Saturday, April 25, 2015

Why are you so fat?

I can't count the number of times I've been asked this question over the last 20 years. While I usually reply in an appropriately sarcastic manner I never really gave it a lot of thought until recently. The non-fat among us generally use the same tired cliches, lazy, eat too much, lazy. But there is often much more to it than that. There is a huge mental aspect to obesity. There are often medical reasons for it, or at least contributing factors. Many times people aren't aware of either. I wasn't. I spent years trying to understand why I was constantly exhausted and able to sleep for 20 hours. I didn't know that I suffered from an extreme case of sleep apnea and was actually barely getting any true sleep at all. When you're exhausted it's difficult to do much of anything. It wasn't until after a great deal of therapy that I finally became aware of the fact that I was eating and would have no memory of doing so. Add severe depression to the mix and suddenly you're a 600 pound fat man waiting to die. I see evidence of this in many overweight people. Especially the depression.

There is a line in a movie that goes something like "I'm depressed I'm fat, I eat because I'm depressed, it's a vicious circle." There's a lot of truth to that. Once you get to a certain point it's very easy to give up, to tell yourself you just don't care, it doesn't matter, it will never change, there's nothing you can do. Society tends to reinforce these thoughts. Being ridiculed anytime you go out in public certainly doesn't help. Having people yell "fat ass" at you as you try to walk simply makes you go home and eat. Having people treat you like a third class citizen when you finally go to the gym, or decide to buy some walking shoes or do anything else to help yourself only makes it harder. Fat is the last acceptable target of bigotry and ignorance. And there are plenty of people more than willing to take advantage of that. People rarely offer to help, or to listen, they simply want to know what it is you did. how you "allowed" yourself to get so disgusting. It's interesting that the same attitude is rarely aimed at drug addicts or alcoholics. No, being fat is a choice, no matter what.

I can't really remember when I started gaining so much weight, but I do know now what caused it. Injuries led to loss of mobility, life lead to depression, one exacerbated the other and I comforted myself with food. And then I slept. Or more accurately I went to bed for hours upon hours. I learned something over the last few years. You can want to lose weight, you can try to lose weight, but until you finally understand what caused you to gain it, you won't accomplish much. This is what causes so many to "yo yo" or "crash diet". You starve yourself until you drop a few pounds but completely fail to address the causes of your weight gain in the first place so you simply gain it back. I suppose it requires getting to the point where your reasons for being healthy outweigh your reasons for being obese. Only at that point will you be successful.

So if you're struggling with weight ask yourself why. Be honest with yourself. Really, truly honest. Are there underlying medical or mental issues that you need to deal with? Would you even know if there are? I didn't.

Friday, April 17, 2015

Exercise and depression..

There is plenty of available research regarding the effects of exercise on depression and anxiety, but what good is that until you actually try it? It's much like shopping for  car online and then taking a test drive. Lots of pictures and words simply don't have the same effect as climbing in and hitting the gas. After 15 days of exercising at least one hour, I can say, that at least for me, it works. I feel better now than I did while taking medication. And the physical benefits are, I suppose, obvious. It can be difficult to find the motivation some days. As with everything, my depression can utterly annihilate my ambition. But I already know that if I get in there and sweat for a while I'll feel better. So I do, and I do.

It can, at times, be very difficult to keep going. It's been many years since I've been "active" and my body reminds me of that every day. There are moments when I look around the gym and see other people doing things I simply can't yet and it makes the "just say fuck it" part of me pop up. So I pick up something heavy and smash it. And I keep going. Because I know that if I do I'll feel better, and feeling better makes all the sweat and the self consciousness and the joint pain worthwhile.

You don't need to join a gym to get enough exercise to feel better. From the studies I've read it seems that 30 to 60 minutes of "strenuous" exercise has shown benefits. By "strenuous" they mean you sweat, a lot. Hard breathing, sweaty, get off your ass and move exercise. A fast walk, a bike ride, a swim. Anything that gets you up and moving will do it. I chose the gym because it gets me out of the house and they have child care. It works for me. After only two weeks I can feel a substantial difference. I have more energy, I sleep better, my appetite has improved (as in I eat less) and I actually feel like doing things. Essentially I feel much like I did when I first started taking Wellbutrin and Lexapro. While those medications eventually stopped working, exercise won't. Or it shouldn't, in theory.

One of the things that I have difficulty with is remembering that I'm a "beginner" again. It's been 20 some years since I spent any time in a gym. And much has changed. The equipment, the attitudes, the facilities. It's a whole new world. As a "beginner" it can be a little daunting. Especially as a guy. There are literally hundreds, if not thousands of magazines, books and websites dedicated to weight lifting, bodybuilding, men's health and exercise. None of them are geared toward beginners. And the ads, my god, the ads. Buy this drink, drink that formula, take this pill and you'll be a stud in days. If you only purchase this special pair of shoes.... Shud up! Right now I'm simply focusing on moving every day, working my muscles, sweating and feeling better. The rest will come with time.

Another point worth making is, listen to your body. The exercise is meant to make you feel better, not put you in traction, hurt you so bad you don't ever go back or piss you off to the point of frustration and quitting. The idea is to alleviate the depression and anxiety, not add to it. There is a difference between good pain and bad pain. The "good" is your muscles working. The bad is your body being injured. If something hurts, stop doing it. If something really really hurts, see a doctor. Form is very important. It is better to do an exercise right a few times than wrong several. Right builds muscle, wrong builds doctor bills.

I'm beginning to formulate some semblance of a routine, as far as working muscles and cardio goes. There are, again, a plethora of prewritten options available, assuming you can do all of the various lifts in these options. I can't yet. To that end, I've found an interesting website called WorkoutLabs that offers some free and many not for free "visual PDF workouts" showing step by step routines. There are also some apps that do the same thing, but most of them cost money or simply have so many bugs in them they're more of a hassle than they're worth.

Here is a sample description from WorkoutLabs:


Machine Seated Shoulder Press
Primary muscle group: Shoulders
Secondary: Biceps, Forearms, Triceps
Equipment: Full gym

  • Keep a tight core and flat back as you remain seated in the shoulder press machine.
  • Look straight ahead as you hold on to the handles.
  • Slowly, press the handles up above your head.
  • Do not lock out your elbow.
  • Slowly, bring the handles back down but do not let the weight stack touch.
  • Repeat the movement.
Muscle & Fitness takes this a bit further by providing some handy videos with their workouts. One important thing to remember is that all of these websites and magazines are trying to sell you shit you don't need. Take the good information and ignore the bad. 

If you're new to the gym, or going back after years away, something like this can be very helpful. It's a little daunting to stand before a pile of iron and pulleys while wondering exactly how you're supposed to sit on it and what that lever does. Or looking at a row of dumbbells and trying to figure out what to do with them. Sure, we lift them, but how? And the how is the most important bit of all. Lifting heavy weight wrong with do much less than lifting lighter weight right. And it will keep you out of traction.






If you want to read through some of the links below, I highly recommend installing Adblock Plus in your browser. It makes for a much cleaner, less annoying web viewing experience.

FitnessRx for Men: A great deal of information on various lifting techniques and a plethora of useless, sexist information. Categories on their webpage include Training, Nutrition, Supplements, Health and a few more.

WorkoutLabs:  Free visual PDF workouts, custom workout builder, Exercise & Yoga Cards and more simple tools for you to exercise with confidence.

Muscle & Fitness: A bit of everything. They have all kinds of different workout routines, complete with instructional videos, nutrition information (for what it's worth) and some interesting articles on the sport of bodybuilding.


Sunday, April 12, 2015

Two weeks in...

And I feel better. In the last two weeks I have gone to the gym 12 days. Worked out for at least an hour. Done some cardio, some weight lifting. And I feel better. Not just physically, but mentally. I've been told for years that exercise will help with depression and anxiety. That's all well and good, in theory. But if you live with depression, you know just how hard it is to get up and do something, anything. When you don't want to get out of bed, you certainly don't want to go to the gym and be around other people, and sweat, and lift things for fun. You want to pull the blanket back over your head, give the world the finger and wait to die. It goes much deeper than a simple lack of motivation, or being "lazy", as so many like to say. Many of our brains simply don't work the same way as others. Getting out of bed may as well be climbing Mt. Everest. But we do it. I do it. Every single day. Exercise is pretty much the same. Every day, I have to force myself to go, but once I do I'm glad I did.

I will say that the first few days were HARD. I did not want to do it. I wanted to stay in my house, in my chair, doing what I always do. My god, people might see me and laugh, or, horrors of horrors, say something to me. But mostly, I just didn't want to do anything. Because that's what depression does to me. It robs me of my motivation, my ambition, my will to do. I had to force myself to go in the doors. It was a struggle to leave the locker room. Stepping on the treadmill was like walking to Mars. And I did it. And I'm glad I did it. Because I feel better. The second day was a little easier, as was the third, and fourth. At the end of two weeks I look forward to going. I go for me. I don't care if people look. I don't care if they comment. But to be honest, they really don't. I get mostly looks of encouragement and kind words. I suppose that has some to do with the gym that I joined. I was very aware of the clientele, the demographic. I think that is probably the most important factor when choosing a gym.

If you feel uncomfortable, you won't go. If you feel like people are pointing and laughing, you won't go. And yes, that does happen in some gyms. I personally had a person ask me; "why's a fattass like you bothering?", I didn't ever go back to that gym. I suppose I could have approached it differently, but I wasn't ready at that point in my life. I simply left, asking myself why I was bothering, what was the point? Went home, wallowed in self pity and crappy food and gained some more weight. So finding a gym that is welcoming, that doesn't allow that type of douchebaggery, that you will keep going back to, is very important. And I seem to have found that.

There are countless articles, books, research papers and opinions detailing the benefits of exercise for depression and anxiety. The Mayo Clinic has this to say:

Regular exercise probably helps ease depression in a number of ways, which may include:
  • Releasing feel-good brain chemicals that may ease depression (neurotransmitters, endorphins and endocannabinoids)
  • Reducing immune system chemicals that can worsen depression
  • Increasing body temperature, which may have calming effects 
It doesn't take a great deal of time to experience the benefits. You don't need to become a gym rat, or start running marathons. Doing 30 minutes or more of exercise a day for three to five days a week may significantly improve depression symptoms. But smaller amounts of physical activity — as little as 10 to 15 minutes at a time — may make a difference. It may take less time exercising to improve your mood when you do more-vigorous activities, such as running or bicycling.

The mental health benefits of exercise and physical activity may last only if you stick with it over the long term — another good reason to focus on finding activities that you enjoy. WebMD has another decent article on the benefits of exercise for depression. Here's some of their pointers:

  • Choose an activity you enjoy. Exercising should be fun.
    • I think this is probably the single most important point and one that can't be stressed enough. As in choosing your gym, what exercise you choose to do has to be fun. Or at the least, not something you hate doing. If you don't enjoy it you won't do it. If you enjoy it, you'll have fun doing it and thus do it more often. I think this is especially true for those of us living with depression. It's hard enough to get motivated, it's almost impossible if you don't like what it is you're trying to get motivated to do
  • Put your exercise routine into your schedule. If you need reminding, put it on your calendar.
  • Variety is the spice of life. Make sure you vary your exercises so that you don't get bored. Check your local gymnasium or community center for an assortment of exercise programs.
    • Most larger gyms offer one or two free sessions with a personal trainer when you join. Use them. Talk to them, be honest about what you need and what you think you're capable of doing. Most importantly, be honest with yourself. 
  • Don't let exercise programs break the bank. Unless you are going to be using them regularly, avoid buying health club memberships or expensive equipment.
  • Stick with it. If you exercise regularly, it will soon become part of your lifestyle and will help reduce your depression.

The Special Health Report from Harvard Medical School, “Understanding Depression”, has some very interesting points taken from various studies on depression and various treatment levels. 

Another study, published in the Archives of Internal Medicine in 1999, divided 156 men and women with depression into three groups. One group took part in an aerobic exercise program, another took the SSRI sertraline (Zoloft), and a third did both. At the 16-week mark, depression had eased in all three groups. About 60%–70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you’re depressed.

A follow-up to that study found that exercise’s effects lasted longer than those of antidepressants. Researchers checked in with 133 of the original patients six months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they were on originally, were less likely to relapse into depression.

I can say from personal experience that I feel much better after a trip to the gym than I ever did while taking medication. While I know that the medication I took has a great deal to do with the fact that I'm alive today, it was not a long term solution. I eventually reached a point where the medication no longer had much of an effect on me. It did its job, no doubt about that, but it's only capable of doing so much. I wish I had started exercising regularly while still taking them. But again, finding and keeping motivation when depressed is very difficult.

When it comes to workouts that fight depression, aerobic and cardio exercises have the edge. “To date, the strongest evidence seems to support aerobic exercise,” says Dr. Muzina. While the correct "dose" of depression-fighting exercise is up for debate, some experts recommend 20 to 30 minutes most days of the week. A recent review of numerous scientific studies found no association between the intensity level of the exercise and its emotional benefit — so simply moving more is a great start. The more you move the better you feel, the better you feel the more you want to move. 


Sources:
Mayo Clinic: Depression and anxiety: Exercise eases symptoms 
WebMD:       Exercise and Depression
Harvard Health Publications: Exercise and Depression

Wednesday, April 1, 2015

Choices

I've been writing here off and on for a few years now. Looking back, I've noticed that not a hell of a lot has changed since my very first post. I'm still fat. I still hurt. And I still complain about it. There is a saying about hitting bottom and needing to make a choice, go sideways or go up. I've been going sideways, for years. I'm great at making plans, having ideas, coming up with solution. What I really, truly suck at is implementing all those brilliant ideas. I worked hard to get bariatric surgery and haven't lost a pound since a few months post op. My current weight is 460. Sure, that's a fuck of a lot better than my highest at 590, but come one man. So, yesterday the wife and I joined a gym. My biggest fear here is that I won't make myself go. I've done it before. Hell, I think that's how gyms stay in business. Don't believe me? Go visit a gym on January 1st, then go back February 1st. All those "new year resolutions" dissolve into sweaty towels and tears. And lower bank balances.

I've belonged to a few gyms over the years. Lost a lot of money to them after giving up. I was always so concerned about what others thought about the sweaty fat guy, I let my perception of others keep me from doing what I needed to do. I guess I'm old enough now that I simply don't give a shit. And that's a good thing. It's time to climb up, not crawl sideways. One of the most frustrating aspects of my depression is the apathy. It makes it so simple to simply hang out at the bottom of the hole. Not comfortable, or fun, or easy. Certainly not enjoyable in any way, other than being simple. When every day is a struggle to simply exist, moving up seems impossible and pointless. And that needs to change.