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Weight Maintenance

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There are now several threads about Dr Barbara Berkeley's Refuse to Regain site so I thought it might be useful to post a quick item about her very useful book.

Dr Barbara Berkeley's Refuse to Regain:12 Tough Rules to Maintain the Body You've Earned is very black and white (as befits someone with her extensive experience of working with obesity+ patients undergoing bariatric surgery) but I should mention upfront that Berkeley frequently writes something to the effect of, "Take what is useful to you and discard the rest".

The 12 Tough Rules

Be Tough, Not Moderate - don't opt for the method that works in the moment
Commit Yourself to a 3 Month Opt-out Period - you need to follow her recommend 'primalist' WOE with no off-list food choices/holidays from it for 12 weeks and permit yourself no opt-outs
Weigh Yourself Every Day - record, track and act upon the data (see below)
Reverse Small Regains Immediately - in some spots, she says act on a 1lb rise by mini-diets until it's corrected. In others, she says 5-10lbs but vigilance may vary depending on what's happening
Eat Primarian 90% of the Time - low carb with little dairy, watch the fat
Eat One Major Meal Per Day - everything else is a snack or 'tide-over'
Perform a Daily "Scan & Plan" - go through your commitments for the day and anticipate what might sabotage your food choices and have a back-up plan for avoidance or handling those saboteurs
Stop eating after 8 PM - reduces unwise choices
Eat from a limited menu - reduce sensory specific satiety (more below - not her phrase but it's basically that we crave variety and our appetite for familiar foodstuffs is less than for items that stimulate us with novelty)
Have one acceptable treat per day - we are human and need to recognise that we crave some sort of indulgence if we're not to feel resentful and deprived. Definitions of 'acceptable' may vary.
Have a love affair with exercise - she says that we need to become athletes not in the sense of being superbly competent at an activity but that exercise becomes part of how we, and others, might define ourselves. Eg, she does Tai Chi 3x a week or plays tennis x5 a week.
Maintain with support and support others - courtesy of FastDay Forums or your preferred IRL group.

What's particularly interesting is that she strongly argues for the existence of metabolic differences (and therefore, to some extent different strategies) for those whose weight loss is 20lbs or so and who hadn't been overweight/obese for long v. POW (previously overweight or obese people who have been so since childhood).

Based on her experience with her clinical practice (obesity+ people who've opted for WLS to support them) she asserts that in her experience, the frequently repeated mantra of 'moderation' does not work and can trap people in rebound cycles of weight loss and gain.

I don't know what to make of it although I accept the sense of several of those rules. I like her, 'Take what's useful, ignore the rest. And, if your WOE is working for you in maintaining your weight and your health and you have no other metabolic issues, stick with your WOE' which would seem to offer appropriate wiggle room for continuing with IF as a schedule and your preferred foods, if there is no other pressing reason to change them.

I remember reading the following on Sensory Specific Satiety and thinking of women I know who maintain well because they have a very limited menu that suits them and their lives. Typically, they have a revolving 3 choice item for breakfast and lunch with more choice for dinner, but it is always a set pattern dinner of a protein with vegetables.

Published 17 Dec 2013, Guardian. The original does come with references to studies that support this.

Title: The science behind stuffing your face at Christmas

Feeling full, psychology and how festive food and drink make a monster of your appetite
The thinking behind [sensory specific satiety] [SSS] is that because humans are omnivores, and we must eat a variety of foods to survive, we evolved this mechanism to keep us from sticking doggedly to our favourite food and consequently getting ill, and/or prematurely popping our clogs. Marion Hetheringon, professor of biospychology at the University of Leeds, describes the process nicely: "If I'm eating a food like pasta, it will taste good at the beginning. Then when I'm halfway through it doesn't taste quite as good – I might add some more sauce to make it taste better, or I might say I'm going to switch to salad now – I've had enough of the pasta." This happens subconsciously. In fact even people with amnesia who not only forget what they've just eaten, but have no idea whether they've eaten at all, still express SSS. Served repeated, identical meals, they will continue to eat them, but they find them increasingly unpleasant.
Sounds interesting and something to bear in mind when I get to my maintaince
That's an interesting point on SSS I wonder if they have done any research using Autism as I know autistic kids lie my own who only eat the same food day in day out.
Thanks for bringing this and Barbara Berkeley to my attention. I am going to read more articles on her site. "Meditations on the Changing Shape of America" is a good one. Grazing, sugar and starches have a lot to answer for, however smoking probably made a contribution to the almost universal skinniness of adults in the 40s and 50s.

As for the 12 rules themselves; I did not weigh daily when losing so I shall not start now as it would probably drive me crazy - too much data - and I think the idea of having a 4-lb band to stay within which is popular on this forum beats freaking out over a 1 lb gain.
Thanks for starting this interesting thread @SSure. I like the idea of taking what was useful...etc.

During my extensive dieting "career", I have always struggled with the concept of "accountability" once I reach my goal. I have even been silly enough to reach goal...& then go straight back to eating all the wrong things....whilst hoping to get away with it. Which of course I never did!!

So, it seems very good advice to hold yourself continually accountable...to yourself. It is much easier to shift a few pounds as opposed to a couple of stones...but vigilance has to be our watch-word!!

:rainbow: :rainbow: :rainbow:
I have to say that "low carb with little dairy and watch the fat" is a VERY poor recommendation. First of all, dairy fat is very healthy and there is some evidence it promotes weight loss. Secondly, if you cut fat and eat low carb, you end up overeating protein, which leads to bad breath. And hunger.

This maintenance plan is FAR too rigid to be useful to anyone who isn't obsessive. I have done a lot of reserach into maintenance and polled quite a few people who have done it very successfully for 5 years or more, and have to say that none of them are doing what this doctor recommends.

My guess is that her advice comes more from dogmatic theory than personal experience or hanging out with people who have maintained significant weight losses for five years.

Sorry. But this is something I am something of an expert on, myself.
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