The Impossible becomes Doable when you're willing to look at goals, break them down into smaller chunks, and have support doing so. Both Angela and I have designed challenges for the At Goal and Maintaining Team at Sparkpeople.com.

If you’ve come this far, what else can you do?

It’s an ongoing theme from many of the maintainers I’ve interviewed over time. That curiosity. And because we’ve all since learned the importance of structure during weight loss, Angela and I have created some maintenance-themed challenges to help make many consider impossible actually doable at Angela’s hang out, Sparkpeople.com.

We focused on two separate elements of weight maintenance:

The Mechanics | Biomechanics is probably the most accurate term. This is the weight tracking, calorie counting, problem-solving nuts and bolts of maintenance. We all have familiarity with this because of weight loss, but maintenance’s needs and solutions are different, and research is proving we maintainers right.

To that end, Angela created several challenges — the most current is “The Springiest Challenge” designed to last through Easter.  Each tracks their weight for a specific duration and a title is awarded.

The Significance | Psychologists discuss all the mental issues associated with weight. Yeah, we know. We all live those Big Girl Issues out and talking about them doesn’t help — doing something about them does. And when you analyze it, the actions themselves are fiendishly simple — create a life you appreciate more than pre-weight, a step at a time.

Visit Sparkpeople.com's At Goal and Maintaining Team tor challenges designed by writers at I Keep It Off.com

Beyond the mechanics of life are clothes, relationships, life goals, books you read, how you design your kitchen, where you shop … and when those are neglected, it makes eating poorly or exercising less much easier.

In other words, you can’t have one without the other, post-weight. The more significant the change post-weight, the easier keeping said weight off becomes. It can be a challenge, but if you have to choose between fat pain and growing pains, at least something great comes out of the latter.

To address the significance — all the elements beyond the nuts and bolts — Russ created the “Making Post-Weight Fantasies a Reality” Challenge.

Same principle applied differently — we list out various life goals and focus on specific actions and allowing Acts of Weight Loss God to intervene. Being goal-driven is important; it’s equally so not to avoiding forcing outcomes, too.

To check out the wonderful community of maintainers Angela has been leading, or to participate, log in or sign up to Sparkpeople.com, select teams and Search for At Goal and Maintaining.

Sauerkraut is traditional Oktoberfest fare, but the variations of homemade kraut offer tremendous variety for few calories and bold flavor.

I gave a quick rundown for traditional Oktoberfest-worthy Sauerkraut for The Gambit Weekly on Monday (see http://www.bestofneworleans.com/gambit/kraut-with-clout/Content?oid=1889432 for the recipe). But in terms of nutrient-friendly strategies to perk up otherwise boring eating, it’s only the beginning.

Fortunately, recipes as basic as sauerkraut beg for experimentation. Some might call it fusion, but in maintenance I call it “surviving.”

It’s a theme I touch on often. John Graham of the NWCR noted of the maintainers that have done it on their own (which is all of them so far) mostly condemn themselves to boring food. It makes sense — you stick with the foods that work and avoid those you cannot control.

This is where something as simple as a sauerkraut recipe turns all this on its ear — using cooking, creative cooking no less, to turn a weakness into a strength. And produce something an important quality-of-life ingredient — variety, creativity and passion.

One tactic that helps is finding similarities between various international cuisines and then blending them together. Condiments, sauces and garnishes become a key method to restoring variety not through your basic macro-nutrients, but how you present, prepare and dress up those macro-nutrients.

Also, the beauty of garnishes, condiments and sauces are how easily they’re added and removed without changing your eating structure. Need calories/fat/etc? Pile ‘em on. At the top of your weight range and require less? Take ‘em away.

In this example, the similarities between kimchi, a Korean fermented vegetable mixture, and sauerkraut are almost identical — so much that food historians theorize sauerkraut’s origins begin in China and their technique of fermenting vegetables in rice wine.

Since Sauerkraut is essentially salt and sliced cabbage compressed and fermented for two weeks, you can add juliened carrot, grated ginger, garlic and jicama among the layers.

Sauerkraut naturally pairs well with pork and salmon; this Asian twist opens up the uses for variations on Vietnamese Po’Boys, stir fries, tofu dishes, and more — striking a balance among creativity, control and clever cooking that proves — like keeping weight weight — anything is possible.

We're continuing to find new research on maintenance definitions, but as the search continues, we often find answers just lead to more questions.

A definition can impose order and structure on a vague concept. And yet the research continues to show that pinpointing maintenance is harder than it looks.

Maintainers are Deviants. Positive Deviants. The term is actually as practical as it is poetic, however -- the idea of studying the practices and behaviors uncommonly successful people. So then why do people focus on mediocrity in weight loss research??

Positive Deviance (PD) is a behavioral science term for studying those who are unusually successful at tasks most deem impossible. This theory has been applied to education and public health in general.

Positive Deviance is also the conceptual glue for maintenance research — what are those who beat the odds, who keep weight off, actually *do*?

I noticed the discussion of the term when re-reading the study published by the American Journal of Preventative Medicine. The study is the first comparative study between weight losers and maintainers, shows evidence that weight losers and weight maintainers are different skills. Here’s where they mention the term:

“As behavioral weight control is the sum total of a great number of practices that each influence caloric intake and/or caloric expenditure,” the study explains, “positive deviance is closely related to the framework of problem solving, where alternative practices are explored, identified, selected, implemented, and evaluated.”

I appreciate the scholastic poetry of the term, Yes, we’re deviants in current weight loss culture. This is, in itself, a double-edge sword.

Discussing weight issues from the standpoint of someone determined to see their weight loss through longterm is such a unique point of view that you can feel like an outcast. Not fat, not thin, nothing is what it seems and what people see when they look at me is not what they get.

My impetus for beginning this site was my frustration with feeling abandoned and ignored. I didn’t change my life to be someone’s PR campaign — and I certainly don’t settle for silent status quo. If I wanted that, I’d still sit in the back of rock clubs and eat a pizza.

And yet, I found, the “x factor” of maintenance was learning to draw strength from that same feeling of  social isolation. At least until those of us trying successfully make maintenance “mainstream.” Until then, let’s hear it for walking your own path – Outcasts, I concluded, make the best pioneers and leaders. We don’t need to follow the pack.

That does not apply solely to myself — that’s all of us. We’re all leaders in maintenance.

Think about it. Given a plethora of unsavory options available — regain weight, be bitter or resigned, for fight for the good stuff, we choose to fight. That’s why I love my community so, and have little tolerance for cynicism and resignation – especially my own. There’s nothing Polyannish about beating the odds or making the impossible doable. It’s something you struggle for.

The law of averages

Too often folks focus on averages, which is the crux of the criticisms launched against maintenance research (which Angela and I discussed last year) and why the health-at-every-size movement’s garnered so much favor. What excites me about this evidence is that it’s the first study to truly distinguish maintenance — the implication being that attaining a weight goal and sustaining it are two completely different skillset. And yet “lose weight … and keep it off!” are phrases usually shoehorned together.

"What do you plan to do with your stories, the new sheriff said, quite proud of his badge?" It's a line from a Tori Amos song, and the answer is simple but profound: what do you do with stories? You tell them. In the case of Positive Deviants like ourselves, it seems we need to keep telling our stories until the world thinks maintenance support and awareness is *their idea,* not ours.

Taken one step further, it follows that maintenance can, in fact, be taught, but the teaching is irrelevant to “and keeping doing what you did to lose weight” or “you’re on your own, kid.”

Scientists are often reluctant to make those kind of logical leaps — which is precisely why maintainers are important to the obesity debates beyond participating in research surveys. Or selling six-inch subs. Someone needs to fill in the blind spots in the obesity conversation, and those “someones” are us.

Obesity is too important to be left to “The Experts” just as science is too vital to remain in its ivory tower. That’s only one point of view available. And Lord knows on some level weight loss and maintenance required us all to adopt and balance many points of views: those of doctors and personal trainers, psychologists and nutritionists, and finally our own.

So why then the resistance to look forward, to examining the blind spots that presently exist in the obesity debates? A recent conversation I had with excellent New York Times reporter Gina Kolata stated it best — people are interested, but the science isn’t there yet. In mine and Angela’s cases, we haven’t found many people interested. Rather, we’ve both had to yell and scream to find people either reluctant or afraid to discuss maintenance at all.

Why all the resistance?

In The Power of Positive Deviance: How Unlikely Innovators Solve the World’s Toughest Problems (2010), authors Richard Pascale, Jerry Sternin and Monique Sternin offer an explanation:

“The PD process is a tool for adaptive work. Unfortunately, we are drawn instinctively to the ‘technical’ stuff–the ‘what’ (specific practices and tools that make the individual positive deviants successful). That’s the easy part–and only 20 percent of the work. What matters far more is the ‘how’–the very particular journey that each community must engage in to mobilize itself, overcome resignation and fatalism, discover its latent wisdom, and put this wisdom into practice. This bears repeating: the community must make the discovery itself. It alone determines how change can be disseminated through the practice of new behavior–not through explanation or edict.”

This passage beautifully explains the limitations and challenges of promoting weight maintenance as something attainable. First, there’s the understanding that science, research, averages — “proof” if you will — is merely the starting point. A scientific study is not the end-all, but rather the beginning. This is what the “I don’t believe anything unless it’s in a study” folks need to understand. Much like our lives, any substantial change or status quo shift requires looking forward. Waiting for a scientific study to prove something we positive deviants explain regularly is limiting what’s possible for men and women struggling with obesity.

More pointedly, this is the fallacy of health-at-every-size arguments. Fat acceptance advocates regularly explain health and weight are similar, not synonymous — you can be healthy at any size. This is possible, arguably. You can also lose weight and keep it off. But you cannot study at obesity and weight regain statistics are condemn weight maintenance as impossible. As recent research shows, no one’s yet figured out how to teach maintaining weight because so few understand it.

Or learn how to make money off it (looking at you, diet industry).

And the challenge is making our own deviance palatable to the wider culture. That’s not a job for science; that’s a job for storytellers, and on a societal scale, very brilliant publicists and marketers.

Until that occurs, it requires all of us to possess the grace, compassion and wherewithal to tell our stories, especially when so few want to listen. To keep talking until people think maintenance awareness is *their* idea, not ours. That’s certainly not a skill I’ve perfected, but I keep trying. We’ve already proven we’re positive deviants. Now’s a new challenge — teaching others what we know to be true.

I recently posted this in our Facebook discussion, so feel free to leave a comment there or here. Do you consider yourself a deviant, an outcast in the weight loss world? Do you give the idea much thought? How do you keep earning your “positive deviant” badge even post-weight? Obviously I celebrate positive deviance, but do you find it problematic? How does it apply to your own life?

Ceviche is an excellent example of a maintainer's diet, in which there's variety in what you cook but not what you eat.

An article I wrote on Ceviche appeared in New Orleans’ fantastic weekly newspaper, The Gambit Weekly. Link below, with recipe and tips:

http://www.bestofneworleans.com/gambit/fish-for-compliments/Content?oid=1847160

As soon as I’m able I’ll add the recipe, here. But the dish is an excellent example of what I call “The Maintainer’s Diet.”

This kind of diet is very different from the diets we’re all used to — but then weight maintenance itself is quite different from weight loss, as has been recently evidenced.

It’s diet in the  ”a method of eating” sense — not “eat this to lose weight.”

In terms of what to eat, by the time you’ve reached maintenance, you know what foods do and do not work for you. In a recent interview, NWCR researcher John Graham remarked that maintainers generally resign themselves to boring food.

Only if you choose it to be so. But the question of whether maintenance food should be dull or lacking in variety is not a question for science to answer.

It’s an answer for cooks, and one that is old as time: how do you make do with what you have?

Cooking in itself began as a response to scarcity, estimated by anthropologists to begin anywhere from 10,000 to millions of year ago.  How do you make what food available work for your survival?

The concept’s antiquated given the wide variety of foods available thanks to advances in agriculture, transportation and commerce. It’s even a quaint cooking concept, considering most chefs, foodies and cooks cook for enjoyment or expression moreso than survival. As time passed,  food availability became a non-issue and cooking became an art.

NWCR research states most maintainers stick to the same food, so much that its researches call it accepting boredom. Frankly, I didn't lose or maintain my weight to be unengaged with life -- I wanted to live. I call "The Maintenance Diet" as a means of escaping that gloomy prediction.

“The Maintenance Diet” turns all these common understandings on their ear:

• “Survival is people’s default state; pre-weight loss eating was maintainer’s default, health complications from obesity aside. Portion and food choices didn’t kill anyone right away. If you’re maintaining, I’d argue you’re doing more than just surviving — you’re creating a better life for yourself than the same-old. Your food should reflect that also. Even if some of the most advanced researchers in maintenance are implying maintenance = being doomed to boredom, no wonder only 6 percent keep weight off within three years.
• There’s a clear distinction among what maintainers eat to maintain their weight loss, how you can manipulate those foods and how you flavor them in ways that don’t undermine your weight goals.
• Survival was a response to scarcity originally; For maintainers, thriving relies on food scarcity and lack of variety.

So what’s the point and what does this have to do with Ceviche?

It’s possible to maintain (pun intended) variety in your cooking, but not your eating. Meaning that while we know which foods works for us (varying on the individual) and we stick by them, variety reappears by focusing on cooking techniques, international dishes with built-in weight-friendliness, flavor combinations and presentation. The possibilities for fun and creativity come not in the food, but how you dress it up.

Ceviche serves as an excellent example of reconfiguring and manipulating lean proteins and weight-friendly foods. Visually speaking, little difference exists between grilled or sautéed fish. And yet the salsa-like Peruvian dish does not look like it was wrapped in tin foil and thrown in the oven. Nor do you serve it similarly. And often this preparation allows flavor combinations that you couldn’t produce with fish fillets.

You might still be eating fish, but how you prepare, flavor and present that fish opens a world of possibilities. In many ways, it can make a creative cook out of you, if only to alleviate  the boredom existing maintenance research forecasts.

Personally, I don’t keep it off to suffer and be bored — I lost weight to give myself a way out of that pizza-shaped hamster wheel.

The puzzle pieces for weight maintenance are different from those for loss.

It is accepted as common knowledge that to keep the weight off, you need to continue doing the things you did to get it off. If everyone says this and believes it, then it must be right.

Or not.

That is the premise of a study to be published next month by Sciamanna et. al. in the American Journal of Preventive Medicine.

The authors asked, “what if there is a difference between the behaviors associated with successful weight loss and successful weight maintenance”?

As the authors point out, most maintenance-oriented programs focus on getting people to continue the behaviors that helped them lose weight. They do not focus specifically on behaviors known to help keep weight off. It turns out there IS a difference, after all.

And this is important, because getting people to focus on less helpful behaviors might be throwing them off track when they get to maintenance.

The authors surveyed 1165 US adults who responded to online and newspaper advertisements. 926 of these people said their BMI had been greater than 25 at some point (overweight).

To figure out what worked for weight loss they took these 926 people who had been overweight and split them into two groups. One group had lost at least 10% of their weight over the past year (98) and the other had not (828).

To figure out what worked for weight maintenance they took these same 926 people and split them into two groups. One group had lost at least 10% of their body weight more than a year ago and kept it off for at least a year (192). The other group had not kept the weight off or lost it in the first place (734).

They asked these people about what they do in their every day lives. There were questions about food management, physical activity, thinking about weight control, and about tracking methods.

Then they looked for patterns among what successful losers do and patterns among what successful maintainers do. And they found significant differences. For example, people who exercised consistently or ate plenty of lean protein were almost twice as likely to succeed in weight maintenance. People who engaged in a variety of exercise activities or planned their meals ahead were about two and a half times as likely to lose weight.

For losers, these were the behaviors most statistically significant (p less than or equal to 0.001):

• Eating plenty of fruits or vegetables
• Eating healthy snacks
• Limiting the amount of carbohydrates eaten
• Controlling portions
• Doing different kinds of exercise

For maintainers, these were the behaviors most statistically significant (p less than or equal to 0.001):

• Eating plenty of low-fat protein
• Following a consistent exercise routine
• Reminding yourself why you need to control your weight

There was only one behavior highly significant among both losers and maintainers:

• Thinking about how much progress you’ve made

What does this mean for us? It means that while transitioning from weight loss to weight maintenance we might need to adjust some of our behaviors. The two modes are distinctly different. It also means that once we’re in “maintenance mode,” if we do gain some weight back, we need to go back into “loss mode” until the weight is back in the happy range.

It means that we need to pay close attention to what works for us during this transition phase. I like to think of it as having training wheels on our maintenance programs. We need to take the time to figure out maintenance through trial and error.

This kind of study gives me tremendous hope. Hope that one day there will be dedicated, evidence-based programs designed specifically for weight maintenance. Hope that one day because of these programs more 20% of us will manage to keep the weight off.

Until that day we’re going to have to figure this out for ourselves from the primary literature and hobble along with the few weight maintenance programs there are – most a clumsy afterthought tacked onto the end of a weight-loss program that focuses on continuing weight-loss behaviors rather than emphasizing weight-maintenance ones.

Much like weight loss, maintaining does not stop with Real Life. We each have our own approaches to travelling-while-eating, but some methods to win out.

I like whitewater kayaking.  As a sport people often joke that it involves 90 percent driving around looking for rivers, 25 percent drinking beer, and 5 percent actual paddling.

While the ratios are usually a little better than that, it’s definitely an activity I view as a REASON to stay in shape rather than a WAY to stay in shape.  Last season I spent nearly 300 hours sitting in a boat, almost 100 days. That translates into a LOT of driving and eating on the go, and the “weight maintenance” aspect of life can’t stop.

Compounded with the hours sitting on my butt driving is the fact I’m frequently with buddies who do not need to watch their calories and do not want to spend a lot of money.  A typical carful of us might include several males between the ages of 19 and 34 and me.  We stay in the cheapest accommodations possible (often camping next to the car along a dirt road) and eat as cheaply as possible.

The beer?  Well, PBR is often a favorite.  I usually bring along a case of Yuenling Light so there is a lower calorie alternative available in case I want some too.

But food is the main issue.  I am not going to fill up on pizza, or wings, or cheese puffs, or corned beef hash from a can.  Instead I keep it off at the grocery store.  Yup, the local market in whatever Podunkville place we happen to be.  As an aside, I should add that I actually LIKE out of the way places and one of the joys of kayaking has been discovering the various Podunkvilles and the people who live there.  They are often friendly and kind and not what you’d expect from watching movies like Deliverance.

Back to the grocery store.  First, it is fast.  I can usually find what I want and get out of there within 25 minutes.  Second, there is Real Food in there, unlike what is available at gas stations and convenience stores.  Third, you usually can figure out what is actually IN the food because it’s labeled.  This makes it possible to put it into the tracker on my iPod.

You can always count on the grocery store to provide the best road food options. But you have contingency options available.

For camping I’ll sometimes buy a carton of eggs for hard boiling.  Dinners frequently include frozen salmon or shrimp or boneless skinless chicken breasts, red and green bell peppers, and a sweet onion.  I roast these in a basket over the campfire while my buddies are eating cold canned ravioli.  I have been accused of “eating gourmet food like a queen” by these bemused paddling buddies.  Some of them have even been converted and eat with me, instead!

Lunches on the river are assembled from the wrap ingredients, dinner leftovers (if there are any) and a hard boiled egg or two.  Hot sauce packets from restaurants can be used to season the eggs.  If I know I’m going to be bringing a lunch in the boat I usually buy or bring some quart-sized Ziploc freezer bags.

Sub shops and pizza places

Sometimes there isn’t a grocery handy and we’re just looking to satisfy the need for a single meal.  In that case a sub shop or pizza place will usually have the raw ingredients suitable for making a salad.  If you buy or bring a spritzer dressing, you’re good to go even if they don’t usually make salads.  I generally ask for 2-3 times the amount of the cooked turkey or chicken they usually put on a salad, no croutons, very little cheese, and lots of different green things and tomatoes, etc.  If I feel like having more protein I might add tuna from one of my packets.  The almonds can be added for extra crunch.

Survival Food

I like to carry protein bars and miniature Clif Bars with me at all times.  I keep them in the car and stuff them into my PFD.  These are necessary for those times when there is either no food available or no food that I feel comfortable eating.  They are also excellent anti-bonking supplies while on the river.  Miniature Clif Bars are perfect because they don’t have a coating that melts (like Luna Bars), they’re individually wrapped so it doesn’t matter if they get wet, and they’re small enough to choke down in an eddy between drops.

The bottom line here is that it is possible to make relatively healthy food choices while on the road, even if you’ve got limited time, a limited budget, and friends along who aren’t interested in nutrition.

And if you take a little extra time you can even track it if you have a mobile device like a PDA, smart phone, or iPod.

Time for a change -- Second Helping began as a food site, only to shift into a community hub for the frontrunners of maintenance awareness. Time our name reflected that.

We promised this a while back, and with a transitory logo now in place we can begin transferring the site to Ikeepitoff.com!

We changed the name for a number of reasons: Second Helping originally began as a food site with some discussion on post-weight life. In the three years since its inception, we found the emphasis flipped.

Moreover, maintaining your weight — on your terms — has always been a strong belief of us here at IKIO (As Stan Lee used to a say, a No-Prize for everyone who catches me calling this Second Helping still). We liked the sense of ownership the new name provided the subject matter. And that self-expression is what we most want to celebrate here.

Bear with us as we continue transferring the site and don’t hesitate with questions, suggestions or requests for how we can better support your maintenance!

Russ Version 2.0 | A 350-pound rock critic changing his life from the outside in

Russ Version 3.0 | A 180-pound food writer

Russ Version 4.0 | Finally, a 150 lb. fighter for the good stuff

Russ Lane began as a 350-lb. rock critic; Losing weight he became a 180-lb. food writer; In Maintaining he ultimately became a 150 lb. boxer, New new Orleanian and maintenance advocate.

First writing about post-weight issues in 2001, Russ Lane set an adventure in motion, not only rebuilding his life but also transforming from a 350-pound North Carolinan to a 150-pound New Orleanian devoted to weight maintenance support and pushing the boundaries of healthy cooking.

Beyond Second Helping Media, Russ’ writes for newspapers, magazines and Web sites across the South, on music, food, arts & entertainment and human interest stories. He received accolades from writers ranging from Susie Bright to Anne Bramley, The eGullet Society to Sparkpeople.com. He’s spoken at conferences, taught others his cooking methods, consulting for fitness facilities, created a healthy eating program for kids with nonprofit Liberation Through Education. He appeared on The Today Show and Newsweek.

In a science-dominated field like weight loss, Russ examines weight loss by merging different traditions: ontology, cultural anthropology, gastronomy and a headful of zen training and a life of facing ugly truths and rising above them. His perspective is from a solider in the trenches, staring at the harsh realities of body image, self-realization and overcoming them.

“I have respect for personal trainers, dietitians, nutritionists … all my teachers.  They were invaluable in my weight loss,” Russ said. “But there’s blanks that need filling in — like keeping weight off, transitioning into a post-fat mindset and finding ways to make health food even more interesting than whatever we used to shovel in. In short, answering a question like ‘Now what?’”

With a 60-inch waist and 350 pounds, Russ always focused on mental endeavours (easy when you don't want to confront the fact you're 350 pounds, right?). His life changed when he decided, for once, to work on himself from the outside going in.

At 16, someone told 350-pound North Carolinian Russ Lane he would have three roles in life: a healer, a teacher, and they didn’t know the third. He just laughed and said, “Physician, heal thyself.”

Every addict has their scare; in college, Russ sat in an anthropology class and suddenly “repressed childhood” memories became reality. Considering your life was a lie was bad enough — feeling like property was the worst. Since he couldn’t fix the past mentally or emotionally, for once he decided to focus on his future, physically — his response was to begin walking two miles a day, soon hiring a personal trainer and learning how to use his body.

Eighty pounds into his weight loss McClatchy Newspapers offered him a position as a food writer, which he accepted with curiosity. Could you be a food writer and lose weight?

It was the simplest of changes in a chaotic time period.  As he was finding his own voice for the first time, Russ suddenly found himself overwhelmed. In time he confronted and redefined his relationship to food, came out and began dating, learned to dress himself, walked into another unhealthy relationship while his mother was also diagnosed and ultimately died of brain cancer, in addition to the deaths of a close friend and grandmother.

The process also taught him to find the good or humor in any situation — and if you can’t find any, them make some.

But there’s a use for in sharing it — examining the lives of successful maintainers with profound weight losses and identity shifts helps pinpoint truths that everyone faces. In people like Russ, those truths are more pronounced, and therefore more accessible for others to ask questions of themselves.

As no consistent scientific definition for maintenance exists, Russ considered himself in maintenance when he attained 180 lbs., 10 percent body fat while he was working as a food writer (the irony, right?) for McClatchy Newspapers.

So pinpointing truths about post-weight life — and creating positive solutions for them — are what propelled him to increase post-weight awareness and support. For all the High Drama during that time. what bothered him most were the simple things, the all-too-common reactions to transitioning into a new body. Nothing prepared him for the ensuing identity crisis. Without the weight, he had no idea who he was.

To keep his weight off, he reasoned, he’d have to rebuild himself from scratch. Now 150, he’s maintained his original goal – 180, 10 percent body fat – for 8 years.

And in doing so Russ found a kindred spirit in New Orleans, where he learned Reiki healing and learned to box. He found a personal style through combining New Orleans’ old world vibe, Aimee Mann’s fondness for vests, and David Bowie’s ability to wear anything anywhere and be true to himself. He also met his best friend, broke free of his past and forged a future devoted that mysterious third role that psychic mentioned years ago.

Russ is a fighter, but he fights for the good stuff: No matter what gets thrown at you, not only can you survive or endure — you can thrive. You can proliferate life, even in a world determined to remain small.

E-mail Russ at russ@secondhelpingonline.com

The American Society of Plastic Surgeons offers a wonderful overview of loose skin surgeries. Here is but one example of the work (notice the scarring).

For those looking for a basic overview of loose-skin related surgery, the American Society of Plastic Surgeons compiled an excellent overview, with photos, outlining the basics of the various procedures.

You can view that guide, Body Contouring After Weight Loss, here.

Personally, one of its members — Dr. Peter Rubin of the University of Pittsburgh’s Life After Weight Loss program, whom I interviewed a few years ago — is among the best in his field. *Shrugs* Besides, I only quote people I think are worth quoting.

But though this present excellent information, the fact the ASPS listed body contouring under “elective” surgery is intriguing.

Do you consider it elective and not reconstructive? In some fashion, the decision to remove loose skin is not a celebrity nose job. It should not be presented as such.

On the other hand … personally, I elected not to have it, as I did not trust my reasons for considering the surgery in the first place.