M.D.


I am a 5'5" woman. In April of 2008 I weighed 271 pounds. My excessive weight greatly impaired my quality of life and posed clear health risks for my future. My life was punctuated by awkward moments like the need for assistance (and a lot of contortions) to get up when I knelt down, the need to squeeze myself into tiny seats on airplanes and at theaters, always being worried about infringing on my neighbors' spaces, and never feeling small enough. I was less than enthusiastic about going anywhere that involved much walking because I lacked stamina and would often become winded quickly.

On April 17, 2008 I first visited the George Washington University Weight Management Program and started the "Program A."

In the beginning, the hardest part was overcoming patterned responses that triggered thoughts and cravings for certain foods. For example, after a long hard day of work my pattern would be to stop at a fast food restaurant and get a take-out meal. After all, I deserved it, I thought. While working with the physicians on the weight loss program, I addressed those cravings during the group sessions. I started to take time to think about what I was feeling and why. By wrestling with those thoughts I was able to move on from the craving.

I also learned a few "tricks" along the way. The meal replacements were satisfying enough as long as I drank lots of water (probably about a gallon a day!). I also allowed myself the occasional solid food item, like celery with a teaspoon of peanut butter or lettuce with a low calorie dressing.

I averaged about 4 pounds of weight loss a week. I learned, though, not to be a slave to the scale. One week I would lose nothing, the next I might lose 6 pounds. I never will really understand this, but that's okay.

After 16 weeks I transitioned to program B. I felt a little trepidation. Program A worked great for me. I felt like I was losing one of my training wheels. It was fine, though. I had a bit of an additional challenge because I am a vegetarian and it is hard to get enough protein without lots of calories. I discovered pre-made healthy foods with lots of protein (mostly products made with soy) and changed my yogurt selection from "Lite and Fit" to Greek yogurt (much more protein and less calories and sugar with Greek yogurt). I bought some reference books and used a chart each day to record my intake (Dr. Kahan gave me one I love). I learned a lot about what acceptable portions look like and where the unnecessary calories were creeping into my diet. I spend time twice a day with my chart planning how to limit my calories and get enough protein. It has become a problem-solving challenge for me that brings real rewards.

After about 10 weeks on Program B, I am now averaging about 2 pounds of weight loss per week and enjoying my foods.

I also added exercise into my daily routine (after I lost some weight, exercise became much easier for me). I now incorporate walking as much as I can in my routine. I have never been an exercise fan and, after two back surgeries, I have to avoid anything that jogs my spine. The important thing is that walking fits the rest of my life. I can always walk somewhere. I find things to do that are fun on weekends and try to manage 10,000-13,000 steps those days. During the work week, I do the best I can, even if just to walk around the office, the neighborhood around the office, or around my house.

As of October (6 months into the program), I have lost 76 pounds and I am still going. My quality of life has changed radically. I no longer dread trying on new clothes. (I went from a size 24W to a 14W or 16W.) I do not get winded when I walk.

I realize this is the way it should be to really enjoy my life and live it more fully. Sure I might be free to eat all I want of whatever I want, but that is the same as saying I am free to kill myself if I want to, and I would rather just be normal again.

I also find it helpful to note the people around me - what they eat, their size, and the impact of a lot of excess pounds if they have them - not from a judgmental perspective, but simply to frame my own sense of what I should be doing and to firm my resolve. I do not see this program as a "diet" but as a way of living. The real test will be to sustain it for the rest of my life. I am working on my strategy for doing that.

Update:

It is now June and I have been on the weight loss program for fourteen months. I have lost 125 pounds. It is hard to believe. I went from 270 pounds to 145. As a result, my blood pressure is within normal range. My blood sugar is also normal. All without medication. I have gone from the largest plus sizes to misses medium and petites. My mental state is greatly improved as well. I no longer hate shopping for clothes. In fact I had to buy all new clothes because of the significant weight loss. My husband commented that it was nice to see me wearing bolder colors. Actually I always wore colors, itís just that me and my clothing were drab and worn. Now I am energetic and much more upbeat. I no longer avoid seeing my reflection in mirrors or store windows. I can walk for miles and never get tired. The feedback I receive from friends and colleagues who have known me for years is wonderful. My challenge now is weight maintenance. I have given myself a range of a few pounds on either side of 145. I am learning how much flexibility I can have with regard to higher calorie foods. I am trying to maintain balance with increased calorie intake which includes smaller portions, less food on the plate and better nutrition choices. The past year really helps, though it will be a continuing challenge. When I see people who have serious weight issues, I can readily empathize and wish I could influence them to try the weight management program at GW. It has been a life saver for me. However, as we all know, those folks have to offer an opening and show some receptivity before offers of help or advice would be welcome. I hope to be able to say two years from now that I have kept it off. It has been quite a journey and not nearly as bad as most people would think looking at me then and now.

— M.D. (not a doctor :-)