A year and a half later, AL called and asked if she could come back to see me. She had finished school and gotten married as planned the previous July. She had also gone on to gain fifty pounds more than when she originally came to me. I could hear the desperation in her voice, and since her life seemed to have settled down a bit, we made an appointment for the following week. This time, she really listened to what I was saying and began planning her eating and exercise ahead of time and writing in a journal regularly. Her husband, a chef, was also supportive and tried to prepare healthier options when he was home. Still, she found it was often easier to do her own thing when it came to meals.
She slowly began to exercise regularly, which is not easy for someone who is eighty pounds overweight. She often found herself winded walking routes that used to be effortless. After six weeks she lost an amazing twenty-one pounds and began feeling less dependent on the number on the scale each week. She still lacked confidence in her eating, and if she made one or two less-than-perfect choices during the week, she came in expecting the scale to be up. It wasn’t. She had eaten well 80 to 90 percent of the time. After another six weeks and an additional sixteen-pound weight loss, she realized that she did not have to be perfect to lose weight. She also decided to exercise more and began playing tennis and hiking with her husband on weekends.
During the next five months, she continued to expand her exercise regimen to include longer cardio sessions, weights, and even spinning classes at the gym she had joined. But she got nervous when she started to feel hungrier. I assured her that this was a normal consequence of exercising more and that she should adjust her food intake upward slightly. I also told her to eat a piece of fruit before more vigorous workouts.
