Thoughts on Doctor Visits as An Overweight Person

Almost my whole life, I have dreaded visiting the doctor, and frankly avoided it at all costs.  I have gone a handful of times for routine visits, but unless I'm really, really concerned or sick, I don't voluntarily go.  It's a weight issue for me, and has caused me an incredible amount of angst over the years.  I feared the doctor scale, the blood pressure reading, and the suspense of whether or not the doctor would comment on my weight.  The doctor's office was the one place I carried the most shame about being obese.  I knew that my health was being compromised.  On the wall, I saw the creepy poster of the fat and thin persons through x-ray - the admonishments about what I was doing to my health by eating too much and not exercising enough.  I would leave the office feeling terrible about my inability to get a grip on my health and weight.  Look at what I was doing to my body!


At my book group meeting this past Saturday, one of my dearest friends, who is also a nurse practitioner at an Optifast clinic (not mine, though), brought up this issue as she heard the sad stories from her bariatric patients.  Her eyes were opened to how the established medical community is failing to help obese patients.  I shared with the group my own experiences with this.

As I reflected on my feelings, what came to light was the absence of hope.  Six months ago, I never dreamed I could lose weight.  The task was just too daunting and I had tried and failed so many times that I never felt confident that I could do it.   I knew that I should do it, but didn't feel that I could do it.   When I think about the public messages at the doctor's offices, what they really lack is compassion and hope.  I didn't need to be scared and shamed any more than I already felt.  What I really wanted was for someone to send me a positive message of hope and help.  You know those signs in the women's restroom that aim to help abused women?  "Are you suffering in an abusive relationship?  We are here to help you.  Call -----."  What if the waiting rooms in doctor's office and clinics had beautiful compassionate posters that said "Are you overweight and overwhelmed?  We have several programs to help you every step of the way on your journey back to good health.  You can do it and we can help!  Call us at ------."

The commercial weight loss industry does this pretty well.  We've flocked to their programs with the "before and after" posters, dreaming that we would one day be one of those people.  The medical establishment could learn a thing or two from their approach.  They are big on naysaying commercial programs (talk about mixed messages!), but what alternatives are they providing us?  In our most vulnerable moments, are we going to reach out and ask for help while we have to face a giant poster with an x-ray of a fat person or when we feel the wagging finger of the medical establishment?  Not me.

I'm lucky that my current medical provider has this special weight loss clinic with a number of programs (some of which are free).  I didn't learn about them through a visit to the doctor's office, though.  I found them online when I was grasping at any solution to my weight problem.  I was also lucky to have a friend who I felt comfortable confiding in, and who worked in a weight loss clinic.  In the end, it was my friend in the medical community who compassionately led me to my current program.  Did I know that Optifast was going to work for me?  No.  But just that little bit of encouragement helped me take the next step.

I'm not saying that Optifast is the right choice for everyone.  At my clinic there are a number of real-food support groups to help people who want to lose weight.  I think that support is one of the most important success factors.

Every day for the past 6 months I've been thankful that I started this journey back to health.  It hasn't been easy, but I am giving it my best and really trying to make changes in my relationship with food.  I still have many months to go as I finish my fast, transition to food, and attend maintenance support groups, so I'm a work in progress.  I'm just trying to soak in every bit of this experience.

If you are reading this and are searching for hope, please know that you are not alone and that there are many great people who have started a long weight loss journey and are maintaining a healthy weight.  You can do it too.  Don't be afraid to research and reach out for help, whether it's in person or online.  Even if you have had a lifetime of being overweight, it is never too late to discover the healthy person that is inside of you right now.

Week 26 Weigh-In: Just Keep Turning the Page

176.5 lbs.

Sometimes the universe provides!  In my Optifast group tonight we talked about moving past our negative choices.  It was comforting to hear (re-hear) this lesson about having more (self) compassion when I choose a path that isn't aligned with my health goals.  I consider this to be a very important issue for me, personally.  In my past attempts to lose weight, I would lose a few pounds, fall off the wagon, and then rationalize a delay in re-starting my program.  By the time "Monday" would roll around I would have several days off the wagon and a whole pile of guilt.   At that point, it would be extremely difficult for me to get back to the healthy eating program.  This is the wonderful thing about attending a support group.  You have a safe place to discuss your challenges among people who can relate and offer insights.



I'm happy that after my last transgression I was able to return to my eating plan and move on.  I think that the reason I'm nervous about those off-program choices I made is because in my mind I don't trust myself yet.  Despite 23 weeks of following Optifast perfectly, I look at my recent bites and immediately forget how strong I am, as evidenced by my ability to lose over 80 pounds so far.  I now see this as absurd thinking.  It isn't that I'm suddenly a bad person because I made a mistake.  I am strong to have gotten this far and I am able to begin again and keep moving towards my goals.

Speaking of goals, I've been enjoying my evening walks and goal to complete at least one mile per day (I'm almost at a two mile mark during the time that my son is in karate class). It's wonderful to to feel physically stronger and more athletic, and it has taken my mind off of food.  It's a stress buster too.

On the family front, we are doing well with our business, and my hubby has a conference call with another company next week.  I'm keeping my fingers crossed for him because it is a direction in his career that he would be excited to pursue.  It would be great for our family as well.  I'm keeping hopeful and positive.

Weekend Check-in and Tough Love

I'm sure if you've been reading my blog for the last few weeks, you've noticed that I've been struggling with food obsession and wanting to eat.  I wrote about tasting and recognizing it as a slippery slope.   Despite processing through all of this, and making some positive strides in the exercise department, I had my worst cheat ever on Saturday.  I ate a meatball and I ate a about 1/4 cup of shredded cheese.  I logged them on MyFitnessPal. What was I feeling when I ate?  I was feeling selfish, and just wanted to eat after fasting for so long.  It smelled good, it looked good and I've been craving them.  People have been complimenting me on my weight loss, and I'm feeling so much better about myself, and my resolve for sticking to it was weak.

I consider this a wake-up call and low point.  I wouldn't dare justify it because I made a commitment to this journey and this goes against that commitment. I'm not at the finish line yet.

This is what I have have done in the past when I failed at weight loss.  I got within an inch of a weight loss milestone or goal, then bailed before the finish line. THERE IS NO WAY I AM GOING TO DO THAT THIS TIME. 

Everything about this weight loss adventure has been different.  I have engaged my mind and heart in looking at past behaviors and triggers, and I really feel like I've grown stronger as a person.  Although I am new to this awareness, I'm not going to ignore what I've learned so far.  This time it's not about ignoring "conventional wisdom" or something outside of myself.  It is about ignoring ME and my own accumulated wisdom. This is where the rubber hits the road, and I need to pass the test.  So today is a no-cheat day and I'm starting fresh with that same no-nonsense approach that I used for the first 5 months of my program.  I know that I can do this.

On a very positive note, I found some FUN workout stations on Pandora that are going to rejuvenate my walks and keep me pumped through the start of the C25K (Couch to 5K) app.  Yes, I'm going to give it a go, if my achilles tendon will let me.  I'm also signed up to walk the Silver Strand Half Marathon with my sisters and friend in November, so the training will begin and I have a bad-ass athletic goal to train for  (heehee).  I'm going to start very slowly, because I'm still only eating 420 calories per day, and I don't want to start working out hard and run the risk of slowing my weight loss progress.

Achieving my weight loss goal is my number one objective and I will reach that finish line first, and modify my behavior and exercise goals to make sure that I get there this time.

Thanks to everyone for your good thoughts and cyber-support.  I am very touched and it means a lot to me.

I will edit this post at the end of the day to report back on my no-cheat progress.

First Edit**:  I just published this blog post, then read a wonderful entry on A Weight Loss Journey (see side bar for link).  It really spoke to me with my current challenges.  Here is an excerpt:

Each Day a New Beginning

I want to do it because I want to do it. Women must try to do things as men have tried. When they fail, their failure must be but a challenge to others.
  —Amelia Earhart

Fear of failure plagues many women, not just those who get into trouble with drugs, alcohol, food. Those of us in this recovery program may still fear failure. Halting our addiction doesn't solve all our problems, but it does allow us to realistically take stock of our assets. Knowing our assets and accepting them provides the confidence we need to attempt a project, to strive for a goal.

Another plus of this recovery program is the help available from our groups and our higher power. All things become possible when we understand we are not alone. Seeing other women strive and succeed or strive, fail, and strive again, undefeated, creates an energy flow that can spur us on, if we choose. Feeling good about others' accomplishments can motivate each of us.

Today, I will pay particular attention to the accomplishments of other women, those close to me and those I read or hear about. I will believe their example and feel the forward push. 

From Each Day a New Beginning: Daily Meditations for Women by Karen Casey © 1982, 1991 by Hazelden Foundation.

Second Edit:  Ended the day in full compliance and with a nice walk under my belt.  Feeling much more confident and at peace.

Week 25 Weigh In - Focus and Goals

179 lbs.

Another week of Optifast down, and God only knows how many more to go :-)  I'm not complaining, I'm committed to the ride, and I'm so thankful for this journey.  But the experience is different now.  In the earlier weeks it was easier to stay focused.  I had more milestones to look forward to and accomplish.  I'm starting to tick them off of the milestone chart now and the list is happily getting shorter.  But some of the biggies are still left to accomplish!  Despite this, though, I realize that I need to find something more to focus on, instead of the day that I can start eating again, and I think the next logical step would be for me to rededicate myself to establishing an exercise routine.  Today in our Optifast class we were visited by an exercise physiologist who talked about the importance of resistance training/weight lifting.  I admit that I've been avoiding this because I'm pretty naturally muscular and am able to build muscle easily.  I didn't want to stall my weight loss since this is my primary focus.  The exercise physiologist changed my mind, though.  I realize that now that I'm in the home stretch, I should start to not only tone my muscles, but more importantly, incorporate weight lifting into my routine.

I haven't fully reestablished my exercise routine since I left my job at the end of May.  Summer kicked in, the kids are home from school, I'm at home for the first time in close to 10 years, and I've started working more on a side business (due to my husband's impending exit from his job).  There is a steep learning curve with this as well.  I'm spending more time on the computer.  And I confess that it's not all business -- I enjoy checking MyFitnessPal, and reading and discovering new fitness blogs. The time suck happens in a blink of an eye.

These are excuses, and I completely realize that I have time to work out.  This is how unexpected life changes (and the resulting paralysis, stress or depression), if I let them suck all of my attention, take over and distract me from my health goals.  I've done this countless times.  Starting a new job, having a baby, moving, injuries, kids activities...the list goes on... and will continue to go on for the rest of my life.  I think this is a good time to stop and recognize what is happening and learn how to deal with change, and prioritize my health and wellness.  This is why I'm treating this experience as so much more than a "diet".  If I want to make this wonderful progress last, I need to stay vigilant and disciplined and focused on my new healthy priorities.  The rest of my life needs to accommodate THOSE things.  Not the other way around.

It all comes down to why I started in the first place.  I want to have more fun and more joy in my life, and being healthy is the only way for me to achieve this (especially the kind of fun I'm thinking of!).   I think now is the prefect time to re-post my vision board and remember why I'm seeking this change.


I hope you all are staying strong and feeling good.  If you're not, keep going anyway and don't give up. We're in this thing together.

Quick Summer Progress Picture

Here's a quick pic of my progress to date. At 75 pounds down, I'm able to walk long distances without pain, feel confident about sitting on any chair or airplane seat, and look "passible" in a bathing suit for my water aerobics class.  It is a good feeling.  Sometimes I look in the mirror and don't recognize myself.

My sister gave me the suggestion of wearing "skorts". I bought them in denim, black and tan and I think they are more flattering on me than shorts.  Feeling sassy!

Here I am six months ago for my pre-Optifast picture - smiling and full of hope (and for good reason!):

Week 24 Weigh-In: Overcoming Obstacles and Getting Stronger

182 lbs. - 75 pounds down!!

I am happy for a loss this week and pleased with my decision and actions to stay on course after I had a few bites.  I was able to pull myself together the last couple of days and stay true blue on my program.  I do feel a shift happening in my awareness about my eating habits and I am willing to fight for this new path in a way that I never fought before in previous attempts.

There was an interesting blog post on Mark's Daily Apple entitled Do You Really Believe You Can Change?  I found it to be very timely and thought-provoking, so if you have the chance, it's worth reading.    It was largely about the concept of self-efficacy in changing health behaviors (as defined by psychologist Albert Bandura).  Basically (and you should read this for yourself), it comes down to our belief in our ability to be successful.  Believing that we can do it.  Dr. Martin Luther King Jr. said "If you believe you can achieve."  This concept resonated with me.  I'm finding it to be true as I strive to challenge my old ways of thinking and enjoy the results of my new commitment to getting healthy.  It's not to say that I don't stumble, but I've come to realize that this is an important part of the learning process.  If I didn't feel challenged and pulled off track, and if I didn't overcome stumbles, then how would I ever develop the resolve, skills and self confidence to make healthy choices a natural part of my life?  I'm starting to realize that this is par for the course!  I am going to try and make these slips fewer and far between, but I will learn to analyze them and get back to it.   I can't fall into an "all or nothing" approach to weight loss.  This hasn't worked in the past.

I'll mention another very helpful blog post from the same website called Mastering the Art of Self-Negotiation which goes hand in hand with the above post.  There are a million ways to rationalize behaviors that aren't in alignment with our health goals.  If we can catch ourselves entertaining those thoughts, then let them float by without giving them time and attention, we can prevent them from taking hold and turning into actions that we will regret later.  We are just making excuses, and there are NO valid excuses for getting off track.

I am so thankful for the many bloggers who share their thoughts and who have inspired me to keep going on my own path.  Reading blogs has been a major source of knowledge and inspiration and I've made it a daily practice to check in with them and get great insights and advice.  The more I read on a daily basis, the stronger I become, because I'm making this journey a very conscious process.

This is such a humbling experience isn't it?  We are smacked down and faced with our shadow side, but we also experience our light and strength which gives us new hope.

A Chink In My Armour

I'm almost 25 weeks into my fast, and I have to confess that I couldn't stay completely strong.  Here's the deal.  I've been thinking about food (a lot.)  Thinking about my life after the fast (a lot).  My life has been stressful, and old currents are pushing up against me.  I didn't binge or anything, but I started tasting my kids' food as I cook. I've done this a couple of times -- a zucchini slice here, a morsel of taco meat there.  I don't think this is earth-shattering or anything, but I see it as a sign of a familiar slippery slope that I need to push back on and investigate.

Regardless of how "on program" I've been in the past.  Here and now, I'm making choices that aren't "on program".  It reminds me of all of my past attempts at dieting.  It starts with a rationalization, and I can hear my voice saying "I've been so good, and this one time won't hurt.  It looks SO delicious!"  I have to ask myself now if those rationalizations got me to my goal or derailed me.  They derailed me for sure, because I didn't stop and analyze them and their cumulative impact on my future health.  It's not about the amount of food, but it's about the pattern of behavior.

Since I'm farther ahead in my weight loss than I've been in recent memory, am I afraid of weight loss success?  I'm noticing more looks and a slight difference in how people interact with me, and I have to ask myself if this is something that is upsetting me on some level.  Those thoughts have crossed my mind.  Am I unconsciously sabotaging my efforts?  Maybe on all of it, or maybe this is an experience and lesson that I need to learn from.  Since my weight has been an issue almost all of my life, there are some challenges and crossroads that keep emerging, and I think this is one of those opportunities.  I need to make different choices to bring on a different result, and I need to have an honest conversation with myself about my goals.

I feel like as I get to be a more "normal" size, my focus is wavering.  But truth is, I'm still at least 35 pounds from my goal.  So close yet so far away.  And once I get to my goal weight, there will be the challenge of maintaining.  It's not the size of the transgression, it's about the action.  As I face these daily choices, my goal is to choose the option that supports my health and well being.  I don't want to feel like that decision is earth-shattering every time it presents itself.  I would love for that choice to come naturally, without ominous music playing in the background.  Perhaps that will take some time, so I'd better just accept the ominous music and "what will she do next?" plot twist for now.  With practice, maybe it will smooth out.  It is what it is.

So far today has gone well.  Cooking seems to be my downfall lately, so maybe today I'll take a break from it and try and regroup.  Walk away from the temptation without falling.  I think just by writing about this experience, I'm feeling better.  My hope for this blog is to chronicle my weight loss experience in all of it's ups and downs.  This is one of those challenging times.

Week 23 Weigh-In

183.5 lbs

I'm just going to do a quick check-in.  I was very happy with the loss this week, since I had to face temptation to eat during the stress.   It's nice when you get rewarded for making the right choices.  That doesn't always happen, of course.  I'm on program every week, and one week I will have a 1 pound loss and another will be 2.5 pounds.  I even lost zero pounds once.  Go figure.  Anyway, I'm really thrilled!  I'm closing in on the 75 pound milestone, and I'm finally seeing the light at the end of the tunnel.  I'm thinking of starting my Progressive Food Encounters (PFE's) at about 155 lbs.

Speaking of milestones, since summer is here, I wore a sleeveless sun dress for most of the day.  My arms aren't pretty, and they do show signs of loose skin, but most of the time it doesn't look too bad, and it's a great feeling to let my skin breathe.

Tomorrow I head out of town and will be packing my shake packets and shaker bottles.  Since I'll be by myself, there shouldn't be any problems with temptations.  I love setting my phone alarm to remind me to drink.

I enjoyed my group tonight.  Even though I've gone through today's exercise before, I'm learning a lot from the new group members and their insights.  We talked about ways to cope with stress, so it was very relevant to my current situation.  The class reminded me to take some time out for brief meditation.  It doesn't take a long time to reach a relaxed state.  I'll need to try and incorporate this more into my daily routine.  Good night!

Practicing Peace in Times of War

I just read this wonderful quote by Pema Chodron, taken from her book Practicing Peace in Times of War and quoted from the Shambhala Blog)

When you’re like a keg of dynamite just about to go off, patience means just slowing down at that point—just pausing—instead of immediately acting on your usual, habitual response. You refrain from acting, you stop talking to yourself, and then you connect with the soft spot. But at the same time you are completely and totally honest with yourself about what you are feeling. You’re not suppressing anything; patience has nothing to do with suppression. In fact, it has everything to do with a gentle, honest relationship with yourself. If you wait and don’t fuel the rage with your thoughts, you can be very honest about the fact that you long for revenge; nevertheless you keep interrupting the torturous story line and stay with the underlying vulnerability. That frustration, that uneasiness and vulnerability, is nothing solid. And yet it is painful to experience. Still, just wait and be patient with your anguish and with the discomfort of it. This means relaxing with that restless, hot energy—knowing that it’s the only way to find peace for ourselves or the world.

This mindfulness practice has been very helpful to me as I work through the uncertainties of my life, and the stresses caused by sudden change.  I won't lie to you - I've been drawn to food.  I've felt like I was moving against a familiar and dangerous current trying to sweep me away.  My old unhealthy coping strategies are pushing against the new direction and momentum I've developed these past few months.  This has been a good test.  I'm choosing to feel the feelings, talk about them and write about them, and I can't believe that it's helping.  I'm strong enough to move through the current and get to safety.

Life isn't all rage and anguish.  We're figuring things out and some of it is very exciting.  And I still have the daily pleasures of a kind husband, sweet kids, a growing garden, a smaller/healthier body, my first private practice client, and the peacefulness of walking during a pale pink sunset.

I don't take those good things for granted.

I hope you all are doing well on your own healthy adventures, and I wish you the very best.