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In February 2018, Paul Fleming, of Plainfield, Illinois, faced a hard truth that he had let his weight get out of hand. A long-time IT professional for a benefits outsourcing company, Fleming had been working from home for the past 10 years, steadily putting on weight and losing his mobility.
“I was so focused on my career, my health had taken a back seat,” says Fleming, who had gotten progressively bigger each year. Now, at 50 years old, Fleming’s weight had climbed to more than 400 pounds.
“I could hardly walk. My joints were killing me, my left hip in particular. I thought, ‘I have to get control of this,’” he says. So Fleming decided to see his primary care doctor, Phamela De Guzman, M.D., family medicine physician with Edward Medical Group, who recommended John Lombardi, M.D., an independent orthopedic surgeon on the medical staff of Edward Hospital.
X-rays revealed Fleming’s hip had no cartilage. He needed a hip replacement, but he couldn’t get one. “Dr. Lombardi said he would never do surgery on someone my size. He explained to me why. He said the surgery would be difficult. At my age, I would probably need another one and I’d be in big trouble if they had to do this again. He told me I needed to see a weight loss doctor,” says Fleming.
Dr. Lombardi recommended Neha Shah, M.D., a bariatric and obesity medicine specialist with Endeavor Health® Weight Management at Edward-Elmhurst Health.
“I had tried to lose weight in the past and failed. I yo-yoed. I’d lose some weight and put it back on. I’d never gone to a weight loss doctor. I didn’t want to go. But I was out of options,” he says.
Fleming made an appointment with Dr. Shah. “The first meeting was so positive. Dr. Shah was totally supportive. It was eye-opening to meet her and her team. I thought it would be one way but it wasn’t. We had an open discussion,” he says.
Fleming says they talked about making some changes to help his metabolism be more efficient. Dr. Shah prescribed medication for Fleming — Topamax® — to curb his cravings and prevent binge eating.
He also met with Toni Havala, MS, RD, LDN, an outpatient dietitian with Endeavor Health® Weight Management. Fleming became educated about foods, which ones fill you up and which don’t. He learned to eat at regular intervals, which was not something he had been doing.
“It’s more than someone hammering you to eat your vegetables. The whole part of this journey is learning how your body works and reacts to food, and the different techniques that can help. It’s not drastic stuff you need to do,” he says.
Fleming also downloaded the MyFitnessPal app, which tracked his calories, taught him what foods are good or bad, and reminded him to eat. “You would think if you’re trying to lose weight you shouldn’t eat, but you have to eat,” he says.
Fleming learned that the times he would mess up was when he was hungry and tired, or hungry and too busy to cook. “If I don’t have food that’s ready to go, it’s a problem. I needed to solve for that,” he says.
So Fleming bought food that he could quickly grab out of the fridge and eat. He got vegetables he didn’t have to peel — broccoli, cauliflower, baby carrots and celery — and he put them in individual freezer bags in the fridge. He also had hard boiled eggs ready to go, along with yogurt, cottage cheese, string cheese, chicken in the can, protein bars and shakes, and soup.
Over the next several months, Fleming would meet with a whole team of weight loss experts. “Having a team is so helpful — knowing I have this support and it’s not just me. If I hit a sticking point, we can talk about it and we have somewhere to go,” he says.
At the end of the day, Fleming is at about 1400-1500 calories, which he says he’s comfortable with. And he says he isn’t hungry because he eats high-protein, clean foods that fill him up.
Months earlier, on Feb. 2, Fleming weighed in at 408 pounds. On Oct. 24, he went back to Dr. Lombardi. He wasn’t sure how much weight he had to lose to qualify for surgery. He weighed in at 292 pounds, and was cleared for a hip replacement on Feb. 7. “It will be one year and five days from the time he told me he couldn’t touch me to when he will be replacing my hip!,” says Fleming.
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“I know there are other people out there in a similar situation. They are walking out of the office like I did on Feb. 2 and they are thinking of not going back because they’re afraid. They feel just like I did. The difference is I made the appointment and I went. And now, I can have the surgery. That’s the real victory here.”
As of Nov. 12, Fleming’s weight was down to 278 pounds. He had lost a whopping 130 pounds in less than a year. His BMI went from 56.9 to 39.9.
“I kicked myself for not going sooner. I should have done this a long time ago. I should have been more afraid to not go then to go,” he says. He adds, “I’ve been struggling with my weight my whole life. How many times do you have to fail to realize you can’t do it on your own?”
One day recently, Fleming says he was out all day doing activities. “I have more energy now. Mentally and physically, I feel a difference with the foods I’m eating and the regularity of eating at intervals. My hip still hurts, but the rest of me is great. I feel much better.”
Fleming says he doesn’t have a target weight in mind. “I don’t want to put a number on it. I don’t know if that’s what defines success. I want to keep going and see where this journey takes me.” He adds, “When I get to where I want, the maintenance is going to be critical — more important than taking it off. I’m never going back. That’s that.”
His advice for others? “Don’t be afraid. There are a lot of people who are afraid to get help. It’s intimidating to go see a weight loss doctor. There’s a fear of being judged, being lectured. But that’s not what happens there.”
“The team at Edward-Elmhurst is so nice. They know what they are doing, and they have the tools and techniques to help. And it’s not judgey. They have knowledge to share so let them help you,” he says.
Fleming continues to see Dr. Shah every five weeks and Havala every other month. He is still taking his medication, and he uses the MyFitnessPal app every day. Once his hip is fixed, Fleming says he will be able to exercise. Although, he points out that he achieved all of the weight loss so far through diet alone.
“Different things seem to happen more when you’re not eating right. I used to get random headaches and crashes of energy. Those type of things aren’t happening anymore. Overall, I feel healthier.”
Fleming’s hip replacement surgery is scheduled for Feb. 7 at Edward Hospital.
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To learn more about your options with Endeavor Health® Weight Management, call 331-221-6100.
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