Don’t Tell Me What I Can’t Do
Confronting Alcoholism, PTSD, and Obesity — and Winning
On May 3, 2018, I stepped on the scale at my doctor’s office and weighed in at 318 pounds. A little over a week prior, my weight was at 308. My body was riddled with acute medical issues that my doctors assumed had become chronic. In short, I was depressed, drunk, fat, and sick. I was also isolated and unemployed, and most days, I didn’t even bother to shower.
It certainly hadn’t always been that way. I had joked for years that I had the metabolism of a nervous hummingbird — so fast that it was virtually impossible for me to ever gain weight. When I was stressed, I dropped weight. I had also been an extroverted entrepreneur with a wide social circle and no lack of work. I wasn’t athletic, but I was certainly active enough to hike a few miles without getting tired. My life revolved around the brewery I was starting and my daughter’s activities.
Starting in 2014, however, things went sideways with relationships and custody issues, and the long-term effects of trauma and alcohol began to invade every aspect of life. I’d already started to gain weight, too, jumping from an average of 160–170 pounds to 205 at the end of the year. Putting the cherry on it, I was diagnosed with hepatic steatosis, more commonly known as fatty liver.
I broke my ankle in late March 2015, and that began my real decline. My health issues increased along with my weight. By the end of that year, my daughter had relocated to live with her mother, and my weight was up to 230. It continued to increase, as did my health issues, through 2016 until I was pushing 270. My drinking had increased, too, but I was still in denial.
The rest of life wasn’t looking so great either. I was struggling to maintain a consulting gig with another start-up, and I talked about what wanted to do. The reality, however, was very different, a fact that became abundantly clear by my first hospitalization in March 2017.
I’d gone to the emergency room at MCV — Virginia Commonwealth University’s hospital complex in Richmond — after my doctor told me to. My blood pressure was spiking, and I was in bad shape. He looked me in the eyes and said, “Go to the hospital now. There’s nothing I can do for you here.”
I was immediately admitted and put in a room one floor down from where I’d been 10 years prior after being shot in a robbery attempt. The unit I was placed in was one step below intensive care.
I was bloated, depressed, and sick. Over the next week, I underwent ultrasounds, CT scans, constant bloodwork, and visits from a range of specialists. I was treated for, among other things, kidney issues causing my sodium and potassium to drop to dangerous levels, gastritis, and acute liver disease. My cardiovascular system was functioning at 40% capacity, and every other system was struggling, too.
My daughter had returned to Richmond a couple months earlier. While that should have been a reason for me to turn things around, I was too committed to drinking, and that would remain the case through two more hospitalizations later that year. Christ, even losing my consulting gig wasn’t enough to get me to wake up and find my way out of the hell I was creating for myself.
Fast forward to May and the epic weigh-in. The issues under treatment comprised a laundry list of decline:
- Liver disease, assumed to be cirrhosis
- Early-stage kidney disease
- Pre-diabetes
- Peripheral neuropathy in my feet and ankles
- Cellulitis
- High blood pressure
- Acute gastritis
- Hypothyroidism
- Soy allergy
- Anemia and leukocytosis
- and other collateral issues
My weight had spiked by 20 pounds in three weeks because my body was simply unable to process fluid any longer. I was prescribed a third diuretic, metolazone, in addition to the furosemide and spironolactone I was already taking. In addition, I was taking medications for anxiety, depression, and the rest of the issues listed above — 14 pill bottles in all. My hepatologist warned me that I was near the point where he couldn’t put me on the transplant list. As my primary care physician would later say, “I’m not sure what would have been worse — death or continuing to live the way you were.”
Get yourself a doctor who can be truly honest with you.
So I stopped drinking. I started going to the Y daily, following a mixed program of cardio on a stationary bike and tracked weights workouts. The Wellness staff became part of my recovery team, and I dropped 50 pounds in six weeks.
Until I had a PTSD attack and started drinking again.
Thankfully, some of the habits that I’d put in place stuck with me. I kept up a gym routine and thanks to the soy allergy paid much closer attention to everything I ate. In addition, I’d begun working again, and having a consistent routine and reason to be out in the world meant I started to care about my appearance again. I was also crucially aware of what it felt like to change my life and see improvements. Testing the waters of sobriety for those six weeks also gave me a clear sense of what it could do for me.
It would be wonderful if I’d been able to take all of that information and put it in action before I ended up in the hospital again and before I shattered my wrist getting a bottle of whiskey out of the car. But I’m stubborn. And I’ve been known to do dumb things.
Fast-forward again to May 2019. Things were really starting to catch up with me. My weight was ticking back up, and my lab work was getting worse again. At the same time, I was starting to think about the next steps in my professional life and dealing with the wreck that my life had become. I was also starting to listen — FINALLY — to my daughter, and her entreaties to get better.
So I did. I set a sobriety date with the therapist I’d begun seeing. I also made an appointment with one of the wellness coaches at the Y to get back on track, and the scale was tipping at 269, down from a high of 285 over the winter. Over the next five and a half months, I would lose 97 pounds, completely remaking my body and health.
To set my goals, I looked at my average weight before everything went sideways and compared that to the average weight for my height and build. These gave me a baseline that felt realistic, even if my timeline — reaching the weight by my birthday in October — seemed aggressive. I also committed to making the weight loss sustainable and the overall journey enjoyable.
Sustainability meant a few things. First, it meant not following a diet plan, since the long-term success of diet plans is statistically not good. Second, it required committing myself to the path, no matter what, and maintaining discipline. Third, it meant looking very closely at my habits and tendencies, and adapting the work to my usual patterns rather than trying to change my patterns. Finally, it meant organizing my life around the work.
I realize this seems impossible for some people, but most of our lives are malleable than we realize.
Enjoyability meant looking closely at drove me as a person, and thinking about what made me happy. As an epicurean who loves a variety of foods and cooking, I wanted to be able to achieve my goals without compromising the pleasure of food. Since I tend to get restless easily, I knew doing the same thing every day wasn’t going to work. Given that I prefer setting goals to following process, it would be necessary to set targets. It was also essential that the goals be manageable enough that I would avoid the traps of frustration and discouragement.
In the course of setting goals, I learned that it was even easier to break them down into micro and macro. The micro goals could be as simple as adding a mile onto a walk or learning a new recipe — things that could be completed easily. A series of micro goals then led to a macro goal, much the way a training team builds mileage each week towards a race. The great part about breaking the goals down into parts was that I also had the flexibility to change my approach according to mood or means, without losing sight of the larger picture. For example, I learned while training that I wasn’t moving my ankles when I ran, walked, climbed — any of it. Having been sedentary and heavy for so long, I had lost that crucial bit of mobility. I shifted my training accordingly to focus on flexibility and mobility, including developing the habit of flexing and rotating my ankles as I sat or stood. Within a few weeks, I could move better in the gym and hit the bike and trails more efficiently, without the same degree of exhaustion as before.
The beauty of those moments is the thorough feeling of accomplishment you get when you can do something you had once done unconsciously — and to do it better, even.
The final thing I had to change was my mindset because the reality is that we create our own limitations. Quitting could not be an option, nor could letting my internal self-critic run the show. This was particularly true since I had given that voice far too much power over the years. Doing this meant shifting my thinking to focus on what was possible, rather than self-imposed or external impediments. Ultimately, it meant simply knowing what I was doing was possible.
When it came to what I ate — and was going to eat, the soy allergy proved to be one of my best friends. Being an omnivore with a high metabolism had meant that I could eat pretty much anything with impunity up until a few years ago. The allergy diagnosis, however, meant that I had to radically rethink my approach to eating. Coupled with the knowledge that I had to be very careful about the balance of what I ate in order to lose weight, I had no choice other than becoming extremely mindful of what I was putting in my body.
It is helpful here to note that soy is used in various forms to make various sauces, mayonnaise, and most commercial chocolate. Soybean oil and its derivatives also appear in commercial breads, snacks, and desserts. In addition, soy is used to manufacture ingredients as diverse as magnesium stearate, lipids, and so-called natural flavorings. To put it simply, this meant I couldn’t eat anything with unidentifiable ingredients.
Being forced to think about everything you put in your body also makes you slow down your consumption in general, because you can’t mindlessly stop at a 7–11 for a snack any longer. Thankfully, I enjoy cooking, and I generally like challenges which meant I chose to see the limitation as an opening rather than a loss. That opening enabled me to look for more creative ways to make or find the foods I wanted to eat. I used that as the foundation, then, for building a diet that allowed me to include things I liked, including pastas, breads, and dessert.
The keys to doing it successfully proved to be twofold: maintaining a caloric deficit and eating a balanced diet. I will write more extensively about both later, but the goal is to let your body’s systems reset and balance out over time.
Much of what I am proposing here flies in the face of the typical American view of food. As a consumerist culture, everything we see and hear tells us to consume and offers us new and different ways to consume. Additionally, it is treated as an expectation that we must not only consume, but seek to consume more and more. The same philosophy applies to food as it does to TVs. If a 42-inch TV is good, a 52-inch TV must be better; likewise, if a burger is good, a burger twice the size is better — particularly if it costs only a $1 more. The problem, however, is that a burger twice the size is probably worse for you — especially if it is only $1 more expensive.
Two of the most eye-opening experiences I had in the early stages of this journey were taking a close look at hospital food and watching how the middle schoolers I was teaching ate. The common thread in both cases was that what we considered food was not, in fact, food. Instead, patients and students alike were being fed ultra-processed foods stripped of their nutritive values. Ice cream had 17 ingredients when it should have four. Apple juice had a small percentage of actual apple juice with the rest made up by sugar, water, grape juice, flavorings, vitamins, and colorings. It could have just been juice.
Here’s the important takeaway: Most of the important nutrients we need are already in the organic materials used to make our food. Processing oils, sugars, grains, and proteins begins to strip away the nutrients — and the real flavor. Processing them to the point that you are creating new products from organic materials means losing the nutritive value in the original. This means that your body will not process them differently — or even not process them at all.
If you are eating something your body can’t process, it isn’t much different from a systemic philosophy than doing exercises that don’t improve your body’s overall functioning.
Early on in my fitness journey, I realized that functionality was essential to sustainability. If I was going to be successful in my weight loss, I needed to look as closely at how my body moved as I did at the number of sets and reps I did in the gym.
The reason here is again twofold: my body had radically changed, and discipline would be required to achieve my goals.
When it came to my body, far more had changed than my health. My posture had changed, with my shoulders tipped backward and my pelvis tipped forward. I stood differently, too, because of the weight, and the neuropathy in my feet and ankles meant I walked and stood differently than I once had. As the weight came off, I learned that my rib cage had changed shape to accommodate the overall weight and the amount of visceral fat I was carrying, becoming rounded and rigid. These were all on top of the physical and psychological scar tissue from past injuries that hindered me in myriad ways.
The combination of issues meant I was compensating for literally everything I did. When I lifted weights, for example, I used my entire body to lift or pull. When I rode my bike, I had my full body going into the mechanics of peddling and turning. Thanks to the neuropathy, I had also lost my sense of (and ability to) balance. Because of this, I realized that any progress I made would be short-changed by not addressing my body’s basic mechanics.
I reasoned that I would do more damage in the long run if I didn’t address these issues. Instead of just dealing with them in the gym, however, I made it my mission to practice them in every aspect of life. For example, when I worked on the mechanics of standing spin the way my body is designed to do, I thought about it every time I stood up, no matter where I was, and if I did it sloppily or something didn’t feel quite right, I sat down and stood up again. I began applying this to everything from walking up stairs, to my posture when I washed dishes, to pivoting at my hips when I bent over to turn the water off in the shower. In other words, it did no good to train in the gym if I wasn’t also practicing in daily life.
What this mindset allowed me to do was to see every action and every experience as part of the healing and reinvention. I also shifted my thinking to work backwards from each goal. Instead of looking backwards and focusing on the starting point, doing this shifted the focus to reaching the goal. It was a trick I had used in my professional life — knowing what the deadline is enables me to figure out all of the things that need to happen to get to that goal. Since I am not a lateral, process-oriented thinker, this enabled me to build a system that started with the knowledge that I would finish whatever I started rather than lose focus and drive.
Saying you will do it is more powerful than thinking you can do it.
Note: This is the first part of a multi-article series.
