Permanent Weight Loss

©2007 Douglas Crockford


My interest in Blissymbolics got me interested in linguistics. That got me interested in the origin of language. That got me interested in the origin of man.

About the same time, the stress of life in an internet startup caused me to gain weight, which led to sleep apnea. It was a long road back, but I came back and I am very happy about that. Along the way, I discovered how to make myself healthy again, and I was surprised to find the connection to our human origins, the Demons from the Ice Age.

Two people who I love very much are struggling with weight loss. I wrote these entries hoping that it could help them. I hope that this can help you too.

Eat less, exercise more


The Maxim for the Attainment of Wealth is

Buy low, sell high.

While it is obviously true, it is not immediately useful. It doesn't tell us how to buy, how to sell, nor does it tell us what to buy or sell, or when, or with whom, or for how much, or any of the other things that are necessary for a successful business. It isn't enough that it is true.

Similarly, the Maxim of Weight Loss is

Eat less, exercise more.

Again, it is obviously true, but it doesn't tell us enough to make us successful at achieving permanent weight loss.

Consult an attorney before beginning any exercise program


I look at decisions as tradeoffs. Every choice has good aspects and bad aspects. Good decision-making is a process of optimization. In that context, I look at the familiar admonition Consult your doctor before beginning any exercise program. I'm not exactly the Surgeon General, or even the Attorney General, but I believe this to be legal advice, not medical advice. It is intended to protect the healthcare industry from lawsuits and shakedowns, not to help you to make good decisions.

I think the statement has the unintended result of discouraging most people from beginning any exercise program. It gives the demons the argument that exercise is dangerous. Which is the greater problem:

The Consult your doctor admonition reduces occurrences of the first, and increases occurrences of the second. If you look at the number of lives saved and lost, and the quality of life improvements and degradations, I think you have to conclude that the admonition's net result is extremely harmful.

And the odd thing is that we only apply it to things that are good for you. We don't have the admonishment Consult your doctor before eating any snack food to excess. You know that your doctor is not going to say "Crunch all you want, they'll make more."

I would like to see some legal reform that would allow people to receive better advice. Then we could say Consult your doctor if you are sick, injured, or in pain. Otherwise, get your fat ass off the damn couch. Ultimately, we need to take personal responsibility for our own health. We should not be taking health advice from lawyers.

Jim Fixx died while running. He fell over with a heart attack at the age of 52. There was heart disease in his family. His father died at 42. Jim was lucky that it was himself that died while running and not one of the readers his book, The Complete Book of Running. The lawyers would have pecked him to death.

Venus of Willendorf


The Venus of Willendorf is a four and a half inch tall limestone statue that was found in 1908 near Willendorf, Austria. It is estimated that she was carved between 24000 BCE and 22000 BCE. She is thought by some to be a fertility symbol, due perhaps to an early misinterpretation by┬ánaïve scholars who thought she was pregnant. This Venus is clearly fat. The person who did the carving knew what a fat woman looked like.

Obesity is now thought to be an illness. In paleolithic times, it was the key to survival. I think that the thing that gave us an edge over the neandertals was not our big brains (theirs were slightly bigger) but our big bellies. Our unique ability to get fat and lazy allowed us to survive during times of extreme hardship. It now works against us in times of sustained prosperity. We weren't made for these times.

Power-saver mode


When we don't get enough food, we go into a power-saver mode in which we reduce activity, shed muscle, and think about food. The survival benefit of such a mode is obvious. The power-saver mode is also turned on when we are getting plenty of food without having to work hard for it. This is what allows us to get fat.

After a big kill, or when there was a lot of fruit on the trees, we stopped hunting and gathering so that we could sit on our butts and pig out. Body fat was the most reliable form of food preservation at the time, so we would try to put on enough to get us through the winter or the drought.

The Ice Age is long past, but our bodies are still struggling to accumulate fat to get us through it. So how do you get out of power-saver mode?

It requires two things: First, you need to be getting enough to eat. If your body thinks it is starving (which is how most diets work) then it stays in power-saver mode. You need to convince your body that you are not going to starve. Second, you need to work for your food. The hunters and gatherers did that mostly by walking around. I recommend at least an hour of walking every day. If there is just enough to eat, and if we are active, then the power-saver mode clicks off and slowly the fat comes off.

Demons from the Ice Age


When we are in power-saver mode, our heads are full of the voices of demons. These demons can override our other programming, forcing us to make bad decisions, even making those decisions seem reasonable. The demons want to conserve our fat and to increase our fat, and they will say anything in order to accomplish that. They are extremely effective. They literally saved us from extinction.

But that was a long time ago. The demons of the ice age are still haunting our 21st century bodies. In the absence of hardship, they are compelling us to behave in ways which are clearly unhealthy. Diets fail because the demons are strongest when we are hungry.

The demons can be controlled by eating properly and by getting daily aerobic activity. When the demons think that we are being successful hunters and gatherers, they go to sleep and allow us to think clearly.

The Big Belly Hypothesis


There is lots of speculation on why we are the sole survivor. The Neandertals went extinct, but not us (yet). Why was that?

Some believe that it was our bigger brains that gave us the edge. Our creativity allowed us to invent our way out of the Ice Age. But that hypothesis is not consistent with the evidence that showed that the Neandertal brain was a little bigger. Our brains are configured a little differently, but there is no evidence that that made our brains relatively smarter.

The position of the Neandertal larynx was higher, which might have had an impact on the range of sounds that they could produce. Some believe that they could not have made all of the the same speech sounds that we make, and then recklessly conclude that they did not have language, so it was language that allowed us to survive because it made us more effective hunters (ignoring counter examples like wolves and Dick Chaney).

Some believe that the Neandertals were just incompetent. But there is evidence that they survived for over 200,000 years, ranging from Gibraltar to Western Asia. They were stronger than we are, robust and hard working.

Some believe that we hunted the Neandertals to extinction. That is extremely unlikely. That would have been really hard given our small numbers and primitive technology.

Some believe that it was our competition for habitat that did in the Neandertals, that we took over all of the prime cave locations and hunting grounds. This hypothesis ignores the fact that Europe is a big place, and the populations were small.

Some believe that it was inevitable that we won. The winners invent writing and then write history. It is a shame that we didn't write down how it was that we managed to survive. Certainly luck is always a big factor in evolution, but ultimately I think that we alone were saved from extinction by our big bellies.

I think that it was the energy saving mode that uses our brains to avoid physical work, and our remarkable ability to significantly alter our fat content that allowed us to survive at a time when the smarter, faster, stronger Neandertals were dying out. The evidence can be seen in our culture's current struggles with obesity. The angels in our brains that saved us are still here, but in this time of abundance they have become demons which, while trying to save us, are making us fat and sick.

Puffer Bellies


One of the things that makes weight loss difficult is the industrial age model that says that a human body is like a steam locomotive that burns food and fat instead of coal. If you load excess coal, then it gets stored in the coal bin. If you load insufficient coal, then the reserves in the coal bin are used. The model says that weight can be managed by simply managing the rate at which you add fuel. If you restrict the amount of fuel, then inevitably you will lose weight.

The problem with this model is that we are not industrial age locomotives. We are ice age hunters and gatherers. The locomotive model fails to factor in your ice age brain and the huge impact it has on weight management. A weight loss program that does not factor in the brain will not be permanent.

Big Brains


Evolution likes dual-use technologies. Birds didn't grow feathers because they thought they would like to fly. Feathers were a skin covering that was handy to have when the planet went cold. And then it turned out that they could also be adapted for flight.

It is commonly thought that we evolved our big brains because we wanted to invent tools and language. While brains are handy for such stuff, the initial role of big brains was for sexual attractiveness. For a long time, hominid females were selecting for big brains. Big brains served the same purpose as big tails do for peacocks. I think perhaps that those females were determined to someday produce a man with the mental capacity to understand women.

That breeding program ultimately failed because large heads significantly increased the likelihood of death in child birth. The difficulty of delivering those big sexy heads eventually selected out the thing that made the big heads attractive in the first place.

As a result, since Cro-Magnon times, human brain capacity has decreased by 4%.

I think that the thing that made brains big also made breasts big and penises big. Big breasts and big brains go hand in hand. Humans are so very, very sexy.

How to get fat


Permanent weight gain usually begins with an event that leads to a decrease in physical activity. It could be moving, or a new job, or getting a car. We go into power saver mode and begin to overeat. We notice that we've put on a few pounds, so we diet. This wakes the demons. Not only does the diet fail, it causes us to shed muscle. We begin overeating again, and in no time we gain it all back and more. Repeat until fat.

Getting Inefficient


When we are in energy saver mode, we become efficient. In order to conserve our fat, we become really good at solving shortest path problems. Most fat people are extremely good at optimization, perhaps without even realizing it.

As strange as it sounds, permanent weight loss requires that you become less efficient. Only by increasing the rate at which you burn energy can you get it off and keep it off. Since your brain is trying to make you more efficient, you must take control of your brain. You need to get more involved in your own decision-making, changing the defaults. You must take action. Here are some things you can do:

When parking your car, don't cruise around looking for a spot that is close. Instead, grab a space that is farther out, and enjoy the longer walk.

If you can, use public transportation instead of driving.

If you have time, get off at the wrong stop and walk a little farther.

If you can, use the stairs instead of the elevator.

When waiting, stand instead of sit. If you can do it without annoying others too much, try pacing.

Choices


Here are two views on healthy eating.

First, the demonic view: Look at everything you are currently eating. Delete the foods that are too sweet, too fatty, or junk. Oh no! There's almost nothing left? We're going to starve! Must find food now! Must eat now! Eat to live!

The other view is that there is a lot of really good food out there. Adopting a healthier diet can open up lots of new choices.

The bad part of living in an age of abundance is that we overeat. The good part is that there is an amazing variety of wonderful, affordable, good foods available to you every day. It will take some study, but your efforts will be rewarded.

Blog Away Those Unwanted Pounds and Inches!


Our commitment to the tribe is stronger than the voices of the demons. When it is possible to hunt or gather food for the tribe, we will do that instead of sitting and hoarding fat. You can use that to your advantage in managing your permanent weight loss project.

Inform the people that care about you that you are undertaking the project. Ask for their support. Make yourself accountable to them. A blog is a really good way to do that. Make an entry every day, recording the food that you purchased, the food you consumed, and the type and amount of exercise. Be honest and complete, even when you stumble.

The best time to control junk food consumption is as the point of purchase. Once you get it home, it will be consumed; no amount of will power can prevent that. It is more effective to not buy it in the first place. You will make better shopping choices if you know that you will be reporting your choices to your community. This can help you avoid demonic impulse shopping.

[Note to Yahoo: You can help support permanent weight loss projects by providing specialized blog entry forms that simplify the entry, display, and processing of food and exercise logs. This also opens up some significant branding opportunities. These projects could be sponsored by sports apparel and shoes, exercise equipment and facilities, weight management organizations, and healthy food products. Couponing and revenue splits with the bloggers could give them additional motivation.]

Walking it off


Exercise, for the purpose of permanent weight loss, should not hurt. I can't speak to exercise for athletic or military training, but the activity necessary to attain and maintain a healthy weight should not hurt.

There is nothing better for bipedal creatures like us than walking. An hour every day of vigorous walking provides enormous benefits. Besides the obvious physical benefits, it is really good for your head. Walking is free. You can do it anywhere, anytime. You can do it alone or in couples or in groups. It requires no equipment except perhaps for a good pair of shoes. It is really easy. We all know how to do it.

For people who are seriously out of shape, or who suffer from foot pain or other problems, there are lots of alternatives. There are machines like bikes and treadmills and ellipticals. And swimming is really good as long as you keep moving.

You need to listen to your body without listening to the demons. This is difficult; it takes practice. Your body will tell you how much it can do, how much it wants to do. The demons will be telling you to get back on the couch. I don't recommend painful exercise because it can strengthen the demons. You should never exercise unsafely or to the point of injury. It should be pleasant because you will be doing it every day for the rest of your life.

philosophy


I really enjoy the philosophy [sic] bath and shower gels. My favorite flavor is double rich hot cocoa, but I also enjoy many others, including banana nut bread, pumpkin pie, and cinnamon bun. They smell like dessert. It is really fun to lather up with them.

I don't like some of the fruitier flavors, such as blueberry pie and key lime pie. They seem to me to have a disagreeable chemical note. But the others are great.

I think the philosophy bath products can be beneficial to people seeking permanent weight loss because they condition your brain as well as your hair. Since you can't eat them, and there is generally no other food in the vicinity of the bathroom, you learn to think about food without having to act upon your thoughts. You can simply enjoy the sensations. And when you step out, you will smell delicious.

The Toothbrushing Trick


As long as the demons are in control, they want to keep you eating so that they can stay in control. I found this trick makes it easier to negotiate with them. Maybe it will work for you, too. You have to adopt two iron-clad rules:

The first rule is just good oral hygiene. The second rule is reasonable, and has lots of childhood guilt to help defend it. If the demons fuss, remind them that this is just a postponement, not a denial. We just can't eat right now because our teeth are clean, but we will eat soon.

If you cheat anyway, try to eat as little as possible and then immediately brush and floss again. Very quickly, the cycle of snacking and flossing looks really absurd. Understanding the absurdity can help you take control.

Demon Rum


The demons like alcohol. It gives them strength, making it easier to cause you to make bad decisions. When you take alcohol, you decrease the likelihood that you will exercise and increase the likelihood that you will overeat.

The Incredible FOOD Diet


Thanks to a miraculous scientific breakthrough, it is now possible to lose weight by eating food.

That's amazing, because I really like food!

Everybody does! But now, thanks to The Incredible FOOD Diet, you can eat good healthy food, and still lose weight.

But wasn't it food that made me overweight in the first place?

That's what makes The Incredible FOOD Diet so incredible!

I'm convinced! So how does it work?

You control your portions. You don't over-eat, and you don't under-eat. And you improve your food choices. Reduce the junk, and increase the fresh vegetables and fruits.

Does that mean I can't enjoy holiday feasts with the family? Do I have to give up forever the foods that I love?

Not at all. You can still take part in the occasional feast or buffet. Just try not to eat until you are sick, and try not to do it too often.

It sounds so easy. Is that all there is to it?

There is one other thing. You must exercise at least an hour every day. Walking is best.

What happens if you don't exercise?

You get fat.

Throw It Out


Somehow, some junk food got into your house. Maybe it was left by a well-meaning, under-informed friend or family member. Or maybe you won it in a raffle. Or maybe you bought it yourself in a fit of demonic impulse buying. The dilemma is that it is wrong to waste food, but if the junk is in the house you know you are going to end up eating it. What to do?

First, realize that if you slam down all that junk, the starving children in Africa will be no better off. Still, it is hard to throw out good food. But it is easy to throw out bad food. You have no hesitation in throwing out moldy bread or rotten meat because you know that that stuff is bad for you. It can make you sick.

Junk food can make you sick. It causes obesity and lots of other related health problems. So throw out the stuff that is bad for you, and then walk to the store and get something fresh. Toss the junk in the dumpster on your way out.

Resolve


As the year began, a lot of people resolved to lose weight. We are now one month into the year and most of those people have given up. What happened?

Many of them adopted improper diets. It is possible to lose weight by eating too little, but the loss will be temporary. It awakens the demons who will inevitably force us to overeat, regaining everything that was lost, plus interest. Temporary weight loss is a form of self-torture. You suffer from privation and then get fatter.

Even on a proper diet it is possible to occasionally overeat. When that happens, the demons will try to convince you that the effort has failed, but maybe you can try again next week, or next month, or next year, but in the meantime there is nothing to do except to continue overeating.

It is hard to think clearly when the demons are yapping. This is what you should be thinking: One session of overeating will not result in a permanent weight gain any more than skipping a meal will result in a permanent weight loss. What matters is what you are eating, on average, every day. So don't wait to get back on the program. Stick with it.

Diet Metrics


Most weight loss diets fail, and the consequences of a failed diet can be worse than not dieting at all. But it is unhealthy and unpleasant to carry around the extra lardage. So it must come off, but how?

Part of the problem is that this formula, which is commonly used to evaluate diets, is wrong:

beginning_weight - ending_weight

This does not measure permanent weight loss. It only measures a spike. The diet is given credit for the weight lost up to the point when the diet fails, and the dieter is given the blame for the failure and the subsequent rebound. It may be that it was the diet, not the dieter, that was at fault, and that the diet failed the dieter. By misplacing the blame, badly performing diets are perceived as effective, and good people are made to feel defective and worthless, and are ultimately made less healthy.

I think this is a better formula:

beginning_weight - weight_after_one_year

It takes longer to obtain the result, but it is a more accurate result. If the result is significantly positive, then we can judge the diet as a success. If the result is negative, then we can judge the diet, not the dieter, a failure.


There is more to you than fat. You are also carrying around a lot of water, and a bunch of muscle and bone and other good things. You want to manage your fat content. Effective management demands timely data. The most available data is the measurement of your total weight.

The quickest way to reduce your total weight is to drastically reduce your intake of water. This does not reduce your fat content. Dehydration is dangerous and is not an effective permanent weight loss method. Drink lots of water.

When the body is in energy conservation mode, it sheds muscle because muscle costs a lot of energy to maintain. A diet program that does not include daily exercise will result in a loss of muscle. That is not an effective permanent weight loss method. We want to be increasing the amount of muscle, even if that results in an increase of total weight.

Your weight can fluctuate by many pounds during the day as you eat and drink and eliminate. The best time to weight yourself is in the morning after urinating but before breakfast. This will tend to reduce the effect of the fluctuations on your readings.


I recommend that you weight yourself every day. On days that you are reluctant to weigh yourself, you know that the demons are in control and that you have to look more closely at what you are doing.

The amount of weight that you should lose in a day is insignificant compared to the fluctuations in weight due to food and drink. This can add a lot of noise to the readings which can be discouraging. The fluctuations can swing many pounds per day. The upswings have the appearance of instantly wiping out weeks of effort. Even if there were no fluctuations, most scales have only half pound resolution. That means that on most days, you would see no change at all, and that is discouraging too. The demons will use discouragement against you.

There are two easy things that you can do.

First, every day, after reading your weight, add up the four most recent readings and divide the sum by four. This will give you a four day average. It will smooth out most of the fluctuations, and it turns little plateaus into little slopes. There are other formulas that have greater statistical meaning, but the four day average is easy to compute and adequate for daily management and motivation.

Second, chart it on a graph. This will make it easier to see the trend. If you are doing everything right, you can see your progress, an eighth of a pound at a time.

If the four day average is not going down day after day, then you need to make some adjustments. Are you eating too little? Are you eating too much? Are you eating junk? Are you getting enough daily aerobic exercise? Should you be doing more strength training?

It doesn't matter how quickly it comes off. The important thing is that it is coming off and never goes back on.


Food contains calories. Exercise burns calories. So it would seem that you could trade off sweat for treats. Unfortunately, our ability to reason correctly about calories is demonic.

Doing some leg lifts doesn't entitle you to a big bag of Fritos. A session on the elliptical doesn't entitle you to a second cupcake. Or a third. Or a fourth.

Just do the work. Exercise every day and plan your meals. Keep it simple.


The demons will tell you that there are no calories in a broken dorito or a broken cookie. Don't listen to them. Ounce for ounce, broken chips and crumbs are just as fattening.

When you do eat snacks, measure out what you plan to eat. It is a really good idea to weigh it out. It is a lot easier to control the volume consumed if you portion it first. If you just eat until you think you've had enough, you will eat too much.

Survivor


I like Mark Burnett's Survivor (CBS Tonight!) because it puts regular people into a hunter/gatherer world. Part way through the 39 day game, you can clearly see the effects of the power saver mode as players experience a series of food shortages. They get really lethargic, saving all of their energy for the challenges, in which they fight for food or survival in the game. The fat people watching them at home suffer from the same lethargy, which can also be triggered by overeating.

Generally, the players who feel it the worst are the body builders. They have so much muscle to feed that they completely run out of gas and fail. They don't cast many overweight guys on the show, but a couple of them (Hatch and Boneham) did really well.

Older people tend to be more efficient than younger people, which is why most people tend to gain weight as they get older. On the show, youthful inefficiency is sometimes misinterpreted as a generational ethical deficiency.

E-besity


America has gotten really fat. We have developed a lifestyle wound around automobiles, televisions, and lots of yummy fast food. The country is beginning to come to the understanding that our way of life is unhealthy and that we must change. It is similar to the country's recognition that tobacco is unhealthy, which led to no smoking areas, and then the banning of smoking in restaurants, airliners, and workplaces. Soon, it will become a national priority to get thin and healthy again.

A surprisingly popular series on NBC is The Biggest Loser. It is an imitation of Survivor, set in a fat farm instead of a tropical island. It is an elimination game in which a cash prize is awarded to the player who loses the most weight. Millions tune in to watch fat people exercise and diet.

As we get more active, there will be less time for television watching. This will be bad news for the Networks and Studios as viewership continues to shrink. It is not necessarily a bad thing for the makers of TV sets if they can persuade consumers that Quality Viewing is better than Quantity Viewing. Television must find a new role as a smaller part of a healthy, active lifestyle. Television must distance itself from the unhealthy, sedentary lifestyle it helped create.

Fat March


ABC has a new show on Monday nights called Fat March. It is another weight-loss in primetime show like The Biggest Loser, except instead of sending the people to a luxury resort to work out on expensive machines surrounded by product placements, the people will walk 570 miles over the series, from Boston to Our Nation's Capital, camping out along the way. The 12 people on the show are seriously overweight, ranging from 225 to 500 pounds.

There are some things about the show that I really like. They got the incentive system right. There isn't a single big winner. Everyone who finishes the walk wins, and the more people who finish, the greater the individual awards. I think this makes the game a healthier environment for the players. There is still an elimination component, but it is much less brutal and arbitrary. I am hopeful that we will see a lot of people crossing the Potomac.

I also like that they are walking. The show is recreating scenes from tens of thousands of years ago, when, after getting fat and lazy on abundant food and exhausting the local supply, we had to get up and go look for more. Humans live everywhere on this planet, and we got to most of those places on foot. Walking is an essential aspect of who we are. If we ignore that, we risk getting fat.

In the first week, the walkers had each lost between 4 and 19 pounds.

"Why do you think I toss at night? It ain't just the apnea."


On The Sopranos last night, we learned that Tony has apnea. This isn't surprising when you see the way he is overeating.

Demons of the Night


As you gain weight, fat is stored all over your body. Some of it is deposited in your neck where it can constrict your airway. This can cause snoring. When more fat is schmeared on, the airway can be pinched off completely while you sleep. You are then aroused enough to stop yourself from suffocating. You then fall back asleep with no memory of your near-death experience. Depending on the severity of the condition, you can repeat this sequence 10, 20, or 60 times an hour. This is Obstructive Sleep Apnea.

When you wake in the morning, you feel tired, not rested. You are unaware that you have a sleep disorder. You may feel hot and sweaty at night because you are working really hard to keep yourself from suffocating. You may experience acid reflux, because in your desparate efforts to suck air into your lungs, you squeeze fluid out of your stomach. You squeeze on your bladder, too, so you feel the urgent need to get up and go. You no longer dream.

You have excessive daytime sleepiness. Your handwriting gets sloppy. You become forgetful. You are unable to concentrate. You sleep a lot, but you are always tired. Since you are so tired, you don't exercise. You sense that your body is hungry for something, so you overeat, not understanding that what your body wants is oxygen. This makes you fatter, which makes the apnea worse. Your symptoms look like clinical depression.

This can happen to anybody. If you suspect that you might have sleep apnea, go to your doctor now and demand a sleep study. If it is found that you have apnea, you will probably get a CPAP machine which blows slightly compressed air through a hose and face mask into your airway, blowing it up like a balloon so that you sleep all night without suffocating.

There are surgical treatments for apnea, but the best treatment is permanent weight loss.

Sleeping on the road


Ten years ago I attended one of Martin Greenberger's Multimedia Roundtable conferences at the Ritz-Carlton, Laguna Nigel. I was really tired, so at every session break I would go back to my room for a short nap. I was pretty much able to stay awake through the presentations, but I had no energy for networking. I tried to sleep at every opportunity.

One of the last presentations was by a doctor who described his experiences with a computerized diagnostic system. He told the story of a homeless man who came into the clinic. He was angry, short-tempered, and unable to effectively communicate with the staff. They sat him down with the computer, and he began to dialog with it intensely. The system determined that he had Sleep Apnea. The condition had not been diagnosed until that moment. It had caused him to lose his job, family, and home. Now that the condition had been identified, he had a chance to get his life back.

It did not occur to me at the time that I was on the same road. I wasn't aware that I had a sleep disorder. I just thought I was tired.

Sleep Study


This is me at my first sleep study. I look really tired, which was how I was in those days. I am a little overweight, but not obese. My airway is very narrow, so I didn't need to gain very much weight to bring the apnea on.

I have electrodes glued all over my head and face. There is a tube in my throat that was threaded thru my nose. I am wearing lots of other sensors. All of the wires are attached to a harness that will be plugged into a polygraph terminal near the bed. There is also an infrared camera in the room and microphones. I will be under observation all night as I sleep.

As unpleasant as it appears, I really looked forward to the sleep studies. They were an important step in getting better.

Beating Apnea


Doug,

Lucy had a sleep test a couple of weeks ago and they found that she has what they call moderate sleep apnea. She is supposed to go back Monday night to find out if, and at what level, a CPAP machine might help. She is concerned about how difficult it is to wear the device, how much noise it makes and how much it costs. Also, what the results are likely to be. People have told her that it's very noisy and uncomfortable. Can you shed any light on the issue?

When I learned about CPAP, I couldn't wait to get one. The clinic had a long waiting list, so I went out and bought a unit myself. I didn't wait to find out if insurance would pay for it. I needed it and was willing to pay for it. I took it with me when I traveled. The idea of sleeping without it was horrifying. It made a huge difference in the way I felt.

Keeping a CPAP machine is a chore. You need to keep it really clean. I discovered that you can't let cats near it because they love to claw the hoses. I got a big sterilite box to keep the gear in. I kept spare filters and hoses.

The hardest part is living with the facegear. I recommend getting at least two different brands of silicone nose masks. It is really important to find one that fits well. An ill-fitting mask will leak, blowing air in your eyes, which makes sleeping even more uncomfortable.

A humidifier is essential. I used a cool unit that worked well. I also got a data cable that let me hook the unit up to my computer. That let me read the performance data that the machine collected, and it let me adjust the pressure myself. I went through this some years ago, but I imagine that the equipment hasn't changed much, except that the computer features should be better now.

It took a while to learn to get used to it. It is weirdly like something from a science fiction movie at first. Early on I somehow wrapped the hose around my neck. But with practice it became easy. The machines are pretty quiet. From a roommate's perspective, it makes a whole lot less noise than snoring.

For a while I went to meetings of CPAP users. They were all dedicated to their machines. Some of them even developed battery systems that allowed them to take them camping. They were prepared to use CPAP every night for the rest of their lives. Life was terrible without it.

I was a candidate for surgery, so I got my airway widened. I don't need CPAP any more. But surgery doesn't work for everybody so it is a very good thing that CPAP is available.

Feeding the Demons


The Food Industry produces vast quantities of processed foods. A lot of it is unhealthy junk and should be avoided. Industry has formulated these foods to appeal to our demon desires for fat, sweet, and salty. We crave those things because their survival value was, until very recently, very high. I don't think the Industry is evil for making this stuff for us. They make it because we want it. They do a lot of research, and their number one objective is to make what we will buy. They know that we say we want stuff that is healthy, so they will try to put the word healthy or one of its synonyms on the package. But they also know that we won't buy it unless it has the fat or the sweet, so they put that in there too. If we wanted stuff that is healthy, they would make it for us. Our demons would rather have us eat junk.

I am not in favor of over-regulation, but I am in favor of a Junk Food Tax that would be levied on snack foods, candy, and sugar water. I think the revenues could be used for public education programs for nutrition and exercise. And with Federal spending running out of control, Congress could use a new source of revenue.

Choose Jolly


I don't think most people choose to get fat. They don't think "Those fat people seem to be so happy and jolly. I'm going to get fat, so that I can be happy and jolly, too." I think instead they become blind to the consequences of their own behavior. Then they wake up one day to discover "Oh my god! I'm fat! When did that happen?" And the worst part is that they don't even become happy and jolly.

The demons effectively disable the sections of our brains that understand the consequences of our own behavior. It is possible to enable them again and regain control of your brain, but it takes exercise.

The e in Feast


The original Plymouth Rock Pilgrims were the first cause of an American traditional feast of thanksgiving. They were thankful that they hadn't starved to death yet. Life in the New World was much harder than they anticipated.

Over the centuries, America has strayed farther and farther from the Pilgrims' religious beliefs. As we became less puritanical, we also became more prosperous. The threat of death by starvation is now a virtual impossibility in this country. Death by overeating is a much more likely outcome. So I think it is time to recast this traditional holiday in light of our new reality.

I propose that from this day forward that we celebrate Thanksgiving with a fast. On that day we will skip a meal, saying to the Creator "Thanks Lord, we've had enough."

Freedom from Want


Before there was Photoshop, images were manipulated and distorted the old fashioned way, with art supplies and lots of talent. For example, the brilliant American illustrator and propagandist Norman Rockwell painted a series of paintings called The Four Freedoms in response to FDR's address to Congress on January 6, 1941. The series, first published in the Saturday Evening Post in 1943, helped sell over $132M in war bonds.

The most famous of the series is Freedom from Want. Rockwell's cook, Mrs. Wheaton, was the model for the grandmotherly provider. She baked a turkey, and Rockwell painted it, and then they ate it. But in the process of painting it, he scaled it up. He zoomed it. Look at the way Mrs. Wheaton is setting the platter on the table. There is no way a woman of her stature could so effortlessly handle such a ridiculously oversized bird. Rockwell supersized the turkey to sell the idea of abundance which is supposed to liberate us from want.

Thanks in part to this amazing painting, we won the war. But the painting had another consequence which is less savory. It has established a new tradition. Every year, all over America, families are struggling to recreate the fantasy in that painting because somehow they think that they are supposed to, that it is the fulfillment of some sort of duty.

So turkey growers have been developing monstrous mutant birds. These birds are incompetent. They are unable to live in the wild. The males are too huge to mate. They don't even taste very good. They exist only to match the image in a picture.

Gobble gobble.

Hunter Gather Crier


Human babies are unique among mammal infants in their ability to produce extremely annoying sounds. Baby physiology seems to be optimized for making awful noise. Indeed, they are capable of little else.

This at first glance would appear to have little survival value. Suppose your clan is being stalked by a hungry sabercat. It is really hard to hide if you have a crying baby giving away your position.

At least some humans survived that scenario, so it seems that crying had a net positive survival value. I can imagine a small band of starving ice agers, facing an utterly hopeless situation. They have given up, rationally awaiting their doom. And the baby is crying. And crying. And crying. A man gets up, says "I'm going hunting." He leaves, looking for a quieter place to die, but instead accidentally falls on an easy kill. He drags the carcass back to the cave, and the clan survives. We were motivated to avoid extinction by the crying of babies.

A personal note: Yesterday I was on a five hour flight with a crying baby sitting behind me. I felt like killing something.

Neandert[h]al


The Neander Valley (near Düsseldorf) was named after Joachim Neumann, a 17th Century Calvinist minister and hymnist. Fossils were discovered in a limestone quarry there in 1856. The original owner of those bones, and his relatives, became known as Neanderthal. In 1904, spelling reform in Germany changed Neanderthal to Neandertal to more correctly indicate the way it had always been pronounced.

British scientists refused to correct their spelling or pronunciation. The intentional misspelling and mispronunciation of foreign words is one of the ways that they show contempt. The British didn't invent this; they learned it from the Greeks. When Herodotus wrote about his visit to Egypt in the 5th Century BCE, he got all the names wrong. This can be forgiven, since the correct recording of foreign names can be very difficult. The amazing thing is that after thousands of years, the errors have not been corrected.


The Fat Lady Spins


In the very early 1980s, George Lucas assembled an amazing team of computer graphics guys. They significantly propelled the state of the art. It was one of the most successful R&D operations in history. Unfortunately, George decided that he didn't like paying for R&D out of his own pocket, so he tried to spin the group out. Ultimately, he sold it to Steve Jobs for $5M. That group became Pixar. This story, and many others, can be found in Mike Rubin's Droidmaker. Highly recommended.

But prior to that, they considered a number of other business possibilities. One of them was to use their computer graphics capabilities for medical imaging. They produced a demo from slices of CAT scans of a fat woman's pelvis, rendered and rotated in 3D with density mapped to opacity. That was a big advance in medical imaging. I noticed at that time that you could see that there was a thin woman inside of the fat woman. You just have to look under the fat.