The impetus for my learning to fast (and it is definitely a learning process) began when I started studying the efficacy of the roux-en-y gastric bypass surgery. Two friends of mine underwent the procedure. I was able to observe the results of one of my friends quite closely as I saw her more often. Suzanne topped the scales at well over 300 pounds, was being treated for severe diabetes, hypertension, and obstructive sleep apnea when she decided to undergo a Roux-en-Y procedure. All non-surgical attempts at weight loss had failed. The surgery went well and she had no complications.
I observed Suzanne closely after her surgery because I was seriously contemplating having weight loss surgery. I wanted to know what to expect. She lost the majority of her weight within the first year, more specifically within the first 6 to 8 months when her surgical site was healing. I remember visiting her in the first weeks after surgery. In those early days she was, by necessity, living on very small portions of sugar-free gelatin, sugar-free sports drinks and vitamin water, and bottled water. She later progressed (under her physician’s supervision) to small tablespoons of cooked ground beef, soft scrambled eggs, and other mild and soft foods, each serving amounting to only a spoonful at a time. This was because her post-surgical stomach was fragile, healing, and could not tolerate more. With this very extremely scant feeding regimen, Suzanne’s body drastically. Suzanne was also taking a daily multivitamin.
The whole process essentially amounted to surgically-enforced fasting. The post surgical healing rendered Suzanne physically incapable of eating the way she had before. With time she was able to increase her food intake and eventually, within 2 years, she was eating normal portions and eventually progressed to larger than normal portions. One day she stated that her surgically-created “small pouch” had stretched. Her safety net was gone. Her rate of weight loss slowed with time and with the addition of calories. She continued to struggle to control her intake, and she was never able to achieve a body weight under 200 pounds. While her doctor expressed great disappointed that she didn’t lose more weight, Suzanne was satisfied with the goals she was able to meet. She had lost enough weight to cure her diabetes, hypertension, and obstructive sleep apnea. She is happy with her current size, though she has never actually become thin.
The Roux-en-Y procedure was not the magic bullet Suzanne had hoped for. Her struggle with compulsive overeating was not resolved by the surgery. She continued to overeat, although not as severely as she had pre-surgery. Her weight loss plateaued. The orthopedic problems she had experienced before her surgery continued because her body mass was still a stressor to her skeletal system.
Two years later I accompanied a family member to an information session at a local surgical weight loss center. I learned that in order for most insurance carriers to cover the procedure, a patient must have a body mass index of 40 or greater along with a major co-morbidity, such as sleep apnea, diabetes, heart disease, hypertension. I have met this criteria for 18 years. I also learned that candidates must begin to make significant lifestyle changes six months before their surgery, including a minimum weight loss of 5% of total body weight (to demonstrate motivation and also shrink the liver), and have strong motivation and commitment to make dietary and exercise changes. The presurgical “last meal syndrome” is also forbidden. To sum it up, before Roux-en-Y surgery I must lose weight and adopt a healthy lifestyle including exercise. If I do this, I can then qualify for surgery.
I left that information session with the firm decision never to undergo bariatric surgery. It was evidently clear to me that if I could accomplish the prerequisite lifestyle changes then I would not need to undergo the surgery. After watching Suzanne resume overeating when she had recovered from surgery, I knew that I needed to start digging deeper to find a better answer. I resolved to learn to eat healthy foods and smaller portions. This was easier said than done, and I continued to gain weight. I tried more diets, all failed.
Of course it has taken years of trial and error. Somewhere along my journey I learned about my appestat and how it is supposed to work. I knew for a fact that my appestat was broken or completely missing. Some people are born without limbs or eyes. I was born with a defective or completely missing appestat. I could not be trusted around food. I habitually have eaten large portions. I love food. It is my drug of choice. Needless to say, I have felt defective all my life.
Here comes the part I was not planning to write about. Sometime in the early 90’s I discovered the books of Geneen Roth. I read them all. She revealed to me a different way of thinking about my overeating. She wrote about compulsive eating and yo-yo dieting as having spiritual and psychological components. In her books she shared her own past pains, her own disordered eating, and her own journey to healing. She said that she learned to trust herself, to trust her body’s innate wisdom. She wrote that she stopped dieting, started trusting herself, and eventually achieved a natural healthy weight. I wanted what Geneen had, but try as I might I just could not get down to the heart of the matter. I could not resolve my overeating issues. I gave up on Geneen for many years.
So here I am on September 29, 2013. With pain comes wisdom, if you’re so inclined. I am so inclined. Getting to the root of my emotional issues has been the key to overcoming the need to eat constantly and eat large portions. I have known all my life that I eat for emotional reasons. I eat to cope. I eat to soothe myself. I eat to numb myself. Despite therapy and counseling over the years, I could not control what I consider my most detrimental habit. I have not been able to stop eating. I began seeing a therapist again this year, and I had said I was through with therapy. I was tired of revisiting the same issues time and again. Never say never. A chain of events began in my life this year, and the result was that I felt the need to find someone to talk to about it all. I committed myself to my therapy and recovery once again. I have begun working on issues I never had the courage to face before.
The death of my father is the single most important issue I have ever dealt with in my life. It was the cataclysmic flood-earthquake-hurricane combination that had to occur for the contents of my inner self to be rearranged. I have been working intensely to deal with the overwhelming grief I still feel. I am learning how to face the issues that have emerged in his absence in healthy ways. Some days these issues prove too much for me, but I am lately having more good days than bad.
In my therapeutic work and outside reading and learning, I have started learning to trust myself. I am trying to stop punishing myself. I am trying to be nice to myself. I am trying hard to learn to love myself. This last task has been the most difficult part. I have always considered myself unworthy, not good enough, weak and undisciplined. I continue to perform some painful but important psychological housekeeping. I have had to be more honest with myself than ever before and have had to admit what is not working in my life. I cry a lot. I write a lot. I get a lot of hugs and I-Love-You’s from my husband and children. My job is far from over; in fact, I haven’t even scratched the surface of this iceberg. I have revisited Geneen Roth’s ideas. They make sense to me now in a way they never did.
Back to the subject of overeating and my decision against bariatric surgery. In the deep part of this learning process, I watched a BBC documentary by Dr. Mosley. It dealt with the issue of intermittent fasting for health. I liked the things I learned and decided I had nothing to lose. I always wanted to learn the discipline of fasting, a spiritual practice I always aspired to but could not sustain. Fasting by Dr. Mosley’s definition involves eating a 500-calorie meal on two fasting days a week, and eating normally the reset of the week. It was the kindest, most loving thing I have ever done for myself. It took only one fasting day to jump-start my appestat and convince my psyche that I would not DIE by fasting, and that 500 calories is enough to get me through a day. This is a miraculous for me since I never deliberately miss a meal.
I now can eat to a point of satisfaction without overeating, without having to “weigh and measure without exception” as one of my former eating plans advised. I am learning to estimate my portions and know what a healthy serving looks like. On my non-fasting days I average between 1100-1400 calories a day. I am losing weight steadily. My clothes are loosening up. I have not eaten a large meal in over a month. I feel energetic enough now so that I actually WANT to exercise. I am only just starting this journey of intermittent fasting and inner healing. The IF part is not a painful or difficult regimen to sustain. The healing is harder and more painful than I imagined it would be.
I realize now that I have lived my life with a fear of being empty, being hungry. I have associated hunger pangs with impending doom for most of my life. Through intermittent fasting I am learning that my world will not end if I miss a meal; on the contrary, my body continues to thank me.