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Nothing changes if nothing changes

I couldn't think way into a new way of living—I had to live my way into a new way of thinking.

"Well you know Dave, nothing changes if nothing changes"

I was meeting my new VA primary care physician for the first time expecting to get the usual lecture about eating less and exercising more, but she was actually talking to me—not at me. As my appointment was just about over, she looked me directly in the eyes and said, "...Nothing changes if nothing changes". At the time, I didn't understand exactly what she meant, or how profound a statement that really was.

Getting started on a solid road to recovery and weight loss would not be easy. Particularly a start that included staying started and actually getting healthier. My physician must have felt like she was standing on the deck of the Titanic trying to stop it from sinking. Statistically, the odds were against someone my size shedding their excess weight and keeping it off. I'm sure she had seen it many times before—patients showing up to her office, seriously overweight and suffering a host of related medical conditions, but not making the lifestyle changes required to improve their health in any substantial way. Oh sure, she would prescribe more tests and the usual medications for high blood pressure, high cholesterol levels, or diabetes as needed. But she and the medications could only do so much, the rest is up to the patient.

I had tried diets before—lots of them. With so many grand beginnings and so many failures, I was feeling pretty hopeless. The truth was, I didn't have a "diet" problem, I had a living problem. Any diet that restricted calories below the level it took to sustain my weight could work. That's not to say all such diets are healthy and safe. A severely obese individual like me didn't need to fix or discover the one right diet, I needed to fix and change my relationship to food, and change a lifestyle that supported my binge eating and compulsive use of food.

That's really a tall order for someone who had been morbidly obese for years. Essentially, it's asking them to change nearly everything about their lives including on the inside—their emotional responses, their coping mechanisms, and many of their usual ways of dealing with and viewing life. It's doubly hard because at this point I wasn't aware that I had the power to do this or how to go about it. I still had a lot of denial about just how deeply my self-destructive overeating was rooted in just about every aspect of my life.

Most medical professionals don't know how to empower their patients to really face this monumental reality and take on the work of such change. Words and charts never seem to really get the job done. There are specialized treatment centers, but they aren't a viable option for everyone.

Sick and tired of feeling sick and tired

At some point, a severely obese person with a binge eating disorder may "hit bottom" to borrow a term often heard at AA meetings. Hitting bottom implies that there is nowhere else to go—that things simply can't get any worse. Hitting bottom may be the point at which a person is frightened and desperate enough to move from the wishing things were different stage, to a state of readiness to be willing to actually do what is required and actively go to any length to get better. But also like the alcoholic, many morbidly obese persons die before they realize that they have hit rock bottom. Their "denial" is so strong that they can't see the reality of their own situation clearly. Denial is a defense mechanism  that includes a range of psychological maneuvers designed to reduce awareness of just how precarious one's health is and to blur the fact that the affected person does have workable options and choices to make that would allow them to improve their health.

I did hit bottom. I didn't really know it that day in the hospital. My physician's words kept ringing in my ears "Nothing changes if nothing changes". I was very unhappy with my physical and emotional state. My life was a mess. I was almost totally disabled due to my excess weight. Over the next few days it dawned on me that I had to "do it" for real this time—that all my "I'll start tomorrows" were all used up. Nothing would change unless I did the changing. My physician had mentioned the possibility of weight loss surgery and at the time, I was desperate enough to tell her that I thought it would be a good direction to go. It was certainly risky, but at the time, I felt it was either risk the surgery or risk certain death from obesity related problems.

Over the next several weeks, I went through a lot of the medical tests and evaluations required prior to bariatric surgery. I was considered a good candidate for the procedure. I wanted to lose some weight before the surgery, perhaps 40 pounds or so, to help reduce the risk of dying from the long list of possible post surgery complications. So I started eating primarily healthy whole natural foods and sure enough, the weight started coming off. After a couple of months of losing 15 pounds a month, I realized that I had never really tried to just eat healthy food before. In all my prior attempts at weight loss, I thought in terms of either a very restrictive diet or eating junk food and binging as usual. Even my early attempts at using Overeaters Anonymous didn't amount to much more than just another temporary and restrictive diet.  I just called them my "lifetime eating plan". I had been lying to myself; it was just another layer of denial.

I surprised my doctors over the next few months by continuing to lose significant amounts of weight. Then I surprised them again by deciding against the bariatric surgery. I figured, "Why should I undergo a drastic form of dangerous surgery, when all I really need to do is eat right". My decision to have the surgery in the first place was a part of my bottoming out process. In the end, I realized that if I was desperate enough to risk dying from the surgery, I should be desperate enough to start eating healthy natural foods instead.

Of course, changing the way I ate wasn't an easy overnight process. It's just that, a process. A process that I  would get better and better at over time. Eventually, I came to prefer this new style of eating. I realized just how toxic my old way of eating was to my physical and emotional well-being.

When I made the decision to start shedding my excess weight, there was one more step that was crucial to my success; taking immediate action. I had to act immediately. Not tomorrow. Not Monday—NOW! It was just so easy to make a decision and then put off taking action. Wasn't that always my problem? 
Action precedes motivation.

Nothing changes unless I change

One definition of insanity is when a person keeps doing the same thing over and over again, always expecting different results. This is the insanity of Yo-Yo Dieting. Yo-Yo Dieting is when a person tries to diet over and over again, loses some weight each time, only to gain it back each time. This is horribly hard on our systems and very soon yo-yo dieting becomes part of the problem not part of the solution.

It can feel like an insurmountable obstacle to reach out and ask for help. It's often very hard to start going to some sort of support meeting. Making an honest commitment to be consistent and dedicated to do whatever it takes to get healthy is frightening. Most of us have underlying reasons why we abuse food and in many cases, deep down fears that make being very heavy useful on some level. Facing all this and deciding to go to any length to improve our health can feel a lot like jumping off a cliff in the dark.

We all have the power to decide to improve our health. Please don't let anyone tell you otherwise. Certainly, if you've tried it on your own a few times and you still haven't been able to both shed excess weight and maintain a healthy weight, get help. You don't have to do it alone.

[More on Getting Started]

If I always do what I always did, I'll always get what I always got. There came a time when I stopped looking for answers and solutions from external sources and realized that the solutions would have to come from within. I saw that only I had the the power to actually do the things and take the steps that needed to be taken for me to get healthy. This is the turning point, I think, that changed my life.

[My Doughnut Epiphany]

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