Sunday, June 30, 2013

Day Thirteen

Saturday I had fruit and a 16oz latte in the morning and went to trader joes in the afternoon. I bought more hummus (hummus is not low calorie) and carrots and a sample. I bought a frozen chicken tikka but I didn't make it. I snacked on carrots with hummus for the entire day and had another peach. I did not eat anything after about 6:00, but I did have a glass of wine. I had some vivid dreams, not for the first time since starting the drug, but I will now track this.

I am at panera right now and they have a stupid internet policy that I can only use the internet for half an hour, and I need to post this right now, so I cannot publish a additional speculation today.

Saturday, June 29, 2013

Day Twelve

Another Friday, another single slice of pizza, feel pretty good, have plenty of energy, also had some sauteed brussel sprouts for dinner (and a beer). I have a thing to do on Saturday so I will probably prepare for that and get some sleep instead of finishing this.

Thursday, June 27, 2013

Day Eleven

coffee, coffee, slice of pizza, coffee, florentine, half egg sandwich, beer. Pretty much nothing on this list is "good" for you, but I didn't feel the need to eat very much of it, so I would say I did well today.

My face looks thinner, my relationship with food is improved, and weirdly, I feel like I have more energy, although that may just be the million or so cups of coffee I drink.

I feel like I have been eating less than those on this pill are typically expected to, but I feel I have found an amount of food that I am satisfied with for the whole day, and for which I do not think about food often. I haven't really spoken about my goal here, but briefly, my goal is to lose 60 pounds of fat by December when I am getting an important knee surgery that I'd like to be thin for. If the drug turns out to not be affecting me (a theory which seems to be losing credibility), or if it stops working somehow, or if 60 pounds turns out to be an unrealistic goal (which it might be, but I think I am extrapolating alright).

By percentage of my weight,  60 pounds is roughly 16%.

Day Ten

some pretzel sticks in the day and a half an egg sandwich and some bread and tomato sauce for dinner. I snacked on carrots and after. I ate when I was hungry, and aside from that I thought about food very little. I almost forgot about the blog.

This is probably the most positive result I have reported so far, so temper it with the fact that I have only been doing this for 10 days.

Wednesday, June 26, 2013

Day Nine

I made an objectivity error, and read someone else's account of their experience on the drug. It does seem to line up with my own experience, here is a link to it, but I fear my future objectivity might have been tainted by suggestion. It is worth noting that this is the first account that I have read.

Today I had carrots and bread with tomato sauce for dinner. I later snacked on some blueberries and a cookie. I also had a beer. I wouldn't be surprised if they find that alcohol to some alters the effect of the drug significantly, but I'm not sure how you would measure such a thing.

Alcohol acts on the serotonergic system, and while it is not clear how it does this, it is also not clear how Belviq works. My first time mixing the two I felt much drunker than I should have after a glass of wine, but I did not notice any increase in appetite corresponding to it. I have recently begun having a beer with "dinner" and I have also been hungrier later into the night. Not hugely, and it certainly isn't a problem. I usually just eat some carrots and maybe a cookie, and I'm satisfied.

If I had to guess this is more likely a result of not eating anything at all during the day, than an effect of alcohol, but it is a little odd because I am quite satisfied after dinner.

Tuesday, June 25, 2013

Day Eight

Coffee and cider in the day, carrots with hummus and bread for dinner.

Eight days is reaching the point that most of my diets do not last longer than, but it's unknown how much Belviq itself is responsible for this.

I don't have anything else to say, probably more tonight.


Sunday, June 23, 2013

Day Seven

A box of raspberries, a mini-bagel with hummus, and a beer until dinner. We went out to eat for my grandfather's birthday, I was happily full well before my meal was finished, and I managed to stop eating without feeling sick about my decision. 

Ordering a plate which contains more food than you want to eat, and then eating all of it, is an american tradition, and one in which I have regretfully participated many times. It was still not trivial to prevent myself from doing this tonight, but my fullness caught up with my hunger pretty quickly, and even though I stopped about halfway through. 

I'm hoping that this, I guess I'd call it food worship, is more of a habit than a psychosis. In the former case, then it is a habit I am reasonably confident of breaking. I also feel very very full after eating a reasonable amount at dinner. As of writing this, I still feel quite full.

An interesting sort of side effect. A lot of the thoughts that distract me during the day at work have faded, and the feeling of being bored is different than it used to be, and does not trigger the same sort of compulsive behavior. I'm not sure if it's that my usual go-to compulsion is eating, or if it's the drug behaving in a more general capacity than advertised, or if I'm just making this up. 

I wanted to talk a little more about standard dieting and why it seems to fail for me, dieting is all about how long you can sustain the illusion that you enjoy losing weight more than you enjoy eating burritos. While it is true that you want to want these things, it is not actually true that you want them. It usually comes after some sort of rock-bottom type scenario (though sometimes it's as simple as looking at yourself on a security camera TV instead of a mirror, and having your self-image delusions briefly removed). But this illusion that you want weight loss more than you want to overeat is impossible to maintain indefinitely, and it's broken the first time you "cheat" on your diet.

Anyway, this was a good day for me, and I feel like I had much more success overcoming this particular behavioral problem than I have had in the past.

Day Six

I spent the day at home, and as such had the opportunity to eat when I was hungry. Over the course of the day I ate a whole bag of carrots, a half a container of hummus, an egg, a piece of toast and a beer. I felt quite full for most of the day. 

I don't really have anything to talk about, and I am very late writing this so I will come up with a better entry tonight.

Saturday, June 22, 2013

Day Five

Well, I don't know what I was expecting. I had one slice of pizza, and it made me full, I was hungry a while later, but I had some juice and that seemed to be that. I had a peach when I got home, and an egg on a piece of toast for dinner.

I am no longer perpetually ravenous, and my stomach does not feel as bottomless as it once did. I am still hungry though, because I have been underfeeding myself, despite my promise to not do so. I speculate without any sort of justification that this is because I feel very strong feelings of guilt when I eat food. I further speculate that, while the ravenousness (raven?) has been removed, the guilt has not. 

Whatever, enough about me. The point is that the compulsion to eat is basically gone, and that's, more than anything else, what I wanted. It remains to be seen if this will last, or even if this is a delusion. However I did not start this experiment without some knowledge of my own typical attempts to lose weight through caloric restriction. I should have probably included this in the first post, but here it is anyway.

The first day I don't eat very much, and I am thinking about this constantly, I search for distractions, but fruitlessly so. If that first day was successful, it's because I went to sleep very very early. The second day is harder, but I eat more. I try all sorts of tricks to keep my hunger in check. The third day is usually quite successful, as are all the days after it until... at some point during the rest of the week there will be some food available that I simply do not want to resist. Pizza is a good example, but more often than not it's just being invited to dinner with friends. From a net-caloric standpoint, I can still possibly do well on this day, but the cost of still being hungry now no longer outweighs the benefit of not eating what I didn't eat.

This cycle may or may not then repeat itself, and, eventually, one one of those not quite bad days, it was actually, verifiably, a bad day, and once a single bad day has occurred, the probability of having a bad day has now been established to have a non-trivial lower bound. I have yet to find a strategy for undoing this seemingly minor damage. You can try to think of it as "starting over" as in trading in your 5 year sobriety chip for a new sponsor. but that seems like a huge failure. You can try to ignore that day, but that establishes a precedent of having ignorable days, and as soon as that's allowed, it is taken advantage of more and more.

I think it's accurate to say that a chink in the armor of discipline will eventually widen to a crack, and the armor will become useless until it is reforged. And the chink in that armor is that, when it comes to food, theres a lot of types of it that you're not willing to give up permanently. 

I have been lucky enough to have encountered exceptions to this rule, but they all involve my being very active, and I think weight loss should at least persist through injury. 

Thursday, June 20, 2013

Day Four

Today I ate 2 peaches, some brussels sprouts cooked in butter, garlic, and chicken broth, and some cheese and crackers, probably less than half of a sustainable diet. I think I did not strictly follow my rule to eat whenever I am hungry, but I didn't feel miserable. I am curious to go off the drug, to see how much more difficult it is to not eat, but I think I would need to hire someone to switch my bottle with placebos at a random time to get any reliable information out of that experiment. 

I don't have much else to report so I thought I'd talk briefly about the AMA decision to classify obesity as a disease. It seems like a matter of consistency. Why would you treat an inability to focus on schoolwork any differently than you would treat an inability to manage your weight?  Depression, addiction, ADHD, OCD, and now poor weight management. All of these diseases were basically conjured out of the drugs which improved them. The classification of disease is a demand driven market. If you aren't taking a drug to manage a disease, then what you are doing is recreational drug use, and there is a lot of stigma surrounding that. 

When science discovers the mechanisms by which our faults are manifested, we may choose to continue to call them faults, but the defensibility of that position wanes. Remember that someday they might well come out with a drug which alters one's sense of self-righteousness over not taking drugs. 

Back to Belviq, tomorrow is pizza for lunch. I have literally not yet managed to eat less than 4 slices of pizza at lunch, and I have felt very bad about doing so every day, so this should be an interesting experiment.

Wednesday, June 19, 2013

Day Three

Today I had coffee and apple cider until I left work. My grandparents were celebrating their anniversary and we ate an an upscale italian restaurant. I have never been so drunk from two glasses of wine. We stayed there for three hours and I didn't feel entirely comfortable driving home. The food was tasty, but the portions were not large, this would normally bother me but today I felt fine.

Normally, I experience a deep seated impulse to eat everything on my plate and everyone elses. Sometimes I am able to fight it, sometimes I am not, but I don't believe that it has ever gone away. In college, as a social experiment, I started sharing my food with my friends. The result was worrying. I don't know if it was just greed, or some more specific psychosis, but even sharing food that we picked up from the dining hall, a FREE buffet, was psychologically exhausting. When I look at a menu in a subway, it is a feat of restraint for me to not order the meatball sub. The very thought of eating not quite enough to leave me stuffed is painful in almost precisely the same way that it is for me to admit that a republican is right about something. (If you are a republican you are free to insert the word democrat into that sentence without, I suspect, any alteration in meaning).

Today was different (though I can't stress enough the power of wanting something to be true) in that something about my appetite seemed more detached, and sharing food did not seem like a tremendous struggle. It wasn't that I wanted to share my food, I was pretty hungry by dinner time. It was more that it didn't feel like the world was going to end if I didn't eat all of the food myself. Like the starvation switch had been turned off. 

That's all I have to report for today.

Tuesday, June 18, 2013

Day Two

It seems to me that the market that Belviq is after are those people who could otherwise only have lost weight through surgery. This may seem like an extreme position, but it is hard to deny that, on average, people tend to gain weight rather than lose it. Here is a New York Times article discussing how hard it is to lose weight permanently.

That said, I think the most effective case study i can do is one in which I do not try too hard to lose weight. So today I tried to eat what I wanted to until I was full, repeating that process whenever I was hungry. I think this worked well.

I took a pill in the morning at about 9, ate a peach, and left for work. At about noon I stopped asking myself every 15 minutes if I was hungry. I made myself some hot chocolate for lunch, took a pill when I got home, and had carrots and triscuits with cheese for dinner. This is a factor of three at least less than what I usually eat at this time, but I almost certainly did not accurately model my regular level of impulse control.

The most noticeable effect of the drug so far is that my abdomen feels warm. I have no idea what this means.

If anyone reading this has picked up a prescription to test it out, please let me know in comments, I'd like to get as much data as possible.

Monday, June 17, 2013

Day One

Full disclosure: I own stock in ARNA, I am not otherwise a representative for the company.

I am writing this blog because FDA studies are somewhat difficult to decipher as a consumer, and because I own stock in ARNA and I want to have as much information as possible. What I present here is not medical advice. At best, everything I report will be anecdotal, and will not apply to everyone. At worst, it will be extremely subjective, uncontrolled, and riddled with my own personal hypochondria. The only promise that I can make to anyone reading this is that I will make investment decisions (in the future) based on what I report here, and that I will try to make this as objective as a self-administered case study can be.

Today 6/17/13, I went to the doctor and got a prescription for a bottle of Lorcaserin HCl. The doctor did not know what it was, so I told him it was an appetite suppressant, and that I was looking to lose weight. He wrote me a prescription and also recommended that I get my thyroid checked. My BMI is 41, which surprised me, as I never thought of myself as "morbidly obese". I have been quite athletic in the past, and I think that I am at a pretty good weight around 200 lbs, or a BMI of about 29.

I filled the prescription at the CVS and took my first pill one hour ago with "dinner". My eating schedule is pretty erratic. I basically live on coffee and a yogurt, or maybe a bag of chips until dinner, at which point I basically make myself food and eat it standing up until I am full, then I snack until I fall asleep. On Fridays, my office has pizza, and I usually eat way more of that than I should (about 4 slices), and then I eat a lighter dinner, but Fridays are not good for me.

Tonight I got home late, and I usually don't eat much when I get home late, but I had some carrots and a peach, and some yogurt. I feel fine, but I usually don't feel hungry when I get home late so no news there.

Next post tomorrow night.