Beyond BMI: Understanding the Complexities of Obesity and Weight Loss

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Coming up on this episode of the
Healthy, Wealthy and Wise podcast.

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So, and, and that's part of the
problem, you know, they said, well,

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just go out and just diet and exercise.

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But then if you're 400 pounds or
whatever, that, that's not a simple,

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that's not a simple thing to do.

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You know, then if you get knee problems
and you need knee surgery, now that's

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another big problem and you can't move.

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So it becomes a vicious cycle.

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And we haven't even talked
about the psychological

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part of it.

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Yeah.

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Welcome to the Healthy, Wealthy,
and Wise podcast with Dr.

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William T.

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Choctaw, MD, JD.

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This podcast will inform, educate,
and motivate you to live a more

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healthy, wealthy, and wise life.

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It's powered by the over 50 years
of medical experience of this Yale

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University Medical School trained
surgeon, who also received his Juris

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Doctorate from Western State Law School.

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He has executive experience as a
former mayor of Walnut, California,

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as a chairman of the nonprofit
Servants Armed, and as president of

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Choctaw Medical Group, Incorporated.

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You've got questions or concerns,
he's got answers for both.

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So let's listen in on an
interview already in progress.

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Yeah, very interesting.

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I, I had listening to a podcast.

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I had learned that piece about,
um, that the studies were

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based on, uh, studying men now.

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Yes, yes, yes, yes.

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So post surgery, I, I could say I was,
I can only speak to my experience.

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I belong to a group of others
who had a really rough time.

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Lots of, lots of nausea,

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pain, even difficult swallowing.

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Um, Yeah, even for a moment thought
These people didn't do anything to me,

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I was walking, I had no pain, um, you
know, I was like, I was like, I'd had,

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I'd only had surgery one time before,
and for an appendectomy, I'd been

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in pain, so I figured, well, they're
removing, they're cutting out six

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pieces of intestine, and yeah, this is
a little different from an appendectomy,

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so my thing was, same kind of pain,
but I was, you know, I was really, you

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know, Extraordinarily well, and I was
able to manage the different phases.

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Um, right.

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Because initially you only, you
drink four ounces of liquid three

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times a day and that's your food.

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And, um, but I think I, it was easier
for me because I was in a, a good, I was

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in a decided place that this is a, okay.

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That makes sense.

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That makes sense.

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I do in some of my group.

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Um, there are patients that talk
about, they'll ask, they'll post,

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well, how soon after your surgery,
were you able to eat pizza?

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After you already ate all the pizza and
tacos, we needed to be, that's not the, my

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thing is, this isn't my focus right now.

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It's pretty had it.

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I'm good.

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And it's what's surprising as something
that didn't happen is I always,

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uh, Whenever someone would say,
well, I'm a vegan or a vegetarian,

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I say, well, I'm a vegetarian.

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I never thought that to myself
that I would be, I would transition

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to that, but I just, I think it's
because it's easier for me to process.

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Um, beef is very difficult
for me to process.

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It just feels, so I, um, I do
eat meat, but it's, I'm more

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about the side dishes guy now.

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Interesting.

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Um, I've adapted really well.

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Um, I lost 160 pounds in a year.

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Well, I feel great.

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Um, everything, it was the reset that I
was looking for and everything changed.

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And it's.

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I can't deny that there's a lot of, uh,
privilege that came with it that I could

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afford to pay for it out of pocket.

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Yes.

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You know, I would have had to go,
um, through that one year waiting

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process and then, you know, see if they
decide am I a good candidate or not.

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And just because just think about that,
just because you had the option because

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you, you were financially secure.

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So you can say, you know what,
I'm not going to wait 12 months,

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blah, blah, blah, blah, blah, blah.

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But imagine if you didn't
have that option, you were

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forced to wait for 12 months.

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You didn't want to do it,
but you were forced to do it.

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And just imagine how that may
have impacted your recovery.

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My point is everybody's different.

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Everybody's a little different.

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And that's why it's very, very difficult
to sort of paint a broad stroke and

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say, All patients who get A are going
to do this or B are going to do that.

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We're all different.

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God made us differently.

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And you were blessed not only to make
the right decision, but to have the,

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have a good outcome that works for you.

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Yes.

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And I, you know, I was very aware
that Because you read, you know,

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there is, there's even a calculation
you can use about, well, if you weigh

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this much, you should be estimated to
lose this much within the first year.

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And I was like, wow, that'd be great.

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And, you know, I was pretty much
on target, um, but there are

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so many other factors like your
age, your ethnicity, your family

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history, you have other, um, um,

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And indeed, a lot of the studies are
now showing, I'm talking about 23, 24,

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that the BMI index is discriminatory.

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You know, just think about it.

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You see, let's say a male, 15
year old male, who's, who's

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big and maybe who's overweight.

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And then you look at the brother and you
look at the father and you look at the

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uncle and pretty soon you figure out,
you know, maybe this is a family trade.

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And so my, my, The point is that a
lot of times, um, um, uh, patients

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who are built a certain way who
look a certain way, again, has

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nothing to do with their lifestyle.

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It's part of, it's part of the genetics
that they're sort of faced with, not

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to mention their financial status.

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Yes, absolutely.

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And I think for me, it's been, uh, it's
been an, a great path and easy, easy one.

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I feel a little bit, uh, I feel
sometimes I feel, I do feel a

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little bit bad that it was so easy.

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Um, some of the people in my group,
you know, they really suffer, um, just.

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With the pain of, um, lots of, I remember
because you're in the hospital for about

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two days and you could hear people in the
next week, just retching all day from the,

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and you don't have anything inside you.

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So it's just your stomach twisting
in a knot and the pain of it, but

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I felt bad for them, but I was grateful
that I didn't have that experience.

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And my experience has gone, um,
really, really, really well.

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And it's been.

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Like I said, my diabetes
remains in remission.

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I don't know for I mean, I tested every,
uh, every other month I test just to

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make sure I'm still processing normally.

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Sure, sure.

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Um, but, uh, yeah, I went
from like a, I was 6.

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7 A1C and now I'm 5.

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6.

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That's excellent.

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My triglyceride, and
that's with no medication.

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Okay.

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Okay.

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Or not even diet.

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It's just.

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And

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at age 50, that's good.

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That's good.

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Um, my triglycerides went from 567 to 113.

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So I don't even think I was
as healthy in my twenties.

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Let me ask you a quick question.

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Did you ever think about, uh, the
medications that are out, Ozempic,

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Wagobe, that sort of thing?

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So when I started this,
Ozempic was just coming out.

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Okay.

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And so I did.

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Um, But then they say, so Ozempic,
what is it, 5 or 10 percent?

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Uh, that you could lose,
you're expected to lose weight.

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I, I think probably at least about 5%.

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Yeah.

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At least

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about 5%.

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Right.

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And I thought about it, um, and
I knew I qualified because I

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was diabetic, so, right, right.

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And, uh, but then I thought, yeah,
but I need to lose more than 5%.

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Losing 5% of my way would be nice, but
I need to lose vastly more than that.

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Um, so, um, I didn't,
I didn't give it much.

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Uh, like stop.

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But I think also in my mind, I
had taking metformin is awful.

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Really?

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I hate it.

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You know, it was, it did help
me manage my, uh, my levels, but

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it's a really an awful medication.

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You can't, it's like, I travel for
work and I would take my medication

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if I was traveling because you
don't know when you're going

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to have to go to the bathroom.

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Right.

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When you

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have to go on metformin, you have to go.

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Right.

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Understood.

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So, um, you know, and it was
just, I hated it so much.

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, you know, they do say that there's
a cell rejuvenation piece that

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Metformin helps, which was, I did
notice I was looking a little bit

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younger in the year that I was Okay.

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Okay.

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It was kind of nice . Um, but I
did the, the side effects of it.

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Um, we're just awful to deal with.

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And so I didn't want
to be diabetic anymore.

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And I managed when I, when I was first
diagnosed, I'm, I was actually doing

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a pretty good job of managing it.

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I dropped my A1C from 6.

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7 to 6.

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2, which isn't too bad, but I, I'm so
grateful that, um, I'm in remission.

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I'm hopeful that it stays for a while.

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I don't know how long it'll be.

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I, I come from, on my mother's side,
all, there's seven, there's seven

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children and all of them are diabetic.

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Yeah.

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Yeah.

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So, you know, my job.

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Yeah.

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You know, my chances are
it'll probably come back, but

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you have a good managing system
in place and you're monitoring it

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regularly, which is what you should do.

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And you just adjust, you know,
you, you do what you need to

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do with medical supervision.

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Um, um, and, and it's gotta be,
it must've been a tough decision.

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Most people don't like surgery,
you know, is, um, uh, that when,

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when they choose that option.

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It definitely was, but I think I was
at, I would even say it was probably

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a piece of, place of Desperation,
because I dropped it to spirals so

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far out of control, and so I had to
try to regain control by working out.

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I was so far gone, and you
know, even walking two miles

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was really painful on my knees.

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Yeah, yeah, yeah.

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If I wanted to jog, I wouldn't be able to.

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Understood.

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You know, and, um,

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so, and, and that's part of the problem,
you know, they said, well, just go out,

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just diet and exercise, but then if you're
400 pounds or whatever, that, that's not

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a simple, that's not a simple thing to do,
you know, then if you get knee problems

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and you need knee surgery, now that's
another big problem and you can't move.

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So it becomes a vicious cycle and
we haven't even talked about the

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psychological part of it, the mental
part of it, depression, um, sadness,

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on and on and on, antisocial.

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Behavior, those things that normally would
help us, but you don't wanna do that.

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You know, you

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absolutely begin to feel this
reclusive idea of like, oh,

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I don't like the way I look.

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I, I'm not gonna go, I'm
not gonna go to this event.

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I don't like the way I, I
don't want people to see me.

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Yeah, yeah, yeah, yeah.

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And start limiting yourself.

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And, um,

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yeah, Mo absolutely there is that
psychological component and I think.

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There were, it happening so,

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so well, and it was in such a
nice timeframe, I think has been

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a real psychological lift for
me, especially turning 50, right?

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Because it's, you're 50 and all of a
sudden, you're in the right, it's, that's

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a good, good point.

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Good point.

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But what did you do
psychological to help yourself?

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Did you have friends who helped you?

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Did you, was there anything particular
that you did or did it just happen?

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A lot of podcasts.

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Yeah.

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So.

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And part of my weight loss is I
walk, I walk 10 miles a day, five

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miles in the morning and five
miles in the evening, 90 minutes.

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Uh, and in that time, uh, it's, you
know, I, uh, sometimes I get lost

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in my brain and thinking about work
things, but, uh, mostly it's listening

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to podcasts and usually they're
health related about, you know, the

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experience, uh, and my age, um, because.

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Really health for a man in of an age
in his 50, you know, his management

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is vastly different from man You bet,

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you bet and health management
for men in the 50s is vastly

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different from health management
of a female, a woman in her 50s.

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We, we men, and I'm generalizing now, but
we tend to not want to go see the doctor.

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We tend to not want to do all that,
all the stuff that we should do.

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And so then, and then, uh, add in that
particular for some men of color, then

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we have all these issues about, well,
you know, there's not a lot of trust

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in, in the healthcare delivery system.

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And And we saw this a lot, uh, you
know, certainly with COVID and that

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sort of thing, people didn't want
to do vaccines and, and everything.

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So there are a lot of things that work
against us getting to the point of, of,

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of good health and health stability.

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And even the piece of.

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Managing your care with them when
you first start and the doctor says,

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okay, come back and see me in a month
if you don't have a flexible job,

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that means three to four hours off
of work and my now I have this fear

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that my job didn't say, why are you
taking so much sick time off, right?

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You know, all of a sudden you're a
bad person because you're missing.

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Yes.

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Um, yeah, so there's that piece and
especially on the male mentality

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is my job is important, right?

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Right.

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Everything else comes second.

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Um, I was fortunate that
I'm the HR director.

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So I got to ask anyone

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when you HR directors have a hard
job anyway, because most people

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give HR directors a hard time,

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but I, with our staff, you know,
I really heard said, you know,

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The sick time is your sick time.

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Take it with the law in California,
even prevents you from asking them and

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questioning their right to take it.

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And I think, um, you know, in our
organization, we even allow, um, you can

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take you sick time as a mental health day.

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If you just eat, you know, there may not.

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Be you just need some time, right?

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It has a vacation.

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You can use it.

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You know your sick time
three days up to three Okay,

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that's good.

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Thank you for listening to this episode
of the healthy wealthy and wise podcast

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with dr William t chakta Md jd We hope
you now feel more equipped with tools

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and actionable information that will help
you live a more healthy Which includes

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the mental physical and spiritual?

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00:15:31,910 --> 00:15:37,060
Wealthy, which includes the financial,
health, and spiritual, and wise,

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00:15:37,120 --> 00:15:41,600
which includes the practical,
theoretical, and emotional life.

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00:15:42,240 --> 00:15:47,139
For this one, and past podcast
episodes, blogs, books, and news

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00:15:47,140 --> 00:15:53,035
you can use, Go to www.twp.com.

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00:15:53,395 --> 00:15:59,695
That's www.thwwp.com, and you've got it.

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In the meantime, remember, you too can be
the change you want to see in the world.

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You've been listening to The Healthy,
wealthy and Wise Podcast with Dr.

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00:16:10,270 --> 00:16:11,425
William t Choctaw.

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MDJD.