THE NONDIET PLAN
Regarding Charlotte N. Markey's article “Don't Diet!” I would like to say, simply, “Exactly!”
In December 2012 I weighed 200 pounds and was huffing and puffing when walking my steeply sloped property. My significant other recommended I monitor what I ate, so I set up a spreadsheet and recorded everything, changing nothing intentionally: snacking, eating out whenever I felt the urge, having a big steak now and then. I also weighed myself every day, at the same time every day, right after a shower. By January, I had a pretty good idea of what maintained my weight—except that, oddly, I had lost a few pounds, too. Interesting.
I shifted gears very slightly. My doctor suggested a good breakfast, a hearty lunch, a modest dinner. So I added a few calories to breakfast and lunch and subtracted some from dinner. I continued to lose weight. Very interesting. I then shaved a few calories here and there by adjusting portions and making sure that I was active after breakfast and lunch and that I ate dinner at least three hours before bedtime. More weight loss. It became a kind of game: Where could I adjust portions (and calories), still feel satisfied and continue to lose weight?
To cut to the chase, my doctor, initially pleased with my weight-loss program, was stunned with the results. Not only had my weight dropped to 160 pounds over a year, my blood pressure had gone from 145 over 80 to 116 over 68.
I continued for a second year, and my weight went down to 150 pounds and then stabilized at 162. There it has stayed for the past 18 months. I no longer use spreadsheets or count calories. To put it simply, I've found that my eating habits have changed. Do I still eat the occasional candy bar? Sure—and without guilt. Do I have a drink now and then? Yep. Do I feel deprived of anything I crave? Nope, because I don't deny myself anything; I just watch my weight. And my blood pressure is to live for.
And my steep property? Weirdly, it seems to have leveled out. I no longer huff or puff. My doc is happy, and so am I.
Grass Valley, Calif.
Recently I used a popular advertised diet plan to go from obese to a normal body mass index (BMI), and I have stayed within five pounds of that goal for about three months. I'm still learning the habits I'll need to stay there. I can testify that Markey is quite right about obsession and cognitive overload. I can also say that one of the pluses of my approach has been a modest time duration. It's been less than a year since I started, and I can see the end of the tunnel. With gradual habit change, I would probably have lost focus along the way.
MARKEY RESPONDS: O'Gorman raises a valuable point about the process of weight loss: Wouldn't it be great if weight loss could be faster? Other readers also wrote in about specific diet plans that have worked for them. It is important to remember that different things may work for different people. When scientists report their findings with the aim of informing interventions and treatments, they describe what works for most people most of the time.
We all (scientists and laypeople alike) would like to identify a diet that results in substantial, quick, sustained weight loss, ideally achieved through the absence of craving of high-calorie, sugary, nonnutritive foods. But to date, the evidence suggests that no diet meets all these criteria. The best reading of the research available suggests that slow weight loss from changes in habits is most likely to be sustainable for most people. If you find another approach that works for you and is healthy—stick with it! Otherwise, try what science recommends and leave the fads behind.
I read with great interest the article “My Son Has a Disorder That May Not Exist,” by Melinda Wenner Moyer. I feel as if Moyer has somehow read my medical records, which are replete with statements such as “has hypersensitivity in smell” or “in feet” or “in hearing.” All smells seem strong to me. I can't stand to wear socks or shoes, and I register even normal touch on my feet as intense pain. I also have incredibly sensitive hearing; for instance, I can pick out a conversation across a crowded room. I have been told since I was a small boy that I “overreact.” Now, at my age of 48, my wife continues to tell me this.
Moyer mentions that adults seem to have fewer sensory issues—or perhaps they simply manage their symptoms better. I believe that in adults these issues are being packaged with other adult afflictions or as a product of aging. I hope that people will see that learning about this disorder in both children and adults is a worthwhile endeavor and that research funding will increase.
FOLLOWING THE MONEY
This issue of the magazine was illuminating, as usual. The article “Raising Awareness or Drumming Up Sales?” by Melinda Wenner Moyer [Pharma Watch, Head Lines], was particularly informative, though alarming. A relatively new tool for patients that was not mentioned is the Open Payments program. Starting in 2013, the U.S. government has required pharmaceutical and medical device companies to track most payments made to all physicians, including psychiatrists and other specialists.
Consumers can see what payments their providers received by searching the published data. The interface is intuitive and quickly returns results. We are entitled as patients to see this information and to have a dialogue with our providers about such payments.
The data are collected and published by the Centers for Medicare & Medicaid Services. Here is the link: https://openpaymentsdata.cms.gov/search.
Castro Valley, Calif.
The Pharma Watch article erred in several respects by stating that the Restless Legs Syndrome (RLS) Foundation is “an organization that is heavily subsidized by GlaxoSmithKline.”
Although the RLS Foundation accepted substantial donations from pharmaceutical companies a decade or so ago, it has not accepted any donations from GlaxoSmithKline since 2012, when the company donated $20,000, less than 4 percent of our then annual income. The RLS Foundation is funded almost entirely by donations from individuals who are RLS sufferers and their relations. Charity Navigator has given the RLS Foundation its highest rating.
Contrary to the impression the article leaves, RLS is a serious medical condition with several known genetic risk factors. It affects millions of individuals in the U.S. and around the world. PubMed lists more than 3,500 articles discussing its causes and treatment. Your implication that RLS is an invention of a pharmaceutical company is unjustified and unscientific.
Karla M. Dzienkowski
Executive director, Restless Legs, Syndrome Foundation, Austin, Tex.
THE EDITORS REPLY: We apologize for the outdated information and any impression that this syndrome is not a real issue for patients. We should have written that the RLS Foundation was subsidized by GlaxoSmithKline in the early 2000s. As such, it fit the trend we hoped to expose: awareness organizations and campaigns are often funded by pharmaceutical companies to coincide with the release of a relevant drug.
“When Cops Lose Control,” by Rachel Nuwer [November/December 2015], wrongly included Trayvon Martin in a list of people killed by police officers. Martin was shot by George Zimmerman, a neighborhood watchman.