Monday, April 1, 2019

Fat kid’s complicated relationship with food and weight loss [350 > 175 > 230 > 175]

Pics: https://imgur.com/gallery/L1F1kUw

This is gonna be a summary of my weight loss journey to highlight some of the lessons I have learnt, including some recent events and struggles. Hopefully some of you can relate to my experiences and take comfort in knowing that you’re not alone. And wow, Reddit! Looking through my previous posts on /r/loseit as well as /r/progresspics, it has been more than 6 years already, and what a ride it has been!

Some context:

I had always been a big kid since 5 years of age. My appetite was insatiable (still is), and sports has never been my forte. It does not help that I was born into a family of bakers. My grandparents, my parents, and 5 of my 8 uncles/aunts run confectioneries. Don’t get me wrong, I am extremely proud of their achievements and hard work, and the food we make is absolutely amazing. It is however the cherry on top of our very own tried-and-tested recipe for obesity, which has unfortunately plagued much of my family.

Fast forward some 13 years, I enlisted into the army (mandatory 2-year service for all able-bodied males in Singapore). While the obese and overweight recruits had to undergo a modified version of the military training aimed specifically at weight loss and physical fitness, my BMI of nearly 50 was prohibitively high. I was deemed medically unfit for physical training solely because of my weight. The literal sense of the term ‘morbid obesity’ hit me, hard. That was my first wake-up call. Unfortunately, it was a wake-up call I chose to ignore. Most people get fitter over the course of their military service. For me, as the bad eating habits and lack of exercise persisted, the weight continued to pile on. My commanders now joke, ‘you have made a mockery of our training, how is* it possible you gained weight in the army, then lost it after leaving the force!*’

Retrospectively, I realised what my biggest problem was: amotivation. There wasn’t any impetus for change. I guess inertia is directly proportional to mass. After my time in the army, I had somewhat of a plan. I was heading off to study engineering at UCL. However, I had no real interest in engineering. I was just gonna do what most of my friends from high school were going to do. In actuality, nothing really motivated me. I felt like a cog in a machine - functioning yet uninspired.

Then came 2012, the year when things changed. Drastically.

By then, I had hit my peak weight of 348lb/158kg. I was in the final phase of preparing for university - renting my apartment in London, getting winter wear (Singapore is really hot), et cetera. I had also just completed a 6-month internship in the field of engineering and ergonomics, which I absolutely hated. Fluke or not, undertaking that engineering project is possibly the single most pivotal decision of my life thus far, for two reasons.

  1. It made me think really hard about my future, and realise that it did not involve a career in engineering.
  2. It gave me the opportunity to discuss other options with the professionals and academics at the institution.

I gave up my place in engineering school, and applied for medical school. I still can’t quite explain it, but there was a complete one-eighty in my attitude towards health and physical wellbeing that came about almost instantaneously after submitting my application. It was as though someone had found a physical switch in my mind and flipped it. I knew I had to do something. I couldn’t be that hypocritically fat doctor who tells his patients to eat well and exercise more. Having lived 21 years with close to no regard for my health, I did not necessarily know how to, but I knew I wanted to change. And I knew it was going to take time and effort. Possibly for the first time in my life, I felt empowered. I was empowered by my new goal and motivation to reach it.

Initially, I was lost. I did not have any specific goals or methodology. I did not even have a weighing scale to start. All I did for the first 10 weeks was to keep in mind the principle of calories in, calories and, and cut down on soda, sugar and supper. To my elation, I managed to lose 13lb/6kg in that period! I felt good and encouraged.

Incrementally, I pushed myself to do more, day by day, week by week. Exercise was hard. Physically, my body had been chronically deconditioned from the lack of any form of activity. Mentally, it’s daunting to be the largest guy on the running track, panting madly away before even finishing a quarter of a mile while every one else passes you on the side. The look from others, imaginary or not, were hard to ignore and weighed on me. However, with scale victories in mind, I pressed on.

Relevant link (1): https://old.reddit.com/r/loseit/comments/16g5vt/lost_40lbs_in_3_months_long_ways_to_go/

I got an exercise buddy to help with the monotony of cardio, and together we would explore new jogging routes, exchange dietary tips. Workouts became more enjoyable and having company definitely helped with my insecurities and confidence issues. My weight was steadily dropping at a rate of 3-4.5lb/1.5-2kg per week, and that definitely further motivated me.

Not long after, I was accepted into medical school, and in February 2013, I left for Melbourne.

Melbourne had been an amazing experience for me. I learned to care for myself. I had new-found autonomy. I chose what to buy, what to cook, what to eat. I chose when to exercise. I moved in with like-minded housemates. However, I was also conscious of the fact that the numbers on the scale became increasingly important to me, eventually to the point of obsession. For a while, numbers were all I cared about. I was weighing my food to the exact gram, calculating calories, tracking exercise hours.

Relevant link (2): https://old.reddit.com/r/loseit/comments/1fskpb/sv_update_4_months_since_last_post_im_into_the/

The efforts delivered results. Eating 700kcal/day for 2 years will make you lose the weight. But in all honesty, I was miserable. I wasn’t able to head out with my friends without being that annoying ‘let’s go to the salad bar’ person. And come on, eating 700kcal/day for 2 years will make you miserable. That’s eating 4 slices of bread for breakfast, and 4 pieces of steamed chicken tenderloin for the entire day. Every single day. For 2 years.

Still, I persisted with my diet and cardio. The numbers game was too addictive. By the second year of medical school I had lost 170lb/77kg. With such numbers I couldn’t possibly veer off course and risk not hitting my weekly targets, could I? My tunnel vision meant I couldn’t see, at that time, that I had lost more than just excess weight. I had sacrificed my social life. And eating 700kcal/day for 2 years cannot be all that healthy.

In fact, I got so depleted I suffered from postural giddiness and passed out a couple of times in my dormitory. I got so skinny my friends started to worry if I was sick. I lost so much weight so quickly my mum couldn’t recognise me the first time I came back to Singapore (we still get a chuckle whenever I recount having to tap on her shoulder at Changi airport and say ‘Ma, it’s me!’, haha!).

Realising that my new ‘healthier’ habits were not sustainable, I had to reassess my goals. I started eating more sensibly, reincorporating more food types and gradually increasing my caloric intake. Even then, always at the back of my mind was the fear of relapse, especially since my metabolism was probably beyond messed up, rendering me more susceptible to rebound weight gain. I started weight training and attended fitness classes. And while the numbers on the scale stagnated, I felt significantly better. I felt healthier. I felt stronger. I looked better in clothes. I was more confident. I was going out more. I hanged out with my friends more often. I started dating as well. I was happier.

Relevant link (3): https://old.reddit.com/r/progresspics/comments/5yy5mp/m25510_350lbs_175lbs_175lbs_update_4_years/

And confidence really is key. Things I wanted to do but was scared of trying, I did. Places I wanted to visit but felt out of place in, I went. People I wanted to profess my love for but never had the courage to, I spoke to. Alas, why didn’t I do this 10 years ago?

2017, I was in my final year of medical school. It was easily the best year of my life - a year jam-packed with amazing experiences, encounters and romance, many of which were new and exciting. I was on an exhilarating roller-coaster ride and I didn’t want it to stop. Not trying to be overdramatic here, but I honestly felt I lived my life to the fullest for the first time. In fact, I felt like I lived through my teens and early twenties within the span of these 12 months, albeit fast-forwarded some 20 times.

Back to the main purpose of this post. Actually, I have been wanting to post this for quite some time, as there were many instances last year when I felt lost and defeated. I had moved back to Singapore and started working as a house officer (or intern). Nothing could have prepared me for the relentless nature of the work that junior doctors do. Yes, I’ve heard stories from seniors, but the vicarious experience does not compare to the real deal even in the slightest. We worked north of 80 hours each week, but that wasn’t uncommon in Singapore. It was the calls. Oh gosh, the calls. In short, calls are rostered duty stints of 15-22 hours that begin immediately after we have completed our day work, during which manpower is dramatically reduced such that the patient-to-doctor ratio swells from 5-10:1 to easily >150:1. It is an intensely stressful period when the autonomy of the junior doctor is amplified multifold (senior manpower is also reduced, and many decisions are made by juniors independently) and he/she is constantly kept on his/her toes. I felt being pushed near the brink of breaking many a times during calls, especially the first few - the pressure is immense, the environment can be extremely chaotic, sleep is scarce (it’s not uncommon for house officers to go without sleep from 6am to 2pm the next day during calls - that’s 32 hours) and eating times are irregular.

Eventually, I reverted to my old ways - comfort bingeing. The momentary indulgence of a sugary rush was all that kept me from exploding/imploding during calls. Call after call, my waistline expanded, my belly grew and my face became rounder. My body image issues came right back to haunt me. I felt ashamed. I promised myself never to rebound - why was I so weak? My self-esteem plummeted. I became more socially withdrawn. Except with my closest friends, family and significant other, I avoided social interaction as much as I could, fearing (irrationally) the judgement and ridicule of others. I hated shopping for clothes as it reminded me of how I looked. My favourite tank top became the only top I would wear, as I thought everything else accentuated my weight gain. The brutality of my work had stretched my body, mind and relationships to the limit. I had serious doubts whether I could get back up from this.

*What’s wrong with me? *I studied psychiatry in medical school. I went through cases of body dysmorphia and anorexia. I examined different models of change. I should know better than most people how to get out of this rut. Yet, I felt powerless. I spiralled. Over the last year, I put on some 55lb/25kg.

Clichéd as it may be, such is life. It does not fully comprise endless fun rides on roller-coasters, and there will be obstacles along the way. I want to thank those closest to me for not giving up on me, and for encouraging me. Whether you told me ‘it’s okay, I don’t care how you look, I still love you no matter what’ or straightforwardly called me out ’you’ve put on so much weight, do something about it!’, I appreciate it all the same. I am so fortunate to be surrounded by people who care about me, and supported me during these hard times. These people, without question, are the most crucial part to my revelation. They have enabled me to emerge from self-pity and take a step back to look at things from a different perspective.

I’ve set my focus on the future. I have just completed my stint as a house officer, and have a sea of options to look forward to (and I do!). Also I am really eager to get back in shape for my brother’s wedding and upcoming beach holidays, only this time I am doing it in a more structured manner.

I have engaged a physical trainer, who has helped prescribe a training regimen and diet modifications to achieve my goals. My goals are more specific and holistic, rather than just the number on the scale. My workouts are more structured, and I try to fit them into free time slots throughout the day, however scarce they may be (whatever it is, hit the gym before you reach home, otherwise it becomes exponentially harder). I am also systematically desensitising myself to social stimuli to work on my phobia.

While there is still some work to be done before I can fully reconcile my relationship with food, body image issues and my weight, I am feeling positive about it.

Thank you for your love ^

TLDR;

  1. Fat kid who one day decided to become a doctor and lose weight
  2. Lost weight, struggled with anorexia
  3. Revised diet, found gym
  4. Started new life, met new challenges with weight loss
  5. Rebounded and felt defeated
  6. Trying to break out of it now

No prizes for guessing which is my favourite tank top!

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