The RIGHT Way to Lose Weight

If you could step inside my doctor’s office for the next few minutes and be a fly on the wall, I think we could learn some things together. I invite you to observe a few patients who came seeking help for obesity.
Kelley
Kelley is roundly obese, in her early 60s, and works in a church. She is very social and articulate. She is really worried about her kidneys because she knows someone on dialysis. She has been overweight all her life. She has tried multiple diet programs. She has been on the medically-supervised fasting program, and more than one that sends meals to her home. She has come to me to get healthy. We evaluated Kelley’s hormone levels and metabolism. Turns out, she has borderline kidney function, high liver enzymes, and very high insulin levels. She states she is very motivated to make some permanent changes. However, after several months of treatment, our conversation went something like this:
Dr. S: How are you doing with the diet?
K: Great!
Dr. S: I see that your weight is unchanged, why do you think that is?
K: I don’t know. I’m doing everything right.
Dr. S: Then why aren’t you losing weight?
(Long pause) She looked up finally and sheepishly said, “I need it.”
Dr. S: What do you mean?
K: Because it protects me. Since I was a little girl, I have been able to keep people at a distance by being overweight. When I’m fat, I’m transparent, people don’t look at me. I don’t exist. I have a wall of protection as long as I’m obese.
Dr. S: Why do you want to keep people away?
(Another long pause, then tears…)
K: I was sexually molested as a child, and I just can’t stand the thought of anyone being close to me. I have never told anyone this, and have never understood why I couldn’t lose weight before.
We discussed this further and what was the right strategy for Kelley to lose weight. It wasn’t the course of treatment we were taking or those she tried for many years. She needed help with childhood trauma. She was suffering primarily from PTSD, and needed to address this need first. Then, she may be able to move forward with the physical illness. In the meantime, she continued taking her medications, and we added some nutrient supplements to help protect her kidneys and liver, as well as a yoga program to help her deal with stress.
Julie
A very nice-looking 40-year-old blonde woman came in to see me. She was a filmmaker and valued her looks. She had started on one of our programs and was seeing the nutritionist, acupuncturist, and health coach. She was overweight, but not obese, and didn’t have any health issues related to being heavy.
Dr. S: Describe what happened.
J: I started getting palpitations, and thought I was going to die. I had chest pain, like an elephant on my chest, and I couldn’t breathe. My friend took me to the ER and they told me it was a panic attack. Since then I have had several episodes. I always feel like I need to go to the hospital, but my friend talked me out of it.
Dr. S: Have you ever had this before?
J: No. It has only happened since I’ve been on the program. I had the first one after I noticed that I lost ten pounds. It wasn’t an “Oh boy!” experience for me, just a feeling of dread – and then I got a panic attack.
Dr. S: Oh, your positive results should have brought some rejoicing, but you had panic, is that right?
J: Yes, that’s what it seems.
Dr. S: Why would you panic?
J: I’m not sure. I want to say that I don’t want to be skinny.
Dr. S: Why not?
J: I think it’s because all my life I have been defined by how I look. Twenty years ago I was a Calvin Klein model, traveling all over the world, having pictures taken of me, walking down runways, and being ogled and lusted-after. It was all about my looks. Nobody cared about me. Nobody knew me. They didn’t want me, they just wanted my body. Now I have a good career. I love making movies, and I’m good at what I do. I don’t want to go back to being that skinny girl that everyone looks at. I want to be seen for who I am, for my talents and abilities…
Her voice trailed off as she looked up at me.
J: Well, I guess I really don’t need your help. Now that I know what the issue is, I can live with it, and I’m not going to lose weight.
Dawn
Dawn was only in her 30s and was very obese. We call it “morbidly obese” because this is something people die from. She was recently diagnosed with diabetes and was prescribed medications. But, the medications were making her sick. She was nauseated and had no energy. She would fatigue with only a little exertion. She hated the drugs and came to me to help her get off them.
For eight months we worked together, trying various things to lower her blood sugar. The different diets and supplements didn’t seem to be working. At this point, I walked in the room and asked, “How is it going?”
D: Fine.
Dr. S: I see your blood sugar is still high, and your weight has not changed?
D: I’m doing everything you said!
Dr. S: (heavy sigh, exasperated) …then why aren’t you losing weight?
D: (in a monotone) Because