As I mentioned at the end of my last post, I needed outside help to successfully lose weight this time. I couldn’t put on my Nikes and run a few miles. I wasn’t even supposed to walk for exercise anymore, due to one knee being bone-on-bone and the other knee threatening to go the same way.

And yet, I have never lost weight through diet alone. Exercise is half of the equation. (God, I hate exercising.) I had no idea how to exercise without making the knee worse—or what kinds of exercises I needed to be doing to prepare for surgery. Obviously, I needed to get expert help.

Okay, another thing I have avoided in the past is paying for something I think I ought to be able to do myself for free. I avoided any sport that required an investment in memberships or expensive equipment, such as golf or skiing. I hated the idea of health club membership because I thought I ought to be able to exercise on my own by walking. But health clubs are where they have exercise equipment, so I needed to join one. I signed up with the health club down the street, which I had used (infrequently) in the past. Endearingly, it is a part of the local “Toadal Fitness” group of health clubs.

Physical therapy was also on my list, but PT only goes so far. I wanted to hire a personal trainer, someone who understood which areas I needed to focus on, and who could tell me how to use the equipment and create a workout routine for me. I mentioned this to my physical therapist, who recommended two trainers who work at my health club. The trainers had undergone training at my PT’s practice on how to work with people with injuries and constraints. So I trotted down to the club and was introduced to Zach. Zach showed me around and listened to me, asked a lot of questions, and we talked.

I don’t know what your idea of a personal trainer is, but Zach wasn’t mine. I guess I thought a trainer would be a lot younger than me, nauseatingly fit, and perky. Zach is starting to push past middle age. He’s fit enough, but not the muscle-bound person I was expecting, and he has his own issues relating to age and injury, so I feel comfortable talking to him about my multiple physical shortcomings. He’s got a sense of humor, which I enjoy. He also pushes me—not hard, but enough that I make progress every time we have a session.

What are we working on? For cardio, I do the recumbent bike. When I started, I could only do a quarter of a mile before my knees became too sore to continue. I decided I would just do what I could do when I could do it. I told myself all I had to do every day was go to the club and bicycle for a quarter of a mile. That seemed easy enough, and it got me to the club. Before long, I was doing a half a mile, then three-quarters, and so on. I am at two and a half miles now.

The program I am using on the recumbent bike is a racecourse, which I carefully selected because its steepest incline is only 3%, and the incline doesn’t last long, either. Right now, I am going for mileage, not endurance. I hate hills, don’t you?

Zach works with me on the machines and weights. We started with machines that work the thighs and hips and the muscles above and below the knees. I am one of God’s Clumsy Children, and some of those machines—especially the clamshells, the ones you exercise your thighs on—are lurking deathtraps, just waiting to break bones. Zach watches me anxiously as I slowly negotiate these complex contraptions—getting in and out is the hardest part. So far, I haven’t broken me or one of the machines. I am actually getting more graceful as I get used to them. Any day now, I might try using them without Zach to watch over me like a mother hen.

I meet Zach once a week at my health club. I haven’t said much about the club, but it’s friendly, and a large percentage of the clientele has gray or white hair. It feels neighborhood. It isn’t fancy, but it has all the stuff, including a saltwater pool.

Now, what about diet? I lost a fair amount of weight in the past using Weight Watchers. I found it an easy program to follow, but I did not enjoy the meetings. I was eating unprocessed, fresh foods. The people in my meeting seemed to find the time involved in preparing fresh food unacceptable. To be fair, many of them had kids at home to feed and deal with, and I certainly could empathize with that, but the discussions weren’t centered around any of my concerns.

These days, you can purchase the WW app for your phone and not go to any of the meetings if you prefer (I do). The app allows you to look up the point value for a huge range of foods and adjust quantities. It tracks your points daily and weekly and keeps a food diary. You can create your own recipes for quickly entering meals you eat frequently. You can track your weight and the app adjusts your available points as you lose. It has lots of other features that track water consumption and exercise, and you can also look up WW recipes, but I don’t use all of its capabilities.

I was working with my doctor’s nurse practitioner, Ashzra, on all this. Ashzra questioned the Weight Watchers approach. She said I should be consuming no more than 1500 calories a day. Did WW conform to that? So for a week I tracked WW points versus calories. I was honest about it—WW counts certain things as zero points, such as fruit and fish, that still have calories. I tracked ALL the calories I consumed during that week. It turned out that using all the WW points for a given day came in at or under 1500 calories. One day, it was 1700, but I had come under the 1500 mark enough times that I was unconcerned.

So, physical therapy—check. Health club, personal trainer, and exercise program—check. Diet—check. The one element remaining was medication. The news is brimming with stories about the new weight loss drugs like Ozempic and Wegovy. The news is also full of how expensive these drugs are and how hard they are to get. 

Next installment: Part 3—The New Weight-Loss Medication Merry-Go-Round