What Could Be Worse on a Summer Day? Angela Battles Necessary Weight Loss

In 2009, at 24, Angela had seemed to have everything going for her. A graduate of Johns Hopkins, she set up a medical practice in Internal Medicine in Abington, near Philadelphia. And she got engaged.  She married and had two children close together. When the kids were tiny the couple began to summer in Wildwood Crest and she sought help for depression. 
Of Italian American background, she loved the rich pasta and breakfast buffets that the Jersey Shore is famous for. Too busy to join a gym, she managed to mother her young children and get dinner on the table for her husband, a successful accountant. Taking the kids to the boardwalk for cotton candy, pizza and soft ice became an easy summer family ritual that helped the time pass. Too busy to breathe, Angela noticed that her weight was on the rise but decided it would be impossible to do anything about this until her youngest son, then 2, was 5 years old. 
“Once both kids are in school, I can get back on track,” she told me. Angela had joined the monthly women’s psychotherapy group where she was highly regarded for her Mensa intellect of 140+, augmented by a friendly and chatty demeanor that puts others at their ease. Although other group members were working on weight loss for health reasons, Angela did not join in the group energy to get healthier. She needed to treat her depression. Frequently weight loss concerns mask anxiety and depression as they did for Angela.
In 2016, Angela returned to her psychotherapy, ready to take charge of her weight. She once again became part of the women’s therapy group but this time she joined those who were serious about weight loss. Now 33 she looked stocky and was appropriately worried. “I simply must lose the 15 pounds I gained when the kids were little. I don’t feel sexy and my clothes look tight and frumpy. I dread doing this! I hate eating tons of steamed vegetables when what I want is the comfort of my best-ever recipe for lasagna. I am going to fight this. I just know it!” Angela’s nose scrunched up, her eyes narrowed and she looked down at her knees. “It is patently unfair! Many of my patients can eat pasta any day of the week. They can lose weight just by playing with their kids. I must turn myself inside out and I still don’t lose weight! Last weekend I struggled with fudge sauce from sundaes that were left over from a party. You might have thought I was a chocoholic … and maybe I am …” Her voice trailed off, eyes turned downwards in shame.
My heart went out to her and I thought some information might help. “Angela, do you want me to summarize key points for you?”  She nodded. “Being only 10 pounds’ overweight increases the force on the knee by 30-60 pounds with each step.” Since she is a physician I pulled out some research and read it aloud. “Federal Guidelines on Obesity were released by the National Heart, Lung, and Blood Institute in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases. These guidelines proposed that health care providers use two easily computed measures to assess overweight: body mass index and waist circumference.”
Angela understood completely. “It helps to hear YOU be the doctor,” she said, slightly embarrassed. We decided to start with an initial weight loss goal of 10 percent, at the rate of one to two pounds per week. Successful strategies included calorie reduction, increased physical activity, and behavior therapy designed to improve eating and physical activity habits. Specifically, we decided that Angela would …
•    Progress to moderate physical activity of 30 minutes or more six days weekly. The ideal would be one hour per day six days weekly.
•    Cut back on both dietary fat and total calories.
•    Make weight-maintenance a priority each day for the rest of her life.
Angela is one of the one-third of Americans who are currently obese. Their common sense has driven them to seek help to manage their exercise and eating within health standards. In a nation of adults who ignore long term health for short term eating pleasure, they deserve our respect and our admiration.
To consider: I am routing for Angela and her health battle with pounds. It helps to get support … whom do you know that needs to understand the content of this article? Will you pass it on? Why? Why not? And … might it help you?
To explore: There are many online resources. One is the Weight-control Information Network (WIN), a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH).
Find Dr. Judith Coche at The Coche Center, LLC, assisting tough weight loss challenges for her clients. Reach her through www.cochecenter.com.