Tuesday, November 9, 2010
The Twinkie Diet for Fat Loss
The Experiment
I've received several e-mails from readers about a recent experiment by nutrition professor Mark Haub at Kansas State university (thanks to Josh and others). He ate a calorie-restricted diet in which 2/3 of his calories came from junk food: Twinkies, Hostess and Little Debbie cakes, Dorito corn chips and sweetened cereals (1). On this calorie-restricted junk food diet (800 calorie/day deficit), he lost 27 pounds in two months.
Therefore, junk food doesn't cause fat gain and the only thing that determines body fatness is how much you eat and exercise. Right?
Discussion
Let's start with a few things most people can agree on. If you don't eat any food at all, you will lose fat mass. If you voluntarily force-feed yourself with a large excess of food, you will gain fat mass, whether the excess comes from carbohydrate or fat (2). So calories obviously have something to do with fat mass.
But of course, the situation is much more subtle in real life. Since a pound of body fat contains roughly 3,500 calories, eating an excess of 80 calories per day (1 piece of toast) should lead to a weight gain of 8 lbs of fat per year. Conversely, if you're distracted and forget to eat your toast, you should lose 8 lbs of fat per year, which would eventually be dangerous for a lean person. That's why we all record every crumb of food we eat, determine its exact calorie content, and match that intake precisely with our energy expenditure to maintain a stable weight.
Oh wait, we don't do that? Then how do so many people maintain a stable weight over years and decades? And how do wild animals maintain a stable body fat percentage (except when preparing for hibernation) even in the face of food surpluses? How do lab rats and mice fed a whole food diet maintain a stable body fat percentage in the face of literally unlimited food, when they're in a small cage with practically nothing to do but eat?
The answer is that the body isn't stupid. Over hundreds of millions of years, we've evolved sophisticated systems that maintain "energy homeostasis". In other words, these systems act to regulate fat mass and keep it within the optimal range. The evolutionary pressures operating here are obvious: too little fat mass, and an organism will be susceptible to starvation; too much, and an organism will be less agile and less efficient at locomotion and reproduction. Energy homeostasis is such a basic part of survival that even the simplest organisms regulate it.
Not only is it clear that we have an energy homeostasis system, we even know a thing or two about how it works. Early studies showed that lesioning a part of the brain called the ventromedial hypothalamus causes massive obesity (3; this is also true in humans, when a disruption results from cancer). Investigators also discovered several genetic mutations in rats and mice that result in massive obesity*. Decades-long research eventually demonstrated that these models have something in common: they all interfere with an energy homeostasis circuit that passes information about fat mass to the hypothalamus via the hormone leptin.
The leptin system is a classic negative feedback loop: the more fat mass accumulates, the more leptin is produced. The more leptin is produced, the more the hypothalamus activates programs to reduce hunger and increase energy expenditure, which continues until fat mass is back in the optimal range. Conversely, low fat mass and low leptin lead to increased hunger and energy conservation by this same pathway**.
So if genetic mutants can become massively obese, I guess that argues against the idea that voluntary food intake and energy expenditure are the only determinants of fat mass. But a skeptic might point out that these are extreme cases, and such mutations are so rare in humans that the analogy is irrelevant.
Let's dig deeper. There are many studies in which rodents are made obese using industrial high-fat diets made from refined ingredients. The rats eat more calories (at least in the beginning), and gain fat rapidly. No big surprise there. But what may come as a surprise to the calorie counters is that rodents on these diets gain body fat even if their calorie intake is matched precisely to lean rodents eating a whole food diet (4, 5, 6). In fact, they sometimes gain almost as much fat as rodents who are allowed to eat all the industrial food they want. This has been demonstrated repeatedly.
How is this possible? The answer is that the calorie-matched rats reduce their energy expenditure to a greater degree than those that are allowed free access to food. The most logical explanation for this behavior is that the "set point" of the energy homeostasis system has changed. The industrial diet causes the rodents' bodies to "want" to accumulate more fat, therefore they will accomplish that by any means necessary, whether it means eating more, or if that's not possible, expending less energy. This shows that a poor diet can, in principle, dysregulate the system that controls energy homeostasis.
Well, then why did Dr. Haub's diet allow him to lose weight? The body can only maintain body composition in the face of a calorie deficit up to a certain point. After that, it has no choice but to lower fat mass. It will do so reluctantly, at the same time increasing hunger, and reducing lean mass***, muscular strength and energy dedicated to tissue repair and immune function. However, I hope everyone can agree that a sufficient calorie deficit can lead to fat loss regardless of what kind of food is eaten. Dr. Haub's 800 calorie deficit qualifies. I think only a very small percentage of people are capable of maintaining that kind of calorie deficit for more than a few months, because it is mentally and physically difficult to fight against what the hypothalamus has decided is in your best interest.
My hypothesis is that, in many people, industrial food and an unnatural lifestyle lead to gradual fat gain by dysregulating the energy homeostasis system. This "breaks" the system that's designed to automatically keep our fat mass in the optimal range by regulating energy intake, energy expenditure and the relative partitioning of energy resources between lean and fat tissue. This system is not under our conscious control, and it has nothing to do with willpower.
I suspect that if you put a group of children on this junk food diet for many years, and compared them to a group of children on a healthy diet, the junk food group would end up fatter as adults. This would be true if neither group paid any attention to calories, and perhaps even if calorie intake were identical in the two groups (as in the rodent example). The result of Dr. Haub's experiment does not contradict that hypothesis.
So do calories matter? Yes, but in a healthy person, all the math is done automatically by the hypothalamus and energy balance requires no conscious effort. In 2010, many people have already accumulated excess fat mass. How that may be sustainably lost is another question entirely, and a more challenging one in my opinion. As they say, an ounce of prevention is worth a pound of cure. There are many possible strategies, with varying degrees of efficacy that depend highly on individual differences, but I think overall the question is still open. I discussed some of my thoughts in a recent series on body fat regulation (7, 8, 9, 10, 11).
* ob/ob and db/db mice. Zucker and Koletsky rats. Equivalent mutations in humans also result in obesity.
** Via an increase in muscular efficiency and perhaps a decrease in basal metabolism. Thyroid hormone activity drops.
*** Loss of muscle, bone and connective tissue can be compensated for by strength training during calorie restriction. Presumed loss of other non-adipose tissues (liver, kidney, brain, etc.) is probably not affected by strength training.
I've received several e-mails from readers about a recent experiment by nutrition professor Mark Haub at Kansas State university (thanks to Josh and others). He ate a calorie-restricted diet in which 2/3 of his calories came from junk food: Twinkies, Hostess and Little Debbie cakes, Dorito corn chips and sweetened cereals (1). On this calorie-restricted junk food diet (800 calorie/day deficit), he lost 27 pounds in two months.
Therefore, junk food doesn't cause fat gain and the only thing that determines body fatness is how much you eat and exercise. Right?
Discussion
Let's start with a few things most people can agree on. If you don't eat any food at all, you will lose fat mass. If you voluntarily force-feed yourself with a large excess of food, you will gain fat mass, whether the excess comes from carbohydrate or fat (2). So calories obviously have something to do with fat mass.
But of course, the situation is much more subtle in real life. Since a pound of body fat contains roughly 3,500 calories, eating an excess of 80 calories per day (1 piece of toast) should lead to a weight gain of 8 lbs of fat per year. Conversely, if you're distracted and forget to eat your toast, you should lose 8 lbs of fat per year, which would eventually be dangerous for a lean person. That's why we all record every crumb of food we eat, determine its exact calorie content, and match that intake precisely with our energy expenditure to maintain a stable weight.
Oh wait, we don't do that? Then how do so many people maintain a stable weight over years and decades? And how do wild animals maintain a stable body fat percentage (except when preparing for hibernation) even in the face of food surpluses? How do lab rats and mice fed a whole food diet maintain a stable body fat percentage in the face of literally unlimited food, when they're in a small cage with practically nothing to do but eat?
The answer is that the body isn't stupid. Over hundreds of millions of years, we've evolved sophisticated systems that maintain "energy homeostasis". In other words, these systems act to regulate fat mass and keep it within the optimal range. The evolutionary pressures operating here are obvious: too little fat mass, and an organism will be susceptible to starvation; too much, and an organism will be less agile and less efficient at locomotion and reproduction. Energy homeostasis is such a basic part of survival that even the simplest organisms regulate it.
Not only is it clear that we have an energy homeostasis system, we even know a thing or two about how it works. Early studies showed that lesioning a part of the brain called the ventromedial hypothalamus causes massive obesity (3; this is also true in humans, when a disruption results from cancer). Investigators also discovered several genetic mutations in rats and mice that result in massive obesity*. Decades-long research eventually demonstrated that these models have something in common: they all interfere with an energy homeostasis circuit that passes information about fat mass to the hypothalamus via the hormone leptin.
The leptin system is a classic negative feedback loop: the more fat mass accumulates, the more leptin is produced. The more leptin is produced, the more the hypothalamus activates programs to reduce hunger and increase energy expenditure, which continues until fat mass is back in the optimal range. Conversely, low fat mass and low leptin lead to increased hunger and energy conservation by this same pathway**.
So if genetic mutants can become massively obese, I guess that argues against the idea that voluntary food intake and energy expenditure are the only determinants of fat mass. But a skeptic might point out that these are extreme cases, and such mutations are so rare in humans that the analogy is irrelevant.
Let's dig deeper. There are many studies in which rodents are made obese using industrial high-fat diets made from refined ingredients. The rats eat more calories (at least in the beginning), and gain fat rapidly. No big surprise there. But what may come as a surprise to the calorie counters is that rodents on these diets gain body fat even if their calorie intake is matched precisely to lean rodents eating a whole food diet (4, 5, 6). In fact, they sometimes gain almost as much fat as rodents who are allowed to eat all the industrial food they want. This has been demonstrated repeatedly.
How is this possible? The answer is that the calorie-matched rats reduce their energy expenditure to a greater degree than those that are allowed free access to food. The most logical explanation for this behavior is that the "set point" of the energy homeostasis system has changed. The industrial diet causes the rodents' bodies to "want" to accumulate more fat, therefore they will accomplish that by any means necessary, whether it means eating more, or if that's not possible, expending less energy. This shows that a poor diet can, in principle, dysregulate the system that controls energy homeostasis.
Well, then why did Dr. Haub's diet allow him to lose weight? The body can only maintain body composition in the face of a calorie deficit up to a certain point. After that, it has no choice but to lower fat mass. It will do so reluctantly, at the same time increasing hunger, and reducing lean mass***, muscular strength and energy dedicated to tissue repair and immune function. However, I hope everyone can agree that a sufficient calorie deficit can lead to fat loss regardless of what kind of food is eaten. Dr. Haub's 800 calorie deficit qualifies. I think only a very small percentage of people are capable of maintaining that kind of calorie deficit for more than a few months, because it is mentally and physically difficult to fight against what the hypothalamus has decided is in your best interest.
My hypothesis is that, in many people, industrial food and an unnatural lifestyle lead to gradual fat gain by dysregulating the energy homeostasis system. This "breaks" the system that's designed to automatically keep our fat mass in the optimal range by regulating energy intake, energy expenditure and the relative partitioning of energy resources between lean and fat tissue. This system is not under our conscious control, and it has nothing to do with willpower.
I suspect that if you put a group of children on this junk food diet for many years, and compared them to a group of children on a healthy diet, the junk food group would end up fatter as adults. This would be true if neither group paid any attention to calories, and perhaps even if calorie intake were identical in the two groups (as in the rodent example). The result of Dr. Haub's experiment does not contradict that hypothesis.
So do calories matter? Yes, but in a healthy person, all the math is done automatically by the hypothalamus and energy balance requires no conscious effort. In 2010, many people have already accumulated excess fat mass. How that may be sustainably lost is another question entirely, and a more challenging one in my opinion. As they say, an ounce of prevention is worth a pound of cure. There are many possible strategies, with varying degrees of efficacy that depend highly on individual differences, but I think overall the question is still open. I discussed some of my thoughts in a recent series on body fat regulation (7, 8, 9, 10, 11).
* ob/ob and db/db mice. Zucker and Koletsky rats. Equivalent mutations in humans also result in obesity.
** Via an increase in muscular efficiency and perhaps a decrease in basal metabolism. Thyroid hormone activity drops.
*** Loss of muscle, bone and connective tissue can be compensated for by strength training during calorie restriction. Presumed loss of other non-adipose tissues (liver, kidney, brain, etc.) is probably not affected by strength training.
Vlogging
Whole Grain Penne with Roasted Vegetables & Parmesan
Tip: Cut vegetables the same size for uniform baking.
Ingredients:
Weight Loss Recipes Amount per Serving: 150 Calories, 6 g Protein, 30 g carbohydrates, 6 g Fiber, 3 g fat, < 1 g saturated fat, 0 mg cholesterol, 230 mg sodium
Ingredients:- 8 oz parsnips, peeled and cut into 1” pieces
- 8 oz rutabaga, peeled and cut into 1” pieces
- 8 oz turnips, peeled and cut into 1” pieces
- 2 tsp olive oil
- 1 tsp Italian seasoning
- ½ tsp salt
- 8 oz whole grain penne or fusilli pasta
- 2 tbsp homemade or bottled pesto sauce*
- ½ cop finely chopped roasted red bell pepper
- 2 tbsp grated Parmesan cheese
- 2 tbsp chopped fresh Italian parsley
- Preheat oven 400 F.
- Place parsnips, rutabaga, and turnips on 15”*10” baking sheet. Drizzle with oil and sprinkle with Italian seasoning, salt, and black pepper to taste. Toss well and distribute pieces evenly over pan.
- Roast vegetables 30 minutes, or until tender and evenly browned, stirring or shaking every 15 minutes. Taste and adjust seasoning if needed.
- Prepare pasta according to package directions, without adding fat or salt. Drain and toss with pesto.
- Add roasted bell pepper and vegetables to pasta. Divide among bowls and garnish with cheese and parsley. Serve hot or at room temperature.
- Note: Bottled pesto is slightly heiger in calories and fat than homemade.
Weight Loss Recipes Amount per Serving: 150 Calories, 6 g Protein, 30 g carbohydrates, 6 g Fiber, 3 g fat, < 1 g saturated fat, 0 mg cholesterol, 230 mg sodium
Monday, November 8, 2010
Roast Beef Sandwich with Horseradish Mayo
Tip: By using lean beef and low-fat mayonnaise, you get a hearty meal with out paying too high a caloric price
Ingredients:
Weight Loss Recipes Amount per Serving: 312 Calories, 32 g Protein, 33 g carbohydrates, 5 g Fiber, 8 g fat, 3 g saturated fat, 53 mg cholesterol, 543 mg sodium
Ingredients:- 1 tbsp low-fat mayonnaise
- 1 tsp prepared horseradish
- 2 slices whole grain sandwich bread
- 1 leaf green leaf lettuce
- ¼ lb lean, low-sodium deli roast beef
- 4 small slices tomato
- 1 thin slice red onion
- Combine mayonnaise and horseradish in small bowl. Stir to blend. Set aside.
- Place one slice of bread on serving plate. Top with lettuce, beef, tomato, and onion. Spread reserved mayonnaise mixture evenly over second slice of bread. Place stop sandwich. Cut in halves or quarters. Serve immediately
Weight Loss Recipes Amount per Serving: 312 Calories, 32 g Protein, 33 g carbohydrates, 5 g Fiber, 8 g fat, 3 g saturated fat, 53 mg cholesterol, 543 mg sodium
Sunday, November 7, 2010
I had a dream
It wasn't really a dream, more of a nightmare.
Since I've been sleeping a lot more lately I've started dreaming again. Unfortunately, most of my dreams haven't been pleasant. The one I had Friday night has stayed with me through the weekend. I can't seem to let it go.
Usually I dismiss dreams as just that...dreams. They don't really mean anything, just silly junk our brain comes up with while we try to sleep.
This one was different. This one is was disturbingly a reflection of my life.
I was inside of a building, standing on a very narrow ledge along a wall. The ledge was so narrow that only the balls of my feet were on the ledge and I was standing on my tiptoes. I was very high up, and there was a cement floor below me. I knew if I fell I would die.
I was facing the wall with my hands and body pressed flat against the wall. I slowly inched along the narrow ledge sideways. I kept feeling like I was going to fall. When I looked down it was a long way to the floor. I was very frightened. I didn't know how I was going to get down.
Finally, I called for my husband to quickly bring me a ladder. He came with a ladder but he held if about five feet from me. I tried to reach for the ladder but I couldn't reach it. Then I lost my balance. I fell.
I didn't die (obviously), but in my dream when I fell I grabbed onto the very narrow ledge with my fingers. Then as I was hanging from the ledge with my fingers, and my legs were dangling, I realized my feet were almost touching the floor. I could let go and I wouldn't die. I was going to be okay.
This could be a reflection of so many things in my life. My job, my marriage, my weight loss efforts. The failure at any or all of these things will not kill me. It might scare me, but I won't die.
Or the dream could have been about the guy at work that was wearing moccasins last week. He told me they were like slippers. I asked him if they had arch support and he said no. I told him that would kill my feet because I have extremely high arches and had to have arch support in my shoes. He told me I needed to practice standing on a Bosu ball with one foot, barefooted. Just stand there grabbing the ball with my foot. That it would build up my arches. I told him I always fall off of those stupid Bosu balls. Yes, I bet that's what the dream was really all about. :)
Since I've been sleeping a lot more lately I've started dreaming again. Unfortunately, most of my dreams haven't been pleasant. The one I had Friday night has stayed with me through the weekend. I can't seem to let it go.
Usually I dismiss dreams as just that...dreams. They don't really mean anything, just silly junk our brain comes up with while we try to sleep.
This one was different. This one is was disturbingly a reflection of my life.
I was inside of a building, standing on a very narrow ledge along a wall. The ledge was so narrow that only the balls of my feet were on the ledge and I was standing on my tiptoes. I was very high up, and there was a cement floor below me. I knew if I fell I would die.
I was facing the wall with my hands and body pressed flat against the wall. I slowly inched along the narrow ledge sideways. I kept feeling like I was going to fall. When I looked down it was a long way to the floor. I was very frightened. I didn't know how I was going to get down.
Finally, I called for my husband to quickly bring me a ladder. He came with a ladder but he held if about five feet from me. I tried to reach for the ladder but I couldn't reach it. Then I lost my balance. I fell.
I didn't die (obviously), but in my dream when I fell I grabbed onto the very narrow ledge with my fingers. Then as I was hanging from the ledge with my fingers, and my legs were dangling, I realized my feet were almost touching the floor. I could let go and I wouldn't die. I was going to be okay.
This could be a reflection of so many things in my life. My job, my marriage, my weight loss efforts. The failure at any or all of these things will not kill me. It might scare me, but I won't die.
Or the dream could have been about the guy at work that was wearing moccasins last week. He told me they were like slippers. I asked him if they had arch support and he said no. I told him that would kill my feet because I have extremely high arches and had to have arch support in my shoes. He told me I needed to practice standing on a Bosu ball with one foot, barefooted. Just stand there grabbing the ball with my foot. That it would build up my arches. I told him I always fall off of those stupid Bosu balls. Yes, I bet that's what the dream was really all about. :)
It doesn't make it all better
After looking at my stats from last year that I posted yesterday, I started pondering why I just gave up and gained 21 pounds. I was near goal, at least the Weight Watcher goal of 155. At 158 pounds I was so close to goal that I could almost feel it. I remember being happy and proud of myself.
So what happened? Why did I just give up? Don't I want to reach goal? It appears that I don't really care anymore, that I gave up giving it my all and I'm just floating along, staying in the 170's, not really giving my weight loss much attention.
A few weeks ago a friend that I walk with on occasion asked me, "Isn't your life a lot better since you lost so much weight?" My immediate response was "No! It's not." Then I told her some things were better, I can breathe easier and my knees don't hurt. I don't get tired as quickly. I have a little more self-confidence. However, overall, I still have the same problems I had at 240 pounds, and I still had those same problems when I was down to 152 last year.
My job is still a job that I don't exactly look forward to each day, but it is a job. My marital problems are still here. My husband still gets grouchy when he's tired and he's tired a lot. I'm still afraid of the same things, becoming one of the morbidly obese and being homeless. I still don't think I'm smart or pretty. In a nutshell, I'm still the same person just in a healthier body.
My friend was shocked that my weight loss didn't solve all my problems. I was only telling her the truth, even though she's trying to lose a hundred pounds and this was disheartening to hear.
Maybe because I know it won't solve all my problems I've made reaching goal not as important to me as it was last year. I still want to reach goal, but for different reasons now. Now that I know it won't fix everything I need to look at in an entirely different light.
I want to lose weight so I can comfortably wear all the size 10 clothes in my closet. I'm back in a size 12. I want to lose weight so I can remain healthy and continue to be active in my old age. I have no intention of moving into an assisted living home in my 80's. I want to travel and not be in a wheelchair.
The reasons for getting to goal are different now. I know it won't make my job more fun or less stressful. I know it won't make my husband happier or my marriage better. I can't control these things, but I can control me. I can control how I handle things, what I put in my mouth, my health.
I think Sheryl said it best in her post last week when she wrote about her struggles at being at goal. The last few paragraphs really hit home for me.
I suspect this is why so many people gain back all their weight and then some more, just like I've done many times in my life. I expected a different outcome when I lost a lot of weight. I expected life to be wonderful and everyone around me to be as happy for me as I was for myself. It just doesn't work that way.
The bottom line is that reaching goal doesn't make it ALL better. It makes some things better, but a lot of things stay the same or only get slightly better. That's okay, small positive changes in life are still good. I just have to expect less, accept that this isn't really a life-altering event to weight 155 versus 175 or 135 versus 175. My life will still be pretty much the same, just a thinner, healthier version of me.
So it doesn't make it all better, but it's a little better and sometimes, a lot better. That's still a good thing.
An afterthought: After I posted this I realized some people might think that what I'm saying is that losing weight isn't worth it. That since it doesn't fix everything then why bother? That's not what I meant.
It fixes a lot of things, but basically you'll still come out on the other side the same person with a lot of the same problems. Some things will be better, some will go away, and you might even have an entirely new set of problems. It's still a very good thing to lose weight.
The other thing you might think is that I'm seeking compliments when I say I'm not smart or pretty. I know what I am. I'm average intelligence, average looks. It's okay, I've accepted it. Somehow I thought losing weight would make me better in all areas of my life. Obviously, I was wrong on that account, but again, I've accepted it.
So what happened? Why did I just give up? Don't I want to reach goal? It appears that I don't really care anymore, that I gave up giving it my all and I'm just floating along, staying in the 170's, not really giving my weight loss much attention.
A few weeks ago a friend that I walk with on occasion asked me, "Isn't your life a lot better since you lost so much weight?" My immediate response was "No! It's not." Then I told her some things were better, I can breathe easier and my knees don't hurt. I don't get tired as quickly. I have a little more self-confidence. However, overall, I still have the same problems I had at 240 pounds, and I still had those same problems when I was down to 152 last year.
My job is still a job that I don't exactly look forward to each day, but it is a job. My marital problems are still here. My husband still gets grouchy when he's tired and he's tired a lot. I'm still afraid of the same things, becoming one of the morbidly obese and being homeless. I still don't think I'm smart or pretty. In a nutshell, I'm still the same person just in a healthier body.
My friend was shocked that my weight loss didn't solve all my problems. I was only telling her the truth, even though she's trying to lose a hundred pounds and this was disheartening to hear.
Maybe because I know it won't solve all my problems I've made reaching goal not as important to me as it was last year. I still want to reach goal, but for different reasons now. Now that I know it won't fix everything I need to look at in an entirely different light.
I want to lose weight so I can comfortably wear all the size 10 clothes in my closet. I'm back in a size 12. I want to lose weight so I can remain healthy and continue to be active in my old age. I have no intention of moving into an assisted living home in my 80's. I want to travel and not be in a wheelchair.
The reasons for getting to goal are different now. I know it won't make my job more fun or less stressful. I know it won't make my husband happier or my marriage better. I can't control these things, but I can control me. I can control how I handle things, what I put in my mouth, my health.
I think Sheryl said it best in her post last week when she wrote about her struggles at being at goal. The last few paragraphs really hit home for me.
I suspect this is why so many people gain back all their weight and then some more, just like I've done many times in my life. I expected a different outcome when I lost a lot of weight. I expected life to be wonderful and everyone around me to be as happy for me as I was for myself. It just doesn't work that way.
The bottom line is that reaching goal doesn't make it ALL better. It makes some things better, but a lot of things stay the same or only get slightly better. That's okay, small positive changes in life are still good. I just have to expect less, accept that this isn't really a life-altering event to weight 155 versus 175 or 135 versus 175. My life will still be pretty much the same, just a thinner, healthier version of me.
So it doesn't make it all better, but it's a little better and sometimes, a lot better. That's still a good thing.
An afterthought: After I posted this I realized some people might think that what I'm saying is that losing weight isn't worth it. That since it doesn't fix everything then why bother? That's not what I meant.
It fixes a lot of things, but basically you'll still come out on the other side the same person with a lot of the same problems. Some things will be better, some will go away, and you might even have an entirely new set of problems. It's still a very good thing to lose weight.
The other thing you might think is that I'm seeking compliments when I say I'm not smart or pretty. I know what I am. I'm average intelligence, average looks. It's okay, I've accepted it. Somehow I thought losing weight would make me better in all areas of my life. Obviously, I was wrong on that account, but again, I've accepted it.
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