On Being Skinny Fat

I've gained nearly nine pounds recently that have been making me very unhappy. I don't feel good in my clothes. I don't like how I look naked. I feel self-conscious about what I imagine other people are seeing and thinking. So sue me, I care what I look like and I care what other people think. I want to be attractive. I'm not alone in that. At all. Although I certainly feel very alone in admitting it.

Although nine pounds might not seem like much, it's a lot on my 5' frame. It's 10 percent of my body weight, 10 percent that I simply don't need to be lugging around. I'm a Lifetime member of Weight Watchers. I have been for more than 10 years. I went on WW after I had my daughter, at which point I weighed 176 pounds. I was beyond miserable.

I tried to convince myself that I was fine with it. "I have a great life and a beautiful, healthy family. That's all that matters." "You are the only one who cares about your weight and why should you care?" "You are not defined by your weight." But the truth was I wasn't healthy. I did care. And, in some ways, I am my weight. Whether I want to deny it or not, how I take care of myself is a big part of who I am.  And based on my build, that number on the scale, at least in terms of my body make-up, meant I wasn't taking care of myself.

The thing is, we can only really know if we're healthy if we get a truly accurate assessment like a DEXA scan, for example. (Too many of the other available tests, like caliper testing, are painfully inaccurate.) Dexa is dual energy X-ray absorptiometry, which uses X-rays of two different energies that scan the body. Fat absorbs one more strongly than the other allowing a computer to determine body composition, body fat percentage, and bone mineral density.

I finally had one of those scans and it has changed me. Completely.

I went to Canyon Ranch Miami to do a four-day detox program. You know, no alcohol, healthy eating, some yoga classes, a few spa treatments, some detox juices, and meetings with a nutritionist and a doctor. Honestly, I didn't expect much more than a pampering weekend that would give my system a break from my usual less-than-healthy habits that included tons of Splenda, too many sweets, and skipped meals in an effort to make up for my sins.

What I got was a whole new way of looking at my weight, my health, and how I eat. I wasn't planning on getting a DEXA while I was there. But when I heard they had one, I was really anxious to check it out. You lay on a table and the machine moves slowly down the length of your body, x-raying every inch of you. You can't hide from the DEXA and that's what makes it so great.

It doesn't judge you. It doesn't have any preconceived notions about you or about weight in a social context. It doesn't care about anything except your age and the make up of your body. As I lay on the table, listening to the machine whir above me, I tried to chat calmly with the guy operating the scan, my exercise physiologist at Canyon Ranch Miami, Jeffrey A. Dolgan, MS, CSCS, HFI, RCEP. But I was too nervous about the results to focus on the conversation.

It wasn't designed to detect a specific and defined life-threatening medical issue like a brain tumor or a blocked artery. But it was going to tell me my true body fat percentage and distribution as well as my bone density. And there would be no way to deny the results. I think I was equally afraid that it would tell me I was fine just as I was terrified that it would say I needed to lose weight.

Before I saw the scan, my goal was to lose eight pounds and some change and, go figure, that was precisely what the results of the scan recommended. There’s a name for this phenom - "skinny fat." I’m skinny fat. I look "fine" but my body fat percentage is 37 percent, which means I am only 1 percent away from being in the "unhealthy" range according to Dolgan.

Two things struck me at that moment.  One, it's true: You cannot tell a person's health just by looking at them and, two, I know my own body. I also felt incredibly empowered by having the facts. I have every right to be unhappy with my body because my body was unhappy with itself. And frankly, I felt relieved that I have every "right" to express my discontent because now it has a medical backing. I'm not just whining about being too fat. I am too fat. I may not be overweight. But I am overfat.

Who would have thought that hearing someone call me fat would actually be a happy thing? Ok, I wasn't happy exactly, but relieved. There was no guessing. There's nothing "just in my head." I need to lose eight pounds of fat and, ideally, gain eight pounds of lean muscle as well (although the latter is going to take me significantly longer). Dolgan recommended a series of strength training exercises to do every other day, as well as advised me that I needed to get some kind of cardio every day for 30 minutes.

But that was only part one. Then it was time to talk to the doc and the nutritionist. I was scared to death of what they'd say and they both said exactly what I didn't want to hear. I had to change the way I eat. I had to.

After I revealed all of eating habits and digestive complaints, my nutritionist at Canyon Ranch Miami, Larisa Alonso, MS, LN, CNS, insisted that I give up Splenda because it is effectively making holes in my digestive system. She prescribed a two-week hiatus from sweets because of my addiction to them. She gave me a list of veggies that I needed to buy organic. And she drew a picture of how my plate should look at lunch and dinner -- half veggies, one quarter (3 ounces) of meat and one quarter (half a cup) of starch.

She told me no more skipping meals and no more fruit binging. She recommended food sensitivity testing due to all of my stomach issues and suggested staying away from BBQ and fried food. I could have cried. I love Splenda and sweets and carbs. And I hate veggies. She told be everything I didn't want to hear. She called me an addict and a disordered eater and it felt like a relief, once again, to hear it out loud. It's my truth and pretending it isn't wasn't helping me.

The doctor, Karen Koffler, M.D., had, not surprisingly, remarkable similar things to say, adding that I should avoid microwaving things in plastic and should start using a "green" dry cleaner.  She also suggested taking probiotics, eating more cruciferous vegetables, and talking to my doctor to see if my body is estrogen dominant. In other words, I needed a complete overhaul.

I moped for a couple of good hours. Why should I have to do all of these stupid things? Why can't I just eat what I want? Why does it have to be so hard? Then I got over myself and decided to commit. Seriously commit. I wasn't hurting anyone but myself with what I was doing. But I was doing some serious harm that was only going to get worse as time goes on.

So here I am, almost eight weeks later. I haven't touched Splenda or sweets and 85 percent of my lunch and dinner plates look like her Alonso's drawings. I've only had alcohol on two occasions since my visit and fried food has only twice made its way from my dish to my stomach. I am still working on the daily cardio and every other day strength training. But I am getting darn close to the schedule prescribed.

I'm already down to 101.8 pounds and I already feel totally different, both because of being lighter and because my digestive system is so much happier with me. It hasn't been easy, especially since I went to Disney World and Sea World the days following my time at Canyon Ranch Miami. But I have already learned to simply say, "No, thank you" to what I would have usually said, "Yes, please." And I have learned to ask for less of what I shouldn't have and more of what I should.

Am I giddy about it? Not at all. I hate it. But I hate feeling uncomfortable with my weight even more. Sure, it would be great if being healthy was my main or only focus. But looking fit and being happy with the numbers I see on the scale and on the tag inside my jeans is important to me. And even my nutritionist said that she doesn't care what keeps me eating healthy, as long as I do it.

When it comes to our bodies, it has to be about whether our body fat percentages fall into the healthy or the unhealthy range. When it comes to food, it can't just be about what we want, it has to be about what our bodies need. When it comes to our doctors, it has to be about the truth, even when it hurts.

I feel better than I have in a long time, and I cannot wait to lose the rest of those eight pounds of fat and gain some lean muscle. I can already see the changes in my body and the muscle delineation beginning to show itself.

I look forward to checking back in at the Ranch and getting gold stars from my doctor and my nutritionist. I look forward to lying on that scanner table again and having my exercise physiologist remove the "skinny fat" label and replace it with "healthy." I, of course, am the only one who can then apply the "happy" label. But that should be no problem when those extra pounds of fat are a thing of the past and nothing but good health is waiting for me in the future.