My Big Fat Greek Diet: How a 467-Pound Physician Hit His Ideal Weight and How You Can Too

MY

BIG

FAT

GREEK

DIET

MY

BIG

FAT

GREEK

DIET

How a 467- Pound Physician Hit

His Ideal Weight and How You

Can Too

NICK YPHANTIDES,M.D.

WITH MIKE YORKEY

Copyright © 2004 by Nick Yphantides, M.D.

All rights reserved. No portion of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopy, recording, scanning, or other—except for brief quotations in critical reviews or articles, without the prior written permission of the publisher.

Published in Nashville, Tennessee, by Thomas Nelson, Inc.

Nelson books may be purchased in bulk for educational, business, fundraising, or sales promotional use. For information, please email [email protected].

Author is represented by the literary agency of Alive Communications, Inc.,

7680 Goddard Street, Suite 200, Colorado Springs, CO 80920.

Scripture quotations noted NKJV are from THE NEW KING JAMES VERSION. Copyright © 1979, 1980, 1982, Thomas Nelson, Inc., Publishers.

Scripture quotations noted NLT are from the Holy Bible, New Living Translation, copyright © 1996. Used by permission of Tyndale House Publishers, Inc.,

Wheaton, Illinois 60189. All rights reserved.

Scripture quotations noted CEV are from THE CONTEMPORARY ENGLISH VERSION. © 1995 by the American Bible Society. Used by permission.

PUBLISHER’S NOTE: This book is intended for general health-care information only and is not intended to supplant medical advice, diagnosis, or treatment by a personal physician. Readers are urged to consult their physician before beginning any weight-loss program.

Library of Congress Cataloging-in-Publication Data

Yphantides, Nick.

My big fat Greek diet : how a 467pound physician hit his ideal weight and how you can too / Nick Yphantides with Mike Yorkey.

p. cm.

ISBN 0-7852-6025-0 (hc)

ISBN 0-7852-8774-4 (tp)

1. Weight loss. I. Yorkey, Mike. II. Title.

RM222.2Y695 2004

613.2'5—dc22

2004014404

Printed in the United States of America

06 07 08 09 10 RRD 5 4 3 2 1

TO MY DESPINA

CONTENTS

Introduction

PART I: THE PARABLE OF MY LIFE

1. The Last Supper

2. Weigh Over the Scale

3. Traveling Through Big Sur Country

4. The Black Hole

5. Reeling in the Years

6. From the Windy City to the Big Apple

7. Makeover Day

PART II: DR. NICK’S SEVEN PILLARS

8. The Seven Pillars of Weight Loss and Maintenance

9. Pillar I: Change the Way You See Before You Change the Way You Look

10. Pillar II: Slash Your Calories by Eating for the Right Reasons

11. Pillar III: Fill Your Tank with the Right Amount of the Right Foods

12. Pillar IV: Burn Calories Like Never Before

13. Pillar V: Plan a Radical Sabbatical

14. Pillar VI: Don’t Travel Alone

15. Pillar VII: Realize That Your weight-loss Journey Is for a Lifetime

PART III: SIDE DISHES

16. The First and Last Word in Fast Food

17. Nurture with Love, Not Food

18. Heigh-Ho, Heigh-Ho, It’s Under the Knife We Go

19. The Last Course

Epilogue

About the Authors

Acknowledgments

Contact Information

Appendix: Nick’s Stadium Tour

INTRODUCTION

Is it true that you lost all this weight going to baseball games?" The inquiry came from Josh Valdez, the regional director of the U.S. Department of Health and Human Services. I met him while attending a White House conference on Faith-Based and Community Initiatives in my hometown of San Diego. As a family physician who has spent his entire professional life caring for the poor and indigent in the community health clinic system (I have never seen a patient with private medical insurance), I was keenly interested in how the medical community and the federal government could work together to meet the needs of those who’ve fallen through the holes of the nation’s safety net.

Well, it’s not as simple as that, I said. Going to the baseball games was a fun diversion while I drank protein shakes and exercised on the road.

I’ve never met anybody who’s lost as much weight as you have without having surgery, Josh commented.

Neither have I, I replied. I guess my story is fairly unusual. I spent eight months on the road, crisscrossing the country and taking in more than one hundred majorleague baseball games at every American and National League ballpark. I didn’t eat any solid food during my road trip. Instead, I drank two or three protein shakes a day.

How much did you weigh when you started? Josh asked.

"I can tell you the exact amount—467 pounds. I kept at it until I lost 270 pounds, which is the combined weight of two average-sized American women standing five feet four inches and weighing 135 pounds."

I could tell Josh was intrigued by my story. What are you doing for lunch? he asked. You do . . . eat, right?

Of course. I love to eat, I laughed. I just don’t eat like I used to.

Good. I know this excellent family-run Mexican restaurant in Old Town. They have great posole, he said, referring to a meat stew containing pork and kernels of corn or hominy with all the trimmings— hot peppers, chopped onions, and diced chilies. Want to join me?

Josh didn’t have to ask twice. Midway through our meal, as I entertained my new friend with anecdotes from my weight-loss baseball tour, he stopped me. Nick, this is incredible. How would you like to come to Washington, D.C., to share your remarkable adventure?

I nearly choked on my fresh corn tortilla. Come to Washington? As in D.C.? Sure. Who would you like me to speak to?

We have a monthly meeting of the regional directors who report to Secretary of Health Tommy Thompson and the White House liaison to the Department of Health and Human Services, and we’d like to have you come and tell us how you lost the weight. Perhaps there’s something we can learn from you, Josh said.

When would you like me to come? I asked with excitement rising in my voice.

Let’s see, he said, pulling out his calendar book. How would Tuesday, April 1, sound? I’m thinking about one o’clock in the afternoon.

I nearly fell out of my chair when I heard Josh say April 1, not because I thought he could be pulling off an elaborate April Fools’ joke, but because that date meant so much to me. You see, April 1, 2001, was the day my remarkable weight-loss story began.

MY CORE MESSAGE

What I told the DHHS regional directors that afternoon in our nation’s capital forms the core message of this book—that you have to change your life before you can change your weight. I’m going to teach you how to do that through my Seven Pillars to Weight Loss and Maintenance, but in Part I of My Big Fat Greek Diet, I will tell you my story. In the past, I would have told you, Do as I say, not as I do. Now I can humbly say, Do as I say, and as I have done.

You see, I had reached a point in my midthirties where I desperately wanted to change my life. Eating had always been important in our ethnic family, but perhaps that’s because I’m as Greek as homemade baklava. My father, George Yphantides (pronounced Eee-fahn-tee-dees), grew up in northern Greece near the base of Mount Olympus. He came to North America in the mid-1950s to attend college in Canada and then the United States. While in New Jersey, he met a wonderful American woman named Bernice Pfaff. They fell in love and were married.

Just over a year later, I—the firstborn of five children—arrived on the scene. When I was four years old, Dad moved his young family back to Greece, where we lived for nearly five years. While living in an Athens suburb, I was enrolled in grammar school, where, as the joke goes, everything was Greek to me.

When I was in the fifth grade, our family returned to the United States, resettling in New Jersey. I had to learn English all over again, but I had a good ear and a good aptitude for schoolwork. I was allowed to skip two grades during my school years, so when I graduated from Tenafly High School in New Jersey, I was a peach-fuzzed and pudgy sixteen-year-old who weighed thirty or forty pounds more than an average kid my age.

I headed west for college, attending Azusa Pacific University in Southern California, where I graduated three and a half years later with plans to become a doctor. There was no doubt I was getting heavy since I weighed 280 pounds. Dad and Mom had always encouraged me to follow my dreams, and my dream was to care for the sick and infirm. Practicing medicine among those who needed it most greatly appealed to me.

While applying to medical school, I earned a master’s degree in public health from Loma Linda University. Then the good news arrived in the mailbox: The University of California at San Diego (UCSD) School of Medicine had accepted my application, and when I graduated five years later at the age of twenty-six, I was one of the youngest physicians in a class of 126. A one-year internship in family practice, and voilà: At age twenty-seven, I hung my shingle at the Escondido Community Health Center, located thirty miles northeast of San Diego.

It was in medical school that I became morbidly obese, which is medically defined as being at least one hundred pounds overweight. I was now over three hundred pounds, and I couldn’t stop eating, especially since I rewarded myself for studying so hard. For instance, when I pulled all-nighters during finals week, I fortified my body with Ding-Dongs and Rocky Road ice cream and late-night raids of the refrigerator. During interminable forty-hour shifts as an intern, I kept my energy up and my eyes open with periodic visits to the hospital canteen, where invariably someone had set out a plate of sweets to be shared by the attending staff.

When I entered the public health arena as a family physician, I could be best described as corpulent. I can’t tell you how much I weighed because I had stopped weighing myself. I was like a runaway train, adding pounds each month. To compensate, I threw myself into my work with my patients, putting in ninety-hour weeks following my promotion to medical director of the Escondido Community Health Center. I loved my work because I was drawn to caring for the less fortunate, of which there were plenty in this working-class city surrounded by avocado trees and orange groves. Many of my patients were Hispanics—some undocumented, some not—who had found themselves outside the system. They and their families did not have health insurance, and thus they were funneled toward public health programs.

My expanding girth actually became an occupational blessing: My patients viewed me as a larger-than-life advocate for the poor, the big man with a big heart who cared for his community in a big way. Overweight patients loved me because they knew they would receive tea and sympathy from someone who also shopped at Mr. Big and Tall. From a doctor’s perspective, I was always gracious with people who struggled with their weight. More than a few times, I can remember saying with a glint in my eye, Do as I say, not as I do.

My weight continued to balloon as I turned thirty. When I began experiencing declining health and a host of unusual symptoms, however, I made an appointment to see a specialist. A week later, I learned the bad news: I had testicular cancer. This type of cancer is rare, but if a man in his thirties is diagnosed with cancer, it’s likely to be testicular. As with all cancers, early diagnosis makes all the difference in the world.

I’m not going to sugarcoat this—I was scared. The surgical excision of my right testicle and aggressive radiation during a twelve-week period saved my life—and caused some soul-searching. The way I saw things, I had dodged the cancer bullet, but there was another round in the chamber: My gargantuan weight had to be causing incredible amounts of stress on my organs—heart, lungs, and liver—as well as my skeletal frame. I wondered how much stress I was putting on my knees, which were bearing such a severe load.

Cancer forced me to face my mortality, and I was sure that each bite of a double-deluxe bacon cheeseburger brought me one swallow closer to the grave. Something needed to be done because I was in the throes of despair regarding my health, my physical limitations, the constant awareness of the special accommodations I needed, and the harsh, judgmental criticism I received from the general public.

For example, when I awoke each morning, the severe joint pain in my knees was so bad that I could barely shuffle my way to the bathroom. My ankles groaned in protest all day long—but I didn’t want to stop playing on my church softball team, though I knew I would suffer for days after each game. I played first base—a position that didn’t demand much movement—and I was a pretty good hitter.

No matter how many gappers I hit into the outfield alleys, though, I could never turn any of my long hits into doubles. When I safely reached first base, I knew I couldn’t run the bases, so I requested a pinch runner. Even though I could get back into the game under our free substitution rules, I felt humiliated each time I replaced myself with a fitter teammate to run the base paths. But that was nothing compared to the razzing I got from the other bench the time I lined a base hit over the shortstop’s head only to be thrown out at first base by the left fielder!

My life was inconvenienced in other ways. When I went out to eat, I dreaded walking into a new restaurant. Where was I going to sit? I couldn’t slide into a booth, nor could I wedge myself into any chairs with armrests. I scrounged up a sturdy chair without armrests. One time, I wedged myself into a plastic patio chair at a Mexican restaurant. Midway through the meal, the chair split in two, and I fell in a heap. Another embarrassing episode. When the waiter arrived to help me off the floor, I claimed the chair was already cracked so I wouldn’t have to pay for it.

I didn’t accept rides with well-meaning friends unless I was sure they drove a big SUV like I did. I needed the extra room as my waistline expanded. Throughout my adult years, I drove a succession of oversized vehicles—a Bronco, an Explorer, and an Expedition—because they were large enough for me to squeeze in behind the wheel. (The seat belt was never big enough for me to cinch around my body, however.)

Flying was even worse. I booked uncrowded red-eye flights whenever I traveled by air, but I’ll never forget the time I had to fly from San Diego to Albuquerque for a medical conference. Southwest Airlines had the only nonstop—and the cheapest fare—so I booked a morning flight. I ran late that day and was handed a C boarding pass by the gate agent. That meant I would be among the last to board, and Southwest does not assign seats.

I squeezed myself down the narrow aisle with a deep sense of dread. My fondest wish was to find two small kids occupying a three-seat row on the 737, but some dreams weren’t meant to come true. The reality that morning was an open middle seat between a man on the window and a middle-aged woman on the aisle.

When I approached that row, I could tell by the woman’s look that she had received some bad news—like a death in the family.

Excuse me, I offered, and she reluctantly stepped out of her seat so I could take the middle seat. I tried to sit down between the two armrests, but each armrest dug into my thighs. The more I pushed, the more it hurt.

Would you mind if I brought this armrest up? I wanly asked. Both of us understood the implication of my request: I would be spilling some of my excess poundage into her space.

Actually, I would mind, she said as she continued standing in the aisle.

An alert flight attendant sized up the situation. Let me see if I can help you, she offered.

Two rows behind us, the flight attendant spotted a mother sitting in the window seat with a three-year-old occupying the middle seat and a nine-year-old boy on the aisle.

I turned my head and watched the flight attendant lean over to the mother and whisper something. The mother looked at me. With a pitying sigh, she nodded yes.

We’re going to switch you with the young boy, the Southwest flight attendant announced. As I stood up to make the move, she whispered, Next time, sir, you need to buy two seats.

I gulped down another heavy helping of humiliation as everyone in that section of the plane watched me move from one row to another. Indignities like that happened continually to me—like the occasion when I escorted several out-of-town relatives to Tijuana so they could get a taste of Mexico. Tijuana’s main drag is called Avenue Revolution, a beehive of buying and selling as a succession of shops and street vendors vie for the Yanqui dollar.

The street vendors were on us like mosquitoes that day, and as we strode past them, they kept up a steady chatter inviting us to buy their wares. One vendor with several dozen leather belts draped across one arm approached us and said in English, Belts—I have belts for sale.

No thank you, I said on behalf of everyone.

The vendor eyed me. But we have them in your size, sir.

No thank you, I repeated, anxious to keep moving and not to engage him in conversation.

We had walked several steps when I heard him say, "We even have them in vaca gorda size."

I understood what he said: He had belts big enough for a fat cow. I spun on my heels. I recognized the phrase because I spoke Spanish every day at the community health clinic where I practiced.

Quien dices vaca gorda? I demanded in Spanish. (Who are you calling a fat cow?)

Lo siento, señor, the vendor replied, holding up his palms as fifteen of his buddies burst out in laughter. My face turned red, and I had suffered yet another humiliation.

My obesity also affected my social life. I had a very short romantic rap sheet as I was deemed unworthy and undesirable in the eyes of most women. I didn’t like the rejection I felt after being turned down for a date. It was painful not to be able to get a date with women I found attractive. It was often obvious that they were repulsed by my size. Some friends tried to match me up with significantly overweight women, assuming that our ideal date would be sitting on a couch and sharing a half-gallon carton of cookie dough ice cream. Then again, I wasn’t any great catch. My obesity and decreased life expectancy had to be legitimate concerns to any woman thinking long term. Who would want me to be the father of her children, only to leave her a widow with children to raise on her own fifteen or twenty years later?

The weight of dealing with my obesity sapped my morale. I was tired of dressing in XXXXL T-shirts and tent-sized gym pants, tired of gawkers staring at my monstrous midsection when I passed through the buffet line balancing two plates heaped high with food. What lay ahead was a future filled with high blood pressure, high cholesterol, debilitating diabetes—and premature death—unless I made some radical lifestyle changes and lost a ton of weight.

I was ready to change my life.

MAKING A GAME PLAN

On April 1, 2000 (yes, April Fools’ again), I notified the Escondido Community Health Center that in one year, I would be stepping down as medical director and leaving my clinical practice. This was no April Fools’ Day joke. I knew that I would need to take time off while I concentrated on losing so much weight. Monumental problems demand monumental solutions! Fortunately, I was not married and could refinance my home and take out equity to cover the cost of my upcoming adventure. I figured it would cost me more than $50,000 to step away from work, on top of my lost salary. I still had bills to pay, including medical school loans and a mortgage. I understand that few people can step away from work for a year—and somehow afford to do so, but, by the grace of God, I could. I made a significant financial sacrifice and put my economic and physical health future on the line.

I formulated a game plan. First, I decided to take an unconventional approach in addressing my personal health needs. Since I wasn’t going to work, I needed something to do—a distraction to keep my mind off being so hungry. The thought came to me to combine doing something I totally enjoyed while doing something good for my health. Since I was a huge baseball fan (literally and figuratively), I could travel around the country watching baseball games in every majorleague ballpark during a single baseball season—the ultimate pilgrimage for any baseball nut. As for losing weight, I decided to embark on a liquid fast—drinking a protein supplement offering just 800 calories a day. This would be a very aggressive diet since I calculated that I had been consuming an average of 5,600 calories a day up till then. (I’ll be talking about liquid diets in detail in Chapter 13.)

Throughout this book, you’ll read more about the remarkable transformation I experienced during my baseball tour of America and learn about Dr. Nick’s Seven Pillars, which are my key principles for weight reduction and maintenance. My hope and desire is that my story and these Seven Pillars will inspire you to lose weight as well as equip you with the tools you’ll need to undergo your own transformation.

Keep in mind that it’s important to implement the Seven Pillars as a whole rather than piecemeal. You should also be sure to seek medical help and supervision prior to leaping into a life-changing transformation. As you think about how to go about this, you can use my Web site—www.healthsteward.com—as a clearinghouse of information.

Meanwhile, if you’re holding this book because you’re overweight— or know a family member who’s struggling with his or her weight—then you’ve come to the right place for advice on how to lose weight. America has an obesity problem the likes of which this country—or any civilized nation—has never seen before. From early morning until midnight, we are awash in breakfast burritos, lunchtime burgers, and barrels of extra-crispy fried chicken for dinner. Pop a movie into the DVD player, and before you know it, we’re ordering a late-night thick-crust, extra-cheese, all-meat pizza. Our collective