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Fork in the road
He didn't want to die. So he chose to change the way he lived - and ate
By JIM HIGGINS
jhiggins@journalsentinel.com

Last Updated: July 6, 2003

Back when I weighed almost 380 pounds, I did most of my compulsive overeating alone in my apartment. But when
I did visit a fast-food restaurant, I had a ritual. I went before or after the lunch or dinner crowds, so the place would
be nearly empty. And I picked a seat close to the door, so I could leave quickly when I was done.

One Saturday, in a downtown burger joint, I sat down, alone, in one of those molded plastic chairs bolted to the floor
in pods of four. When I finished gulping down my food, I lit out for the door, but got stuck in my seat. In my
struggle to get free, I somehow worked the bolt loose, and the whole pod of chairs, with my body still wedged in
one, toppled sideways to the floor.

To live as an obese person is to feel trapped in many ways: trapped in an oversize body that's difficult to clothe and
difficult to move around in; trapped in habits of overeating, partly chosen, partly ingrained from childhood, perhaps
partly triggered by genetics; trapped in a culture that mocks and condemns fat people, but also subverts their efforts,
however halting, by pushing food and promoting instant gratification.

Alarmed by the rising number of obese Americans, including children, then-Surgeon General David Satcher issued a
call to action on obesity in December 2001. The media, responding to the alarm of Satcher and other public health
officials, are increasingly exploring the subject in ways that go beyond the endless cycle of profit-hungry diet books
and arguments about fat vs. carbohydrates vs. protein.

As someone who was obese for many years, beginning in childhood, I second one of the key points in the surgeon
general's call to action - we need to change the public discussion of obesity so that the primary concern is one of
health, not of appearances.

I'm one of the fortunate ones who's managed to lose more than 100 pounds and keep it off for a number of years.
While I swallowed a super-sized portion of shame about my appearance during my fat years, it was health that led
me to change - the deep concern of my closest friends and my own fears of dying prematurely.

Today I can pass for normal - a middle-aged dad with a desk job and a belly. But I still know what it feels like to be
the 380-pound man waiting for a bus and the 180-pound student who struggles to finish a lap in gym class.

How it all started
Looking back, I believe my obesity was overdetermined - that is, it had multiple causes, including my obvious
failure to stick with a sensible eating program.
Several members of my family have struggled with overeating (though none to my extreme), so there may be a
genetic element.

Both my parents knew hard times as children, and, perhaps to compensate, food was plentiful and celebrated in our
home. That was a good thing. Spiritually, I think sharing meals with other people is something sacred. But I never
developed the shut-off valve inside me that told me when enough was enough.

In childhood photos I don't start to look fat until 9 or 10, but I remember hiding cookies in my pockets and being
preoccupied with food at a younger age. In the Pittsburgh parochial schools I attended, I was teased occasionally by
classmates and strangers about my size. In the '70s, a certain Bill Cosby cartoon series was popular, so I was called
"Fat Albert" more times than I can remember. It hurt, but the hurt alone didn't make me gain control over my eating.

As my weight grew, both my mother and the school nurse fretted, starting me on diets and healthier regimens, which
I followed for a few days or weeks before subverting or failing them. I still have fond memories of the grapefruit
diet, which involved a half grapefruit at each meal and a lot of salad. Of course, my mother was doing all the work
of preparing those special meals while also feeding three other children and my father.

After puberty, I gained weight at an alarming pace: 50 pounds my first year of high school, another 50 pounds my
first year of college, with incremental increases in between. The summer before college, I lost some weight while
working with a young doctor at the neighborhood medical clinic; his mixture of empathy and encouragement to take
responsibility worked for me.

Unfortunately, when I left Pittsburgh to attend Marquette University I also left that sensible approach at home. I
succeeded in the classroom and made some quality friends, but also ate uncontrollably, fueled in part by alcohol and
marijuana. I graduated with honors, but also well over 300 pounds, and scared about the future. Painfully self-
conscious about my size and appearance, I dreaded the challenge of competing against normal-size people for work
in my field. Instead, I got a janitorial job in a fast-food restaurant (not the best place for a depressed fat guy), and
told my friends that I was working on various creative writing projects - which was only occasionally true.

Getting fired from that job got me into crisis counseling long enough to clean up my hygiene and get back to work,
first as a temp and then as a part-time journalist and reviewer. Unlike my fellow journalists, I was too big to fit into
the State Fair's old grandstand seats, so I had to watch Willie Nelson and Joan Jett from the aisle.

I wasn't the only one who noticed I had a problem.

Beginning in 1984, three close friends and my new employer, the Milwaukee Sentinel, confronted me about my
weight. Like Surgeon General Satcher, their concern was for my health.

Despite my size, I had always enjoyed playing team sports. When I had to take myself out of a softball game, red-
faced from exertion and barely able to walk up a few stairs, my school friends Greg and John were worried enough
that, some weeks later, they drove up from Chicago together to talk with me about it. That poked a big hole in my
shell.

Next Kathleen, who was both my closest friend and the woman I had a massive crush on, implored me to do
something about my weight. I don't want you to die, she told me while we were riding in her car in a heavy
downpour, both of us crying.

I began to take the need to change more seriously. On Ash Wednesday 1984, I started a food diary to keep track of
what I ate. One day I recorded that I ate more than 16 different times.

Finally, the managing editor at my job called me in for a discussion. He was pleased with my work but worried
about my health and urged me to get help. He even volunteered the help of the company nurse in researching
treatment options for me.
Somehow I said yes.

Six months of self-discovery
When I showed up at DePaul Hospital on the south side in March 1985, I began the six months that would change
my life. DePaul no longer exists, but back then it was famous locally for treating alcoholics and drug addicts, using
the principles of Alcoholics Anonymous. DePaul had just started working with people with eating disorders on the
same lines.

While I had used drugs and alcohol in college, they weren't an addictive problem for me, and my use fell off almost
completely when I left school and ran out of money. Overeating was my all-consuming issue.

As a part-time employee, I had no health insurance, but DePaul let me pay for my outpatient treatment over time.
Paying my own way was a powerful incentive to take my treatment seriously.

The food plan was simple. It's always been simple for me, as I have no allergies or special medical conditions. A
nutritionist can explain it in a few minutes and one sheet of paper. Three moderate balanced meals a day, without
sugar and certain binge foods.

Sticking to the plan and getting on with life was (and is) the difficult part. My treatment was about learning how to
build a new lifestyle without overeating and without obsessing about food.

As part of treatment, the DePaul staff assessed each of us psychologically. Eighteen years later it's still sobering to
re-read mine:

"This is a young man, who has been horribly damaged by the disease of compulsive over-eating. He has become
insecure, low in self-worth, full of resentment, blame and self-pity. The disease has affected his physical, emotional
and spiritual life. When he sought treatment, he did not have an open, honest style of relating left to him anymore."

During those six months, I went twice a week to group therapy and to one-on-one sessions with the program staff.
Some of the fellow group members were bulimics, some anorexics, some compulsive overeaters like me. We both
confronted and relied on each other in learning how to live without destructive eating.

In my case, the "learning how to live" was literal. I had a blood pressure reading of 180 / 100, wore size 58 pants
and had 3 days worth of wearable underwear. At 26, I had never learned how to ride a bicycle, never driven a car
and never had a serious romance - normal stuff for many people, but all casualties of my obesity and my reluctance
to make myself vulnerable enough to learn new physical things.

The therapists were supportive, but not afraid of confrontation. Early on, I was hemming and hawing with one of
them about getting some regular exercise. I was planning to go swimming, I told her, but I was ashamed of how I
looked and wanted to feel more comfortable with it before I started going to the pool.

You have it backward, she insisted. You have to take the action, and the feelings will follow.

On my way to the YMCA I was so nervous I called a program buddy from a pay phone to boost me. But I got in the
pool and discovered a few things - that it felt great to do something good with my body again, and that none of the
other swimmers cared how I looked.

Binge eating isn't completely pleasant, but it is an intense physical experience. The DePaul program nudged me to
live in a calmer zone, less attached to a cycle of bingeing and crashing in self-remorse.
I was too big to get weighed on any normal scale. A couple of weeks after I started, I got on the industrial scale at
work to learn I then weighed 372 pounds. As the days went on, I could tell by my baggy clothes that I was
shrinking, but my counselors forbid me to weigh myself until the end of the six months. When I did, I'd lost 80
pounds. I visualized that lost weight as a chain of five bowling balls rolling away.

My co-workers, who'd quietly supported my treatment without embarrassing me, surprised me with a "graduation"
present: A little black & white TV to replace my only set, which I had been too busy and too broke to replace.

Eight more months of aftercare helped me transition into independence by reinforcing the discipline of the treatment
program: Make a sensible food plan and stick with it, rely on my peers for support and get on with the real business
of life. Three years after I began at DePaul, I was down to 200 pounds, and could buy a man's shirt at a normal
department store for the first time in my life.

Getting it done
A rueful joke among overeaters is that anyone can lose 100 pounds - it's keeping it off that's really hard. So why did
it work for me?

When I'm asked this question I fumble around like a student trying to cram an essay into the tiny space allowed for a
fill-in-the-blank question.

First, I have to acknowledge the grace of God, the pure serendipity that lined up so many things in my favor. I was
young and single, I had the time to work hard at changing. Good treatment was available to me, even though I had to
pay for it myself. My workplace and friends supported me. Not every obese person has these advantages.

Just as important, I was desperate to get better. Deep down in my bones, I didn't want to die. And I didn't want to be
a freak or an object of ridicule anymore. That desperation became my ally, the current that powered a new way of
life.

How did I do it? It was simple but damn hard. I had to change my entire way of life. I had to take planning my food
as seriously as anyone with juvenile diabetes would (in fact, I consider people living healthily with diabetes my role
models and inspirations). I had to make a new set of friendships with other recovering compulsive eaters, who share
my struggles and correct me when I get off track, to this day.

I have never considered myself cured. I have had relapses since 1984. They weren't long enough for me to put all
that weight back on. But it was humiliating to re-experience the loss of control I felt when I was eating snacks I had
hidden in the trunk of my car. Those humbling relapses remind me of the need to keep rediscovering that
desperation I had when I started at DePaul.

Today I weigh about 225 pounds. That's still too much for a 5-foot-11-inch frame. My doctor has suggested a goal
weight of 180 pounds, a weight I have held for one short period in my life. I would be pleased to get under 200 and
stay there.

Fortunately my spouse understands and supports my efforts to live a healthy life. Even our children, who are 8 and 5
(and show no sign of becoming compulsive eaters), help. I'll tease them when they have a treat by asking, "Can I
have some?" Their forceful reply: "No Dad, you can't have sugar."

People sometimes ask me, when can you eat like a normal person again? When can you eat one cookie, one
doughnut, one piece of cake?

Never, folks. I can never do it again. Deep inside, I don't want one doughnut. It would do nothing for me. My
insatiable compulsion to overeat wants a whole box of doughnuts and more. I could never eat enough doughnuts to
satisfy it.
I am not a member of Alcoholics Anonymous, but I have drawn a lot of inspiration from its literature over the years.
When it comes to the prospect of my eating "normally," of eating whatever I feel like eating, I think of a line from
the "Alcoholics Anonymous" book about the chances of an alcoholic drinking normally again:

"We are like men who have lost their legs; they never grew new ones."

Jim Higgins is assistant entertainment and features editor for the Journal Sentinel.



                                  From the July 6, 2003 editions of the Milwaukee Journal Sentinel

				
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