Maintaining Weight Loss by Decreasing Sedentary Time: A Patient and Physician’s Perspective

Abstract

This article, co-authored by a patient living with obesity and his obesity medicine specialist, reviews how the patient has successfully lost 200 lb and maintained that loss for over a decade. This was achieved primarily with a behavioral intervention including support visits, a structured food plan, and changes in his physical activity. He did not undergo bariatric surgery. For the majority of this time, he was not treated with anti-obesity medication. This article will review how the patient lost the weight and kept it off, particularly in relationship to the importance of decreasing sedentary time. PATIENT'S PERSPECTIVEMy journey to healthy began as a child. I was a big kid, much taller and stockier than the rest of the kids in my classes. I have struggled with maintaining a healthy weight my entire life. Weight issues were not unique to me. Everyone in my family struggled with being overweight at some point. Healthy eating was never prioritized in my household, and overeating was commonplace. As a child and young adult, my weight was controlled by countering the bad eating habits with physical activities such as playing baseball and other sports. On the menu there were plenty of starchy foods, soda, and desserts. This is just how things were. For me, this was ''normal.'' Throughout my teenage years, although I was a big guy, I remained very active and relatively healthy. My atrocious eating habits seemingly flew under the radar. Throughout college my activity levels dropped, and I could see my body becoming more sensitive to weight. Let's just say the ''Freshmen 30'' was really the ''Freshmen 50.'' Being young it was not a big deal. I could surely get the weight off easily just as I had been able to in high school. To put it in perspective, I was 6 0 2 00 with a relatively large frame and so being a bit on the husky side was not a huge issue for me. I was told I ''Distributed the weight nicely.'' Two hundred and fifty pounds? No problem! By the age of 23 I was married and having a child. I worked full time and continued school part time; I had done a relatively good job of maintaining a stable weight through the first few years of college, but with this new life as a married, working, studying dad, I became very sedentary. After work I would settle into study and make attempts to spend time with my family, but being active was not a priority.From the age of 23, starting at about 230 lb and in relatively good shape, to the age of 36, I gained over 230 lb reaching a terrifying plateau of 460 lb. I doubled my weight in 12 years! I was in trouble. Two constants had remained throughout this period of my life: first, the atrocious eating habits, and second, the sedentary lifestyle. To be retrospective for a moment, in addition to not making the healthiest of food decisions, the largest contributors to my bad eating habits were controlling my portions and pace. Seconds were a given. Thirds often if there was more to be had. I did not allow my body to understand what it meant to be satiated. It had to be st...