Jefferson University Hospitals

One Man's Weight Loss Journey

"Jefferson's Weight Management Program is an excellent tool for learning about your personal challenges and solutions, and it worked for me."

The American author and columnist Dave Barry once said, "I recently had my annual physical examination, which I get once every seven years, and when the nurse weighed me, I was shocked to discover how much stronger the Earth's gravitational pull has become since 1990."

As much as people tend to use comedy to make light of their frustration and disappointment with how they look, being overweight or obese is no joking matter.

According to the CDC, there has been a dramatic increase in obesity in the United States during the past 20 years, and rates remain high. A whopping 68 percent of adults age 20 years and over are overweight or obese. Being overweight is defined as a body mass index (BMI) equal to or greater than 25 but less than 30. Obesity is a BMI equal to or greater than 30.

While it's true that men typically lose pounds faster than women because they have more muscle mass, the reality is that it's equally hard for a man as it is for a woman to lose and maintain weight; the only difference is one's journey.

Forty-four-year-old Patrick Lardieri has been obese almost his whole life. Even though he has lost a considerable amount of weight, he's still classified as obese. He quickly learned that losing weight isn't a temporary fix; it's a lifelong commitment.

Joining Jefferson's Weight Management Program

Patrick is just one of the many men and women to come through Jefferson's Weight Management Program. Registered dieticians Cheryl Marco and Michelle Porter lead the Program, which is designed for seriously overweight people at high risk for medical complications. It consists of a medically supervised OPTIFAST® liquid fast paired with lifestyle education and ongoing personalized support—during and after weight loss.

Patrick began the Weight Management Program in late January 2009 just after his wife joined earlier in the month. "Her commitment to do the Program with me," he tells me, "kept a lot of those troublesome foods out of the house and provided great motivational support, though Cheryl advises the latter is not the case with all couples."

Patrick and his wife heard about the Program through friends who were diabetic. The husband and wife team knew the Program would lead to a significant amount of weight loss, because of the liquid fasting.

The Program consists of three phases of weight management:

1. Beginning (lasts six to 12 weeks)

  • An 800-calorie-a-day OPTIFAST liquid diet
  • An average 15 to 20 percent loss of body weight
  • Mandatory weekly group meetings (held days and evenings) to understand and recognize food-related attitudes and behaviors

2. Beyond Diets (lasts six weeks)

  • Transition from the liquid OPTIFAST to a new, healthy way of eating
  • Implementation of a detailed transition-eating plan
  • Weekly education sessions on nutrition and long-term weight management

3. Maintenance (ongoing)

  • Either continued use of some OPTIFAST products as meal replacement or another customized eating plan
  • Ongoing group support sessions to learn about nutrition, maintenance issues and healthy behaviors for a lifetime

After Dr. Serge Jabbour and Lisa Coco, CRNP, cleared them for the Program, most of their interaction was with Cheryl who, according to Patrick, "made all the difference in the world."

Losing the weight

Obese people grow up feeling like they are unable to control themselves. They view their weight problem as a personal deficiency or weakness, using terms like "good" and "bad" to judge their eating behaviors. Cheryl tries to alter this defeating self-perception by educating participants on the many environmental, physiological and physical things that drive eating behaviors. During each group meeting, Patrick never felt that he was being talked down to or scolded when times got tough.

"Cheryl displays a tremendous display of compassion for the challenge of this task without any pity," he explains. "She acknowledges that it's hard and that life is not fair sometimes. But if you want to take responsibility and accept that this is the change you need to make in your life, she's behind you every step of the way."

When Patrick started fasting, he was never really hungry – just miserable. Patrick was able to tolerate the hunger but slowly had to deal with the fact that he was going to feel bad for awhile. Taking food away from the equation makes you realize what drives your eating behavior, and for Patrick, he didn't have food as a crutch to deal with everyday stresses and emotions. He is a very pleasure-driven eater, and he can easily get into a "mindless pattern of consuming huge quantities of food just because it feels good, like a drug."

After six months of the first phase of weight management, Patrick entered into the transition period where Cheryl slowly brings you off the fast and back onto regular food. Each weekly education session is dedicated to a specific topic (eating out, carbohydrates, etc.), and you are given a daily calorie intake target. What's great about these education sessions, Patrick points out, is that you get ideas and experiences from other people; you know you're not alone and it helps to reinforce why you're there in the first place.

The last phase of the Program is of course the most difficult: maintenance. Cheryl told Patrick and the rest of the participants in the Program that the most successful people are the ones who continue to come to the support sessions regularly. Patrick attends once a month, and he knows that he needs to build on that emotional commitment: "It's not building a sandcastle and then walking away." In other words, you have to keep at it or else all that hard work gets washed away.

Through Jefferson's Weight Management Program, Patrick has lost 22 percent of his body fat and has kept it off for about two years and counting. As for his wife, she regrettably was unable to continue attending the maintenance classes because of family and work-related resource constraints, which underscores the challenges of sustaining the level of commitment that one needs to maintain a managed eating lifestyle.

Patrick's Advice

For men who are struggling to keep off the weight, Patrick has these words of encouragement:

  1. The first step is that you have to admit that you need to be educated about nutrition and exercise. This is why dieticians and personal trainers are so great at what they do.
  2. The second step is accepting that you have to change your lifestyle and behaviors in some way. You can't return to what you have been doing after losing the weight; that's why it's called weight management.
  3. The third step is to be on a balanced program of exercise that includes cardiovascular and weight training as well as a self-monitored eating regime where you have some real feedback or control. This can be counting calories, portioning meals, restricting foods you eat most of the time or not eating out.

He goes on to say that there is no one-size-fits-all solution; everyone's situation is unique. A big part of the journey is learning your personal challenges and solutions; Jefferson's Weight Management Program is an excellent tool for that and it worked for me. Losing weight is the easy part. Keeping it off is the real challenge, but a challenge that can be overcome with the right tools and commitment.

While Patrick found his best solution using Jefferson's Comprehensive Weight Management Program, that may not be the right solution for you. At Jefferson, the Bariatric and Metabolic Surgery Program offers solutions for those that are morbidly obese, that is, anyone who is roughly 100 pounds overweight or roughly 75 pounds overweight with other weight-related conditions such as hypertension. Finally, our Internal Medicine offers a medical weight loss program and works closely with our bariatric program to help patients lose weight prior to surgery.

If you're interested in learning more about Jefferson's Weight Management Program, please call 215-955-5732 or e-mail weightinfo@jefferson.edu. To make an appointment for any of Jefferson's other weight loss programs, please call 1-800-JEFF-NOW.