My story began years and years ago, knowing I had become plumper than I should be for my height, age, and short 5′2″ stature. I was carrying rolls of uncomfortable weight, particularly around my midsection, eating more and larger portions than I needed, and not being discretionary with food choices. I grew up the oldest child of five and helped raise my four brothers and sisters. I assisted my mother, a single parent, with their care and, unknowingly, took on more responsibilities than is ordinary for such a young person.
I clearly remember eating my siblings’ leftover food in the hope they would not be as hungry as I seemed to be most of the time. Our family often ate from a box such as Hamburger Helper®, Macaroni & Cheese®, canned vegetables, pre-made spaghetti, or a TV dinner. We also ate food cooked in bulk with minimal, if any, nutrition and always with more carbohydrate than protein. Diversity of flavor was not a priority then.
During my adult life, I made multiple attempts to take off undesirable pounds with popular low-fat diet strategies such as Jennie Craig®, Weight Watchers®, and NutriSystem®. I recall eliminating 20 to 25 lb each time, then slowly regained all of it and more. Physicians had told me during those years that I needed to lose weight, and that I had too large of a midsection that could lead to a heart attack. However, the physicians did not educate me that being overweight or obese could put me at risk for diabetes and other serious illnesses. Although they implied my weight was a medical problem, they neither treated me themselves nor referred me to a physician who would. Receiving no treatment I gradually gained more weight. When I was diagnosed with diabetes, hypertension, and high cholesterol in mid-life I was treated with sitagliptin, metformin, a statin, and an antihypertensive medicine but still did not receive treatment for obesity. I felt ashamed, hurt, and not in control of my own health. I was told to adopt a healthy eating style. I honestly believed I already understood how to do that, so I did not think to complain.
Then, 5 years ago, I went to a work-related picnic, and noticed a friend that had transformed her body by losing 30 lb under the care of an obesity medicine specialist in my community. My friend looked healthier, happier, and slender. I was in awe. Seeing her made me realize I needed to become a patient of a physician willing to treat my obesity. A few weeks later, I entered into a medical practice weight management program. After an evaluation by the physician that included a review of my medical history, an electrocardiogram, a body composition analysis, and a physical examination I was a bit shocked when my new doctor told me my fat mass was 44% of my total weight of 174 lb. He prescribed a very low carbohydrate, ketogenic diet and the anti-obesity medicine phentermine. I was also started on a multivitamin, vitamin D, and several other nutritional supplements. Over the course of 6 months, as I continued on this regimen I lost 50 lb. Surprisingly, even though I was on an energy-restricted diet, my energy level was higher than it had been in years, and I was only hungry when I ignored my eating schedule and waited too long before eating.
During the 9 months as I was losing weight, my doctor examined me weekly at first, then every 2 weeks. At each visit, he checked my weight and my blood pressure. He listened to my heart, questioned me about potential medication side effects, and then discussed what I was eating, commenting on what was good and bad in the process. Between my time with the doctor and with his nutritionist, who I also saw on some visits, I learned a great deal about my own metabolism and what foods were and were not a part of healthy eating. My past, present, and future eating and exercise behaviors were also frequent topics of conversation at my doctor’s visits.
I was happy with my weight loss but after several months on their maintenance program, still on phentermine and a low carbohydrate eating style, I regained a few pounds. I had experimented with increasing my carbohydrate intake and the result was that I began to crave sugar, I ate more, and I gained weight. To my dismay I noted that I was losing control of my eating. My doctor then suggested continuing the phentermine and adding a second anti-obesity drug, lorcaserin. To my relief, after starting the second drug my cravings disappeared with return of complete control of my eating. Presently, 5.5 years after starting my new life, I am 50 lb lighter, five sizes smaller, and am successfully maintaining my weight loss. I continue to see my obesity medicine physician quarterly, I am still taking a combination of phentermine and lorcaserin, and have had no adverse effects. I am now retired and can enjoy all the activities my husband and I had looked forward to during our working years. I sometimes gain a few pounds when we travel but I always get back on my maintenance regimen when at home.
My diabetes is gone and I no longer take any medicines for it. I am still on an antihypertensive, but at a lower dose, and my blood pressure is in good control. My primary physician still advises a statin, but in my most recent lipid panel my high-density lipoprotein (HDL) was higher at 103, and my triglycerides far lower at 57 than before I lost weight, so I plan to discuss discontinuing the statin with him at my next visit. I am forever grateful to my obesity medicine physician. I feel as if I have gained years of life.