The Process, Part 10: When Losing Weight Definitely Is Not A Good Thing

Unfortunately, my experience successfully losing weight to deal with diabetes is making not losing it now to deal with cancer much more difficult.
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I was diagnosed with Type 2 diabetes almost exactly one year before dermatologist #2 told me I had Merkel cell carcinoma.

I didn't think I was heavy, but one of the first things my internist said when I found out I had diabetes was that I needed to lose weight.

He asked for 10 pounds so I, of course, lost 28.

How? I simply ate less and exercised more. And I got on the scale every morning to see how I was doing.

This is not what the weight loss professionals tell you to do. But the professionals typically deal with a... well... typical rather than an excessively compulsive patient like me. (He doesn't use those exact words, but that's my internist's characterization, although I really can't argue with it very much).

Honestly, getting on the scale and noting the steadily declining number was fun to see while I was losing the 28 pounds, made me think I was getting better and provided daily data-driven reinforcement that I had taken control of the situation. The best way to explain this is something my Washington, D.C. friends will readily understand: It was like running for office and getting daily tracking poll results each morning that show you're doing well.

My weight loss was a source of pride and a topic of conversation each day with my trainer and my beautiful and talented wife (The BTW). It also didn't hurt that I looked great. In fact, I hadn't weighed that little since I was in my early 30s and running 10K races once a month.

Unfortunately, my experience successfully losing weight to deal with diabetes is making not losing it now to deal with cancer much more difficult.

Here's the problem: I'm not supposed to lose weight, or at least not much weight. The concern from all my oncologists, my internist and my dietician is that the combination of two of the side effects of The Process -- losing my sense of taste and having trouble swallowing -- will mean that I just won't eat much. That will make it impossible for my body to get the nutrition it needs to deal with the radiation.

Over the past year, I've put back about 10 of the 28 pounds I lost in connection with diabetes and I wouldn't mind if I lost that again now. That makes getting on the scale and seeing the number fall during The Process a positive.

But Team Stan doesn't want me losing too much too fast, and that makes getting on the scale and seeing the number fall a negative.

Any accelerating weight loss that before The Process began would have been a good thing now has to be monitored closely and slowed.

It would be great if I could re-lose the weight I gained over the past year and then not lose any more. But it's far more likely that the weight loss will continue after I reach my personal goal of 7-9 pounds unless I eat more. And, as I explained in Part 9, eating just isn't much fun when you can't taste anything.

All this means that I'll somehow have to find an alternative for the less positive reinforcement I'm going to get when I step on the scale each morning. Telling myself that it will be better for me in the long run not to lose as much as I can is going to be a difficult sell, given how up to now the lower numbers on the scale has always been the goal.

It's this kind of situation that often makes The Process so difficult: I have to reprogram myself to do some basic things very differently than I've done them over most of my life.

I now have to force myself to eat food that doesn't taste good and to eat as much of it as I can. Not losing weight is a positive rather than a negative. Eating lots of nibbles -- noshing -- all day and night is what I should do, even though I've always been told the opposite.

So far the weight situation has been hard. Having clothes that fit well (or are even a little loose) still makes me smile, even if that's not the way I should be thinking right now.

This is a continuing series of blog posts by Stan Collender about his experience fighting cancer. "The Process" Stan is describing began last August.

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