Numbers Don’t Count

There is proof, again, that weight is just another number. What it comes down to is the balancing out of how we really feel within ourselves. That doesn’t mean we have to always feel good and it doesn’t mean that we have to always like what we see in the mirror. All it means is that we can’t let our self-images revolve around a couple of little digits. The value we need to find is one that cannot be defined in numbers. They, in reality, are obsolete and the last few days have really highlighted that fact for me.

Ever since I reached my 90%, and eliminated the 2 Ensure Pluses, I have stuck relatively close to that number. Some days I’ll go up a quarter to a half a pound only to find that the next time I am weighed I have lost it again. Overall I have been more comfortable in my body as of late since I got here in July. This past Wednesday, however, added a little more perspective. When you have reached your 90% but then drop below it you have to be under it two consecutive weight days in order to catch any consequences. On this last Monday I checked in at a half a pound above the magic 90 which has been normal for me recently. Wednesday, just two days later, neither the nurse weighing me nor I could believe our eyes when I stepped on the scale – I had apparently lost 5 whole pounds!

I have no idea how that happened and, although I’m generally in tune to my body enough to be able to feel if I have lost or gained, I felt the same as I had on Monday. We blinked at the scale, blinked at each other, I got off, and we tried again just in case it was a fluke, but wound up with the same result. It was written in the book and I signed my name next to it as usual to show that we both saw the same thing on the scale and then I went on to worry about whether or not my passes would be revoked due to the loss. Thankfully, since that was only the first time, nothing was affected, but I was warned that if on Friday it happened again I would not be able to use the passes I had written up for the weekend. Not only that but both the Ensures would be added back into my schedule.

Now, this weekend is the only weekend out of my whole stay here that I have a visitor. My mom was able to come up the coast from Virginia for two nights and we had lots of plan for the short time she would be here. It would be a real shame if, for any reason, I wasn’t able to leave the center.

I was anxious when I got up on Friday – fuzzy with anticipation. It turned out though that I actually had nothing to worry about. Just as I had inexplicably lost the 5 pounds two days earlier, I managed to gain that plus another 1 and 1/2 back. Now, through all this neither my diet nor my activity level has changed in any way that could be described as more than minor, and yet the scale seems to have a mind of its own. For as surprised as I was, yet again, at the numbers I was even more surprised at how comfortable I felt in my skin even knowing the amounts. Just as I hadn’t felt any different the day that I had lost weight, I didn’t feel any different this day that it jumped either.

So, in the end, I got to keep all my weekend passes. I really don’t fee like I have anything to complain about through all this. I just goes to show that the numbers don’t have to make sense. They don’t have to rule your life or even just ruin your day unless you let them. Today is Saturday and I feel just as good today as I have the whole rest of the week…and I thnk thats good enough to rely on.

Do Not Cross

There is this thing called the “Buffer Zone” that has infiltrated the morale of the unit. The phrase gets tossed around casually, almost with and air of laughter, but its not what it seems. In actuality that one combination of two little words holds more weight (literally and figuratively) than one would ever deem possible upon first hearing them.

The term “Buffer Zone” can make or break you if you let it. What it refers to is the 4 pound difference between when you hit your 90% and when the team comes to the group decision to start reducing the 3,000 calorie daily intake. At this point the Ensures are already gone. Out of the two prescribed per diem they take the first off the schedule when you get to your 90% the second time, the same day they grace you with the holy passes, and the second Ensure goes the following weight day. All of this, the Ensures, the buffer zone, passes; it all pertains to the most important stage of the recovery process – the weight maintenance phase.

My problem with the buffer zone is that people here seem to give it an immense amount of power over them. Its a cause for over-analysis with eventual freak out potential. We all feel at least a minute amount of hesitance as we approach our 90%s because its the universal do not cross line for gaining here. In truth though, what so many people often fail to recognize, is that even at our 90% we are still not 100%. We are still considered underweight according to the standards set by our heights and ages. Even within the 4 pound buffer zone, above our 90%s, we are still not at our ideal body weights yet, in many people’s minds, it seems to become a glass ceiling. Elle was one such thinker. There were more than a few weight days before her final departure that prompted the morning to begin in tears. I know that its hard to see the scale numbers rise. I’m not at all trying to say its easy, even for me. Its just putting that name, that label, to it turns it into a boundary. Would it really be that bad to go above the buffer though? If any of us leave here believing that we have limits to our recovery process we are just going to damage our chances for success.

My view of it all is that I remember, very clearly, that only a handful of years ago I was right below the middle of my normal weight range and I felt really good about myself. I was 123, a good 10 pounds above my 90, and I was happy. Sure I had problems but they weren’t about my looks. It was only later, when I realized I couldn’t control some of my problems, that insecurity translated itself into an eating disorder. I guess what I’m saying is that I just don’t want to go there. Its for my own safety. If my mind lets the standard get set to a lower bar I won’t get through this.

Self protection is a must right now.

The Slow Climb

Okay. I am officially frustrated with my weights. Not because they are going up but because, despite my best efforts, the gaining process has slowed to the speed of one of those living statues that are seen all over Europe. You know, those people whose movements are so fractionally minute that you can’t tell they have done anything at all unless you leave and don’t come back for a few hours. That is what my metabolism is doing to me at this point. Still, each meal, every single time, I’m eating 100%. Beyond that I have not only drank my 2 daily Ensures but I have also taken the one additional PRN Ensure for the last 5 days. Its almost like the more I give my body the more it uses.

I know that for many anorexics those last 5-10 pounds needed to reach a healthy weight can be the hardest to put on. I have heard that many times, and part of me is very glad to see my body complying to the laws of reality, but I’m so close. My next goal is reaching my 85% and, right now, I am 3/4 of a pound away. At 85% I will be able to go out with Sally’s lunch group on Wednesdays and do shopping for cooking group along with various other things. I think most on my mind though, what I’m most anticipating, is the upcoming level change that 85% brings.

Level 4b, the ‘b’ standing for ‘building’, is the next step. Its not much really. All it means is that I will get to go out and walk around without a staff members accompaniment so long as I stay inside the institution. There are a couple of things this allows, such as being able to visit the fresh air park when I want, the invitation to explore the building’s multiple floors, and the freedom to hang out in the cafe with its beautiful view of the Hudson. Its hard to find alone time on the unit these days and I think that, too, just being able to get away for a few minutes will make a big difference. With so many new patients, their emotions running amok, still trying to get settled in, its pretty hectic around here lately.

Originally I had wanted to reach my 90% by now but I can see that thats going to take longer than I expected. I would have thought, if someone had asked when I first got here, that I would have been more adverse to the gain as I watched the scale rise. Its a daily surprise each morning when I find that I’m actually relatively comfortable with my body and am actively trying to gain more. I don’t want to say its easy because its not. At all. It takes more work than is explainable to someone who hasn’t actually gone through the recovery process themselves.

The reason I had wanted to be at my 90% by now is because all the patients that I have known since I got here are now getting ready to leave. Elle, Benji, Laura, all 3 are going home within the next 2 weeks and I’ll be the patient who has been here the longest. I wanted the level 4a change that came with my 90% so I could start going out on passes with my friends, even just a few, before they left. Well, things are what they are. As much as I may feel somewhat stagnant at this point in the program I know my body is smart. It will get there when it needs to.

It will be good to go on passes when I am able. I know that thats the next thing I am going to need to practice with – picking my own meals out of a lot more diversity and not being held so accountable for my actions. I know its going to be though, too, and I want as much time as possible before going home. I think I’ll just chalk up this whole snail’s pace of progress as a practice in patience. Yeah, theres meaning behind everything.

The pitfalls of good health

Lisa is back. Directly after breakfast on Friday morning she, along with most of her belongings, had been hastily packed up and escorted via wheelchair to the actual hospital part of Columbia across the street. She is the one here most at risk of refeeding syndrome and findings that morning had revealed dangerous potassium and electrolyte imbalances. Due to the high possibility of cardiac arrest there was someone at her bedside throughout her entire 48-hour stay. She returned to us unexpectedly this morning in a stabilized condition…for the moment anyway.

Refeeding syndrome, if its going to happen at all, usually occurs at the beginning of treatment when patients are first introduced to a healthy diet. Metabolic disturbances are a common effect from a sudden shift from fat to carbohydrate metabolism and and increase in insulin levels. Very basically, its a major shock to the system of a starved or severely malnourished person. When instituting a new diet the shifting of electrolytes and fluid balance increases cardiac workload and amps the heart rate. Our hearts, already depleted of muscle strength, sometimes just can’t handle it and it puts someone starting the refeeding process at acute risk of heart failure.

All of this is why inpatient treatment is so highly recommended for more sever eating disorder patients. Even if a greatly malnourished person wants to change and has the wherewithal to just fix their diet and start eating more at home inpatient is still the better choice. There has to be gradual steps in the process of renourishment. Every few days adding a little more into the diet to avoid an overload of healthy eating that can ultimately kill. Refeeding syndrome, for us, is just as big a threat as death by starvation is. All of it is a scary, delicate process.

One of the problems in successful eating disorder treatment lies within the basic diagnosis. There is no specific weight range that simplifies a written report for someone seeking treatment. The outward appearance of someone with the disorder does not dictate the amount of physical danger they are in. Some people with anorexia can be slightly overweight, while others with a binge eating disorder can also be underweight. Without constant medical monitoring, the checking of vital signs, pain level documentation, blood testing, and EKGs there is no way to tell who is at risk of refeeding syndrome.

When Lisa was taken 2 days ago we weren’t told anything even though it all happened right under our noses. The realization of actual death being that possible was a heck of a reality check as we all sat around trying to make sense of the wheelchair and panicked nurses busting around us. I don’t know what would have happened if it turned out that we never saw her again and I don’t really want to think about it. All I can say, and I think I speak for the group of us patients in this, is that we are glad to have her back no matter difficult it may be to look at her in her state. At least shes alive.

Gaining

Every body is different. Thats something that I have to remember. We all gain and lose in different places and the skin we wear is suited to fit each of us perfectly. I say the now as a reassurance because lately I have caught myself thinking more and more about how this recovery looks on me. I have to call it that – Its not weight, its health that I’m regaining. I know, too, that when I look in the mirror, what I see may be the common view but I interpret it differently than others would.

When I look in the mirror I try to point out the good things about where recovery is working its wonders. My waist, for instance. In my eyes it is all settling around my waist there is scads of logic and miles of reasoning to rebuke that. Its a fact that in the refeeding process the initial weight does seem to amass in the abdomen. This is because of a few things such as your stomach, not used to food, is digesting slower. It makes sense. Your body, not knowing when it is going to be deprived of food again, tries to hang on to what it does get for a longer period of time than normal.

Its also a fact that, when a person starving themselves of the nutrients that supply energy, the body takes that energy that it needs from internal things in a certain order. Fat goes first. When it has used that up the energy stored in muscle is the new target. Those get used and limbs start looking gaunt and thin, and so it goes down the line. Eventually the energy needed starts getting taken from some organs to keep other, more vital, ones working. Organ mass is lost and shutdown of different ones can occur as your body does its best to keep the two most crucial, your heart and brain, going as long as it can. Thus, when your body is gaining everything back, it regains first what it last took from and things in your torso get replenished before arms and legs do.

All of this comforts me when my mind starts to wander into the questioning black hole realm and I know that what I see around my middle will disperse through the rest of my body in time. I also know that I am going to gain differently than some of the other girls here by comparison for one very BIG and important (and cute as can be) reason. Reese. I have had a child and most of them have not. My amazing, now 8-year-old, son is the driving force behind so much of my work here and there will never come a day when I would choose a flat stomach over him.

We are all different, in all unique shapes and sizes, and if defined by no other label, I am ME.

The Trust

Dusk is slowly rolling in and the couple of floodlights meant to illuminate the fresh air park have flickered on. We walk and chat, Benji, Laura, and I, the only ones with the ability and desire to go outside at this point, as our 8 pm snack digest. This time there is focus on the conversation. Its turned to an attempted tackling of the trust issue, specifically in regards to dietitians.

“Look, its not possible for Sally to know the exact calorie count of every food item in New York City. I think thats the point shes trying to make though, that its just not as important as we want to believe it is.” I feel like I am skirting the edges of this conversation because I really don’t want my mind to delve too much into the realm of calorie analization. Its just one of those places that I don’t feel safe letting my thoughts go to yet.

“I don’t know.” Laura states as she ambles along to my left. “Its just something I would like to be able to count on. If we are expected to make our own meals in regards to a specific calorie count then I feel like I should know so that I can do it right.”

“Are you sure thats not your eating disorder talking?” Benji, on my right, having remained thoughtfully silent, now pipes up. “We all know all too well that the eating disorder is about control and rigidity.”

“I don’t know.” Laura says again, her previous conviction wavering. “Maybe I should get a dietician for when I leave here.”

“If you do that,” says Benji, “you will have to choose to believe what they are telling you. If you are just going to question everything he or she says then there wouldn’t be a point in paying the money for sessions with one.”

“Right now I just want to be able to trust Sally and I’m not sure if I do.” Laura sighs with frustration, not at us or at the conversation, but at the delicate situation. “Once there is that ounce of doubt I can’t help my mind from just questioning everything.”

I watch the ground move beneath our feet as I try and choose my words carefully. “I think one of the main things that is the job of a dietician, when treating a person in eating disorder recovery, is to portray that it really doesn’t have to be exact. We have such a need for strict planning when it comes to our meals, and there is the idea that keeping with that but in a different way will help us to get healthy, but when it comes down to it we really don’t need all that rigidity. It doesn’t matter if its aimed at the goal of health or not. That rigidness is still part of the eating disorders control. What we need to learn and apply is intuitive eating. Our bodies know whats best for them and, if we learn to listen to what they are telling us instead of the ED, then we know we can trust them. I think its somewhat of a dietician’s job to ultimately help us to identify and really use our filters between the disorder and what our bodies are really telling us.”

Laura seems a little more at ease but its visible that her mind is still hard at work. “I mean, yeah, I know that our bodies are smart about what they need and all. I don’t know. I just want to know that I’m doing the right thing, and if Sally says something is 220 calories when its really 300 how can I trust that I am getting the calorie count I am supposed to?”

“I think thats what shes saying though,” Benji added into the mix, “Its that over all that 60, 80, 100 or even 200 calories shouldn’t matter in the long run. At the end of the day variations just don’t make a difference if you keep your generalized calorie count in mind.”

“I get the feeling that dietitians just don’t outwardly stress how much discrepancies of that nature don’t matter because, as eating disorder patients, most of us can’t deal with that lack of control over what they eat. I think thats why they add on specifics like 200 extra calories now, an extra 300 next week, an extra protein bar for a daily snack, etc.” I said, as i watched Gina rise from her bench and signal that it was time to head inside.

“I know you guys are right,” said Laura, rounding the last corner before the door. “Its all just so much easier said than done.” With that Benji and I nodded in agreement as he held the door and we filed inside.

A dawning

Monday morning and its a quarter to six as I sit here at my worn wooden desk. I’ve got my little purple booklight attached at a workable angle so that it shines only, but brightly, focused on my notebook. With Elle still asleep in one of her innumerable bizarre positions across the small room I am weary of waking her with the searing glare of the overhead. I think its nicer this way though, with darkness still curling around the edges of my periphery. Its makes me feels like I am the only person in the world thats awake at the moment enjoying this unnatural silence. Everyone else will be up soon enough.

With my head in my hand I find myself staring vacantly at the light greenish-gray wall in front of me, my mind miles away. Its pleasantly surprising to realize that my palm is actually cupping cheek. There is actual, real, soft flesh on my face. I have a presence of health, of life, to now rest in my hand. It has replaced the angular strictness of my jawbone and the definitive protrusion of facial contours. I’m starting to feel a little more whole, more like a person of substance, one who matters, these days. Its a good feeling that for me can only be described as having previously been a ghost that is now slowly coming back to life. If this is what reincarnation is then I’m all for it.

The little Buddha belly, that I’m told only I notice, has gone again. It builds up at the end of each day and then quietly disappears as I sleep. I’m hungry and my stomach is audibly reminding me of that fact but breakfast is still an hour and a half away. I know all things in their due time but my stomach remains impatient. I breathe and realize that my fingertips still smell like oranges, the result of dinner last night. The scent doesn’t help to quiet my belly. This morning we have weights again and, although I was sure yesterday that I wouldn’t have a problem due to the fullness, at this point I’m a little bit wary. Its all due to what I have dubbed “that wacky metabolism”. We’ve all got it here, loud and clear, and none of us can predict it.

So the clock ticks and dawn slowly breaks outside illuminating the eastern windows of the tall surrounding buildings in gold. Its supposed to be another hot one today although not as bad as the last few weeks this heat wave has laid on all of us. When I checked the computer the prediction was a high of 90 with sun. Hopefully the mugginess will stay to a minimum. Thats whats been the real killer during fresh air breaks recently. Its hard not wanting to be continuously cooped up indoors but also not wanting to be bathing in my own sweat upon the first step outside. This is one time a happy medium may not be found.

I hear a soft “whump” behind me and turn to see that Elle has knocked her pillow to the linoleum floor in her sleep again. She is softly snoozing on her back with one leg awkwardly crossed over the other and everything from the collarbone up is hanging off the edge of the bed along with her right arm. I have no idea how she sleeps like that but, whatever the reason, it seems to work for her. I rise from my desk to retrieve the lost pillow and smile to myself as I put it down by her feet, the only place on the mattress with enough room. Just then there is a knock at the door and the announcement of “weights” peals loud and clear before traveling on down the hall toward the other rooms. I put on my socks and step out to begin the day.

Weekending

It seems that lately things around here have been a strange oscillation of slightly uncertain, a bit topsy-turvy, and relatively quiet. Its almost as though everyone is waiting cautiously to see whats going to happen next but they have no idea what that might be. Then again, maybe thats just the take I am getting from things. Although there havent been any recent arrivals, apart from the new med students starting their monthly rotations, there have been a few departures and pending dates to return home announced.

Right now I am RTU (restricted to unit) for the weekend. This is because I didn’t gain the minimum of 3/4 of a pound between Wednesday and Friday. When I got on the scale I was only off by a quarter of a pound and half-heartedly cursing myself for using the bathroom when I first awoke this morning. It is what it is though and theres not too much I can do about it at the moment. I’m still eating 100% of everything so the slight slip isn’t from lack of trying. All it really means is that I can’t go outside for fresh air breaks until the next weights on Monday. There isn’t any reason why I shouldn’t make that one unless my metabolism goes truly haywire and Wednesday morning is the one I really need to be sure to make anyway.

This coming Wednesday is the Target trip everyone has been waiting for. We are supposed to leave here at 11:30 am, lunching at Applebees first, and then carrying on to shop at Target and it’s surrounding stores. Then we are supposed to be back by 5 pm, just in time for dinner. I don’t plan on buying anything clothes-wise because I’m in such a transitional period as far as my body size goes right now, but I’m still looking forward to the outing whole-heartedly.

There is an Applebees menu floating around here somewhere too because most of us have to preplan our lunch order so no one is caught off guard when we are at the table and only have about 5 minutes to decide. I’m pretty excited about Applebees because the group of us eating there is probably going to prove to be very interesting. I think I am prepared for just about anything to possibly happen. I just need to make my Wednesday morning weights…my fingers (and toes) are crossed for it!

Other than that the weekend looks like its going to be pretty slow. Not being able to spend time outside, art being cancelled, and recreation being held in the gym tomorrow where I can’t go on RTU, theres not a whole lot left on the docket. Oh well, Maybe I’ll be able to get some artwork done. That would be nice and I have been eager to try out the brand new liquid acrylic paints my boss from the tattoo shop bought for me before I left. So thats the wekend – relaxation…its not a bad thing.   🙂

Clickety clack

The scale clicks as one of the nurses moves the little weights around. It takes a minute to get it right. The final verdict has to be perfect, safe, and secure. There can not be room for error. It’s an important process and, after a few minutes, Tiffany emerges from the exam room and holds the door for me to take her place.

I rise from my sitting position on the hallway floor and get a couple of “good luck” comments from Amy, Elle, Benji, and Laura who are next in the queue. Today is the day that I am aiming to meet my 75% of ideal body weight goal. If I can do this I can move up to level three and assume all the privileges that come along with it. There is the ability to go on staff-accompanied outings to pretty much wherever they are willing to take us. There is the emergence of new activities on the schedule that I wasn’t eligible for below 75%. These include some of the more physical things like going to the gym for a game of badminton on Sunday, participating in the yoga group thats held twice a week, and going food shopping off the unit in preparation for coffee klatch. At 75% there is also the cooking group that is immediately followed by a lunch in which we dine on what we have cooked. There is now the Wednesday lunch group in where the unit’s dietician, Sally, takes a few of us out to lunch at one of the many nearby restaurants or delis. Then, at 75%, there is the group that has been my aim for a while now – Menu Planning.

Finally I will get to decide from, limited mind you, list of meal options for each week. I have been here long enough to go through the rotation and try everything they have to offer, for better or worse, and now I can have more say over the composition of the meals I am consuming. I consider this with a slight smile bringing light to my still sleepy 6 am face as I enter the exam room.

The heavy door closes behind me and i start to get undressed. Its just me and today’s nurse in there and she is busy updating and organizing the charts on her clipboard while I lay each article of clothing on the counter as it comes off. The room is not as chilly on my bare skin today and I am thankful for that. I am down to the one thing we get weighed in, my underwear, and she follows me into the tiny bathroom where the scale stands tall and intimidating. The authority this hunk of metal takes on is almost eerie; its extreme influence unnerving.

I am used to the nurses doing double and triple takes when they first see me undressed. At first glance it almost looks like I am still clothed due to all of my tattoos but this nurse has been through weights with me before. It’s not new to her. I step up onto the scale’s platform with determination, feeling the rough non-slip surface beneath my bare feet.  The nurse slides the bottom weight around, first to the 100 which proves too much, and then back down to the 50 pound mark. The upper, smaller weight takes a little longer to adjust, a bit more back and forth. I watch the needle on the side do it’s slow shimmy.

Finally, with one reassuring glance at the exact numbers, I get my answer. In the last 48 hours I have gained the one pound needed to hit my 75% goal. Its just the first of many accomplishments in this arena and I can’t wait to see what is behind the new doors it will open for me. I dress again and head back to my bedroom giving the others in the hallway a thumbs-up as I go.

The weight of progression

I am sitting in the dimly lit dining room where the tables have been pushed against the wall and yoga mats laid around the floor. Stress and coping group is rolling right along as the Friday afternoon sun leaks in through the slatted blinds. We do different things each week in this group but it’s mostly meditation and guided imagery oriented. If we aren’t into that sort of thing we have the option to read, journal, or do something else deemed suitably soothing quietly while the meditation tape plays in the background.

Elle is asleep with her Star Trek novel open in her lap on the couch next to me and I look up from my writing as her breathing becomes audible. On the other side of her, in a chair, Benji struggles to keep the comic book he’s reading from falling to the floor as his own eyes threaten to give in to the atmosphere of this makeshift sanctuary. The others lay on the mats more or less following the direction of the recorded voice that urges calming exercises between interludes of piano music and nature sounds. If proposed, I’d definitely place a wager that more than one of them is asleep as well.

Its one of the more stressful days due to some clashes between patients and staff earlier and the weekend weights taken this morning. The rule is that, once each of us enters the official weight gain phase of treatment, we have to gain a minimum of 3/4 of a pound each time the numbers are taken. Every Monday, Wednesday, and Friday are the stressful days as, at 6:30 am on the dot, we line up outside the exam room for the scale’s verdict. These days it’s a difficult balance that shakes everyone’s ease. It’s hard for most to watch the scale go up no matter what the amount is but, at the same time, we want that 3/4 difference because if we don’t make it we will be RTU until the next weights check.

RTU stands for “Restricted To Unit” and basically means that we are confined here no matter what our status level is. For me that would mean no fresh air breaks, which I value pretty darn highly due to it being the only outdoors life I have right now. For Elle, who is on level 3, to be RTU would mean the loss not only of fresh air breaks but also of any other outside privilege. At level 3 we have the eligibility to go on staff-accompanied outings to places outside the building. sometimes its to the store down the street for supplies. Sometimes its a trip out to eat with one of the staff members for practice. Then, occasionally, its doing something that involves delving deeper into the city like going clothes shopping or getting a haircut.

To have that freedom and then lose it, for any amount of time, can be a depression-inducing blow. RTU is meant to limit the amount of physical activity a person does so they can gain the intended amount of weight by the next official day. However, these days can be mood lowering on the other hand too because a lot of girls here are still terrified of the scale moving at all. They may be eating more but they are still giving their eating disorder sanctuary in their back pockets and letting it have its way from there.

Regardless of the confusion and sense of upheaval most of us feel regarding the weights vs. RTU issue, I believe they have a really good system here. They know what they are doing, as far as the program structure goes, and what a lot of it comes down to is acceptance. There is no other choice beyond that of accepting your body, accepting the weight gain, and accepting that you will have to live with your new self for at least 4 weeks once you are in the weight maintainance phase and doing a bulk of the research participation. I don’t know the exact numbers but, from what I’ve heard, Columbia has a higher long-term success rate than many other in-patient programs, and that’s some news I can definitely accept.