Losing weight, gaining insight

Until last year, I didn't even own a scale. Sure, I knew I'd gained weight with each of my three pregnancies and realized that my wedding dress wouldn't fit-I'd crept up to a size 14 from a size 8-but I'm 5'6" and felt I carried the extra weight pretty well. In fact, I'd always thought of myself as active and fit.

I figured I logged at least two miles of walking a day trying to keep up with my kids, so I felt comfortable digging into the platters that pharmacy sales reps brought three times a week. And after I'd finished my meal, I'd just keep picking until my children had finished their dinners. At night I always treated myself to a dish of ice cream. I'd felt good and thought I'd looked good.

That's why I was hurt when one of my colleagues brought in doughnuts, but said only two of the staff could help themselves. He said the rest of us didn't need doughnuts. I was surprised to be seen as a member of the latter group.

Getting on that scale made me decide to pay attention to what I was eating instead of eating without thinking. I immediately switched my daily breakfast of a bagel and cream cheese to high-protein cereal and sugar-free yogurt. At lunch, I cut my portions in half and doubled up on veggies. At dinner, once I finished eating, I stopped picking at seconds and started crocheting to keep my hands busy. I still had a bedtime snack, but I switched to low-fat ice cream instead of regular. I started reading labels and tracking my caloric intake. Learning more about the calorie content of foods, I realized that I'd be better able to advise my patients on a healthy weight-loss program.

The first five pounds came off quickly. It was pretty motivating and made it easier to keep eating healthily. I bought a scale and weighed myself every day. As the pounds started to come off, it became easier to avoid the temptations that fill each day.

I made a concerted effort to bump up my exercise regimen. Although I could only spare about 30 minutes a day, I was determined to make that time intensive. I started using an elliptical trainer, and did brief spurts at a level of maximum exertion. Two days a week, I substituted weight training for cardiovascular exercise. I started using 5-pound weights and then worked up to 15-pound weights. In six months, I had lost 35 pounds.

Lots of patients commented, "Doc, you look great! How did you do it?" That invariably opened up the discussion of diet and exercise and gave me a chance to talk about what worked for me and whether a similar plan could work for them. The majority of my patients are overweight and about half qualify as obese. It was a wonderful feeling to know that I was a role model.

Last April, I saw my patient, Nellie, for the first time since I'd started losing weight. Nellie was obese and on medication for hypertension.

She looked at me and said, "Wow! What have you been doing?" Watching what I eat and exercising more, I told her. Then we began talking about her eating habits. Nellie was fond of fruit juice and likened it to eating a fruit. I realized that she, like many others, was unaware of how much sugar fruit juices contain. I realized that many of my patients were consuming 600 or more calories a day in sugary drinks-calories that the body doesn't even fully take into account when determining satiety. I counseled her that making all beverages calorie-free should be the first simple step to weight loss.