, so we did another three sessions as a mental tune-up. I like her, feel comfortable with her, and she’s given me some really good insights to think about over the sessions. As an aside, I had a real problem with something at work back in late January, and I was having real trouble “letting it go”. Shirley was out of the city for an extended period, so I saw a specialist in Cognitive Behavioural Therapy. Wow, *that* was an experience. It was helpful, but a way more active form of counselling, not my style at all. It was easy enough to deal with in two sessions but still.

So I don’t have trouble asking for psych help, and she’s a good resource and I’ve met with her a few times in recent weeks (I’ll come back to that later). Yet with my big plan in place as of mid-summer, I knew I needed other types of help with my weight loss, and a lot more guidance. I just don’t have much previous capacity in those areas.

On the health front, I’ve mentioned before that I really don’t like the supervising physician that I’m assigned to in my doctor’s practice. We just don’t get along well. So when I can, I choose to see the intern / resident instead. Anyway, in mid-summer, I went in, met the new intern (Dr. Ali), and said, “Okay, let’s do this. What do I need to do first before I start such a massive change?”.

First up was some blood work. And we had meant to do a stress test a couple of years ago but scheduling was a problem, I was on a waiting list, and then I somehow disappeared from their waiting list or something. It wasn’t urgent, but still, I wanted one. So we booked that. I already wrote about my experience with the first stress test (#50by50ish #36 – A stress test with a side of manscaping) and I did the bloodwork the same day.

I immediately got a call a day or two later — come see us now, Dr. Ali needed to talk to me about the bloodwork. In the blog post mentioned above, I was expecting one of several possible outcomes of the bloodwork. It might have been that I was high for something related to diabetes. Because there is diabetes in my family, and I’m carrying extra weight, they always want to test for that. But it has always comes back negative. Not even close. Alternatively, it could have been some sort of infection (my ears were giving me problems unrelated to blood pressure). Or it could have been some completely unrelated item about cholesterol or my thyroid or something else that spiked. I was mostly worried about the fact that I also have large lymph nodes and regular headaches, so I had asked them to check some protein markers.

As it turns out, it was about diabetes. My AC1 number had blown up in the last two years — I went from “not close” through “pre-diabetes” and now officially a 0.1 step into officially being diabetic.

But the diagnosis meant nothing to me. I don’t mean that I didn’t understand it, I mean that it meant nothing new. I already knew my weight was affecting me, I already knew I needed to make changes to my diet, it wasn’t at a level to require insulin, and so nothing really changed. I was in the same situation before the diagnosis as after, more or less. That seems incredibly weird to me, but it really didn’t change anything in my approach. Except in a round-about way, it did. Since I am officially diabetic, and a new diabetic at that, four things happened at once.

First, I get to go on a higher-priority list for all follow-up. I’m no longer on the routine “let’s check this out” list, I’m on the “do this reasonably soon” list. Works for me. I’m not on the “TEST HIM NOW” list, but I get relatively quick referrals.

Second, my diagnosis automatically triggers offers of additional supports through a diabetes clinic. I get a nurse (Rosie) who works in their social worker unit (although most of what she does is talk to me about foot care, not a small issue for diabetics), a registered dietician (Genevieve) to go through my diet with me and answer questions, and at my request, access to a kinesiologist (Anna) to help me figure out some of my plans for exercise.

I’ve already had my first big session with the nurse, Rosie, and as I said, it was all about my feet. No real concerns, my circulation shows fine for now.

The time with the dietician was more instructive. I had already gone through a bunch of online materials two weeks earlier and changed my diet, so when I met with her, almost all of it was her answering my questions, I already had covered the basics.The biggest challenge for me is a form of binge-eating, not the classic view of binge-eating of wolfing down a whole gallon of Rocky Road ice cream. My problem? Eating large amounts at irregular intervals. So my primary changes are:

1. Eating breakfast…I am not a morning person, I’m a night owl. So when I get up in the morning, I am frequently out the door ten minutes after getting dressed, and that includes a bathroom stop. When I say that I “skipped breakfast”, I mean that I would only have had something to eat before 10:30 a.m. on average about 1-2 days per month. Very rarely. Now I make sure I have SOMETHING decent every day.
2. Drink more…I suck at consuming water during the day, mostly because I have very bad experiences with water coolers. Almost every time I’ve tried to up my game to drink more water each day, and start using the coolers, I get sick almost immediately. A cold, the flu, something. I’m also terrible at plain water. I thought that was the only option, as I don’t like adding lemon or cucumber thingies, but the dietician approved a couple of flavourings that I showed her that are just fine. I’m still not doing great on this, too many days where I have gone most of the day with nothing other than the morning yogourt drink or something, so definitely a work in progress.
3. Sugary drinks…This one was bothering me, not because I didn’t know I should dump them, but more because I didn’t know what would be left as a replacement. As I said, I don’t like plain water normally, too raw on my throat, etc., and if I eliminated soda, I was screwed. I knew that you’re not supposed to have too much milk, I don’t like tea or coffee, I don’t drink alcohol, and honestly, there aren’t a lot of other choices available that I even like. I could dump the regular drinks and switch to diet, and while it would be better to have none of them, the dietician showed me that in limited quantities, the diet sodas were viable options. Plus, as I noted above, the flavoured water was okay as my main “go to” choice.
4. Snacks…Most people think of the change for snacks as switching to healthy ones, and that was part of it, but more important for me was simply HAVING a snack. I am really terrible at this. This has actually been a source of tension at times with Andrea…we would be doing something, and she would go 3 hours without at least a snack and be ready to pass out; meanwhile, I had skipped breakfast, had no snack, drank nothing, and I was still raring to go. Probably cranky, but still okay. And at work, the scenario was not regular but not uncommon for me to get to work in the morning without having anything except a yogourt drink on the way, sometimes not even that, no snack, working away, and the next thing I know it is 3:30 p.m. and I’m feeling peckish, but suddenly realizing the last thing I ate was almost 20 hours earlier for supper. Yes, I know how stupid that sounds. But I wasn’t dying of hunger or anything, in fact, sometimes I only noticed because of the time, not hunger. And yes, the dietician explained what my body was doing during that time to compensate, almost none of it good. I guess I just felt that my extra fat reserves were at least good for something.

As noted above, the dietician helped fine-tune what I had already figured out. Most of my new plan was one she approved of and thought was looking great. She wondered if I had enough variety to keep it interesting during the day, so I’ve tried to expand a few things her and there. And she was able to answer certain “this or that” type questions as to which was better.

I confess, I thought she was going to suggest a lot more changes, that I didn’t have it quite right, and thus give me a “diabetes diet” to follow. But from the first health appointment to the meeting with her, I was already almost six weeks in, so I had already made most of my changes. And she pointed out, there is no such thing as a “diabetes diet”, it is just healthy eating that everyone should do. Which I guess is true, but I felt like the diabetes diagnosis DID help with my diet choices — I went from having an almost infinite variety of diets and diet advice out there to wade through, and suddenly had it all more narrowly focused on diabetic-friendly advice. 

I haven’t met with the kinesiologist, Anna, yet, as I have had to move the scheduled appointments around a bit.

The third thing that changed was that it gave the doctor some ideas for changes to my medicines. For example, I’m on blood pressure meds and there are some that work better for diabetics, so she wants to transition me. As well, another med helps the body handle insulin usage so I’m trying to work that into my regime without shortcircuiting what I’m already doing/taking.

Oddly enough, when the doctor gave me the diagnosis regarding the diabetes, she said almost in passing, as part of her encouragement, that “even” losing 20 pounds could be helpful. And I laughed. I actually laughed. I didn’t mean to be rude, but she was asking me to try to help her help me by my losing 20 pounds, rather than the reality that I’m planning to lose 157 pounds and she’s along for the ride. I might even describe my reaction as almost scoffing at her. When I went back later for a follow-up and told her that I already passed the first 25 pound mark, I think she was almost shocked. Very few patients do that, I know. But the diabetes diagnosis wasn’t a motivational factor for me, it was more an afterthought for what I’m already doing.

The fourth and final part goes back to my mental health mentioned above. I am doing okay, but I am confronting a big-ass dragon in a cave, I am saying openly that it is tough, I’m feeling scared AF on certain posts, and it occurred to me. — shouldn’t I have another professional in the mix? Not as part of the Employee Assistance Program, I felt that was more for acute issues than planned / regular mental health care, but just for my own mental well-being?

So I made some appointments with Shirley again, the social worker who helped me work through the grief and with mental tune-ups previously.

Which means, I have a decent team of professionals:

• Dr. Ali, the overall doctor who will be around for most of the journey;
• Rosie, the nurse, to help me monitor foot care issues and potential circulatory challenges;
• Genevieve, the dietician on demand, to help me modify my diet regime as I go;
• Anna, the kinesiologist. to help me figure out some decent exercise options (some people prefer a personal trainer, and I may do that at some point, just not what I need right now, which is more planning advice); and;
• Shirley, my therapist/counselor/social worker, to help me through the mental anguish and to help me chase down random squirrels.

Shirley cautioned me with last week’s post, asking me if I was sure that such a drastic step was possible or needed. I understood her concern, and I’m glad she raised it. But I was sure. And I feel I was right. The relief I have felt in the last few days of having that over and done with, at least for the first time ever, was almost a mental cleanse. I’m more focused, I’m more attuned to some of my issues, I’m more patient with my progress. Well, generally. I’m down about my current plateau.

I had another session with Shirley today, heavily focused on the upcoming six weeks. My previous project at work was finishing, and I didn’t have a new one starting right away, so I took advantage of the lull to take six weeks leave from work just to focus on me. Not great for the paycheque, true, but I am hopeful it will help me through the time and maybe kickstart some of my exercise options too.

Yet I still have a somewhat tightly-bound set of issues to deal with, and we’re coming up on a stressful time of year where two of my frequent coping tools — drink and food — are not available to me. It is not as bad as an alcoholic having to get through a bunch of social occasions where everyone is drinking, but there are some similarities in there for me. I am worried that I won’t be able to maintain my commitment and resolve, or that I’ll feel self-conscious with every bite, since I’ve been more open about my weight loss and now everyone knows.

In the meantime, I have Dr. Ali, Rosie, Genevieve, Anna, and Shirley to back me up. I may need more professionals in the mix before the journey is over, but for now, this is my external medical team — five women advising me on how to save my life.