Are You There Yet? Weight Loss is a Journey

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August 8, 2015

Are you one of the women who tend to get anxious every time you go for your physical exam?  Do you hold your breath while the nurse is adjusting the scale to register your weight?  Do you get upset when you ask for your weight last year and she informs you that you have gained a few more pounds? How do you respond when your doctor discusses your weight?  Do you get angry and defensive? Do you tell your doctor you did everything you could or do you stay silent?  

Every year, I have seen quite a few patients like you.  Several years ago, my nurse Roxanne warned me how I was about to walk into a room facing an angry patient.  She didn’t want to hear that she gained 4 pounds from the year before.  She said the scale was wrong.  She said she did everything she could and it was not possible that she gained all that weight. 

I walked into the room and the patient was sobbing.  She claimed my nurse was weighing her in her winter clothes, at mid-day, after two meals.  She claimed her boots alone must have been more than a pound.  She claimed she had not had a bowel movement that day, maybe it was her constipation and not a true weight gain.  She claimed she did everything she could and listed all the healthy vegetables and nuts and grains she was eating every day and she wondered why she gained the four pounds.  The visit lasted much longer than the 15 minutes allowed for a routine gynecology appointment.  I reassured her, as I have done so many times to many overly-concerned slim women, that she will not die an obese woman, that her weight was perfectly normal, that she didn’t have to eat all the legumes and nuts that she had consumed.   

She was a slim woman, slimmer than me.  I was so close to advising her to seek therapy, as her obsession with weight gain was not mentally healthy.  With her being so upset, however, and her body mass index being within normal range, I did not think she could handle my advice to seek counseling.

Recently I had the opposite reaction from a patient.  She had gained a lot of weight from the year before, putting her body mass index at almost 40.  When the BMI is above 35, there’s an increased risk for all kinds of health problems including diabetes, stroke and cancer.  As I walked into the room, the patient stared at me in the eyes, obviously angry and sternly asked me not to discuss about her weight.

“I know what you are about to say, as you have said before. I know how my weight is, and I don’t want to hear about it.  I am not going to change because I have no time to change anything.  My weight is my weight and there’s nothing I can do about it and let’s not talk about it.”  She then stared at the wall while I silently performed her physical exam.  I gently told her before she left how, whenever she’s ready, I will be there to help her with her weight problem.  It can be done, I told her, it would take time, but it can be done.  She walked out in silence.

We women rarely are happy with our weights.  I wouldn’t be surprised if the Pew research about wealth, how only 1% of wealthy people consider themselves wealthy, is parallel to the survey about women’s weights.  We are never skinny enough.  Once many of us reach a certain weight, there’s a sense of hopelessness and desperation.  We don’t think we will be able to change our weight; it is too late as it already reaches “that” level.  We unhappily “accept” our fate of being above our desirable weight and stop fighting to lose it.  Most of us understand the risks of obesity, but why is it so difficult for us to lose weight?  Don’t we want to live a longer life? 

Weight loss requires multiple steps of interventions, and taking one step at a time would lead to a longer lasting result.  To exercise intensively while drastically reducing caloric intake can lead to severe fatigue and lack of energy.  It’s better to take smaller but more steady steps to reach one’s ultimate weight loss goal.

Today, start your weight loss program in small steps.  Stop buying simple sugar snacks and get rid of those in your kitchen cabinets.  Replace them with fruits and vegetables such as carrots or beets.  Replace fruit juice with flavored water.  Squeeze a slice of orange into your water.  Stop buying soda.  Get yourself a sparkling water making machine, or buy plain sparkling water from grocery stores and add your favorite fruit slices into it to give it some flavors. Fill your kitchen shelves with nuts and low fat crackers.  Fill your refrigerator shelves with yogurt and low fat cheese.

Today, avoid taking the elevator for less than two floors.  Take your time to walk up so you won’t get short of breath or fatigue too easily, as it will discourage you from using the stairs again.  Talk on your cell phone if necessary or listen to your favorite music as you are walking up the steps to distract your mind from your sore legs.  

Today, park your car in the middle of the lot so you can take a longer walk to the office building.  Maybe tomorrow, you can park even further away.  Eventually, you can fast walk to your car, parking in the farthest spot of the lot.

Today, make a note to yourself to start bringing lunch to the office instead of ordering out.  Don’t give into the temptation of snacking on sweets during office hours.  Bring some fruits or nuts or crunchy vegetables for snacks.  Keep some yogurt in the office refrigerator and use it as your cold treat, your version of ice cream as mid morning or mid-afternoon snacks.  In the evening, fill your plate with your favorite vegetables before eating your main course.  Drink water between bites.  Put your fork down on and off.  Chew slowly and intentionally.

Give it a few weeks, and start adding mild exercise into your routine.  Walk 15 minutes before eating dinner, use your stairs to walk up and down for 10 minutes before your morning shower.  Join a gym at this time if you have more time.  Go to gym classes where others will cheer you on and inspire you.  You are about to start a new phase of your life.  You soon will be ready to use smaller serving plates for dinner, stop using all elevators, park your car much further out, and three times weekly, you will either run in your neighborhood or take classes at the gym.  Pick something you like to do whether  it’s swimming, kayaking, kickboxing, cycling, or simply power walking on scenic routes.  Like everything else in life, you have to like what you do to keep doing it.  Exercise should be something you look forward to, not something you dread. Like me, you might get hooked to that lifestyle with a high level of energy.  You will look back at your journey and say to yourself:

“Why did I need all those sweets?”