Bill's 20/20 Lifestyle Program

Steve is blogging about his 20/20 experience at http://spaces.msn.com/stevewort/.

Well, yesterday was my visit with my 20/20 doctor (Dr. Upton). This is my final appointment before I actually start my diet and exercise program. Basically, the doctor told me what I already knew:

• My cholesterol is a bit too high (at risk for heart disease, etc.)
• My blood sugar is a bit too high (at risk for diabetes)
• My tryglicerides are way too high (at risk for a heart attack)
• My blood pressure is too high (at risk for a stroke or heart disease)
• I'm overweight and out of shape

He said that I have insulin resistance/metabolic syndrome, which basically is all the symptoms above. That's the bad news. The good news is that he said the 20/20 Program can fix all these problems at once. Most of these problems above are fixed by losing weight, exercising, and getting better nutrition. Dr. Upton said that the 20/20 Program actually hits all three of these areas, and this "triple whammy" is very effective at fixing all these problems.

He let me in on the meal replacement shake thing: basically, I'll be eating primarily shakes and chicken breasts for the first few weeks of the program. He also told me that to be a 20/20 superstar, you had to do the 30-60 minute cardio workouts on your own during the week.

I'll be meeting with Dr. Upton again after 5 weeks of the program.

I read on a web site formula that helps you calculate your base caloric requirements to maintain your current weight. According to this calculation, I need to eat 2501 calories a day to maintain my weight. From what I hear of the Pro Club diet plan, they keep you on about 1500 calories per day. That means that over a week, I will be 7000 calories lower than what's needed to maintain my current weight (not counting exercise). Given that to lose a pound you need a caloric deficit of 3500 calories, I should lose two pounds per week (assuming that formula was accurate as was my math). Exercise should help increase this as will losing water weight.

I've seen other, less complicated formulas for calories required to maintain a given weight. One formula says to muliply your weight by 14. This would put me at 3080 calories to maintain my weight. This seems high, but let's go with it. If this is accurate, then I will lose a little over 3 pounds per week.

My goal is to lose 2 pounds per week of the 10 week program, and 1 pound per week during maintenance (12 weeks). That would equal 32 lbs lost during the whole program. This is not my final goal, but I would be pleased with this result. What would really be good is if I could lose 2.5 lbs per week during the 10 week program. This would put my total loss at 37 pounds. That would be awesome.

It turns out my dirty little secret (pigging out on things before I go on my diet) may not be anything to be proud of, but I am not unique in doing this. In fact, Nelson (the trainer who conducted my fitness evaluation) actually said this is fairly normal and didn't discourage it. He also mentioned that some people had entered the program having put on over 5 pounds between the time that they signed up for the program and their fitness evaluation (I've put on 2)...

In an effort to avoid depriving myself of everything at once (food, caffeine, candy, lethargy, etc.), I have decided to eliminate caffeine from my diet now. Hopefully, this will make things a little easier when I actually begin dieting.

So how much caffeine do I consume each week? Well, weekdays I generally have at least 2 cups of coffee every morning. On top of that, I drink quite a bit of Diet Pepsi every day. When I was filling out the forms for the program, one of the questions was "How many diet soft drinks do you drink a week?" I answered 20 cans.

I'm no expert, but that seems like a fair amount of caffeine every week. I've pretty much stopped the caffeine over the past week. I do feel a bit more draggy than normal, but I haven't gotten headaches or anything (which I've heard can happen to people). Today I fell off the wagon a bit: I'm sitting here at the MINI dealership in Fife waiting for my car. It is so cold in here that I am having a cup of coffee to warm up. Unfortunately, they only have regular coffee.

So, I guess I've already begun my lifestyle change!

Well, today was my big fitness evaluation. This is where they find out how out of shape you are so that you have something to gauge yourself against at the end of the program. They also go over the policies of the program. Some of the things that I have to commit to are:

• Meet with the personal trainer 3 times weekly
• Meet with the dietitian weekly
• Meet with the doctor as appropriate
• Work out twice a week on my own
• Keep track of everything I eat in a food journal

Some of the other things I learned:

• No caffeine (yikes!)
• No alcohol (not a problem)
• At least 64 oz. water per day (not a huge problem)

Nelson conducted the evaluation, during which he made the following measurements:

• Weight (it was over 220 on their official scale! Yikes!!!)
• Body composition (percentage of body fat, measured with electrodes connected to my hand and foot)
• Blood pressure (which was rediculously high [145/105], I think partially because of all the water I've been drinking)
• Body measurements, including chest, waist, hips, arm circumference, and thigh circumference
• Strength (I did a bicep curl on a machine)
• Flexibility (I had to do a sort of toe touch on the same machine)
• A lung test using something called a spirometer
• A sort of stress test on a treadmill (I had to walk on a treadmill that increased speed and incline every 3 minutes; Nelson timed how long it took my heart rate to get to 152)
• A recovery test (Nelson recorded my heart rate 1 minute after the stress test was over)

We also went over my blood test results. Generally, things were not too good. My blood suger was slightly above normal, as was my cholesterol (which was one of the things that got me into the program). My good cholesterol was too low, and my triglycerides were over twice what they should be (not good). Nelson assured me that after 5 weeks things would be much better. I certainly hope so...

Finally, I paid for the whole thing today ($1,222), took my "before" photo, and got a kickin' water bottle! Next up is my consultation with the doctor that happens next Monday.

Stay tuned...

One of the things that they require for the 20/20 program is that you meet with a counselor once a month or so. Yesterday was my first visit. I think the goal of the counselor is to help you deal with the psychological side of making a lifestyle change. I also think the shrink is on the lookout for other issues that may be causing you to be overweight, such as binge eating, depression, etc. Finally, the counselor is there to monitor for eating disorders or other unhealthy activities.

Anyway, the session was pretty much uneventful. I spent about 45 minutes with Donna Flynn going over my background, etc. I think the counselor's opinion is that I just eat too much and don't exercise enough.

Not too exciting, but one more thing out of the way...

My dirty little secret is that over the past week or two, I've been eating more than normal because I know that I won't be able to eat a lot of the things I like for a while. For example, Panera Bread just opened in Issaquah. This is one of my favorite places to eat from when I lived in St. Louis, and all my old favorites are now available to me (especially asiago cheese bagels!) I've been going there way more than I should because I know that soon I won't be able to have this food soon.

This is probably not the best way to start a diet...

I got a call on Friday from the 20/20 coordinator to set up all my initial meetings and visits. It looks like things are really going to take off.

Here's what I've got scheduled:

1. A one hour meeting with a psychologist. (I guess they need to get into my head and figure out why I eat like a pig!)
   
2. A 1.5 hour fitness assessment. (I suppose the personal trainer doesn't want me to keel over on the treadmill...)
   
3. A 1 hour meeting with the doctor to discuss all the tests and evaluations they've done so far (and other things?)
   
4. Three 75 minute personal trainer sessions per week with my trainer, David Sams.
   
5. A 30 minute session with the dietitian after my Tuesday training session.
   
6. I also have to participate in a group counseling session every week that has yet to be scheduled.

My first training and dietitian sessions are on February 7th. I guess this is where things will really take off.

Let the games begin!

So far, I've done the following:

1. Saw my doctor and got a full blood test and physical. He filled out a form that recommended I participate in the 20/20 program.


2. Went to a informational program at the Pro Club to learn about the program. Got lots of forms, etc. This was January 3rd.


3. Discussed the program with my wife, Cheryl. Given the success rate of the program, and the rather sad state I'm in, she and I agreed that the program would be a good idea (and worth the $1200 it would cost).


4. To participate in the program, you must have a form from you doctor stating that you are healthy enough to participate. I stopped by the doctor to get this form filled out by my doctor.


5. I filled out a bunch of forms, both paper and online covering goals, health history, genetics, attitudes, etc.


6. Stopped by the Pro Club to turn everything in. I also scheduled a blood test that they require before starting the program. This happened on January, 5th.


7. Went by the Pro Club for a blood test on January 10th.

It seems hard to believe that I made the decision to go on the 20/20 program less than 2 weeks ago. Right now I'm waiting for the program coordinator to call and set up my first real meeting with the 20/20 staff. Hopefully, it will happen in the next week or so.

My goals for the 20/20 program are as follows:

1. Get my blood pressure to normal, preferably without medication


2. Get down to 180 lbs. (i.e., lose 35 lbs.)


3. Get my cholesterol down under 200


4. Get in shape to run at least a half marathon within 1 year

Not too impressive, but from where I stand, it will take something pretty special to pull off. The good thing is that I'm ready to work really hard to make it happen.

Now if we could just get started...

You may be wondering why I'm doing the 20/20 program. I have three areas that I need to work on: weight, blood pressure and cholesterol.

Weight

I currently weigh 216 lbs. I had been about 205 for a long time up until about 18 months ago. At that point I made a decision to start running and was really good for about 6 months. I got up to about 20 miles a week, and got down to 190. Unfortunately, I started to get some pain in my left knee and, according to the physical therapist, had to stop the running for a while to heal. Then I got sick, then the holidays came, etc., etc. Next thing I knew, I was off the bandwagon completely. The weight started to come back, and before I knew it I was back to 205. Unfortunately, I didn't stop when I got back to my starting weight. I kept gaining until I got to the weight I'm at now. It really sucks because this week I actually had to buy 38" waist pants.

Blood Pressure

My was diagnosed with high blood pressure about 3 to 4 years ago. I've been on 8mgs of Aceon each day, and even still my BP is a little high: generally 130+ over 83+ at its lowest. I've measured it where the bottom number was as high as 96 which is not good.

High Cholesterol

My cholesterol is probably the least of my worries. It is high, but not dramatically high. The last time I got a full blood test, it was 221. I know its not good, but it could be worse.

Stay tuned for my goals....

Welcome to Bill's 20/20 Lifestyle Program blog. This blog is where I'll follow my progress as I go through the 20/20 Lifestyles program at the Pro Club in Bellevue, WA. The 20/20 Lifestyles program is a medically-supervised weight loss program.

What

20/20 is a very intensive plan that consists of 10, 15, or 20 weeks of exercise, diet, and lifestyle modification. After the main program is complete, program participants move to a maintenance phase of the program that is a slightly scaled down version of the program. According to the staff of the program, 48% of the people who go through the 20/20 program keep their weight of at least 5 years (compared to approximately 5% or less for a typical diet).

My employer, Microsoft, pays for 80% of the program if you are clinically obese, or if you have certain medical conditions. Since the program can cost up to $10,000 or so, Microsoft spends a significant amount on this for the employees going through the program. However, Microsoft claims that for every dollar they spend on the program, they save well over a dollar in insurance costs.

Why

I am going through the 10 week version of the program. I am eligible for Microsoft's assistance since I have high blood pressure and high cholesterol. In addition I am clinically overweight (my BMI is approximately 29). The doctor who invented and runs the program states that he can get 70% of hypertensive participants off their medication within 10 weeks.

Although Microsoft pays for a significant portion of the program, I have to put significant financial skin in the game: over $1000. I actually think this a good thing in that if I fall off the wagon, I will have thrown away a grand for nothing.

Stay tuned for postings about what I hope will be a very successful program.