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Personal Account #2

By: Miriam Shark

I’m half the woman I used to be and twice as vigorous. I have lost 50% of my body weight and gained an enormous sense of well-being. It’s a pretty conspicuous change and therefore not surprising that lots of people ask how I did it, what diet I followed, and what I’ve learned. They want to know why I decided to make these changes and what I’m planning to do to maintain the weight loss. This note is to try to share some of the story and to put the diet itself into the larger context of personal change.

My personal change story has four chapters. First, I made an inventory of how I experienced myself, my life and my possibilities. Second, I made a decision that I did not like what I saw and decided to change it. And, third, I made a choice about how I would begin to make that change. But I am not claiming victory. Not yet. The fourth chapter is a work in progress.

Chapter I: Making an Inventory
There are a million ways in which being obese can interfere with, compromise or threaten everything from physical health to professional achievement to the practical details of daily living. But a creative set of psychological defenses can overcome even the most vivid evidence. Ironically, it wasn’t something that I was doing wrong that was the biggest obstacle to change, it was something I was too successful with – the ability to stare reality in the face and just not see it.

Just how good was I? My creative defenses explain how I could put on a "big shirt" and think that, like some kind of Harry Potter invisibility cloak, it camouflaged my bulk. Even with the feeling that significant negative health consequences were just around the corner, I could go for years without a check-up to avoid having my instincts confirmed. My defenses allowed me to endure the looks of panic and/or disgust in the eyes of the person in the airline seat next to me, whose space I couldn’t help but invade; to think of a seat-belt extender as a standard piece of business-travel equipment; to blame architect incompetence for the complicated ballet I needed to perform in order to maneuver in the confines of tiny NYC hotel bathrooms; and to spend hours honing an important presentation or speech while ignoring the fact that, as persuasive as it might be on paper, its credibility would be undermined by the appearance of the person delivering it, given the very real public prejudices, stereotypes and assumptions about obese people, especially women.

Conventional wisdom suggests that people change behavior when they hit bottom, when a certain threshold of intolerable circumstances is reached. My experience was different. Mounting evidence of the consequences of obesity pushed me even further into denial, calling forth even stronger defenses, and made me less likely to confront the facts. Once enough things were going well, I had the comfort level, motivation and confidence to drop the screen, and see the ways in which my weight was compromising my future … and it gave me the momentum to do something about it.

Chapter II: Making a Decision
Once the screen of denial had been pierced, the bright light of reality came flooding through. In that light, I recognized that my weight was having significant physical, social and business consequences. I saw that I was capable of and that I wanted greater personal well-being and success. The obvious became inescapable – nothing less than a profound physical transformation would work and I realized that I could do it, whatever it took. I didn’t so much decide to lose weight as decide to get out of my own way. I decided to step up and do what it would take to get the life I would prefer to live. And not just for today, but for the long-haul. A 53 year old with 93 and 89 year old parents has pretty good odds for longevity. I wanted to be in good enough shape to enjoy it.

I believe that making the decision to change my life was the pivotal moment. It was a decision that I made from deep within me, on my timeline and for my reasons. It was about "want," not about "ought." As such, it made the diet regimen a gift, a way to achieve a nearly impossible goal, not a deprivation.

Chapter III: Making a Choice
The big decision was to embark on a physical transformation. Finding the right program was a secondary decision but it was an important one. What made it possible to act on the big decision was choosing a program that worked for me. I was anxious to get started, to see significant progress, to begin to feel big changes. Even though I qualified for bariatric surgery, the risks, recuperation and permanent side-effects were unappealing and just plain scary.

I wanted a medically-responsible, evidence-based program that was proven to work in the real world. I needed something simple and practical, that would work in my life. The Weight Management Center (WMC) at Johns Hopkins offered all of the above.

My WMC program substituted nutritious "supplements" for conventional food. I followed the program faithfully for more than year, eating "real" food only on rare occasions, when required by business protocol or social convenience. To most people, that sounds like a recipe for constant hunger and feelings of deprivation. In fact, I felt liberated. As the evidence quickly showed that my program was working, I felt grateful. I felt liberated from the frustration, and sense of failure and futility that result from losing the war with food. I felt grateful to Dr. Larry Cheskin and the WMC staff for offering a lifeline and to myself for grabbing it. I felt buoyant – both literally and figuratively. I loved that feeling and was never seriously tempted to depart from the regimen.

What I’ve Learned So Far
While it is far too early to declare victory, I can identify several reasons why this program really worked for me.

Autopilot – The supplements are portable, pre-packaged, pre-measured and require no thinking, no attention, no preparation and no clean-up. They come in enough forms, flavors and textures to satisfy different tastes and most of them taste quite good. I closed my kitchen. There was nothing in the refrigerator but water, nothing in the pantry but supplements and nothing at all in the freezer. I went to the grocery store only for coffee, soft drinks or cleaning supplies. When I traveled—which I do extensively for work—I simply carried supplements with me. I sometimes had to use a larger suitcase, but I was immune from having to scrounge for food in the airport, or figuring out what to do in a late flight arrived after restaurants and room service were closed for the night. Without the supplements, such situations are usually very difficult to manage without resorting to the candy bars in the hotel room's honor bar. In fact, autopilot worked so well, and I was so buoyed by the success, I resisted the transition back to real food. The confidence and sense of control that come with it are addictive and I would willingly have continued to rely on supplements alone.

Momentum and Milestones – Just about any diet will result in quick progress over the first several days as excess fluid is lost. Unfortunately, what often happens is the resolve that propels one to start a diet fades at about the same rate that the quick, early weight loss levels off. With this program, I continued to see progress all along which helped keep me at it. In the earliest phases, the evidence of progress came mainly via the numbers on the scale. Later I could see differences in the way clothing fit and I had more energy. Others began to notice the changes and their compliments (and sometimes their envy) were wonderfully reinforcing.

My health indicators were also improving. My blood pressure came down very quickly, as did my blood sugar. The acid reflux disappeared and I slept better.

There were scores of large and small personal milestones: buying my first "regular" rather than "plus size" clothes; being able to leave the seatbelt extender at home; finding airline seats more comfortable; and being able to walk up the stairs without getting winded.

A Sabbatical from Food – Taking a year off from thinking about food helped to "reboot" my eating habits. Old habits had gone dormant, so I could focus on learning new habits rather than having to control old habits while replacing them with new ones. For instance, I have built a repertoire of nearly auto-pilot meals that have a long shelf life, take no planning, can be prepared with only slightly more effort that opening a supplement packet, and are high in protein and low in calories. Now I never find myself in the position that used to send me to the drive-through window of the local fast food restaurant, or to define popcorn or peanut butter sandwiches as dinner.

Taking a year off also allowed me to reset my appetite and my sense of portion size. In the months since I’ve been eating food again, I’ve become aware of the kinds of "food porn" that undermine even the most disciplined eater. Tantalizing ads for high-calorie, low-nutrition foods are everywhere. Equally dangerous are the portions served in restaurants. Eating restaurant-sized servings is a recipe for weight gain. At home, I weigh and measure food and serve it on smaller plates. With an increasingly practiced eye, I can more accurately determine how much of the salmon filet or hamburger to eat, and how many calories and carbs to log in my daily journal. As with many endeavors, when it comes to weight maintenance, information is power.

Get Moving – Without a doubt, my rate of weight loss was accelerated by increasing physical activity. For the first few months, I didn’t do much. Then I began to take a casual walk around the block or a few blocks a few times a week. After about four months and thirty pounds lost, I was walking more regularly. After six months, I was walking nearly every morning and had really picked up the pace. It took awhile to be able to reliably track how far I was walking because, as I discovered after purchasing three or four of them, pedometers have to hang perpendicularly to the ground in order to function. Until I had lost enough weight to change the geometry, I couldn ’t use a pedometer. By about nine months, I had increased both distance and speed and wasn’t feeling physically challenged so I began to run part of my route. By the time I reached my current weight I was running several times a week, sometimes as far as six miles, and I’ve gradually increased the speed.

Exercise serves two important continuing functions for me. First, being able to run, and to do so further and faster is daily confirmation of the benefits of weight management. I thoroughly enjoy the running. It adds immeasurably to my sense of well-being and it would be completely impossible without my physical transformation and mental attitude. Second, exercise really helps to start my metabolic ‘engine’ every day, helping me burn calories so that I can stay on the right side of that simple but challenging equation: calories in + calories out = weight maintenance.

Chapter IV: What’s Next
Along the way, people asked how I was going to celebrate when I reached my goal weight. I never really had a good answer. I didn’t crave any foods and I didn’t have any desire to begin undoing everything I ’d accomplished by gorging on calories. Eventually I realized for me, the weight loss was a means to an end, not an end in itself. Make no mistake, I’m thrilled to be 155 pounds lighter, significantly healthier and exuberantly more active. It is a kick to buy stylish clothes in small sizes. I like myself better and so do other people. But this is the beginning of a transformation, not the end. It makes it possible for me to push myself professionally, to be more active physically, and to be more engaged socially. Now my challenge is to step up to the possibilities I have created for myself. That is what will be worth celebrating. That makes it both necessary and possible for me to maintain my focus and to make my current regimen into a set of lifelong habits. That is what it will take to beat the odds against maintaining the weight loss. I’ve taken the first step, a giant one, but I can’t stop here. Stay tuned!


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