Thanks for the kind words!
To answer your question, I'm 39 and happily married. I've been obese most of my life (not just "my adult life") except for a three year period in the late 1980s and early 1990s. After many attempts to get my weight under control, I was able to lose 75 pounds on Weight Watchers, and keep it off for three years (which, I'm told, weight-loss experts consider "practically forever"). I kept to the program very closely ("diet exchanges" back then), drank lots of water, did a five mile walk three times per week, and basically starved myself, to a great extent, down to 175. I kept the weight off through diligence, watching everything I ate, and maintaining my walking regimen.
About ten years ago, I took a job as an international management consultant, which put me in a different city, just about every day or two, 200+ days per year. It was nice to see the world, but the disruption to my control over my intake and expenditure of calories was immediately noticeable (by all except me, of course). Over the course of a year, I gained the weight back, and over five years of this job, I managed to top-out at over 265.
I, of course, made many attempts to get back to a healthy weight. I tried Weight Watchers again, but for some reason it didn’t work this time. My suspicion is that I had decimated my muscle mass the first time, and so my old approach wasn't suited to overcoming both that and addressing the weight problem as well. The less I ate, the less my body burned. I had become more efficient. :\
I tried Atkins. I was relatively successful, losing 35 pounds. However, I'm in that 10% minority that reacts negatively to Atkins, and my cholesterol shot through the roof. My doctor took me off Atkins.
Other efforts were ineffective, or only temporarily effective. I was on Meridia for a while, and lost about 15 pounds, but gained it right back after I stopped taking the drug.
In 1999, my wife and I started practicing yoga. Yoga is one of those wonderful activities that can work well regardless of your current physical condition. I gained a lot of flexibility, and a little bit of strength. As I got better, I started noticing a small pain in my leg. It eventually grew to a shooting pain. It wasn't debilitating, but it was annoying.
Doctors were puzzled. It didn't fit any condition they could think of. I had x-rays and did physical therapy, in addition to continuing my yoga, for many months. Eventually, the orthopedist "gave up" and sent me for an MRI, figuring that there really couldn't be anything there that would be illuminating, but it was a necessary step before recommending exploratory surgery. I was on the treadmill in physical therapy when the orthopedist received the MRI back; he sent the PT right in to get me OFF the treadmill, telling me, "You're done here."
What they found was Degenerative Disc Disease, with multiple manifestations throughout my back. One disc had ruptured and was applying extreme pressure to my sciatic nerve. The doctors were amazed that I was still able to walk. Remember, I was not only able to walk, but I was practicing yoga several times per week, at a moderately advanced level. Indeed, it was the yoga that was keeping me from being in as much pain as they would have expected to see given the problem I actually had, which is why they had such a hard time diagnosing it.
I was referred to a neurosurgeon who showed me the extent of the problem. He pointed out the ruptured disc and said, "That's what we're going to fix now." Then he pointed to another black splotch, "That's a couple of years down the line." Then another, "That's a couple of years after that." And so on. I asked him what could I do to avoid these future back problems? He said, "Absolutely nothing. You have DDD; you will have these problems."
The only thing I could do was delay the inevitable, through a combination of strengthening my back muscles (which, of course, the yoga was already helping with) and losing weight. He guessed that if I lost 30 pounds, it would push that next problem out from two years down the line to maybe five or ten years down the line.
After my surgery, I did physical therapy for a while and then went back to yoga, slowly. However, that next back surgery was still looming for me. Finally, after a trip to Egypt (see my web site for a cool travelogue of that trip) that reinforced how much LIFE I was missing out on because I couldn't do so many things due to my weight, I was ready to try to lose weight again.
This time I was dead serious; the stakes were too high. I did a lot of research. I investigated drugs, surgery, and every regimen I could get my hands on data for. In the end, my decision would be governed primarily by one metric; the ultimate success rate metric for weight-loss: percentage of weight-lost maintained over a two-year period. The program was a medically-supervised very-low calorie diet, through a clinic of Newton-Wellesly Hospital, here in Massachusetts, operated by Health Management Resources. Their "success rate" has been pegged by external researchers at about 22% (compared to 5% for Weight Watchers, for example).
I spent about 13 weeks on a primarily liquid diet of protein shakes, working up from 5000 calories per week to about 8000. I built up my exercise from about 1200 calories per week to about 2000 calories per week during that time. I lost about 45 pounds, and had a completely different outlook on life. I was feeling stronger and better than I ever had on other diets, which did not take into consideration the amount of protein necessary to safeguard muscle mass. Rather than running out of steam, I was just getting started.
I had been supplementing the liquid shakes with pre-packaged low-cal entrees at times ("never get hungry" was the rule), and my second 13 weeks build on those to a greater extent, as well as adding in fruits and vegetables over time.
After about seven months I had lost all the weight I had gained over the previous ten years, and was back to 175, the top of the "healthy range" for my height. I transitioned into maintenance, and kept up my calorie balancing and exercise regimen, averaging about 3000 calories of physical activity per week, spread among walking, biking, hiking, yoga, Viniyasa (power yoga), and later kayaking. I feel that the focus on getting enough protein, and making sure I was doing enough weight-bearing exercise, was key in helping me continue to lose weight, until I reached what I consider an ideal weight for me, which I reached about a year ago. I've fluttered around that mark since then, but haven't gone more than +2 or -2 from there, now being sure to balance my expenditure with adequate intake each week.
So, that's my story, what I hope can be considered a success story, in time. Having gotten to a healthy weight once before, and maintained that healthy weight for what many consider the long-term, I feel confident that I'm much better positioned this time. I lost remarkably little muscle mass this time. (Indeed, I had to lose some, since my muscle mass when I started was higher than my current total weight!) I'm building up muscle, which will help me burn-off any excess caloric intake that happens to slip by my vigilant food journaling, not to mention safeguard my back from the disease that threatens it. I haven't checked with my neurosurgeon since I lost the weight, but I suspect that my next back problem is far more than ten years away at this point.
My weight management program relies heavily on use of meal replacements (such as protein shakes and low-calorie pre-portioned entrées), fruits and vegetables, exercise, and support. Weekly meetings help reinforce what we've learned and what we live, and each week we undertake exercises -- specific challenges -- around one of the keystones of the lifestyle we now embrace. For example, one week, the assignment was to have two "high PA" days -- days with greater than average exercise expenditure.
The weekly meetings were very helpful. I also draw on the support of my wife, who undertook the same challenge I did two years ago, and lost 65 pounds herself. While the meetings are helpful, they're not free, and they’re not all that convenient -- sometimes I think that the time I spend commuting to and from the clinic could be better spent exercising!
So, a couple of months ago, we start supporting ourselves to a greater extent. I'm active in a few online weight-loss support forums. I feel that these forums are excellent ways of both getting the support you need to lose weight, but also to maintain the healthy lifestyle that you've adopted.
These are the fundamentals of our lifestyle now:
1. Make changes for life.
View changes as a permanent change in life-style,
rather than changes made to accomplish weight loss.
2. Don't leave anything to chance.
Do detailed meal-planning. Know, in advance, what
you'll likely be eating each day. Make sure you
have everything you need, on hand, in order to
make those plans work.
3. Control your environment.
If you're going to be in a situation where there
will lots of temptation to vary from your plan,
make sure you bring along whatever you need to
help you deal with that temptation. For me,
that means bringing my own snack replacements
whenever I attend a party where there will be
4. Journal incessantly.
Log every bit of food your eat, as soon as you
eat it. We say, "Mouth to hand." Note when,
what, how much, and how many calories. By
similarly keeping track of your exercise as
well, you can quickly come to learn exactly how
many net calories is the right amount for your
weight loss or weight management goals, and that
helps you say "no" when you see how much any
temptation impacts those numbers.
5. Exercise every day.
Aim for 2000 calories burned per week. ("10000
steps" will typically get you there.) Vary your
exercise to ensure you're getting some aerobic
exercise and some weight-bearing exercise. Get
yourself to the point where you become annoyed
if you can't get your exercise in.
6. Eat a balanced, low-calorie diet.
Start evaluating food based on nutrition, not just
taste or personal preference. Choose foods with
great ratios, such as protein grams per calorie.
7. Use meal replacements and snack replacements.
Use meal replacements as tool to crowd out higher-
calorie foods. Instead of a bagel and cream
cheese, have a protein shake, getting far more
nutrition, saving 300 calories, and resulting in
longer-term satiety. Instead of a slice of pizza,
have a low-calorie packaged entree, again with
better nutrition, calorie ratios, and satiety.
Use only high-quality meal replacements, with
excellent nutritional stats, and little or no
8. Get and give support.
Participate consistently in efforts that support
your weight loss and weight management and overall
health goals. Work with a support group, a group
of friends as committed as you are, or with your
9. Reward yourself.
Reward yourself for following your plans, but
don't ever reward yourself with food. Don't
worry about rewarding yourself for your success;
success is its own reward.
10. Keep your priorities straight.
Recognize and remember that your health is, and
always should be your #1 priority -- that all other
considerations are secondary because they all rely
on your health. This means that you can say "no"
to invitations to parties that you don't feel you
will be able to have adequate control over
temptation. It means that you can delay the start
of your day out with friends, so you have enough
time to complete your exercise.