Super morbidly obese. Where do I start?

[Anonymous]

35 F
350 lbs
I've been big my whole life. In my teenage and early 20s, I'd start a diet, then quit within days or same day. I eat at any time of the day, mostly sweets, lots of carbs, take-out about 3x a week, rarely ever any fruits, vegetables or water. I often overeat, even when feeling full, and regret it later. Haven't seen a PCP in about five years but pretty sure I'm Diabetic, I know I have high blood pressure, and probably other issues. Currently not taking any medication or supplements except a multivitamin.

I work outside the home but usually evenings and physical activity isn't needed much so I'll read or watch shows in my down time. Never exercise. I'm completely independent and don't need assistance with anything.

I'm well aware that I have to do something to turn my health around/stop this path or I'll die soon. I don't know how to start. Any tips for someone like me who needs to lose 200+ lbs? It just feels so overwhelming (completely my fault, I know.) I'm going to make an appointment with PCP to see if I can get a check-up and necessary testing but as far as lifestyle changes for losing weight, I'd love tips. TIA.

[Anonymous]

I would start with walking. Walk every day for 20 minutes. After two weeks make a different goal.

And join weight watchers. Count and track your points for a week without changing anything. Then look at where you can make a small change. Maybe you decide not to drink your calories except coffee creamer. Or maybe you realize that switching from a bagel to yogurt can help you reduce points.

Take it one step at a time. Ask a friend to help you keep accountable.

Don't freak out if you backslide. Two steps forward, 1 step back.

[Anonymous]

The first stop is therapy. If you treat all the emotional issues that got you to this weight and has kept you at this weight, you will lose weight without dieting.
-- Trauma survivor and formerly obese person with 20-yr eating disorder who did EMDR + CBT (and a LOT of it).

[Anonymous]

Absolutely start with your doctor. Untreated diabetes is no joke.

As part of the visit to a PCP, I'd ask for a referral to a therapist.

For a first step, work on adding fruits and veggies to your diet. I think adding works a lot better than taking away when you are getting started. Stop when you're full. Allow yourself some treats too.

One day at a time. One meal at a time. You deserve your own loving care.

[Anonymous]

Begin by walking 30 minutes today. I don’t care if you do it in 2- 15 minute segments or in one segment. I don’t care if you have to do it this evening with a flashlight. Then, overtime we can increase your cardio activity and introduce light weights. For today, you should try to drink 8-8 ounce glasses of water. These changes can be immediate. We can work on your diet when you go to the grocery store next.

[Anonymous]

Talk to your doctor and google Wegovy.

[Anonymous]

Anonymous wrote:Absolutely start with your doctor. Untreated diabetes is no joke.

As part of the visit to a PCP, I'd ask for a referral to a therapist.

For a first step, work on adding fruits and veggies to your diet. I think adding works a lot better than taking away when you are getting started. Stop when you're full. Allow yourself some treats too.

One day at a time. One meal at a time. You deserve your own loving care.

Agree with this 100%. Healthcare (mental and physical) followed by exercise followed by adding fruits, veggies, and water. I wouldn’t worry about subtracting anything for probably a year.

It’s going to take a loooong time. But that okay! What matters is your direction of travel, not your speed.

[Anonymous]

The first step is asking for help like you are today. That's not easy. Make a commitment to yourself that you will take a step toward healthy living every day. It does not have to be a huge step every day. This could be, walking around the block, drinking more water, booking an appointment with your doctor. This is a very emotional process. Allow yourself to have good days and bad days. Keep a journal, that includes a gratitude process. Your emotional well being during this process is just as important as your physical. Its really not possible to stick to this unless you are taking care your your mental wellbeing at the same time. It's more than calories and exercise. Hang in there!

[Anonymous]

After talking to your doctor I would focus on one small thing at a time. It is very overwhelming to think about changing to much about your lifestyle at once. Start with something like committing to a healthy breakfast every day and do that for 2 weeks. Don't stress about the rest of your day just get in the habit of breakfast. Then change something else small. Maybe commit to a short walk every day. After a few weeks target improvements to late night snacking etc. Remember its a marathon not a sprint so you don't need to change everything today.

[Anonymous]

Gastric sleeve. Totally life changing but you need to really commit to the program. You need to address why you over eat first with a therapist.

[Anonymous]

I would start with getting rid of the goal to lose 200 pounds. That goal is too big, and it isn't really maintainable. Your goal needs to be to change your lifestyle to one where you're taking care of yourself, both mentally and physically.

First stop needs to be a PCP - you need to get any diseases diagnosed so you can begin treatment.

Then, start taking steps. For your body, pick a step and then implement it -- not as a temporary measure so you can lose weight, but a permanent lifestyle change. Start walking 20 minutes every day. That's it. Once you've been doing that for two weeks, add another step (cut out a day of takeout, add one veg to your diet every meal, switch one snack carb to a healthier option, etc). Keep adding a step every two weeks.

For your mind, start looking into therapy - eating when you're full/comfort snacking is really common, but people often need help to break that association. Cognitive behavioral therapy will be extremely helpful, especially since this has been such an entrenched pattern for you.

Finally, if you're goal oriented, that's great! Definitely use goals to motivate yourself, but I wouldn't use weight as a goal. If your dr says you have high blood pressure, make your goal to get your blood pressure under control. Maybe your goal is fitness related -- you want to be able to walk a 5K. Keep picking goals as you achieve them, but make them achievable and health-centric.

The only way this works, long term, is if it's a series of steps, not one big push. You can do this. Good luck.

[Anonymous]

WW

[Anonymous]

I agree with therapy and semaglutide (ozempic if insurance doesn't cover wegovy). Also look into weight loss surgery or try to get on the clinical study for this one.

https://www.sciencealert.com/experimental-drug-breaks-record-for-weight-loss-in-latest-clinical-trial-results

[Anonymous]

Congrats--by asking how to start, you have already taken the first step.

I have not personally struggled with this, but I have watched my mother go through it. Definitely start with your doctor and therapy. If you want a program or can't afford doctors, my mother finally found some help with Noom, which incorporates some therapy aspects into its program.

Baby steps -- walking 20 minutes a day might be too much at first, so start with 5, then 7, then 9, etc.

Instead of trying to quit unhealthy foods/habits, try to replace them with healthier foods/habits. This was how I was able to quit smoking. And, if you fall off the wagon--which everybody does at some point--forgive yourself and get back on. Don't use it as an excuse to give up.

Reddit has an incredibly supportive weight loss forum. While you are on there, also look up "no zero days", which is not weight loss specific, but is a helpful way to think about any long-term goal you are trying to accomplish.

[Anonymous]

Anonymous wrote:The first stop is therapy. If you treat all the emotional issues that got you to this weight and has kept you at this weight, you will lose weight without dieting.
-- Trauma survivor and formerly obese person with 20-yr eating disorder who did EMDR + CBT (and a LOT of it).

I agree with this. I prefer trauma therapy.