How Chronic Pain Forced Me to Take Those Last Ten Pounds Seriously
I’ve never been particularly interested in writing about my own struggles and successes with weight management, in part because it’s an incredibly sensitive and highly personal subject for a lot of people. However, lately a few people in the dreaded throes of lockdown gain have privately asked me how I manage my shit, so here I am, oversharing. Much like a recipe blog, I gotta begin with a little essaying to provide personal context before I get to the good stuff, so feel free to skip ahead if you’re impatient, but then don’t come after me in the comments cause I WILL BE ABLE TO TELL YOU DIDN’T READ THE THING.
Anyway — sensitivity. The title of this essay is true, but I wasn’t completely comfortable writing it — someone will inevitably come along, get mad, and tell me they have chronic pain and THEY have not been able to lose weight by any means necessary and HOW DARE I suggest all that is needed is the right kind of motivation? Well, I’m not. I’m telling you what worked for me, and me only. I get it, I promise. Despite a lifetime of other people commenting on my body, I’ve never been Capital-F-Fat so I do not have to deal with the bullshit experienced by those whose pain isn’t taken seriously at the doctor. I easily fit into airline seats (although I find them too small to be comfortable, which is really saying something shitty about airlines given the circumference of the widest part of my ass currently measures 35".) I’ve never been Capital-T-Thin, either. Thinness is the shape of your body goddammit, not the size. What I am is small, which is different from thin.
Small means when I was 21 years old and 115 pounds, my first boyfriend told me my arms were fat. “It’s just weird”, he said. “You’re disproportionate.” Ahh the incredible lack of awareness from the average young white man. When I dated him, he was a short, skinny, and prematurely-balding man at twenty-one years old, so I can only hope he’s learned since that most people (including him) are “disproportionate”. Proportionate people are in fact, so rare, that they have entire well-paying professions just for them. A few years later, another boyfriend (I had terrible taste in men in my 20s) told me I would have the “perfect body if I worked out a little”. He had no comprehension that my existing size was already the result of working out, so what he meant was I’d have the perfect body if I worked out a LOT. Was this man at least a muscled Adonis himself? Reader, no, of course he wasn’t.
Being small but not “thin” also means I’ve also spent decades embarrassed by wearing small sizes because they are unfortunately associated with thinness. A LOT of people don’t generally understand how sizes actually work. A curvy 4'11", 110-pound woman with a soft belly and 25% body fat is a size 00 in J Crew. A tall, lithe, 130-pound woman with 10% body fat and a flat stomach is a size 4. Ergo, the thin woman with the enviable frame wears the larger size. HELLO. Small sizes are for small people - not necessarily thin people, and has a LOT more to do with height than anything else. I am 5'3" and 118 pounds at 41 years of age (at the time of writing this). My 23" waist is a little soft, my thighs touch at the top, yet several mainstream brands that have fallen victim to “vanity sizing” don’t make anything small enough for me to wear. And at least once a year of my adult life, I have had the cringe experience of going through the checkout line or entering the dressing room and having some tall salesgirl who is thinner than me make some passive-aggressive remark because she doesn’t understand how my curvy 35" ass could be swimming in a size that is too small for her 38" skin and bones. It’s a bananas world we live in, I tell you. BANANAS. Shopping in person is really irritating for a number of reasons and I hope malls die soon. LONG LIVE ONLINE SHOPPING.
Anyway, there is also the incredible real estate dieting takes up in your head. When I was a teenager, I was yard-saleing with my dad one Saturday morning and I had him stop at one that had a stepper— you know — one of those purple plastic things that was the workout fad of 1993. Anyway I asked how much it was and the well-meaning woman making change in her fanny pack cocked her head to the side, waited a bit, and finally said with great tragedy, “Five dollars, but… you don’t need it, hon”. I thanked and paid her, took the thing, but ignored her, suddenly flushed, self-conscious, and wondering if I had done something wrong. Holy fuck I don’t miss how everyone used to think about exercise — that it’s only for people who need it. If you have children, I can’t beg you enough to make sure they are taught that exercise is normal, healthy, and frankly necessary for fucking everyone. Around the same time in the mid-90s, the big deal in food was avoiding fat which it turns out was the opposite of truthful advice. So everybody was crazy for Snackwells, the sugar industry was literally funding weight loss studies, and everybody got fatter on processed, empty carbs.
Most of my adult life I’ve wavered and waffled between 118 and 128 pounds. Ten extra pounds makes for a dramatic difference visually on a petite frame. But to be perfectly honest, most of those fluctuating years I was navigating in the dark. When I gained weight, I didn’t really know why and nervously went to bed hungry to compensate. When I lost weight, I didn’t really understand what I had done right. I probably spent ten years of my adult life hanging on somewhere in between and although I never developed anything like an eating disorder, I didn’t have a good relationship with food because I felt like I couldn’t trust food. I didn’t understand how it all worked, which in turn, increases that rent in your head.
The thing that woke me up was two things: pain, and the realization that menopause was on the horizon. These fears fed on each other, too, because I knew the chances of gaining weight in menopause were high. Menopause robs you of an additional 200 calories PER DAY — the equivalent of a 24-hour fast one day per week. That’s a lot. And the thing is, my pain could feel every… additional… pound. I have mild Lower Spinal Stenosis and a herniated disc. One caused the other, and we’re not sure which came first (or for that matter, how it happened). From a specialist, I learned a lot of people actually walk around with spinal issues but only feel them if they are close to the nerve, as mine was. Different doctors and physical therapists told me conflicting things, so I did all of them for good measure (swimming beat them all and then some). But I also understood for the first time that I could no longer treat dieting as a vain pursuit to be discarded when I was busy or felt guilty. You see, therein lays the double-edged sword: we are told to diet, but we are also told doing so is vain and shallow. We are told to be thin, but we are also treated to endless stereotypes about women who care about such things. When this duality was taking up too much rent in my head in the past, I would put my foot down, stop, and delve headlong into what was important. But it also meant I was in a place in my life in which I had no real clue how to lose weight now that I felt I had a good reason to do so. Again, we’re talking about the difference between a soft 26" waist, and a (still fairly soft) 23" waist. But to me, those three inches weighed on my nerves. Literally. So I had to take it seriously for the first time.
This business of having permission to take it seriously is telling, in and of itself. Why was this so liberating? One of the women who emailed me over the last month asking for dieting advice mentioned she felt guilty for feeling bad about her body in a pandemic where people are dying. Again, that fucking rent in your head, that double-edged sword. The sense that you care about it too much because you’ve been brainwashed to do so, yet you’re not allowed to show it for fear of being mistaken for a superficial person. Ugh.
Anyway, I learned how to do it properly, and more importantly, how to maintain it. And there is a LOT of shitty advice out there. SO MUCH SHITTY. So this essay is about how I keep that number on the smaller end of things. If you need a disclaimer stated: I am writing about my own experience only after 41 years on this earth, which may not apply to you for any number of reasons. I have never had an eating disorder, never had thyroid issues or any other medical impediments to weight management. I was raised lower middle class, but now have the privilege to buy the best quality meats and produce. I’m also not a doctor. That said, be aware that most doctors have taken exactly three credits of nutrition — often decades ago when they would have learned severely out of date information— so approach what they say with equal skepticism.
1. Don’t romanticize weight gain as an inevitability of the natural world
I saw a TED talk a few years ago by a scientist who had discovered that going on diets causes weight gain over time. This made a lot of sense, and she had the research to back it up. However, her conclusion was basically that you shouldn’t go on diets at all, you should just eat healthily and let nature decide how much you should weigh. This isn’t terrible advice or anything — eating healthy is, after all, what we’re talking about here — we’re just aiming to be more specific since one person’s idea of eating healthy is someone else’s idea of eating poorly. More to the point: this business of shrugging at a problem that feels too overwhelming to face head-on is oft-repeated in the culture. Bodies are designed to hold onto weight. Bodies like fat. All of this has a grain of truth to it, but the message should not be ergo stop trying. It should be: Okay, fad diets are unhealthy over time. Don’t do fad diets. Instead, figure out how your body works, and eat that diet accordingly for the rest of your life. Part of this means accepting that the way the majority of Western culture eats is going to lead to weight gain whether you are constantly fad-dieting or not.
After all, many of these fad diets, themselves, have truthful aspects to them, they are just then taken much too far. For instance the Adkins and Keto diets both reveal how much weight gain can be attributed to empty carbohydrates. However, in making your body sick from a total lack of carbs — even healthy ones found in a cup of strawberries, your body just freaks out. You’re going to make yourself feel ill for weeks or months only to have your weight come right back afterward. Ignore any diet that has you “go back” to a “normal” way of eating after a time. You need to learn how to eat for real, for perhaps the first time in your life — you will be eating some variation of it for the rest of your life for lasting success, but I promise you, you won’t be hungry. You might get a craving for something you probably shouldn’t have, but that isn’t hunger. Learn the feel of the difference. A trainer once told me that I had to accept a little hunger in order to achieve my goals, but I have not found that to be true — and worse, hunger (real hunger) lowers your metabolism. If I am hungry before bed, I’ll have a hard boiled egg, half an apple, and a few almonds.
2. Whatever else you do, definitely weigh yourself (almost) every morning.
I cringe every time a trainer or nutritionist recommends ignoring the scale in favor of “going by how your clothes fit” or other such incredibly subjective measures. Your body composition naturally fluctuates according to a number of factors all day long, so by weighing yourself every day (first thing in the morning), you grow accustomed to this ebb and flow of waking up on a Tuesday at 118 pounds, 120 on Wednesday, and 118 again on Thursday. By keeping track of the daily changes, there are no big, depressing surprises. Bodies love to sneak-gain weight, so by developing the habit of keeping an eye on it as a regular part of your daily routine, you are preventing yourself from getting your choices disconnected from reality. You are avoiding the nasty disappointment of someone who is changing their habits blind and weighing themselves once a month in hopes something in there took. I don’t weigh myself during my period for what I would imagine would be obvious reasons, but by doing it the rest of the month and treating my body like my personal, ongoing data-based science project, I can adjust my food intake as necessary on a daily basis. When the normal fluctuations are expected, you learn pretty quickly the difference between normal variance and actual weight gain.
3. This is Chemistry, not Math
I can’t stress this enough, but the biggest and most harmful food myth being repeated over and over again is the dreaded “A calorie is a calorie”. Absolutely fucking not. If you listen to no other piece of advice from me, this one is the most important. If half a handful of chocolate has the same calories as a whole apple, aren’t they interchangeable? Sure, I’ll have the apple sometimes to be nice to my body because it has nutrients I need, but meanwhile, I can have that candy and my numbers will be the same, right? No. No. No. The reality here is if you eat 1800 calories a day based on whole fruits and vegetables, you can lose weight. Whereas if you eat 1200 calories a day of pasta and candy and treat fruits and veggies like condiments, you are not only not going to lose weight, you’re going to feel like shit and develop not-fun things like fatigue (and eventually, type 2 diabetes).
A disclaimer: It is worth noting that trainers and others who make their careers following the published science will disagree with the second half of this, and I disagree with them. They will agree about the veggies, but argue that the person eating 1200 calories per day will lose weight regardless of what they eat, provided their calorie counts are accurate (many do not know how to get accurate counts) and that their caloric allowance is accurate (you may have been given 1200 by an app, but the actual number may be closer to 1000). The thing is, there is a lot more we don’t know about weight loss than what we do know. MANY if not most of these studies only tested men as the default, so for instance, my lived experience that different foods react very differently to female hormones, isn’t something you’ll get from your very muscled, very male trainer. I know that through years of analytical experiment, I absolutely learned how to correctly count calories, only to still fail. And now I don’t count them at all, only to be in the best shape of my life at 41. And my personal experience was, resolutely: I can eat far more calories overall, if the majority of those calories come from whole fruits and veggies.
If you don’t believe the difference is as dramatic as I claim, do an experiment for me: make sure 75% of all your meals are whole fruits and vegetables for one month. Make no other change and eat whenever you are hungry. At the end of the month, the changes in your body are going to be dramatic. It’s one of those things you have to witness for yourself to fully understand, but once you do, you will break the cycle of seeing your body as a calories-in, calories-out simple machine, and start seeing it as the complex ecosystem it is. No other food is better for human bodies than the water and fiber density of fruits and vegetables. The difference is so bananas, I don’t even count calories anymore, there is no point. I keep an eye on how many carbs I consume from non-fruits and vegetable sources. For instance, I count fresh juice since the fiber content has been removed. Food choice is 75% of weight loss, so the choices you make every time you eat something account for the vast majority of your success or failure. This is such an important, foundational part of weight loss that if you’re skeptical and just started trying to lose weight, it’s worth focusing on this entirely before adding workouts to the mix.
4. Give yourself time and patience to learn how to eat fruits and vegetables properly
I was born in 1979 and raised mostly on (nasty) canned veggies, TV dinners, and candy, so I pretty much hated vegetables and had to learn how to prepare them properly in my adult life so that I would actually enjoy them. One of the coolest things I’ve learned is that you can put a lot on fruits and vegetables and won’t fuck up your progress. I wouldn’t recommend chocolate fondue of course, but I eat my strawberries dipped in full-fat yogurt and my apples dipped in peanut butter all the time. I also don’t limit salad dressing. That other 25% is often used up, in fact, by the condiments I put on fruits and vegetables to give them more flavor and variety. It takes time to slowly introduce yourself to new foods and new ways of cooking or preparing familiar foods. I eat more salads in summer and fewer salads in winter because I want something warm and comforting in December. A typical breakfast for me might be coffee with 4 ounces of yogurt and a cup of strawberries or a lightly-fried plantain with real maple syrup. On Sunday, I might have eggs, bacon, and potatoes with a side of fruit. Lunch would be a salad with chicken and nuts (or various vegetable-based soups in winter) and dinner would be a piece of salmon with steamed and buttered veggies, or a 4-ounce steak with a small potato. Then while watching TV after dinner, I might have another piece of fruit, a handful of nuts, or a cup of sea salt popcorn. I don’t count anything that is mostly-fiber, I just keep track of what I put with it. Although I eat bread and rice occasionally for variety, there are ZERO health benefits to consuming bread, pasta, and rice that you can’t get from nuts, fruits, vegetables. NONE. In fact, most of the nutrients touted by the people insisting bread is a necessary food are actually additives like iron, riboflavin, thiamine and niacin. If you need more proof, consider this reality check: Most humans eat between three to five pounds of food per day, suggesting that heavier, nutrient-packed foods are your best friend and lightweight, high-calorie, nutrient-starved foods are not your friend.
Although I now consciously eat small portions of meat once or twice a day, it is worth noting that vegans and vegetarians can fall victim to eating too much processed foods like potato chips, and too much rice and pasta, so if you don’t want to eat meat, that’s okay, plenty of broccoli, soy, and nuts will likely have plenty of protein for you. But do make sure you really can base a meal around whole fruits and vegetables rather than unwittingly replacing meats with the density of (often simple) carbs.
5. Design your routine around your baseline life, not your idealized life.
If you are a normal, everyday person — aka not a model with hours free every day to work out — you will make much more progress by what you don’t eat, rather than by a dramatic and unrealistic plan to work out all the time. I have no children and a relatively open schedule, I am privileged to have a beautiful dedicated home gym, AND an indoor Endless Pool and it is still unrealistic for me to work out every day. It’s boring, even with the gym TV on. Know yourself well enough to plan for your worst days and your “most days”, not the self you are when you are your most motivated, inspired, or energetic. Inaction is more important than action.
6. Exercise Matters, just not in the way you’d think
Let’s imagine two moderately-active coworkers who want to lose weight. Person A changes their diet almost completely but changes nothing else. Person B starts a workout program, but doesn’t change their diet. A year goes by. Person A is further along than Person B which should be encouraging if you hate working out. Person C did both and is best off of everyone. So, how should you approach exercise?
Again, exercise is overvalued because it is taught in terms of calories lost, and as I said, you’re not a simple 2+2=4 machine. The average person who goes to the gym 3x per week isn’t burning 500 calories per visit, they are burning a “small snack” amount of calories. If you spend 20 minutes on the elliptical, you just burned off a single Reese's Peanut Butter Cup. This is why the average person can’t burn off a poor diet. If you love exercise and want to work out 2 hours each day, be my guest. I don’t, so I focus on what I put in my body in the first place. That said, exercise still helps, and was not optional for me due to the core and upper leg strength necessary to help hold my back in place.
Cardio pretty much exists to keep your heart and brain happy. Feel free to do 5 minutes of it per day, or 15 minutes every other day. It’s important for overall health, however, muscle gain is where the weight loss help truly resides. Muscle burns calories at rest, so muscle mass determines your caloric allowance. A thin woman with little muscle has to eat less than the same woman with higher muscle mass.
If you don’t know how to start a workout routine, start by getting a yoga mat. Once a day, alternate between planks, downward-facing dog, and squats. You may only be able to do 15–30 seconds of each if you are just getting started, but continue alternating those poses for a total of five minutes per day, five days a week. Then add more things at your own pace. My own exercise routine has evolved over time. I typically work out 4–5 days a week on average, and don’t work out at all for the worst three days of my period. Each workout lasts about 30 minutes. Monday I might do 20 minutes on the Peloton at the highest resistance I can stand, bookended by planks. Wednesday I might do 5 minutes on the elliptical, followed by lifting weights for the rest of the 30 minutes. Thursday I will do a 30-minute swim, and so forth, repeat. The more variety I incorporate in alternation, the better the results — just don’t skimp on any one activity for too long, else you will lose definition. I keep a whiteboard in my gym so that I can keep track of what I did, when, and you develop a sense of how soon to repeat the same (or similar) activity for the same set of muscles. You probably already know that it is difficult for women to put on muscle, let alone retain it throughout menopause, so I take it seriously.
7. You can cheat — just not for the whole day
I want to discourage the assumption that you must eat perfectly or you fall off the wagon entirely. In fact, once your diet is mostly fruits and vegetables, you will probably find that your margin for error is more generous than it would be for any other diet (likely due to the fiber content which helps you process other foods). If I am eating properly most of the week, it doesn’t affect my numbers if I have one meal per week that breaks the rules. Maybe this means I make pizza for dinner. Maybe it means I attend a party and am served a slice of cake. What it does not mean is the “cheat day” which I’m pretty sure is a term invented by men who have a completely different body composition than a petite perimenopausal woman. The point is, make sure you keep track of your fuckup allowance, and weighing yourself every day and keeping track of your food will give you a sense of how much give and grace you are personally allowed. Giving yourself an entire day off once a week is a recipe for disaster, but one MEAL per week, plus one whole day twice a year to cover the more indulgent holidays is fine.
8. Do mind the little stuff
Finally, the little stuff that is supposed to help? DO THEM. Exercise and a diet based on fibrous plants also helps you sleep better, and guess what motherfuckers: good sleep helps weight loss too. So does water intake, which I constantly have to remind myself to do, thanks, in part, to a bladder the size of a walnut (it is worth mentioning that before I switched to eating a lot of fruits and veggies, dehydration was frequent which is one of those DUH BINGO moments for me — you don’t have to douse yourself if your meals are high in water content). I tend to try to drink as much water as possible during the day when it doesn’t matter if I have to pee every hour, and stop a couple of hours before bed so that I’m not interrupting my sleep too much. I also don’t skip baths, especially on days I don’t work out, and most especially during my period when I’m both not working out AND likely desirous of the pain relief that comes from the heat. You may have seen the widely-reported study go around claiming that a hot bath burns as many calories as a 30-minute walk. The sample size was much too small to take the study seriously on its own, however, if you’re a fan of baths anyway as I am, it does make a certain amount of sense that “passive heating” your body is at minimum, a great way to help a little on days you didn’t get in a workout, and it certainly can’t hurt.