“If You Were Serious, You’d Make Changes”: How Scary Does It Have to Get?

This statement is actually in the opening of each episode of My 600 lb Life.  Dr. Nowzaradan has said it to many of his patients and it really is the truth.  The problem is that most of us don’t want to hear it because most of us are not serious.  Many of his patients are a minimum of 500 lbs when they show up at his door, and when they first arrive, he always asks them “what was your highest weight?” and they always answer “this is my highest weight.”  I used to wonder why is he asking that? I was thinking, “Duh! Of course this is their highest weight!” Then it finally dawned on me that he was really asking how hard they have tried on their own to lose weight.

The truth is that most of them haven’t tried.  There are some who have tried diets only to regain the weight plus more, just like the rest of us!  But many of them are in the same boat I know I was in for a very long time: I really really want to lose weight, but……. at the same time, I don’t want to do the work. Yes, I know that is so incredibly not-shocking! I’d love to be thin and fit and strong, but I still want to eat cookies and chips and bread by the actual loaf! I want to eat graham crackers and peanut butter and chocolate and cupcakes with mounds of frosting, and I want to be skinny too! Isn’t there some magic procedure that can make me skinny without having to give up all the junk I want to eat?

The other thing that took a while to sink in for me is that almost without fail, the patient shows up and steps on the scale for the first time usually in many months (if not years) and when they see their weight, they are always ‘shocked.’  It’s always higher than they thought it would be and some of them start crying.  They’re scared because their weight is way more out of control than they thought it was, as in 500+; 600+, 700+.  That’s some pretty scary weight, especially since some of the women are about my height and their weight is over 500 lbs (I am 5’4”- almost!)  So I know how heavy they are and I know how hard it was to move and get around at my highest weight (438).  What shocks me is that after consulting with Dr. Now and going over their new eating plan with him, they go home and eat fast food, or junk food, or whatever they want. They make excuses and justifications: “I’m tired of eating healthy stuff”; “I have to have something I enjoy”; or “Not every meal has to be the best choice.”  They are justifying eating what they want to eat because for most of them- and us, too!- they want to do the bare minimum in order to meet what they think is Dr. Now’s arbitrary (and ‘magic’) weight loss number so he will give them the ‘magic surgery’ that will let them eat what they want and be skinny too!

The problem is that obviously there is no ‘magic surgery or procedure’ that lets you eat all the things you want to eat and still be skinny, fit and strong.  When they show up at his office after having ‘tried as hard as I could but I wasn’t a hundred percent,’ they get angry and frustrated because, even though most have lost some weight, they didn’t hit Dr. Now’s goal- a goal they think is arbitrary.

Except it’s not an arbitrary number.  It really isn’t some kind of formula, as in “if the patient weighs 500 lbs, he needs to lose 30 lbs, but if the patient is 600 lbs, he needs to lose 70.”  Whatever the number is, it’s enough weight to show the doctor that the patient can control his or her eating. If they can control their eating enough to lose weight for a sustained period of time, then the surgery will allow them to lose more weight faster while they can get help for whatever issues are driving them to eat.  Bariatric surgery sure isn’t magic, as Dr. Now plainly tells his patients.  While making the stomach smaller and bypassing part of the small intestine, patients are forced to limit the amount of food they eat at one time and fewer calories (and nutrients) are absorbed due to the shortened intestine; however patients can still eat all day long and can still gain weight!  Healthy weight loss is a team effort: both the doctor and the patient have to do their parts otherwise it’s not going to work, and unfortunately, most of the work falls on the patient.  The doctor functions much like the coach: he gives the patient-player the game plan and the patient has to put it into action.  If the patient follows the game plan correctly and it’s not working, then the doctor-coach needs to re-evaluate that plan.

The problem is that the patient-player expects to ‘win the game’ without implementing the game plan. These days, every kid on a team gets a ‘participation medal’ just for showing up, and while it’s a nice idea, it leads to the same kind of thinking.  These patients want their prize medal even though they didn’t win.  They didn’t do the work but they still think they deserve to win.  The problem is that weight loss doesn’t give you a participation medal- it’s an ‘all or nothing’ fight.  You want to win? Then you better fight harder than your cravings.  Think Rocky running up the steps to the Philadelphia museum- it’s freaking hard!!

I don’t mean that we have to view food and treats as the enemy, but when your health is so bad that you can hardly move, when walking to the car makes you sweat, and when you can’t stand for more than five minutes without leaning on something to support your weight, it’s an ‘all or nothing’ situation.  Even when your weight isn’t over 400 or 300 lbs, it it’s affecting your life in a negative way, how bad does it have to get before you change how you think about what you eat? Most people think of ‘life-threatening weight’ as 300+ lbs, but it doesn’t have to be.  These are what’s called ‘diseases of life style’ now and super obesity is only one symptom.  There are a lot of skinny people who have super high blood pressure or blood sugar or other metabolic problems that threaten their lives.  When how you eat or how little you move threatens your life, how scary does it have to get before you start making changes?  Elizabeth Benton (Primal Potential) frames it like this: “Do I want $5 now or do I want $50 next week?” Rationally, most of us think it’s a no brainer, but when it’s “do I want those chips now or do I want to lose 2 lbs next week?” most of us opt for the chips, even though it’s the same bargain: I can feel good for five minutes now or I can feel better for longer next week.

When I watch Dr. Now’s patients eat the donuts or the fries or whatever junk food they decided on, I hear Dr. Now’s voice in my head: “if you were serious, you’d make changes.” If you really want to lose weight or eat healthier or get more activity, you’d make the changes.  No one promised that it would be easy; the only promise anyone or anything can give you is that if you do the work- consistently- you will see the results, and if you don’t, then- and only then- you can go back to your doctor and ask them to change the game plan.

I think this is on my mind lately because I wasn’t doing the work.  I knew I wouldn’t get the results I wanted because I hadn’t followed the game plan: I was eating junk and I wasn’t going to my work outs.  I had reasons, and they were legitimate ones (I was taking care of my mom after her surgery), but weight loss doesn’t give out participation medals.  So, once I was able to get back to my regular life, I had been away from the game long enough to want bread again, and cookies, and other junk.  Walking through the stores, I could see the stuff I wanted on the shelves and looking at it, feeling the temptation (it’s just one!), I could hear Dr. Now’s voice in my head:”if you were serious, you’d make changes.”  I realized that yeah, I’m serious! Put me in, coach! I’m ready to get back in this game!

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