The following is an excerpt of my personal journey to overcoming obesity on the path to finding wellness. You may find some similarities in your journey:
Sometimes when I share with people regarding my health journey, they have a hard time believing that I was once straddling between being overweight and obese for a good part of my life. Most people, looking at me and my current state of health, think that I have always been in a healthy weight range. In that same vain, when I was a child, I thought that no matter what I tried, I would always be fat.
Or as Kelly, a friend in grade school, once told me after someone called me “fat”, “You’re not fat. You’re pleasantly plump,” commenting on my pudgy build in fourth grade. I really appreciated that euphimism, though it still pierced me like a dagger. Why would it though? It was afterall true. The shame and low-self esteem grew.
At around the fourth grade – I had accumulated enough adipose tissue around my waist to fit in the overweight category. Before that time, I never had to think much about it. I remember my kindergarten photo with a Fonzi shirt and my hair slicked back. Where did this adorable child go? The first accumulation of weight came on the sides as “love handles”. Then, I started noticing more on my face, chin, chest, arms, and legs.
As a child, meal time other than dinner was usually casual. Breakfast was a healthy bowl of raisin bran or cheerios with milk – or maybe not so healthy. Lunch was often sandwiches or leftover pasta from the day before. We were often left to create our own meals – and as growing teenage boys, we sure could eat! My mother or father prepared dinner when they got home from work, and we all had to sit down to dinner together every day. The typical foods for dinner were the staples during the seventies and eighties: spaghetti, “poor man’s lasagna” – a mixture of macaroni, tomato soup, ground beef and chedder cheese slices, sub sandwiches. One of my father’s classic statements when he was preparing pasta was “if I could have pasta for breakfast, lunch and dinner, I would“. He often tried just that. Sometimes, when we were running late, my parents would bring home McDonalds or order pizza.
Our whole family has had problems with weight. My grandma on my mother’s side died at the age of 62 when I was only 7. She had kidney failure requiring dialysis and poorly-controlled diabetes. Imagine having diabetes in the 1970’s, giving yourself insulin without even checking your sugar. My mother and father were like most of the parents of the time, not well informed about healthy eating. I had no nutritional knowledge growing up. My information was what a child could get watching cartoons and School House Rock. I remember learning about the food pyramid around the fifth grade. I thought, how could I have become overweight? I was eating mostly the base of the pyramid – plenty of bread, pasta, and cereal. That was healthy, right? I remember thinking even back then that something didn’t seem right about what was considered healthy eating.
When my father went shopping, he liked to bring home fresh fruits and vegetables, and from the local import store, Italian meats, cheeses and olives and lots of bread. He usually made a salad with iceberg lettuce, tomatoes, cucumbers, and celery with olives and pepperoni with an olive oil dressing – ideally every day. I detested celery and tomatoes at that time, so didn’t explore the salad too much and probably didn’t have salad more than once a week. Little did I know at the time that this was a missing ingredient from my diet.
I remember the wonderful holidays as a child and my first “sweetheart” – chocolate. My mother gave us loads of chocolate and candy for Christmas and Easter, stuffing the stockings and the baskets full. During the holidays, we would make chocolate specialties by melting the disks of chocolate — making haystacks, chocolate with cherries and other delectable deserts. There were times when I craved chocolate and didn’t want to eat anything else. I would make “chocolate runs”, walking or riding my bike a mile to the nearest store. You could probably guess that my favorite book and movie as a child was Roald Dahl’s Willie Wonka and the Chocolate Factory.
As a teenager, I was enrolled in the gym and would go very often to exercise. Back then, the common knowledge was that if you got overweight, it was because you had “bad genes”, you were not disciplined enough, and you ate too many calories compared to what you expended. So you needed to cut the food and to exercise more. I tried all too many times various diets — juices, grapefruit, sometimes skipping meals and finding that my hunger drive was taking me to eat from the cabinets – grabbing the worst food options from the boxes, like pretzels, cookies, chips, and cereal. My mother was also diagnosed with diabetes when I was a teenager – she was in her early forties.
As I grew taller during puberty, I did grow into my weight a little and was in the middle range of the overweight category. I joined sports like basketball, wrestling and soccer, as a way to optimize my weight, but just resorted to the foods that I grew accustomed to eating – fast foods like burgers, gyros, tacos, pizza and subs. I quit many of the teams after the first month of joining, because of the demand.
Without as much emphasis on sports, I put my efforts on being a good student and being involved in multiple extra-curricular activities. My father rewarded our scholarship very well with $5 for an A, $4 for a B,etc. I mostly earned A’s. I found exceeding in school was something that would give me approval and a feeling of accomplishment.
Just before entering college, I had to have jaw surgery, recommended by my orthodontist on account of a significant overbite. I was told that if I did not have surgery, that I could later be at risk for sleep problems, like sleep apnea. My mother was able to arrange a similar surgery for her malocclusion at around the same time. We joked about the fact that our jaws would be wired shut, so there would be no way we couldn’t both lose weight. I did end up losing about 20 pounds, but during my college years my weight increased to approximately 192 lbs with a height of 5ft 10inches, which calculated to a BMI of 27.5.
In medical school, my weight was at a steady state, though I longed to get healthier. I continued my regular exercise, though I struggled to maintain good sleep habits on account of the demands of medical school. I continued to gain weight slowly through medical school and residency, though had a few periods of weight loss, which were associated with more rigorous general fitness.
It was at a time, while preparing for boards (rigorous tests of several hours that designate a physician as “board certified”) that my activity level dropped, my stress level rose and my eating habits hit rock bottom. My body was fueled by pizza and Chinese food brought by well-meaning pharmaceutical representatives and the frequent pharmaceutical dinner programs – I rationalized that it would save me money and provide socializing time. Unfortunately, by the end of my training, I was well in the range of what is considered obese. My weight increased to 225 lbs; a BMI of 32.5. I regularly had night-terrors and poor sleeping habits, which reflecting on it now, were likely related to some degree of obstructive sleep apnea.
I ate whatever I could, and admit to resorting to pasta and pizza regularly and not eating much natural food. In preparation for getting married, I decided to force a diet change. What did I have to lose … other than maybe weight? I considered my options, knowing that prior attempts were unsuccessful. My life was more stable with a more predictable schedule. My diet was mostly centered on South Beach / Atkins premise – eating more fat and protein and less carbohydrates. I organized my plans, and ensured that I prepared my own lunches and avoided fast foods and complex carbohydrates, including pizza, pasta and bread. There were times I had to pinch my nose shut while I forced spinach or sardines down. For desert, I would have ricotta cheese with cocoa and almonds and sucralose, or desert teas during the evening, which were enough to replace my nighttime cravings. I practiced saying “no” to desserts, which were often brought into my work setting — “no” to cookies, cakes and pies, while I nibbled on beef jerky and almonds. I found myself gaining momentum, confidence — and even discipline — making these first steps. About three weeks into the diet, I felt different. I had less cravings, I didn’t have to eat as much food, as long as I provided myself three meals a day and a few snacks. Over the course of about 8 months, I lost about 40 pounds, with a drop from a tight 38 to a comfortable 34 pant size. I had to have my wedding ring resized after I dropped the weight, because my ring slipped off my finger so easily that I lost it for a moment.
The cravings that I had for the usual carbohydrate-rich foods passed after the first few weeks. I found myself just as content with saying “no” to short-term sugar fixes over the long-term goal of better health. I visualized what my body was doing when I had consumed higher carbohydrate foods. I reminded myself that it wasn’t about taking foods out of my “bucket” of usual foods, but about putting new food options into it. Unlike other diets, this was a journey I made one step at a time, one day at a time, one meal at a time. This was the last diet I ever had to go on.
Continuing on this same trajectory through the years, I have lost a total of 60 pounds from my maximum weight and have been able to maintain the weight loss for the last 16 years. I am empowered now knowing that, if I ever were to slip and start gaining weight, I can re-evaluate my daily carbohydrate intake and adjust accordingly. I eat a high vegetable, moderate fat/olive oil and protein diet and low carbohydrate diet — amounting to the most natural form of food and have never had to count a calorie.
Lessons that I learned:
First work on addressing the stressors that let our guard down to consuming rapid-fire simple or complex carbohydrate foods. This includes adding exercise, walking, meditation and some breaks in the day.
Plan your meals, including packing a lunch to “protect” you from cravings at work – either the vending machine or well-meaning work partners bringing in cookies and cakes. Say “no thank you” and feel your discipline getting stronger by doing so.
Discipline comes with practice and strengthens as you go forward. It is a skill that you develop, one small step at a time.
It is OK to fall off the wagon, but get right back on. Nowadays, your steady path doesn’t have to be affected by vacations, holidays, birthdays and eating out – order the freshest options and small plates and enjoy. Consume a small amount of dessert, if you can. Know yourself.
Being overweight or obese is not a character flaw. It is a dietary disequlibrium that takes practice and self-nurturing to adjust one step at a time. It is not a past tense or future tense thing, it is taking control over the now.
I hope that you enjoyed reading this blog. Please share it and refer to the Overcoming Obesity section for more related topics. Dr. Christopher Cirino