Success Story: How Tim Lost Over 30 Pounds, Lowered his A1C from 9.2 to 5.8, and Lowered His Triglycerides by Over 100Nov 21, 2019
You Will Learn:
- What motivated my dad to take better control of his health.
- The top 4 takeaway points I want you to learn from his story to inspire and motivate you to do the same.
- My dad's top 4 tips to reduce your sugar intake.
Living in the Gray-Zone
When I worked in traditional geriatric physical therapy, a big part of my job was identifying how to prevent things like falls and hospitalizations. As I went through my education, I realized that in healthcare, all too often we are working at the effect level, not the cause level.
By that I mean we are working on secondary consequences instead of treating the cause of those consequences, namely preventable disease.
That’s my passion. I love helping adults 50+ learn what to eat, how to move, and what other lifestyle factors can be optimized to lower their risk of developing things like type 2 diabetes, heart disease, dementia, etc. If we can prevent disease in the first place, we will also be preventing many falls and hospitalizations, along with a myriad of other health problems.
It didn’t take long in my schooling to realize my dad had a lot of risk factors to end up like many of the patients I was treating in traditional geriatric physical therapy. He was overweight, sedentary, had poor blood values like elevated cholesterol, triglycerides, and blood sugar. He had a high stress job that at times threw off his sleep patterns.
He was in what I consider the “gray-zone” of healthcare.
He didn’t qualify for traditional physical therapy, and quite frankly didn’t need traditional physical therapy. I don’t know if his insurance would have covered registered dietician services, but if so it likely wouldn’t have been for very many visits. He had used a personal trainer before to train for a half-marathon we did as a family when I was in college, but he didn’t need that either.
He needed basic education about nutrition. He needed accountability and structured goal-setting. He needed a progressive activity program he would actually do. Hence the creation of Reshape Physical Therapy and Wellness, LLC. I decided if I couldn’t help my own dad get healthy to reduce his risk of developing diabetes, obesity, joint problems, etc, then I would not be putting my passion, the years of education, and experience I had to the best use possible.
If I couldn’t help my own father improve his health habits and really see results, I had no business even being in business, pun intended. You could call him my guinea pig.
The Magic of Motivational Interviewing
The first spark of my idea to help him came when I was going through my geriatric physical therapy residency program in 2015. We had to do an evidence-based project and I decided to do a literature review about how to motivate an older adult to engage in an exercise program.
What I learned was that I cannot make anyone do anything, but I could help motivate them to make changes by:
- Helping them understand the benefits of the desired behavior.
- Highlighting the consequences of not making any changes.
- Dig deeper and help them discover their internal motivation to get healthy.
- Problem-solve and troubleshoot to remove barriers.
- Provide accountability.
- Help prioritize where to put their focus.
I started using motivational interviewing techniques to help him discover the benefits of getting healthy, and the consequences of continuing to neglect his health. When asked why it was important to get his blood sugars under control he said,
“I’ve seen the end process...horrible amputations...damage to blood vessels. At my last eye appointment the optometrist took an extra close look at the blood vessels in my eye and talked about how diabetes can cause blindness. The end game is bad. Can you put a price on losing your eyesight or feet? Insulin is expensive, so are the other meds. The costs get more and more expensive as the disease progresses. ”
When I asked him to tell me about his weight loss journey, he told me,
“One doctor I used to have told me if I wanted to lose weight I had to be hungry all the time. I didn’t get consistent advice about how to lose weight. I thought if I worked like a dog painting and doing things to the new house, the weight would just come off because I was burning enough calories with activity, but I wasn’t changing my diet - the one thing that’s most important.”
The above comment from his previous doctor can be Exhibit A about crappy diet advice.
The Turning Point
My dad was the Director of IT for a Community College. He had a desk job and didn’t exercise. His nutrition was pretty bad. Often he would get a breakfast burrito at work and do fast food for lunch. Taco Bell is his favorite. He wasn’t doing the right things, even though he was concerned about his health.
He decided to take action at age 50. He said that was a good age to get his blood checked and become more informed about what was really going on in his body. The numbers surprised him and several medications were subsequently prescribed for blood pressure, blood sugar, and cholesterol.
At his highest, he weighed around 235 pounds and had an A1C of 9.2, well over the diabetic threshold. Over the years his dosage of diabetes medication increased, then another medication, Januvia, was added. After insurance this one pill cost him $3 per day. My dad is very financially savvy and didn’t like the out-of-pocket expense. He was starting to understand the financial incentive to taking better care of his body.
His Results (Thus Far!)
After working with my dad on his health habits for the last few years, he has made big improvements as you can see from the chart below.
Dad has made amazing progress.
He’s lost over 30 pounds, lowered his A1C from 9.2 to 5.8, and slashed his triglycerides by over 100.
To be clear, he is not finished. There is still work to be done.
I would love to see his waist circumference under 35.5 inches as this is the cutoff for men to be at a lower risk of disease according to the International Diabetes Federation.
His current goal weight is 190. While this would still be in the overweight category, it would be a big improvement from the obese category where he started.
I’d also like to see his HDL cholesterol increase, and triglycerides decrease into healthy ranges.
A big goal I have for him is to get a variety of exercise on a consistent basis, especially flexibility and strength training to reduce his joint stiffness and risk for falling.
Top 4 Lessons from My Dad’s Story:
- Just because you are getting older, does not mean you have to get sicker. He used to have pain and tingling in his feet from high blood sugars, but now that his blood sugars are better controlled he doesn’t have neuropathy anymore. He has reduced the strength of his medications and is almost in normal ranges for all of his numbers. Once he sees a trend of “normal” for a couple of blood tests, he plans to have the discussion with his doctor about reducing medications. Poly-pharmacy is a big problem in geriatric medicine. I love seeing him take action to reduce his need for medications to avoid not only the cost and side-effects, but the potential drug-to-drug interactions that occur as the number of medications increases.
- Slow and steady wins the race, and consistency compounds. While some people can focus on changing 4-5 health habits at a time, my dad prioritized ONE habit to focus on for several years. He focused on lowering his sugar and refined carbohydrate intake. He knew this change would have the greatest impact on his health so he decided to start there. Did he lose .5 to 1 pound per week? Absolutely not. It’s been much slower. But it has stayed off. See the next section for his tips on how he has been able to reduce his sugar intake.
- Social support is important. My mom changed her lifestyle at the same time. Since she is the one who does most of the grocery shopping and cooking, her support was crucial to his success. If you can find a buddy or convince your spouse to get healthy with you, it helps you stay motivated and inspired.
- Structured goal-setting, evidence-based education, and accountability is important. It wasn’t until I actually assessed my dad, provided consistent education, helped him set goals, and reassessed him on a regular basis, did we start to see the needle move. Just saying you want to lose weight and get healthy won’t get you far. Having someone holding you accountable, and being there for questions was helpful for him to reach his goals.
Tim’s Top 4 Pieces of Advice to Eat Less Sugar:
- Use a phone application to see how many carbs are in your food. I like using the Carb Manager App. Plugging in a Dairy Queen Blizzard or Taco Bell burrito helped him understand why those foods spiked his blood sugar so much. It helped him “make wiser food choices on the spot” and compare different foods to see which foods would be less likely to spike his blood sugar.
- Portion your food, especially sweets, then get it out of your sight. If you want to indulge, okay, but try not to overdo it. After you have decided how much you want, get the rest out of your sight.
- Push yourself away from the table. My dad has always been good about clearing the table and rinsing off the dishes for my mom. It wasn’t until I interviewed him for this post that I realized this is one of his techniques to stop eating...to actually leave the table and get away from the food.
- The less you have sugar, the less you will want it.
I’m really proud of my dad. He’s made a consistent effort to change his health. Has it been as big of an effort as I would like all of the time? No, but I’ve realized that’s okay. Everyone changes at their own pace. Once we stopped reassessing every month that seemed to take the pressure off of both of us. If you are not seeing progress from week to week, or even month to month, look back and think about how far you've come.
Remember that getting healthy for life takes a lifetime. It takes consistency, accountability, education, and troubleshooting. You don’t have to be perfect or get it right 100% of the time. But keep trying and don’t give up on yourself. Try to make healthy decisions more often than not, and remember that you have people that love you and are cheering you on.
- International Diabetes Federation. The IDF consensus worldwide definition of metabolic syndrome. Brussels. 2006.