The New Year’s Resolution

I’m going to start this blog post with a quick trigger warning and a disclaimer. In this blog post I am going to be writing about calorie tracking and weight loss. This may be triggering to those who struggle with disordered eating. If this post is not supportive to your journey, please catch me on the next blog post. Please note that I am not a dietician, nutritionist, naturopath, or personal trainer. In other words, I have no qualifications whatsoever to tell you how to live a healthy lifestyle in general or while living with MS. This blog post is a report on what has been working for me.   

On January 1, 2021, my husband announced a New Year’s Resolution. He advised me that whether I joined him on this mission or not, he was going to lose weight in 2021. My husband had been dealing with borderline high blood pressure and gastroesophageal reflux disease (GERD) so severe that he was popping TUMS like candy. He knew that weight loss was likely to solve both of these issues. When he was lying down for bed in the wee morning hours of January 1, 2021, he decided that he needed to make a change.

I also had a lot of weight to lose. I packed on some weight when I underwent recurrent miscarriages trying to get pregnant, and I was already overweight before I added these depression pounds. I also did what many of us did in the face of the COVID-19 pandemic, soothed my anxiousness over the situation by doing too much baking and not enough exercise. I happily signed on to the New Year’s Resolution made by my husband, albeit I started on January 2nd after nursing my New Year’s hangover with some leftover Frank’s Red Hot Buffalo Chicken Dip.

Come April 20, 2021, when I developed optic neuritis, I had lost 44 pounds. To treat my optic neuritis, I was prescribed 1250mg/day of oral prednisone for 5 days, followed by a tapering off of 80mg/day, 70mg/day, 60mg/day, 50mg/day, 40mg/day, 30mg/day, 20mg/day, and 10mg/day each for 5 days. In other words, a metric butt ton of prednisone. Those who have taken prednisone before will know that even 30mg/day is a lot of prednisone and it comes with a common side effect of weight gain. This operates through two mechanisms. First, it makes you retain water. Second, it makes you ravenously hungry, often resulting in overeating.

I am a big proponent of the “calories in, calories out” (CICO) approach to weight loss. The gist of CICO is: if you consume more calories than you burn off (calorie surplus), you will gain weight; if you consume less calories than you burn off (calorie deficit), you will lose weight; and if you consume the same number of calories as you burn off (calorie equilibrium), you will maintain your weight. To lose weight, you must be in a calorie deficit. This is the only rule of the diet that my husband and I used to lose weight. This diet is simple. If I want to eat some chips or a chocolate, I can. If I want to have a glass of wine, I can. I just have to build these foods into my calorie budget for the day. If I want a glass of wine with dinner, I have a lower calorie dinner to offset the extra calories from the wine. The CICO approach will naturally encourage you to consume low-calorie-density foods (vegetables, lean protein, etc.), because you can eat more of these foods without blowing through your calorie budget for the day. You can lose weight eating 1400 calories of ice cream or chips each day if that’s all that you eat. You’ll be starving and miserable, but you will lose weight. However, if you eat fruits, salads, vegetables, lean proteins, whole grains, and just the occasional item of “junk food”, you’ll be able to maintain a calorie deficit and still eat satisfying meals and snacks. In essence, our approach to weight loss is like maintaining a household budget. If you want to add to your savings and pay off your debts, you either need to spend less money, make more money, or both. If you want to lose weight, you can consume fewer calories, exercise to burn additional calories, or both. We do both.

With this approach to dieting in mind, I knew what I had to do while taking the prednisone: I had to maintain my calorie deficit. When I was hit with prednisone-induced hunger, I had fresh vegetables on hand to fill myself up with low-calorie-density foods. I didn’t want prednisone to derail my success, so I found myself two new mantras: “there are no calories in prednisone” and, quoting Homer Simpson, “in this house, we obey the laws of thermodynamics!” I must have said these mantras to myself 700 times per day while I was taking the prednisone. It helped, and not only did I not gain weight while taking the prednisone, but I actually lost more weight. I did gain 9 pounds of water weight during the initial 5 days when I was on the super high dosage, but this came back off relatively quickly during the tapering period. I never ate extra calories, so I didn’t pack on any fat.

I have always been an emotional eater. I overeat when I am stressed and when I am upset. While I am not diagnosed, I believe that I have binge eating disorder. As an emotional eater, going through the stress of being diagnosed with MS posed a very real threat to my weight loss success. However, I have chosen to treat my MS diagnosis as a motivator for my healthy lifestyle and not as an opportunity to smother my feelings with excess food. Binge eating will only make my MS prognosis worse.

As I write this, I am now down a whopping 73 pounds since I started my weight loss journey on January 2, 2021. My husband has lost a staggering 87 pounds. He has resolved his GERD and brought his blood pressure down into the normal range. We have both lost more than 30% of our initial body weights. We did this while eating cake, ice cream, chips, pasta, cheese, and all of the so-called “forbidden foods” when you are trying to lose weight. The key is, we did so in moderation.

If you are reading this and you want to lose some weight, I want you to know that you can do it. Look at the difference that 10.5 months has made in our lives. If we can do it, you can do it too. I would encourage you to choose a diet approach that you can maintain. I know that I can’t live my life without carbohydrates. I love pasta. I love pizza. I love chips. Going “keto” would make me miserable and it would be completely unsustainable for me. Here’s what I have learned: you don’t need to follow any particular diet to lose weight; choose to eat in a manner that leaves you in a calorie deficit and that you can sustain. How much of a calorie deficit you need depends on how much weight you want to lose and how quickly you want to lose it. A pound of body fat roughly equates to 3500 calories, so if you have a calorie deficit of 500 calories per day, you can expect to lose about a pound per week (over 50 pounds in a year), and if you have a 100-calorie deficit, you can expect to lose about a pound per month (about 10 pounds in a year). There are online calorie calculators that can help you to determine your basal metabolic rate (essentially the number of calories that you would burn if you just laid around in bed all day), and a rough estimation of your caloric needs. But do bear in mind that these calculators provide just rough estimates. It’s important to listen to your body and see what works for you.

I have had people tell me that calorie counting didn’t work for them. This is usually due to some inaccuracy in their calorie tracking. Either they have overestimated their caloric needs, or they are consuming more calories than they think that they are. There are a number of ways that this can happen. Food manufacturers are allowed to be up to 20% off in the calories listed on their products. A piece of toast that you think is 100 calories may actually be 120 calories. Many people forget to measure the oil that they use to cook their food. At 120 calories per tablespoon, if you don’t count the oil you will quickly eliminate any calorie deficit that you think that you have. Also, there are no zero calorie foods. There are lots of foods that report that they are zero calories, but here’s the trick – if a food has less than 5 calories per serving, the food manufacturer is allowed to say that it has zero calories. Take cooking spray as an example. A ¼ second spray has “zero calories”. In reality, it could have up to 4 calories per ¼ second spray. When’s the last time that you used a ¼ second spray? Never. So, your 1-2 second spray could include 16-32 calories that you counted as zero, relying on the label. These little things can add up to wipe out a perceived calorie deficit.

Now, I don’t mean to come across as saying that macro- and micro-nutrients don’t matter. They do. They don’t matter insofar as fat loss is concerned, but they do matter insofar as muscle maintenance and growth is concerned, and they do matter insofar as general health and wellbeing are concerned. When you lose weight, you will lose both fat and lean body mass. Obviously, what we are trying to accomplish is fat loss. To minimize loss of lean muscle, we try to ensure that we are getting enough protein for our body size (we strive for half a gram to a gram of protein per pound of body weight). Eating a colourful range of whole foods as your primary source of calories will result in better overall health, so we aim to do this daily too.

Below are some photos showing me before I started my weight loss journey, and now, a little over 10 months into my weight loss journey. I don’t call them before and after photos, as I haven’t reached the “after” or “maintenance” stage just yet. I am continuing to lose weight. While I am currently at a healthy BMI and a size 6 or 8 depending on the brand (US/Canadian sizing), I still feel that I have fat to lose, and I would like to be at a lower weight within the healthy BMI range. I don’t have any particular target weight in mind. I think that I will know it when I get there.

MS has served as a reminder for me that I only have one body and how I take care of it matters. I feel fortunate that my first MS attack (at least the first one that I knew about) happened when I was already down 44 pounds and, apart from having MS, healthier than I had been months prior. Already being on a path towards better health has helped me to stay on that path in the face of a very difficult diagnosis.

There are a number of MS-specific diets that are touted: the Wahls Protocol (an amped-up version of the Paleo diet), the Swank diet, the Overcoming MS diet (OMS), the Best Bet diet, the McDougall diet, as well as intermittent fasting, Keto, and the Mediterranean diet. There’s little to no evidence that any of these diets work to reduce MS symptoms, relapses, and progression (I define “evidence” as well-designed scientific studies; I acknowledge that there are plenty of anecdotal accounts of each of these diets sending their proponents into “remission”). I am currently researching the various MS-specific diets that have been developed in order to evaluate what I should do to better manage my MS. It is unlikely that I will adhere to any of these diets fully. Frankly, the MS-specific diets are so inconsistent with each other that they can’t all be correct (some advocate raw-food veganism and others advocate regularly eating organ meat, with Dr. Wahls going so far as to suggest that my decade or so as a vegetarian may be responsible for me getting MS). For now, I am learning all that I can and considering what tweaks I can make to improve my nutrition. I am focusing on eating mostly whole foods and reducing my consumption of processed foods. Heck, I’m even giving organ meat a shot (and it is every bit as disgusting as I remember it being). However, I’m going to need to see some pretty compelling studies before I decide to cut out all gluten and dairy from my diet, as Dr. Wahls advocates. Gluten is what makes food taste good in my humble opinion. And, to quote the late great Julia Child, “with enough butter, anything is good”.

2021 has been a shitty year. We’ve spent most of it in pandemic lockdown. We haven’t been able to see our friends and family anywhere near as much as we would have liked. I was diagnosed with MS. But, courtesy of my husband waking up on January 1st with a New Year’s Resolution in mind, it has also been a year of transformation. A friend of mine recently commented that I am one of the few people that she knows whose health has improved during the pandemic. Honestly, these words felt comedic in light of my MS diagnosis. But she is likely right. The MS diagnosis was coming for me regardless, and the other improvements that I have made to my health have likely allowed me to fare much better through receiving this awful diagnosis. If you are reading this and you want to improve your own health, my message to you is that there has never been a better time than right now, because you never know what the year ahead has in store for you. It is never too early or too late to work towards being the healthiest version of you.