The cure for my obesity came from something bigger than dieting or an exercise plan.
I thought being fat made me miserable, but is it possible that I got fat because I was unhappy?
My Story
I was in my surgical residency when I went all wrong. But there had been hints of an impending disaster while I was still in medical school. To meet the extreme demands of medical studies, I started giving up things I enjoyed. The first was reading. With all the medical text I needed to swamp through, I didn’t think I could afford the time to read for fun. One of my favorite past times, reading, was tossed out.
Cycling undoubtedly helped me cope with the extreme pressure. For the first year, I did keep up with regular 16-mile bike rides several times a week with a longer ride on weekends. But as I moved into clinical rotations and put in long hours with little or no control over my time, the opportunities to ride evaporated. I saw this self-sacrifice as the price I had to pay to become a physician.
When I went to surgical residency, it all got cranked up by an order of magnitude. Not to bore you with horror stories of residency in the “bad old days,” but I was working twelve hours or more every day, with thirty-six-hour on-call shifts every fourth day. Plus, we worked every weekend — or at least they expected us to, although we tried to sneak in one weekend off a month for each team member
That was how it started; I gave up one thing after another to meet the demands and expectations of my training.
I had already given up reading and biking; now, I sacrificed all friends and interests outside of surgical training. I even had to give up time with my beautiful wife, who sat home alone night after night while I worked late or spent the night on call. Under those demands, I became what was expected, a resident wholly dedicated to my work.
It was like I had joined a cult that denied me contact with people or activities I had known before joining. I left my beautiful wife, old friends, and all my interests and hobbies behind for five years. It was clear to me that good residents dedicated themselves to the program thoroughly and dropped everything else, and I wanted to be a good resident, so that is what I did.
I made myself miserable.
The result was that I was miserable. I felt like a shell of my former self. The anxiety I felt as a resident had no outlet to release the pressure. So I took what comfort I could in the form of food.
There were always donuts and coffee at the morning meetings, so I indulged. When the service was light, and the team had time for breakfast between rounds and the start of surgical cases, I feasted on pancakes with lots of syrup. And when the service was overwhelmed, those mini pizzas were the perfect grab-and-go snack for a busy resident.
Comfort food may not be that comforting.
I was eating to comfort myself. I was seeking solace in food. But the tragic outcome is that the food didn’t make me feel good; if anything, it did the opposite. The sugar crashes followed the sugar rush, leaving me feeling lethargic and needing another hit. I suffered from heartburn, bloating, and indigestion that kept me from benefitting from the few hours of sleep I was allowed. Worst of all, my quest for comfort in food made me fat, giving me one more reason to feel bad and seek more comfort from eating.
So I was unhappy in my current situation and seeking comfort in eating. But the food wasn’t making me feel better. Instead, it was making me feel worse. So why was I “comfort eating” to the point of discomfort?
Why was I overeating if it wasn’t for comfort?
The truth is, I wasn’t eating for comfort. Instead, I was overeating as a quiet act of rebellion. I was acting out in the cafeteria. I felt I always needed to be doing the right thing. Not what I wanted to do, but what I was supposed to do. Eating became a way to do something I knew I shouldn’t be doing and get away with it.
I secreted cookies and candy in the call room and tried to conceal soda cans in my lab coat pocket. I snuck away for moments to indulge in things I knew were bad for me. I did it expressly because it was terrible for me. And I did it in secret.
You have a problem when you hide your behavior from others, which is what I was doing. As I drove home, I would eat chicken fingers or a burger and fries. Then I would dispose of the evidence in the trash bin behind a gas station before I got home. Only to go out to dinner with my wife or order a delivery pizza like I hadn’t just eaten on the way home. I kept my bad habit a secret from my coworkers and wife. I was demonstrating the classic symptom of addictive behavior.
Days of shame.
It hurts when I recall the day my loving and supportive wife took me to a Big and Tall store to get new clothes because I couldn’t fit into my old ones, nor could I find new ones that fit at a regular store. What I could not keep secret was my ballooning waistline. I had a problem but didn’t know how to change it.
I tricked myself into believing this was OK in residency and that it would all be better after I graduated. But private practice held its own expectations, and I was again under intense pressure to put in long hours, work hard and take call every third night. My situation didn’t appreciably change, so neither did my behavior. I again ate the donuts at the meeting, always had a cookie — or three — with lunch, consumed multiple cans of soda daily, and then came home to take out pizza and ice cream. I was continuing to eat for comfort and finding it anything but comforting. Bloated and dyspeptic during the day and unable to sleep from reflux at night, I was chronically unhappy and exhausted.
I wasn’t eating as a form of comfort, I was eating as a form of rebellion, but the only person this rebellion was hurting was me.
How I Lost the Weight.
I tried several tactics to reduce my consumption, from fad diets to self-imposed eating strategies, but none worked. If anything, my attempts to rein in my dysfunctional behavior were making it worse. It should have been obvious that more rules wouldn’t help, as I was eating as a form of rebellion, and when I added more restrictions to my life, I just gave myself more reasons to rebel.
So what to do?
The impetus to change came in the most awful way possible. It happened on a visit to a Caribbean island with my wife, three kids, and a debilitating case of pneumonia from overwork. I was so febrile that I shivered under two beach towels despite the hot tropical sun. Then I lost it and yelled at my children to leave me alone when all they wanted to do was to enjoy the water with their father. Watching their little faces sag from shock and disappointment, I realized things could not go on.
Motivation the hard way.
After that horrible vacation, I faced the fact that I was fat, unhealthy, and unhappy. I finally realized that things needed to change. I seriously considered leaving surgery in particular and medicine in general, but was my job the problem, or was it me? I may have been outwardly successful by most people’s estimates, but what good is success if you are miserable?
The call to a better life.
The Zen masters say that when the student is ready, the master will appear. Well, my master arrived courtesy of the US postal service. I received an invitation to join a medical expedition to the isolated Buddhist nation of Bhutan, high up in the Himalayan Mountains. At first, I set the letter aside without any serious thought. It was just a given that it would be an unfair burden for anyone to take three weeks of vacation in a group of three surgeons. Traveling to the far side of the world would also be expensive, and there were more “responsible” things I could do with that money. Plus, I had a young family that needed me.
Resisting the call.
I had many good reasons why I couldn’t go to Bhutan, but that letter lingered on my nightstand, calling to me. I re-read it over and over again. Bhutan had fascinated me for years. Not only is the nation geographically isolated by its Himalayan location, but it had refused admittance to all outsiders until the 1970s. It was as close to the mythical Sangra La as any place in the world could claim, and I wanted to see it before it opened to tourism in the coming decade. I needed to seize this opportunity now or miss out on it forever.
A new and better rebellion.
Going to Bhutan became my new act of rebellion. I would take the time away from work and let someone else be the one to make up the slack. I would spend the money on myself rather than prudently invest it in the future. I would do something crazy and a little bit scary.
I was not in the physical shape needed to hike in the Himalayas, so I joined the YMCA and started working out. Once I took that first rebellious step, other small acts of positive rebellion followed. Sneaking away from work to hit the gym had the same feeling as sneaking food. I got the same embarrassment when someone I knew caught me in the gym as when someone intercepted me buying snacks from the vending machine. So, at first, I only went early in the morning or after work, but as I got more brazen, I might even go at noon.
I worried about what others would think.
I worried about what other people would think if they knew I was taking time away from work. Would they see me as lazy and uncommitted to my career? Would I be shunned for failing to put the patient’s needs ahead of mine? The answer surprised me, but people were supportive. People applauded my transformation as I lost weight, gained energy, and improved my attitude, and some asked to know my “secret.”
They wanted to know if I was doing a special diet or exercise program, but the truth was that I was finally putting myself first in my life. I was looking out for myself and my priorities. It felt rebellious, but in a better way than sneaking food. I became less misanthropic and more content with myself and my life. In short, I stopped making myself miserable, and I got healthier and fitter in the process.
The root of my problem.
I was unhappy because I lived a life of external and self-imposed rules that did not fit with who I was and what I valued in life. So I sought comfort in food. But the overeating brought me no comfort and instead made me feel worse. The comfort came from the small act of rebellion every sneaked snack represented.
My selfishness made me more selfless.
My transformation occurred when I undertook the ultimate act of rebellion and started making myself the most important priority in my life. That may sound selfish, but I can assure you it turned out to be the most selfless thing I did. Before I became my number one priority, I had done my work reluctantly, grudgingly, and unhappily. I felt like every patient’s problem was a drag on me rather than an opportunity to help someone in need.
After I rebelled against the way the system had made me, I started to do things because I genuinely cared for people and wanted to help. By putting myself first at times, rather than putting the patients first all the time, I became a better person and a better doctor. My selfish act of looking after my health and happiness made me more selfless and genuinely committed to compassionately caring for all of my patients. My rebellious act of selfishness turned out to be the most selfless thing I could do.
The Rest of My Story
In 2018 I ran the 17.1 miles Imogene Pass Run over the 13,000-foot high mountain pass of the same name. Today I weigh about 100 pounds less than I did at my worst — I went from a size 46 waist to a size 34 — and I have maintained that weight for over a decade. I continue to exercise daily, eat smart (mostly) and engage in activities that keep me grounded (reading, photography, playing with my children when those moody teens will consent to spend time with their boring old father.) I’ve changed jobs twice to ensure I can live and work a lifestyle consistent with my values. It hasn’t always been easy, but it has been worth it. We only live once and can’t afford to waste a moment of that time being miserable.
Conclusion
Take a look at your life. Are you living in alignment with your values, or are you seeking comfort from food, shopping, social media likes, alcohol, or drugs? If it’s one of the latter, is what you are using to comfort yourself making you feel better? Or is the eating, spending, posing, or escapism only worsening your problems in the long run? Now ask yourself what makes you unhappy and what you want out of life. Then permit yourself to pursue a life that is meaningful to you. Break a few rules if you need to. You will find that being “selfish” in this way may ultimately be the best and least selfish thing you can do.
