Chapter Ten

When you lose a lot of weight, you discover things you might not have expected. In this excerpt from Chapter Ten, I discuss one of them.

Twenty things you learn when you lose a lot of weight

While I was in the hospital, I lost close to sixty pounds real fast in the form of the water they managed to squeeze out of me with a diuretic IV, but that left me at 220, which was only slightly less than I’d been hovering at for a while. It took me exactly a week to break the 200 lb. barrier going down, and then about seven months to lose the next 20. It was exactly a year to the day after I went into the hospital that I dropped below 170 for the first time.

So it’s not a fast process by any means, and there are ups and downs along the way, although fortunately because of my changes in diet and lifestyle, the “ups” were very small and temporary, and never more than six pounds in a day, although generally I would also lose most of that gain by the next morning.

Here’s a fun fact: Yes, it is possible to lose weight while you sleep. In fact, it’s apparently totally normal, something I’ve documented by weighing myself twice a day, every day — right after I get up and go to the bathroom and right before I go to bed. Remember: We breathe in oxygen and breathe out carbon dioxide, which is 38% heavier than oxygen, so there’s some of your passive weight-loss right there. The vast majority of the air we breathe — 70% at sea-level — isn’t even oxygen, it’s nitrogen and other inert gases, so it just goes right in and right out.

Sweat can also remove weight while you sleep.

Here’s another fun but totally anecdotal fact that I’ve verified with my handy digital bathroom scale: A good ripper of a fart can actually make you slightly heavier! Although note that your results may vary and come down to whether your gas is predominantly methane or hydrogen sulfide, which determines whether you’re losing weight or losing buoyancy. Yes, that’s actually a thing. Gas inside your intestines can make you a little less dense and a little more “floaty,” or affect you the other way around.

The more you know…

Anyway, in my case, it was that rapid 20 lb. loss right at the start that helped really kick-start things for me and kept me from getting frustrated or really noticing (even until now) that it took so long for the rest of the weight to drop.

There are both pros and cons to losing weight. Some of them are probably pretty obvious. When you lose weight, you’re healthier, it’s easier to get around, seats on subways and in theaters are much roomier (although not necessarily more comfortable), and people don’t give you the stink eye when they see you coming.

But some of the benefits and annoyances will probably surprise you. What surprised me was not only going through them myself but, as I was researching for this book, finding people with similar stories and realizing that things that I experienced that I thought were weird were totally normal. Here are just a few of them.

* * *

It gets cold

For most of my life, I’ve been more a fan of colder weather than hot — which goes really great when you grow up in Southern California (sarcasm), and has gotten even less great as the weather has gotten hotter and hotter over the years. But when I was younger, I could have run around naked in the snow and worked up a sweat, but not have cared one bit or felt at all cold — but let it get much above room temperature and I’d have started sweating like crazy.

And this was always independent of my weight. Whether I was fat or thin, I always preferred it cold. That all changed this time around, but that’s probably an advantage. All of a sudden, the heat doesn’t really affect me at all while the cold does. This was probably why I willingly made so many trips to Palm Springs this year — I can now tolerate temps above 110ºF (43ºC).

This isn’t something that we’re all imagining, either. Called “cold intolerance,” it’s a real phenomenon with several causes. The most obvious one, of course, is that you lose a lot of insulation. For me, that translated into an 11- to 12-inch drop in waist size, from 42 to 30-ish. I saw “ish” because 31 inch pants are a little big on me while 30 are a little small, so I’m right in between. Another issue can be caused by Calorie restriction, which slows your metabolism. Lowering metabolism is like damping a furnace — less energy burned, less heat created.

In my case in particular, I had also developed a bit of anemia, although that finally cleared up. But it’s a condition that can also contribute to feeling cold. In fact, this is one of the reasons that women are often colder than men in the same situations and temperatures — losing blood can cause anemia, and menstruation leads to blood loss, which most men don’t even realize is a thing.

One of the places where I found a lot of confirmation of what I’d experienced was in a Reddit thread in the Ask Reddit sub with the question “Former fat people of reddit, (sic) what were some unintended side effects of your weight loss?” Feeling cold happened to be the most popular response, but far from the only one.

Yeah, who knew — useful information from an online news aggregator. (Actually, if you pick the right so-called sub-reddits, you can learn a lot.)

* * *

Read an excerpt from Chapter Nine or go to the Prologue.

Chapter Eight

In this excerpt from Chapter Eight, I begin to discuss some of the unexpected places where excess sodium, sugar, and fat are hiding and how to avoid them.

The dirty yet open secrets of food

Once my doctor and nutritionist taught me how to properly pay attention to those Nutrition Facts labels, I started to see traps everywhere. They were right. Sodium wasn’t just in the obvious places, like pretzels and chips. And although that was my only initial concern, I began to see that fat and sugar were hiding in places you wouldn’t think to find them, either.

There are some things that naturally have sodium when you wouldn’t expect it. For example, spinach actually has 24 mg per cup. Not a huge amount, really, and totally safe. The fruit and vegetable families are generally sodium-free, but there are still surprises like this. Here are some others, with their sodium count per cup: chard, 77 mg; celery, 81 mg; carrots, 88 mg; beets, 106 mg; artichoke, 320 mg; and seaweed, 792 mg.

Seaweed probably shouldn’t be that big of a surprise since it grows in salt water, but what about the most common shellfish? Those figures are, again for one cup: oysters, 193 mg; lobster, 401 mg; mussels, 649 mg; Dungeness crab, 669 mg; shrimp, 810 mg; clams, 1,364 mg; and Alaska king crab, 1,895 mg.

Since I’m going to cover all of the food groups, let’s look at meat. Those numbers are: beef, 59 mg; turkey, 109 mg; chicken, 170 mg; lamb, 186 mg; pork, 1,262 mg; honey smoked ham, 2,043 mg; bacon, 2,384 mg. The last three are a really good reason for pork to be considered tref and haram.

You wouldn’t think that the cheese aisle would be a minefield of sodium, but it is. A look at that list shows why the only cheese I eat anymore is Swiss — and I find the “Most Sodium” award winner in this category to be very ironic. The per cup figures are: aged Swiss, 440 mg; Jarlsberg, 1,053 mg; havarti, 1,187 mg; Gruyere, 1,378 mg; pepper jack, 1,405 mg; provolone, 1,419 mg; Brie, 1,428 mg; mild cheddar, 1,460 mg; string cheese, 1,703 mg; mozzarella, 1,703 mg; Gouda, 1,859 mg; imitation American, 3,053 mg; and deluxe American, 4,061 mg.

The per slice figures aren’t much more encouraging. Based on 20 grams per slice, they work out to be: aged Swiss, 35 mg; Jarlsberg, 93 mg; havarti, 105 mg; Gruyere, 121 mg; pepper jack, 124 mg; provolone, 125 mg; Brie, 126 mg; mild cheddar, 129 mg; string cheese, 150 mg; mozarella, 150 mg; Gouda, 164 mg; imitation American, 269 mg; and deluxe American, 358 mg.

Did I mention that I used to love to have grilled cheese sandwiches with eight slices of that imitation American cheese? Toss that between two slices of wheat bread and slather with margarine, and voilà: 2,555 mgs of sodium in a single sitting! As for the other figures, that one sandwich had 2,336 Calories, 171 grams of fat, 70 of sugar, and 165 of carbs. But it was just so damn delicious!

Was it any wonder why my heart conked out on me?

I already mentioned in Chapter Seven my annoying habit of eating an entire pizza in a sitting, with 1,360 Calories, 60 grams of fat, 2,840 milligrams of sodium, and 12 grams of sugar, sometimes adding extra cheese to bring it up to 1,520 Calories, 72 grams of fat, and 3,180 milligrams of sodium. This was also at the same time that I was having those English muffins with cheese and butter every morning for breakfast at work that I mentioned in Chapter Six.

So I was essentially existing on a diet of cheese, carbs, and salt. And where did the habit for that kind of diet come from?

I hate to do it, but I have to blame my mother. In the same way that smoking seemed normal to me growing up because she did it, I swear that she subsisted on a diet of cheese sandwiches. That was her go-to lunch late afternoons when she’d finished up the housework, and I remember many times when I was a little kid watching her at the kitchen table with the same thing: American cheese slices on Wonder Bread, which doesn’t really qualify for either word, with some Miracle Whip (not even real mayo) and mustard — French’s Yellow, which, I’m sorry, but in my opinion, is one of the worst tasting mustards I’ve ever experienced.

By the way, I only ever knew Miracle Whip growing up and did not experience real mayonnaise until I got to college, but as soon as I did… OMG, what a revelation. See, Miracle Whip has always been classified as a salad dressing and not mayo. It also has more sugar and carbs than real mayo, which has none of either and is lower in sodium. On the other hand, real mayo does have more Calories because it has more fat, so it’s a trade-off.

Did I mention that real mayo tastes a hell of a lot better than the abomination that is Miracle Whip?

But, as a kid, I loved the cheese sandwiches my mom would often put in my lunch and the grilled cheese sandwiches (swap mayo for margarine, but otherwise the same) she would make and the mac and cheese, made with longhorn Colby cheddar and a can of cream of mushroom soup. Both of those combined, even divided by the number of servings, were still ridiculously loaded down with sodium.

That’s the thing about soup — it is ridiculously high in sodium, almost without exception and, quite often, the “light” or “healthy” options are almost as bad. Here are just a couple of examples of Campbell’s brand soups. Their Healthy Request® Italian-Style Wedding Soup does only have 410 mgs of sodium per one cup serving, but switch to either the regular or light version, and suddenly you get 790 mgs. Their light creamy chicken Alfredo only has 100 mgs less sodium than the regular version, at 690 vs 790. The same is true for their New England clam chowder, but worse, with 790 and 890 mgs of sodium respectively for the light and regular versions.

“Vegetable medley” sounds like a perfectly healthy soup, right? Nope. It has the same 790 mgs of sodium per serving as some of the others, and that’s according to Campbell’s own nutritional info site. And don’t forget that a typical can of soup actually has two and a half servings in it. If you’re the type to ignore that information and just eat the whole can, you can find yourself on the receiving end of as much as 2,225 mgs in one meal — or in less than one meal, if you have a sandwich along with your soup.

By the way, I’m only picking on Campbell’s because they are one of the top brands in America, with four out of the top-ten selling soups in the market. In 2017, the company is projected to have over $7 billion in sales and gross profit of $3.06 billion. That’s a lot of soup. However, the tide may be turning there, with soup sales in the U.S. actually showing a decline beginning in 2009, and then very little growth after 2013. It’s not clear, though, whether the problem is the soup or the can itself, and Campbell’s has been moving away from metal containers to market two different lines: Campbell’s Go Soup, which comes in pouches, and Campbell’s Soup on the Go, which comes in a plastic container.

But don’t think that the packaging makes it healthier. The champion in this category for the Go Soups is coconut curry with chicken and shiitake mushrooms, weighing in at 830 mgs of sodium per serving — and the convenient pouch holds two servings. But, again, who’s going to split a container that seems designed to hold one serving?

At least both types of Soup on the Go are more reasonable, at only 410 mgs of sodium, and those containers are single-serving.

If I seem to be overwhelming you with math, it’s only because it’s something I’ve had to learn to live with and get used to. It’s not always possible to avoid absolutely everything in the grocery store that comes in a box or a can, but it is possible to make an informed decision. That’s why, for example, I only buy one particular kind of hamburger buns and one type of cheese. They are the lowest sodium brands available that I’ve been able to find in the regular store.

There are ways to go lower, but that gets heavily into “make it yourself from scratch” territory — although that isn’t a bad thing and I’ve gotten very used to it myself. Not that I’m going to start making no-salt cheese any time soon, but I have made re-fried beans, corn tortillas, and bread, as well as prepared horseradish, sweet and sour sauce, a soy sauce substitute, and both traditional and tofu-based tzatziki using no sodium at all, and they tasted just fine.

If you thought that everything in boxes and cans in grocery stores was bad, then stay out of restaurants. The sodium content in a lot of restaurant and fast food is outrageous. According to Pop Sugar, some of the most heinous examples include the Quizno’s turkey bacon guacamole sub, with 2,470 mgs of sodium; Dairy Queen’s 4-piece chicken strip basket at 2,530; Panera Bread’s bacon turkey bravo on tomato basil, with 2,290; Olive Garden’s Tour of Italy entrée at 3,830; IHOP’s country fried chicken steak and eggs with sausage gravy, 4,210; and Applebee’s chicken fajitas rollup, with 4,290.

However, the most staggering restaurant item is the Jersey Mike’s Buffalo chicken cheese steak, with a literally heart-rending 7,795 mgs of sodium per serving. For comparison, the most sodium-heavy item on the entire In-n-Out Burger menu is the double-double with cheese, at a mere 1,440 mgs of sodium. That’s less than one-fifth the amount found in the chicken cheese steak.

In 2017, the American Heart Association created a series of video spoofs awarding “MilliGrammy” awards to restaurant meals with high sodium content. Perhaps Jersey Mike’s didn’t quality in the national competition. After “accidentally” announcing the Big Mac Value Meal (970 mgs) as the winner, they corrected their La La Land-esque mistake and awarded the real winner, P.F. Chang’s Pad Thai, at 3,720 mgs.

* * *

Read an excerpt from Chapter Seven or Chapter Nine, or start at the Prologue.

Chapter Seven

In this excerpt from Chapter Seven, I explain the importance of those nutrition labels, and why you really should pay attention to just what it says on the tin.

Labeling, not enabling

Not long after I got out of the hospital — I think it was between two and four weeks, but I don’t remember exactly — Kaiser invited me to a free post heart-failure class, which was led by a nurse and a nutritionist. There were several dozen attendees in the room, and other than the nutritionist and one kid who must have been his grandmother’s ride there, I was by far the youngest person in attendance. And I don’t mean by just a couple of years. Everyone else there had to have been at least two decades older than me. If they weren’t, they sure looked it.

I found myself wondering why there was such a huge difference. As far as I could tell, no one in that room was a current hospital patient, so they all must have been through the same experience. Now, granted, my relative youth might have been an important factor, but I’m only assuming that everyone was so much older. Again, it could have been perception, and there may have been younger people in that room who were just a lot sicker.

After all, in the months before I’d gone into the hospital, I had looked a hell of a lot older myself.

But it was a strange sort of encouragement. I felt downright chipper and energetic, and if what I was looking at around that room was the alternative, then I had either really lucked out, really done something right, or both.

This feeling really kicked in at about the halfway point when the nurse had finished talking about the importance of physical activity, then said it was time for a stretch break and asked us to stand up. Three of us did — one patient, the aforementioned grandkid, and I. The nurse quickly covered with the request, “If you can’t stand up, just put your arms up.”

Some of those efforts were totally half-assed as well, and I really began to feel sorry for a lot of folks in that room, also remembering that not all that long before this class, I would have been in their boat, and not paddling along on my own.

I hope this isn’t making the class sound useless, though, because what the nutritionist taught us is still invaluable. It’s advice I follow to this day, and information I alluded to in Chapter 2. This is where I learned to start watching people in restaurants in order to see if what she’d told us was true, and it is — the first thing the vast majority of people do when their food arrives is to grab the salt and start shaking away, even before they’ve tasted a single bite.

She also taught us the importance of those nutritional information labels on the backs of packages that we often wind up ignoring, which brings up another one of those funny doctor moments.

Before I wound up in the hospital and as my doctor was scheduling my echocardiogram, I had mentioned my dieting attempts and how they weren’t working, but I insisted that I always read the nutritional labels. As the conversation continued, though, I realized that I wasn’t really reading the labels. I was only looking at the Calorie information, and only on a few items. After all, if you go by only Calories, an entire jar of 100 grams of olives only has 115 — but it has 735 mg of sodium. And a condiment, like a particularly snooty brand of mustard, only has 5 Calories per serving but 120 mg of sodium.

(Free grammar and science lesson: “Calorie,” with a capital C, refers to the things in stuff you eat. The other one, “calorie” with a lowercase c, refers to a specific scientific unit of measure, and is 1/1000th of a Calorie. No, I don’t know why, but the easy way to remember is that Calorie, with the big C, is bigger than calorie with the little c.)

My M.O. had only been to look at the Calories on pre-packed, frozen entrees, but I hadn’t given it a thought when it came to other things, like bread, buns, condiments, juices, and so on. I also gleefully ignored the serving size rules, meaning that the Calorie counts on the package became meaningless. After all, if the serving size is one fifth of a package at 260 Calories, eating the whole package would actually be 1,300 Calories, or a huge chunk of an adult’s needs for the entire day.

The hypothetical product I’m basing that on would also jump from an already ridiculous 960 mg of sodium to 4,800 mg — way over double the RDA.

Guess who used to ignore the serving sizes and consider “one package” and “one serving” to be synonymous? I used to eat an entire 12-inch pepperoni and sausage pizza for a meal. A meal like that was loaded down with 1,360 Calories, 60 grams of fat, 2,840 milligrams of sodium, and 12 grams of sugar just for fun. Sometimes, I’d even add extra cheese, bringing it up to 1,520 Calories, 72 grams of fat, and 3,180 milligrams of sodium.

Hey, at least the cheese didn’t add any sugar, right? And I won’t say which brand that pizza was, other than that it’s very appropriately named. What I will say is prepare yourself now, because pizza is one of those things that’s going to become very, very rare in your diet if you want this to work.

If your initial reaction to that comment was to express some degree of skepticism or disdain at losing out on pizza, then you are going to have to work extra-special hard at all of the tricks I’m sharing, because you are being your own enabler. In order to succeed, you’re going to have to learn to cut off all of your enablers, including yourself.

That cutting off begins by doing what I learned to do. Read those nutrition labels on absolutely everything.

* * *

Read an excerpt from Chapter Six or Chapter Eight, or start at the Prologue.

Chapter Six

In this excerpt from Chapter Six, I introduce three psychological tricks you can use to get yourself into the mindset for achieving a healthier lifestyle.

The first three steps to a new you

How did your first diary entry go? Because you did that, right? Good. Now this chapter is going to give you three specific things to do that will help you get into the new mindset necessary to go on this journey and make it easy. We have a lot of old habits and lifetime programming to undo, and a lot of new ways to learn until they’re second nature.

Don’t let that sound daunting to you, because it isn’t as scary or difficult as it seems. I’ve got a nice analogy to explain the process to you, and it comes from my summer camp adventure as well.

We jammed a lot of activities into that weekend, and two of them were things that I’d never done before: canoeing and zip-lining. Now, the old me would have just said, “Well, I don’t know how to work a canoe and dangling on a cable is scary, so I’ll be in my cabin.”

New me was all about it, and a funny thing happened once I got out on that lake. It was a three man canoe, with me in the front, another paddler in the back, and a passenger in the middle — and I found that being able to control that boat was almost intuitive. Before we got out there, I’d thought that it was going to be difficult, we’d hardly move anywhere, maybe we’d wind up going in circles. Nope. We got that canoe going a lot faster than I’d thought possible, and I was doing most of the steering, maneuvering around the lake and avoiding other canoes and people who were fishing.

When that experience was over, I was let down only by the fact that it had been way too brief a trip. I could have paddled all over that lake all day long.

So the lesson there is don’t judge the difficulty of an experience before you’ve tried it, because you may be totally wrong. But the bigger lesson came in the zip-lining.

That experience was somewhat like my first time on Space Mountain — a lot of build-up to the big moment. The staff at camp had to teach us about safety, fit the harnesses and helmets on us, make sure everything was secure, then send us on our hike around a meadow and up to the launch platforms.

Funny how much higher up those platforms seemed from on top of them, but by that point I’d committed. If you’ve never zip-lined, it works like this: You’ve basically got your legs in a harness, and that’s what’s holding you up. This is connected to a rope that has a huge carabineer on the other end, and that carabineer hooks onto the zip-line itself.

All of that’s the easy part. The hard part is literally a leap of faith, because nothing happens until you step off of that platform, and that’s the bit that really takes trust, courage, and maybe a little bit of stupidity. The first time I went, I hesitated for a second or two, and then just let go.

And that’s where the real lesson comes and the magic happens, because once you start going on that zip-line, everything else is physics and gravity. The hard work is done, and your only job is to enjoy the ride and hit the ground running.

I must have liked it, because I went around five times and, again, would have gone more, but we’d hit the time limit for the event. And while taking that first step was always a little weird, it got a lot less scary, but the fun and the adrenaline rush was entirely worth it.

Following the steps I’m going to give you is just like zip-lining. I’m going to provide the instructions and the harness and point you on the way. Then it’s up to you to step off that platform and enjoy the ride. The first step is the hardest, but once you take it, the rest of it follows right from the rules of nature.

For the impatient sorts, so you don’t have to peek ahead, here are the short forms of those steps:

  1. Get out of your routine
  2. Get out of your space
  3. Try something new

One important thing to remember: Some of these may work very well for you and some of them may not. You don’t have to use all three. If you can, great — but if you find one that really does the trick, then stick with it and don’t worry about the others.

Are you ready? Okay. Strap on your helmet and let’s step off the edge.

* * *

Read an excerpt from Chapter Five or Chapter Seven, or start with the Prologue.