I have a story I can share with you that's very personal and inspiring. Here's how it goes.
When I started my internship back in 2019 at Diyatalawa, a beautiful and serene town nestled in the Uva province, I was excited for my first year of training in the medical profession. I remember being quite skinny back then, weighing around 65kg and comfortably fitting into my 32-inch pants. Back during campus, I played football and was physically active. My first appointment was in pediatrics, where I joined two other house officers.
Internship was a pleasant experience. I enjoyed my training under a kind consultant and with amiable colleagues and staff. There was also plenty of food around! The happy parents of children who were admitted and treated for various conditions always brought cakes to show their appreciation. My colleagues and staff also brought in food, and there were regular small occasions like birthdays. I also developed the habit of having tea almost 3-4 times a day with something to snack on. For dinner, we sometimes ordered food from outside, and on regular occasions, we indulged in delicious pizzas and submarines from a place called Pizza Hub.
My eating habits gradually became unhealthy. I ate more than I worked. My belly grew larger than that of my pregnant colleague who was 20 weeks along! I became easily tired and lethargic, but I continued to eat. My colleague's mother-in-law, who used to bring her lunch in her absence, started to suspect that I was eating her lunch instead of giving it to her! My pant size increased to 34 inches, and I couldn't wear the shirts I had bought when I started the internship. Of course, my weight increased by a staggering 10 kilos within a few months.
Moreover, the COVID-19 pandemic arrived. We were confined to the hospital and our quarters. Physical activity became less and less frequent. We had rice and curry three times a day, which was almost the same meal for about two months. You can imagine the result!
The turning point came when I asked my friend Uma, who was a Relief House Officer in radiology, to perform a scan on me. It was mostly for fun and because I had never had an ultrasound scan before. She did my scan, but her face grew dim. My liver appeared very opaque on the scan images, consistent with grade 2 fatty liver! She looked at me and gave me a stern warning about my lifestyle. I felt ashamed and realized that I hadn't practiced what I had learned or preached as a doctor. I decided to change my lifestyle.
My experiments began with my diet. I did a lot of research on what to eat and what not to eat. I read articles, books, and guidelines, watched YouTube videos, and even Netflix documentaries. I tried various things, including intermittent fasting, plant-based diets, vegetarianism, keto diets, and simply not eating. Unsurprisingly, I was unable to maintain any of these diets. I didn't cook for myself and relied on hospital canteen food, which was mostly high in carbohydrates and starchy foods with fewer vegetables. I was frustrated!
For physical activity, I achieved a modest breakthrough when I started my RHO period after the internship. I had more free time and was able to engage in regular physical activity, including playing badminton and cricket and exciting adventures like mountain climbing and exploring the hills and landscapes around Diyatalawa, Bandarawela, and Ella. My short stint working at the COVID-19 intermediate care center with army personnel also positively influenced me to engage in regular physical activity. I joined them in their physical training sessions to keep fit and incorporated them into my daily schedule.
But it wasn't enough. My weight remained the same. I still wore size 34. My BMI was 31.
Eventually, I was selected for training in family medicine in 2022, which is essentially general practice. I realized that non-communicable diseases, including diabetes, hypertension, dyslipidemia, and ischemic heart disease, are the most common burdens encountered by primary care providers. And obesity was a major risk factor for developing all of the above. One notable incident occurred during my short clinical appointment in endocrinology. The consultant took a close look at me and said I would definitely develop diabetes within another 10 years. This devastated me, as both my parents are diabetic patients, and I was going to inherit that in my thirties. I learned that a darkening discoloration of the neck, called acanthosis nigricans, along with a strong family history of diabetes and obesity, easily predicts the future of inheriting diabetes.
All of this triggered me to make a drastic change and put on the top gear. I realized that I couldn't become a good family physician unless I practiced a healthy lifestyle myself. I would be a hypocrite. While I received valuable training in family medicine and preventive healthcare, I decided to implement it on myself as I preached.
Firstly, I re-explored my diet. The biggest challenge was our regular Sri Lankan diet, which is carbohydrate-dominant. If we ordered a lunch of simple rice and curry, it was mostly rice with small portions of curries. For dinners, we cheated with fast foods such as kottu, pizzas, and burgers, which was a recipe for disaster. And I loved indulging in desserts whenever my mom made them. After doing my research, I found the calorie restriction diet using the smart plate model to be the most practical. One-fourth of carbs, one-fourth of protein such as meat, fish, or eggs, and half of vegetables, including green leafy vegetables. Potatoes, carrots, beetroot, jackfruit, and breadfruit were part of the carbs. I only served myself a cup of rice, approximately 200g, not a grain more. My mother was concerned as I wasn't eating enough rice, which is typical for Sri Lankan mothers. Gradually, I convinced her to prepare meals accordingly, and I proved that even her blood sugar levels became controlled with the same medications by simply cutting down on carbohydrates. Now all of us at home eat smartly as described above.
Secondly, I focused on my exercise routine. I didn't join a gym or engage in a regular sport. Moreover, I couldn't find the time to take regular walks around the neighborhood as the roads were very busy with fast-moving traffic and lacked designated walking paths. Furthermore, the warm, hot weather was very discouraging. Occasionally, I went cycling, but I couldn't make it a habit. Then, on Facebook, I found something that became a significant aspect of my daily routine. On my regular newsfeed, I started seeing an app called MuscleBooster. I simply ignored it for months because I thought it was just some money-making scam by Americans. But I became curious and decided to give it a try. I entered my data, including age, BMI, and my weight loss goal. I learned that there was a subscription fee involved, which was around 3000 rupees per year. I felt stingy at first, but since nothing else had worked, I subscribed to it.
The app suggested a regular routine of 10-minute personalized workouts based on my requirements. The workouts were fun, and I enjoyed doing the movements, which mostly used body weight and sometimes a bench, chair, or dumbbells. However, I didn't see any significant improvement for four weeks, but I had some faith and continued to enjoy doing them.
Then, there was something that particularly encouraged me to keep going no matter what. I was a bit of an avid reader of self-improvement books like "Atomic Habits" and was familiar with the concept of Kaizen, a Japanese concept for making small incremental changes for positive improvement. What struck me the most was that the initial period of any intervention or new habit will not lead to any visible or tangible changes. But continuous engagement for more than four weeks leads to massive improvements and skyrockets towards the target following a latent phase of 4-6 weeks. Thus, I realized the power of small habits, perseverance, a little bit of faith, consistency, discipline, and patience – one step at a time.
Healthy diet and regular physical activity became a part of my lifestyle. My diet became aligned with the smart plate model, similar to the Mediterranean style, and indulging in fast foods became less and less frequent. Exercise became a regular habit, as natural as washing my face and brushing my teeth every morning. I was always looking forward to doing my 10-minute workout. Slowly but surely, I was being transformed. I became healthier, fitter, happier, and more confident.
You must be curious now about what actually happened. Well, if you must know, I can now fit into my 32-inch pants and wear my old shirts and t-shirts that I was planning to donate to charity!
