Pulse
Big Losers
Sixty-four-year-old Ray Christensen, M.D., recalls the day three years ago when he knew his habit of careless eating had gotten out of hand. With a 5’10” frame, he tipped the scale at 275 pounds. A family physician at Gateway Family Health Clinic in Moose Lake, Minnesota, and assistant dean for rural health at the University of Minnesota, Duluth, he was well-aware that the weight he’d put on came with health risks, from extra pounding on his joints to hypertension and diabetes. Beyond that, he could tell he’d begun to lose clout with his patients. Those who’d come to him for decades unabashedly expressed concern about his health during their own scheduled appointments. And when he discussed diet and exercise with overweight patients, “they just laughed at me,” he recalls.
For Christensen, “all those pieces came together at once.” He went home from work one day and embarked on a diet that cut back on portions, trimmed carbs, upped his servings of fruit and veggies, and eliminated nighttime snacks. “I went to bed hungry for the first four or five days, and I hadn’t slept better in years,” he says. Even though he’d been exercising about an hour a day on a stationary bike, he stopped reading the newspaper while working out so that he could focus on pedaling more vigorously. In addition, he set out on a program to run or walk 10,000 steps (five miles) a day. Burning 3,500 calories a week through exercise, “the weight melted off pretty fast once I got going,” he says. Over the next two years, weathering a few vicissitudes on the scale, he managed to trim down to 190 pounds and was delighted to find his new state improved everything from his stamina to his critical thinking abilities.
Although doctors may be better informed than anyone about the devastating effects of obesity, the stress and long hours associated with practicing medicine aren’t always conducive to a healthful lifestyle. And when it comes to eating and exercising, doctors have the added pressure of being role models. Studies have shown— and common sense suggests—that patients are more likely to heed advice from fit physicians and that physicians who make wise choices themselves are more likely to recommend healthful behaviors such as exercise to their patients. What’s also clear is that those who have struggled with obesity but gotten down to a reasonable weight have much to offer from their own experiences.
One (Difficult) Step at a Time
For Randy Rice, M.D., being diagnosed with diabetes four-and-a-half years ago was the critical wake-up call. “I’ve always been on the heavier side,” says the 48-year-old family physician who also practices at Gateway Family Health Clinic in Moose Lake. “I never really paid that much attention to my weight.” But the day he weighed in at 285 pounds and was found to have an A1C over 9, he came home and got on the long-abandoned exercise bike in his basement. It took a year to build his strength and endurance, but biking emboldened him to enter his first-ever 5K foot race. The race was torture, he recalls, but also edifying.
As he incorporated running into his workouts, he says, “I started to enjoy it.” Paying close attention to what he ate, calculating “calories in and calories out,” and running daily, he winnowed his weight down to 165 pounds over two years. His lifestyle changed too: He increased the length of his daily run and eventually attempted a marathon. Today, he’s a veteran of three.
Now weighing about 220 pounds and sticking with one mainstay medication for his diabetes, Rice knows his weight will bob up and down within a range, but he talks with more confidence when he broaches the topic of weight loss with patients. “I try not to get too much into my own personal story, but there are times when people are expressing frustration with how things are going and whether they feel they can exercise. [I tell them] I was never athletic, and it’s just been a matter of taking things a step at a time.”
He takes particular pride in having been a positive influence on his teenaged sons. When Rice ran his first half marathon three years ago, his wife and two sons, then ages 12 and 15, took part in a 5K race that was part of the same event. He has since completed three half marathons with his older son.
Helping Others Help Themselves
For some physicians, however, the weight-loss journey has had more than a casual effect on their careers. Milan Schmidt, M.D., is one whose experience sparked a new professional passion. A family physician, Schmidt blamed his weight gain on the pressures and grueling schedule of being in a solo practice. “So I joined another group, and [the weight] didn’t go away on its own,” he says wryly. By the time the 5’8” physician realized he needed to take drastic measures to gain control of his health 10 years ago at age 46, he weighed in at 220 pounds.
Feeling frustrated and hopeless, Schmidt approached the problem by turning to the medical literature. “I began looking into the research,” he says. “The question in my mind as a physician was not ‘Can you lose weight on a cabbage soup diet?’, but ‘How can I do this in a way that’s going to make a lasting impression?’” He determined that the best approach would be multidimensional: diet, exercise, behavior, and, in some cases, medication. He found a commercially run weight-loss program that offered nutritional information, counseling, fitness training, and support. He was astounded when six months after he’d begun the scale read 155 pounds.
It took another year to stabilize his weight, but the experience so inspired him that he wanted to bring it to his patients. Schmidt became board-certified in the new specialty of bariatric medicine and opened a wellness center of his own, Sage Weight and Wellness. The New Prague Clinic has an in-house team that includes a dietician, exercise physiologist, sports medicine coach, and nurse. Through individual appointments and group classes, patients can learn how to change their eating habits and increase the amount of exercise they get. Schmidt’s wife, a minister, offers advice and relaxation guidance to help spiritually inclined patients stay the course. “I view obesity as a chronic recurrent disease with potentially fatal complications,” Schmidt says, acknowledging that staying on top of his own weight is a daily struggle. “As a clinic, we expect patients will visit us once a month for the rest of their lives.”
A Career-Changing Experience
Family physician Christopher Balgobin, M.D., of Fairview’s Cedar Ridge Clinic in Apple Valley, is another physician whose weight loss put a new spin on his career. Teaming up with his wife to stop snacking and develop a daily exercise regimen, the 34-year-old went from 304 pounds two years ago to a lean 190 pounds. Moreover, he found he had the opportunity to be a positive role model. “I live near where I work, and I see my patients at the gym and at church,” he says.
Balgobin readily explains how he slimmed down: chronicling what he was eating, limiting calories to 1,800 a day, and slowly increasing his daily workout on the elliptical machine. He also discovered P90X, an at-home fitness program that combines sit-ups, pull-ups, weight training, and yoga, and got hooked (Sheryl Crow is a fan). Now, as a newly signed coach for the commercial program, Balgobin works with clients from all over the world who contact him for daily inspiration and work-out tips over the Internet. Even though he makes some extra money for this sideline work, Balgobin says he’s in it for the enjoyment. To avoid conflict of interest issues, he doesn’t promote the program with his patients at Fairview. But his slimmed-down physique and new-found energy give him an opportunity to tout the benefits of any manner of exercise.
When it comes to empathizing with patients who are struggling, doctors who have lost weight have an edge—they appreciate that the weight-loss journey is difficult and highly individual. As Balgobin advises patients: “You have to figure out what your own motivation is. Is it your health? Your family? Is it so you can bend over and tie your shoes?” But these doctors don’t need to preach during appointments; patients can see the transformation and envision what’s possible for them. Christensen has gotten raves from patients about how he looks, and feels he has new authority when he discusses lifestyle changes with them: “It made my ability to talk about weight loss much more believable,” he says, adding that he still hopes to shed another 20 pounds. “I haven’t hit my goal weight yet,” he acknowledges. “It takes time. But these are finishing touches I’m working on now.”—Kate Ledger