Michael, 68 “It Takes A Village”

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ContributorMichael, 68Read Full Bio


Michael is a 68 year-old businessman and former college athlete. He’s married for a second time, the father of two and a proud grandfather. His weight issues began in his mid 40s and continued into his 60s when he was pushing 300 pounds. The moment he knew something had to change was when he noticed himself merely sitting and watching his granddaughter play instead of actually playing with her. After his doctor told Michael “you have a death wish” due to weight problems, he pursued bariatric surgery. He reveals his struggles to get health insurance approval to pay for surgery. Having lost almost 100 pounds, he is back to playing tennis and golf while enjoying his family. Nowadays, Michael runs around the backyard with his granddaughter.

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ContributorDr. Adrienne YoudimRead Full Bio


Dr. Youdim specializes in medical weight loss, medical nutritional therapy and nutritional and metabolic support of bariatric surgery patients. Dr. Youdim received her bachelor’s degree from the University of California, Los Angeles and her medical degree from the University of California, San Diego School of Medicine. She completed her internship and residency at Cedars-Sinai Medical Center as a well as a fellowship specializing in nutrition and bariatric medicine. She is currently Associate Professor of Medicine at UCLA David Geffen School of Medicine and Assistant Professor of Medicine at Cedars-Sinai Medical Center. Dr. Youdim is very open about the issues associated with trendy diet medications of the past like Phen Phen, but is optimistic about new developments in this area in the near future. She does not shy away from discussing bariatric surgery with her patients and warns that obesity is second only to tobacco for cancer diagnoses today.

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Michael is a 68 year-old businessman and former college athlete.  He’s married for a second time and is the father of two and a proud grandfather. His weight issues began in his mid 40s and continued on past his 60s when he was pushing 300 pounds. After his doctor told Michael “you have a death wish” due to weight problems, he pursued bariatric surgery. He reveals his struggles to get healthcare insurance approval, to pay for surgery. The moment he knew something had to change was when he noticed himself merely sitting and watching his grand daughter play instead of actually playing with her. Having lost almost 100 pounds, he is back to playing tennis and golf while enjoying his family. Nowadays, Michael runs around the backyard with his granddaughter.

My name is Michael. I'm 68 years old, come from a fairly large family; there's 5 boys, 2 girls. I’m married and have three children from my first wife. Oldest one is married with two kids. My middle son lives up in Seattle and my daughter lives Los Angeles.

When it comes to family issues regarding food and etc. there was really no significant factors within the family or genetically that said you're going to be heavy. I became heavy and I think most of that was really out of choice, I ate and I enjoyed eating and tended to eat the wrong things.

When I look at obesity as to whether it's a disease or not, I actually look at it almost like an alcoholic, and I look at it as if I'm an alcoholic. I'm just addicted to food, and so when I look at the kinds of things for, let's say, the last 15, 20 years that I've gone through, like many weight loss individuals there's a yo-yo effect, losing, gaining, losing, gaining. That occurred throughout my life for the last 20 years, so is it a disease? It's classified as a disease when you get to morbid obesity and things of that nature, so to that extent, yes, it is a disease. But at the same time there's a lot of choices that are made within that process.

Eating is a necessity so to say it's an addiction, making choices that are poor could be an addiction. A gallon of ice cream or a half-gallon of ice cream or a pint of ice cream still ends up being a choice. Probably started having weight issues by way of noticing it as being significant anytime after my 40's, and then it just seemed to creep up almost every five years, another 10 pounds, and never went anywhere's else other than just up.

When it comes to how many different diets did you approach I could count on my hand, 3, 5, 7 and whether it was Jenny Craig, whether it was Weight Watchers or going back through a period of time when Phen Phen was the thing. All of those things were part of what I addressed, and in a way I'm almost glad to say I'm glad I did each one of them, and the reason I say that is cause like many things in life it's a series of cumulative experiences. You learn from each one of those,

Many weight loss patients, including myself, when it comes to medical issues live in denial. Clearly I fit into that category. In 2005, 2006 or so, I had a blood clot, lower leg, and how it occurred I can't answer, you know, in terms of whether it was on an airplane, traveling, or whether I bumped into a table I can't answer how it occurred but I was so ripe to have that blood clot. I mean, you could cut me and I wouldn't bleed. I would just simply ooze a little bit. So my blood sugars were inordinately high. I wasn't eating right. There was limited activity. I was overweight.

My doctor clearly said, you need to lose some weight, which I did, lost maybe 30, 40 pounds, and came back a year later and real specifically I had regained the weight, and he just looked at me, and my wife was with me at the time, and dead seriously looked me in the eye and says, I can't help you anymore. He says, you have a death wish; there's nothing I can do for you, so I'll keep you alive. And I was jolted. And he says, right now you're on three medications; when you're 65, you'll be on five; when you're 72, you'll probably be on seven; and once you're 75 and over I'll probably have you on eight different medications to keep you alive. He did say, you need a bariatric surgery, and I at that time said, I can do this on my own.

That was a real clear picture from my doctors at what the future was going to be for me given the weight that I had gained, but I did go back and say, no, I can handle this on my own; I can still lose this weight. And I did. Lost another 40 pounds. Kept it off for about an hour and a half and then it just regained.

I'm going to take a guess that my weight at the time the doctor had said I had my death wish. I was probably 270, 275. When I got to 295, then I knew I really have an issue here and I'm not managing it. Now interesting enough, it wasn't the only thing I wasn't managing in my life cause weight is really kind of one of six things that you're dealing with simultaneously in life.

There was kind of an ah-hah moment all along the way, knowing that I needed to do what I needed to for myself to lose weight but the real key was kind of taking that step in terms of having in my case a bariatric surgery. It took me a good three years to get to that decision; went through a medical weight loss program, of which my insurance company denied me. Regardless of medical necessity, the insurance company just said, not a part of the plan, so you appealed it; they rejected it. I appealed it again; they rejected it. Frustrating, inordinately frustrating, and I was on what one would think would be a PPO plan and a better choice plan. I ended up finding out that in the State of California, to offer an HMO there are certain medical procedures that HMO's must provide. So, for example, whether it's women's breast exams, whatever it may be, bariatric surgery, if you met the criteria of a medical condition of obesity and morbid obesity, etc., without getting too technical, BMI's, "x" amount of points above what it's supposed to be, they have to authorize that. And I had skyrocketed well beyond all of the authorization points and so I made the decision to switch to an HMO and the very first thing my doctor, when I was assigned to an HMO doctor, was tell him exactly what I wanted to do. And he referred me to a surgeon, etc., and I started the process again, so that was re a two-and-a-half year process from the beginning to the end to ultimately when the authorization came.

Probably the most glaring part of how my life was affected by my weight was my granddaughter. She would have been 2, 3, 4 at the time and like I'm doing now I would sit and watch her play. That's just a sad comment to be able to watch your granddaughter play, not playing with her. We were able to do it in water, mind you, okay, but above ground, no. I lost out on the ability to play with my grandchildren. I lost out on playing tennis. I lost out on really enjoying golf. I ceased to play tennis altogether. You know, your life became much more sedentary. You just lost out on the joy of much of what goes on. That's what I missed the most; that's when I decided to change.

I think that's the most critical part of weight loss to begin with when you're choosing the path of bariatric surgery is really what's the homework's that done before. You go through a psychological exam. You go through a nutritional exam. You're talking with a variety of counselors. You're talking with medical doctors along the way. The reality is any medical weight loss program, and I don't mean this in a negative way, the mere fact that you have the surgery, you could mail in the weight loss for three or six months. Your stomach's smaller. You're uncomfortable. You don't want to eat as much. Lo and behold, you're consuming less, but if you haven't done the homework prior to surgery, if you haven't made the commitment to make those internal changes in terms of what's you're going to consume it, how you're going to consume it, the way you're going to consume it, it's not going to be successful.

The smartest thing I ever did was have absolutely no expectations. Whether I ended up at 210, whether I ended up at 220, it's all better than 295. I ended up at 190 after a year and I maintained that 190 weight for close to three years now. I didn't set any arbitrary weight parameter that I had to be at. By doing that I think you're going to say I want to be 185 so then I've failed.

There were three surgical options at the time. There was the lap band, the gastric sleeve and the bypass. I ruled that out for one reason because they had to make too many incisions; therefore there's too many things that need to heal. The lap band I didn't like only because I looked at that as a very high maintenance surgery.

I ended up deciding that I was going to do the gastric sleeve. The gastric sleeve limited your quantity of what you can eat, and that was probably the first time I began to feel when I would eat more than I ought to, boy, that was uncomfortable. That was a feeling that you're sweating; you're uncomfortable; there's no solution. I found the only solution was to get up and walk and walk more and walk as much as I could, you know, anything I could to kind of help the digestive process.

So you just learn to chew more, eat less but eat more frequently, so I would eat five to six times a day, small portions, almost every 2-1/2 hours.

I thought the process of healing teaches you a great deal because over time every two weeks or every three weeks you're able to expand what you're able to eat, the quantity, the texture as well. And that's when I started to pull all of it together on an ongoing basis, you know, let's say six months after the surgery cause for all intents you're back to normal. A year later you've healed. There are no issues anymore. What's to prevent you from having four milkshakes every day? What's to prevent me from stopping at Randy's and getting three donuts before I go home and eat? Nothing. I can still do that. I can do that today. I don't and I won't because I know what the results of that is. You're going to regain the weight that you've lost. And it's not uncommon from the experiences I've seen for people to regain weight cause they don't embrace the components of consumption, what you need to do, how you need to do it, and how you want to change. I found the stages you had to go through in terms of broadening your foods were a tremendous benefit because it pulled back the ways in which to manage what you eat. But more importantly, long term, you realize that is how you have to eat thereafter.

The side effects were really minimal; they really were because, the doctor said, mind what you eat, be very careful because you are stitched up; obviously if you expand those stitches too soon, you're going to run the risk of stretching them, and then we'd have to go back and, you know, re-stitch. I wanted to make sure that I got through that three-month period with little or no issues. So there was really nothing uncomfortable other than when I would eat foods that would just kind of sit there and you feel uncomfortable from that but not as a result of the surgery or complications thereafter. Again, it had more to do with choices that I made along the way.

Normally in my bathroom it's a half mirror and that's all I look at, you know, from the chest up, there's not too many full mirrors in the house or if there are I don't go near them, let's put it that way. I figured I'm not going to buy a new wardrobe; I'm not changing anything. And then one day, kind of the second time I went to the tailor, almost in maybe 20 pounds or 15 pounds, 15- to 20-pound losses, would take me back to the tailor. And all of a sudden I looked at the mirror and I says, wow, I've lost a lot of weight. I might need to go back to buy a new pair of pants cause I mean the back pockets were touching one another. You know, you can't keep taking them in.

Fortunately there's a lot of elasticity in my skin. I happen to go to a group currently and one of the things that the group always talks about is, you know, finish the job is the term they use, and that's really referring to excess skin and cosmetic surgeries. If anything, it would be more vanity in my case; there's still a little excess skin and that hangs in my stomach and, you know, off my face and things of that nature, but, I don't rash; I don't bleed. I don't have any of those issues when it comes to it so it's really not something I've ever addressed.

One of the things I did with my weight loss and everyone approaches this differently and by no means do I want to get political here, but I'll use the term 'it takes a village' and I'll use that term only because I was very, very public with everything that I was doing. I was public with my family; I was public with people in the office cause they also have seen me go up and down all those other years. I've been working with this one company for well over 20 years to begin with. So I was really clear that this is going to be a journey of many. It takes a lot of people behind you to support you, to make it work for you. My children sure got a benefit out of it. They all wanted to see me, you know, approach my weight differently and my lifestyle differently. I was grateful that those people were there; I was grateful that those people were vigilant; that they would be supportive of me along the way; and I'm so grateful today that they're still there and with that same support.

Activity was a critical part of what I was liberated to be able to really do again. Walking the golf course as opposed to riding. Started playing softball on Sundays, which I hadn't done since college, and I played four years of college baseball, so it's not like there wasn't activity in my life. Started playing tennis again. I keep a pedometer on me. There was a time when I was doing 10,000 steps a day. I've kind of narrowed it down at the 4,200 to 5,000 and working my way back so I'm kind of now looking at 7,000 a day as being my guide. It's liberated me to re-do the things that I used to find within my life as being a passion; and all to the good in that respect.

When it comes to family, it's really interesting. And what's interesting is, none of them remember me like I used to be. You almost have to look at a picture to say, wow, that was you, Uncle Mike? Wow, dad, I don't remember you looking that way. Do you mean you really were that big? And that's the same with people at work and the same with people that I work with, when it comes to clients and things of that nature. It's almost that over time they've just got used to who I am today. I like it that way.

To the left of my desk I have all of my old pictures of who I used to be. After I had lost a hundred pounds or so, in my back yard I mounted 10 bowling balls on my back fence, and this was a whole project and it was a whole effort on my part to search out the bowling balls, to find the bowling balls. And I collected about 15 of them and the intent was to mount them on the wall so I'd have a visual reminder every day of a hundred-pound weight loss. There were 10 of them that I mounted. Each ball signified 10 pounds of weight. I count them every day and I do that for a very specific reason, I lost a hundred pounds. And that's my water level for what I will never regain again. So if I go down to, let's arbitrarily say, 180 and gain 15 pounds that's fine, but if I get one pound over 195, I’ve got a problem. You need to find the things that will motivate you to help you sustain your weight loss and that was one of the things I did.

3-1/2 years out from the surgery I still go to a nutritionist once a month. I still go to group classes with psychologists, maybe once a month, twice a month. Some are just men only; some are combined. I think I kind of referred to it earlier as an alcoholic having to go to AA on a daily basis or on a weekly basis. I looked at it the same way. That support team is critical to me. It's part of how I address what I need to do for myself, and those around me support that. I find all those things are really very, very critical. In absence of me embracing it, my fear would be that I would find a way to let it all go again, and that's what I've chosen not to do.

Every day the thought of the weight coming back is always there but that's why in my particular case I plan my meals every day. I'll take my lunch to work. I know what I'm going to eat. I know how often I'm going to eat and what I'm going to eat. Not to say that I don't have a piece of cake, and not to say that I don't have ice cream. You're not precluded from what you used to do; it becomes a choice of what you don't want to do any longer.

There was a woman in a class about three weeks ago that was talking to those that have kept off their weight, and she says, it sounds like you guys are on a diet, and I listened to her, and I just said, you can use that term if you want but it's not a term that I even embrace any longer. I'm not on a diet. I just weight manage what I do. I manage my consumption. I manage what I'm going to eat and I kind of manage my lifestyle.

The only weight that I actually look at is when I weigh myself with the nutritionist once a month. That's my gold standard of where my weight is. We write that down so that becomes my benchmark for what I need to do, or whether I need to re-look at what I've been doing.

I've kept it off for 3 years, 3-1/2 years, and I plan on keeping it off for the next 3-1/2 years and then the next 3-1/2 years thereafter, you know, and it's just a commitment I've made to myself.

Weight loss is one thing that changed in me. But my outlook on life significantly changed. My relationship with my family has changed. My business, it's changed. Dealing with financial issues has changed. Things that I chose to bury 10 years ago, 15 years ago and 20 years ago. Forcing me to deal with all of that. So in a way, when that time comes cause I don't control how long I'm going to be here, I know that I'm going to leave this world as clean as I can with very little left behind me that anyone needs to worry about. Weight has been the key factor to liberate me, to deal with all those other things, and to that I'm grateful and I want to continue to be grateful cause I'd like to go back to that blank tablet, upon death, okay, as opposed to with a lot of things that's cluttered there so if I can get there I'm a happy man.

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