So, I'm...uh...starting a diet.

You know, after just having published a post trashing the "diet industry" I can understand that WTF look on your face.  Didn't I just rant about how they're all a bunch of liars and stuff?  Yep, I did.  And so now I'm saying I'm starting a diet?  Yep, I am.  Much of the frustration in the post about the diet industry came to a head when evaluating this program.

Anyone who knows me knows I'm a big guy.  And the fact is that I've been very lucky as a big guy.  I'm not diabetic (although I am pre-diabetic at this time - readings have been stable for 5 years), my cholesterol is pretty normal, and generally I don't really yet have any of the life-threatening complications of obesity.  I do have knee pain however which is impacting my daily life.

The motivation behind starting this program is twofold: one is I would like to be more mobile and active.  I want to do more fun things.  Secondly I am deathly afraid of diabetes.  I've seen too many stories about people needing dialysis or having limbs amputated.  That stuff scares me to death.  I really want to avoid that.  And studies have shown that diet and exercise is VERY good at keeping "pre-diabetes" from becoming diabetes.

The program I am starting is the HMR Weight Management Program.    HMR is a national company but the local program (which I've linked to) is run by/affiliated with the health group that I go to, the Palo Alto Medical Foundation

I chose this program for a few reasons.  Firstly, I like the fact that it's closely aligned with PAMF.  While the "HMR" company does make money off of the stuff I buy the fact is that PAMF itself doesn't.  The profit motive here just didn't feel that high.  I didn't feel pressured. 

Secondly, the program I am doing is medically supervised.  I will see a nurse every week and will be seeing a doctor once a month.  Blood work is done every two weeks.  They keep a very close eye on your health during this program.  And since PAMF/Sutter has a pretty good computer system it means that they have access to all the data and results from my PAMF primary care doctor and my PAMF doc will get to see the data/lab results they collect in the HMR program.  I like that sort of integration.  It will help them "realize exigent synergies". *snicker* 

The program is a "VLCD", or Very Low Calorie Diet.  They have 3 basic levels of the program: weekly doctor visits, monthly doctor visits, or no doctor visits.  The amount of supervision also ties in to how many calories you get.  The good news is that I'm healthy enough to only need monthly doctor visits.  (This saves money.)  And although I only see a doctor monthly I do see an RN every week to get my vitals checked and to discuss how things are going from a medical perspective.  But I am still doing a level that requires medical supervision because I want it to be rapid and effective.  The program gives you a "minimum prescription", and on the monthly supervision plan that is 800 calories a day.  Yeah, that's pretty damn low.  (800 calories is the point between a Low Calorie Diet and a Very Low Calorie Diet.)  Every dietician I ever talked to said I shouldn't go that low.  But the idea here is that it can be safe when you're being closely monitored.  That's why the program is medically supervised. 

Also, HMR has a slogan: "More is better".  If you're hungry you're supposed to have another shake.  So the 800 calories is truly a minimum - it will probably not be actually what I take in.  I will be curious to see what my actual intake is.  I may not end up on a VLCD at all, at least not technically.

The shakes come with vitamin pills in the box, not something you have to buy separately.  (That was one of the things that made me feel nice - they don't make you buy any "extras" - it's all built in.)  Also I have been prescribed ursodiol to avoid the formation of gallstones.  Apparently before they started prescribing this drug to their patients they say about 1/3rd of them getting gallstones.  With this drug they saw that drop to 4%.  

I won't say that I'm not concerned.  Dig some of the possible side effects:

    • Constipation/Diarrhea
    • Dizziness
    • Fatigue
    • Cold intolerance
    • Temporary hair thinning
    • Gastrointestinal distress if you go off plan
    • Leg cramps
    • Gallstones (see above)

Holy crap.  I've never had a diet list side effects like that before.  It seems a bit scary.  Part of that may be why I'm doing it - if it's this intense then it had better work.  

They also include exercise in the program.  They want everyone to start with walking - hopefully they'll listen to my Ortho doc and be sane about it.  I've worked myself out to the point of having to spend days off of my feet before.  I don't intend to do it again.  I will be very careful about exercise until I start to see some real progress (and hopefully less knee pain).  

The good news is that I at least bought a new toy for the diet.  (Anyone who knows me knows I love a good excuse to get a toy.)  I got myself a Blendtec blender.  Yep, from the "Will It Blend" folks.  I am now prepared to mix the hell out of those shakes, yo.  (And keep quiet all you VitaMix nazis. They're both fine blenders.)

I will also continue to use DailyBurn to track both my diet and exercise.  (Interested folks can see my public profile there.)  I will also be tracking my weight there.  I won't be using their weigh-ins since they are done with clothes on and such.  I also plan on getting a Withings scale once I've lost a bit so that I can get my weigh-ins automagically uploaded to DailyBurn.  

I have high hopes for this program.  It is "decision free".  None of the food I eat will be from a store, so I'm hoping that by taking shopping and other decisions out of the equation for a while I will be able to get a handle on things.  I know that these types of rapid diets have a tendency to also involve rapid regain, so I know I'm signing up for a "lifestyle change" here. But my hope is that the positive results will reenforce the lifestyle changes.  Wish me luck!