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| This is my belt. The punched hole (far right) accommodated my bulging waist 3 months ago. Now smaller |
Early but Overlooked Signs
It was last February when it hit me. I was becoming very uncomfortable in my own skin. Although the signs had been in place for several years, it was in February 2019 when I began noticing them. My attention to the warning notices began when we were celebrating our granddaughter’s first birthday. More signs flashed into view in May, when my son and three-year-old grandson flew all the way from Australia to surprise me on my 70th birthday, and again, later in May, when I was attending a major audiobook publishers’ convention. The final message board lit up in front of me in October, when I was holding forth as a workshop presenter at a literary festival. I was uncomfortable because my skin was stretched taut like the surface of a helium-filled blimp, and every item of clothing I was trying not to look uncomfortable in, was spilling out my blimp-ness to everyone who chanced to see me — and that was a lot of people. Brontosaurus, or thunder lizard, comes immediately to mind.Morbidly Obese
My girth, or bulk, at 306 lbs. (well into the clinical definition of “morbidly obese”) for a 5’10” man did not just appear overnight; it was the result of an accretion of fat and other junk that accumulated on me over the years like barnacles on a tramp steamer (By the way, I realize I’m mixing metaphors here — blimps, tramp steamers, and large dinosaurs — but when you are so overweight that you are light-headed after going up a single flight of stairs, when you plod down the sidewalk like a brontosaurus, and when you pop buttons off your XXL jeans, you are not constrained to being just one example of enormousness — you can be a barnacle-covered, blimpish, aging steamer carrying a herd of thunder lizards).
Insidious Gain and Caloric Overload
In all fairness to the year just ending — a crappy year by almost any measure, including a tape measure — I did not just find myself at 306 lb. at the beginning of 2019. For the six prior years, as an audiobook narrator, I’d been ensconced in my home studio (the Dungeon), sitting on my slowly inflating ass for hours a day, so focused on narrating that I ignored the insidious signs of weight gain that were whispering, then yelling at me. Couldn’t hear those shouts through my headphones. The facts that I was consuming about 3,500 calories a day and downing well over 10 ounces of wine every evening were indicators of my depression and frustration.Eating out of Embarrassment
Also working on me in May was my 70th birthday and a surprise party in North Carolina thrown by my family and friends. While I was delighted to see so many wonderful faces, including the happy expressions of my son and grandson who flew in from Australia, I was struck by my excessive weight and commensurate balloon-like appearance — to be in front of so many kind people but feeling so burdened by my bulk was almost more than I could bear.Almost an Addiction
By October, with a commitment to run a literary festival workshop in Maryland, I found myself at a men’s clothier, having a pair of trousers let out by inches, and a jacket re-tailored to accommodate my swelling hugeness. A new belt — much longer than any other belt in my closet — was required, and even at that, I had to punch one more hole in it near the end to get it to fit properly (see picture above). Like a drunk who needs to hit bottom before recovery can be started, the fat me had descended emotionally about as far as I’d ever been.Family Intervention: The Reason to Address the Problem
Throughout the spring and summer leading to October, I visited my daughters and my granddaughter in Raleigh, North Carolina, and found myself huffing and chuffing through the smallest of exertions — like lifting my 20-month-old granddaughter over my head in grandfatherly play, or getting up off the floor after watching her color with markers and play with her doll house. My wife and daughters commented with serious concern about my breathlessness, struggle to stand up from sitting on the floor, and my lumbering gait, and they each expressed worry about my health.My youngest daughter — our granddaughter’s mom — was quite clear in her vision that I should be looking ahead to my granddaughter’s and our Aussie grandson’s high school graduations in 17 or so years. In my current state, she opined, I might not make it to those celebrations. My two daughters’, son’s, and wife’s expressions of worry turned into urgings for me to address the problem professionally, and so, by the end of the summer, I forged ahead and made appointments with several members of my health care team.
Having a Supportive Health Team is Crucial
My first stop was with my cardiologist, who ordered a nuclear heart scan (the one where you get a radio isotope injection, get scanned, run on a treadmill until your heart rate is well-elevated, then get scanned again). The results of that test were promising: my heart is fine, and there are no issues with my arteries — yay. However, he put me on atorvastatin because my blood work indicated a trend toward cholesterol problems.
Next stop, my pulmonologist who addressed my breathlessness. He put me through some diagnostic exams — X-rays, blood work, and a session with the spirometer — an advanced form of breathalyzer tests, minus the state trooper — and confirmed that, among other issues, I was not exhaling enough CO2 and was probably in the early stages of COPD (chronic obstructive pulmonary disease). He prescribed a twice-a-day inhaler and agreed that my weight was a significant — but reduceable — factor in my problem.
Then it was off to see my internist, one of the best and nicest doctors you’ll ever meet or need. He reviewed my lab work and pulmonary and cardiac tests and listened to me describe my latest symptoms and my family’s concerns. Knowing I am a terrible self-starter, he recommended two courses of action: hire a dietitian and hire a personal trainer. He reckoned, correctly, that only by investing in help — putting hard cash in the hands of professionals — would I stick to good eating and physical improvement routines.
When You’re Not Good at Sticking to Exercise
I must admit that I don’t do gyms well at all, at least not commercial sweat-lodge-like gyms lined with stationary bikes, treadmills, stair-steppers, and rowing machines, along with towering and intimidating weight contraptions spread around the hangar-like floors. No matter how slick those back-beat-driven commercials touting the benefits and like-minded camaraderie of fellow exercisers, at 70 I just don’t picture myself chugging along at tortoise-speed in amongst a line of 20- or 30-something workout impalas. Even as I write this, two days into the New Year, our local NBC affiliate broadcast a report on what to look for when signing up for a gym membership. The background in the video is very dissuasive for folks like me who want to avoid the crush and body-shame of a multi-plex gym.I’m one of those older, stuck-in-my-ways guys who needs the privacy of a small gym and the one-on-one attention of a coach who won’t make me feel like a hopeless case. Fortunately for me, it turned out that the swim club I’ve belonged to for 50 years (and rarely used), has a nicely-equipped gym that is often inhabited by men and women my age or older who are totally non-judgmental and discreet when it comes to sharing floor space with their fellow members. It was equally fortuitous that I was able to track down and hire a personal trainer who is affiliated with the club and trains several other club members in the club’s gym and pool.
Find a Trainer Who Knows What You Need
My trainer works with men and women my age and older — of all shapes, sizes, and conditions. She’s building an exercise routine for me that is do-able and scale-able, that is, I can build on it over time, and increase the repetitions of each routine safely. From treadmill to upper and lower body exercises, to free weights and weight machines, my trainer’s careful prescription of just the amount of exercise I can handle is working. I can also do many of the routines at home, with only minor investment in equipment such as resistance bands and light weights.
Don’t Forget to Walk
The foundation to all her advice was the strength of my desire to take up walking daily. In college in Colorado I was a good skier and a pretty good technical rock climber and avid hiker; as a photojournalist, I was humping 40 lbs. of camera gear all over the place; but by the time I hit my 60s, I was a chair-bound writer, down to a slow walk around the neighborhood. In the past two months (November-December), I’ve upped my walking game to 3+ miles per day, on terrain that rises and falls enough to get me into a cardio zone for at least half the time. Running is out — knees are shot. I track my walks on my Fitbit and with the Samsung health app on my Galaxy S9+. Slowly but surely my distance and times are improving.
It’s not impressive, but it’s an encouraging sign of building health for a 70-year-old.
When You Know What’s Right to Eat, but Don’t Know How to Organize Meals
Build a healthy diet skillset for long-term success
With respect to following the advice of a dietitian, the initial trick is in finding the right professional, someone who not only gets you and understands your specific eating problems, but someone who is capable of helping you set and manage reasonable expectations for what a good diet is, and what it can do in the long run.What you should be looking for is a professional who can help you develop a healthy eating skillset for the long run, not for a short-term goal that will be — and statistics bear this out — illusory and disappointing. In the words of Whitney Stuart of Whitness Nutrition, during an interview with Business Insider:
“Most fad diets have strict, specific rules. ‘Ultimately,’ Stuart said, ‘these diets tend to be unsustainable for long periods of time, let alone the rest of your life.’
The idea of deprivation, ingrained in many diets, ‘gives us control over a situation’ in the short term,’ Stuart said, perhaps leading people to think, ‘I haven’t eaten any cookies, I’m so good.’”
‘This short-term diet doesn’t become a habit,’ she said, ‘and 10 days — maybe two weeks — later, we see that deprivation rebound when self-control finally dwindles. Because that is limited.’”
“Goal” is a Trip-Wire Word
After my first meeting with the registered dietitian my doctor recommended, I felt like I’d hit the winning lottery ticket not only for weight management but also for a long-term healthful eating plan. In our first meeting, my dietitian listened to my health story as it related to my current lifestyle — older, relatively sedentary, arthritic, hit-and-miss eating habits with too many carbs and not a thoughtful selection of proteins, etc. — and then she asked what my goal was.I told her my goal was to be lighter by at least 80 lbs. by July 2020, when the family (including those from out of the country, and our in-laws) would all be gathering to celebrate the 4th of July at Williamsburg, Virginia. As measured from the time of that initial consultation, I’d have a little over nine months to hit that goal. She cautioned me not to overreach reality, and suggested I start with a 40 lb. reduction.
We talked a bit more about the word “goal” in the context of a specific number of pounds to lose, and she gently nudged me in the direction of thinking about the journey toward and then beyond that admittedly arbitrary number. “Goal” is a trip-wire word when it comes to establishing and sustaining healthy eating habits after decades of letting oneself go deep into the obesity range. Setting a goal is all well and good, though fraught with disappointment if all you want to do is hit a number. Having a reason to get into shape will drive you toward that outcome even when disappointment crops up from time to time.
Starting a healthful eating regimen means winding up in a place where you can look back and say you sustained your efforts to eat right, day by day, meal by meal, until you are doing that effortlessly and without fear of failure. It means developing a healthy eating skillset that you can apply without thinking.
Losses are Inevitable: Don’t Obsess Over Them
To reach that healthy state means you must accept some losses along the way. There will be days or weeks where the scale seems to be your opponent, pushing you back. I’m just starting to learn that — much to my chagrin and much to the amusement of my dietitian who has encouraged me not to step on the scale daily, but rather aim for once a week (I had to bargain with her to get to twice a week since I’d already been checking my weight once or twice a day).The key to making my dietitian's plan work was not making weight loss my end game, but to learn to eat within my caloric needs while eating a balanced blend of vegetables, fruits, proteins, starches, and fats. She created a personal food plan for me that set 1,800 calories per day as a do-able intake (vs the 3,500 I’d been consuming).
But What About My Favorite Foods?
My dietitian was unfazed about my worries that getting into a healthy eating habit based on 1,800 calories daily would mean cutting out foods that taste good. Seriously — I had this wonky vision of a healthful diet as one that either tasted like cardboard or relied on teaspoon-sized servings of bland proteins and watery vegetables. I gotta say, I love this dietitian. She laid out a chart headed by columns of starches, vegetables, fruits, milk/yogurt, protein, and fat/oil.
Under each of those headings were foods I’d always eaten and could continue to eat. In the starch column were sweet potatoes, pastas, oatmeal, English muffins, baked potatoes. Under veggies were carrots, tomatoes, snap peas, red, green, and yellow peppers. In the fruit column were all the good ones — bananas, apples, oranges, berries, kiwi, cherries, raisins. Milk (which is a staple of mine) and yogurt (also a fav) topped another column. The protein column really surprised me: lean beef, chicken, pork tenderloin, eggs, fish, veggie burgers, peanut butter, eggs, and cottage cheese, and more. Even the fat/oil column held out hope, with olive oil, salad dressings, mayonnaise, cream cheese, and bacon!
Above each column, my dietitian wrote her suggested daily serving size or daily calorie count for each category, for example: 5 starches, 4 vegetables, 4 fruits, 1 milk or yogurt, 8 ounces of protein (4 oz at lunch, 4 oz at dinner), and 10 servings (usually measured in teaspoons or tablespoons) of fats/oils. By selecting from each column as I planned my meals, I would get close to the daily 1,800 calorie intake. My dietitian stressed that I should not obsess over any exact number…a bit over 1,800 calories would not ruin my diet (although diving too far below 1,800 would be unhealthy and counterproductive).
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