October 2024
I had avoided getting a physical for years because I felt guilty and was tired of doctors telling me “you could lose some weight”. I know this is a stupid attitude and I am embarrassed about it — however, alas I suspect this is a pretty common pattern with middle-aged, overweight men.
My wife (who had also not seen a doctor for years but is much healthier than I am) finally decided we are grown-ups and should get a PCP. On a side note, here in Boston, it’s very hard to find a PCP that takes new patients. She finally found one with an appointment six months later! It blows my mind that in the Boston area we supposedly have some of the best universities and hospitals in the world, but apparently few med students want to go into general/family medicine.
Anyway, I saw the PCP (actually a Nurse Practitioner who turned out to be great) and I was in for a shock. I knew I had gained weight, but I had avoided weighing myself (stupid again!). At the doctor’s office, I was shocked when I saw the weight on the scale: 373 lbs! For reference, I am 6’4” and 52 years old. This is a BMI of 45 and really gave me a jolt. Before the visit, I had already thought about asking about a GLP-1 agonist, and luckily, the PCP brought up Zepbound, which I enthusiastically agreed to. We also found that my blood pressure was high (126/90 after measuring it 3 times), which was not surprising but a little scary as my mom had hypertension most of her life.
My bloodwork was okay-ish: A1C 5.4 and lipids slightly high (unsurprisingly):
I got a prescription for Hydrochlorothiazide and Zepbound. Most importantly, I left the doctor’s office with a resolve to change my life. I had blamed depression and COVID for gaining weight, which was partially true, but clearly, I needed to take responsibility and make changes.
When I got home, I started reading about weight loss and health. I finally learned what “macros” were. Very quickly, I realized that for me, calorie tracking was important , since I really had no idea what I was eating. Also, I wanted to limit my sodium intake to help with the blood pressure — I remember my mom always preaching to limit salt for that same reason.
I quickly settled on the Cronometer app and started scanning barcodes and entering foods. I found it very easy to get into the tracking habit (my wife would joke that’s because as a German I like rules…). I was surprised how quickly I lost weight: 20 lbs in the first month (most without Zepbound due to insurance issues — more on that later). Presumably this was mostly “water weight”.
Next up: fighting insurance and getting on GLP-1