Introduction

          Zelda was one of the reasons I chose to write this book. She was only 53 years old when she died, and I had cared for her for 15 years. She was jovial and always had a smile on her face when she came to the office. She was one who liked illness and when I first met her she was on thirteen different drugs. I was able to get her off ten of the different medicines, but over the next 15 years she was able to find different doctors that added one different drug back on after another. She worked in sales, she loved what she did, was happily married, without children, and loved her husband who was 12 years older than her. She lived in a mobile home, and kept a very neat yard. She loved her flowers and was very proud of them. She was looking forward to the time when her husband was going to retire and the two of them could do more together. That time was right around the corner.
          Zelda always had a problem with her weight, and was never able to deal with it. When you talked with her, she claimed that she never ate anything; when you asked her husband, he replied that she had a “healthy appetite.” She weighed approximately 300 pounds and died of complications from her obesity. Zelda had a stroke, and three days later had a second massive stroke and died just a few hours later. The first stroke left her unable to talk, although she was well aware of what was going on. After the second, she sank into a coma and died. The vast majority of her medical problems were diet-related--from her diabetes, to her hypertension, to the elevated cholesterol. From my point of view she was a patient who ate herself to death. Despite all my efforts, she continued on the path of self-destruction that ultimately led to her untimely death.
          Tragically, this is not unusual in America today. Too many people in this country are literally eating themselves to death.
          You probably bought this book because either you or someone you know has a problem with their weight. The problem of obesity has reached epidemic proportions in our country, and most people want help but do not know how to get it. With 60% of the American population overweight, the odds are that you or someone in your family is struggling with this problem. In the United States, 300,000 people die every year from obesity—making it the leading preventable cause of death--and that number is only projected to grow. The health care costs attributable to obesity in the year 2000 hit $117 billion. The costs in dollars are a number that most of us can hardly imagine, and the cost in lives is likewise hard to fathom. Three hundred thousand people dying constitute the size of a moderate-sized city. In some parts of the country, it is equal to the total number of people in the county or even several counties.
          During my medical practice in oncology over the past 20 years, I have been privileged to care for many people as my patients. Included in this book are some of their stories. I hope that you will enjoy the successes that some have had, and that you will feel the pain of those who were not so fortunate. The people that you will read about are real, although I have changed their names to protect their privacy. Their stories are illuminating.
          The American people and our policymakers complain about the cost of health care, and I agree it is expensive; but if people chose to take care of themselves and got their weight under better control, we could balance the federal budget on the money saved on health care costs alone. To me $117 billion is just a number with lots of zero’s after it; it does not seem like a real number. Yet it is, and it is a number that is only going to get larger with time. If we choose not to deal with health prevention, then we will choose to pay the bill. What most Americans don’t realize is that if we all chose to take care of ourselves, then we would have a lot of money to spend on other programs that we would like to implement, such as programs to help children read and fight the war on drugs.
          This book is written in a format so that you will be able to refer back to sections from time to time as needed to review the information. I do not expect you to remember all of the pertenate information after just one reading. I have also tried to put it into a format that is readable. It seems to me that a number of the existing books that deal with weight control are poorly written and fail to engage the reader. They seemed more like textbooks than information for people to use. Most of the books out there require that you have several large pots of coffee at hand if you plan to make it through them.
          The stories in my book may help you remember more of the information, and may resemble situations that you are facing--and that is why they are included. If you have questions as you read and learn, feel free to contact me at JamesNAtkinsMD.com. I will post the questions and comments so that it can help others as well as you.
          Although Zelda lost the battle with obesity, some of my other patients have had stirring victories—and I think we can all take inspiration from that. Angela, for example, was one who triumphed. She was referred to me because of the swelling in her legs—a condition known as lymphedema. She was slightly over 500 pounds at the time and was 5 ft 5 inches. She was a single parent and tried to work two jobs to make ends meet. She had one child who was a young teenager. She always waddled as she walked because her legs were so large that she could not get them anywhere near each other. She was and is a happy person, one that you would love to call a friend, one that is a helper and would always be there for you. She was limited in what she could do, however; she had to have sedentary jobs because she did not have the stamina to stay up on her feet. She was a religious person who had a strong spiritual faith. Angela was simply a joy to know.
          We talked about her weight problem—and her situation was dire. Though she was only in her early forties, if she failed to get her weight under control, she would probably die in the next couple years. Angela always said that when people made comments about her weight, she viewed it as their problem not hers; for her part, she was fat and happy and at peace with herself. But after we talked that day, she realized that the problem was in fact her problem and not theirs. She took ownership of the problem and has been very successful in dealing with it. Angela lost approximately 300 pounds and the quality of her life is better then it has been in years.
          Because she took responsibility for her weight loss, Angela is alive and healthy today. Sadly, Zelda failed to do so, and is no longer with us. I hope that this book will motivate you to take ownership of your weight problem, so that you, too, will emerge a victor in the battle against obesity. To win this war, you need to set goals that are attainable, establish a time-line that is realistic, and choose to take care of the temple that you have been so fortunate to have been given. You might think that the journey you are traveling is hard and tough, but to be honest I do not know of anyone who does not have a hard road to travel. They just have different problems to deal with. We are all traveling a hard road, so be kind to yourself.

Chapter 1 >