No more hiding

He’s living proof that it doesn’t matter where you are on life’s journey – you can always move forward. Read on as this newspaper reporter lays bare his struggle in a shocking and courageous story about taking the first steps towards recovery from morbid

Columnist Daniel P. Finney shares how he is regaining his health

“Do you want me to get a wheelchair?” Reality overcame denial in that simple, earnest question from a friend.

I was in a Des Moines hospital for a story that involved touring a neonatal intensive care unit with the hospital’s public relations man, whom I had known for years.

I was in terrible pain. Lightning bolts struck the base of my spine and sent shocks through my body. My legs felt like dead logs dragging across the floor.

Though it was a cool day in February, sweat rolled off my bald head from the simple exertion of walking from the elevator to the nurses station. My navy golf shirt was soaked, the crotch of my pants damp.

In practical terms, it was maybe 20 metres. For me, it felt like 30 kilometres.

I blamed the back pain on carrying too many groceries. But that was a lie I told myself to avoid the truth I’d been dodging for almost a decade.

The problem is my body. It’s practically immobile because I am morbidly obese.

The turning point

Morbid obesity is a medical diagnosis for someone who has a body mass index (BMI) of over 40. Mine, I learnt after that day in the hospital, was 64. Obesity, the more common diagnosis, is a BMI of 30 or greater.

Of course, I’m not the only hefty American. The Centers for Disease Control and Prevention (CDC) estimates about 36 per cent of US adults – roughly 85 million people – are obese. The people hit hardest are ages 40-59, according to CDC data.

Things aren’t any better in Australia – a 2015 Australian Bureau of Statistics survey found 63 per cent of Australian adults, about 11 million people, are overweight or obese.

The risks are well-known: type 2 diabetes, cardiovascular problems, skeletal and muscular stress, among others.

I knew all this, of course.

I have a mirror at home – just the one, which I avoid looking into directly, especially when I get out of the shower. Still, I’ve been a master of self-deception. I ignored my weight when the doctor’s scale – which measures up to 227 kilograms – could no

longer measure me. I ignored it when I stopped fitting into seats at theatres, sporting events and concert venues.

I ignored it when a walk to the mailbox – about a block

– was enough to leave me winded for nearly 20 minutes.

I ignored my weight when the seatbelt in my car no longer fit without an extension. I didn’t even know extensions existed until I saw them at a big-and-tall clothing shop, where I got mine.

I rarely rode in other people’s vehicles because I worried the seatbelt wouldn’t fit or I couldn’t wedge my hulking frame inside. And forget about flying. I didn’t fit in the seats with the armrests down. I wouldn’t buy two tickets.

I ignored it when cleaning myself after using the toilet became a painful, nearly impossible task. And public bathrooms? The handicapaccessible stalls might work, but a regular stall was always too narrow. I usually just rushed home, often risking embarrassing accidents. Even using the urinal was a challenge.

And I ignored it when my doctor diagnosed me with type 2 diabetes.

Reality hits

But on that day when my friend offered me a wheelchair because I could barely walk under the weight of my own body, all of the denial vanished.

I was now too fat to do my job. I’m a newspaper columnist for The Des Moines Register in Iowa, one of the few public faces of my home-state newspaper. It’s been my dream for as long as I knew there was such a thing. It’s the best job I’ve ever had. I planned to hold onto it until I retired. But suddenly, I faced the real possibility that

I wouldn’t be able to go to interviews or even stand up for more than a minute or two.

On that February day, the facts were undeniable. I was well on my way to the wheelchair. Next would come the motorised scooter, possibly the cemetery. At 39 years old, I had the mobility of a hospice patient.

The photographer and the PR man went on with the assignment. I rode the elevator to the lobby and collapsed into one of its upholstered circular benches. I keep some antianxiety medication in a gold cylinder attached to my key chain; I screwed off the top, shook out two pills and then swallowed them without water to fight off a bubbling panic attack. I was overwhelmed by the pain and shame.

What had I done to myself? Would I ever be functional again?

I fished my iPhone from my pocket. I dialled my doctor right there in front of total strangers shuttling back and forth through the lobby’s revolving door. I worried they were eavesdropping, but it’s likely no one noticed me having one of the greatest turning points of my life.

“I’ve hurt my back,” I told the nurse who answered my call. “I’m in terrible pain. I think it’s time to talk about my weight.”

If my life was a Rocky movie, this is probably where the heroic montage would start. But I think we all know that the biggest struggles of our lives can’t be condensed into a catchy pop tune. I had work to do.

The beginning

For years, my doctor has suggested I look into bariatric surgery. I always said I would,

the way I promise the dentist

I’ll floss three times a day. But I wasn’t ready to commit.

She wrote me a prescription to alleviate the back pain and referred me to a physical therapist and a dietitian at a special weight-loss clinic.

I already had a mental health therapist – I live with generalised anxiety disorder and persistent depressive disorder. I take medication to control the biochemical malfunctions in my brain that cause the trouble, but talking about the psychological causes of my overeating became a top priority in our sessions.

This became my healthcare team. Together we began the long process of rehabbing my body – a body that, if it were a house, would be dangerously close to being unfit to occupy.

Thank God I have a full-time job and health insurance. But my insurance doesn’t cover visits to a dietitian, or pay for a membership to the YMCA or health club. It doesn’t pay for classes to teach me healthier cooking or better food-shopping habits. All that is 100 per cent my bill. However, my insurance will pay for nutrition counselling if it’s in preparation for bariatric surgery. And it will pay for bariatric surgery.

To me, this seems insane. Medicine is supposed to be transitioning from reactive care to preventive care, but most insurance companies won’t cover an array of cheaper measures that could prevent costly surgery when it comes to obesity. Every insurance plan is different, and there’s no universal standard for coverage for chronic obesity. But if you’re beginning your own recovery, talk directly with your insurance company about what is and isn’t covered. Doctors often make recommendations for care or medication but have no idea how much either of these will cost you.

“At 39 years old, I had the mobility of a hospice patient ... I was well on my way to the wheelchair”

It behoves us all to be informed and ask for alternatives when money is an issue in our care.

Still, I’ll tell you this much – every cent I spent on this process was worth it. Nothing that I could have purchased, no holiday I could have taken and no night out on the town would have brought as much value and happiness to my life as beginning recovery.

Making progress

My journey began in earnest about a week after the wheelchair incident.

I was still in crippling pain and practically immobile when I met with physical therapist Stefanie Kirk. She asked me to walk a small track marked out with tape on the floor.

One lap was 50 metres.

“Just do as many as you can,” she said. “I’ll be right here with you. Stop at any time.”

The first few metres went easy enough, but at the quarterlap point I started to hurt. By half a lap, I was sweating and wanted to stop. I forced myself to finish the lap.

Stefanie brought me a chair, a cup of water, and a towel.

“On a scale of one to 10, how would you rate your pain?” she asked me.

“Ten,” I said, and hung my head. Stefanie crouched down and her eyes met mine. “Hey,” she said. “This isn’t going to be easy, but you are going to get better way faster than you think.”

The hard way

The next day I met Jacque Schwartz, my dietitian. The first thing she had me do was step on a scale.

The kind of scale needed to measure a person my size looks like something you’d find at a cattle yard – a black platform about half a square metre with handrails that meet in the middle, where a computer panel displays your weight.

I stepped on. For the first time in more than a decade, I knew my exact size – 255 kilograms.

“That’s horrifying,” I said. “I’m more than a quarter-tonne.”

I envisioned having to be moved around by forklifts like cargo in a port. I felt completely inhuman, just a massive thing. Yet there was some relief in actually knowing that number.

“What did you think it would be?” Jacque asked.

“I figured it was up over 600 pounds [272kg],” I said.

Jacque laid out the options the weight-loss clinic offered. One was a meal-replacement plan. The cost was absurd: US$6000. I ruled that out – I just don’t have that kind of money, and I had a sinking sensation it wouldn’t work anyway.

Jacque told me I could also choose bariatric surgery. She said the clinic doctors typically perform a gastric sleeve procedure, cutting out about 80 per cent of the stomach. The idea was that I would feel fuller faster, and my stomach would produce fewer of the hormones that stimulate appetite.

“What do you think about that?” she asked.

“I hate it,” I said to her. “I’ve never even had my tonsils taken out. I’m terrified of cutting away most of a healthy organ.”

There was one final option – the hard way.

Eat less. Move more.

Keeping the ledger

Because my back was mangled, moving more would come later. Eating less started at once.

Jacque suggested using an application for my phone to track kilojoules. There are lots of them. She used a free app called MyFitnessPal. The app allows me to scan the barcodes of packaged foods and provides good estimates of kilojoules for fresh produce, meat and other items.

You’ve probably guessed by now that this makes me kind of a pain at restaurants. I pester servers about the ingredient amounts, preparation and if they can grill something rather

“No holiday

I could have taken and no night out on the town would have brought as much value and happiness to my life as beginning

recovery”

than fry it. I try to add to the tip if I’m particularly obnoxious.

But the more I know about a meal, the better I can estimate kilojoules and the more comfortable I feel eating. It can make me an annoying dinner companion, especially to my less-patient friends, because I take so long to choose and spend a lot of time punching food into my phone. But it’s worth it to me.

I had long avoided counting kilojoules because I thought it would be tedious. But the memory of the wheelchair was so intense, and I was desperate to get better. Kilojoule-counting became like keeping a bank ledger. My daily goal was how much I had to spend. Going over was akin to being overdrawn. It helped me make better choices.

Hitting a roadblock

The process takes practice, and I make a lot of mistakes. I tend to overeat less out of hunger and more because of emotional situations. Recently, a friend suffered a hypoglycaemic attack while we were out having lunch. He’s lived with diabetes for 10 years, mostly in secret. But having never witnessed anything like that, I was badly shaken. I thought my friend was having a stroke – I called emergency services and his wife, and in the end, everything was fine. But on my drive home, I started shoving leftovers in my face as fast as I could. Manic eating at its worst.

I made it home but I felt wretched. The scare was bad enough, but the eating – the pure desperation of it – rattled me more. I was convinced this was the moment I would lose control and undo any good I’d done up to that point. I called my therapist.

“You called emergency services and had the presence of mind to get a hold of his wife and put her in touch with the medics?” he asked.

“Yeah,” I said.

“Dan, do you realise you have terrific survival instincts? Not everybody can do that.”

“What about the eating?”

“So you did some emotional eating,” my therapist said. “Are you still eating?” I wasn’t.

“Do you plan to keep eating that way for the rest of the day or longer?” he asked. I didn’t.

“Then you’re going to be OK,” he said. “Incidents happen. You deal with them. Whether you know it or not, your coping skills are excellent. How do you feel?”

“I’ll make it,” I said. And I did.

No cold turkey

The things Jacque taught me about food were not shocking. Eat fresh fruits, green veg and lean meats. Avoid junky carbs and sugars. But the day-to-day process is slow.

I didn’t go cold turkey on anything. I slowly gave up my beloved liquid candy, Mountain Dew, finally weaning myself from it entirely after a full month. I switched from low-fat milk to skim. I let go of my morning orange juice.

I started measuring things.

If I wanted some baked potato chips, fine. But I was going to measure out a single serving – 30g – and stick to that.

Sometimes it’s tedious, but I feel good when I’ve stayed below my kilojoule goal. I feel

better when I see a smaller number on that scale at my monthly weigh-ins.

The food changes aren’t as stressful as I’d imagined. I envisioned myself dashing to a service station at night, holding my face under the Mountain Dew tap, gulping down as much as I could until the police hauled me away to the hospital for a mental health evaluation.

The truth was less dramatic. My overeating tends to be driven by feelings rather than cravings. So a lot of the things I ate and drank were out of habit and routine. It’s morning – have a glass of OJ. Anytime is a good time for a Dew. But I found other substitutes. Instead of OJ, I eat a grapefruit. Zero-kilojoule sports drinks sub in for soft drink. But it can be frustrating.

My parents host an annual Independence Day party with all the fixings – homemade pork and beans, grilled pork and brisket, coleslaw, my mother’s magnificent potato salad, a table of desserts so sweet they could melt a blood glucose monitor.

My therapist and my dietitian remind me of moderation. No foods are banned, just limited.

So last Independence Day, I carefully planned what I was going to eat. I figured a cup each of my favourites. But I forgot the homemade pineapple sherbet, a once-a-year treat that’s tied to so many fond memories of my childhood.

When I thought I couldn’t have that dessert, I nearly cried. Then I remembered: not banned, just limited. So I had a cup. And I still lost weight at my next weigh-in. That’s a win.

I’ve been doing a lot of that since this recovery started. I think it has to do with seeing a therapist. He helps me try to figure out the emotional hole inside of me and why, for most of my life, I’ve tried to fill it with food. I’m dealing with all of it. I’m a work in progress.

Keep on moving

Since this process began, I’ve lost more than 34 kilograms. People say I look slimmer. My pants are baggier. My belt is so loose it’s useless. And I do feel stronger. I can make it up a few flights of stairs. The walk to the mailbox won’t cripple me.

Yeah, I’m still obese, but my BMI has dropped from 64 to 59.

I figure it’ll take four years or more to hit my target weight and the rest of my life to stay healthy. That’s why I use the word ‘recovery’ instead of ‘diet’.

I may one day be fit again, but I have to remember that I will always have the potential to relapse. That is something I am determined to prevent.

Sure, some days I would give anything for a pizza. Many days, if not most, I want to blow off exercise and sit in my house and not be seen. And again I think of the wheelchair.

Then I stand up and get moving. Because there’s just one direction I’m headed right now – forward.