Health is more than absence of illness

Daniel P. Finney, dafinney@dmreg.com

MORE MAKING WEIGHT: Current updates to this blog are here

THURSDAY, MAY 19, 2016

Redefining health

Thank you to everyone who turned out earlier this month for our Making Weight event at the Wellmark YMCA of Greater Des Moines.

It was a wonderful evening of conversation between myself, members of my medical team and readers who’ve followed this journey for more than a year.

We spent most of the session answering questions from the audience. It was a thoughtful public discussion of obesity, mental health and wellness.

I offer my deepest thanks to dietitian Jacque Schwartz of Mercy Weight Loss and Nutrition Center in Clive, physical therapist Stefanie Kirk of Mercy South Physical Therapy, Dr. Eric Barlow, psychiatrist from Compass Clinical in Urbandale, and trainer Nate Yoho of CrossFit Merle Hay.

Regular readers have read many a praiseful paragraph about these people, as well as Dr. Shawna Basener, my family doctor, who could not attend, and my psychologist, who chooses to remain anonymous in these columns.

The event allowed a lot of people to learn just how spectacular these people are and how much the care about not only my personal health but that off all their patients and clients.

One of the points I emphasized in response to an audience question is one that I want to make here: It is essentially that you connect with your healthcare providers on an intellectual and emotional level.

I’m not a fan of the word “providers” when describing the people have helped me to lose nearly 100 pounds in the last year. I prefer the term “partners.”

This isn’t just semantics. A partnership is a dynamic in which both people involved benefit from progress. I believe every member of my team is invested in my continued improvement. And if you can’t say that about your doctor, your coach or mental health professional, they it might be time to make a change.

An intimate relationship with your team is essential. You have to be able to trust doctors and therapists with your worries, be open about uncomfortable things in your life, with your body and goals.

Barlow brought up an interesting point during the event. He said he wished he could have similar meetings with the health care teams that worked with his regular patients.

The realities of the daily practice of medicine prevents regular face-to-face meetings between physicians, mental health professionals, trainers and dieticians.

But all professionals present agreed the holistic approach would benefit patients. Hopefully, as the medical field continues to evolve from reactive care to preventative care, we will figure out better ways for medical professionals to communicate more effectively between offices and across disciplines.

The most surprising question of the evening came from my dear friend Tyler Teske, a fellow East High School alumnus, who showed up to support his old locker mate.

Tyler asked me if my experiences working to curb morbid obesity, contain my mood disorders and other issues helped me redefined the meaning of health for me.

The question gave me pause.

The truth is I don’t think I ever gave much thought to a definition of health until mine failed me. I never thought about the long-term consequences of what I put in my body, how sedentary my life had become or the psychological consequences of those actions or inactions, as the case may be.

I think I thought healthy simply meant not being sick. But now I know it is much more than that. It is more than just diet, exercise, medicine and maintenance.

Health, to me, is not merely the absence of illness, but the presence of wellness. And wellness, like life itself, is not a destination but a journey.

Here is to Year 2 of Making Weight. As always, I thank you for reading and wish you the love, dignity and respect all humans deserve.

THURSDAY, MAY 12, 2016

Anxious days

I’ve really been struggling with my anxiety disorder the last week or so.

That’s bad news on multiple fronts.

First, panic attacks stink. My heart races. I sweat. My hands shake. It feels as if I’m in the middle of a life-threatening situation just sitting in my apartment trying to watch the NBA Playoffs.

Daniel Finney lifts weights with coach Nate Yoho at CrossFit Merle Hay Monday, March 21, 2016.

The worst attacks feel like my skin is itching on the inside.

Secondly, anxiety spurs binge eating. Panic attacks are chemical imbalances in the brain. Biologically, my body will do whatever it thinks is necessary to restore proper chemical balance.

Medication helps. But in the throes of the attack, I’m prone to hit the fridge or drive the restaurant. And I’m not likely to pick green beans or broccoli when I get there.

I’m looking for a tiny boost of serotonin, the most common and one of the most powerful naturally occurring mood regulators in the brain.

Sometimes that comes from fried food or pizza or whatever.

One day last week, in a fit of anxiety, I plowed through a pound of boneless chicken wings and a pound of taco meat slathered on cheese sauce.

It felt great for all of 15 minutes. The good vibes from the short serotonin burst quickly faded. The anxiety again churned my gut. This time the cause was simple: I’d ingested a lot of calories at a time when I’m trying to lose weight.

The third thing I do when my anxiety is bad is buy things I don’t need with money I don’t have. The effect on mood is the same as overeating. It feels really great to get a new toy, book or movie for my collection.

But again the anxiety resurges, because I’ve spent money meant for rent, groceries, retirement or other necessities.

As I have written many times, you can spend yourself into bankruptcy and eat yourself into an early grave.

The most obvious question here that if I recognize the destructive nature of these patterns, why, then, don’t I simply stop them?

I’ve written before about schema. These are the behavior patterns we all develop to negotiate the world. A simple schema would be not putting our hands on hot burners to avoid being burned.

These schemata form when we’re young. And you really can’t change them. What you do is build new ones to create new behavior patterns that are more constructive.

Let me assure you typing that sentence is a lot easier than acting on it. My schemata are deeply rooted and hard to override.

I won’t get into the details of my childhood other than to say it was chaotic. I learned to take pleasure in food and presents. These things gave me the security and comfort in ways my family situation did not.

The trouble is the emergencies of my childhood have long since passed, but the patterns of behavior remain. And so, too, does the nagging anxiety.

Sometimes I can tell what causes a panic attack. I can trace it to an incident or problem I’m having. Other times, panic seems to strike me from what I like to call “free-floating anxiety.”

One afternoon last week, I dozed off during a basketball game. I woke up in a full-blown panic attack. Was I ruminating on some troublesome problem in a dream? It’s impossible to say.

The good news is I have a terrific support system in place. Parents 2.0, the kindly east Des Moines couple who raised me after my first set of parents died, are always there for comfort and support. My girlfriend takes many late night calls, as does my saintly therapist who helps me break the cycle of anxiety.

Still, these cycles are exhausting. The drain my creative energy and I find myself cold, distant and detached from the people I love the most.

I should also mention that the transcranial magnetic stimulation treatments, or TMS, that I underwent last year do not directly treat anxiety.

I consider that treatment a resounding success. It sent my depression into remission or, at least, severely curtailed it. I have not suffered a major depressive episode since I completed the treatment in December.

I controlled the anxiety with prescription medication. And my talk therapist and I work every two weeks to find ways for me to break the negative thoughts that spiral into dark thinking.

There was, at least, one spot of positive news on the Making Weight front. At my latest weigh in, I lost 11.8 pounds in a month.

That brings my total weight loss up to 99.8 pounds since the journey began more than a year ago.

I know there is a long way to go before I’m anything approaching fit. I also know all too well there will be bad days ahead, both mentally and physically.

But even an anxiety junkie like me can say losing nearly 100 pounds is a good day.

FRIDAY, MAY 6, 2016

Talking ' Making Weight' 

Daniel Finney recently spoke to Iowa Public Radio about his one year anniversary of Making Weight. Take a listen to the conversation below: 

MAKING WEIGHT EVENT

Join Register columnist Daniel Finney for a talk about a year in his effort to lose weight and regain his health. Meet some of the people who've helped him along the way, including trainer Nate Yoho, physical therapist Stefanie Kirk, dietitian Jacque Schwartz, physician Dr. Shauna Basener and psychiatrist Dr. Eric Barlow. The talk, which is free and open to the public, is scheduled for Thursday, May 12 from 5 to 6 p.m. at the Wellmark YMCA of Greater Des Moines, 501 Grand Ave. To register, visit: https://tickets.desmoinesregister.com/e/making-weight-one-mans-journey-from-fat-to-fit/tickets.


THURSDAY, MAY 5, 2016

Fat jokes

Criticism comes with being a columnist. It’s only fair. This newspaper gives me a lot of space to share my opinions. It’s reasonable some people will disagree, even vehemently so.

But there’s one trend I notice in negative responses I receive that I struggle to understand.

For example, a reader who disagreed with my column in which I said convicted murderer Joseph “Jo-Jo” White Jr. should never be released from prison wrote this email response:

“I find it difficult to believe that one who has done such damage to his own body can pass judgment on another judged by the state to have committed a terrible crime against another human being.”

Daniel Finney works with coach Nate Yoho at CrossFit Merle Hay Monday, March 21, 2016.

That's a whopper of a non-sequitur, but if I translate this correctly, it really says, “You’re fat. You shouldn’t have an opinion about a murderer getting released from prison.”

Another reader, who described himself as a 31-year journalist, did not care for my profile of Drake University President Earl “Marty” Martin. After he finished his criticism of that piece, he added:

“Eagerly awaiting your next ‘Really folks, I’m trying to lose weight … oops, I gained 7 pounds’ series. I do wish you good health.”

Aside from having severe doubts about the sincerity of the writer’s wishes for my good health, I’m stumped by those sentences.

A generous reading of the email might suggest he’s simply not a fan of anything I write for the paper. Or perhaps in the heat of writing an email — that “firing off a note” cliche comes from somewhere — his desire to get a really cutting line typed overcame his sense of decorum.

I can understand that. It’s happened to me as a writer more times than I would like to admit.

But I think he threw in the dig about my recent gain of 7 pounds as simple spite.

It is as if he did not have enough confidence in his original criticism and decided, “You know what? I'll throw the fat thing in there, too.”

This is where I get confused. I understand disagreement with my work. But I don’t understand the base need to attack me or anyone else because of their weight, body size or appearance.

Please don’t read this as “woe is me.” It isn’t. As I said, I understand criticism comes with job.

But cruelty does not — and it shouldn’t come with anyone’s job. It genuinely troubles me that people think pointing at fat people and laughing is still acceptable.

I’ve written before how I cringed when retired late night TV host David Letterman riffed on New Jersey Gov. Chris Cristie’s weight. There are many things about Christie ripe for lampooning, but his weight seems the least and laziest of topics.

But it isn’t just comedians and emailers. Making fun of fat people for sport is commonplace.

The cruel website peopleofwalmart.com posts unflattering pictures of shoppers at the retail chain, many of them holding obese people up for ridicule.

I have a friend who once posted a picture of an obese woman riding her scooter through the drive-through of a fast food restaurant. He made comments I thought were mean and I posted a response. We argued a bit. Nothing came of it.

Someone will almost certainly accuse me of being politically correct for pleading with the public to be kind to obese people, myself included.

I am OK with that. Political correctness, though it can be overdone, is simply people asking others to describe them with dignity and respect. All people deserve that.

Underlying all these “fat funnies,” I believe, is the myth that obesity is a simple problem of self-control. Put down the fork. Eat less. Move more.

If you’re fat, the thinking goes, it’s your fault.

There are reams of scientific research that show obesity has roots in genetics, changes in the makeup and portions of food we eat, socio-economic status, childhood trauma and a host of other issues.

But instead of scientific evidence, which the public seems all too eager to ignore, I will appeal on humane grounds.

I am not an overly religious person, but I believe the Sermon on the Mount attributed to Christian savior Jesus Christ is probably the finest treatise on how humans should treat one another ever written.

I won’t quote it here because this is not Sunday School. I encourage you to Google it sometime and keep an eye on the lines about mercy.

Then consider whether we might not have a much better world if we focused on mercy instead of fat jokes.

THURSDAY, APRIL 21, 2016

Controlling hunger

Sometimes it’s tough having a former U.S. Army Ranger as your psychologist.

I sank into his recliner last week feeling glum.

My weight was up. I worked with my nutritionist. We decided to trim my daily calorie goal by 200 in an effort to restart the weight loss.

But I was really feeling the difference. I found myself thinking about eating a lot more than I had at any point since I began this effort to lose weight and regain my health.

I complained of the problem to my therapist, who asks not to be identified in these columns because of the work he does with public safety agencies.

My therapist told me a story about Ranger survival training when he and his troop were on one ration a day.

“The first few days, you were so hungry you would drink swamp water just to have something in your stomach,” he said.

Well, then. I guess it isn’t all that bad after all.

Eating is a biological necessity. But hunger pangs can be controlled in much the same way I work to wrangle anxiety when it bubbles in my brain.My therapist wasn’t going with tough love, though. He was making a point.

The best tactic I’ve found for stemming panic attacks before they blossom – besides prescription medication, of course – is by breaking the cycle of thinking that causes panic to spiral.

Sometimes this is phoning a friend. Other times it’s distracting myself with a good book or even taking a nap.

I’ve found the same tactics in nursing my way through attacks of hunger pangs, with a few exceptions.

TV is rarely a good pick because if you’re feeling hungry there are a lot of commercials about food and none of them are particularly healthy options.

But favorite movies on DVD or a Netflix binge watch is much better than a food binge in the kitchen.

Conversation is always good, but don’t ruminate on food. I might call my girlfriend and complain about being hungry, but we switch topics fairly quickly to the latest antics of her cats.

I call my friend Paul in Memphis to talk about how bad the summer movie slate looks. And so on.

I want to make a couple of points here. I’m not talking about starving myself. That’s just as unhealthy as eating junk food.

I’m talking about the hunger pangs that come not from the biological need to eat but thinking about food, being tempted by the smell of a favorite dish or the reflex desire to eat out of sheer boredom.

I struggle with bored eating lot. I find myself looking into the refrigerator for entertainment rather than sustenance.

Another appetite control technique I’ve learned: Avoid fast foods. I don’t mean the drive-through restaurants. I mean premade foods that you can pop in the microwave or tear into like potato chips or other snack food.

Most of my grocery bill goes to fresh veggies, meats, a few fruits, eggs and so on. The only quickie foods I have on hand are protein bars, which are low in calories and high in nutrients. So if I do break down and have an unnecessary snack, noshing on one of those isn’t a terrible choice.

The best thing, though, is a distraction. And the good thing about my apartment it is that it’s stacked ceiling to floor with books, movies and music. I can always find something to do besides eat.

So far it’s worked. As of this writing, I’ve stayed within my new calorie goal for 21 consecutive days. We’ll see how well it’s paid off at my next weigh in in a week or so.

THURSDAY, APRIL 14, 2016

A setback amid celebrations

Last week, we celebrated the one-year anniversary of Making Weight, my ongoing effort to recover from morbid obesity.

I wrote a big front-page story in the April 10 edition. We hosted a Facebook Live chat on Facebook.com/DesMoinesRegister. (Click here to watch a replay.

I received dozens of emails, letters and phone calls. Almost all praised me and several readers shared their own experiences.

It felt great.

This doesn’t: I’ve gained 7.2 pounds since my last weigh in.

It is the biggest single weight gain I’ve had between benchmarks since I started the process.

I can easily find where I got off track.

I bought foods that I shouldn’t have, like peanuts, which are high in nutrients but also heavy in fats. In the recommended servings, they’re a fine snack.

But the recommended serving is very small. But I take a handful and then another and then another. And pretty soon a half pound of nuts has been consumed.

They are a poor choice to have in the house.

I didn’t do much better eating out. A while back, I had some nachos for the first time in a while. It was like an alcoholic trying to take a single drink.

Pretty soon nachos were regular meals. Sometimes, I’m ashamed to admit, those nachos were “appetizers” followed by full meals.

I got sick in late February and early March. I missed several sessions at the gym. And I didn’t eat well during that down time.

I looked at MyFitnessPal, the smartphone app I use to track calories. Some days I hadn’t logged all my calories. Other days, I blew my calorie goal.

I think I blew my calorie goal for seven out of 10 days at one point in March.

Now, the weight gain is not all bad. The computer at Mercy Weight Loss and Nutrition Center in Clive gives me information about water weight and muscle mass.

Since my workouts with Nate Yoho, owner of CrossFit Merle Hay, began in February, my muscle mass has increased by more than 6 pounds.

That’s terrific news. As Nate says: “You don’t get stronger by adding fat.”

I am getting stronger. But I’ve also added some fat.

I worked with dietitian Jacque Schwartz at the Nutrition Center. I decided to reduce my daily calorie goal from 2,700 to 2,500.

As of this writing, I’ve stayed at or below that goal for 13 days in a row.

But that’s come with its own side effect: I’m hungry.

Since this journey began, I’ve been able to lose weight largely without major hunger pangs.

Yet I feel them with this 200-calorie cut. They’re manageable. If I get too hung up on them, I do what I always do when I get locked into a pattern of negative thinking: I phone a friend.

Sometimes it’s my therapist. Sometimes it’s a text message to Nate. Sometimes I call my girlfriend or my buddy, Paul, in Memphis, Tenn.

With my girlfriend and Paul, we don’t necessarily talk about eating and food. Sometimes we talk about movies, TV and sports — just anything to break the loop of thinking.

Pretty soon I forget about being hungry.

What I don’t want to forget, however, is that are these lapses are natural.

I’m not going to spend a lot of time beating myself up about this. Yeah, I gained some weight. But I have all the tools in place to lose that again and make more progress.

And I’ve already taken action to stop the current slide. There’s been a lot of broccoli and green beans consumed in my house recently. My George Foreman Grill is getting a lot more work.

With hard work and continued vigilance, I’ll have a lot better news to report the next time I step on that scale.

THURSDAY, MARCH 31, 2016

Throwing weight around

I stayed in bed Monday morning and pulled the covers over my head.

I fiddled with a “Star Wars” video game on my smartphone when the alert from my calendar popped up. It was time to go to the gym.

I did not want to go. I spent part of the weekend, as did many of my colleagues, covering the deaths of four people in a tragic head-on crash on Interstate 80 near Waukee.

Among the dead were two Des Moines police officers. I did not know the officers personally, but I worked as a police reporter for several years before eventually becoming a columnist.

My uncle Larry was a Des Moines cop. I’ve spent years learning about police procedure, tactics, their mindset, the challenges and struggles of the job.

In the process, I’ve gotten to know some law enforcement professionals very well. Some I call close friends. And I felt their grief even though it was not mine to carry directly.

I was having a hard time with my emotions after writing about the incident. In fact, my brain chemistry was so jumbled up that I took some time off just to attempt to relax.

I want to be very clear: I do not equate the emotional state I was in with that of those who lost loved ones, including the police.

My struggles were insignificant and infinitesimal compared to those who lost a son, a daughter, a mother, a father, colleague, friend and so on.

Still, I did, in fact, have an emotional reaction to those officers’ deaths, and the last thing I wanted to do was go to the gym.

But I thought of the officers who reported for duty the next day and did a job far tougher than stacking paragraphs. The absolute minimum I could do was get out of bed and go to the gym.

When I arrived at CrossFit Merle Hay, my coach, Nate Yoho, spotted something off about me right away as we began warm-up stretching.

“You look like you have a lot on your mind,” he said.

We talked about the sad events of the weekend and where my head was at.

Nate knows tragedy. I first met him after his wife, Laura, died of brain cancer and their daughter, Caralyn, was born by surrogate a few months later.

Nate, of course, isn’t a therapist. But he’s a smart man and one whose experiences grant him good perspective.

We talked while I worked out. As the sweat ran, my heart rate picked up and my blood pumped, I was able to focus on something other than the confused set of emotions rattling around in my mind.

Nate put me through paces on a deadlifting exercise. For some time, I’ve joked to Nate that I was looking forward to the day when I could throw weights on the floor.

The fitter and more experienced athletes in Nate’s gym do a variety of lifts that after they’re done, they simply let the heavy weights fall to the ground rather than risk injury by trying to lower them to the ground.

Until that session, Nate worked gingerly adding weight to my deadlifts because of my tender, oft-injured back.

Perhaps sensing I was ready for a challenge or simply that I needed to put my mind to work on something other than sadness, he challenged me with the heaviest weight I had deadlifted to that point.

“When you’re done with your reps, I want you to drop that bar on the ground,” Nate said.

He showed me the proper technique. I lifted. I focused on breathing and form. And when my reps were done, I let loose of that bar.

It slammed into the rubberized floor with a satisfying clatter. I lifted my arms in the air with some sense of relief.

Throwing that weight on the floor did not erase my sadness. But it sure helped.

And my exchanges with Nate that day made me realize how much I had come to trust this man with both my physical health but also as a friend and confidant.

That epiphany did lift my mood. Because among the best medicine for sadness is the knowledge that you are not alone in this world.

Physical Therapist Stefanie Kirk works with Register Columnist Daniel Finney Tuesday, June 16, 2015.

THURSDAY, MARCH 24, 2016

Mental, physical health linked

I recently wrote about a woman who is dying of lung cancer. Someone asked me if the subject of my story smoked. She didn't.

The question is, in a way, a natural outgrowth of decades of anti-smoking campaigns. The link between smoking and lung cancer is scientific fact.

But an unintended consequence of those campaigns is that when people suffer from lung cancer, there is almost an attitude of, “Well, they deserved to die wheezing because they were stupid enough to smoke.”

I thought about the question in the context of my own ongoing recovery from morbid obesity. Writing about this publicly has brought scores of kind notes and letters from readers who share the same struggle, know of others who do or empathize with the journey.

But occasionally — and mercifully rarely — I will hear from the reader who believes this ongoing chronicle is self-indulgent and displacing real news. After all, the argument often goes, obesity is my own fault.

In essence, I’m fat because I ate too much and I deserved it.

There is some truth to that. I have overeaten for much of my life and rarely exercised. But no one reaches 563 pounds — the weight at which I began changing my life to avoid crippling myself at 40 — simply by overindulgence.

There is a growing body of research that links childhood trauma with obesity. Kaiser Permanente, a health care company in Oakland, Calif., did some groundbreaking investigations into the link in the early 1980s and was the subject of a Time magazine profile in 2010.

The data essentially says people with high adverse childhood experiences have higher risk for a host of negative health problems as adults, including alcohol and other drug abuse, chronic depression, heart disease, smoking and, yes, obesity.

Adverse childhood experiences describe a wide array of problems ranging from verbal, physical and sexual abuse to problems related to poverty, abandonment, family history of mental illness and drug abuse and other issues.

I took a 10-question survey at acestoohigh.com, a very good website about adverse childhood experiences, and scored a 4. That’s the highest category measured by the Kaiser Permanente ACE Study.

Without going into unnecessary detail about my childhood, it was, to say the least, a challenge.

And, no, I’m not blaming me being obese directly on childhood trauma. But I absolutely believe in the link.

When you suffer trauma as a child, you do what you can to feel safe and comfortable. The things I did most often to feel safe and comfortable was eat and buy things: toys, comic books, movies and so on.

These actions, my behavioral therapist tells me, create a chemical reaction in the brain that calms me, even if briefly.

The problem is, of course, you can spend yourself into bankruptcy and you can eat yourself into the grave.

I work with my therapist twice a month to learn new ways to cope with stress. He takes a call from me two or three times a week when I face an anxiety situation that could spiral into negative thinking that could lead to anything from overeating to suicidal thoughts.

Just the act of talking out those thoughts helps them dissipate and remove the chance of me acting on them.

One knee-jerk reaction might be to say, “Look, childhood was a long time ago. Get over it already.”

Cognitive function, alas, is more complicated than that.

I am also 40 years old. That means I’ve been acting on a series of behaviors ultimately bad for my health for a very long time.

Psychologists called these learned behaviors schemata — a learned cognitive response to certain stimuli.

Here’s the tricky thing about schemata. They can’t be changed. Once they’re in place, you’re stuck with them.

What you can do, though, is build new ones. This is a tough task. I’ve been in therapy off and on since I was 15 years old.

My behavioral therapist, who asks I not name him because of the work he does with public safety agencies, is the best medical professional I’ve ever worked with.

The work we’ve done in our two years of sessions is some of the most important and life-changing in my life.

And still I find myself reaching out to him when I am on the precipice of or in the middle of a panic attack. That is, in fact, part of a new schemata that’s under construction. When the cycle of negativity starts, find a way to break it.

So, to bring this back to the obesity battle, yes, I ate too much of the wrong things for a long time. And sometimes I still indulge where and how I should not.

But like a smoker who is trying to quit or a cancer sufferer trying to survive, I am working as hard as I can to find a new path to a healthier life while fully realizing I will stumble and fall often along the way.

As for the idea that a smoker who gets lung cancer or an obese person with health problems “deserve them,” I think of Clint Eastwood’s line before he kills Gene Hackman’s sadistic sheriff in “The Unforgiven:”

“Deserves got nothin’ to do with it."

THURSDAY, MARCH 17, 2016

Enjoying exercise? It happens

Boy, it felt good to get back to the gym last week.

And that’s a sentence that I never expected to type. I mean I’m the kid who used to walk the mile in middle school. I rarely even tried in P.E.

But there I was last Monday at the gym eagerly putting on my shoes and getting ready for the day’s activity.

I missed nearly two weeks of workouts because of a heavy chest cold that left my lungs wheezing. Two rounds of steroids and antibiotics and three doctor visits finally got me back on my feet.

As a side note, as someone who lives with an anxiety disorder, the heavy stimulants in steroids and oral inhalers made for a very edgy couple of weeks without much rest.

But once Nate Yoho, my coach and owner of CrossFit Merle Hay, started putting me through my paces, I started to feel spectacular.

In fact, I think I got an exercise high. This is a rush of endorphins in the brain spurred by exercise. Runners talk about it a lot when they push to a new level of exertion.

I’d never experienced it before. But it felt great.

That I actually enjoy exercise and look forward to it as a part of my thrice weekly routine is a compliment to Nate.

He designs workouts that are varied. I rarely do the same thing twice in our three sessions.

Nate also excels at the human touch. On my second day back, the weather was pleasant. We took a short walk in the parking lot as a cooldown activity.

Nate told me my confidence of movement was improving. I didn’t know what that meant.

He said I approach activities less tentatively than I did when we started working together. I pick up weights without fear of injury, he said.

I thought about what this meant. I came to Nate after finishing physical therapy with Stefanie Kirk at Mercy South Physical Therapy.

The pain of limited movement was fresh in my mind. I also had a mindset that an injury meant I had to stop, rehab and restart the process.

But as I’ve gotten more comfortable working with Nate, I’ve begun to realize that some nagging problems — such as knots in my calves — can be treated on the spot.

Nate “rolls out” the knots with a special tool he has. It’s unpleasant, but it’s an intense discomfort in the short term to avoid limping for a full day.

I felt my calves, which had been dormant with the rest of my body during my illness, tighten up during a stepping exercise Nate gave me.

I told Nate they were right on the edge of knotting up. He adjusted the workout to more upper body and core challenges and we avoided aggravating the calves further.

At the end of the day, I drank my protein shake. I had a couple extra bananas that evening as snacks. The calves felt acceptable the next day. They were sore, but not injured. We got on with the business of working out.

The key lesson here is the clear line of communication between Nate and I. I feel comfortable telling him, “Hey, this isn’t working.” And I trust him to challenge me to get better.

The blessing of this is that it allows me to focus on continuing to recover from morbid obesity without relying on the singular metric of how much I weigh.

Yes, I’m still morbidly obese. But in just a couple of months, my strength, flexibility and mobility have all improved that even I, the ultimate skeptic in recognizing my own personal improvement, can notice the difference every day.

This is an important and somewhat risky period in the recovery, I think. Once I cross the 100-pound mark for weight loss, there is a temptation to let up, to look back at how far I’ve come and rest on my laurels.

That’s why I’m so blessed to have Nate and his gym in my life. Nate is a master of thinking both day-to-day and big picture. He comes up with the workouts that get me sweating and stressing three times a week.

But then he talks about what I think is patently impossible: pull-ups, competing in CrossFit Games and so on.

I tend to keep my focus in the present. I’m not even sure I want to compete as an athlete. But having someone looking that far ahead does make it easier for me to avoid feeling too satisfied and, instead, keep moving forward.

WEDNESDAY, MARCH 9, 2016

Better even when sicker

Oddly enough, I appreciate the improvements to my physical health most when my body fails me.

Here’s what I mean: For almost two weeks, I’ve been plagued by a bronchial infection that I can’t shake. My lungs sound like a saw cutting through old wood.

The breathing problem curtailed my workouts with my coach, Nate Yoho at CrossFit Merle Hay, for more than a week.

It’s tough to exert yourself when you can barely get a chest full of air.

Still, I think of how much worse I would have been if I were still carrying the 94.8 pounds I’ve lost over the last 11 months.

I am by no means svelte, but I am definitely stronger. Even with diminished lung capacity, I’m able to walk to and from my car without stopping. I’m able to walk into the doctor’s office without assistance or breaking out in a fugue of sweat.

I like how many of those sentences begin with “I’m able.”

An infection like this would have totally incapacitated me a year ago.

A chest X-ray revealed no signs of pneumonia, but a lung ailment sidelined Daniel Finney's effort to lose weight for nearly two weeks.

I’ve been sickly to be sure, but I’ve mostly been able to work.

My voice hasn’t been strong, but my body has had enough strength for short bursts of energy needed to get things done: Pick up prescriptions or supplies at the grocery store and so on.

I remain morbidly obese, of course, but the progress from March 2015 to March 2016 astounds me most when I hit a challenge such as illness.

Then there’s this strange feeling: I actually miss the gym. Early in the lung ailment, I pushed through a workout and I got sicker. It wasn’t my brightest move, but I have come to enjoy my time with Nate.

His gym is as he promised: a place where anybody of any ability level can feel comfortable getting stronger.

I’ve come to look forward to my thrice weekly appointments there the way I used to look forward to hanging out with my high school sports teammates or my weekly Dungeons & Dragons group.

There is a camaraderie. The gym is absent of judgement and heavy on encouragement.

So that I haven’t been able to go due to illness has been a disappointment both physically and socially.

I really want to round off a full 100 pounds before the end of March, when the year anniversary of Making Weight rolls around.

I still hope to pull that off, but this lung problem slowed that, to be sure, but Nate checks in on me nearly every day. That’s dedication.

And I must admit, I’ve been blessed with a good cross-section of people who work very hard to help me get better.

When the cold first started to migrate to my chest, I went to an urgent care clinic. The doctor prescribed a round of medications. But as that course wound down, it was clear the problem wasn’t working.

I groused about this on Facebook and got a surprising response.

My family doctor, Shauna Marie Basener of Mercy Westown Internal Medicine Clinic, messaged me and told me to get into see her at once.

Does that count as a house call in the social media age?

I don’t know. I guess we’ll see when the bill arrives.

But I must appreciate a doctor who is paying close enough attention to my health that she reads my status updates.

I did, in fact, go to see Shauna and she got me on a new round of medicine. A chest X-ray showed no signs of pneumonia. That’s good, though I’m still wheezing as of this writing.

Still, I feel pretty good, at least from a mental standpoint. Just as I appreciate the physical transformation spurred by Nate and physical therapist Stefanie Kirk at Mercy South Physical Therapy, I am grateful for Shauna’s doting care.

In fact, I’m so enamored with Shauna’s work that I’m going to follow her when she changes offices in April and moves to an office in Ames.

Sure, it’s a few extra miles on my Dodge, but when you develop a relationship with a good doctor – or any healthcare provider – you do what you can to preserve it as long as possible.

So my message to my fellow travelers on the journey back from obesity is that there are good people out there – doctors, therapists, trainers and others – whose mission in life is to help you get better.

Who are we to turn our back on such open acts of kindness?

THURSDAY, MARCH 3, 2016

Now we're getting somewhere

"Have you tried on some of your old pants?" said Mom 2.0, the kindly east Des Moines hairdresser who raised me after my first set of parents died.

"No," I said.

"Well, you should," she said. "These are getting pretty baggy. The cuffs are dragging on the ground."

This conversation repeated itself a half dozen or so times in the last two or three months. She asked. I said, "No."

I still had several smaller sizes of khakis hanging in my closet at home. But I refused to pull them off the hanger.

I was too scared.

Yes, I'd lost weight since my efforts to recover from morbid obesity began nearly a year ago. But I refused to recognize it.

I looked in the mirror and did not see what I was, but remained haunted by what I was not.

This is the way of things for a lot of people in a vain culture. But it is an especially acute problem for the obese. I simply could not see any difference.

Sure, when my physical therapist, Stefanie Kirk of Mercy South Physical Therapy, pointed out specific things I could do after working with her that I couldn't do months ago, I intellectually understood that to be true.

But I didn't feel it. I still felt like the same lumpy, hopeless fat guy who was a few french fries away from a heart attack.

Sometimes, I still do.

Even now, when my fitness coach Nate Yoho works me out three days a week at his CrossFit Merle Hay gym, I see great leaps forward in physical abilities.

A major part of Nate's program is retesting me on exercises we've done a few weeks earlier to see how much stronger and faster I've become. 

He posts the numbers to a private Facebook page that only he, Stefanie and I can see. We talk about the improvements.

I really do feel stronger. I notice it in small ways, like the ease in getting up from a chair or getting out of my car.

At the beginning of this journey, it must have looked like my Dodge Charger was giving birth to a 563.2-pound baby elephant every time I got out of it.

I once needed my arms to pull myself to a standing position because my poor, overburdened and arthritic knees couldn't take the strain.

Now, I just stand up without so much as a sigh or groan. That's a credit to the paces both Stefanie and Nate put me through.

But this pants thing was too much for me. I was afraid that despite all that progress, I would somehow slip on that smaller size and they would be as tight as they were when I pushed them to the back of the closet with the other "maybe someday" clothes.

I finally acquiesced to Mom 2.0's request after a session at Nate's gym. He takes videos of me doing various exercises to show me what I'm doing right and wrong with form.

He showed me squats from my first week working with him and squats about a month later. I happened to be wearing the same shirt and shorts in both videos.

I noticed my belly was visibly flatter in the profile shots. I made Nate show me both videos multiple times. He agreed. There was much less Finney in the second than the first.

Still, it was hard for my brain to accept it. I showed the videos to my girlfriend. She reminded me she had been telling me for months that I'd slimmed out in the face and my belly was less bulky.

So I went home and pulled that pair of pants a size smaller and pulled them on. They fit marvelously, maybe even a hair looser than I would have expected.

After that, I decided it was time to do something I'd been avoiding since December: Get weighed.

I knew my diet had faltered during the holidays and my exercise evaporated before I started working with Nate. 

But now it was late February and I was wearing slightly smaller pants. Progress seemed to be lurching in the proper direction. I might as well test the theory with an actual measurement.

The result: I was down 13 pounds between Dec. 14 and Feb. 23. I've lost a total of 94.8 pounds since this journey began nearly a year ago.

I want to knock out that last 5.2 pounds before the year is up, just to get a nice triple-digit loss.

But, of course, I immediately got a vicious chest cold that sidelined me at the gym for several sessions.

Still, the momentum is shifting in the right direction. It's going well enough that even I can see it.

FRIDAY, FEB. 19, 2016

Challenge, encouragement hallmarks of workouts

It still feels weird to call Nate Yoho “my personal trainer.”

Nate owns CrossFit Merle Hay, where I’ve taken up an exercise regime in my latest effort to recover from morbid obesity.

There is something very gauche about the phrase, like showy jewelry or riding around in a stretch SUV limo. I guess I’m just aggressively middle class that way.

The term I prefer is “coach,” because it feels both more accurate and less pretentious. And it describes my relationship with the man.

The best coaches are teachers. And Nate definitely teaches me with each session.

Early on, my legs burned and my back ached so bad I wanted to quit.

Nate taught me about protein drinks. I always thought protein drinks were for body builders.

Not so, Nate said. Science says a high-protein drink within 45 minutes of an intense workout will help build muscle and encourage recovery.

I was skeptical. But I went off to the grocery store and bought a few of the Hy-Vee brand plastic jars of whey protein that were low in sugar and carbohydrates and high in the nutrients Nate recommended.

I put two scoops in some water, shake it up and drink it after workouts.

And … wow.

The difference was awesome. My muscles were still sore after workouts, but the searing pain from lactic acid buildup was gone.

“Recovery,” Nate said, “is just as important as the workout.”

These protein drinks gave me new life for workouts. I don’t tolerate pain well.

And since I live with general anxiety disorder, my brain chemistry malfunctions tend to take a rational caution about pain and turn it into a paralyzing fear.

Now that I knew the protein shakes work just like my coach said they would, I could embrace workouts with greater vigor.

One of the things I enjoy most about working with Nate is the way his mind seems to be always working on the parallel processes of challenging me and encouraging me at the same time.

Early in our workouts, we did a cycle of exercises that were timed. I performed four cycles of belly crunches, calorie burning on a rowing machine and ring rows, which require me to pull myself up to a standing position from an incline using gymnast’s rings.

I was to do four cycles, taking breaks as I needed.

The first time we did this on Jan. 26, it took me 13 minutes, 38 seconds. I gasped for air the entire time and took many water breaks.

I confess I needed the water less than I was simply stalling for time to get my breath back.

We retested the cycle about two and a half weeks later on Feb. 11. I made the cycle 2 minutes, 36 seconds faster than the last time.

Nate said he typically doesn’t retest this quickly on exercises. But that’s where the encouragement side of his challenge-encouragement dynamic comes in.

Nate wanted to show me that I was making progress even if my brain stubbornly refused to see it.

“The numbers don’t lie,” he said.

Another little touch Nate offers: He checks in every day by text.

He texts after workouts to see how my body is feeling.

He texts before workouts to check my mental readiness.

He texts on off days just to ask how I’m holding up.

The other day I told him I had some soreness in my triceps after some bench press work we did.

I told him it didn’t hurt. In fact, it felt kind of cool. It reminded me, “Oh, yeah. I worked out and that was cool.”

Nate replied: “You’re body is starting to figure out what’s going on.”

And maybe my brain will follow along soon, too.

TUESDAY, FEB. 9, 2016

Life after my 'brain zap'

Many readers have asked me how my “brain zap” treatment for chronic depression went.

I hesitated to answer right away because I wanted to get more data before I gave a definitive answer.

But more than a month after I finished transcranial magnetic stimulation, or TMS, under the direction of Dr. Eric Barlow at Compass Clinical Associates in Urbandale, I can safely say the treatment was a resounding success.

A brief recap: TMS uses magnetic pulses to stimulate the nerves in the brain to make them more receptive to the naturally occurring mood-regulating chemicals swirling around in our gray matter.

I live with what is known as progressive depressive disorder and general anxiety disorder.

That simply means that I sometimes get very sad or very scared beyond what is reasonable for what’s going on in my life.

A portion of this problem is caused by chemical imbalances in my brain. I’m essentially not getting enough of the juices that make me better at handling stress or grief.

I took TMS five days a week for six weeks and once a week for another several weeks.

Others noticed the change in my mood before I did. My Grandma Newcomb said I seemed like my old self. Barlow said after a couple weeks that I was a lot more animated and brighter than I had been when the process began.

I remained skeptical, in part because that’s how a good paragraph stacker should be, and in part because hope is a tough thing to embrace for people who live with depression.

Now, though, having lived life after treatment, I would say my depression is in remission.

I don’t know if that’s a term Barlow or the medical community would use, but that’s how I feel.

Remission feels like the right noun because I recognize my depression is not cured. It’s a condition I live with like high blood pressure or Type II diabetes.

I can do what it takes to keep those conditions in check, but they’re still a part of my health profile.

I still have down days. But that’s it. It’s a day or two at the most. It isn’t a month or three months.

I’m much better at recognizing when I’m down and acting to break the cycle. Sometimes this involves changing activities. Sometimes it means taking a nap.

I still see a cognitive behavioral therapist twice a month. The other part of mental illness is understanding how you think, why you think that way and developing new ways to cope with the world.

I liken the process to being asked to run 10 yards on a football field loaded with dozens of tackling dummies.

After a while, you get winded because there are so many obstacles you can’t make progress.

TMS removed half or more of those tackling dummies from my path. I work in therapy sessions to either dodge those other obstacles or find new ways to cope with them.

I’m not the kind of person who endorses medical procedures. That’s a personal choice that individuals need to make in consultation with their medical team, family and their own values.

I will say this: My behavior therapist is deeply skeptical of TMS and believes I am experiencing a strong placebo effect.

He might be right. I trust my behavioral therapist with my life. And he’s by far the best therapist I’ve ever had, and one of the finest men I’ve had the pleasure to know.

He might also be wrong. TMS, placebo or otherwise, helped me be more comfortable with who I am.

It didn’t make me a cheerful person. My coworkers and editors will attest to that.

But it allowed me to be more comfortable with who I am and accept myself, foibles and all.

And that’s a wonderful thing, when I used to spend days ruminating on what a crummy person I am.

One side note: though anxiety and depression often occur together as mood disorders, they are separate conditions.

My anxiety is probably about the same as it always has been. It ebbs and flows, spiking and dropping based on what’s going on my life.

I still find myself calling my talk therapist when I get into a mess of persistent ruminative thoughts — that is, getting stuck in a rut of negative thinking that tends to take a small problem and expand it to the worst possible ending.

But even my talk therapist agrees that I am getting better at recognizing those periods of gloomy rumination and breaking the cycle by calling him to talk it through.

So for now, I’m embracing life without the burden of feeling like I’m a bum, but I’ll always be braced for the possibility such thoughts will reoccur.

THURSDAY, FEB. 2, 2016

Wanting to quit

Sometimes I feel like Humpty Dumpty, the fairy-tale egg man who fell off a wall and required all the king’s horses and men to reassemble him.

I propped my right knee on pillows and gingerly leaned back into my bed.

Two weeks of training at my friend Nate Yoho’s CrossFit Merle Hay studio left me with a swollen knee, knots in both calves and the return of the lower back pain that started me on my journey to recover from morbid obesity.

I was ready to quit. I wanted to quit. I was hurt, humbled and ashamed.

I knew joining a gym and working with a personal trainer would be a challenge for my obese body.

I just did not realize how much my body would rebel against the change – and how hard the emotional repercussions of that rebellion would hit me.

First, I should note that Nate is an excellent trainer. He speaks in a clear, gentle voice and explains all the exercises, lifts and other activities to me in clear instruction.

He focuses on proper form and injury prevention just as much as my physical therapist, Stefanie Kirk, of Mercy South Physical Therapy.

The problem is my body. I carry a lot of weight in the front of my torso – my gut. Over years of hauling this girth around, I’ve developed the bad habit of leaning back slightly to balance out the extra weight that pitches me forward.

The problem is all that leaning back has compressed my spine in the lower back. And those compressed vertebrae pinch nerves. This leads to shooting pain that I sometimes feel all the way to my finger tips and toes.

It also makes sitting, standing or any kind of movement from a prone or supine position exceptionally painful.

I aggravated my back doing a lifting exercise. When fatigue sets in, I start to rush. When I rush, I lose form. And when I lose form, I hurt myself.

In this case, I leaned back a few too many times while lifting weights.

Nate didn’t notice it at the time because I didn’t feel pain and didn’t grimace. Conversely, when knots developed in my calves, he stopped the exercise right away because he saw the pain in my face.

But over a few days, the back injury caught up with me. I became immobile.

That’s when the fear and shame crept in.

Nate has made every effort to make his gym as comfortable and inviting to me as possible. But there are mirrors and I see myself. I may have lost a lot of weight to this point, but I still don’t like my own reflection. That’s a self-esteem problem and I’m working on it.

When the back injury returned, I knew exactly what happened. I overcompensated for that weight on my gut pulling me forward.

It felt as if my own body betrayed me. I got emotional. My thoughts spiraled to unrealistic finalities. Had I done so much damage to my body that getting from fat to fit was actually impossible?

I was ready to quit the gym and just crawl under my blanket and hide from the world.

Enter all the king’s horses and men.

The first call I made was to my therapist. I told him my dilemma. He suggested that maybe the exercise was too much for my current weight.

I told him I was worried that I liked him saying that because it was what I wanted to hear. I wanted to quit.

If I quit, though, I wanted it to be because I was injured or was really overwhelmed, not because I was afraid.

My therapist replied: “Then you’re going to make the right decision whatever you decide because you’re asking the right question.”

I texted Stefanie and told her of the injury. I confessed I was thinking about quitting.

She urged me to stick with it. Care for the injuries, she said. Tend to the pain. But I had to keep moving.

“There were days in the first five sessions with me that we didn’t make any progress but you kept coming back,” Stefanie wrote.

It may be cliché, but it is often difficult for men to talk to other men about emotions. Still, I confided to Nate my emotional worries along with my physical ones.

He, too, urged me to come in for my final workout of the week. He said we didn’t have to go hard. We could even meet for lunch. He just wanted the conversation going.

“It’s OK to be emotional about it,” he wrote. “How could it not be? I think if you continued your old ways making it to 50 would be pushing it. Look at what you’ve done in the past six to nine months. You’re on the right path.”

How could I turn my back on a man who was working so hard to convince me to get better?

Finally, I called my primary care provider, Dr. Shauna Basener at Mercy Internal Medicine in Clive. She thought exercise – at a reduced level – was OK.

She renewed a muscle relaxant prescription and another anti-inflammatory that is slightly stronger than over-the-counter stuff.

So, I iced my knee. I took my medicine. And with a mixture of trepidation and resolve, I went to my last workout of the week.

Nate put together a cycle of exercises that didn’t require much bending. He constantly checked on the condition of my back. We both remained vigilant on spine position.

The workout was not as intense as previous sessions. But it did not matter.

For that day, winning was just getting through the door.

FRIDAY, JAN. 29, 2016

THE NEW GYM

I barely slept the night before I reported to CrossFit Merle Hay to work with my new trainer Nate Yoho.

Anticipation is the worst part of starting anything especially for a chronic anxiety junkie like me.

I passed off my trembling upon walking in the studio as an effect of the cold weather. The truth was I had no idea how this was going to go.

I half expected to leave on a stretcher.

The activity started off poorly. The first thing Nate did was take my picture, front, profile and side.

I enjoy having my picture taken about as much as I enjoy listening to a dental drill at top volume on a movie theater speaker system.

Nate said they were to mark my progress. He posted them to a Facebook page that only he and I are a member of.

We started with some stretches. I managed to get through that without breaking into flop sweat.

Nate explained every step calmly and articulately. I started to settle.

Next were something called box squats. Per Nate’s instruction, I held my hands over one another and sat down on a box.

This is not as easy as it reads, especially for someone who carries his weight in his doughy middle.

Nate cautioned me to be mindful of form. He told me which muscles to use and how to rotate my legs.

The sweat the fell by this point was from exercise rather than nerves.

We moved to standing push-ups. He put a weight bar on a rack. I leaned forward into it and pushed back to a standing position. This too is not as easy at reads.

Again, Nate directed my form. I followed directions as best I could. My editors wouldn’t believe how easy I was to command.

The bench press came next. I just did the standard 45-pound bar. We rotated between the bench press and a stepping drill similar to one I had done many times in physical therapy with Stefanie Kirk over at Mercy South Physical Therapy.

We finished with some dumbbell exercises. I was beat. I pulled my towel out of my gym bag and changed my shoes.

Day 1 was finished. I had survived.

Stefanie texted me: “I haven’t received an SOS call, so I’m guessing everything went OK.”

It did. The workout was good. I felt like I’d really done something.

The second day brought a new set of exercises. Nate introduced me to deadlifting technique. We worked just with the bar again focusing on form rather than strain.

I got plenty of strain anyway.

We worked on a shoulder exercise before we advanced to the toughest part of the workout.

Nate sets a series of exercises out. This time it was something called “ring rows,” crunches and using a rowing machine.

Ring rows involve grabbing metal rings attached to straps that are lashed to a metal frame. I leaned back to about a 45 degree angle and pulled myself up to standing position. I did that eight times in a row.

Then I hustled over to do 10 crunches — what old people like me used to call sit-ups with a slightly different technique that involves a special pillow to support the lower back.

When I finished that, I switched to the rowing machine, where my goal was to burn eight calories.

The goal was to complete four sets of all three exercises. I wheezed and groaned my way through it. I stopped to get water. Nate made me stop once to catch my breath.

The whole thing took 13 minutes, 38 seconds. We finished with a 300 meter walk.

Nate said we’ll revisit that work out in a few weeks and mark the progress by how much more quickly I’m able to work through the cycle.

Things went along fine, but I don’t think I truly trusted Nate until my third day at his shop.

We worked a step exercise and I felt my right calf muscle pull. It was a familiar feeling. It happened several times in physical therapy with Stefanie.

But Nate caught my grimace right away. He asked what hurt. I told him. We stopped. I laid prone on the floor.

Nate worked the calf muscle with a piece of PVC pipe, rolling the knot out similar to the way Stefanie used to torture me with these metal tools.

He cautioned me that when I feel something off, I needed to tell him. The goal was always to avoid injury.

And this is a weird thing to say about your trainer, but in that moment I felt safe with him. I knew he cared about my health. He offered to train me after all.

But here he was working on the injury, telling me how to handle it and looking for ways to keep the workout moving forward without causing a bigger problem.

This is the kind of moment that builds a bond between coach and “athlete.” (Nate calls all his clients athletes. I don’t feel like one, but it’s not wise to contradict the guy who spots you when you lift weights.)

We finished the last day with some rope climbing. I sat on a bench. My goal was to pull myself into a standing position by mostly using my arms.

It was tough.

“This is the first step to you one day being able to do a pull-up,” Nate said.

I told him that my life has been pull-up free for 40 years. It’s never happened. I couldn’t even do it in high school when I weighed 190 pounds, played basketball and regularly jogged.

Nate smiled.

“I’ll take that as a challenge,” he said.

And I had this odd feeling that he might just get me to pull it off.

THURSDAY, JAN. 21, 2016

UNCERTAINTY ABOUND

My nerves are really getting to me now.

By the time these paragraphs reach our print edition, I will have graduated from physical therapy for a second time.

The next step is work with personal trainer Nate Yoho of Crossfit Merle Hay in Urbandale.

And I am terrified.

I can’t get a good handle on why. I know some of it rests with a fear of failure.

And if I’m honest, I’ve let nutrition and exercise slide in recent months.

That enthusiastic burst this summer faded in the fall and all but evaporated in winter.

This is true for lots of people who exercise and struggle with weight.

The holidays provide so many irresistible treats. The weather discourages activity.

But I’m in a funk and I won’t deny it anymore. Weight loss plateaued in October.

I’ve probably gained a few pounds because more fried foods, fatty foods and carbohydrates have found their way onto my plate and into my stomach.

No, that’s not the right way to say it. Food isn't animated. It didn't jump down my throat. It was me. I chose and chose poorly.

Even Mom 2.0, the kindly east Des Moines hairdresser who raised me after my first set of parents died, has had to scold me not to go for a third bowl of her delicious chili.

I haven’t made an appointment with my nutritionist, Jacque Schwartz at Mercy Weight Loss & Nutrition Center in Clive, since late November.

I put it off using the holidays as an excuse. The truth is I didn’t want to look at that number, because I knew it went in the wrong direction or, if I was very lucky, just stayed the same.

Jacque has again and again admonished me not to take my weight as the end all, be all of my health.

But I do. Everybody does. Thinner and leaner is better. Rounder and plumper is not.

So I’ve avoided going to see her because I’m afraid to face the number.

I know, I know. I should just suck it up and go and get back on track.

I should. And yet I don’t.

Because not knowing gives me a slim hope that I haven’t undone as much work as I think I have.

(And given my penchant for anxiety-driven self-flagellation, I’ve practically convinced myself I weigh more than I did when I started this process last March.)

I’ve enjoyed my work with physical therapist Stefanie Kirk at Mercy South Physical Therapy. She’s the best. She really is.

Aside from my talk therapist, I cannot think of a better relationship I’ve had with a medical professional in my life.

Stefanie has worked with me as much as possible on this transition from her clinic to Nate’s gym.

She went as far as to talk to Nate on the phone about what we’ve done, what I can do and where I need to improve.

She tries hard to convince me I’m in better shape than I feel. But my anxiety is stubborn even when controlled by medication.

I am afraid I am going to fail. I am afraid I’m not going to get any better and the slide to immobility will begin again.

This is the reality of the recovery. I’ve written about this many times: “Rocky” movies have montages. Life does not.

Right now, I feel like I’m playing the same note over and over again. It’s tedious. It’s tiring. I want to give up. I just want to roll over, pull the covers up and go back to sleep.

But Stefanie stares me down with her big brown eyes and reminds me I once couldn’t walk more than 156 feet without stopping because of pain.

Now I’m doing balancing exercises that weren’t even possible back in May when I discharged from physical therapy the first time.

I try hard to keep these positives in mind. But I have a mirror. And I don’t like what I see. And every little comment, even the ones by people I don’t know and shouldn’t care about, seems to hit like a punch.

I spoke to a fraternal group the other day. The first question from an audience member — the first damn question — was “how much do you weight?”

I answered, but I felt like an exhibit at a freak show. I feel that way more often than I’d like to admit.

I wish I could type inspiring paragraphs for readers every week with a smile on my face and joy exploding from my fingertips.

But that isn’t how this works. There are highs, lows and everything in the middle.

I’m in a low right now and have been for longer than I’d like to admit.

So I’m going to have to take some of my own advice. When you get low, you’ve got to ask for help.

Stefanie has taken me as far as she can. Now I turn to Nate and his skills.

And I’ll have to find the fortitude somewhere to keep moving forward.

WEDNESDAY, JAN. 13, 2016

TOUGH TALK

A reader wrote in to ask my advice on a delicate question.

I’ll pause for regular readers to stop laughing.

The reader carries a few extra pounds herself and has followed this blog as I write about my efforts to recover from morbid obesity.

She noted that a friend of hers is obese. The woman loses her breath walking from her desk to the restroom.

The reader wanted to know my advice for talking to her friend about the subject.

Well, that is dicey, isn’t it? The reader knew that.

“I know that when people would tell me that I needed to lose weight, it only saddened me — making me more likely to eat more,” the reader wrote.

I am afraid I don’t have very good advice here.

Obesity is absolutely a life-threatening health condition.

But unlike most diseases, it comes with a great deal of shame and scorn.

I don’t want to get into the victim culture debate when it comes to obesity. But no one blames someone who gets cancer for getting cancer.

Well, unless they smoke. I always find it odd and crude after someone dies of lung cancer to have someone ask, “Did he smoke?” If so, I guess he must have deserved to die.

Anyway, there is, of course, some measure of personal responsibility in maintaining a healthy weight.

But to argue that a person is obese simply because they overeat oversimplifies a complex disease.

And yes, I call obesity a “disease.” Because that’s what it is. The Centers for Disease Control and Prevention  agrees with me.

Obesity has roots in genetics, food portions, the chemistry of food and even trauma.

Sure, the No. 1 reason I am morbidly obese is because of overuse of my excellent hand-to-mouth coordination.

But the underlying causes: including a chaotic childhood and depression and anxiety conditions that I’ve written about here are just as important.

I overeat when I’m stressed. I binge eat to feel better. I make poor food choices when I’m anxious or depressed. These are all part of a holistic approach to treating the problem.

So the first bit of advice I’d give: Don’t assume obesity is just because the person lacks self-control.

The second thing, and this is very important, remember that the person knows they are obese, or at least fat.

Nobody ever had to tell me I was fat. I knew. I thought about it every time I saw a reflection in the mirror or a window.

I knew it every time my arthritic knees cracked and popped when I stood up or my embattled back cried out when I tried to shop for groceries.

And, as the reader noted of her own experience, when people brought it up to me, I just slipped into a deeper depression, ate more and was more self-destructive.

I had a good friend tell me point-blank that I was too fat and he was worried he was going to have to attend my funeral soon.

I knew it came from the heart and he meant it from the deepest part of personal concern.

I ignored him. I ignored the doctor who diagnosed me with Type II diabetes, too.

I only sought help with my body broke down to the point that I could not do my job and could barely function.

I don’t believe it has to come to that for everybody.

I do believe that everyone has to come to terms with their disease in their own way.

I would never discourage a friend from expressing concern over the health of another friend.

But be forewarned: Even if you do it in the kindest possible way, with the gentlest language or with blunt force honesty, there’s every chance there will not lead to immediate change.

So, yes, dear reader, talk to your friend about your concerns about her health. But take extraordinary pains to make sure she knows your words come from a place of love and not judgement and scorn.

Because believe me, she’s doing enough of that to herself already.

TUESDAY, JAN. 5, 2016

MOST IMPROVED

Nate Yoho was busy with a client when I arrived at his gym shortly before 10 a.m. Tuesday.

Nate owns Crossfit Merle Hay, located on the backside of the former Carlos O’Kelly’s restaurant in a strip mall south of the Interstate 35-80 bypass.

I took a seat on one of the barstools – still emblazoned with the defunct O’Kelly’s logo. I watched the action.

A woman easily taller than 6 feet jumped on a wooden box that looked to be about 3 feet tall.

The woman looked like an athlete. Her body size and shape reminded me of the late Missy Lange, a former Drake women’s basketball player who was 6-foot-4 whose former coach, Lisa Bluder, once described as “having the perfect body for basketball.”

The woman jumped on the box about 30 times. She didn’t grunt once. Her balance was impeccable.

She moved from the box jumps to deadlifting what appeared to be 225 pounds. She sweat, but she was in total control – strong, powerful and determined.

Behind her, another fit man was squatting on one leg in a balance exercise that looked nigh impossible to me.

My first thought, my only thought, was to get the hell out of there. This place was not for me. This was for fit people, not fat slobs who injure their back lifting 10-pound barbells.

Nate was a minor league baseball player. He was a real athlete. I was never a real athlete. I played basketball and baseball as a boy, but I was terrible. I just wanted to be on the team with the other guys. It was something to do other than go home.

I won “Most Improved Player” my sophomore year at Winterset High School. This is because I went from making zero of 10 free throws at the beginning of the season to four of 10 free throws by the end of the season.

Nate finished with his client and took me next door to a quieter room. His 2-year-old daughter, Caralyn, was with him. She ran around with adorable boots with animal faces on the toes.

Nate had kind eyes and a gentle manner. He shares the same gift of making a person feel welcome and at ease possessed by Mom 2.0, the kindly east Des Moines hairdresser who raised me after my parents died.

Still, I could not conceal my nervousness. I felt overwhelmed at the sight of the powerlifters next door.

Nate assured me.

“You won’t start there,” he said. “If anything, the first few days are going to be kind of easy. I would rather have that than you going too hard and getting hurt.”

Nate opened with a thorough interview. He wanted to know what kind of exercise I’ve been doing in physical therapy, how I hurt myself most recently and my comfort level with various stresses on knees, my back and so on.

Nate is good at his job. I can tell because when he talked, I actually believed I could do whatever he put in front of me. I feel the same way when I work with my physical therapist, Stefanie Kirk of Mercy South Physical Therapy.

Yet as I walked out to my car, I felt overwhelmed again. I was never, ever going to be powerlifting like those people I saw today. I remembered trying out for the East High School basketball team my junior year.

I was so slow in sprints that Coach Chuck Sutherland, after two days of tryouts, offered to let me be team manager. I was much better at taping ankles and handing out towels and Gatorade than playing sports.

I had a talk therapy appointment after meeting with Nate. My therapist asked me what I was so afraid of.

I said I was afraid of getting hurt and I was afraid I couldn’t do it.

My therapist said what I was really afraid of was embarrassment. He said I was focused on the wrong thing.

“Embarrassment is an emotion, not a measure of performance,” he said. “You’re right. You may never be able to do what those other people in the gym can do. But that isn’t the goal. The goal is to improve your health.”

I thought about this. He’s right. I’m not shooting for varsity here. I’m just trying to fit into movie theater seats and build up the strength and endurance for everyday life.

Come to think of it, “strength for everyday life” was a phrase Nate used.

So, in a few weeks, I’ll be at Nate’s gym. I’ll be the one in the back, covered in flop sweat and going about an eighth of the speed of everybody else.

But if everything goes well, I might just win Most Improved Player again.

THURSDAY, DEC. 31, 2015

RECLUSE NO MORE

I start work with personal trainer Nate Yoho, who owns Crossfit Merle Hay in Des Moines, as soon as I discharge from my latest round of physical therapy, which looks to be about Jan. 22.

I meet with Nate soon to look at his gym and talk about training techniques. The occasion will mark the first time we’ve met in person despite the fact that I’ve written four stories about him as both reporter and columnist.

Regular readers will remember the beautiful, tragic love story of Nate and his wife Laura. They met while working at a gym. They fell in love.

Nate’s proposal was so romantic a jewelry store later recreated it for a commercial. But Laura got aggressive brain cancer. She died in July 2013. Their daughter, Caralyn, was born in November that year by surrogate.

The story is easily the most heart-wrenching and beautiful I’ve written in my career. But I never met Nate.

The first time I wrote about him, I was on a tight deadline trying to beat the TV competition. The other times, though, well, that’s a little hard to talk about.

READ THE SERIES:

When I was writing about Nate, I was at the peak of my obesity: more than 560 pounds. I was having a real hard time getting around physically.

The walk from the parking garage to the office, about a block, was almost too much for me at the beginning and ending of my workdays.

Nagging and cyclic injuries often laid me up for days at a time.

So whenever possible, I did my interviews over the phone, even on stories as sensitive as this one.

There were many reasons for this. One was that I was afraid wherever I met people, there would not be a chair strong enough to hold my weight.

This was a real concern. Once I was at an assignment where I was sitting on a metal folding chair. It collapsed beneath my weight. I landed flat on my back in a room full of laughing school children.

There is a sort of slapstick humor to that, of course. Even I can see it.

But there is an underlying truth that is far more terrible: I was so ashamed of my body and appearance that I didn’t want to be seen.

That’s a horrible feeling to have.

Nate, for his part, was always kind to me. He actually wanted to meet me after one of the stories I wrote about him.

And I admitted to him something that I never told anyone: I was afraid to meet him because I didn’t feel worthy.

Nate is a guy who is doing life right. He was a pro baseball player in the Milwaukee Brewers system. He takes care of his body.

He married a beautiful, loving woman who shared his passion for fitness. He tended to her until her last moments.

And he dotes on their daughter.

I look at Nate and see all the things I am not, especially physically.

I don’t know why I opened up to Nate in this way. Like I said, we’d never met before in person.

But he trusted me with his intensely personal story about his wife and daughter. There was a connection there beyond the paragraphs.

Nate asked me some time ago if I was a recluse when I felt ashamed, even around the people I trust.

I did and I do. I never want the people I love to see me at my worst.

But that was a long time ago. I’ve lost 82 pounds since then. I can do things physically that I thought were impossible when I first spoke with Nate.

So finally I took Nate up on his offer to help me get fit. That’s what he does for a living at Crossfit.

And hopefully he will help me show myself and the people I love me at my best.

TUESDAY, DEC. 22, 2015

BAD MATH

I sat down at Jethro’s BBQ near Drake University for dinner with a pal last week.

I opened up MyFitnessPal, the smartphone application that I use to track my calories. A new feature popped up.

It allowed me to search restaurants in my area based on the GPS location of my phone.

This is a major development.

Since I began using the app, back in March when the weight-loss journey began, I’ve been forced to estimate the calories in foods at my favorite restaurants.

I eat out a lot, more than I should. This would, at least, provide me with a consistent baseline.

That was the good news.

The bad news was I was vastly underestimating the calories of several of my favorite foods.

Not all the restaurants in my area are on the app, but Jethro’s is. And a few of my favorites are heavier in calories that I figured.

This goes a long way to explaining the lengthy plateau in weight loss. I was guessing wrong and it was going against me. I was treading water instead of making meaningful strokes to the other side.

The truth is I’ve probably been blowing my calorie goal more often than I thought for months.

This was a frustrating revelation, but it is better to know than to constantly be wondering what is going wrong.

Once you know what’s going wrong, then you can make adjustments.

Speaking of adjustments, my work with physical therapist Stefanie Kirk at Mercy South Physical Therapy continues to go well.

I’d been sick with a fever and some gastrointestinal issues and missed our last session.

I don’t like missing appointments with Stefanie. No matter what my mood is going in, I’m usually feeling centered and sharper going out.

The rest was doing well. My posture has improved as well as my form in walking.

It is still a strange thing for me to think about so many different things as I walk.

Tighten the abs. Adjust the pelvis to a neutral position. Flex the gluteus muscles as part of my stride. Keep my hips steady and not swaying. Force my toes to point forward.

What a list to consider just to take a step.

But bad form leads to injuries and that leads to more setbacks. This plateau has gone on long enough. It feels too much like wallowing. It’s time to break through to the next level.

Holiday eating is always a challenge. I was frustrated enough with my plateau in November to skip one Thanksgiving meal with my Uncle Larry and Aunt Sharon and have a scaled-down, healthier offering with Parents 2.0, the kindly east Des Moines couple who raised me after my parents died.

I have two Christmas celebrations planned this season. I’ll have lunch – pork loin is the main course – with my parents.

My folks are watching their weight, too. Mom 2.0 is a type II diabetic like me, so she’s mindful of carbs and sugars in her offerings.

Mom 2.0 also will be cooking the meal for the other Christmas gathering, set on Dec. 28, which brings Dad 2.0’s side of the family to my folks’ stately east-side manor.

There will be more foods to avoid at that gathering than our Christmas Day festivities, but I think I’ll manage.

I find my appetite can be slaked by good helpings of foods that I like and are low in calories and high in nutrients. I just have to be mindful of portions.

But if the story MyFitnessPal tells me is true, then I’ve got a lot of work to do to get my diet changes back in order.

I eat out to socialize, either with friends or with the acquaintances I meet among bartenders and servers.

My girlfriend is changing jobs soon and that means she’ll be working fewer nights. We are committed to eating healthier.

The easiest way to do this is to make our own meals. I think it’s time I started putting my crock pot to use as well as my George Foreman Grill.

I’m sure there will be plenty of trips to Jethro’s, Tasty Tacos and other favorite haunts.

But now is the time to hunker down and get serious about this recovery. I’ve made great progress to be sure, but this isn’t the time to start feeling satisfied.

FRIDAY, DEC. 18, 2015

CHANGING DIRECTIONS

Anxiety precedes every visit to my primary care doctor.

This is not a reflection on Dr. Shawna Basener of Mercy Westown Internal Medicine Clinic. She is an excellent doctor with a terrific, upbeat attitude whose approach to medicine matches mine: The best medicine is no medicine.

Under her care, I’ve already shed an expensive cholesterol medication and a diabetic pill. In my latest visit, she encouraged me to drop an iron supplement because my blood hemoglobin numbers are strong.

Still, I get very worked up before every visit. I feel like going to the doctor is like going to the mechanic. She's going to find something wrong and it’s going to be very expensive.

The night before doctor visits, I’m rife with anxiety. I sleep fitfully if at all. I drive myself to the brink of a crack-up just to get a checkup.

The news came in mostly good. My A1C, the critical measure for diabetes, was down to 5.3, lower than my September visit. My blood pressure, the doctor said, was perfect.

But the weight, well, it was the same. Actually, it was up two-tenths of a pound. That’s such an insignificant number that it could be thrown off by how big a cup of water I had when I took my morning medications.

Still, I was discouraged. For nearly three months, I’ve been unable to move that number on the scale.

I know. I know. Plateaus are a part of weight loss. My nutritionist tells me that. My physical therapist tells me that. Social media commentators tell me that.

Still, I feel like I’m in a car that just won’t start.

My eating habits aren’t horrible. My blood work shows that. I’ve excised most sugars and carbohydrates from my diet. I keep to my daily calorie goal of 2,700. I’m usually much lower.

Injuries have hampered my physical activity. I reinjured my back going too hard on the elliptical machine at my gym. I went back to my physical therapist to get it worked on. She’s focused on form and balance.

This involves a lot of awkward retraining of my posture. Tuck the pelvis in. Tighten the butt muscles. Squeeze the hips. It feels silly and weird. But if there’s a person in this world I trust to get me on the right physical path, it’s Stefanie Kirk of Mercy South Physical Therapy.

Stefanie and I are going to be working through the end of the year and maybe slightly into the new year.

After that, well, I need to change my fitness routine in a significant and meaningful way.

My attitude toward exercise is soured. I don’t know if it is the colder weather or the rain and gray skies or simply apathy. But home seems so warm and comfortable and the gym seems so dull and uncomfortable.

Still, if this weight loss effort — and this column, for that matter — is going to be anything more than complaining about not having the mojo to exercise, I need to do do something different.

As soon as I’m discharged from physical therapy, probably in mid-January, I’m going to start working out with my friend Nate Yoho.

Regular readers might remember Nate from a story I wrote about him and his late wife, Laura, who died of cancer. Their daughter, Caralyn, was born by surrogate a few months after Laura died. It’s probably the most popular and touching story I’ve ever written.

Nate and I have kept in touch. He is a former minor league baseball player and fitness guru who owns his own gym. Several times, he’s offered to develop a program for me. I always turned him down.

I gave lots of lame reasons. But the truth was basic: I was afraid.

Nate is the real damn deal when it comes to fitness. The guy has arms like steel cable.

And, well, I’m a wimp. I was afraid I would get hurt or be embarrassed.

But these days, it’s pretty embarrassing to write once a week about how I haven’t really been exercising and I haven’t lost any weight.

So I finally took Nate up on his offer. 

To his credit, he’s got the same upbeat attitude Dr. Basener has when I visit her. So maybe I’m worried about nothing.

In a way, this is only fair.

Nate trusted me with the most intimate story of his life. The very least I can do is trust him to help in my ongoing effort to save my own life.

FRIDAY, DEC. 11, 2015

DEPRESSION SPECTER

I’ve lived with chronic clinical depression for a long time. 

The transcranial magnetic stimulation, or TMS, treatments I took under the direction of Dr. Eric Barlow at Compass Clinical in Urbandale seem to have done their job.

To recap, TMS uses magnetic pulses to stimulate the nerve endings in the brain to make them more receptive to mood-regulating chemicals such as serotonin. 

I took acute treatment five days a week for six weeks. I’m finishing the year taking maintenance treatments once a week.

I think it worked. I would like to declare it an unqualified success, but, like I said, I’ve lived with depression for a long time. I’ve had breaks in the blackness only to fall right back down that bottomless elevator shaft.

In real, measurable terms, I feel less depressed. And that, in itself, is a strange thing to feel. 

Sometimes I think depression is stalking me, just outside the periphery of my vision, waiting to strike if I let my guard down.

So far, that hasn’t happened.

Barlow is so pleased with my progress, he suggested we begin to taper my antidepressant medication and sleeping pills.

I am wary of this, but also excited.

The excitement comes from the fact that many antidepressants, including the ones I take, come with a side effect of increased appetite and weight gain. Since I’m fighting morbid obesity as it is, it would be nice to remove one of the obstacles, no matter how small it is.

But the wariness is great as well. I feel pretty good right now. Do I dare tamper with it?

In the short term, anyway, the answer is yes.

Not long after I finished the acute treatments, I noticed I was sleeping a lot.

Sleeping a lot is a behavior I associate with depression, especially the deeper varieties that include anhedonia — loss of interest in things that previously gave me pleasure.

I would put on a ballgame and sink into the recliner. I would be asleep in moments. Sometimes I would sleep for a few minutes. Other times, it was for hours.

The thing was, I didn’t feel low. I wasn’t in a “woe is me” mode. I was just sleepy and, on the positive side, so relaxed that I drifted off to sleep.

There are far worse fates than this, of course. But I wanted the lift of depression symptoms to correspond with a bit more pep. I love to read and when I was in the thick of the major depression episode, I couldn’t concentrate enough to stay with a story for more than a page or two — even a comic book.

And my exercise mojo seemed to have evaporated completely. If it weren’t for my physical therapist, Stefanie Kirk of Mercy South Physical Therapy, working on my posture and strengthening my bum right hip and groin, I wouldn’t be moving much at all.

So, Barlow and I consulted and we decided to halve my sleeping pill and drop my antidepressant down by a quarter. 

This has corresponded with a slight uptick in anxiety.

Unfortunately, TMS treatments don’t address anxiety directly. Anxiety and depression are two heads of the same mood disorder dragon. But the chemicals that cause panic attacks are different than those that cause depression.

So, I know anxiety is probably always going to be a part of my life. It’s something I’ll have to manage, like high blood pressure or cholesterol.

I am worried that the drop in my antidepressant is contributing to my anxiety. Then again, we’re in a chicken-or-egg argument, aren’t we? Is a lower dose of antidepressant causing more worry or is me worrying about a lower dose of antidepressant causing the worry?

I don’t know. The only thing I can do is stay the course. I show up for my maintenance treatments and meet regularly with Barlow to talk things over and keep the brain juices in a proper cocktail.

Hopefully, one day, I’ll stop looking over my shoulder for the bad juju of depression. 

But for now, I try to enjoy the relief, but keep one eye on the rear-view mirror.

FRIDAY, DEC. 4, 2015

BALANCING ACT

I lean left, but not in the way Register columnists are usually accused of.

Instead of a political sensibility, it is an issue of physical balance.

I favor my left leg. Much of the time I find myself standing with most of my weight on my left leg and my right leg dangling almost like a kickstand.

The lean may seem harmless enough, but it’s the latest focus of my ongoing effort to recover from morbid obesity.

I reinjured my back by taking on aggressive workouts at my gym. The setback frustrated my efforts to lose more weight, leaving me stalled for more than a month.

Further, it brought back the same pain – though not at the same level – that led me to seek treatment for the health issue in March.

I was happy to be working with my physical therapist, Stefanie Kirk of Mercy South Physical Therapy, again. But I was annoyed that I wasn’t able to keep healthy.

Stefanie, as she usually does, saw the problem right away: my butt.

Specifically, the gluteus muscles weren’t firing when I was climbing stairs or walking.

This was likely caused by bad posture I assumed when I weighed more than 530 pounds.

These are the small, harmful changes in your body that you don’t realize occur when you’re obese. You can see the fat. You mop up the flop sweat. You know your endurance is low.

One of the many things I really didn’t understand about my condition was how much damage the extreme weight was and continues to do to my physical structure.

Morbidly obese people make all sorts of adjustments to their posture and movement. They’re slight and almost imperceptible, but over time there are terrible consequences.

My bulging belly forced me to carry myself in a poor posture, which in turn changed my gait.

This wasn’t a problem when I was content to wheeze a few hundred feet to the car or mailbox and be done with movement for the day.

But when I started doing more walking outside and on the elliptical machine at the gym, the out-of-whack walking style caused my back to break down on me again.

The weight loss also has one negative side effect: My center of gravity changes with each handful of pounds that come off. That means my body is relearning balance on a regular basis.

Stefanie has me working on a variety of posture-improving techniques, strengthening my gluteus muscles and my hip flexors.

Since I’ve been so large for so long, one of the bad habits I’ve picked up is sitting with my hips splayed wide open. This is particularly acute when I’m driving my car.

Stefanie tells me the body has something called a neutral position, similar to a car transmission. However, my neutral positions are out of alignment with the center of my body.

My right hip – which I used to work the pedals in my car – is especially open.

This might all sound rather technical, but what it boils down to is that when you don’t stand and move the way the body was designed, you injure yourself.

This round of physical therapy with Stefanie is a lot different than my first. I was much more passive then. I just did what my physical therapist told me. I was happy to get any movement.

Now I’m trying to move the right way. It’s the difference between throwing a baseball casually with a buddy in the park and throwing nine innings for a major-league club.

I ask a lot of questions. And the physical therapy sessions are less sweaty endurance tests and more about the right form, concentrating on making sure the right muscles are firing at the right time.

I have a lot of problems with my hips. They dip and sway in the wrong way. Some days it feels like Stefanie is one of the censors on the old “Ed Sullivan Show” and I’m Elvis Presley trying to break all the rules.

Still, the constant correction is helpful. It feels awkward to concentrate on every step.

I have a list of things I’m supposed to do just when I walk. Tighten my abdominal muscles. Make sure my shoulders are back. Tighten the glutes, especially when I’m climbing stairs. Unlock the knees. Point my toes forward and force my hips to move in the proper direction.

I bet I look pretty silly watching my feet when I make a stride just to see if my toes are in the right place.

I don’t remember how old I was when I learned to walk, but I’ll likely always remember that at 40, I had to learn to walk all over again.

TUESDAY, NOV. 24, 2015

BRAIN BUILDING

I wrote a column earlier this month about how transcranial magnetic stimulation, or TMS, helped ease my chronic depression symptoms.

But I want to make an important clarification: I am not cured of depression. 

I’m not even in remission, which by definition is the absence of symptoms over a sustained period.

I feel fine, better than I have in a long time, but I’m not free of depression or anxiety. In fact, I still have quite a bit of anxiety in crowds and in social situations.

TMS is not meant to be a cure. It is, like prescription medications, a tool in helping rein in a sometimes debilitating health problem.

Depression and anxiety are controlled on two fronts. The first is medicine and treatments such as TMS. 

Those treatments address brain chemistry. Severe depression occurs when the brain is deprived of serotonin — the brain’s mood-regulating hormone.

A plethora of medicines exists to try to regulate this. Many of them are very effective. But my depression was treatment-resistant and my psychiatrist, Dr. Eric Barlow, suggested TMS.

TMS uses magnetic pulses to stimulate neurons in my brain, making them more receptive to natural levels of serotonin and other mood hormones.

And, so far, that feels pretty good.

What it did not do, however, was change my thinking patterns. As we grow up, our brain develops ways of dealing with the world. These are called schema.

A simple example of a schema is learning about a hot stove. At some point in your childhood, you probably touched the burner of a stove despite the warnings of your parents. The pain that resulted led your young brain to build a schema that said, simply, “Don’t touch hot stoves.”

But I had a chaotic childhood. Along with the more common “hot stove schema,” I developed some schemata to deal with the struggles associated with a mother who was addicted to prescription pain killers, suffered violent mood swings and memory loss, and had other boundary issues that I choose to keep private.

I developed schema to survive these situations. 

For example, if I recognized my mom was lashing out angrily, saying cruel things, I learned to keep quiet and make myself scarce, but a part of me believed my mother’s erratic behavior was triggered by me being a bad little boy.

This is a reasonable response to what seemed like a threatening situation as a boy. But as an adult, I have a job that often leads me into conflict with people.

Honorable people disagree, but sometimes, especially behind the veil of social media, unkind things are said and feelings are hurt. My reaction is often to either withdraw or lash out. 

And always there is a rush of self-loathing, assuming that I am still a bad person because of the flawed schema I developed under a now outdated set of circumstances.

Such self deprecation is not particularly helpful in fostering productive, civil dialogue.

So while I hope TMS has given me a long-term break from major depression, I still have plenty of mental health work to do with my talk therapist.

For example, when I was a boy, I often felt uneasy or nervous. My parents quelled this disquiet by giving me toys or taking me out to dinner at a fast food restaurant.

So the schema my brain built included thinking that the way to feel safe and loved is to buy things and eat. And, to a degree, that still works in that I get a serotonin rush from a buying spree or a food binge.

But it is not a particularly effective way to live as an adult because it drains my bank account and expands my waistline.

The work I’m doing with my talk therapist now is focused on building new schema. My therapist said you can’t remove an old schema. You can only create new ones.

This all seems rather technical, but the brain is a complicated organ. And I like that my medical team explains the science to me. 

Knowledge is power. I like the idea that I can take more control of how I think by understanding why I think that way.

There are still bad days. An incident arose just the other evening that had me on the phone with my therapist for a half hour. 

I was in a loop thinking I was a bad person. The truth was, I had run into an old thinking pattern triggered by a current conflict.

I was somewhat downtrodden that I was still struggling with these same kinds of thinking errors, but my therapist reminded me that I’m getting better at catching these moments when thoughts start with a relatively minor incident and then increase in awfulness until I’m nearly panicked.

And he reminded me that now that my brain chemistry is under better control, I can more freely work on better thinking.

That is very good news … I think.

FRIDAY, NOV. 20, 2015

GIVING THANKS

Thanksgiving is associated with overeating more than any other holiday.

And why not? Such a bounty of delights: turkey, stuffing, mashed potatoes, scalloped potatoes, sweet potatoes, cranberry sauce, green bean casseroles, pumpkin pies, pecan pies and, for the sadistic, mincemeat pies, and, of course, delicious gravy.

My mouth waters at the thought of a heaping plate with heavy dollops of everything and then some.

But I’m fighting morbid obesity. I’ve lost nearly 82 pounds since March. Nothing I could eat on Thanksgiving could undo all that work.

Still, my journey is long. I have 220 pounds to go before I’m outside the obese range. Thanksgiving poses a challenge for which I have no good answer.

I could attend a family event Wednesday night at my aunt and uncle’s Bondurant home. I could, as I did at my family’s annual July 4 celebration, map out what I was going to eat in advance and limit myself to that.

I could stick to the green veggies and salad and skip the pie altogether. My family would understand. They’re a good family like that.

I needn’t worry about them being uncomfortable at the chow line while I poke at a few slices of turkey, green beans and salad.

No, the problem is with me. I want to eat big and bad. And I don’t trust myself at the event. My family might remind me of my goals if I forget in a frenzy of pie, but I don’t want them to have to do that, either.

What I want to do is feel confident enough to eat sensibly at Thanksgiving or any other day. And the truth is I just don’t right now.

My weight-loss efforts have been stagnant since fall began. Plateaus are commonplace in weight loss. This one seems too long to me.

I have to admit my culpability in that. I eat out too often. Wings, which is fried food, are my kryptonite. I’ve indulged too often.

Meanwhile, injuries and a general malaise have stymied my exercise efforts. I’ve lost my workout mojo. Some of it is just plain laziness. Some of it is a cramped schedule the past six weeks while I went through an intense new treatment for my chronic depression and anxiety issues.

Regardless, I’m moving less and while I’m not necessarily eating more, I’m definitely not eating as well as I should be.

So this Thanksgiving, I’m taking a knee. I’m sitting it out. Parents 2.0, the kindly east Des Moines couple who raised me after Parents 1.0 died, and I will have a quiet dinner together Thanksgiving Day. My apologies to Uncle Larry and Aunt Sharon, but this year I’m won’t be at the table.

They’ll understand and I’m thankful for that.

In fact, despite recent foibles and the occasional unkind gripe from disgruntled readers, I’ve got a lot to be thankful for.

I’m thankful for my friend Gregg Lagan, the public relations man for Mercy Medical Center. He was the fellow who back in February offered me a wheelchair when I was covering a story at the hospital and was in so much pain from an injured back I could barely walk.

The injury was exacerbated by weight and his kind offer finally broke through that it was time I took my health seriously.

I’m thankful for my longtime friend Lew Jordan, who when helping me hang shelves in July 2014, stopped suddenly and looked me in the eye.

“I already lost (my dad),” he said. “I don’t want to lose you, too.”

He and his family, who live in Urbandale, have been some of my biggest cheerleaders on this journey.

I’m thankful for Stefanie Kirk, my physical therapist at Mercy South Physical Therapy on Southwest Ninth Street. During a recent visit, she asked me what I remembered about our first visit. I told her I remembered only being able to make one trip around the 156-foot track and hurting a lot.

“You looked at me and said, ‘Is there any hope for me?’” Stefanie said. “I knew I had my work cut out for me.”

I can’t see the changes in my body, the improvements in my strength and stamina. But Stefanie does. She points them out at every opportunity. I am beyond grateful that fate put me in Stefanie’s capable care. Every step I take without pain, I attribute to her guidance.

I’m thankful for Dr. Eric Barlow, my psychiatrist, who encouraged me to try transcranial magnetic stimulation for a longer-term solution for my treatment-resistant depression.

I’m thankful for my psychologist, the talk therapist who asks not to be named because of the sensitive work he does with law enforcement. He’s taken many emergency calls from me well after midnight and always settled me down. I am forever humbled by his insight, humanity and skill.

And, finally, I’m thankful for you, readers. This journal is not an easy thing to write. A longtime Register reader and former school board member railed against it on social media the other day. He decried it as fluff that squeezes out hard news before ranting about the decline of the Register.

It’s true. This story is about my personal journey, but it’s hardly just about me. Nearly 35 percent of Americans are obese, including more than 1 million in Iowa, according to the U.S. Department of Health and Human Services. The prevalence is highest among middle-aged adults 40 to 59.

But it’s more than just numbers. I’ve received 2,119 positive emails from readers since I began writing a column for the Register in November 2014. (I didn’t save the negative ones.) The overwhelming majority of them were about Making Weight.

I’m just a guy who wants to stack paragraphs as long as possible. To do that, I’ve got to confront the biggest challenge to my ability to do that outside the business itself: my weight.

Writing about it has touched a lot of lives. That’s what people tell me in message after message, in letters and phone calls. I’m especially pleased when a reader says they’re not obese but these writings have changed their minds about how they think and talk to their obese friends.

Readers often tell me they’re thankful for this space because they see themselves or someone they love somewhere inside the struggle.

I, in turn, am thankful for each one of you. Your encouragement, your stories and your kindness inspire me beyond description. Oh, there are bad days when somebody says something that really hurts my feelings. That’s going to happen in this business because sometimes, probably too often, I say things that make people angry or hurt their feelings.

But there’s only one option when one of us has a bad day: Get up tomorrow and try again.

FRIDAY, NOV. 13, 2015

JUST DAYS

A reader who apparently isn’t a fan of these writings called recently and described this ongoing journal of my efforts to recover from morbid obesity as “tedious.”

Tedious means “boring, long and slow.” The word is hardly a compliment, but I think the reader picked the perfect word to describe this journey.

People like narratives that have a clearly defined beginning, middle and end. Fiction is often kind to us that way. There is a conflict and then a resolution.

Life, however, is rarely so neat and compact. Life is routines. It is two steps forward and one step back. It is rinse and repeat. It is, in a word, tedious.

And this health journey is very much tedious. Maddeningly so.

Sometimes it feels like I’ve gained and lost the same 10 pounds for two or three months.

In the beginning, way back in March, changes were fast and swift. I would lose 15 or 20 pounds in a month. Every visit to the nutritionist’s office felt like hitting a home run.

I was a rookie in the weight loss game then. I thought every time I stepped on that scale I would see a smaller number.

And I thought it would be easy to keep eating tuna fish on mixed greens and guzzle gallons of water or tea instead of pop.

Physical therapy was going well. I got stronger. I thought once I strengthened my back muscles, I would be off and running, burning off pounds in big chunks every trip to the gym.

But no. That isn’t how this works.

There is, in fact, a great deal of tedium to the whole thing.

I haven’t lost my mind and gone back to eating massive portions of sugar and carbohydrates. But I’ve eaten pizza and pasta. I still eat too many fried foods.

I’m under my calorie goal most days. But some days I break it.

Exercise has been much the same way. I make great strides. Then I get injured.

It happened in the summer while swimming when my body was too exhausted to move after too many consecutive days working out in the pool.

It happened again earlier this month when I pulled a muscle in my back. I also pulled a muscle in my groin and am limping through some foot problems.

Injuries tend to happen when I try to do too much too fast. Injuries are the worst. Because the illusion that I can somehow speed up this process blows away like so much magician’s smoke.

And the reality of it sets in. Everything slows down. I may want to sprint, but this isn’t even a walk. This is a crawl.

Again, more tedium.

And I know I’m not alone from the scores of readers who’ve written me since I started this journal in March. We all want the same thing. We have a goal we want to reach, but it seems so far away that it’s overwhelming.

Every hiccup on the way is frustrating and when a few problems collect at one time, we think all the progress we’ve made is going to unravel.

For me, I’m haunted by the specter of an “after” picture.

You know, like the TV commercials for weight-loss products. There’s a grainy “before” photograph of someone overweight or obese.

Then you see the “after” with the person muscled and tanned wearing sexy clothes.

All it takes is 30 minutes a day on a machine that costs as much as car or daily doses of magic beans not evaluated by the FDA.

But those are pleasant little fictions. In the reality of weight loss, there aren’t any shortcuts — even gastric surgery, which is a life change so seismic I refused to try it.

There are only long, slow and, yes, tedious marches with successes and stumbles peppered in with many days when nothing spectacular happens at all.

There are good days. There are bad days. But mostly there are just days.

I want that “after” picture more than anything. Actually, what I want is to restore my “before” picture.

I have this image of myself from my sophomore year in high school, with a full head of hair and trim waste. I used to jog then. I lifted weights. I played basketball and baseball. I was the fittest I’d ever been in my life.

That’s the picture I want to show people today, minus the full head of hair, because there are some things you can’t undo.

And maybe I will get there someday.

But it isn’t going to be any time soon. Because when you’re on a journey like this, you really have to take every step, even the ones backward.

FRIDAY NOV. 6, 2015

SETBACKS

Perhaps my favorite part of “Rocky” movies is the montage.

This is the moment in each of the umpteen films in which Rocky gets into shape for the big fight. A ripping pop tune blares as Rocky pounds hanging meat or drags a dead tree in the snow.

After a few minutes, training that takes months is finished and Rocky is ready for the ring.

There are no montages in real life, unfortunately. Despite my favorite music thumping in my ears during every workout, I’ve not found the right collection of songs to speed up time to go from morbidly obese to something approaching fit.

This, however, has not stopped me from trying to go fast. And while there’s nothing wrong with pushing my limits — in fact, it’s a required part of the journey — this also can be problematic.

I mentioned that overdoing it on the elliptical trainer and treadmill led to some plantar fasciitis in both feet. A walk with a sock wrinkled in just the wrong place left blisters on my right foot that are still healing.

These nagging problems let me to take it easy on cardio, still trying to naturally walk more than a mile a day, but not hitting the machines as much.

I switched to strength training. Now, as I’ve said before, I’m not looking to become a beefcake. I’m just working to look less like a wedding cake that’s slid off the table.

But even in weights, I pushed too hard. And I probably didn’t use proper form, which is critical when lifting weights, even light ones.

The result? I re-injured my back in the same place that I hurt it when this journey began almost a year ago.

Now this injury is not as crippling as it was in early March, when I started physical therapy. But it is sore. My back stiffens when I sit for even short periods.

I use the stretches I learned in PT to limber it, but there’s definitely an injury there. I tried the elliptical machine at the gym. I went at a moderate pace, covering 2.3 miles in 35 minutes. If I really push, I can hit 2.6 or 2.7 miles. My goal has been 3 miles in 35 minutes.

But the last time I went to the elliptical, I started to get spasms. I gritted through the workout, but when it ended, I could barely step off the machine.

I walked out of the gym sore — and not the good kind of sore. I was hunched over as I walked out to my car. My back was really barking.

I tried the usual remedies: heat and ice. I was mindful of how I sat. 

I took a break from the weights in hopes it would heal. 

But after the elliptical incident, I decided I needed some outside help. Fortunately, I got a lot of that.

I called my primary care physician, Dr. Shauna Basener at Mercy Westown Internal Medicine. She referred me back to my dear friend Stefanie Kirk, the physical therapist from Mercy South Physical Therapy who got me on the healthy path.

And while a part of me is excited to see Stefanie again, I would prefer it be under better circumstances.

Still, despite the setbacks, I remain optimistic. My calorie counts have been at goal or under most days. Oh, there are flaws in my food choices to be sure — too many fried chicken wings and not enough green vegetables — I’m still in such a better place than I was in March, when the journey began in earnest.

So I’ll work through a few appointments with Stefanie. She’ll get me fixed up. We’re going to work on the injury first and then take a look at the form I use to lift weights.

I’m pretty sure I’ll be back on the elliptical and hefting iron in short order.

But not as quick as a “Rocky” montage.

FRIDAY, OCT. 30, 2015

NEW METRICS

Sometimes it takes walking the same path to remind yourself how far you’ve traveled.

I’ve been pretty dumpy about my efforts to recover from morbid obesity since I hit my first weight-loss plateau about a month ago.

I was practically hysterical when I nudged up a few pounds while in the midst of a major depression episode in early October.

Then a string of minor but annoying injuries slowed my cardio workouts at the gym. Blisters on my right foot and other nuisances forced me to take more rest than I wanted.

I’m always afraid if I take a break I’ll never get started again. It’s irrational, I know, but such is the nature of fear.

For the last week or so, I stuck to light weightlifting at home. I hate to lift weights. It’s dreadfully dull.

And I’ll be frank, it’s kind of embarrassing. My arms shake like flags in a swirling wind when I do repetitions with 10-pound dumbbells.

I work out at Drake University’s Bell Center. There are young guys in there tossing around 25- and 50-pound free weights like they were cans of pop.

And then there’s monstrous old me grunting to do two sets of 15 with the wimpy weights.

This is why I never lift weights at the gym. I’m no beefcake and I don’t want those who are to hurt themselves laughing at me.

My physical therapist, Stefanie Kirk of Mercy South Physical Therapy, always harps on me to do some weightlifting exercises. It works the upper body muscles that don’t get as much challenge as my lower body during cardio workouts on the elliptical strider.

I usually do what Stefanie tells me, even if I complain the entire time. She’s like an editor that way.

Thursday night, the blisters on my feet had mostly healed and other annoyances had abated. I decided to go for a short walk from my apartment at 23rd Street and University Avenue to the Jethro’s BBQ restaurant at 31st Street and Forest Avenue for a late dinner.

I cut through the Drake campus. I like to do this from time to time. As I get older, I find I have two sets of eyes. One set sees my city as it is now, cleaner, shiner and brighter. The older eyes remember buildings long gone, pathways that have been replaced and students without earbuds hanging from their lobes.

My present eyes marveled at the improvements made to the aesthetics on Drake's campus. It’s lit more brightly than I remembered.

The walkways between Hubbell Dining Hall and Meredith Hall are smooth and even. When I was a student more than 20 years ago, they were pock-marked blacktop.

My old eyes remembered ramshackle houses where Drake West Village now stands. And so on.

But my memory didn’t have to stretch back too far to remember a different me walking this same distance back in March.

I’d pledged to meet some friends at Jethro’s and decided to walk. It’s about three-quarters of a mile on foot cutting through campus. I had just begun my recovery and progress was slow.

I remember scanning the pathways for places to sit along the way. And I took advantage of every single one I saw. I walked a few hundred feet and then sat down, covered in sweat on a cool day, drank heavily from my water bottle and then waddled on for a few more steps.

The walk took almost an hour. I was late for dinner. My shirt was sopping wet. I was completely out of breath.

My friend offered me a ride home. But, like I said, it was early in my recovery. I was too fat to squeeze into her tiny car.

So I was forced to walk back. It took me longer to get home. I was afraid I was going to have to call someone to pick me up.

By the time I was finished, I had two calf muscles that were throbbing, on the verge of being pulled. My thighs burned. My hips screamed. I was thoroughly defeated.

But my new eyes noticed something different on my latest walk. I was covering the distance with ease. I climbed a short flight of stairs without having to do it one step at a time.

I managed the uneven ground with little trouble. I made the distance in a little more than 15 minutes. I wasn’t breathless when I took my seat at the bar. I was a little sweaty, but that’s to be expected when I’m wearing my winter coat on a cool autumn night.

I ate my dinner and walked back home, again with no trouble.

This felt terrific. Since weight loss stalled, I’ve been trying to find other metrics to mark progress. Retaking that path eight months into my recovery was an important reminder that even if the scale isn’t reflecting the change I want, there are real, substantive changes to my quality of life.

Oh, and about that scale. I went to Mercy Weight Loss Center in Clive last week to get a new measure. I was down 7.1 pounds, bringing the tally lost to slightly more than 80 pounds since March.

This is winning.

FRIDAY, OCT. 23, 2015

INDELICATE INJURIES

Well, this is going to be awkward.

Here at Making Weight, I’ve sought an open, honest and raw discussion of everything related to my ongoing recovery from morbid obesity and efforts to contain mood disorders of anxiety and depression.

But, dear readers, I tell you that it’s a lot easier to write about crushing depression or struggling with cravings than the topic I’m about to address.

So, this is your last chance, oh ye of faint heart. Look away and come back next week. Because here forward, we’re going to be treading across uncomfortable territory.

OK, here’s the problem: My butt hurts.

Finished laughing? Because I assure you this is not as funny as it reads. I write this column perched atop an extra pillow, which is capped with an icepack.

The condition is called coccydynia. That’s the fancy way of saying tailbone pain. The ailment is relatively rare and affects women about five times more often than men. It’s often related to post-childbirth symptoms.

I, of course, haven’t given birth to a kid. But I have lost a lot of weight. And the shape of my body has changed. With those changes come different distributions of fat.

In short, I’ve lost some weight in my butt and I’m sitting on my coccyx in such a way that is giving me a real pain in the rear.

The pain is actually worse when I stand from a sitting position.

The good news is there are plenty of non-invasive treatments, including icing and heat and stretches and exercises.

I note this somewhat comical trouble because I seem to be running into a lot of them lately. They’re all minor but highly irritating and frustrating.

A long walk outside wearing some new socks inside my shoes led to a nasty blister on my right foot, complete with a mess of loose skin in the pad of my foot.

The pain would be enough to hobble me, but I was already limping because of a flare-up of plantar fasciitis. That’s a condition in which my arches and heels hurt like heck because the tendons tighten up after inactivity.

The plantar fasciitis eases when I roll the arches of my feet across a tennis ball to stretch out the tendons. It’s not perfect, but it helps. I still find myself hobbled after a long period sitting.

The slightly more embarrassing condition I’ve picked up is a case of tinea cruris. I’ll let interested parties search Google for what that really is.

For polite conversation, let’s just say it’s similar to athlete’s foot, but in a different area of the body.

Tinea cruris is easily treated with some spray and powder treatments. But it sure is irritating.

All of these issues can be linked to my more intense attacks on walking at the gym. I’ve been aggressive on the elliptical trainer and up until the series of troubles described above, I was making good progress.

I was covering more than 2.6 miles in 35 minutes at medium resistance and incline.

But, as is often the case in recovery, I tried to do too much too quickly. My feet rebelled. My rear got out of gear. And so on.

All this is minor stuff, really, but it is frustrating. I always want progress to be a straight line forever angling up to infinity.

I guess I’m like Wall Street speculators who expect every stock to double its profit every year.

But that isn’t how it goes. There are setbacks and, worse still, stalls.

I’ve been stalled on weight loss for about a month, maybe more.

And now I’ve hit kind of a wall in progress on my cardiovascular training. My body is tired and sore. It’s asking me to take it easy for a bit.

This happened to me once over the summer. I was aggressively swimming nearly every day. Then for about two weeks, I just couldn’t get my body to perform. I felt drained and tired all the time. It just wouldn’t recover.

Eventually, the moment passed. I’m sure this will pass, too.

For now, I’m concentrating on strength training. Doing more work with free weights as my physical therapist recommends.

I always put it off because lifting weights is dull. Still, better to choose a dull exercise over no exercise.

Last week, I took a walk outside. Outside walks are harder than treadmills or elliptical. The terrain is uneven. The climate changes how you dress and react. It’s more difficult to keep a consistent pace.

Some evenings I walk from my apartment at 23rd Street and University Avenue to a friend’s house off of Kingman Boulevard slightly more than 2 miles away. It takes me about 40 minutes.

When I get there, my friend gives me a ride home. The last time I made this walk, the blister on my foot was barking. My left calf felt like it might pull at any second.

I could never quite get comfortable in my pace or frame of mind.

Still, I traversed the distance. I turned down my friend’s street and noticed the diamond “DEAD END” sign.

I paused, sore and irritable, and considered the philosophy of the sign over its more practical application.

Dead end? I thought. Not if I can help it.

FRIDAY, OCT. 16, 2015

TUNING IT OUT

I don’t like to exercise. People tell me they get a rush out of it. I get sweaty and sore.

Oh, don’t get me wrong. I understand the importance of exercise in my ongoing efforts to recover from morbid obesity.

And exercise definitely has improved my life. I’m stronger, more mobile and more flexible because of the exercise regime that began under the guidance of Stefanie Kirk at Mercy South Physical Therapy this spring.

But I still don’t like it. Well, that’s not fair. I like it when it’s over.

I also like where I exercise: Drake University’s Bell Center. The school offers alumni memberships at a modest fee. I bought one.

I like going there. It reminds me of younger days, covering the Drake women’s basketball team coached by Lisa Bluder. Those were some of the best days of my career.

I worried that the younger, fitter students would wonder what this old bald fat guy was doing in their workout room. I needn’t have. They don’t even notice me. Most of them wear earbuds while they lift weights, use treadmills or other equipment.

A few text while they’re on treadmills, which is a talent I admire. If I tried that, I would stumble on the treadmill and be thrown into the cinder block wall and end the whole thing with a severe head injury.

I have gone native in one respect: I listen to music while I work out. I’ve put together a play list that allows me to think that I’m anywhere else but atop an elliptical strider trying to get another .01 miles on my 35-minute tally.

Here’s a look at my a few songs off my playlist and what goes through my mind during a workout.

1. “Not My Idea,” by Garbage. Shirley Manson sings a line that I think sets the perfect tone for me and exercise: “This is not my idea of a good time.”

2. “Silent Running” by Mike + the Mechanics. Mike Rutherford asks, “Can you hear me running?” Of course you can. The wheezing and groaning is the giveaway.

3. “Tales of Brave Ulysses” by Cream. The line “And you touch the distant beaches with tales of brave Ulysses: How his naked ears were tortured by the sirens sweetly singing” feels a lot like the torture my hells go through with ever step on that dreaded machine.

4. “Wildest Dreams” by Taylor Swift. I’m a Swiftie. I’m not ashamed. This is my favorite ballad of hers. Thinking about Taylor Swift for 3 minutes, 40 seconds beats thinking about how much more time I have on the machine.

5. “Batdance” by Prince. This is a nostalgia trip for me. My summer of 1989 was obsessed with the “Batman” movie starring Michael Keaton and Jack Nicholson. I’ve probably watched that movie more than any other in my lifetime with the possible exception of “The Big Lewbowski.” I use the 6-minute album cut to kill more time during the walking with pop culture memories.

6. “Sparks” by the Who. This instrumental track comes off their “Tommy” rock opera double album. I like a good instrumental track now and then. This one distracts me from the buzzing noise in my head that screams, “My God! Is that clock moving in reverse?! When will this end?”

7. “The Joker” by Steve Miller Band. This track doesn’t really pump me up as much as it does remind me of a high school crush from my Winterset days. I love that line, “I really love your peaches, want to shake your tree.”

8. “Kyrie” by Mister Mister. This song, which usually ends my 35-minute workout, was a big hit when I was in middle school. Up until about 2002, I thought the lyrics were “Carry a laser down the road I must travel.” Now, that’s laughable, but I grew up in the era when Han shot first.

The real line, of course, is “Kyrie eleison, down the road I must travel.”

Kyrie eleison is Greek for “Lord, have mercy.”

Coincidentally, those are the exact words I use when the workout ends.

THURSDAY, OCT. 8, 2015

UPS AND DOWNS, PART 2

I visited Mercy Weight Loss and Nutrition Center on Wednesday for the first time since late August. I took a break from focusing on weight loss to spend time preparing for some ongoing depression and anxiety treatment.

I didn’t stop dieting, though I probably ate more fried foods and carbs than I would have liked. I few sugars slipped in there. 

I blew my calorie goal a few times, but not nearly as many times as I felt like blowing it — which was every day in the grind of this major depressive episode.

It was just a quick pop in to get my weight. I stepped on the scale. Damn it all, I was up 5 pounds.

I actually pounded my fist on the table, which startled poor Jacque Schwartz, the nutritionist who has been shepherding my weight loss efforts.

Jacque, as she always does, tried to be comforting. There were good numbers in my body metrics readings, she said.

The percentage of my body that is fat dropped from 47 percent in late August to 42 percent at my most recent weigh in. 

My fat mass dropped from 228 pounds in August to 206 pounds.

There were a couple of mitigating factors, too. I had just come from lunch, during which I drank several glasses of diet soda. The weight of the food and the hydration played into the weight, Jacque said.

But all I saw was the number 489, five pounds greater than I was more than six weeks earlier. 

I had hoped I had lost. In fact, I was hoping to fall to 463. That would be an even 100 pounds since I began this journey more than 200 days ago.

And in a practical sense, it didn’t make sense. My clothes were looser. I have to tighten my belt — my new belt — to the second-to-last notch to get much good out of it.

When I stand naked in the shower — and don’t hold that image for too long, because I wouldn’t want to — my arms fall flatter against my sides.

My friend Jessica points out that my belly used to extend higher when I sat in the driver’s seat of my car. 

And I finally stopped using the seat belt extender because I didn’t need it anymore.

Still, the scale was unyielding: I was 5 pounds heavier. And I wasn’t coping at all.

I skulked back to my car in a fit. I was somewhere between punching something in disgust and crying.

I was already wrestling with acute depression. I felt a nasty spiral coming on. 

Spirals are brutal. Essentially, one bad thing happens — or at least something I perceive as bad — and I connect that to every mistake, every negative comment someone makes about me (and in this job, there are plenty) and every awful thing I secretly believe about myself.

By the time the persistent negative thoughts take their toll, I’ve convinced myself I’m utterly worthless as a human being.

I called my mental health therapist. He was assuring, as well. We ran through the things that are actually going well.

I’m exercising a lot at Drake University’s Bell Center. The first few weeks, a mile in 30 minutes was a struggle. I’m up to 2.2 miles. 

I’m doing more walking over uneven ground. My balance is improving. I am stronger, more agile and it’s easier for me to get up and down from a sitting position or on the floor.

And I don’t hurt all the time, the way I did back when I first sought help. My back aches now and then, but it’s not debilitating. 

My heels hurt, but my physical therapist, Stefanie Kirk of Mercy South Physical Therapy, suggested some stretches that have all but wiped that out.

“You’re looking thinner every time I see you,” my therapist said.

I told him other people tell me that, too. But I don’t believe it.

Because I can’t see it. I see that number that’s bigger than I want it to be. I look in the mirror and see flaws.

I look at pictures and see my massive gut. I feel like I’m trapped in this monstrosity of a body.

“So everybody is lying to you?” my therapist said.

I admitted that they probably weren’t.

My therapist said I needed to change my thinking about weight loss. I needed to shift my emphasis from all on body weight to other, tangible gains.

The belt loops count. Dumping the seat belt extender matters. Feeling my arms closer at my side is a win. The strength and cardiovascular gain from exercise is important.

Still, that number loomed in my thoughts, souring all those things. I still felt like a fat creep.

That’s the thinking I’ll have to change, my therapist said.

And that may well be harder than any pound I’ve lost.

MONDAY, SEPT. 21, 2015

GETTING BETTER

I haven’t been doing so well lately. It’s not so much the diet and exercise, though those are steadily listing into the so-so category.

About a month ago, I fell into a deep depression. This is a difficult sensation to describe to people who haven’t gone through it before.

I think a lot of people think depression is the same as having the blues, a kind of general melancholy that comes along on rainy days, or perhaps a bit of personal strife.

Melancholy is a good day for someone who suffers from depression. As for personal strife, I tend to be very good in a crisis.

But depression is a black, brutal, cancerous thing that erases all hope and turns your mind against itself.

When I struggle with major depression episodes, I hate myself.

And I’m using the word hate intentionally. I am completely incapable feeling good about myself.

Some years ago, a colleague of mine at the Indianola newspaper wrote a story about a woman who went skydiving. Her parachute didn’t open, but she survived with a fractured skeletal system.

That’s about as good a metaphor as I can come up with for how it feels to be in the jaws of major depression. I just feel completely broken.

This affects everything.

It affects my work. It affects how I spend money. It affects how I eat and my desire to exercise.

This bout with depression comes at a dangerous time. I’ve slid back up on the scale a few pounds.

This is a source of great anxiety for me. But the temptation to plow through pizza and nachos at top speed is strong.

So far, I’ve kept my calories mostly in check. I’ve edged above my 2,700-calorie goal a few times in the last month.

But the way I feel, the fact that I can stay in the neighborhood is victory in itself.

I bought an alumni membership to the Drake University Bell Center. I’ve slogged away on a treadmill three or four days a week since then.

My non-depressed friends tell me exercise makes them feel great. They see it as a cure for depression.

I find that I’m depressed. I’m depressed and exercising. Then I’m depressed and sweaty.

But at least I exercised.

And that’s going OK. Two weeks ago, when I joined the gym, I could walk a mile in about a half hour.

Now I make more than 1.6 miles in the same time. The treadmills raise and lower to give a hill effect for extra challenge.

But I’m still sick. Any boost of endorphins I get from the exercise fades before I reach my car. By the time I get home, which is only about four blocks from the gym, I’m back to negative thinking and self-loathing.

To that end, I’m going to try something new. After consultation with my psychiatrist, Dr. Eric Barlow of Compass Clinical Associates in Urbandale, I’m going to try transcranial magnetic stimulation, or TMS.

Scientists believe the area of the brain where depression “lives” is a spot on the left frontal lobe. TMS is a treatment that uses magnets to send pulses to that portion of the brain. The pulses ultimately retrain the neurons to accept normal levels of chemicals that create even moods.

The procedure is non-invasive — no incisions. It’s all done outpatient.

It was first approved by the FDA as a depression treatment in 2008. The type of treatment I’ll be receiving was approved in 2013.

There aren’t many long-term studies on the treatment because it’s so new, but evidence suggests clinically significant improvements in about 45 percent of patients and total remission in about 33 percent.

That’s a nearly 80 percent chance of feeling better. What’s more, my doctor says he’s had patients taper off their regular medications.

It’s almost impossible for me to imagine life without a handful of pills to swallow every night.

The first appointment takes about an hour. The follow up appointments take 20 minutes.

I go five days a week for the first round and then once or twice a week for follow up appointments. I start Oct. 6.

I’m going to write about it for The Register. I’ve been about as open as a person can be my health struggles.

One of my hopes is that it takes the shame and stigma out of seeking treatment for both obesity and mental health struggles.

But first I’m going to take some time off. I’m going to rest up and try to relax.

Because right now, I’m really grinding. I’m raw. I'm emotional. I’m foggy. Sometimes moment to moment.

I’m not myself right now, and I don’t particularly like the person I am. I’m picking fights on social media.

I’m saying bombastic and mean things just to get a rise out of people. That’s not who I am. And that isn’t who I want to be.

I won’t blame all my recent curtness, rude behavior and other social gaffes on my depression jag. Sometimes I make bad decisions.

Social media is like having a stenographer for every dumb thought you’ve ever had.

But for the next couple weeks, I’m going to draw inward. I’m going to shut down my Facebook account and delete my Twitter app from my phone. I’ll be back to work Oct. 5.

I’d planned to take a 10-day vacation at the end of October. I’m just moving it up a few weeks to hopefully mellow out before TMS.

Thank you in advance for your understanding and kindness. I’ll be back soon.

FRIDAY, SEPT. 11, 2015

FISH OUT OF WATER

The water was still in my apartment complex’s pool as of this writing late Friday, blue and inviting behind the locked black-painted iron gates.

The loungers were already packed away for the season. Alan, our maintenance man, pulled the tarp out from storage.

Soon he would drain half the water in the pool and a company would “winterize” the remaining water to prevent pipes from freezing.

As much as I hated to admit it, summer was gone, if not technically on the calendar certainly as it comes to the activity of swimming.

A melancholy mood filled me. Much good exercise was accomplished in that pool since late May. I swam more this summer than I ever have in all my 40 years.

My late father would be astonished. As a boy, I was terrified of deep water, certain I would drown. I faked illness to avoid swimming lessons so often he finally gave up.

Yet that pool was a lifesaver in my ongoing efforts to recover from morbid obesity. It’s shuttering for the winter, though anticipated, brought some anxiety.

Few exercises burn as many calories as swimming. I did not swim everyday this summer, but I swam most of them. I took off as many as three or four days in a row, but never a full week.

My mobility in water and on land tremendously improved. My left quadriceps were weakened by the back injury that led me to seek treatment for my obesity. For a long time it felt as if I was going to fall when I walked downstairs.

But after a summer in the pool, I can manage stairs just fine. Oh, I wouldn’t want to live on the fifth floor of a walk-up building, but I could make it if I had to. That in itself is major project.

Next to my magnificent physical therapist, Stefanie Kirk of Mercy South Physical Therapy, the pool was the most important factor in my improved physical health.

It closed at a particularly vulnerable time. My dieting had been going poorly. I’ve been overeating and dabbling in too many fried foods, breaking my calorie limits and not as enthusiastic about exercise as I need to be.

I find myself drifting to foods that I easily avoided at the beginning of this process. Oh, one plate of nachos won’t hurt, I tell myself. But then it’s nachos one day and wings the next and before long, a week has gone by and more food is coming in than calories being burned.

I was very upset when my weight loss plateaued so dramatically at the end of August. And as if summoned by the psychic weight of that, a wave of hellish depression and anxiety hit that led to medication adjustments.

In truth, it has been a lousy three or four weeks both physically and mentally. And now the pool is gone.

Thursday was another bad day on the calorie count. I over-indulged on a boneless wings special at my favorite barbeque restaurant.

The battle of obesity and mental illness at the same time is a vicious assault on my sensibilities on two fronts. The chemical imbalances in my brain that caused the depression and anxiety are offset by endorphins and serotonin.

The medication I take usually keeps this balance in order. But when it fails, as it sometimes does, I feel driven to do just about anything to feel something other than miserable and terrified.

I usually resort to one of two things: buying things I don’t need with money I don’t have or overeating. In this case, I ate too much. This, of course, intensified the depression and anxiety because I fear climbing back above 500 pounds and losing the ground I have gained.

My psychiatrist has adjusted my medication and late Thursday, I started to feel more like myself. I drove up the street to the Drake University Bell Center, which houses the recreational facilities for students, faculty and staff.

The school offers memberships to alumni at a nominal fee. I paid for the semester. After my wing indulgence, I climbed the stairs to the indoor track in my street clothes and tennis shoes.

Seven and a half laps equal a mile.

I pushed my earbuds in and cranked up some Taylor Swift. It took me 26 minutes, but I made slightly more than a mile. I was sweaty and tired.

But for the first time in a few weeks, I felt like I was moving in the right direction.

FRIDAY, SEPT. 4, 2015

BIG QUESTION

Herb Strentz invited me to speak to the Golden K Club, a division of the Kiwanis Downtown Club for retirees interested in community service and volunteer work.

Herb was one of my journalism professors at Drake University. He told me not to prepare any remarks and just take questions from the audience. I did just that because if there’s anything I learned in college, it’s that if the teacher tells you there’s no homework, don’t question it.

It was a spirited and wide-ranging discussion. The topic of these columns about my ongoing efforts to recover from morbid obesity came up.

One man asked: “I’ll take it upon myself to win the unpopularity contest. How did you get so large?”

This is not the only time I’ve been asked this question. A while back a commentator on The Register’s Facebook page said much the same thing.

It’s a fair question, though it feels like there is an underlying subtext of judgment in it. Maybe I’m being oversensitive and reaching beyond the context. That’s possible.

But the question sure feels like what the person isn’t saying but kind of wants to say is, “I’ve never been that fat and I would never allow myself to get that fat.”

The answer is fairly obvious. I ate a lot. I didn’t move. My diet was high in sugar and simple carbohydrates: lots of pasta and nachos, big portions of everything and most of it washed down with several big glasses of pop.

My job is fairly sedentary. I sit. I type. The biggest exercise I got in the day was walking down to the vending machine to buy some chips and another pop.

Most of us have jobs like this. There aren’t many factory and construction jobs anymore. We sit in our cubicles and punch numbers and letters into a computer.

Again, though, I’m nagged by the subtext of the question: “How did you get so large?” It feels like there’s some of that old-fashioned “If you’re eating too much, just back away from the table” attitude.

That’s good advice – to a point. But obesity is a complicated disease mitigated by many factors.

Research indicates genetics are a factor. I was born a ward of the state and adopted. I don’t know anything about my genetic history. Maybe there were obese people in my bloodline. Maybe not.

Also, as I’ve detailed many times, I live with chronic depression and anxiety conditions. One of the symptoms of those brain chemistry malfunctions is that I constantly look for ways to feel better about myself.

When we emotionally feel good, it’s the result of the release of a chemical called serotonin. This happens in lots of natural ways, from exercising to enjoying the fellowship of friends and family to getting a big sloppy kiss from your dog when you get home from work.

But when the chemistry is off, as it is in my brain, serotonin levels can be low. This leads to feeling unreasonably rotten about oneself and their lot in life.

I take medication for both depression and anxiety. It works most of the time. But still I have my episodes, just as a diabetic who carefully manages their blood sugar will still have spikes and lows.

When I get particularly low, I had avenues to increase serotonin, neither of which were particularly healthy. One was buying things I didn’t need with money I didn’t have. The purchase of a DVD or a toy or electronic gadget gave me a temporary boost.

But, like the thrill compulsive gamblers get from betting on horses, it fades and only guilt and anxiety remain.

The other way I got a lift was by eating copious amounts of food. Sometimes just the act of drinking a can of Mountain Dew would give me a quick boost.

It was more than the sugar and caffeine. I was consuming memories of long-gone days of hanging out with buddies watching TV or riding bikes around Winterset or playing football in Lew Jordan’s front yard.

Like any addiction, however, you build up immunity. The high faded faster and faster, so I ate more and more to try and feel better. What I felt was stuffed, sick and guilty.

There are other issues with obesity, too. Bad food is cheaper. Lean hamburger is more expensive than fatty burger meat. Fast food is cheaper than fine dining. Organic tomatoes from local growers cost a lot more than the flavorless tomatoes shipped in from Mexico.

Before I started recovery, I could buy two weeks’ worth of groceries for less than $100. Of course those bags were filled with sugary cereal, fatty dairy products and processed meats like baloney.

Now my grocery bill teeters closer to $175. My bags are filled with fresh vegetables, lean meats, protein bars and no-calorie sports drinks.

There is also the question of what is in our food. I’m not denouncing the science of genetically modified organisms or blaming all obesity on high fructose corn syrup.

But more than a third of Americans are obese and half are overweight – more than ever before. It strikes me as more than coincidence that the rise of GMOs and replacement sweeteners occurred at the same time.

There’s also the question of portion size. When I was a boy, you went to the restaurant and got an 8-ounce glass of pop. You drank it slowly because when it was gone, that was it.

No everybody has a bottomless cup – and the cup begins at 12 or 16 ounces. The cup costs $2 or $3, so you feel like you need to drink a silo’s worth to get your money's worth.

So, how did I get this large?

There are a lot of reasons, really. And, yes, one of them is a lack of self-control and self-care. But if I’ve learned anything in six months of recovery and 79 pounds lost, it’s that searching for something to blame is far less fruitful than finding strategies to get healthy.

MONDAY, AUG. 31, 2015

MAN VS. CAKE

My hands held a slice of cake.

My apartment complex in the Drake Neighborhood had a barbecue for the new residents. A lot of the units tend to turn over in late July and early August as the fall semester approaches at Drake University.

I ate a couple of hot dogs and a cheeseburger at the event with a few cups of mixed grapes and watermelon. I skipped buns and the chips. There was cake, but I stayed away from that, too.

My neighbor, Dennis, left the event without a piece of cake. Dennis is a humble man who lives quietly in a studio apartment. He has no TV, by choice. He listens to classical music on his radio in the evenings.

I decided to bring Dennis a slice of cake. I cut a corner piece with extra frosting, the way I would have wanted one back when I ate those kinds of things.

I knocked on Dennis’ door.

He asked me to wait a second. No problem, I said.

The smell of that cake drifted up to my nose. Oh, that delicious, sweet frosting. I started to salivate. My hands shook — they actually shook. I wanted to dive face-first into that piece of cake and not stop lapping until I reached the paper plate.

Such cravings have become more common and harder to control in this phase of weight loss. I don’t know why, but it’s awful.

I’ll be typing away on my laptop or watching a movie and suddenly have this overwhelming urge to eat. The cravings are nonspecific at this point. I’m not desperate for any particular thing. I just want food and I want it now.

My mental health therapist and my nutrition counselor both advise these cravings are likely driven more by emotion than actual hunger.

But never mistake the word “emotional” as a synonym for “not real.” Because in the moments I’m having these cravings, the desire is overwhelming to the point of distraction. 

Sometimes exercise will quell the appetite. Other times, I distract myself by reading or, when all else fails, I take a nap or go to bed. 

I have a terrible tendency to obsess on things. It isn’t as troublesome as obsessive compulsive disorder, but it is still a hassle. 

I don’t hear compliments. I’m lousy at celebrating things. There are a lot of reasons for that, including my ongoing struggles with chronic depression and anxiety disorders. 

The root of it is, though, I’m afraid to accept compliments. I don’t trust them. 

Because if the good things said about me are true, which I’m not at all convinced they are, then all the bad things that are said (and that I relentlessly think about myself) must also be true. 

That’s terrible logic, but such is the plight of a perpetually worried mind. 

My obsession for the last week or so has been the 3 pounds I gained in July and early August. After five months of sustained, double-digit losses, I went up. And it messed with my head. 

My nutrition counselor, Jacque Schwartz, was so worried about my worrying she invited me to come in a few days early for my monthly appointment. She suggested that I not even weigh in and we could just go over goals. 

But no. I wanted to know. I had to know. How bad had it gotten? 

Because in my head, I was already well on my way back to the state of morbid obesity that led a hospital public relations man to offer me a wheelchair because of my immobility. 

I convinced myself I could actually see the 3 pounds on my body. (This is, of course, nonsense. Three pounds on a body like mine is like noticing a single handbag among all the luggage at Chicago O’Hare.) So I stepped on the scale expecting the worst. 

And the answer was I had lost 3 pounds. Actually, I had lost six pounds. I weighed 484. That was 6 pounds less than I weighed a week earlier at the doctor’s office. It was 3 pounds less than my weight of 487 a month earlier. 

So that’s good news. But I felt like a failure. 

Gaining weight and losing it in the course of a month feels like spinning my wheels on an icy road. I wasn’t making much progress and probably doing some damage in the process. 

I figured at any moment I was going to balloon back up to nearly 600 pounds and be headed to the surgery table, have a heart attack or simply drop dead. 

Jacque worked with me for more than an hour. We looked at the foods I’d been eating. Yeah, I could lay off the fried foods, she said. But my body is also changing — gaining muscle and losing fat. It could just need more calories right now. 

I expressed, almost tearfully, my worries about recidivism. 

Jacque asked me what my exercise plan was once the pool in my building closed. I told her I was either going to buy an alumni membership to Drake’s gyms or try walking at the malls and some free weight lifting at home. 

“This is how I know you’re not going to go back to your old ways,” Jacque said. “You have a plan. You’re thinking ahead about what comes next. You’re not talking about giving up.” 

Jacque encouraged me to reach out more often when I’m worried about cravings or other food issues. She said I’ve assembled a good team and I should use it. 

“In the beginning, I told you weight loss was like a set of stairs,” she said. “You’ve just reached the bottom of your first stair step.” 

I took some comfort in that, but not much. I told Jacque about the cake incident. She asked me how it turned out. 

Well, I waited for Dennis to come to the door. I handed him the cake and went home and took a nap. 

“Now that,” Jacque said, “you should take comfort in.” 

THURSDAY, AUG. 20, 2015

SUPER STEFANIE

This video by Register photojournalist Zach Boyden-Holmes really captures the terrific comradery I shared with physical therapist Stefanie Kirk of Mercy South Physical Therapy.

This was shot several weeks ago on my last visit with Stefanie. I hadn’t watched it until this week. Zach, who is a terrific photographer, perfectly encapsulates the warmth and friendship that developed over our months of working together.

I still wince when I see myself in photographs or videos, but this video makes me smile. It reminds me of all the people who helped me and continue to help me on this journey to recover from morbid obesity.

Stefanie and I still correspond via text message. She sends along workouts and calms my worried mind on days when I’m struggling. She is as kind and decent as she appears in this video. I am tremendously thankful I was able to work with her in the first stages of this recovery.

Physical Therapist Stefanie Kirk works with Register Columnist Daniel Finney Tuesday, June 16, 2015.

We rarely think about our health care providers as friends. We think of them, I think, as service providers, not unlike mechanics. But the relationships I’ve developed with my doctors, therapists and nutritionist during this journey are truly meaningful to me.

I work harder to get fit because I know how hard these people have worked on my behalf, both mentally and physically. If this blog accomplishes anything, I hope it erases any lingering doubts in my providers and perhaps all providers that their work does make a difference and is life-changing.

If you’re reading, Stefanie, thank you again.

MONDAY, AUG. 17, 2015

UPS AND DOWNS

493.

The moment the number flashed on my doctor’s scale, I knew it would be my obsession for the rest of the day. It meant the unthinkable: I’d gained six pounds since my July 22 weigh in at the Mercy Weight Loss and Nutrition Center in Clive.

I tried to play it poker faced. But I was terrified. What had gone wrong? Six pounds in the wrong direction felt like 6,476 in my worried mind. This was no way to meet a new primary care provider.

My first appointment with Dr. Shawna Basener at the Mercy Internal Medicine Clinic in West Des Moines went as well as it could be. She has a terrific bedside manner. Most doctors ask you to disrobe and then come in to poke and prod. Shawna ran my vitals and then we had a conversation about where my health was going.

She’d read Making Weight, or at least heard about it. I’ll take a reader wherever I can get one, even if it’s someone who has to check me for prostate cancer once a year. She asked me if there was anything bothering me.

Well, now that you mention it, the scale shows I have gained six pounds, I said. I’m upset about that.

Shawna remind me of something that I already knew: There are plateaus in all weight loss efforts. She also said there are differences between scales. She suggested I stop by the nutrition clinic to be weighed there. That’s what I use as a baseline and it’s the same scale every time.

That’s terrific. I wanted to run out of the room and drive to the clinic at once. Shawna provided me with lots of good news, which I didn’t listen to. I was obsessed with this six pounds. Sure, I knew that there would be ups among the downs. And my last weigh in was a big loss: 22 pounds.

But my mind has a way of making me the exception to everything. Usually it works in a negative way. For example, before I visited Shawna’s office, I was convinced that I would be less healthy despite almost six months of sustained diet changes and exercise.

I was mercifully wrong. My A1C test – which diagnosis diabetes – came back 5.4. Pre-diabetic is 6.0 and diabetic is 6.5. I’m out of the diabetic range for the first time in a year. The doctor even told me I could stop taking Metformin, a common medication used to treat type II diabetes.

This should be cause for great celebration. But, as I mentioned before, my mind was on the six pounds. Nothing was going to shift it off there. Even the news that my blood pressure was a perfect 120 over 80 – another victory.

My mental exceptionalism worked against me with my weight because I secretly believed I would lose weight in big gobs and sprint to my target weight. I talked a good game about needing four years to do it, but with such early success, why wouldn’t I hope it continued unabated?

Well, science doesn’t work this way. The reason the nutritionist, the doctor, my mental health therapist and the physical therapist all warned me about plateaus is because they’re a natural part of the weight loss process.

My body has been burning up fat a lot for the past six months or so. But now I’ve reached a point where I’m adding muscle. Muscle weighs more than fat. When I gain enough muscle, my body will be able to more efficiently burn the fat. But for a while, weight loss will stall.

This doesn’t mean I’m shredded like a bodybuilder. It means that which was all flab is now some muscle. After finishing at the doctor’s office, I headed over to the clinic. My nutritionist was off that day, but another dietician agreed to weigh me on the fly.

The machine confirmed a weight gain, but only of three pounds to 490, rather than the six the doctor’s office showed. This offered some relief, but not a lot. I was still beating myself up about eating too much and not exercising enough. I beat myself up like it’s a hobby. I work on it with my therapist, but sometimes I feel like I’m being hunted by my own brain.

There were bright spots in the data from the weigh in at the weight loss clinic. The percentage of my body that registered as fat dropped from 49.4 percent in July to 40.9 percent last week. And my fat mass was down to 200.5 pounds last week, down from 240 pounds in July. So, it’s like everybody on my medical team said and I refused to believe: less fat, more muscle, or at least non-fat.

Still, I thought about the handful of times I broke my calorie count and went about 2,700 for the day. One day I topped out at 3,100 – a height not seen since March or April. I changed the weight I was estimating the calories on one of my favorite foods – the boneless wings at Jethro’s. But the truth is, I should be changing the frequency of when I eat wings from often to sometimes.

I was down. I felt the blackness of depression seep into the corners of my mind, mixing with the already bubbling cauldron of anxious waves in my gut. I was sitting in the parking lot of the weight loss clinic. I called my therapist.

We talked about ups and downs. I was suffering from what psychologists call “persistent ruminative thoughts.” That is, I was stuck on an idea that didn’t make sense, but I kept running scenarios in my mind that made everything seem like it was going to end in humiliation, failure and death. That doesn’t come close to explaining how bad these kinds of episodes really feel. The only thing I can really tell you I that it’s exhausting.

As usual, my therapist reached me with clear-headed logic: “Let’s say you’re right and you’re gaining weight and doing things the wrong way,” he said. “What’s the plan?”

I had a nice meal of salmon with green beans. I pushed away a cornbread muffin. I threw a towel over my shoulder and headed out to the pool to start doing laps. Even if my mind is dark, it’s a shame to waste a sunny day.

TUESDAY, AUG. 8, 2015

DOCTOR WORRIES

I have a doctor’s appointment this week. Not a nutritionist or physical therapy appointment. A full-fledged doctor visit.

I am, of course, scared to death. Sure, all the stuff I’ve been doing since March should mean I’m in the best health in years. Losing more than 75 pounds is great. Changing my diet and actually exercising is even better.

But I always feel like going to the doctor is like taking the car to the mechanic. They’re always going to find something wrong and it’s going to be worse than you expected and expensive as hell.

My big worry is my blood sugar. It defies logic, as most fear does, but I’m worried that I’ll have to go on insulin. I’m a type II diabetic, but I don’t check my sugar. I’ve never gotten a meter or test strips. I just took my Metformin and hoped for the best.

Now, if my body reacts the way it should have, I will have lower sugar than I’ve had in years because I’ve really cut carbohydrates and sugars. I’m no longer inhaling a massive bowl of pasta and washing it down with a half-gallon of Mountain Dew – the fully leaded variety.

So that should help the sugars. But I’m scared. I’m scared because sometimes I think being scared is my hobby. Some of it is my anxiety condition, I suppose.

But some of it is leftover fear and loathing from before I started this journey to recover from morbid obesity. I dreaded going to the doctor because I knew I was sick.

I knew my increasing weight and sedentary lifestyle had tremendous health consequences. I was already feeling them. My knees creaked. My back hurt. A brief walk resulted in fugue sweats as I gasped for air.

I’m in recovery now and have been for a little while. I know I’m not at my target weight. I’m not even halfway there. But I’m getting better. I’m looking better. I’m feeling better.

Still, worries about going to the doctor persist. What if it isn’t working? What if all the good signs are just aberrations? What if I’m actually gaining weight? What if I have cancer? What if, what if, what if.

These are the thoughts of a chronically worried mind. Medication controls the worst of my generalized anxiety disorder, but the negative thinking patterns are another matter. These are burned in place and they’re very hard to correct. It’s exhausting.

Well-meaning friends often offer pithy advice – “Think positive!” – but it isn’t as simple as that. I’ve been hating myself for a long time. It isn’t easy to correct that. I see a therapist twice a month. The poor doctor spends much of our sessions together talking me out of the terrible opinion I have of myself.

So a visit to the doctor’s office is a mix of emotions, mostly unpleasant.

I will try to take my friends’ advice and think positively. I’ve lost weight. I’m eating better. I’m exercising. I feel good. In fact, I can’t think of a single physical health complaint other than I’m still allergic to cats and thus can’t adopt one. Stupid genetics.

I’m going to see a new doctor. My previous internal medicine physician, Dr. Lisa Jensen, left the Iowa Clinic for a job treating veterans. Her husband is a vet. It’s a good move for her. I will miss her.

My new primary care physician will be Dr. Shawna Basner at the Mercy Westown Internal Medicine Clinic. We meet for the first time Friday.

Hopefully, I’ll make a good first impression both in person and on the charts.

TUESDAY, AUG. 4, 2015

FAT SHAMING

"Fat shaming” never had much meaning to me, until I started my weight loss journey.Then people started to share with me their stories of struggling with obesity. 

One person admonished me not to use the word “obesity” so freely. She said it was an insult and fat shaming. I countered that it was a medical diagnosis that many people run from rather than accept, myself especially so.

But in my ongoing effort to listen to people, rather than simply hear them, I began to see the patterns of pain and anguish caused by insensitive comments, ignorance or gross indifference.

I went to an office supply store the other night to buy some new shelves for my desk. The staff was busy shuttling around with inventory and looking at their smart devices.

I took a seat at a desk and watched as they moved about. I started a timer on my phone to see how long it would take one of them to notice a customer was loitering at one of their desks.

It took just 5 minutes, 9 seconds for an assistant manager to ask if I needed anything. I bought my shelves and was on my way.

I tweeted about the experience, amused more than anything, at customer service in the digital age.

But a friend responded to my tweets. She said she has waited for long periods in stores to get help. She believes she’s ignored because of her weight.

“Fat people,” she said, “are invisible. It’s the weirdest thing. You’d think we were super visible.”

She described people walking past her acting like she wasn’t there and the sharp, stabbing feeling she got because she wasn’t worthy of attention from someone who is paid to pay attention to her needs.

I’d never felt this way. I’ve written about awful things people have said to me because I’m fat. Sometimes I barely feel them passing. Sometimes they hurt a lot.

The other day, after one of my posts to this blog, some cheerful Internet commentator asked, “How the hell did you get so large?” I snidely replied: “Eating trolls. They taste like chicken.”

But the question stung a little. It’s certainly one I’ve repeatedly asked myself.

And the answer is more complicated than, “Oh, I ate a lot and didn’t move much.” It’s a mixture of genetics, food choices, the stuff that’s in food, food costs, the sedentary modern workplace and emotional issues related to mental health problems.

The commentator said she worked hard to control her weight and it was a constant struggle, but she never got to the morbidly obese stage I’ve reached. Good for her. Lots of people don’t struggle with their weight. But lots of people do. I’m one of them.

Yet I never quite connected the word “shame” to how I felt about being fat and the worries I had about how others perceived me because of my weight. I’ve certainly felt shame after various encounters.

I’ve had well-meaning friends, colleagues and supervisors suggest both bluntly and gently that I needed to lose weight. They were right. But it hurt every single time somebody mentioned it.

It’s kind of like when your best friend marries someone you can’t stand. Do you tell him you think he’s making a huge mistake, or do you just stand back and let people live? My rule has always been the quickest way to lose a friend is to interfere in his or her love life.

But what if the partner was doing the friend actual harm? Obesity certainly causes actual harm. I was on the verge of using a wheelchair to get around at age 39 before I started this journey.

Yet all of this isn’t really what my friend was talking about. Fat shaming, or bullying by another name, is a real problem.

Another friend sent me a link to a New York Times story about a study done by the University of Connecticut in Hartford.

The study showed “being fat” was the most common reason children are picked on in the United States, Canada, Iceland and Australia – greater than race, religion, sexual orientation, academic ability or physical and mental disability.

Worse still: Obese workers earn less than non-obese workers, according to the Centers for Disease Control and Prevention.

And perhaps worst of all: Obese teenage girls receive less financial support for college from their parents than girls who aren’t obese, the CDC report concluded.

That’s the handle, I think, to my friend’s complaint about being ignored in stores. It’s not just an obesity problem. It’s gender bias and fat shaming combined.

I’ve written before – and earnestly so – that I think fat men have it easier than fat women. Society will tolerate a fat man, but there’s little room for deviation for women in society. There are few women in the public eye with round figures.

Skinny supermodels and actresses dominate the covers of magazines designed to manufacture anxiety and self-loathing in women. This will, in turn, convince people to buy the products advertised in the magazine in hopes of hiding from the public.

The pressures I’ve felt to get fit are almost exclusively internal. Sure, people have said mean things. Others have expressed worry. But ultimately I decided I needed to reform, lest I die a little bit at a time well before I’m ready to go.

Women keep getting hammered with external messages that they are unworthy of love, dignity and respect unless they meet a certain unrealistic beauty standard. And women are shamed into feeling less than whole because of their size.

Of course, this isn’t news to women. I’m disappointed in myself that I haven’t thought of it along these lines before, though.

And I don’t have a solution. Despite the overwhelmingly positive response this blog has gotten from readers, the Internet remains the space in which the most base, cruel and hateful dialogue occurs.

I guess I’ll have to return to the same refrain I play so often in this space and my other work:

Remember we’re all people regardless of what we look like. Treat people with dignity and respect and love when you can manage it. Put as much kindness as you possibly can into the world.

And no matter what you get hit with, how hard you fall down or how terrible life seems: Keep moving forward. 

TUESDAY, JULY 28, 2015

SPEED LIMITS

I dropped another 22 pounds and fell below 500 pounds for the first time in nearly a decade.

This should ease some of the psychological pressure I put on myself in my ongoing journey to recover from morbid obesity.

Right?

Dumbbells given to obese columnist Daniel Finney are helping him recover his health.

Wrong.

The first thing I did after notching the milestones was to blow my calories goal two days in a row.

I’m not talking about the calories goal I keep for myself – between 2,000 and 2,500. I’m talking about the goal set by my nutritionist of 2,700 calories.

I overindulged. There’s no spin to put on it. I simply ate too much.

Everybody who has ever tried to change their diet will tell you these days happen.

They will also tell you that you’ll convince yourself that you’ll never be that person. You will be perfect when somehow everyone else who’s followed this path has stumbled.

I certainly thought I would. I got a pretty good streak going, too. I didn’t blow my calorie goals for 131 days in a row.

Hey, even Yankees great Graig Nettles let one slip by him at third base every now and then.

Of course, my anxiety riddled brain immediately seized on this opportunity to rattle me with thoughts I was already on my climb back to 500 and beyond.

So I did what any reasonable person would do in this situation: I hit the pool so hard I nearly injured my back and legs.

I worked out in the pool vigorously for seven days in a row for at least 30 minutes and some days as long as two hours.

One night during the streak, I dried off, walked back to the apartment and collapsed into my recliner feeling almost nauseous.

I sent a text messaged to my former physical therapist, Stefanie Kirk of Mercy South Physical Therapy. Stefanie gently reminded me that it is important to rest.

She is athletic and fit. And she takes two days off a week.

But what about the calories? What about packing on the pounds? It’s all going to fall apart, isn’t it?

Stefanie, in kinder words, told me to settle down. Take a day off. Get some rest.

I promptly ignored her and spent two or three more days overdoing it in the pool.

Finally, rain intervened. A powerful thunderstorm closed the pool for the day.

I couldn’t try to lose every pound I’d gained since my sophomore year in high school by running in the pool to collapse.

The rain spared me a grueling session.

I managed to sneak in a different kind of workout, however. Stefanie long suggested I do some light weight lifting and strength training to strengthen my upper body.

I resisted because I didn’t have any weights and I didn’t want to join a gym.

No fat person really wants to go to the gym. Even if no one says anything to you the whole time you’re there, you see the strong, fit people and feel lesser.

And you’re convinced every person in the place is secretly judging you for your obesity.

Plus, and this is just me, I hate gym locker rooms. I never need to see another man naked. That’s just how I am. It creeps me out.

Fortunately, my friend Jessica had some dumbbells she wasn’t using. She loaned them to me. I had a range from 5 pounds to 12 pounds.

Stefanie cooked up a workout to test my shoulders, triceps and biceps. She suggested starting with the 5-pound weights and working up over time.

I boldly thought I would not need to start at such a puny weight.

It turns out that 5-pound dumbbells are pretty heavy. I estimate they weigh about 9,572 pounds each, especially on repetitions 12 through 15.

My arms shook like flags in stiff wind as I hefted the tiny dumbbells above my head in a standing overhead press. Stefanie gave me just five exercises.

My shoulders burned after each one. I often took breaks for water and to let the pain pass.

I thought it was a good thing I was bald so I don’t have to raise my hands above my head to wash my hair in the shower.

The free weight work is far less intense than the pool, but it doesn’t involve my fatigued legs.

I worked them too hard. Panic fueled my drive. And I pushed myself too far.

I wasn’t in danger of anything except fatigue. But it’s the manic nature of the constant swims that worry me.

I know, intellectually at least, that this recovery is going to be a long, slow haul. But emotionally, I want to do as much as I can every day to bet better.

I was down after a weigh-in a couple months ago. I called Mom 2.0, the kindly retired east Des Moines hairdresser who raised me after my parents died.

I told her I was bummed out by what I thought was middling results for weight loss.

Mom 2.0, in her direct, plainspoken way said, “I know you want to lose 100 pounds every time, but it ain’t gonna happen. You’ve got to take it slow.”

She’s pretty smart, that Mom 2.0 of mine. 

THURSDAY, JULY 23, 2015

GAINING LOSSES

Jacque Schwartz, my nutritionist at Mercy Weight Loss and Nutrition Center, tapped the LED screen attached to the scale I stood upon.

It read “487.0 lb.”

“Are you as excited about this number as I am?” she said.

This chart from Daniel Finney's MyFitnessPal app shows his weight loss progress since he started a journey to recover from morbid obesity. He's lost 76.2 pounds since March.

I didn’t say anything at first. I just stared at the screen in disbelief.

I had lost 22 pounds in the month since my last weigh-in. It represented the biggest weight loss of the journey that began in earnest this March.

In all, I’ve lost 76.2 pounds, dropping from 563.2 pounds on my first weigh-in to the current 487.

Yes, I was excited. I was thrilled. I was elated. I could have done a fist pump, maybe a brief touchdown dance.

But all I said in response to Jacque’s question was: “Yeah, I guess.”

I’m bad at expressing positive emotions. Very bad.

Despite my absence of reaction, there is no denying – even for someone with as bleak an outlook and low as self-esteem as me – that dropping below 500 pounds is a major milestone in my ongoing recover from morbid obesity.

Five-hundred pounds is a quarter ton. That is far more flesh than even my 6-foot-4 frame can carry. And I weighed 568 at the start. My body was beginning to break down at 39. I faced the real possibility of a wheelchair or scooter.

In the month since, I’ve changed how and what I eat. I’ve worked with a physical therapist to regain the strength and vigorously exercised in the pool at my apartment complex.

I’m leaner and stronger than I have been in years. As hard as it is for me to admit to myself – I feel better.

“How long has it been since you were under 500 pounds?” Jacque asked as we sat down in a room for the remainder of our appointment.

I wasn’t sure. I remember going to the doctor for some small ailment, the flu or a stomach bug, at a clinic in Indianola back in 2006. I was more than 460 pounds then.

I remember recoiling at the high number, but it did not spur lasting change that day. I put it out of my mind as I had so many other warnings: arthritic knees, cascading back and leg injuries and Type II diabetes.

When I weighed in at 460-something nine years ago, I did what I always did when terrible health news came to me: I avoided it.

I rarely visited the doctor. On the rare occasion that I did, I no longer fit on any of the scales, which only went to 500.

So it could be that I’ve actually weighed more than a quarter ton for the better part of a decade.

To be less than that after careful diet and exercise is a great accomplishment.

And that I lost more weight this time than at any other point in this first five months of treatment is an encouraging sign.

Specifically, the exercise pays off. I exercised more regularly and for longer periods in June and July. The results are evident.

Even my depressed, anxious mind can begin to see and feel the changes to my body. Oh, I’m still fat. I’m still morbidly obese.

But my body is changing. My pants are looser and sagging. My belt is practically useless. My legs are stronger.

Little tasks that were once exhausting – getting the mail, going up a couple flights of stairs, grocery shopping and even sleeping – are easier than they have been in years.

My calorie counts remain good. I have been hungrier, I told Jacque.

She said I should keep an eye on my protein. My muscles need fuel to keep up the exercise pace.

Jacque said it was better that I eat more when I exercise than less. Otherwise I risk burning muscle instead of fat, which can be problematic for keeping my strength up.

I knew this. But I’m scared of eating more. I’m afraid it will lead to a binge that takes me back above 500 again.

We went through my food diaries. Jacque noted I had eaten some foods I’d said I would never have again such as pizza, bread and my parents’ homemade pineapple sherbet.

She asked why I did that.

I ate pizza, but I didn’t eat the crust. I allow myself a few pieces of toast once in a while, usually in a sandwich or BLT. And the pineapple sherbet comes but once a year on the Fourth of July. I would be very upset if I didn’t get some.

Jacque said she was glad I tried those foods in moderation. It was an important part of adjusting to the major life changes I made by beginning this journey.

Finding a comfortable way to eat foods I enjoy will help prevent binges.

The appointment ended and Jacque gave me more encouragement. She said my progress was excellent and well beyond what she expected at this point.

That felt good. In the moment, I felt uncomfortable. Because I am uncomfortable with compliments. I think of myself as undeserving.

Jacque asked me why. I told her I felt largely responsible for my obesity. Sure, some of it could be side effects of antidepressants, the social changes to serving sizes, the makeup of food itself and the sedentary life of the modern American.

But I put the food in my mouth in great quantities.

“That may be true,” Jacque said, “but you are also 100 percent responsible for the changes you’ve made to your life that has resulted in this weight loss and improved help.”

That felt good, too. I think I might have heard that.

I called Parents 2.0, the kindly east Des Moines couple who raised me after Parents 1.0 died. I told them of the latest weight loss.

They were thrilled. Mom 2.0 asked how I felt about it.

“Well, you know me,” I said. “I’m not very good at expressing positive emotions.”

Without a pause, Mom 2.0 said: “Maybe that’s something you can work on next.”

MONDAY, JULY 20, 2015

MENTAL GYMNASTICS

I have a weigh-in on Wednesday. I dread it, of course.

A depressed and anxiety-riddled mind is a terrible place. I’ve already convinced myself I’ve gained weight back.

There’s no evidence to support this.

In the month or so since my last visit to Mercy Weight Loss Center in Clive, I’ve kept my calories within my goal. I spilled over twice, I think.

But I haven’t made the best choices. I eat a lot of bacon. Jethro’s BBQ n’ Bacon Bacon is my favorite restaurant, now that Angelo’s in West Des Moines is gone.

I usually eat the salmon or the catfish, both pretty good choices. Of late, I’ve eaten four orders of green beans – this amounts to about four cups.

But I’ve also taken part in many of Jethro’s famed Buckets of Bacon. As choices go, bacon isn’t the worst. It’s low in carbohydrates. But it’s a fatty meat with very few nutrients.

Still, it’s a food I eat to make me feel like I’m not in a straitjacket.

Because that’s how exercising this much control over what I eat feels. I wrote about how emotional I got when I realized my family’s homemade ice cream was off limits during our annual July 4 party.

I ate it anyway and stayed within my calorie goal.

But my malfunctioning brain chemistry gives me no quarter. I ate something that isn’t 100 percent healthy. Therefore, I’m doomed.

Intellectually, I know that doesn’t add up. It’s bad math manufactured by my old nemesis depression and its sidekick anxiety.

That doesn’t mean I don’t feel it, though.

I take days off from working out in the pool. My physical therapist even says that’s recommended. The body needs a chance to recover.

But the day I don’t go, I think, “That’s it. This is where I start to undo all the good I’ve done so far.”

Sure, that’s unreasonable. But when you’re talking about neuro-chemical disorders, reason doesn’t really enter into it.

I can type these paragraphs and know full well that the thoughts I’m having aren’t accurate or true. But that doesn’t mean the thoughts aren’t there. The worry feels real, even if the cause isn’t.

So here I am, a day or so removed from a weigh-in, a nervous mess already absolutely convinced I’ve failed.

It goes against the evidence. Even I’ve noticed appreciable changes to my body in the last month or so.

Clothes are looser. Belts need tightening. I can feel muscles, albeit small ones, where only flab once was.

And yet, still, I enter into this with a sense of foreboding and doom.

People say nice things. Friends and family say they can really tell I’ve lost weight.

I can’t hear them. I mean, I’m physically able to hear them. But my brain doesn’t listen.

Sometimes I think this is a good thing. It keeps me working harder.

But the truth is, the whole process is exhausting.

I want to quit. I want to quit every day and twice on Saturdays.

I struggle to look at each pound lost and each fiber of muscle gained as progress.

Instead, I feel the burden of past mistakes holding me down and threatening my life.

Still, I keep going. Because that’s really the only option.

The alternative is to slide back to the point where someone offers me a wheelchair. And I'm not doing that again until it’s time for hospice.

The truth is, I don’t mind exercise. In fact, of the diet and exercise combo pack, I far prefer exercise.

But the mental gymnastics are what really wears me out.

MONDAY, JULY 13, 2015

STRESS EATING

I met a friend for lunch in West Des Moines last week. I drove into the parking lot as he walked into the restaurant. He moved slowly.

We sat down to the usual chatter. Dark circles stained the skin beneath his eyes. He looked very tired. I asked him if he slept poorly the night before. He shook his head, but didn’t really answer.

We ordered our meals and two diet pops. About halfway through the meal, things got weird. My friend started to repeat the same phrase: “I’m sorry.”

He’s a jovial person and a well-known kidder. I thought maybe it was a joke. Then he started flip his head back, push his chair away from the table and then scoot back into place. He kept doing this.

I asked him if he was OK. He didn’t respond. He poked at his food, missed and failed to get the fork to his mouth. Then he repeated the head flip and chair routine.

I thought my friend was having a stroke. I called 911. He sternly objected.

“Whatever you’re doing, just stop it!” he barked. I have known my friend for 21 years. I’ve been yelled at by him before. I wasn’t sure what was happening. I only knew he was not himself.

Suddenly he stood up and walked toward the front door. By this time, the commotion drew the attention of the restaurant staff. I tried to stop my friend from leaving, but I was on the phone with the emergency dispatcher.

A waitress convinced my friend to come back into the restaurant and sit down near the back away from the crowd. The medics arrived. I called the company where my friend’s wife works and the public relations man put me through to her.

I handed my phone to the medic. They talked for a bit. Then they handed me the phone back. She said she would come right over.

My friend was more affable with the medics than he was with me, but he was still acting as if he were drunk. The medics wanted to take his blood sugar. What finger do you want us to use?

My friend stuck up his middle finger. It was only then that I knew I was right to call for help. My friend had given me the finger in jest many times. But he wouldn’t do that to a complete stranger, let alone a public servant trying to help him.

It turns out my friend is a type II diabetic. He has been for 10 years, his wife told me, but even close members of his family don’t know.

The medics got him a glass of Mountain Dew, the fully leaded variety. His blood sugar raised from a very low 30 to an acceptable 68 in a short period. His wife gave him a ride home.

The restaurant was kind enough to comp our meals. I left a tip for the waitress, at least. I went to my car and had an attack of my own: a panic attack.

I thought my friend was going to die. The last time I saw someone that badly in distress was a hot August morning in 1988, when I was 13 years old. My dad and I had driven from Winterset to Des Moines to see the movie “Who Framed Roger Rabbit.”

We stopped at the barbershop where we got our haircuts when we still lived in the city. We were waiting our turn. I read a magazine. I looked over at my dad, who was sitting to my left. He was fine. I looked down at my magazine.

A few seconds went by. I glanced at Dad. He was having a heart attack. His body shook uncontrollably. I told the barber to call an ambulance. He quickly did. I dug into Dad’s shirt pocket and retrieved his nitroglycerin pills. I put one under his tongue.

And Dad died. The EMTs arrived quickly. They laid him out on the floor. No pulse, they said. They shocked him with a defibrillator. I told the barber this was it. This was the end.

The EMTs shocked him several times. Finally, a pulse flickered. They loaded him into the ambulance. I sat in the front seat.

I craned my neck to watch them work on him. Several times, the ambulance pulled over to shock his heart back to function.

When we arrived at Mercy hospital, they shuttled Dad off to surgery. They ushered me into a waiting room. I was alone. There was a clock on the wall. It was probably just the adrenaline and anxiety, but each second ticked as if a sledgehammer pounded iron.

Eventually, a priest came in and sat with me. I wasn’t sure I could talk to him. I wasn’t Catholic. He said it would be OK. My older brothers and their families arrived soon. Dad survived the day, but it was the beginning of the end. He died that December.

Back in the present, I relieved that terrible moment in my parked car. I didn’t think about each event the way I described it above. But I remembered the feeling, that tingling in my chest and that absolute lack of control I felt of my emotions.

I called my therapist, who called back quickly. He assured me what I was feeling was normal and the panic attack made sense given my previous trauma.

He complimented me on my survival skills. I never know what he means by this. I was scared. I made some phone calls. I tried not to lose control. He explained what he meant, but I wasn’t really in a place where I could hear a compliment at the moment. I seldom am.

I took my anti-anxiety medicine and waited a few minutes for it to take the edge off. I drove home. The wait staff at the restaurant kindly packed up our leftovers. The carton sat on the seat next to me.

Typically I eat half an order of the boneless wings at this restaurant and save the rest to use in wraps later. But as I drove home, my nerves got the better of me.

I opened the box and started to jam handfuls of the leftover wings into my mouth. Forget about small bites and swallowing before taking another bite or the day’s calorie count. I just kept pushing food in my mouth.

The leftovers were gone in a flash. And I still wanted more food. I considered a stop at a fast food place or maybe getting a pizza.

I was practically frantic and ravenous.

I didn’t get more food. I don’t know if the medication kicked in at just the right moment or I was intellectually able to process that I wasn’t eating out of hunger but out of stress.

Either way, I made it home. I texted my editor and said I needed to rest. I explained the events of the day. I took a long nap. I felt better, but as often happens after panic, depression seeped in in the days after.

I managed to keep my calorie count just below 2,500 for the day of the incident. Even while fighting the blackness of depression, I haven’t over-eaten too much.

But I sure wanted to. I didn’t just wanted to eat. I wanted to binge. I wanted it all and all at once. I can’t say why I didn’t this time and have so many other times before.

Maybe it’s the discipline I’ve learned from this recovery so far. Maybe it’s medication. I know for sure talking through things with people, such as my therapist or close friends, helped calm me down and keep my hands off the refrigerator.

Stress eating is a real problem. I think some people think depression and anxiety are small things that are managed by aphorisms such as “think positive thoughts” or “show some will power.”

But depression at its worst is like taking an elevator to the top of the 801 Grand tower, having the floor fall out from under you and feeling like you’re never going to hit bottom.

Anxiety isn’t just worrying about asking someone out on a date or being a little late for an appointment. It’s crippling fear that overtakes almost every sense.

Mix that in with my problems with eating, and, well, you get a 568-pound man who can barely walk.

In a way, I’m glad that moment happened. Because up until that point, I think I had always separated my mental health issues from my physical health problems.

I didn’t see the symbiotic relationship until I realized I was stuffing those bits of chicken into my mouth as fast as I could to numb the anxiety from seeing my friend in a bad way.

My friend is fine. His wife says he takes good care of his blood sugar and they have an appointment with his doctor soon to figure out what’s causing this series of low blood sugar attacks.

And I’m fine, too. I’m still a little depressed and probably have been for several days longer than I can remember. But I have a call into my doctor to figure out if a medication adjustment is warranted.

The happy ending to this story is that both of the people in it are getting the help that they need. But we both may have taken then long way around to get there.

MONDAY, JULY 6, 2015

TRICKY TREATS

Parents 2.0, the kindly east Des Moines couple who raised me after my parents died, host a big potluck picnic on the Fourth of July. They invite the whole family, a few neighbors and even a few of my friends.

It's easily the single most Americana thing I do. There are picnic tables in the garage, American flags everywhere you can see and the workbench – free from the clutter of gardening supplies and tools – serves as a buffet table for the delights of American cuisine.

Holiday treats challenge Register columnist Daniel Finney's efforts to get fit.

There are usually two meat dishes. This year it was ham and turkey. Other staples include: baked beans with bacon, scalloped corn or potatoes, a selections of chips and dips and, of course, my very favorite, Mom 2.0's magnificent potato salad.

I knew the holiday was going to be a challenge in my ongoing recovery from morbid obesity. It marked the first major holiday to pass since I began this journey. And it required some planning.

I discussed the event in advance with my nutritionist, Jacquelynn Schwartz of Mercy Weight Loss Center in Clive. We had the conversation not long after she encouraged me to pay attention to my body's signals about being hungry and full.

Jacque suggested I take the day off from calorie counting in the MyFitnessPal app on my iPhone and just listen to my body on fullness.

But I didn't trust myself. I look at the calorie limits and calorie counting like banking. Nobody wants to be overdrawn at the bank and I don't want to be eating more than my calorie limit.

Instead, I decided to plan ahead. Of course MyFitnessPal doesn't have calorie estimations for Mom 2.0's potato salad or pork and beans, but I can find something pretty close. The night before the party, I fiddled with the app and planned a meal that would be heavy on the calories but not break the bank.

I allowed about 8 ounces each of ham and turkey, a cup of green beans and a cup of potato salad. I would have gotten a cup of coleslaw, but nobody brought any this year. I eschewed the chips, dips and table of delicious cherry cobbler. I even turn my back on some of Grandma Newcomb's magnificent strawberry rhubarb pie.

I practiced my small bites techniques. I ate slowly. I enjoyed the company of family and my good friends Aric West and Paul Russell, who flew for a visit especially to catch Mom 2.0's annual July 4 bash.

The meal was a resounding success. I finished my plate. I was full and, though I missed the flavor of desserts high in sugar and calories but low in nutrients, I was fine.

I didn't have the shakes like a food junkie wanting to go back and get another fix of potato salad. Though, in truth, I'll admit when people started putting the food away, I was relieved. The temptation was removed.

Except I had forgotten one thing: the homemade ice cream and sherbet.

Parents 2.0 usually offered two varieties: vanilla ice cream and pineapple sherbet. I love the latter. It ranks with the glazed cherry doughnuts from Highland Park Bakery and the juicy fried chicken from the now-defunct original Bear's restaurant in Ankeny as the best foods I've ever tasted.

My folks have an old-fashioned ice cream maker with a hand crank. Years ago, the youngsters in the family gathered around Dad 2.0. Some of us broke ice frozen inside old milk jugs with a hammer.

We jammed the chunks into the wooden bucket to keep the mixture in the metal cylinder cold. The rest took turns cranking the handle until the ice cream had hardened enough to serve.

The kids grew up and the next generation didn't seem as interested in turning cranks and breaking ice. So Parents 2.0 make both the ice cream and the sherbet a day or two before the party.

Mom 2.0 walked around with a box lid filled with ice cream, offering some to each guest. Most took a cup. A few declined, including my buddy Aric, whose stomach was overburdened by his second plate from the buffet.

Paul, who sat across from me at one of the picnic tables, selected the pineapple sherbet. He chipped away at it with a plastic spoon.

And for a minute or two, I wanted to cry. I started to feel all the things I always feel when I want to eat something I shouldn't eat anymore: failure, frustration, disappointment, anger and, mostly, just profound sadness.

I am often glib about the sacrifices necessary to lose weight and regain my health. Sometimes I say that I don't eat pizza anymore because I ate all my allotted pizza in the first 40 years of my life. If I make it to 70, I'll start eating pizza again in whatever form I want.

The truth is, though, the emotional ties I make to food – that many of us do – are very strong. That ice cream wasn't just something that tasted wonderful. It was the memory of cranking that handle with Dad 2.0 and the little ones. It was so many Fourth of Julys in the company of good friends and family.

That I had mismanaged my health to the point of doing serious damage to my body – type II diabetes and back and leg problems – emphasized a long-held internal belief that I'm a massive screw up who can't get anything right.

I felt a dark cloud of depression seeping into my consciousness on an otherwise beautiful day. I felt small and weak because I wanted this treat and pitiful because I treated my body so poorly and my health so cavalierly that I couldn't have it.

Except that wasn't true. Again, science saved the day. I looked at my calories for the day. I ate just a grapefruit and a zero-calorie sports drink for breakfast. The meal as described consumed about 1,400 calories – a massive amount of food to take in one sitting.

But I have a 2,700-calorie daily limit, though I prefer to be at 2,500 or below to keep weight loss at a steady pace. I knew that I would not be able to go the rest of the day without another meal.

My friend Aric, also a type II diabetic, does that sometimes. He eats a big meal and that's it for the day. I prefer two larger meals and a smaller one. If I cut off calorie intake at 3 p.m., I would be hungry, irritable, anxious and depressed by late evening.

But I had enough calories available to me to have my beloved pineapple sherbet. So I ate it. I savored every spoonful in small bites, of course.

By the time I finished the ice cream, I was a touch over-full, but not the lethargic, unbuckle-your-belt post-Thanksgiving full. Just full.

After a light evening swim, Paul and I grilled lean, center-cut pork chops with mushrooms, grape tomatoes and pineapple. We each sipped a small glass of whiskey and toasted our mutual turning 40.

My calories for the day were below 2,500 – just where I wanted them. I managed to get some exercise in. The emotional distress was unnecessary in the long run.

But that's how these kind of life changes go. There are days when I think I would do just about anything for some of that deep-dish pizza at the Wig & Pen in Ankeny. I resist.

People often tell me I should allow myself the occasional treat. And being over on calories once in a while won't hurt me. The science is strong on that, too, but I don't trust myself.

It was only three months ago that I was going out to restaurants ordering a full-size appetizer, which I consumed by myself, then a full meal and four or five glasses of fully leaded pop.

It wasn't that long ago that my back hurt so bad that I could barely walk to down a short hallway or get in and out of my car. I sweat heavily on every step. I spent a lot of time leaning on walls and railings because my back and legs could not take the strain of flesh I packed onto my body.

I am stronger now, of course. But I am terrified of going back to that place, maybe to the point of obsession. So I allow myself few treats. Maybe someday. But not right now.

On the Fourth of July, I allowed myself that pineapple sherbet. It felt good. And so far I haven't ripped the door off the freezer at the grocery store to load up on five kinds of ice cream.

But I'm not saying it hasn't crossed my mind.

WEDNESDAY, JUNE 24, 2015

NEWS NAGS

Some of the toughest days to be obese is when a new study about obesity in American comes out.

That happened earlier this week when Washington University School of Medicine in St. Louis produced a research paper that said two-thirds of Americas are either overweight or obese.

Cue the images of fat people walking on the street with a focus on their lumpy mid-sections.

Their faces are always cropped out of the picture, of course.

That's fitting. In a way, having your face cropped out of a picture is how it feels to be obese, at least to me.

Sometimes I feel like the only thing people see about me is my fat. My face, my personality – who I am – is just buried beneath hundreds of pounds of extra flesh.

I long ago learned to avoid the comment sections on news stories posted online. Savagery and cruelty reign there. This is especially true when it comes to talking about fat people.

Look, I own my obesity. I also believe in my case it is largely self-induced. I made a lot of bad choices for a long time and I lived a sedentary life.

The pounds packed on until I was finally at a point that I either had to do something about it or face the possibility of being in a wheelchair by my mid-40s, if not sooner.

There are other reasons, too. Note I use the word "reasons" and not "excuses," because there is a difference. Depression and anxiety contributed to overeating. When you don't feel good, you want to feel better. Eating a good, rich meal made me feel better.

And I learned some survival tactics growing up that were necessary at the time but have become harmful in my old age.

This is complex and exceptionally private, but the short of it is I often feel a vast emptiness inside me and try to fill it by either buying things I don't need with money I don't have or stuffing food in it.

Neither, of course, was effective slaking the emptiness. That may come one day through therapy. It's a constant struggle.

So when obesity is in the news, it feels like I'm exposed. Suddenly, the whole world is looking at me and jeering, "Look at the fatty!"

You can't be much more open about obesity than I am. That doesn't mean I haven't spent years hiding.

I'm an introvert by nature and don't care for crowds or gatherings. There is nothing wrong with this, by the way. Half the population is introverted. You just never notice them because the extroverts are busy making so much noise.

Still, until I started working on my recovery, I didn't realize just how much I was hiding because of my obesity.

A friend's young son once called me "fatty." I didn't go to his house for almost two years.

I didn't ask women out on dates because I felt so horrible to look at that I couldn't fathom anyone wanting to go out with me. I shied away from cameras at family gatherings.

I arrived early at some appointments so I could stop the sweat before I had to do an interview. I avoided anywhere there were stairs. Whenever possible, I tried to do my work over the phone. It was just better to be unseen.

Don't mistake this as me advocating not talking about obesity lest we hurt someone's feelings. It's the opposite.

We need to talk about obesity a lot more.

We need to talk about nutrition for children and adults alike.

We need to eat less and move more.

We need to make sure people of all socioeconomic levels have access to the medical care, education and exercise facilities to help prevent and recover from obesity.

We need to switch from reactive care to preventive care. It's insane that most insurance companies will pay tens of thousands of dollars for gastric surgeries but not copays for regular visits to a nutritionist.

We need to stop treating the word "obese" as an insult and more of what it is: a medical diagnosis.

That last point I'm particularly passionate about. I ran from my diagnosis for years. (Well, figuratively speaking, of course.)

I didn't go to the doctor because I knew the advice was going to be diet and exercise. I blew off appointment after appointment because I was afraid to face what I already knew: I was too fat to live and if I didn't change something quick, I was going to have a major problem.

I was so ashamed of my obesity that I hid from treatment. Because when you see images of fat people on TV, they are usually either set up for laughs or scorn.

And obesity is obviously a health epidemic in the United States, a crisis even. But at some psychological level, even when you know you're obese, you don't want your name associated with "epidemic" and "crisis."

It just feels awful.

I'm not blaming TV, though I believe TV news' No. 1 directive is to frighten people so they will keep watching rather than to inform; the truth is obvious: We're a nation of fat people.

And I'm among the fattest. I'm not just obese, I'm morbidly obese. The Centers for Disease Control and Prevention defines obesity as someone with a body mass index of 30 or greater. Morbid obesity begins at 40 BMI.

I have a BMI of 62. The good news for me is that I'm working on getting better. My BMI in May was almost 64. So it's headed in the right direction.

Now if we can just get more Americans on the same course.

MONDAY, JUNE 22, 2015

SLOW BITES

I was grumpy.

No, that's not quite right. I was angry. Even a small irritation sent waves of seething rage through me. If I were Bruce Banner, I would've Hulked out and torn up the town.

The problem was I skipped lunch for my weigh-in at Mercy Weight Loss and Nutrition Center in Clive. I didn't want food sitting in my stomach when I stepped on that scale.

This wasn't a great idea. I was a terrible mess of anxiety. I usually am before these appointments. I always assume they're going to go badly.

The truth is, I assume that about a lot of things. This is life with depression and anxiety. My mind works in exceptionally creative when it comes to being mean to myself.

My nutritionist, Jacquelynn Thiele, could tell something was off right away. She asked me what my hunger number was. I had no idea what she was talking about.

She showed me a document called "The Hunger Scale," which rated hunger feelings from zero to 10. A zero is "empty" – or unhealthily hungry.

Jacque used a different word: "Hangry," meaning being so hungry one is angry. That's definitely where I was.

She asked me what level of hunger I feel before I usually start eating.

I realized I didn't know. Obviously, I recognized extreme hunger – when I have skipped a meal or eaten too lightly throughout the day. But I rarely notice feelings of hunger.

Most of the time, I eat reflexively. That is, it's around noon, I'll have lunch. Sometime in the evening is dinnertime.

Sometimes I eat out of stress or boredom, which I know is particularly dangerous for my morbidly obese condition.

Jacque said lots of people don't listen to their bodies' signals when it comes to hunger. She said that contributes to overeating and emotional distress.

This also means we don't hear the "full" signal from our brains while we're eating. The food after we eat that tends to push us into feeling stuffed or that awful, pants-busting, post-Thanksgiving sickness.

That food eaten after a certain point tends to be stored as fat – something I've been trying to get rid of on my body these past three months.

Jacque and I looked at how I take in calories by reviewing the data stored in my MyFitnessPal app. I take in as much as 45 percent of my daily calories at dinner.

I told Jacque that I often "save" calories for the end of the day so I can have big, satisfying meal for dinner.

Jacque said she appreciated that approach, but it may lead me to overeat at dinner and also force me to be "hangry" more often.

At each visit to the nutritionist, Jacque and I set three goals. One goal after this session was to practice using the hunger scale at each meal and become more attentive to my body's signals of hungry and full.

Jacque had another suggestion: Eat slower. I admitted that it usually only takes me 10 minutes or less to eat a meal, even a big one.

She said speed eating reduces enjoyment of meals. This, too, leads to overeating. (Lord, what doesn't?)

Jacque suggested an app that dings every so often to signal I take another bite.

I rejected that. My damn phone beeps and dings enough with alerts, emails, push notices and other nonsense. The last thing I wanted was the miserable device governing my meals.

Jacque offered an analog solution: Put my fork down between bites. Also, don't have food on your fork if there is food in your mouth. Take a drink between every few bites.

I thought I could manage that, though Mom 2.0, the kindly hairdresser who raised me after Parents 1.0 died, might be offended.

When I still lived at home, she would note how much Dad 2.0 and I enjoyed one of her delicious meals by the fact that we didn't even stop to take a drink.

Mom 2.0 is also a Type II diabetic. She will understand. She usually understands. She's fairly awesome that way.

I've been practicing the slower eating thing since my meeting with Jacque last week. So far, I like it.

I sometimes forget to do it. For example, I was having Sunday dinner at Court Avenue Brewing Co. I was hungry, but not "hangry." I gobbled up dinner salad fairly quickly.

I reminded myself to slow down when the pork chop and mixed vegetables arrived. I've long had a habit of eating my food in a specific order, usually from least favorite to most favorite.

It's a practice that my Grandma Newcomb, Mom 2.0's mother, finds bizarre. My theory on this is that the last bite is the flavor that lingers on your tongue. Why not have it be your favorite thing on the plate?

Anyway, I ate the veggies one bite at a time. I drank more in between bites. I cut my pork chop into smaller pieces and enjoyed more bites of the meat.

This new process, at least in the early going, has helped me enjoy food more without eating more. I taste the flavor of individual foods with more flourish and feel fuller – but not too full – after meals that once left me wishing for another serving.

This journey continues to surprise me. A small change such as slowing my eating down has produced enjoyable results and likely will contribute to further weight loss and a healthier long-term outlook.

Sometimes I get overwhelmed by this journey, wishing I could shed 100 pounds in a week or two. But it's these little moments that really make recovery worth it.

I'm getting better one bite at a time.

FRIDAY, JUNE 19, 2015

PROGRESSIVE ANXIETIES

I shed another 16 pounds according to my latest weigh in. That's 54.6 off in about three months.

I began this journey in mid-March barely able to walk at 563 pounds. Though I am hardly svelte at 509 pounds, the difference is obvious and palpable. I have the physical strength and stamina to perform all daily activities — from grocery shopping to stair climbing — without pain or crushing fatigue.

Even better, the percent of my body that is fat has dropped from 50 percent a month ago to 42 percent at my latest weigh in at Mercy Weight Loss Center in Clive.

That means, in part, that I'm adding muscle mass through regular workouts with my physical therapist, Stefani Kirk at Mercy South Physical Therapy, and on my own in the pool and elsewhere.

So why did I feel so crummy after a successful weigh in?

Part of it is a numbers game. I lost 20 pounds the weigh in April. That number dropped to 17 in May. And here's June and we've trickled down to 16.

Intellectually, I'm able to process that I can't lose 20 pounds every weigh in. That's unfeasible and possibly unhealthy.

But I spend much of my time terrified that I'm gaining weight. My mind tricks me into thinking I'm going backwards when there are obvious, verifiable signs I'm headed in exactly the right direction.

That's my old nemesis depression whispering lies into my ear. I know that. Yet it doesn't change how I feel.

It's absurd, really, to be so pessimistic after what should be a celebratory moment.

I'm terrible at accepting praise. I have an inability to hear good things about myself. I just refuse to believe I'm doing a good thing.

David Letterman once said, "I've never managed to convince myself I'm good at anything." I feel that way a lot.

Hundreds of readers have written me such kind, encouraging letters as I've blogged about this journey and published columns on the topic in our print editions.

The other day, Ray Cole, the Citadel Communications president who used to run WOI-TV, tweeted that my writing on this topic is courageous. It's a humbling compliment. But boy I don't feel courageous.

I'm scared all the time. I'm afraid of losing control and plowing through an entire pizza or a rhubarb pie.

I find myself grousing at a friend's birthday party because I want a plate of little smokies, pork and beans and chips with sundry salsas and cheese dips.

But I can't. Well, I can in moderation. So, I don't. I think one taste will set of a binge and I'll come out the other side having consumed 5,000 calories.

I abstain. It works. But it is a challenge. I am lucky enough to work out of my home office, The Register's unofficial Drake University neighborhood bureau.

This is good for my sometimes shaky mental health. I tend to be exceptionally negative in group settings, even surrounded by colleagues I've known for years.

Working alone allows me to control the anxiety I have in social situations and prevents me from saying something truly embarrassing or meaner-than-I-meant-to-be to a colleague. And I still manage to screw this up from time to time.

And the other big reason is somebody is always bringing in some damn cookies, cupcakes, doughnuts, bagels, pie or food from a restaurant where there was a photoshoot.

Let me assure you, it is rarely fruits and vegetables that ends up on what we reflexively call the dining desk but might more accurately be known as the gorging table.

Anyway, my mind has a terrible habit of turning good things into bad things. I have a diminished capacity for appreciating the moment. I'm always looking ahead for the next thing that could go wrong and assuming it probably will.

So that's how I felt at the end of a good day. Bizarre, isn't it?

I shook off some of the nerves by having a long workout in the pool. I ate a nice dinner of pork chops and green beans. I talked on the phone with my friend Paul from Memphis, who is coming to visit next month.

A man left a message while I was talking to Paul. He said he had been sober for more than 30 years. He noted I had written about my fear of recidivism in a recent column.

Early in his recovery, a thought occurred to the man.

"We don't live from day to day," he said. "We live in the flow of time from one second to the next. Those seconds add up to minutes. Those minutes up to hours. The hours add up to days. The days add up to weeks. And the weeks add up to years.

"Anybody can stay sober for one second, no matter how bad the desire is. As you build from second to second of sobriety, you feel strength against the next onset of desire.

"Watch the clock. Every second you resist that compulsion, that desire decreases and eventually it stops. Not forever. But for that time. And all that time you resisted gives you a little bit more strength to resist the next time that desire hits. … The more time you gain, the easier it gets.

"Come the 29th of December this year, it will be 31 years that I've been sober. There have been times I have been terribly tempted.

"So I start my watch that has a counter on it and as the time passes, that need, that addiction quiets down and goes away."

The caller promises that it will work.

Who am I to argue? After all, I'm just a mere mortal. I can only move forward in time. One second, one good decision at a time.

TUESDAY, JUNE 16, 2015

MORE TO LOVE

I hesitate to write about this, but it upset me, and I thought it merited consideration in this blog about my ongoing recovery from morbid obesity.

A friend sent me a message through Facebook the other day. He said he read about my efforts to eat less and move more and asked if there was anything he could do to help.

I thanked him for the offer but said I was doing well. I asked about his family. He replied they were well and then added the following:

"I hope this goes well for you, because I think that if you can improve (in this) area you'd be surprised how many women would like you."

Now, I know my friend pretty well. I know what he said came from a good place. But it still hurt like hell.

He's not the first person to say that to me. Another friend, also a male, regularly encouraged me to have gastric sleeve surgery so I could slim down and be more attractive to women.

I turn 40 next week. I'm not married. I don't have a girlfriend. And, at the moment, I'm not really looking for a partner.

Sometimes this gives me pause for reflection, sadness and even loneliness. But there are a vast number of reasons why I'm not in a relationship and haven't had a truly successful or long-lasting one, the reasons for which I am not going to share here.

Very low on that long list of personal foibles is my weight and body shape. I recognize that by the standard of, say, Chris Hemsworth, the guy who plays the Norse god Thor in Marvel Studios movies, I'm a poor example of the male form.

But I never thought I was unworthy of love or a relationship because I was fat. I never felt ugly or repulsive, just fat.

And what ticked me off about what my friend wrote is that there is a sense that I've been judged by him for years. That if only I were a few hundred pounds lighter, then women would want me as a partner.

He's fit and muscular. He's doing it right. That's why he's married with children. That must be the whole key to the success of their relationship: his body.

Maybe I'm reading too much into the statement. I tend to overthink things, one of my many problems in relationships.

There is some truth to what my friend said, I suppose. Aesthetics matter. Almost no one, no matter how liberated they believe they are, is able to completely turn off their sense of physical beauty.

Though this invites a lot of screeching from the far left, I'm a heterosexual male and freely admit that I find the women society deems extraordinarily beautiful – actresses, recording artists and others in the public eye – attractive.

And in terms of sexual fantasy, which invites screeching from the far right, I would probably fantasize about Emma Stone before Melissa McCarthy. Similarly, a heterosexual woman might well find Hemsworth or hip hop artist Usher more fanciful than heavier set comedians Patton Oswalt and Louis C.K.

This is, by the way, not a comment on any of the individuals' talents. They're all talented people who are enormously successful in their field.

Nor is it a comment on their personalities, as I don't know any of them and likely never will.

This is a comment about physical attraction and personal fantasy, which we all have - even if we lie about it and pretend we have nothing but pure, sexless thoughts.

So, in that vein, no, I suppose don't have the body that fuel heterosexual female fantasies.

Maybe my obesity has cost me a date. But if I didn't get a date because I'm too fat, it was never going to work anyway, because that person is probably too shallow for me.

Maybe I'm naive, but I don't believe being fat has cost me any relationships, at least not any important or meaningful relationships.

I've dated women who are very thin, have a few extra pounds and who are overweight. None of those relationships ended in marriage. There are lots of reasons for that, most of which are exceptionally private.

But not once did a relationship end because my partner said, "You're too fat. I'm breaking up with you." Maybe that's what she was thinking and just didn't want to say it. But I don't believe that.

I believe relationships are hard work, maybe the hardest work human beings do. Everybody brings strengths, weaknesses, hopes, fears and history to a relationship.

How well a couple is able to blend their strengths and weaknesses and grow together over time is the challenge of a relationship.

The initial rush of sexual attraction is brought on by a set of chemicals that scientist have compared to a drug high. But that high always fades.

What's left then is the people you are together. That's where true love blooms.

At least that's my working hypothesis. I've never been able to prove it.

But I will take the advice from one of my heroes, the late children's television maestro Fred Rogers. In my Internet wanderings, I stumbled across this quote from Mr. Rogers:

"Love isn't a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now."

MONDAY, JUNE 15, 2015

THE FIRST THREE MONTHS

Sunday marked 90 days – three full months – since I began my recovery from morbid obesity. Here are some random thoughts on the journey so far.

1. I feel stronger.

2. In the spirit of preventative rather than reactive care, insurance companies should help pay for trainers and physical therapists before cases become acute.

3. Stefanie Kirk of Mercy South Physical Therapy is a damned good physical therapist and one of my heroes.

4. I still get very discouraged.

5. I worry about what I eat all the time.

6. Sometimes inertia gets the better of me and I don't exercise.

7. The days I fail to exercise, I mentally beat myself up pretty badly.

8. I really miss pizza and pasta.

9. Yes, I know I could eat pizza and pasta in moderation, but for me, pizza and pasta are like an alcoholic just having one drink. It's better to stay away.

10. I really like fish.

11. I eat a lot of tuna.

12. I am still eating too much sodium, but I don't think I can cut that and carbs and sugar and not go insane.

13. Counting calories via MyFitnessPal is much easier and more convenient than I ever thought it would be.

14. I like it when my muscles are sore after a workout.

15. I still hate to see myself in the mirror – especially naked.

16. Slowly I'm learning not to care what people think about my body when I walk out to the pool.

17. The pool at my apartment is a godsend.

18. It's frustrating that other people say they can see weight loss but I can't, even though I know that's in my head.

19. I had a salad for a midnight snack the other day. I don't even know who I am anymore.

20. I tried kale.

21. I don't like kale.

22. I tried mangos.

23. I hate mangos.

24. I miss peanut butter.

25. Sometimes when I'm around a good-smelling dessert, I think I'm going to lose my mind and dive face first into a pie, cake or pan of Rice Krispies treats.

26. I know it's got a lot of sugar, but man I really miss my morning orange juice.

27. I rarely drink pop and when I do, it's always diet or a 10-calorie variety.

28. I don't miss Mountain Dew as much as I thought I would.

29. Bacon may taste good, but it uses too many calories for too few nutrients.

30. Center-cut pork chops are a gift from heaven. I promise you, Iowa hog farmers, those pigs have not died in vain.

Physical Therapist Stefanie Kirk works with Register Columnist Daniel Finney Tuesday, June 16, 2015.

31. Single packs of steam-in-the-bag microwave vegetables are terrific.

32. I bought my first steam-in-pod edamame by mistake, but it was wonderful.

33. The blackened catfish at Jethro's is amazing.

34. Turkey sausage is pretty good.

35. I never reach my recommended daily limit of potassium. I don't think it's even possible.

36. I don't drink enough water.

37. I don't drink enough water. Yes, it's on here twice. That's because I don't drink enough water.

38. I went to the barber to get my hair cut, and I fit in the seat for the first time in years. It felt great.

39. It will be a while before I fit in airline seats or old theater seats.

40. The back injury that led me to begin this journey has largely healed. It only gets sore when I work out too hard and too long.

41. When I was getting out of the pool the other day, I thought I saw the beginnings of an ab: my one-pack.

42. It could have been a mosquito bite.

43. After knocking three holes in my newer belt to make it fit tighter, I switched to my old belt. It's a squeeze, but it fits snugly at the first notch.

44. I'm often surprised how much stronger my body is after only a short time working out.

45. Nobody has offered me a wheelchair in months.

46. I worry constantly about breaking down, backsliding and failure.

47. Being this open about this intimate of an issue is the most challenging thing I've ever done in my career.

48. I know I've made progress, but I still get overwhelmed by the long journey.

49. I emphasize again: I am not a doctor or therapist of any kind. I'm not writing prescriptions. I'm just writing about my journey. Before you do anything, consult with a doctor and make a plan that's best for you and your body.

50. Being a columnist for The Des Moines Register is my dream job and I am actively trying to prolong my life so that I can do it as long as possible.

THURSDAY, JUNE 11, 2015

KEEPING THE PACE

I visited Des Moines Area Community College's campus in Ankeny this week.

It was a hot day, but not too humid. The kind of rare late-spring day to be cherished. I had to walk to the building from parking lot.

I don't know how far it was. I'm terrible at estimating distances, especially when they're not in a straight line.

The thing was, it wasn't a problem. I traversed the distance without breaking into a sweat, without stopping to lean on something or without giving much of an effort at all.

This isn't really breaking news for most people, but for someone recovering from morbid obesity, it's the kind of thing I wish I could hire a skywriter to spell out over the State Capitol.

I have been morbidly obese for so long that even though I've lost a relatively small amount of weight in comparison to what I want and need to lose, my mobility has improved so much I easily feel as strong as I have before I started this journey more than 85 days ago.

As I walked into the building, I looked for benches I could sit on if I suddenly got too weak to continue. That happened all the time nearly three months ago.

Where were the good leaning spots? I always needed a place to catch my breath and wheeze and fugue sweat. Sometimes this is after only a few steps.

I spied a DMACC staff member driving a golf cart. Maybe I could beg him for a ride, I thought to myself. Three months ago, I probably would have.

But I didn't need a ride. I could get there under my own power, without sweat and wheezing and without fear.

I don't want to give the impression that I'm fully recovered. I'm not. Not even close. I'm still morbidly obese. I'm still diabetic. And so on.

Yet my physicality has improved so much that it often astounds me. I can stand longer. I can walk farther. I can go get the mail. I can take out the trash.

I can walk two miles. I can work out in the pool for 45 solid minutes. I can carry in my groceries. I can get down on my hands and knees and get back up again. I can bend over to pick a book on the bottom shelf.

The best part of every one of those sentences is they begin with "I can." Because for so long, at least two or three, maybe as long as five years, I couldn't.

I've written many times about my anxiety about being discharged from physical therapy. Part of it is the great therapist-patient relationship I have with Stefanie Kirk at Mercy South Physical Therapy.

But another concern is physical therapy – and exercise in general – is where I have registered the most significant and life-altering gains.

I wrote about the fact that despite losing about 40 pounds, I still haven't changed pant sizes or shirt sizes. I had a buddy punch a couple holes in my belt so that I could pull it tight enough to hold up my pants, but that's about it.

The body loses weight in odd ways. I'm thinner in the face, but my gut and my butt are still bulbous.

Were I to measure success only on weight loss and what the scale told me, this would truly be a discouraging endeavor.

Yet the physicality of exercise allows me to easily measure the difference between walking one lap of 156 feet and two miles.

Regaining the ability to do simple household tasks and the physical needs of daily life is such a wonderful improvement that it's hard to describe how much I revel in it.

I guess the best I can do is what I tweet after getting back to my car, sitting down and pondering how nice it felt to make that walk without pain, sweats or shortness of breath: "Boy, it's nice to be able to walk again."

MONDAY, JUNE 8, 2015

SIZES AND NOTCHES

Saturday was a strange day in my ongoing recovery from morbid obesity.

I beat my steps goal. I finished a 25-minute workout designed by my physical therapist. Sweat rolled. Muscles worked.

And I ate about 2,055 calories, well below my maximum of 2,700 and on the low end of the range I like to keep: 2,000 to 2,500.

Yet, I still felt lousy at the end of the day.

This wasn't my old friend depression creeping in. It was something else, something almost as terrible: I shopped for clothes on Saturday.

Clothes shopping is a crummy experience for lots of people. But for the obese, it's a nightmare. Those throngs of clothing stores at the malls? Forget it.

Even when I was a 195-pound kid who played basketball and baseball, I had trouble finding a good fit there.

Oh, they might have a couple XXLs on the rack for show, but there's no selection for anyone approaching my girth. I just don't go in and spare myself the grief.

Just like my anxiety about my physical appearance swimming, I realize that as a man, I have it a lot easier than women.

Sizes for men usually have something to do with inches. A 40-inch waist, for example, is roughly the circumference around one's midsection.

For women, their sizes are some kind of mysterious language devised by sadists to make everyone who isn't Gisele Bundchen feel like a whale.

It seems to me – and I don't know because I don't wear women's clothes – that today's fashions for females are tighter and more revealing than when I was a boy.

In this respect, I've got it easy. If I can find a couple of navy blue golf shirts and some khaki slacks, I'm good for practically everything but weddings and funerals. For those occasions, I mark "declines with regrets" on the RSVP card and send a check. (OK, I have a nice black suit. But I hate crowds.)

Anyway, I have lost some weight. It's summer. My birthday is coming up later this month. I got a $20 gift card from one of the big-and-tall retailers in the metro. So I figured I'd pick up a pair of shorts for summer.

But I tried on a few pair and none fit. The store had plenty of large sizes, but in the past I've been so big I needed to order from the catalog. That would be the case that day, too.

The shorts I tried on were too tight in the gut and were really uncomfortable. To make matters worse, I found a terrific pop culture T-shirt featuring one of my favorite superheroes, Captain America. They had two very big sizes, one in 6XL and another in 7XL.

I was certain I could slide easily into the 6XL, but just in case, I brought along the 7XL. I thought I tried on the smaller of the two shirts first. It was slightly snug in my gut area, but certainly livable.

I slid on what I thought was the larger shirt to see if it was roomier. But I could tell right away as I spread it over my shoulders that it wasn't big enough at all. It was, in fact, the smaller shirt. Which means the bigger shirt just barely fit.

I threw both shirts in a pile on the side of the bench and sat in my boxers facing my own image in the mirror. I hate seeing myself in the mirror. I felt particularly loathsome in that moment.

All the awful things I think about myself and my weight ran through my mind. I put my clothes back on. I bought the larger Capt. America shirt and a lovely blue and white tropical pattern shirt.

All this progress, I thought, and I still can't downsize. People keep telling me I look different. I'm thinner in the face, they say. My friend Randy Evans said there appears to be "less of me" when we met for lunch last week.

I know the science. The body does not lose weight uniformly and rarely in the places to see progress the most.

Changes in muscle mass from working out more mean my body is becoming stronger. I'm able to do all the normal tasks of my daily life without pain or great exertion.

I should celebrate that progress. But I felt glum and defeated. Clothes shopping stinks.

Sunday, I ate turkey sausage for the first time. It was delightful and much lower in fat than hot dogs or other sausages. I worked out in the pool for about 40 minutes.

I decided to go downtown to Court Avenue Brewing Co. for a late dinner. I put on my pants and belt. I noticed my belt was very loose. I tightened to the last notch, but it still was more a decoration than a way to keep the pants up.

I called my friend Lew, a craftsman and Realtor in Urbandale. I went over to his workshop, where he punched three holes in the belt.

"One for today and two for the future," Lew said. Optimistic. I like that.

I put the belt back on and notched it to the first new hole. It still wasn't tight enough. Lew suggested I go one more. So I did.

And it felt good.

So maybe I'm not one full size down in shirts and shorts, but I'm still two notches better in the belt.

It's a weird way to measure progress, but I'll take it.

WEDNESDAY, JUNE 3, 2015

GETTING STRONGER

Tuesday was a win.

I had my final walk test at Mercy South Physical Therapy. The results were

When columnist Daniel Finney started physical therapy in March, he could only walk one lap of 156 feet. Last week, he notched 40 laps in more than 26 minutes — an improvement of 3,400 percent.

spectacular: 40 laps in 26 minutes.

Consider this: My first day in physical therapy back on March 26, I could only manage a single lap. By the end of it, I was in serious pain and had to sit and pant. I wanted to cry.

I worked with the marvelous Stefanie Kirk, whose exercise routines and stretches slowly alleviated my back pain and increased my strength.

The second time I took the test, April 13, I managed 10 laps for 1,560 feet. I was spent at the end of that test and in considerable pain.

Then more therapy. Stefanie increased my workouts, picked up the pace and challenged my muscles to work in new and more challenging ways.

The third test came April 30. I made 20 laps for 3,120 feet in 14 minutes, 51 seconds. I was spent again. Stefanie said, "I was labored and limping."

Still, the improvement felt great. I had doubled my tally from just 15 days earlier. I was getting stronger, gaining some flexibility and better able to handle basic daily tasks such as walking to the mailbox, getting in and out of the car and grocery shopping.

More work followed. The workouts were getting intense. Stefanie pushed both upper body and lower body exercises. My core was stronger.

I found myself walking faster and with better strides. I leaned on things less. My back, which was once so painful a hospital PR man offered me a wheelchair, can handle standing for longer periods now.

Heck, sometimes I can even go up three or four flights of stairs. (Going down is trickier, oddly, because of a weakness in my left thigh muscle.)

So, Tuesday came. It would be my last walk test with Stefanie. I have just two visits left with her. And, as I've written many times, I'm very nervous.

She's been the perfect physical therapist. She's got an upbeat attitude, but she isn't one of those phony chipper people who say silly things like "turn that frown upside down."

Stefanie always supports her directions with science. She explains what muscle groups I'm working and how that will help me in my long-term recovery from morbid obesity.

She prescribed a handful of home workouts that allow me to keep pushing forward and will guide me through the steps I need to keep getting better without direct supervision.

"It feels like we're breaking up in a couple weeks," Stefanie said in an email. "I've truly enjoyed working with you."

She means, of course, in strictly therapist-to-patient sense, of course.

I wanted to smash that 20 laps. I wanted to kill it. Stefanie was thinking 30. I wanted 40. I kind of wanted 50.

But another thing Stefanie reminded me of often: I needn't push myself to injury. There are many steps to be taken in recovery. I can't do them all in one day. And when I try, I usually end up taking a step back.

I laced up my walking shoes. Even the ability to do that is a major improvement. When I visited physical therapy for the first time in March, I needed a 3-foot shoe horn just to get my shoes on.

I never tied them. I just left them tied all the time. I even considered getting Velcro shoes. I didn't because I couldn't bend over far enough to tie the laces or pull the Velcro strap tight.

Now, I was tying my shoes and it didn't leave me breathless. That's a big deal.

I walked. Stefanie followed me with a timer in one hand and a lap counter in another. She complimented my stride and speed.

I felt strong. I felt powerful. I hit 20 laps in less time that it too me before. I wasn't fatigued. There was no pain. I knew I could smash 30 and maybe grab 40.

One of the other physical therapists asked Stefanie how far I'd gone. She said 36 laps. The therapist said, "You've got to get to 40. You're so close."

I did. I stopped at 40. I was sweaty, tired but not in pain. I traversed 6,240 feet – more than a mile – in 26 minutes, 6 seconds.

And you know what? I could've probably gone a few more laps. I don't know if I could have gotten to 50 or not. But I think I could've gone at least four minutes longer. I kind of wished I had.

But I'll take 40. Because that's progress. Big time.

I'm not math wizard, but in terms of percent change from the March 16 single lap to Tuesday's 40 laps, that's 3,900 percent better.

Like I said, Tuesday was a win.

TUESDAY, JUNE 2, 2015

HUNGER OR ANXIETY?

The time was 1:14 a.m. I was in bed reading a magazine. My stomach grumbled. I felt a tightness in my chest.

My mind was suddenly consumed with the three all-beef brats in my fridge and a wedge of cheddar cheese.

Was I hungry? Or was it anxiety?

It was probably some cruel mix of both. My anxiety has been grinding a lot that last month or so.

Sometimes it is difficult to tell if I'm hungry or anxious, but anxiety almost always drives hunger.

Then again, I hadn't eaten in a while and my sleep schedule had been off in recent weeks.

I went to the kitchen. I wanted those brats badly. But they run 180 calories a piece and are very fatty.

I didn't exercise Monday. I went almost 50 minutes in the pool Sunday. I wanted to rest my legs for my walking test at the physical therapist's office Tuesday afternoon.

I had pushed my calorie goal the previous two days. I wasn't over. My limit is 2,700 calories. But I like to stay below 2,500 calories.

Actually, I like to hover around 2,000 calories. But that's hard to pull off.

But Sunday and Monday my calories were slightly more than 2,500. This bugs me. My bad brain juju contorts this into pending failure.

Yes, it does this over and over again. This is the nature of depression and anxiety. My brain lies to me. It tells me I'm a terrible person and that I'm going to fail. And I believe it more than I care to admit.

I wrestled with this. Ignore the hunger. Go to sleep. No, I'm having a panic attack. Take a pill. Back and forth. To and fro.

Finally, I called my friend Jessica. She suggested that she often suffers from anxiety when she hasn't eaten in a while.

I hadn't eaten in a while. So I skipped the brats and cheese and went straight for some tuna with light mayo on a flat wrap and steamed green beans.

I finally started to feel better after I finished the meal.

Was it hunger? Was it anxiety?

I don't know. But I feel better and didn't break the calorie bank for a meal.

FRIDAY, MAY 29, 2015

LINEUP CHANGES

I'm facing a double whammy from my medical team in the next few weeks.

First, I will soon be discharged from Mercy South Physical Therapy. There I've worked with the amazingly talented Stefanie Kirk.

I'm very emotional about this. I was assigned Stefanie by chance, but it proved a perfect match. She is smart, driven and directed, but has a good sense of humor and takes my sarcasm in stride.

If I had ended up with one of those screeching trainers like Jillian Michaels on "The Biggest Loser," I would quit after the first visit.

Stefanie has been tough, thorough and encouraging throughout the healing process. I went from not being able to walk much more than 150 feet to having the strength to live everyday life largely unencumbered by pain.

Still, the goal of all treatment is to get the patient into a position where they can maintain their own self-care. It's like (I'm told) being a parent. Eventually the kids move out and start their own lives.

My time with Stefanie comes to an end soon and I'm nervous about it. Her encouraging presence helps me stay accountable to my goals.

But she has given me the tools I need to move forward. To her great credit, I think I'll be OK. It'll just be a bummer not seeing her a couple times a week.

Thursday, I got a letter in the mail from my primary care physician, Dr. Lisa Jensen of the Iowa Clinic. She's looked after me since I moved back to Des Moines at the end of 2005.

She's taking a new job with the VA. Her husband is a veteran and the new gig will allow her to spend more time with her family.

My work with Dr. Jensen has been less productive than it should have been. And that's entirely my fault. I ignored her admonishments about my increasing weight for the better part of 10 years.

I skipped appointments and sometimes only popped in for my annual physical. I cancelled so many appointments, her office considered dropping me as a patient at one point.

Dr. Jensen, though, is a very good doctor. I remember visiting her after I'd gotten beat up in a city park while covering a story a few years back. I was touched by her genuine concern and the kindly way she removed the stitches in my ears and looked at bruises on my eye socket.

Similarly, she was equally receptive that dark day three months ago when I finally realized my morbid obesity was ruining my life. She got me in right away and prescribed pain medication for my back. She offered several referrals.

She did so kindly and with nary an "I told you so." She just wanted me to get healthy. That's how it is for most doctors.

Dr. Jensen is finishing up in July. My time working with Stefanie ends in early June.

I've said this before, but it needs repeating: For any health plan to work, the patient must have an excellent relationship with their healthcare providers.

I have been extremely blessed in that regard. And though those relationships are going to change, I am happy to have known and received such excellent care.

THURSDAY, MAY 28, 2015

TAKING A SEAT

I was out on assignment interviewing a rabbi in his office this week when I had trouble sitting down.

This isn't the setup for a joke. It's a true story.

The chairs in the rabbi's office were too narrow for my wide behind.

I finally turned so I could wedge one of my butt cheeks on the seat and kind of balance myself there while we did the interview. It was uncomfortable, but at least I got through it.

This happens to me quite a bit. It's one of the unsubtle daily reminders of my morbid obesity.

There are movie theaters around town that I love, but avoid because my rear end can't fit the seats.

I don't even try to go to sporting events anymore, unless there's true bleacher seating.

And I have to be very careful when I visit offices because many seats are too small to support my frame.

I've broken a few chairs in my day. A couple months ago, I was working on a column about a photographer.

He had me sit on a metal stool while he took my picture and we talked.

The stool collapsed and I hit the ground hard. The photographer was mortified. He blamed the stool.

But I knew the truth. My body weight challenges the structure of most common furniture.

We have a lot of common spaces in our Register offices in Capital Square. Most of the chairs I refused to sit in because I'm afraid I'm going to break them.

The two chairs in Register Editor Amalie Nash's office are too small for me. On the rare occasion she summons me from the bullpen, I usually stand, or sit on the edge of the seat.

If I go to the restaurant, I always ask for a table. I don't want to be in that awkward position of having my gut pushed in by the fixed table in a booth so much that it's hard for me to breathe.

It's happened more times than I care to count.

When I eat alone, I prefer to sit at the bar. I like to talk to the bartender, but there I have to be careful, too.

My bottom is wide and if I get myself settled poorly on the seat, after a few minutes, it feels like my hips are going to pop out of their sockets.

Cars are tricky, too. Mom 2.0, the kindly east Des Moines hairdresser who raised me after Parents 1.0 died, bought a new car a while back. I can't even duck inside to sit in it.

A while back, my friend Angela offered me a ride home for a restaurant. I didn't fit. I walked.

My physical therapist, Stefanie Kirk of Mercy South Physical Therapy, notes my right leg is much stiffer and less flexible than the left.

That's because over the years, as my obesity changed my body, I've been forced to push the seat further back in my car so my gut doesn't rub against the steering wheel.

My butt is so puffy that I have to twist my body slightly so that my right leg has the proper leverage to work the gas and the breaks.

I have a seatbelt extender, just like on an airplane.

Oh, and speaking of airplanes: Forget it. I'm too fat to fly. I don't know if an airline would force me to buy a second seat, but I'm not taking the chance.

I know I'm not alone. I was working for my alma mater, Drake University, while the remodeled Drake Stadium.

One of the reasons why they are fewer seats in the revitalized stadium is because new specs recommend slightly wide space for butts on bleachers.

I'm not writing about this because I expect sympathy. Nor am I advocating massive changes to seating in offices, venues and so on nationwide.

Although at the rate the obese and morbidly obese population is growing, this may have to happen simply as a practical matter.

I'm writing about it because it's one of the little indignities I've brought on myself with this largely self-inflicted condition.

Furniture and seating are designed for the average person. I've never been average in size or shape, but to know I deviate so far from that is a painful reminder of how far I let my physical health deteriorate and how far I have to go.

There is one positive note to come of this morose musing: Later the same day as the rabbi interview, I had physical therapy.

I worked very hard in a series of alternating exercises that challenged my legs, arms and trunk.

I'm stronger now than I have been in a very long time. I can walk. I can push and pull weight. I can handle cardiac endurance.

Am I running a race? No. And, of course, I still have trouble fitting in chairs.

But at least I have the hope to know that one day I might slide right into a seat and not think twice about it.

That's going to be a lovely day indeed.

TUESDAY, MAY 26, 2015

WORK TO DO

The swimming pool at my apartment complex opened over Memorial Day weekend.

I looked to this day with both dread and excitement.

The excitement is access to a pool for the next three months. Water is a perfect place for me to jog, walk and otherwise exercise without seriously damaging my joints.

Buoyancy reduces impact on joints, but the water adds resistance. The result is a good, tiring workout that makes my legs stronger with reduced chances of straining a calf or popping a knee.

The dread, though, is a deeper issue. I'm fat. And I hate – hate – to be in public with my shirt off. I'm ashamed of my body in its doughy, morbidly obese condition.

Heck, I don't like to catch glances of myself in the mirror getting out of the shower. But to go outside wearing nothing but swim trunks? Yikes, that's scary.

By the way, I don't want to sound like the title character from the old "Cathy" comics, but finding trunks for someone of my girth is a challenge.

I had to buy a pair online a couple years ago because even the stores around the metro that sell big and tall sizes didn't have something that was comfortable for me.

I pause here to recognize that whatever agonies I might experience here, I fully understand that it is incalculably worse for women.

Society tolerates fat men. It does not tolerate fat women. It is cruel and shunning to them. Even women with perfectly fit bodies, well beneath the standards of obesity or even overweight, shun swimsuits because the ideal created by models, magazines and cosmetic companies is so impossible.

So, I don't want to pretend I have it as tough as women when it comes to exposure at the pool. But it's not fun, either.

My apartment is close to Drake University. A lot of students live there. And many of them are young with muscular, lithe and beautiful bodies. I look at them and back at myself and feel disgusting.

There are times where I am embarrassed to go to the pool. I feel like one of the dung-covered peasants in "Monty Python and the Holy Grail" walking into a banquet hosted by the list from People Magazine's Most Beautiful People in the World.

I ate tacos with my parents on Memorial Day and headed home. The pool was open, but there were some neighbors having a barbecue. Other neighbors sunbathed while their kids splashed in the water. (The super models had the weekend off, apparently.)

My first thought was, "Dammit. There's people there."

Of course there are people there. It's a beautiful late spring day. Why wouldn't there be people there?

I actually hoped it would be overcast with a light rain. It would be cold and unpleasant, but at least no one would see me.

Still, this journey is going to end quickly and in epic failure if I don't keep up the increased activity. I didn't become morbidly obese simply because I ate too much. I also didn't move very much.

Most of us don't. Few people have physical labor jobs in this consumption-based economy. We sit and punch keys on a computer and eat sugary and salty snacks while we're there.

Step one is changing what and how I eat. Step two – moving more – is just as critical if not more so.

So I slid on my trunks, a navy blue pair with a pattern of white palm trees. I threw a towel around my shoulders and marched out to the pool.

I waved to the folks grilling meat. They nodded. I said hello to the children playing with a beach ball. I nodded to their parents.

And then I got to work.

Because it doesn't matter what they think. It doesn't matter what I think.

I've come too far to let shame and fear limit me now. Somebody thinks I'm fat? They're right. But I'm doing something about it.

Somebody says something about my obesity? Well, that's never happened. And if it did, well, readers say crummy things to people who work at the newspaper all the time. I can probably let it slide.

Because when I slid those trunks on for the first time since last summer, they were loose. I needed to tighten the string.

That means all this sacrifice and sweat has been worth it. It's working.

I recall my swimming lessons as a boy at the old Winterset pool. The teacher had me climb to the top of the 10-foot diving board to jump in. He promised to catch me.

I was terrified. My dad, a Navy veteran of World War II, was mortified. He stood outside the fence pointing down. Just jump, he gestured. It will be OK.

I wasn't convinced, but I did. I plunged into the 10-foot deep end of the pool. I wiggled to the top and learned how to swim.

Thirty years later, my diving days are behind me. Dad's long gone.

But I thought of him as I got into the water and went to work.

FRIDAY, MAY 22, 2015

TELLING THE STORY

Charity Nebbie of Iowa Public Radio's "Talk of Iowa" interviewed me for Thursday's show. She also interviewed Dr. Bob Spanheimer from the University of Iowa Hospitals and Clinics and bariatric surgeon Dr. Todd Eibes from Belmond about the ongoing issue of obesity.

Check out the full program here:

THURSDAY, MAY 21, 2015

MIND TRICKS

Living with depression and anxiety conditions and trying to make a major life change such as recovering from morbid obesity, my mind can play tricks on me.

This body composition analysis shows the percentages of fat in my body as well as how many calories I would have to eat to keep my current weight.

That's why hard data is so important to the cause.

My brain tells me I'm getting fatter.

But the math doesn't.

I have to trust the math.

Earlier this month, I met with my nutritionist, Jacquelynn Thiele at the Mercy Weight Loss and Nutrition Center in Clive.

She had me step on a machine called the Tanita Body Composition Analyzer.

The machine not only weighs me, but uses my height, age and weight to make some important readings on my body.

For example, it can tell me how much of my mass is fat. Currently, it is 50.9 percent. That's wince-worthy, but it isn't as if I didn't know I was fat.

The rest of my mass is made up of muscles, bones, organs and whatnot and water weight.

The most important piece of data the machine recorded, at least for me, was: 4,054.

That's the number of calories I would have to eat in order to maintain my current weight of 525.

So, let's take that back to an emotional level.

I'm always worried that a slice of bacon or string of spaghetti will send me spiraling backwards, undoing all the good work to this point.

But Thiele explains I would not only have to break my daily calorie limit of 2,700, but I would have to blow it up – and I would have to do it every day for a sustained period.

My mental health therapist reminds me that by the time I finally sought medical help for my morbid obesity, I had already started to make small changes in my diet.

So it's possible I was eating as many as 5,000 calories a day – or an average of that – before I started my recovery.

My initial calorie goal when I started was 3,900. I hunkered down and regularly stayed below 3,000. After my second visit to the nutritionist, we dropped it to 3,250.

This time, we got stricter: 2,700. And, in my mind, the goal is to stay between 2,000 and 2,500 calories.

Any time I creep past 2,500 calories, I get antsy.

That nervous energy can be a real problem. Live with anxiety disorder, it isn't just nervousness that troubles me. It's a bad pattern of thinking.

For example, my friend Jessica and I had dinner at Jethro's BBQ Bacon Bacon this week. I had a sensible meal of Cajun blackened catfish with green beans and a side salad with fat free dressing.

Jessica had a breakfast dish that included bacon. And I decided I really wanted some bacon. I ordered a bucket of bacon. It's not really a bucket. It's more like a desktop flower pot of bacon. It holds eight slices.

I ate them all.

Now, I know there are a lot of bacon lovers out there. Culture worships bacon. It is tasty, but it's fatty, salty and largely unhealthy.

The eight strips of bacon had more calories than the 12 ounces of fish I ate and almost none of the nutrients.

I loved every bite. Until later that night. That's when my old nemesis anxiety paid a visit.

"Bacon!" the evil voice in my head shrieked. "Way to go fatty! You're lucky Capt. Ahab isn't around or he'd harpoon you, you big whale."

(I don't actually hear voice in my head. That's just for literary affect.)

The bacon splurge came on a day when I had a nice grilled ribeye steak and some French fries and a piece of Texas toast. Trust the French and Texans to conspire against me.

That's a lot of carbs for a Type II diabetic. And I have largely sworn off fries and most bread since the recovery began.

So, of course, the worry was I was undoing good work. I was off the path and careening toward destruction.

It's all irrational, of course. But it's hard to understand that in the moment. Anxiety is a brutal bummer of a disorder.

But there is comfort in the data.

Despite the fries, toast and bacon, my calorie total for the day was 2,515. It was under my 2,700 limit and only slightly above my 2,500 limit.

Most importantly, it was miles below the more than 4,000 calories I would need to eat just to maintain my current weight, let alone make me gain.

Now, there are realistic drawbacks to the carbs and fatty meats. One of which is increase sodium and cholesterol.

Still, realistically, it wasn't a bad day at all.

That's why the math is important. And believe me, it pains me as a newsman to say that. I avoided math in college the way hikers avoid rattlesnakes.

When my emotional state isn't copacetic with reality, every bit of data helps.

WEDNESDAY, MAY 20, 2015

SEEKING SUPPORT

From the #MakingWeight inbox:

Q: I am very much like you. I have been up and down from 420 lbs. I am trying to reprogram myself and was wondering if we could help support each other by email.

A: My first suggestion, as always, is to see a doctor to set up a plan that works for you. I also suggest a mental health professional and, if possible, regular visits to a nutritionist. Recovering from morbid obesity requires a team of professionals to help you sort through the issues of body and mind.

Secondly, I recommend you look to close friends and family for the support you've reached out to me for. They know you and care about you. And while I am touched that you would think of me for support, I'm not really qualified, either as a professional or a friend.

Friends and family are essential in this process. I lean on mine for support. I've written often about calling friends in the middle of the night when panic strikes or hanging out with another buddy to shake off depression.

I am honored that my writings have touched so many people. I have tried to be as open and honest as possible, but in other ways I am closed. I still live a private life and am protective of that.

It's very important for me to have a place where I don't have to think about saying the right thing or regularly discuss my weight, mental health, my diet and exercise.

As you go along this journey, you will get very tired – both physically and emotionally. You'll need that reservoir and safe place to visit often lest you fall into the trap of eating your feelings.

I can't be that person for you. I am open and honest, but I am not necessarily a nurturing person.

This doesn't mean I don't care. I do.

But everybody has to find their own path. Some take great solace in group therapy, for example. This would not work for me. I prefer one-on-one interaction.

Please don't take this note as rejection. Take it as encouragement to root yourself in the place that you are and take advantage of the resources already available to you.

The road is long, but you will make it, with a lot of help from your friends.

Be well and brave heart

.

MONDAY, MAY 18, 2015

THE LONG WAY AROUND

Sometimes being this open with readers takes a lot out of me. I've opened a raw nerve. I'm a sensitive guy, maybe an over-sensitive guy for the job I have.

But sometimes I just don't want to talk about exercise, food and weight.

Yet it's on my mind all the time. And that wears me out, too.

I think about how terrible I look in the mirror. I get overwhelmed by how long and lonely the journey is.

And sometimes I snap at readers who suggest their magic beans or offer their particular services to me.

Some offers are earnest. I have said many times I am comfortable with my faith journey, but I have received many offers of prayer and invitations to various churches.

I politely decline. I'm not offended by that. To a devout believer, they are offering me the greatest kindness they know. I'm not going to dump on that because I may have a different belief.

Sometimes people want to give me things, like wearable fitness items or custom shoes. One company offered to send me freezable lunch bags to keep my healthy lunches cold all day.

This is dicey. The offer is kind, but it comes with an expectation that I will write about the product, preferably in a positive manner, though nobody explicitly has said that.

Our ethics policy specifically prevents me from accepting gifts and it makes it easy to decline.

I would offer that if there is, indeed, a sentiment of wanting to help behind those offers, then make a donation to the charitable arm of your favorite hospital.

They all offer nutrition counseling and physical therapy. Help someone else get the help my insurance is helping me get.

And barring that, make a donation to Wounded Warriors, which helps severely wounded vets of the Iraq and Afghanistan wars find jobs, education and other resources.

I am not feeling terrible open at this writing. I've had problems with my anxiety all day. My psychiatrist allowed me to increase my dosage of anti-anxiety medication. It greatly helped.

It also induced a much-needed nap.

I promise to be more thoughtful – and open – in my next post. And wherever you are, my fellow travelers on this journey or supporters along the way, behave and be kind.

Brave heart to all.

FRIDAY, MAY 15, 2015

WEIGH-IN NO. 2

The number came up so quickly.

A month of work – diet, exercise, calorie counts, food choices, abstinence from unhealthy favorites, sweat and pain – came down to a moment in a small examination room at the Mercy Weight Loss Center in Clive.

I slid off my shoes and socks. I stepped on a machine called the Tanita Body Composition Analyzer.

Before the torrent of anxiety that plagued me in advance of the appointment could take hold and really rock the panic, my nutritionist Jacquelynn Thiele said, "525."

That was my new weight: 525 pounds. I'd lost another 17.6 pounds since the previous month's weigh-in.

Overall, I've lost 38.2 pounds of the 563.2 I weighed when I began my journey to recover from morbid obesity.

Let's put that in perspective: 38 pounds is 5 pounds more than a cinder block.

It's the weight of more than five newborn babies weighing 7.5 pounds each.

Or, my favorite measurement, in two months I've lost the equivalent of more than 300 glazed doughnuts.

Cute comparisons aside, I was somewhat disappointed by the number. I wanted to lose 20. That was the number stuck in my head.

I lost 20.6 pounds the first weigh-in. It was a nice, round number. A big number.

Seventeen was only 3 pounds less, but felt much smaller in my depression-riddled brain.

I am not very good at expressing positive thoughts, especially as they relate to myself.

To steal a line from David Letterman, "I've never been able to convince myself I'm good at anything."

By all objective measures, this progress is excellent. But my brain is not an objective place.

I know that the first pound is easier to lose than the last pound.

And I know there are plateaus in any weight loss effort – periods where you are still making good decisions about food and exercising, but your body just won't give up the weight.

Thiele, the nutritionist, encouraged me. She said I could keep losing 15 to 20 pounds for a while.

But in my mind, I've already stopped losing weight. By the time I got to the car, I had gained 5 pounds in worry.

This is what it's like to live with depression and anxiety, two pesky ailments that were no small contributors to the morbid obesity I'm trying to recover from.

Thiele and I went over my food diary. She was pleased. I'm eating more foods that are low in calories but high in nutrients: green vegetables, pork, chicken and fish.

She had a suggestion. Maybe I could get rid of my morning glass of orange juice.

This upset me. I like orange juice with my breakfast. Heck, sometimes orange juice is breakfast.

But it's mostly sugar. I get plenty of Vitamin C from other sources, including fruits, veggies and a daily multivitamin.

It runs about 110 calories for an 8-ounce glass. It's completely rational to get rid of orange juice. In fact, it's a good idea.

Yet when Thiele suggested it, I dug in.

"Not my orange juice, too," I said.

She said I could just eat an orange and get better nutrients.

And suddenly orange juice became some irrational line of demarcation. I'd sworn off nachos, pizza, pies, cakes, doughnuts, Mountain Dew, pastas and so many other things of which I used to, as the Coneheads said, "Imbibe mass quantities."

Thiele sensed I was getting emotional. She said there were other ways to trim calories or make better choices.

We set a new calories goal: a maximum of 2,700 calories per day with the idea of being between 2,000 and 2,500.

That seemed reasonable. I've generally kept that range for the last month. I hadn't approached the 3,250 calorie maximum we set a month ago.

I left Thiele's office in a grump. Damn. Orange juice, too.

I went to physical therapy and worked out to continue strengthening my core. The morbid obesity caused arthritis in my back and a narrowing of the spinal canal.

It's much better now. I can walk unencumbered by pain. I can get in and out of the car. I can fetch the mail. I am achieving my daily steps goal with more regularity. I'm whipping it a few times a week.

Wednesday, I climbed four flights of stairs after dinner. I was winded, but I made it fine. Two months ago, I wouldn't have even tried.

I've got four more visits over the next month to Mercy South Physical Therapy with my therapist Stefanie Kirk.

I'm worried about that, too. Kirk is very good at her job. She has taken excellent care of me. But soon I'll be on my own.

I could hire a personal trainer, but it'll be tough to find someone I like and trust as much as Kirk.

I took a few laps at the physical therapy office before I drove home. My mood was still melancholy.

I called my psychologist. I asked him why I can't feel positive emotions.

"I should be happy about this, right?" I said.

He said I should. But, he noted, being negative is a defense mechanism. I learned it a long time ago to protect myself from hurt.

That's true. I don't like to be hurt. This is normal. Most people don't. What's different for me is sometimes I worry so much about how emotionally painful something is going to be that the anxiety is far worse than the actual event.

My therapist offered good advice, as he usually does.

"Say it out loud," he said. "If it sounds irrational when you hear it, it probably is."

I thought about that. He was right. I am OK. I'm not better yet, but I'm getting there.

"I'll tell the insurance company to put a little something extra in your next check," I said.

He laughed.

I went home and grilled chicken breasts.

It really was a good day, even if it took me longer than everybody else to realize it.

THURSDAY, MAY 14, 2015

DOING THE WORK

I have my second weigh-in Thursday afternoon and I'm terrified.

There's no reason to be terrified.

I've done the math. My calorie count is down by more than 35 percent since I started recovery from morbid obesity two months ago.

Not only am I eating less, I'm eating better. Few fats, carbs and sugars.

I went from the occasional fully leaded Mountain Dew as a treat to only diet pop. I switched from 2-percent milk to skim.

I'm physically stronger. My work with Stefanie Kirk at Mercy South Physical Therapy has been life changing.

Hell, I walked up and down four flights of stairs Wednesday night. Sure, I stopped once.

But two months ago when this journey began, I wouldn't have even tried to go one.

So why am I terrified?

It's irrational. It's the anxiety. It's the depression.

Somehow my bad brain chemistry convinces me that I'm gaining weight when I'm actually losing it.

I won't lie: This journey has not been without its awful days.

The other day, I wanted pizza so bad I was practically homicidal.

And I usually don't get cravings.

One or two slices of pizza would be fine. But I can't stop at one or two. I would eat those and the rest of the day be sneaking another slice of cold pizza until the pie was gone.

I felt bad that on Mother's Day, I had to ask Mom 2.0, the kindly east Des Moines hairdresser who raised me after parents 1.0 died, not to serve her terrific rhubarb pie for dinner.

She and Grandma Lois love the stuff. And so do I. But I can't have it around.

One slice is about 550 calories. That's a whole meal.

Mom 2.0 was, as always, wonderful about it. She said she and Grandma would have it another day.

She's a Type II diabetic, too. She's watching sugars and carbs just as hard as I am. She understands.

Plus, she's a mother. They protect their kids.

I still felt guilty. Damnit, I wanted a slice of that pie.

It bothers me that I know I can't control myself around certain foods.

Malo, the fine restaurant in the Des Moines social club, is one of my favorite haunts.

But I haven't been there since I started the journey. They serve nacho chips with this terrific house salsa. I could eat two baskets of them without taking a breath.

Finally, I went Wednesday night with my friend Jessica. I had a terrific salmon dish. She munched the chips and had a burger. It was fine.

But I was upset with myself. Why can't I just eat a few?

I don't know. Why can't the alcoholic just have one drink? Why can't the smoker just take one puff?

That's how I am. It's better to say no than risk saying yes too many times in a row.

I'm not a particularly religious man, but my friend and fellow East High School classmate, Tyler Teske, is a man of deep faith.

He often reminds me that there are some things in life that we cannot control.

Accepting that is harder than I would care to admit.

I'll tell you the truth: It feels unmanly. I know that's a terribly dated, possibly sexist perception. But it is how I feel.

I feel like if I were tougher or had some true grit, I could easily resist all these temptations. I wouldn't go to the refrigerator for entertainment or emotional comfort. I would go there for sustenance only.

But I don't. And I haven't for such a long time that I've put my body in a terrible place.

So I'm terrified of failure. I'm afraid I'm not losing weight or I'm not losing enough weight.

Yes, I know it's a long journey. And so many wonderful people have been and continue to be supportive.

But I am scared. I'm sad that I'll never again allow myself to enjoy a deep dish pepperoni from the Wig & Pen in Ankeny or Mom 2.0's magnificent potato salad on the Fourth of July.

I worry that the stinging pain in my quadriceps, an inflammation between the muscle and the connective tissue on the sides of my thighs, will never abate.

Most of all, I worry that one day I will just give up and come out the other end 50 pounds heavier in a room full of empty pizza boxes covered in duck sauce and egg roll crumbles.

It's irrational. I know, but that's part of the journey. I don't want to give folks the impression that it's a joyous discovery every day.

Some days, I don't want to count the calories. I just want to eat.

But that's not how I roll anymore.

Because when I step on that scale Thursday afternoon, I want to see a smaller number than the last time.

That takes work. Work that is seldom fun or cherry.

But if that number keeps shrinking and my body keeps getting stronger, it's work well worth doing.

TUESDAY, MAY 12, 2015

BRAIN VS. STOMACH

It was shortly after 3 a.m. on Monday morning when the anxiety began to set it.

The cause? Unclear. But the fear clutched my chest and squeezed like Tom Brady's throwing hand on a deflated football.

I recognized the feeling right away, of course. A man doesn't live with generalized anxiety disorder as long as I have without understanding the sudden buildup of agitation.

I took a pill right away. It's an assault team in a half-milligram yellow pill that hunts down the malfunctioning chemicals and rounds them up. It strikes fast and efficiently, usually driving out the anxiety in 15 minutes, 45 minutes tops.

But in that window, lots of bad craziness passes through my head. Bad thoughts. Stupid thoughts if I really think about them. But in anxiety, you don't just think. You over-think. Every hiccup, stumble or foible is twisted into an ultimately humiliating and lethal narrative.

Example: I ate too much Sunday. That means I'm not going to lose weight. No, that means I'm gaining weight. In fact, I've gained back any weight I've lost and more. I'm fatter than I've ever been. I'm going to die face down in my bathroom. Tonight.

It's all nonsense, lies manufactured by bad chemistry in the brain. I know they are lies. I know it's just a bump. But in the moment, it is awful. I will do just about anything to shut the bad thinking down.

This is when I might run to Little Caesar's and crush a large pepperoni pizza with a side of crazy bread and chase it with a liter bottle of fully leaded Mountain Dew.

Little Caesar's is closed at 3 a.m., but my refrigerator is open 24-7. I could slam together a massive sandwich or heat up one, two or maybe three chicken pot pies.

I don't. I sit in the dark and let the train of bad thoughts run off the track and into the river. I wait for the pill to take hold.

There are physical symptoms to anxiety attacks, too. My hands shake. I mentioned the chest tightening. Sometimes my body tingles with a general sense of uneasiness.

I think of it as reverse Spider-Sense, the precognitive power of Spider-Man. Instead of warning me of danger, it's just making me feel like there's an emergency when everything is fine.

The worst attacks, and the one Monday morning was of that unfortunate variety, feels like my skin is itching on the inside. I promise you it is less pleasant than it sounds.

Slowly the pill releases its medication. The thoughts fade. I grow tired. It is almost 4 a.m. now and my body is exhausted. I take a gulp of tea and turn out the light.

I rode the anxiety beast for about an hour. I didn't empty the refrigerator. I have a regularly scheduled visit to my therapist Tuesday and physical therapy in the afternoon.

Monday was a crummy day, "a bad mental health day" in the parlance of our times.

Tuesday is a new day. A new day to move forward.

THURSDAY, MAY 7, 2015

FROM THE READERS

I've gotten a lot of wonderful calls, emails and notes from readers who offered their support in my effort to recover from morbid obesity. Many have shared their struggles with me and asked me for advice.

I want to emphasize, again, that I am not a doctor or therapist of any kind. So any advice I give is simply from my experience. Always defer to your doctors when making medical decisions of any kind. I've withheld the names of the writers because while I choose to be open about my journey, others should be free to make that decision for themselves.

Here are a couple of recent exchanges.

"I feel I'm my worst enemy. between anxiety and depression. I'm almost 500 pounds. I'm 32 and single father of 3 and not being able to watch them or even playing with them. I'm blowing it I only have one shot at this. I just don't know where to start? Any advice would be great." — Des Moines reader

Me:Consult a doctor as soon as you can. Get into a therapist as quickly as you can. Discuss your options. And make the change. You have a lot to live for. Don't make your kids bury you. I don't mean to be harsh. But you have to find a way. I lost my dad when I was 13 and mom when I was 14. Take care of yourself so you can enjoy your children for many years to come.

"Your article today (April 28) was excellent and such a great description of inertia. Dealing with my partner's symptoms exactly as you described them, makes it the first time I have seen it in print. But loving someone with these symptoms is not easy either because I'm not sure what the best approach is for me to take.

"Do I just accept this part of him or do I push, cajole, prod?" — Des Moines reader

Me: That's a tough question. I don't know what the right answer is. I don't have a partner and my mental health issues are, in part, a reason for that. I can be a difficult person to get along with in the best of moods. A thought: Have you considered visiting a therapist on your own for advice and counseling. My mother was a prescription drug addict. I learned that though the affliction was not mine, the side effects certainly were. It might be worth it so you can better understand your burdens in the relationship and how that affects your behavior. Despite our best intentions, we cannot make other people seek treatment or change. It just doesn't work. That choice has to come from inside the individual. I hope your partner will find his way sooner rather than later. Brave heart.

I ran across this quote in a magazine recently. I thought it would be useful for my fellow travelers:

"The most difficult thing is the decision to act; the rest is merely tenacity."

— Amelia Earhart

TUESDAY, MAY 5, 2015

SHADOWS AND SHAME

I attended the first class of the "4 Weeks to a Healthier You" series offered jointly by the Mercy Weight Loss and Nutrition Center and the YMCA Healthy Living Center on Monday evening.

Six people signed up. Only two of us showed, myself and a woman from Des Moines who needs knee replacement surgery. Her doctors won't consider surgery until she's lost some weight.

I don't know why the others didn't show up. Maybe they were sick or had conflicts. But I wonder if at least one or two of them didn't come because of a darker reason: shame.

Being fat in society comes with a lot of shame. I'm only beginning to realize how much of it I internalized and carried (and continue to carry) with me as I grew more obese in recent years.

Some of it is external. It's still OK to mock the fat. Comedians do it. I have loved David Letterman's goofy humor since I was 7. I've seen every episode of his old NBC "Late Night" series. Recently, when New Jersey Gov. Chris Christie came to national prominence, Letterman mocked him, often using his weight. I haven't felt comfortable watching Dave since. I know they're "just jokes." And Christie is lampoon-worthy, but why not attack the corrupt nature of his state or toddler temper tantrum politicking. No, hit the easiest target: He's fat. It's lazy.

Those using the Internet are, of course, hateful to fat people. There's a blog out there about people who shop at Wal-Mart. A big chunk of the posts are shots of obese people in ill-fitting clothes. Nothing is so loathsome as a fat person to the savages gleefully sneering anonymously behind their screens.

A few years ago, a friend posted on his Facebook feed a picture of an obese woman going through a drive-through window at McDonald's. He made a rude comment. I replied that I was his friend and a fat person. I know he wasn't thinking about me when he posted the picture, but it still stung nonetheless.

But there are smaller slights that only an obese person truly knows. If I use a public restroom, will there be enough physical room for me to turn around and clean myself? Yes, that's gross. But it's a real problem, one that I've faced and it's hellish. I've driven miles home and nearly suffered humiliating accidents because I feared the public restroom available to me wherever I was just too small.

And these are just the jokes other people tell. I've developed a complete canon of self-deprecating fat jokes. It's better if I make them before someone else can. I used to joke with firefighters that my donation to the department was living on the ground floor -- so they wouldn't have to carry me downstairs. I told my friends I wouldn't die on them because I didn't know six guys who could carry my casket.

Years ago, I gave up shopping popular chain stores. I can't even buy a shirt that fits at the big discount retailers such as Target or Wal-Mart. I have to go to costly specialty stores. There I pay what I call the "fat tax." The merchant will lie to you and say the additional cost is due to the extra material. But if that's true, why is their no discount for the small and medium sizes? The obese are a captive consumer. Retailers regularly overprice goods because there are only a few places to buy them. It's a markup similar to beer at the baseball park.

Heaven help me if I had to squeeze into a changing room, even at specialty store. And due to my lack of fitness, both the shirt I tried on and the one I wore in were likely soaked with sweat by the time the experience was over. To avoid this horrifying experience, I bought oversized clothes through the Internet. I bought a closet full of Navy blue polo shirts all the same size. I wear them until they're threadbare.

Oh, the sweat. At my worst, a walk to the mailbox and back would have me wheezing, my legs crying out in pain and me dripping with sweat. I arrived at appointments for work early because if I had to walk any distance to get to the people I had to meet, I knew I would be out of breath by the time I got there.

I am an introvert. That means I don't care for crowds, parties or loud venues most of the time. But I only recently realized how much I've been hiding from people -- even those I know love and care for me. When a friend joined a gym and started to get fit, I felt betrayed. Was I to be the last freak in my tiny circle of friends?

A childhood friend's son called me "fatty" in 2013. I didn't go back to his house for two years. I was so ashamed I couldn't face my friend, who has always been slim, his beautiful, athletic wife and children. I was, to my way of thinking, a wheezing, sweating monster. I felt repulsive. I stayed away despite my friend's regular invitations.

I should note that one of the turning points that set me on this journey was a frank discussion with this same friend. He was helping me hang bookshelves in my new apartment last summer. It was not long after he'd lost his father and he bluntly said he did not want to bury me, too.

And when I first wrote about the "fatty" comment, I did not identify my friend or his son, but he knew right away it was one of his sons. He called to tell me they had a chat. He is my friend and I love him like a brother. I always have. He was my friend when I was thin. He's my friend now. The problem was with me. I was ashamed.

Things are better, now. The shame is still there. I still avoid the one mirror in my house. I don't like seeing my picture or having it taken. I see myself in pictures and think, "What happened?"

So I can see why somebody who signed up for a class about weight loss and healthier living would bail out. Sure, they hate being fat and maybe even hate themselves a little bit. But we're all a little judgemental. We sit in a room with other obese people and say, "Well, I'm not as bad as that guy or that woman."

And if you come to such a class, you're admitting, once and for all, that you have a problem. That is a hard thing to do. A damned hard thing to do. It took me years to do it. I hid for as long as I could. I kept saying it wasn't really that big of a deal. I was going to be fine. There were people worse off than me. Those people are the ones in those classes.

Then I reached a point where I could barely walk. I felt like I was going to be atop a scooter going through a drive-through sooner rather than later.

So now I'm in class and I'm taking notes. I appeal to all of you, my fellow travelers, join me. The first move is yours and its the toughest.

Please make it.

MONDAY, MAY 4, 2015

DOING THE MATH

Depression whispered its loathsome song into my ear Sunday evening.

I enjoyed a nice meal at Court Avenue Brewery. I ate an appetizer of salmon cakes. I followed it with some fried cod with mixed vegetables and a diet pop. Sure, baked fish is better than fried. And salmon cakes are higher in carbs than grilled salmon. But I had already compromised. The main dish on the menu is fish and chips. Chips, of course, being what the British call fries. I subbed the veggies for fries. It was a good choice.

I entered my calories into MyFitnessPal. The tally for the day was about 2,400, far less than the 3,250 maximum my nutritionist and I agreed upon. But anytime my calories go up one day compared to the last or one week compared to the last, I start feeling anxious.

And depression seizes the moment.

"Fried fish, eh, fatty?" said the jerk in my brain chemistry. "Might as well have had the fries. You're not going to make it. You're going to crack. You're going to plow through a dozen doughnuts and a stack of pizzas. You'll always be fat. Everyone is looking. And you're going to fail."

Depression lies.

I know this. I control it with medication. And most of the time, I'm OK.

But there are still moments like Sunday evening, when the anxiety and depression drown out common sense. I took an anti-anxiety pill to quell the growing panic in my gut. It was late enough that most of my friends were in bed or, in the case of my fellow night owls, still at work.

It wasn't a big enough emergency to make a call to my therapist, though he has taken calls in the wee, small hours from me on many occasion.

So, I decided to do something that my middle school self would have never thought comforting: I did the math.

I borrowed a pen from the bartender and pulled a receipt from my wallet. I went back through my calorie counts since I started recovery seven weeks ago.

The first week I started the journey, I averaged 3,302 net calories per day. Net calories on the application I use are calories consumed minus calories burned by exercise and other physical activity. One day -- the first day of the journey -- I ate more than 3,800 calories.

But each week, my calorie tally generally dropped. Oh, one week might be higher than the previous week. And certainly there were spikes day-to-day. But overall, the trend in the next six weeks was down. Through the seven days that ended Sunday, my calorie intake was 2,096.

That's a decrease in weekly net calories of 37 percent -- more than a third of my food intake.

I felt a lot better. Depression quieted down for the rest of the night, and so did I.

Depression lies, but the math doesn't.

FRIDAY, MAY 1, 2015

DOUBLETIME

Columnist Daniel Finney, right, and physical therapist Stefanie Kirk celebrate Finney doubling the number of laps he can walk without stopping to 20 with a selfie.

Just a quick update for Friday because I'm taking the day off:

I wrote about taking pleasure in small steps and having enough short-term memory to appreciate progress.

Here's what I mean. On my first trip to the physical therapist March 16, I was able to make one lap of 156 feet before having to sit down breathless and in tremendous back pain.

That gradually improved. Two weeks ago, I made 10 laps in about 10 minutes, a major improvement.

Thursday, my physical therapist Stefanie Kirk of Mercy South Physical Therapy put me through the paces again.

The result? Twenty laps in just less than 15 minutes. The distance was nearly three-fifths of a mile without stopping.

The last three laps were rough and the last half lap, I felt my tender right calf wanting to give out. But I could see 20 on the horizon and I wanted to cross that line.

Physical therapist Stefanie Kirk holds the lap counter and timer for morbidly obese columnist Daniel Finney's latest walking test. He made 20 laps of 156 feet in less than 15 minutes, doubling his previous high of 10 laps just two weeks prior.

I was drenched in sweat. My legs were shaking. But I made it. I doubled my previous record. And man, oh, man, did that feel great.

I have the day off Friday because "The Avengers: Age of Ultron" is coming out and I'm going to see it on the day it comes out the way all Americans should.

Be well, my friends. Again, I thank you for all your encouragement and remember to keep moving forward and spread kindness wherever you can.

THURSDAY, APRIL 30, 2015

GOING THE DISTANCE

I can be something of a downer, but I try to celebrate little moments in this recovery from morbid obesity.

For example, Wednesday I was very sore from physical therapy. My trainer, Stefanie Kirk of Mercy South Physical Therapy, suggests I work on upper body exercises and walking on days between therapy. But both my legs felt like dead tree stumps beneath me.

My first appointment was at 8 a.m. at Waukee High School. To get to the classroom where I was meeting students, I had to climb a full flight of stairs and walk down a hallway.

I was sore, sure, but I made it. In fact, I made it without wheezing or sweating.

I was drinking a cup of water in the back of the room when I realized how far I'd come. In late February, I was reporting a series of vignettes for a column I wrote on University Avenue. One of the stops was at AE Dairy. The staff wanted to take the photographer upstairs.

This was well before I started the journey, but I begged off. My back was in severe pain. I went and sat in the breakroom for a while feeling slightly ashamed.

Later in the day, we stopped at Mercy Medical Center downtown. As we toured the neonatal intensive care, I broke into a fugue sweat. My back was on fire. At one point, Gregg Lagan, the public relations man for Mercy, offered to get me a wheelchair. I begged off and went and sat in the lobby.

I was utterly and completely humiliated. I was too fat to do my job. That was rock bottom. Sitting in the lobby at Mercy, I called my doctor for an appointment I'd put off for months and began the process of recovery.

It's late April and I'm climbing a flight of stairs with relative easy. Oh, I'm not as flexible as I'd like and my stride up stairs is hardly graceful. And my legs are stiff and sore after brief walks. But I made it on my own power. No wheelchair. No scooter. I made it.

My mental health therapist often cautions me about looking too far back. Sometimes I get depressed when I remember the 198-pound high school sophomore I was. I could run a mile in under 9 minutes. I played basketball and jogged.

But it's good to steal a glance in the rearview mirror to see what's just immediately passed. I'm walking farther than I have in years. And compared to just a couple months ago, I'm so much stronger and mobile.

I have physical therapy again Thursday afternoon. Stefanie wants me to walk laps. The first time I did this back in early March, I could go only a single lap for 150 feet. The last time we did this several weeks ago, it was 10 laps or 1,500 feet.

I don't know how far I can go Thursday, but I've got a good feeling about it, which in itself is terrific news.

WEDNESDAY, APRIL 29, 2015

SHORT STRIDES

I had a productive session with my mental health therapist Tuesday afternoon.

I was beating myself up for a variety of reasons, most notably because I wasn't able to keep my calories as low as I wanted.

My therapist asked me what my goal is. I told him my nutritionist and I set 3,250 calories. But mentally, I wanted to be at or below 2,000 calories.

"Why that number?" he asked.

I said it's the number used by the USDA to figure nutritional tables that you see on the sides of packaged foods.

I was frustrated because I was regularly hovering around 2,500 calories a day, usually a smidge below that.

He said I was trying to do too much. Yes, he said, I should cut calories. That's healthy. But stick with the goals you've set with your nutritionist.

He reminded me that trying to lose too much weight too fast is unhealthy and can lead to problems. I admitted that once or twice I had been light-headed on low-calorie days.

I'm not eating enough, he said.

That is not something a 543-pound man expects to hear. But it's an important lesson. I can't starve my way to fitness. It has to be done incrementally and under careful guidance.

I ate a nice dinner, nothing crazy, some pork chops with green beans and a glass of diet pop. I was full. My calories were good, about 2,400 for the day.

I was above the false ceiling I'd created of 2,000 calories, but well below the goal of 3,250.

The old saw really is true: everything in moderation.

My physical therapist offered a similar lesson Tuesday afternoon. My calf was healing nicely and she put me through my paces with resistance bands, some light weight lifting and balance work.

I was whipped. As I left for the day, she, too, reminded me not to push too hard on my walks. Slow and steady is OK.

Both reminders are important. I'm an American. I want instant gratification. I want to be trim and fit. But it's going to take work. I knew that going in, but I wanted to go faster that my body will allow.

I just need to remember small steps and short strides still count.

TUESDAY, APRIL 28, 2015

COUNTING BLESSINGS

This very public documenting of my ongoing recovery from morbid obesity is a daily education.

Daniel Finney, the Register's Metro Voice columnist steps up to the scale as Jacque Thiele, RD, LD looks on Thursday, April 16, 2015.

The first thing I've learned is that people, even those who comment on websites, can be overwhelmingly supportive and kind. I work in news. Years of people yelling at me and my colleagues over the phone and by letter and the web has made me cynical, even bitter toward public discourse. It is often cruel and vile.

But from the start, this project has been different. The kindness, prayers, well-wishes, virtual high fives and fist bumps extended to me by readers humbles me. I've said I struggle with depression. Sometimes I wonder how these words about my recovery can mean so much to so many people when I often hold myself in such low esteem.

Oh, there are days when I wish I hadn't opened up my life to such scrutiny. That's when somebody wants to sell me their magic beans for weight loss or slap their product label on me as if I were a NASCAR racer. That's when I get offers of salvation even though I've repeatedly said I'm comfortable in my faith.

Yet before any of those touchy moments annoy me, I remember getting a handshake from a man outside Jethro's Pork Chop in Johnston. He said he enjoyed my columns on this topic and wished me the best. The man called me "Rob Finney," perhaps conflating me with the late Register columnist Rob Borsellino. (I'm not sure if that would have horrified or amused Rob. Probably a little of both.)

Then there are the hundreds of people who have written me, tweeted to me or otherwise contacted me to tell me of their own journeys. They tell me — a complete stranger — about their successes, their struggles and each and every one close their email or letter with a note say they're cheering me on.

I am a fortunate man. I have a knack for making paragraphs and am paid to stack them for my hometown newspaper. Not everyone who struggles with obesity has access to a large audience. I've been offered a lot of shoulders to cry on. And, again, I am humbled and deeply moved by each and every kindness.

What I ask of those of you who have shown me such decency is that you do the same for the people who are close to you in your life. Everyone knows someone who is struggling. Help them. Offer an ear to hear their problems. Drive them to a doctor's appointment. Hold their hand as they wait for test results. Do what you can to spread the love and empathy to those closest to you -- your friends, your family, the people in your neighborhood, workplaces and churches.

That's another lesson I've learned in this journey: I can't do it alone. It's too much. I get too easily overwhelmed. I need people I can rely on and trust to help me through a bad day, people to keep an eye on me.

I have the luxury of insurance. The doctors, nutritionist and therapists I see all come at a price. I have a good job, to my mind the best job in the world. I can afford them. But I know there are many who can't. So spread some of that love there, too. Make a donation to one of the hospital funds to help pay for someone's medical care.

I am blessed to have so many wonderful people in my life. My friend Aric is a constant companion in these difficult days. Sometimes he walks with me at the mall. Two years ago, he was diagnosed as a Type II diabetic. He lost 100 pounds and got off insulin. He's largely kept it off. He's an inspiration. We walked together last night at Valley West Mall.

Parents 2.0, the kindly east Des Moines couple who raised me after Parents 1.0 died, are wonderful guides. Mom 2.0 was diagnosed with Type II diabetes. She's cutting carbs and checking her sugar. She regularly invites me over for good, home-cooked and healthy meals.

My friend Paul from Memphis, a fellow Drake University alumnus, chats with me on the phone. He started losing weight a while back, too. He takes water aerobics at his local YMCA. He's another inspiration. Our long conversations about pop culture minutia and sports hyperbole keep my mind engaged and my fingers out of the fridge.

My friend Jessica takes calls in the middle of the night when I am sad or panicked. She accompanies me to dinner and tolerates me as I fidget with my phone to properly estimate calories on my fitness app.

The point is if you're of the mind to be kind, and so many of you have shown that you are, I ask that you pass it along. Be the Aric or Paul or Jessica or parent or friend someone in your life needs. I'm honored by your caring and it inspires me.

But if you truly want to honor what I'm trying to do here, then go out there and inspire someone else. Because as my favorite author, Kurt Vonnegut, said in "God Bless You, Mrs. Rosewater:" "There's only one rule that I know of, babies ... you've got to be kind."

Daniel Finney, the Register's Metro Voice columnist, at his apartment March 31.

MONDAY, APRIL 27, 2015

STRUGGLES OF BODY, MIND

I call my effort to get fit "recovery." It's language I've cribbed from addiction. I look at my obesity the way an alcoholic looks at drinking. I may one day hit my target weight, but I will always be a fat guy in recovery -- a few binges away from totally out of control. And while I don't know if psychology defines excessive eating as an addiction, it certainly feels that way to me. I've written that the triggers for overeating often begin with an attack of my depression or anxiety disorder. And sometimes it comes out of sheer boredom.

I work with my mental health therapist to find ways to quell my mental health issues and find other solutions to panic and sadness than emptying the refrigerator. That's a private process that I'll not discuss here, but I will tell you my doctor is very good and I trust him. My medication for anxiety works very well. One pill will knock out a panic attack in as little as 15 minutes.

Depression is harder to wrangle. It sneaks up on me and before I realize it, I'm numb. I think a lot of people think depression is simply low self-esteem or profound, crushing sadness. And sometimes it is very much that. But more often than not, for me, it's numbness. I lose interest in the things I love. I close myself off from family and friends. Already a natural introvert, it makes it hard for people to know whether I'm out of touch because I'm enjoying solitude or because I'm struggling.

In terms of changing my lifestyle and diet, the biggest threat is that depression leads to inertia. When I'm down, sometimes I just sit and stare. I'll get up with the alarm and stay on the edge of my bed for a half hour or more. I'm not really thinking about anything. I often forget what I was planning to do next. Inertia talks me out of going for a walk. Inertia convinces me to sleep a few more hours. Inertia says it can wait until tomorrow.

Inertia is the enemy.

Because these struggles are an everyday part of my life, I really take it hard when there are setbacks in the recovery process. I am extra hard on myself if I miss my calories goal for a day. And if I miss it two days in a row, I may as well have regained the 20 pounds I lost and put on 20 more.

That's the depression talking, too, whispering in my ear that I'm no good and I'm not going to make it.

I write about depression and anxiety anthropomorphically, as if they were characters in a "Looney Tunes" cartoon. But what they really represent is some malfunctioning chemistry in my head and some outdated survival tactics I learned as a boy. I've learned to outwit depression and anxiety by relying on medicines, therapy and friends and family.

My friend Jessica, a fellow night owl, often gets a call or text well after 1 a.m. with me ranting and raving about what a terrible person I am and my impending doom. Sometimes her message to me is simple and direct: "TAKE A PILL. NOW." Other times, it's a long conversation that eventually drifts away from the rage and anguish to other more pleasant topics.

But I've found it particularly difficult to wrangle depression and anxiety and the changes I'm making to my diet and overall health. I planned to walk the Grand Blue Mile last week as part of the Drake Relays. Several coworkers at The Register walked specifically because they've followed my fitness journey. But two weeks ago, I pulled a calf muscle while walking at Merle Hay Mall. It left a lump the size of a fist at the top of my calf and me with a limp.

When I withdrew from the walk, I felt terrible. All of my colleagues and friends and many more readers were supportive and understanding. But in my mind I had failed. I expected there would be setbacks in recovery, of course. And the calf injuries have been a symptom of my obesity for a long time. Still, I was emotionally wounded. Worse, because of the injury, I couldn't walk as much as I had been. I felt my progress slowing and there were those old haunts, depression and anxiety, sneaking in on the periphery.

I didn't have a great vacation. I didn't move as much as I would have liked and I ate more than I wanted to. I didn't blow my calorie goal, but I didn't progress as far as I wanted to. My injury was a problem, but thanks to my awesome physical therapist, Stefani Kirk at Mercy South Physical Therapy, my calf has made great progress. I hope to return to more aggressive walking for exercise soon. And the pool opens at the end of May, which will provide convenient opportunities for high-resistance, low-impact workouts.

The good news is every day provides a new opportunity for success. Rick Green, the former Register publisher, used to say he doesn't have a rearview mirror. I do and I probably spend too much time looking in it. That said, I embrace the idea that when something goes wrong, you get up tomorrow and try again.

Or, as the Sylvester Stallone said in "Rocky Balboa:" "You, me or nobody is gonna hit as hard as life. But it ain't about how hard ya hit. It's how hard you can get hit and keep movin' forward. How much you can take and keep movin' forward. That's how winning is done."

TUESDAY, APRIL 21, 2015

A SETBACK

I planned to walk in the Grand Blue Mile on Tuesday in downtown Des Moines with a team of coworkers from The Register. But with deep regret and great embarrassment, I bowed out early the day of the event which helps kick off the Drake Relays.

In preparation for the Grand Blue Mile, I walked a mile at Merle Hay Mall on Sunday with some degree of success, though I did stop to rest several times. My friend Aric West was a companion, hovering like a shadow near me. He made sure I didn't fall, but let me wheeze and sweat in peace. He is a good friend to have when you're in that struggle.

During that walk, I injured a calf muscle. This is a common injury I suffer that is cyclical. One calf will suffer a slight or major pull, then the other and then both. This, of course, is due to the very obesity I am trying to recover from and a total lack of fitness in my body. I followed my physical therapist's instructions on treating the aching muscle, including ice and adding some iron and potassium supplements to encourage red blood cell production. My calf muscle felt catchy, but on the mend Monday.

I originally thought the GBM15 was Monday. When I figured out it wasn't, I decided to take a small walk to meet a friend for a ride home. This resulted in two painful charlie horses in my legs and flashes of the back pain that sent me to the doctor and on the journey to recovery. My physical therapist says my body is not yet used to being at work. As such, exercise, even something as short as a mile, takes me longer to recover than a healthier body would. In short, I overdid it on Saturday and my body wasn't ready to try again on Monday or Tuesday.

I fought the notion that I would not be able to participate in the Grand Blue Mile until about 4:30 a.m. Tuesday. But the pains were still in my thighs, despite lots of water, ice and supplements. I had to take my physical therapist's advice: Slow down and listen to my body.

I am deeply embarrassed I won't be able to join my Register colleagues and the rest of the Grand Blue Mile participants on Tuesday. I know several of my coworkers participated in the walk because of my recent column about my obesity and my efforts to recover from it.

I let you down and I am sorry for that. And I let myself down, too. I pledged to do something I was not yet ready to do. That's a wound to the pride that's tough to describe. But it serves a poignant reminder that this is a long journey and despite my desire to speed it up, it will take as long as it takes.

Alas, injuries suffered at this early juncture impede the important progress I'm making to recover and become fit. So I will trade one form of exercise, a very public one, for a private one.

Rest assured that I will be at my physical therapist's appointments as scheduled Tuesday and Thursday working to get stronger. Certainly I will be ready to walk the GBM in 2016 -- maybe I'll even be able to run part of the way.

But this year, I cannot.

And, again, please accept my humble and embarrassed apology.

All recoveries have setbacks. Mine simply has crummier timing than I would prefer.

For those of you running or walking Tuesday, please enjoy your mile and cherish your health and fitness. I did not do so for many years and find myself encroaching middle age attempting to regain it.

I'm on vacation this week, so blog entries will return next week. When I get back, I want to talk to readers about the healthiest dishes at their favorite restaurants.

THURSDAY, APRIL 16, 2015

AT LAST, PROGRESS

In the voice of Gerard Butler from "300:" "This! Is!! Progress!!!"

After four weeks and four days of eating less and moving more, I've lost 20.6 pounds.

I started at 563.2 on March 12. Thursday, I weighed 542.6.

My first thought was to make a self-deprecating joke: "Yeah, 20 pounds. Big deal. That's like throwing a suitcase off the Queen Mary."

That's the weight of a tire for a full-sized sedan. It's four fully grown Chihuahuas. It's more than 260 glazed doughnuts. It's 10 racks of baby back ribs.

Mmm … doughnuts and ribs.

OK, maybe that's enough examples.

Daniel Finney, the Register's Metro Voice columnist, steps up to the scale and weighs in at 543 pounds on April 16.

It feels good. I won't deny that. I may act nonplussed, but that's in part because I don't want to disproportionately react to a small victory.

I will honor the milestone. I'll rest up for an evening. Friday, it's back on the trail.

WEDNESDAY, APRIL 15, 2015

EATING LESS

I love to eat. Most people do. Thanksgiving is my favorite holiday. It's like a three-way between me and my two favorite deadly sins, gluttony and sloth. But that mindset is killing me. At 563 pounds, it's time for moderation.

Again, for all my fellow travelers, I want to emphasize I am not a nutritionist, doctor or mental health professional. I'm writing about what I'm doing in hopes that it will help others. It's not a prescription for you and I wouldn't presume to counsel you on what to eat, how to eat or what change in diet is necessary.

Similarly, if you have a program that works for you, terrific. Keep moving forward.

If I sound somewhat defensive it's because the world is full of scolds and givers of unsolicited advice. I don't want to be one of those people for Register readers because I hate it when people do that to me.

Right now, my biggest focus is cutting calories. I'm using a free piece of software called MyFitnessPal. It's available for the iPhone and Android. There are other programs out there, but this is the one I'm using.

And MyFitnessPal has been a terrific tool. Everything I eat, I enter into a daily diary. For example, if I make a tuna wrap with a slice of deli cheese, low-fat mayo and sweet relish, I can scan the bar codes of the ingredients. The program connects to a database that puts in the nutrition information for me.

For produce, such as my current favorite midnight snack of two Cuties oranges and a banana sliced in a bowl, I just enter the brand name of the produce, such as Dole or Sunkist and find what I'm looking for.

Another terrific feature: At most of the large chain restaurants, the meals are in the database. If you getting a hamburger at Applebee's, it will automatically download into your diary.

Daniel Finney, the Register's Metro Voice columnist, goes over his daily eating diary on his phone with Jacque Thiele, RD, LD on April 16.

If you're a person who likes to frequent non-chain restaurants, you're going to have to estimate. For example, if I'm having wings at Court Avenue Brewing Co. on Sundays,a weekly treat, I estimate that against a similar sized portion at a chain. It's not exact, but it's good enough to tell you whether you should eat five wings or splurge and have 10.

The program keeps your nutrition information and allows you to track your progress over time. Because I'm so heavy, my calorie goal is very high. As I drop more weight, my nutritionist and doctor say I will be able to set a lower calorie goal.

I should mention that your daily goal is the number of calories you eat plus the exercise you do in a day. MyFitnessPal imports the steps data from my phone. You can also enter other exercises such as swimming, weight lifting and stretching.

Currently, I can eat up to 3,900 calories. If I do that, I won't lose weight, but I won't gain. But since I started using MyFitnessPal, I've gotten smarter about calories, spreading out food between meals and snacks and portion size. The result is I'm slowly and largely painlessly reducing calories while I increase my exercise.

When I started changing my diet, I was averaging more than 3,200 calories a day. The next week I was down almost 15 percent, to about 2,800 calories. I'm hovering around 2,500 calories now. I had a few bad days when I was sick with a cold. I couldn't exercise and I ate a little too much while convalescing.

The program is helpful to me because I have to remind myself what I've eaten. Then I decide what to eat to stay within my goal. I like to be around 2,500. I'll meet with my nutritionist Thursday to set new goals going forward.

Another nice feature of the program is it gives you a breakdown of the nutrients you've taken in. If you're watching carbs or sugars, like I do for my Type II diabetes, it tells you if you are over or under your intake goals. If you have high blood pressure, you can keep an eye on the salt and potassium, too.

Since I've been using the program, I haven't suffered too much food withdrawal. I'm not much of a cravings guy anyway. I'm more likely to binge eat because I'm depressed or anxious or if I'm bored, which is sometimes a manifestation of my depression.

I've certainly taken a break from some of my favorite dishes, such as the Drunken Nachos at Malo. But it I find that I can have good, tasty and even a little fatty food if I portion it out. If I want pizza, I just need to limit myself to a slice or two.

For example, Wednesday night I wanted to go out to eat with my friend. But my calories were creeping high on the verge of my first weigh-in since I began the process. So, I decided to have a small meal at home and get some extra steps in walking to the store to get a bottle of diet pop.

The program is just like your bank ledger. It tells you whether you can afford to do something or not. And since I started MyFitnessPal more than a month ago, I'm happy to report I haven't been in the red once.

TUESDAY, APRIL 14, 2015

MOVING MORE

I thought I'd let readers know the specifics of what I'm doing to lose weight.

The basic premise is to eat less and move more. It sounds simple, but it's tricky. At my last weigh-in, I was 563.2 pounds. One does not just start jogging and hitting weight training at that weight unless one wants a slew of discouraging injuries.

Such injuries would really frustrate me. I would be more likely to eat more and move less. So I wanted to be careful. I was already dealing with spinal stenosis and arthritis in my back to the point of being practically immobile. If I pushed it too hard, too fast I would be in bigger trouble and on my way to surgery, a method I chose to make my last resort.

I started out with two approaches. My family doctor, Lisa Jensen at the Iowa Clinic, referred me to physical therapy. I chose Mercy South Physical Therapy for no other reason than I have a good relationship with the Mercy public relations guy, Gregg Lagan, who is always bending my ear about the stuff Mercy does.

(It should be noted that all the hospitals have similar programs and individuals are free to choose the provider they are most comfortable with.)

There I work with physical therapist Stefanie Kirk. She introduced me to a series of stretches. Some I do daily and others rotate two to three times a week. They're simple and easy to perform. The only tool I've needed so far is some elastic therapy band, which the clinic provided.

Inside the physical therapy clinic is a short square path marked out. Each pass is 150 feet. The first day I met with Stephanie in early March, I made one lap and had to sit down. I was covered in sweat, breathing hard and in terrible pain. On the pain scale of one to 10, I was at a solid seven.

I was very disheartened. Honestly, I felt as close as I'd ever been to dying. I just did not think I was going to get better.

Stefanie seemed to sense this. She emphasized that the stretches may not seem like much, but they really do help over time. She said by the time I finished working with her, I would be a lot better.

She's a woman who doesn't oversell her abilities. I've still got about five weeks of appointments left, but at my last visit – Monday – I cruised through 10 laps on the track with only soreness in my hips.

Stefanie reported my pace was even and faster. I made each lap in about 1 minute.

I started doing some light walking in the neighborhood, too. I live near 24th Street and University Avenue by Drake University, my alma mater.

Note to students: If you see an ashen faced fat man wheezing around campus, dial 9, 1 on your cell phone and wait a minute to see if I keel over before hitting the last 1.

I kid. I kid.

I walk on campus because there are a lot of benches, stairs and places I can stop if I start to get sore or out of breath. That happens more than I would like, but it's good to walk again.

When I was younger and fitter, I could walk 3 miles in a span of about 35 minutes. It took me more than 90 minutes – with lots of stops – to make it a little more than a mile a week or so ago.

If I look back at that, I get discourage. I think about how far I've fallen.

Stefanie reminds me, as does Fleetwood Mac, that yesterday is gone. It's time to start thinking about today.

So today, I'm good for at least a third of a mile in about 10 minutes. As for three miles, Stefanie says: "We'll get there."

MONDAY, APRIL 13, 2015

Wow

I've covered the funerals of soldiers, the victims of murder, rape and all manner of terrible things people do to one another intentionally or unintentionally.

Daniel P. Finney

I've written about presidential candidates, feel-good stories about local successes, champion sports teams and everyday people turning their tragedy into triumph.

None of it ever generated the kind of reader response I received for my column Sunday about my own struggles with morbid obesity.

The final tally is still being counted, but I received more than 50 voice mails and spoke to at least a two dozen people by phone on Sunday and Monday.

More than 200 people followed my Twitter account @newsmanone and I lost track of the number of Facebook friends I added. In all, I spent more than 12 hours Sunday replying to messages and just reading the sheer volume of it all.

And again, I say: Wow.

Virtually all of the correspondence was overwhelmingly positive and encouraging. Oh, a critic here and there couldn't help but point out they typically don't like my column, but they liked this one. Another person groaned this wasn't "front page news."

But in the era of social media and mean one-liners -- something I'm guilty of trading in, too – this much kindness is enough for me to put a little faith back into the inherent decency of human beings.

In all that correspondence, even ones with a small dig, there wasn't one fat joke. There wasn't a single scold. It message was: "Good for you. I've been there. You can do it."

I am overwhelmed with the kindness. Truly. And I am similarly inspired by the many of you who told me about your own struggles with weight, diet and exercise.

I'll try to update this blog daily as I go on my journey. It may be nothing more than a couple of tweets or brief notes. Sometimes it will be more. I tweet about my weight loss with the hashtag #recovery, for those of you who want to follow things that way.

A couple of ground rules before we move forward:

1. I am comfortable with my faith. Many of you have offered prayers and I think you for that. It's a kind and warm thing to do. Others have suggested I join a particular church or follow a particular faith. I was raised United Methodist, but I don't practice and generally prefer to keep my thoughts on faith and religion private. I welcome prayers, but I ask everyone to respect my boundaries on faith.

2. No solicitations. A few people, even close friends, tried to sell me a product. They gave great testimony to the quality of the products and how they helped their lives. That's good. I'm happy for you. But I'm not shopping for a plan. I have one. I've got a fine family doctor at the Iowa Clinic and a physical therapist and nutritionist through Mercy Medical Center.

3. I'm sticking with the plan … for now. I've been at this for slightly less than a month. I'm not ready to scrap it for surgery or other options yet. I know surgery has a good track record. I heard a lot of testimonials in the last couple of days. There were a couple reasons why I decided to wait on gastric surgery.

First, except for a brief period after college, I've never seriously tried to lose weight. I've gone through spurts of increased exercise, but it usually waned within a few months. I believe I should give "eat less, move more" a try. The actions I'm taking now -- logging calories, exercising and going to physical therapy -- are all in line with what I would have to do to prepare for gastric surgery.

Daniel P. Finney works on strengthening his back with physical therapist Stefanie Kirk on March 31 in Des Moines.

Secondly, there are drawbacks to gastric surgery. The one that holds me up is that I'm cutting out 80 percent of a healthy organ. This reduces cravings, but cravings aren't my problem. Emotions are. I want better control of the psychological motivations for eating before I decide to have surgery.

That's all for Monday, but, again, my deepest thanks to all of you who wrote, called or otherwise reached out. You humble me and I will do my best to live up to the kindness you've shown me.

All I ask is that you keep up the good work and continue spreading kindness in your part of Iowa and the world.