It wasn't easy, but these three men lost their excess weight naturally

Before (left) and after: Devthiran managed to lose 52.8kg and reduce his blood sugar levels back to normal in about a year of following his wife’s diet plan, formulated with the advice of his cardiologist, and daily exercise. — Photos: Dr KANNAN PASAMANICKAM

As physicians, my colleagues and I emphasise lifestyle modification as the very first and most important step in preventing and treating disease.

Towards this end, a balanced and healthy diet, regular exercise, avoidance of smoking and moderate (if any) amounts of alcohol is emphasised during every consultation with a patient.

However, it is often amazing and unbelievable to see people not being disciplined enough to follow these simple rules, even after they have suffered major illnesses.

I have patients who have suffered heart attacks and undergone coronary bypass surgery who refuse to quit smoking!

One man quit smoking only after his lungs had been destroyed due to a progressive illness and he became breathless, even after walking a few steps.

In Malaysia where food is available in abundance, it is difficult for people to diet even when they are unwell.

I feel helpless when I see young people who are markedly overweight, who refuse to listen to advice, even though their future health is at stake with diabetes and high blood pressure brought on by obesity, lurking round the corner.

So I was gratified to find these three young patients who decided to take stock of their lives, listen to advice, alter their diet, exercise daily, and in the process, lose a large amount of weight and regain their health.

I am very proud of them. I tell their stories to inspire the many others in similar predicaments that lifestyle modifications can and should be done.

Taking care of your health, which is taken for granted by most, is the most important investment you can make, both for yourself and your loved ones.

Motivated by kids

Maheson used his son (right) as a role model and motivation during his weight-loss journey.

Maheson, a consultant engineer, was 35 years old when he was first referred to me for treatment of high blood pressure and elevated blood cholesterol in March 2006.

He smoked heavily and was obese at 87kg for a height of 163cm, giving rise to a body mass index (BMI) of 32.7 (a healthy BMI for Asians is 18.5 to 22.9).

He was under a lot of emotional stress with the then recent death of his mother and the demands of his business.

Lifestyle modification advice, especially regarding weight loss (diet, exercise), was given in addition to drugs to control his blood pressure and lipids.

He came for follow-up appointments intermittently, and seven years later in June 2013, had a heart attack at the age of 42.

An emergency angiogram found one completely blocked coronary artery, which was opened with angioplasty and a stent implanted, as well as partial blocks in the two other coronary arteries.

He admitted then to still smoking and weighed even more at 88.8kg.

However, the heart attack resulted in Maheson quitting smoking.

Three months later, he had recurrent chest pains.

An angiogram showed that his stent had narrowed and that the blockages in the other two arteries had worsened.

He had to undergo coronary bypass surgery at the young age of 42.

For the next three years, his weight continued to increase, hitting a peak of 95kg in March 2016.

I kept badgering him to change his lifestyle at every consultation.

Then in February 2017, I was shocked when he walked through my consultation room door – he had lost so much weight as he had been dieting and exercising.

By October 2019, he weighed 71.1kg (BMI 26.8).

I asked him what made him change; he told me that his young children and his responsibilities towards them were prime motivators.

His son was then a medical student, who exercised regularly and kept himself trim, providing Maheson a role model to emulate.

Maheson’s very slim wife was another great source of inspiration.

These days, he gets up at 4am, prays and meditates, then exercises for one to two hours by jogging for 45 minutes and lifting weights for another 45 minutes.

When he started, Maheson was the only one in his neighbourhood who exercised; now, his neighbours, motivated by his example, also jog along with him.

Wifely support

Devthiran is a manager in the multimedia industry. His wife of seven years, Anusya, is his main source of inspiration and support.

He was first referred to me in October 2015 for elevated blood pressure.

He was grossly overweight at 148.8kg, with a BMI of 47 (severely or morbidly obese).

I remember him crying during the first consultation because he was frustrated that he could not lose weight and had a fear of doctors, hospitals and illness.

His arm was so big that I needed a special cuff to measure his blood pressure.

While he was motivated to change, his weight did not decrease until about three-and-a-half-years later.

By that time, his blood glucose levels had been elevated above the normal range for about two years – his fasting blood glucose level was around 6.3mmol/L (normal is less than 5.5mmol/L) and his HbA1C (average level of blood glucose over three months) was 6.3% (normal is less than 5.6%).

I wanted to start him on medications for diabetes.

But Devthiran and Anusya asked for one more chance to lose weight.

I was amazed when in the next three months, he lost 17.6kg with his fasting blood glucose levels going down to 5.1 mmol/L and his HbA1C to 5.7%.

After another three months, he lost another 22kg and his blood glucose levels normalised.

Currently, Devthiran weighs about 96kg – a loss of 52.8kg since he started!

During his last consultation, I could use a normal-sized cuff to measure his blood pressure and the dosage of his medications could be reduced.

Along with my advice, Anusya did some research, spoke with friends and formulated a diet that Devthiran stuck to religiously (even his mother could not tempt him with his favourite dishes).

Since March 2019, Devthiran does one to two hours of cardio exercises daily, using a combination of treadmill, cycling, light weights and 50 to 60 sit-ups.

Anusya is willing to share her husband’s success story and give advice to others in a similar predicament, so I have roped her in to help improve the lifestyles of my patients with weight problems.

Latest success

Mohan, an engineering manager, is the latest success story.

He saw me in January (2020) and had no symptoms, but his blood pressure was elevated at 140/100mmhg and blood tests indicated diabetes with a fasting blood glucose level of 7.7 mmol and a HbA1C of 7%.

He was obese, with a weight of 103kg for a height of 177cm, giving rise to a BMI of 32.9.

He also had symptoms suggestive of obstructive sleep apnoea – a breathing disorder aggravated by obesity that can have serious health consequences.

I did not prescribe him any drugs, but instead, introduced his wife Gayathiri to Anusya.

Partly with the advice from Anusya, Gayathiri came up with a diet plan to which Mohan stuck to religiously. He also started to exercise.

By April, he had lost 13kg in weight.

His blood pressure was also normal at 110/80mmhg and his glucose tolerance test (the gold standard test for the diagnosis of diabetes) was completely normal.

His obstructive airway symptoms had also significantly subsided.

Food control

The diet these three men successfully followed consisted mostly of vegetables and fruits, lean proteins like fish and chicken, and minimal carbohydrates. — Nestle

There is a commonality in the diet these three men follow.

The main principles are consuming only food prepared at home (packed lunches when necessary), marked reduction in carbohydrate intake and frugal snacks, if any.

Maheson has been vegetarian since 2017. His meals consist of vegetables and fruits.

He does not take rice, instead, he has idli, thosai or upma (a thick porridge made of semolina).

Devinthran and Mohan have two boiled eggs for breakfast and either salads or wholemeal bread.

Lunch and dinner consists of either fish or chicken, served with fruits and salads.

Occasionally, nuts are consumed as snacks.

If rice is consumed, it does not exceed half a cup.

Maheson, Devthiran and Mohan are testimony to the fact that with discipline, diet and exercise, everyone can lose weight without drugs and gain back their health.

Additionally, Devthiran and Mohan exemplify the link between diabetes and obesity, and how weight loss alone, without the help of drugs, can help one fight the disease.

A study published in January 2019 by the Royal College of Physicians in London titled Calorie Restriction for Long-Term Remission of Type 2 Diabetes provides scientific proof for the benefits of the lifestyle changes achieved by these three men.

Do note however, that everyone must consult their doctor before embarking on a diet plan, as serious consequences could occur, especially for diabetics who are on medications for their condition.

Dr Kannan Pasamanickam is a consultant cardiologist. For more information, email [e-mail]. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.