By Doug Brunk, San Diego Bureau
When patients came to Nick Yphantides, M.D., for advice on how to lose weight and keep it off, he used to tell them, "Do as I say, not as I do" before replying with specifics.
That's because the 6-foot-2-inch physician weighed 467 pounds.
"I was board-certified in hypocrisy," said Dr. Yphantides, a preventive medicine specialist based in Escondido, Calif., who is an advocate for the medically uninsured.
In 1996, he ran for a seat on the Palomar Pomerado, Calif., health district board of directors. He was just 31 years old, but the local newspaper referred to him as the big man with a huge heart.
"My campaign motto was 'Big problems need big solutions. Vote for Dr. Nick: the big man for the big job,'" he recalled. "I was a big man with a big heart and big convictions."
He won the seat and went on to chair the health system's board of directors, but his push to make a difference for others came at the expense of his own health. A testicular cancer survivor, Dr. Yphantides said he became "so consumed with the mission, with the professional responsibilities, and with the requirements of maintaining what I had set out to do that I had to sacrifice my own health and balance in my own life."
That meant no time for exercise or making healthful food choices. As a result, markers of failing health began to show: borderline high blood pressure and high cholesterol, sleep apnea, and sore knees and ankles from the weight he carried.
"I believe there are lots of physicians who sacrifice their fitness and health in general," he observed. "They don't have to weigh over 400 pounds like I did, but the time commitment, the sleep deprivation, the stressall of the factors that are part of a package of being a practicing physicianput us in a greater liability of falling into that trap of having an imbalanced and unhealthy lifestyle."
On April 1, 2001, Dr. Yphantides embarked on a yearlong effort to shed pounds nonsurgically from his massive frame. He took a year off from his practice, secured a bank loan, and crisscrossed the country for a year in a converted van called the U.S.S. Spirit of Reduction to visit all 50 states and to watch baseball games at every major league ballpark. That was the fun part.
The hard part was sticking to an 800-calorie-a-day liquid diet and working out at YMCA gyms along the way (a friend had bought him a pass to use at any YMCA in the nation). Various travel companions, in the form of family and friends, accompanied him on two-thirds of the trip. "The first game I went to was a Dodgers' game," he recalled. "I remember wanting to tackle the [food] vendors. It was rough."
By the spring of 2002, Dr. Yphantides had lost 270 pounds, and today he maintains a weight of about 220 pounds.
"I'm working just enough to put salad on the table," he said. "I've gone from being a physician who was convinced he didn't have time to work out to a physician who is convinced now that I don't have time not to work out. It's a matter of life and death, and if I don't pay attention to my personal health … I'm not going to have a future."
He chronicled his success in a book, "My Big Fat Greek Diet" (Nelson Books: Nashville, Tenn., 2004) and maintains a Web site in an effort to inspire others to lose weight (www.healthsteward.com
Losing 270 pounds produced unexpected reactions. When people first learned about his dramatic weight loss, some presumed that he underwent surgery. "I've literally had to raise my shirt to show people the lack of scars," he said.
Some of his own patients have told him that they miss his former "teddy bear-like" presence. "I have had patients tell me that they felt more comfortable, more secure, more accepted [with me heavier]," he said. His transformation from looking like a walrus to looking like a shark may have threatened some people, who felt that his weight was part of his persona, he added.
He considers the surgical treatment of obesity "a last resort" for patients and frowns on consumer advertising of it. "I am not against the surgery. I am against the surgery being provided or performed on people who have not exhausted every other option," he said. "People who are obese are desperate. They are vulnerable."