The pros and cons of losing weight vary from one person to another, but there are some variables that remain constant. Some of the things I found interesting on my journey to lose weight and maintain a healthy lifestyle...

- The only person who truly cares about your weight loss is you, because you are the harshest critic when it comes to judging yourself

- It takes an enormous amount of will, motivation, and discipline to lose over 100 pounds; that teaches you how to overcome some of your shortcomings, deal with your weaknesses, or even incorporate them into something productive

- Fear of failure is infinitely more powerful than the desire for success

- The guilt that comes with eating unhealthy foods will most likely stay with you for life, even after you reach your goal weight

- People fall into 3 groups; those who are truly happy for you, those who are jealous of your success, and those that want nothing to do with you after you lose weight

- The possibility that some family and friends will cut off communication with you to the bare minimum because you remind them of what they could not achieve or their failure to lose weight

- The identifying glance between fat people will become confusing to some because you look at them with a familiarity yet they see the slim you and don't understand why you are so friendly; they are used to being treated with disdain

- Eating a rich meal/dessert will taste good going down but will feel like shit within half an hour (making you swear off treats altogether)

- Before you lost weight you couldn't jog because you were too heavy and your joints would scream at you every time you tried; now that your weight is not an issue you still cannot jog because you have exercise induced asthma and you're supposed to walk instead of run... you just can't win

- It is possible to fit into a size Small after fitting into a size 4X for half your life

- How inspiring your success could be to those who also wish to lose weight even if it's jealousy or contempt that motivates them

- It takes a wonderful husband to constantly remind you of your success even if it's in the subtle statements he makes

- There will always be people who refuse to attribute success to all your hard work and instead are more comfortable believing that you are sick or have some disease that is causing you to lose weight

- You will end up wasting a lot of clothes, and there will be days when you won't want to go out because you literally have nothing to wear that does not fall off your waist (that includes underwear)

- Second hand clothing stores are possibly the best idea EVER

- Even your feet will lose weight and you will end up with footwear that might have been extremely uncomfortable in the past but is now part of your essential wardrobe

- Make no mistake, your bra size will change too, though that may not include the cup size which makes it infinitely more complicated to find a style that properly fits

- Being able to wake up in the morning without heartburn or lead-belly is a feeling that can't be beat, not even for chocolate lava cake

- You will go from absolutely dreading it to looking for opportunities to exercise (including the 20 minute walk in minus 1000 degree wind chill with a lame excuse like grabbing the mail)

- That you can still appreciate fat jokes (and ones about skinny people too)

Since losing weight I've had a lot of people compliment me on all my hard work. The majority of them believe that I lost the weight by banning all the foods I love and doing all the exercise I hate. They are often surprised when I mention how instrumental my dietitian was in helping me lose weight.

I've been told that perhaps I'm giving too much credit to my dietitian and not enough to myself for managing my weight loss. I have to stress that I don't think I could have lost that much weight without her help. A dietitian is someone who helps me create a balanced meal plan that is suitable for my body. She also helps me maintain my weight loss by motivating and encouraging me when I don't believe I can do it, or also keeping me from jumping off a cliff on those days when I'm adamant that it was the cupcake I had for my daughter's birthday that prevented me from losing an extra pound this week. Frequent weigh-ins with my dietitian keep me accountable to myself; to know that the weight loss is attributed to an effort I put in as opposed to sheer luck, and the weeks I gain weight are not necessarily a result of something I did. The visits help me stay focused on the positives. As a fat person I already give myself grief about my weight; I don't need a dietitian to do that for me. Similarly, I don't need someone to remind me that if I don't lose weight I could die from heart disease. That's the doctor's job (which he does very well).

I believe a good dietitian is a food therapist if you will. They're not interested in judging you or the choices you make, rather in helping you make better choices that will ultimately bring you closer to your desired goal. That includes, but is not limited to, giving you the freedom to eliminate foods you don't like, and eating the foods you do like, within reason, if those foods are not part of a healthy meal plan. Typical by-the-book dietitians are a lot like banks in that they put everyone in a series of buckets. You fit in bucket A, B or C; high risk, medium risk, or low risk investment. If you want something more tailored to suit your needs, then you may want to invest with an actual funds company that specializes in nothing but investments as opposed to a bank who offers homogenized investment opportunities. A by-the-book dietitian labels and puts you in one of those buckets because it's easier for them to do that than to customize a bucket just for you. A good dietitian is one who puts the effort into knowing you and your life style, and customizes an individual plan that will work for you. The difference between the two is subtle, but it's apparent in the little things they do and speaks volumes about their perception of fat people.

I have yet to see a fat dietitian. Most of the ones I know are skinny or average at most. So naturally, they lack the "fat perspective". Don't get me wrong, they know all about fat and what it does, but they have no clue of what it's like to go through life being fat. Fat people know they are fat; they are not in denial about it. There's a portion of the population who think fat people deliberately overeat, and don't care how they look. That may be true for some but not all of us. I have yet to meet a fat person that has not tried to lose weight in some way. Why do you think weight loss scams are so successful? It's because fat people know they are not accepted. They want to fit in and in doing so they try methods that may or may not be successful. Some of us like to eat just as there are some people who like to drink, gamble, or what have you. The difference is that as a society we have been trained to see beauty in skinny people, whereas a fat person resembles whatever we find repulsive.

Typical dietitians (or skinny ones) have not gone through life with the nickname porky, pudgy, or fatso. They were not teased about their weight on the playground and were not ridiculed by classmates in gym class - not for their weight. As adults they don't get the brush off at high end clothing stores, and unfriendly smirks in sporting goods stores. Indeed, I have lost over 115 pounds in the last year; I've gone down from a size 4X to a size Small, but I'm still fat on the inside. I identify very much with fat people and I still see skinny people as outsiders. I think like a fat person. I still go into stores and subconsciously end up at the plus size section even though nothing fits me there any more. I still like the styles targeted towards fat people. It's nauseating when I walk into the high end clothing stores nowadays, to see the very same clerks who brushed me off 6 months ago swarming all around me to sell me something that not's even full price but rather a clearance item, so it's not a commission related thing. That is what I find repulsive. The fact that I couldn't get a clerk to even notice me when I walked into the store 6 months ago, or the ones that look me up and down and then say they'll be right there, and the striking difference in their treatment when I walked into the same store last week and saw the same clerk who greeted me with a big smile and even complimented me on my choice of outfit; it's astounding. That's the treatment I was accustomed to for the last 20 years of my life. As a result, I tend to pick up on those little involuntary yet derogatory gestures. I get it at most places, and sometimes I even expect it, but not at the dietitian's office. It's my safe haven; it's the place where I can safely admit that I am fat, that I don't like being fat, and that I want to change it. It's the last place I would expect to feel judged. If you feel judged at the dietitian's office, then someone let you down. If your dietitian judges you then they have failed you and themselves.

My relationship with dietitians and nutritionists in the past has been rocky. I've been told what foods I should eat and which ones I should not eat - should being the keyword. A good dietitian does not should all over you, rather suggests that you avoid certain foods, not all the time, but most of the time. I've seen moderate dietitians, and some really horrible ones. I can't recall the number of times, for example, that I've been told I have to eat cottage cheese for breakfast, despite alerting the dietitian to the fact that I would rather eat a bullet then put cottage cheese in my mouth. When a dietitian lumps you into one of the usual categories for fat people, they are inadvertently telling you that they don't really care about your health or the effort you are making to maintain a healthy lifestyle, because by limiting your options they ensure that you will not be able to maintain healthy eating habits. It's unrealistic to expect someone to eat a food they hate everyday. A good dietitian knows that. By the same token, it's unrealistic to expect someone to give up a favourite food forever. Telling some one who eats a cupcake everyday that they cannot have them any more is ridiculous, and guarantees that this person will never be able to maintain a healthy lifestyle. A black and white approach to food is not conducive to any kind of change let alone a positive one. A good dietitian is flexible and understands the value of compromise. Instead of having a cupcake once everyday, we can start by limiting cupcakes to 2 times a week and take it from there. The goal of both you and your dietitian is to create and maintain a healthy lifestyle without adding stress. It's those little things that to anyone else come across as insignificant but what it tells you is that the dietitian actually cares about helping you achieve your goal and is not simply labelling you to fit into some pre-set notion of what others think you should be.

I guess in a nutshell I would say that the difference between a dietitian and a good dietitian, is that the former treats you like a patient, whereas the latter treats you like a customer.

Before I go on about today's rant to demonstrate why so many people are reluctant to see a dietitian, I would like to respond to the many people who asked about my diet plan. I do not follow any special "diet". I think all diets are fads, and fail eventually. What I've done is essentially a lifestyle change. I incorporated a healthy meal plan along with exercise, and the additional guidance of a dietitian. Basically, I limit sugar, fat and sodium intake, increase my exercise to 4 or 5 times a week, and my dietitian helps me do that. This is not something I am doing just to lose the weight, but rather a shift or change in behaviour that I hope will remain with me for the rest of my life. 

Many people have asked me for the 'recipe' or secret method to my weight loss. I don't have one and don't know of any one method but what I do know is this. There is a reason why weight loss programs don't work the same for everyone. Successful weight loss programs often incorporate proper diet and exercise and more importantly guidance and accountability. I believe that a good dietitian is essential to successful weight loss. Not any dietitian; it has to be someone you like and get along with. If you do not like your dietitian you will resent the appointments and the weigh ins, and his/her advice will fall on deaf ears. I like my dietitian; I trust her advice and I appreciate her help very much. Open communication and a certain social chemistry is necessary to achieve your goal weight and more importantly, to feel healthy and happy. This week I was confronted with this reality. My dietitian was out sick with a cold, so to keep the schedule running smoothly, her office typically gets another dietitian to fill in while she's gone. This was the third time I saw someone other than her. The other times she was away, I saw a really nice lady who was equally professional. Unfortunately, this week, I saw a different person who was not too nice (which I think represents the majority of dietitians I've met during my never ending cycle of trying to lose weight). Where do I start?

The first thing I noticed and which caught me off guard was how rude she was. She cut me off mid sentence, several times. It seemed she was not interested in how I was really doing or what I had to say. She just wanted to hear herself speak.

She also provided unsolicited advice. She suggested (and I'm using this word liberally here) that I change some aspects of my diet because she does not think it will work. For example, she rhetorically asked "Can you eat some other fruit, because bananas have too much natural sugars in them and I typically don't recommend them to my patients any more than 3 times a week". She made two mistakes; a) she assumed I'm a typical patient which implied that she did not even look in my file to learn that in less than a year I have lost over 100 pounds, all the while eating bananas more than 3 times a week and b) she provided advice that indirectly undermined the expertise of my original dietitian; very unprofessional. She insisted she was right even though I mentioned that my dietitian never brought this up as it was never an issue and I have been losing weight steadily despite eating bananas more than 3 times a week sometimes.

I was offended by her condescending attitude. She complained about my meal plan and what she perceived as a lack of variety. Instead of asking me if I'm okay with the recipes or foods that I am eating, she arrogantly asked if I see myself following this meal plan for the rest of my life because she was concerned about the "lack of variety". When I confirmed yes, she insisted that "some people just do this until they lose weight and then they go back to eating unhealthy" implying that I'm going to be one of those people. I had to bite my tongue and politely explain to her that I do all my meals in advance and that as long as I like something, I don't have a problem eating it several times a week. I also explained that due to family history and other health issues, I am well aware of lifestyle changes and that I have no intention of going back to unhealthy habits. I did not think I had to explain myself to her and I felt like it was more of an interrogation as opposed to a discussion. I was offended.

She was unprofessional at best. She hadn't read my file and was not interested until I told her that I lost over 100 pounds. She was surprised and congratulated me but did not seem very genuine. This was confirmed later as I left the office. On my way out, I spoke to the receptionist. I advised her that my husband is interested in registering with my dietitian because he is impressed by how much weight I lost and he's looking to lose some too. I explained that he wants to see the same person I see. At that point, the dietitian interjected and stated with an exasperated tone that he can see her and that she's "had patients who lost over 100 pounds too". Clearly, she was interested in neither me nor my husband, but rather in her own image and how she appeared around the office. It was fairly obvious to me that she was resentful of my original dietitian. I don't really care about all that; it's office politics. However, it should not be apparent to the customer. It reflects badly on the entire organization.

In short, that dietitian had nothing good to say, complained about my eating habits and in general made a bad impression. I felt that she spoke down to me. I left the appointment feeling negative and completely unmotivated. If she was my dietitian I would not have lost all the weight I did. I shudder to think of how she makes others who have not had as much success as I've had feel. If I were part of upper management, I would make sure she goes nowhere near people. She is best served in a back office somewhere doing redundant paperwork. That's about all her brain can handle.

Though on the upside, it takes skill to be this ineffective at your job, and she's got it.