“Now What?” (Is an Open-Ended Question)

I am an obesity parolee. It is the most apt description Dr. Tro and I have come up with for what it feels like to lose 200 pounds after a lifetime stuck in the matrix of countless failed diets, lost hope and desperation. Somehow, I made it to the other side, but like many people that find themselves free after years behind bars, I don’t know what this new life should look and feel like.

It’s difficult to wrap my head around how to just…be…when my entire identity was based on something that is no longer true, and even my own reflection in the mirror can’t be relied on as a means of recognition.

I am immensely grateful and proud. Blah, blah, blah. That’s the party-line, anyway. But underneath the surface, inside? I will always be 400 pounds and afraid. No matter my size, I will forever carry the mental scars of a lifetime in prison.

When a dear friend I’ve known since college recently told me that if she met me today my weight wouldn’t be among the first ten words she would use to describe my appearance, I was stunned. The prism through which all my thoughts, relationships, plans and experiences have been seen for decades? Breathtakingly shattered.

Now what?

For years, every waking thought was about losing weight, how to navigate life in a morbidly obese body, about my next “fix” or my next diet. What do I think and worry about when these are no longer relevant?

I’ll tell you: gaining the weight back, losing the last 20 pounds, being the “fat health coach,” and being found out as an imposter. I have replaced obsessing about losing weight with a preoccupation with going back to jail, and the shackles are my fixation over what everyone around me thinks about my diet and weight loss, the data on food trackers, fitness apps, CGMs, and most often, the (damn!) numbers on the scale. It all feels really…ugly…and quite frankly, not at all “free.”

As a health coach I regularly talk to people who are frustrated by the slow validation the scale provides. Clients who have invested their time, money, energy and most significantly their hope in this process, who are doing everything right, who are trying so hard, and yet, still, the scale moves at a snail’s pace. The frustration can derail all of us…I understand it (all too well!) and spend a good portion of my time urging clients to look at other metrics for success, non-scale victories: health markers, clothing, body composition, comparison photographs, fitness goals, validation from loved ones, something, anything that can sustain us long enough so we can achieve meaningful and sustainable weight loss.

To this end, I offer myself up as a cautionary tale (with full awareness that it might appear easier for me to say this having lost 200 pounds): please remember that the endgame is not a number on the scale or what anyone else thinks of your body, and if you are healthy, or very much on your way to getting there, figure out what else you need to keep mentally and spiritually sated. Once your physical appetite is under control, these are the insatiable hungers that need to be nourished.

I have been so busy looking for ways to stay motivated in this process by seeking validation from everyone and everything else: the scale, friends, loved ones, doctors, trainers, neighbors, my reflection in the mirror, lab results from blood tests, social media, the digital display on exercise equipment, food logs, training apps, clothing sizes…anything I can latch on to. It is a whole new addiction, with a high that needs to be continually chased, the last hit never as potent as that first one.

The root cause: fear that this new body is only a stay of execution, and that life in prison is the best I can hope for. Really, what right do I have to believe otherwise? I had been denied bail over and over and over again.


One thing we talk about with health coaching clients is the importance of putting layers of defenses in place to fortify weight loss efforts. One of those defenses is cultivating community and support. In other words – find a tribe of people that will not flinch when you order two steaks at a restaurant (hold the bread and potatoes) or bat an eyelash when you bring your own dessert to their fancy dinner party.

I consider myself beyond blessed to have found a group of people (some of whom I am even related to!) that believe in the best parts of me, that have voices louder than the ones on a loop in my head telling me I’m not enough — people that were confident I was capable of things I couldn’t even conceive of at most points. These are people who made me feel like I belonged when, for years, I only believed in my despair and brokenness. They didn’t necessarily understand everything I was going through or why I did the things I did, but they loved and respected me enough to stick around even when my struggles made me not so pleasant to be with.

If you don’t have those in your life who can provide a safe place to land, please, please, please seek out the help of a supportive doctor, health coach, therapist, clergy member, trainer or social media network. I needed help many times along the way, and when my family or friends, for whatever reason, couldn’t or didn’t know how to provide it, I reached out to professionals and other resources. This has been an instrumental part of my success. It really, truly, has taken a village.

But…during this current phase of my weight loss journey, I have become so distracted by looking for that outside approval — and I include the scale on this list of potent and sometimes harmful validators — that it is counterproductive. Now that I’ve found and relied on my community and support, it’s time for me to start moving past what they all say and start listening to myself, to internalize their belief in me and my abilities.

Intuitive eating, intuitive living, self-reliance on what I know to be true.

Those external voices, supports and tools have been critically important in my journey to wellness, but the need for approval has become yet another means of keeping me bound to the obesity matrix I want out of — imprisonment rather than freedom. There comes a point where relinquishing them is necessary, as scary as it may be. It’s not that I’m never going to look for outside signals, it’s that I don’t want to be dictated by them. They are not a moral compass or a value of my self-worth.


About a year and a half ago, I was headed to the hospital for surgery. There were some scary unknowns and I remember bargaining on the way to the hospital and making promises about all the things I would do if I survived it and the results were okay. I was desperate for another chance, and in deep regret over wasted time and all I had taken for granted, all the things I had done to abuse my body over the years, much of it because I didn’t know better, but a lot of it because I was young and foolish.

In the end, the surgery and results were the best-case scenario of a crappy situation, and fast forward to today, I have mostly made good on those promises I made to myself: doubling down on weight loss efforts and kicking exercise into high gear so that I could reorient my life to prioritize peace and joy, and mostly…do some good in this world.

No one ever faces a life-threatening situation and says, “Damn, I wish I had dieted more!” And though I won’t be around to read it, I am guessing my obituary is not going to read “kept carbs low.” I have given two eulogies and performed one marriage ceremony, and never once did I think to mention how many pounds anyone had lost or what their macros were.

But, despite the fact that losing weight is not the purpose of life, it is a means to an end, and for me, the beginning of being able to live, move and find joy in a life that for decades felt like a death row prison sentence. That’s why I take it so seriously and want to scream about low carb to anyone who will listen (and even to those who won’t…especially to those who won’t).

We only have one life, but if we are really lucky, we get a bunch of opportunities to make it worth living. I got a “Get Out Of Jail free” card, a second (third, fourth, tenth?!) chance. A Golden Ticket. I’m not giving it up.


At some point over the last four years I stopped seeing low carb as a diet. Not sure when this shift in mindset happened, but it is enormously comforting.

There is no after. It’s all part of a continuum, one life. In my dieting history there was always an off ramp, one that led to some back road of regret and shame. But in the past year or so, with all the excitement and fury of losing a ton of weight, the new clothes, the admiration from friends and family, the scale, I got distracted and forgot that there is no there there. This is it.

That awareness has allowed me to hold my head up a little higher and not be (nearly as) embarrassed or ashamed of my eating. I’ve said it a million times before and I believe it to be true more than ever… I am not exceptional, but I am consistent. I make mistakes very often. I still eat in ways I’m not always proud of, but I feel less and less shame, something that, counterintuitively, has helped me rebound quicker. I show up every day, no longer looking for perfection, but instead for ways to improve on the day before. It’s really all I can ask of myself.


This new life is not what I expected it to be, like nothing I could have foreseen. It’s perfectly imperfect – burnished and polished by pain and experience. It is also tinged with some regret, if I’m being totally honest. And still, with all that – it’s worth fighting like hell for.

So, to that end, I urge you: keep going, keep fighting. Even when your confidence has been stripped by the forces working overtime to remind you of your shortcomings or your progress feels miniscule and insignificant.

Showing up, day in and day out and believing in your possibility is a brave and heroic act. A good part of my job as a health coach is to remind clients of their potential for success, and that I trust they will get there. It’s so easy to forget even the things one knows with certainty, and guiding clients back to these core beliefs is an honor and a privilege.

All the soul searching and work? All that time spent believing myself to be an utter failure, all that time “wasted,” of hitting my head against a wall trying to lose weight and wondering, over and over again, why I could never get there, despite wanting it so very much?

All those lessons have come into focus, with purpose and meaning — a plot twist I never could have predicted.


Read more articles from our team

Dr. Tro’s Medical Weight Loss and Primary Care provides nationwide medical weight loss, primary and metabolic care through an individualized approach that reverses and prevents disease. 

Subscribe to our updates.

Dr. Tro’s Medical Weight Loss and Primary Care provides nationwide medical weight loss, primary and metabolic care through an individualized approach that reverses and prevents disease.

Subscribe to our updates.

Copyright ©2022 Northvale Primary Care d/b/a
Dr. Tro’s Medical Weight Loss & Direct Primary Care.
All Rights Reserved. Privacy Policy & Terms