Just the Physical Facts, Ma’am!

Last week, I met with Dr. Piotrowski for my comprehensive physical at Lahey Clinic’s Medical Weight Loss Center.

At the appointment, my body composition was analyzed on a fancy-schmancy looking scale (see Bioelectrical Impedence Analysis (BIA)  for details re: how it works), I learned the results of my recent blood tests and the doc measured the circumference of various and sundry body parts. Finally, we discussed the next steps in my weight loss adventure.

I learned a lot about my physiological makeup, asked tons of questions, and walked away with my brain hurting a little from info overload. I needed a couple of days to wrap my head around it before I could even attempt to post details here.


There’s nothing like seeing your body’s fat mass percent at 8:45 in the morning. HELLO! I’m awake now! (and horrified)

Knowing you’re fat is one thing. Reading it in black-and-white as output from an objective/accurate machine is another. Quite a reality check.

My BIA printout indicated the desirable range for fat% is 23-34%. Mine is 53.8%. That’s right. My body is literally more fat than not.

My corresponding fat-free mass (FFM) is 46.16%, The FFM is rather obvious – it measures the nonfat components of my body (e.g., skeletal muscle, bone, water).

My total body water (TBW) is 33.74%.

Major Takeaway – I knew the stats would be bad, but it’s worse than I thought.


All the tests came back normal, except for two.

THYROID: In 2007, I was diagnosed with a very mild case of hypothyroidism; I have a “sluggish” thyroid. It seems that my thyroid is a little lazy (like the rest of me). Fortunately, my current medication (levothyroxine) has the situation under control.

Frankly, I had hoped the 2007 test results were a fluke and that my new test would indicate I could go off the medication completely. Alas, not in the cards for now.

Here’s what I absorbed when the doc explained it to me: The brain sends a signal (Thyroid Stimulating Hormone or TSH) to the thyroid to produce triiodothyronine and thyroxine (T3 and T4). T3 and T4 control your body’s cellular metabolism.

In my case, my brain sends the signal, but my thyroid doesn’t respond very effectively. Ergo, it’s “sluggish”.

My recent blood test indicates my brain’s TSH signaling is higher than normal levels, but my thyroid responds within normal levels. That means my medication works. It kicks my thyroid out of its lazy state to produce the desired amount of T3 and T4, which helps my metabolism function “normally”.

If I experience difficulty losing weight or losing fat versus muscle, this may become relevant. I may have to up my medication to adjust my metabolism. We’ll cross that bridge if/when it becomes necessary. Until then, it’s another factoid to tuck away in the already overstuffed folder of weight loss factors to remember.

GLUCOSE 2HR W/ INSULIN: It’s official. I’m pre-diabetic. Evidence that when you push your luck, it often gives out. Total bummer. Here are the details:

My fasting glucose level was slightly higher than normal range (104; range is 70-100). My glucose levels at 1hr and 2 hrs were within range (148 and 134, respectively). However, my fasting, 1hr and 2hrs insulin levels were high (20, 131, and 100).

The good news is that I am still pre-diabetic, so I have some time to turn it around with food and exercise.

The doc said we’ll see how my levels progress as I lose weight. If the levels remain high, she may recommend I take some Metformin or Glucophage.

Like I needed another motivation factor for losing weight…


The doc measured my neck, bust, waist and hips. I can cover this segment of the appointment by simply saying the number of inches for each body part was big. I also went home and measured my upper arm and thighs, so I’d have them, too.

I plan to post all of the measurements on the progress page I’ll create after my next appointment in approx. 2 weeks.


INSURANCE COVERAGE: After all the test results were reviewed and the measurements taken, the Doc let me know I’m being “coded” as having a metabolic syndrome. She suggested I contact my health insurance provider to confirm they cover the expenses associated with Lahey’s program.

Greg’s covered, so I assume I will be, too. She told me not to assume anything. Good advice when dealing with large health insurers.

BCBS of MA – don’t fail me now!!

APPOINTMENTS: I have my next doctor’s appointment in approx. 2 weeks. The following week I meet with a nutritionist. It sounds like I’ll see the doc every two weeks to check on my overall progress and a nutritionist once a month to review what I’m eating and adjust my food plan.

I also have an appointment with a behavioralist the day after my next doctor’s appointment to determine if I need or would benefit from individual or group therapy.

Group therapy anyone? Hello. My name is Barbara and I am addicted to food – all food.

FOOD/ACTIVITY: Finally, we discussed the food and activity levels associated with my weight loss plan.

Based on my BIA results, the doctor could tell exactly how many calories I need to eat to lose weight. Talk about a personalized plan!

I start with an 1,800 Kcal a day regimen that consists of breakfast, a morning snack, lunch, an afternoon snack, dinner and an evening snack. It adds “fuel” to my body every 2-3 hours.

Frankly, I don’t usually eat breakfast. I know…I know…breakfast is the most important meal of the day, but I rarely feel like eating when I first get up. Guess I have a slow “boot up” morning process.

If we find the 1,800 Kcal plan isn’t effective for me, we’ll migrate to a 1,500 kcal plan.

I’m thinkin’ I’ll have a tough enough time adjusting to the 1,800 plan to start. There’s no need to cut out those 300 additional calories just yet!

Getting any activity into my schedule is good, but the expectations are low to start. The ultimate (long term…not in near future) goal is to get to 10,000 steps per day (approx 5 miles!) and to exercise 210 minutes per week.

When she said 10K steps per day, my expression changed to one of concern. She looked at me and said, “Good luck with that,” and we both burst out laughing. She wasn’t being negative. She was acknowledging that it’s not something I need to focus on right now, because it’s unrealistic.

Right now, I just need to add some activity into my day – every day – in whatever way I can. Start walking…just move my butt. Start slowly (5 mins a day) and work up to the 30 mins of activity and a bazillion steps goals.

Time to incorporate many new habits into my daily life.

Factoid Alert – Studies indicate that it takes approx. 21 days or 30-40 repetitions to form a habit. In addition, if you stick with a habit for 66 days, you can generally keep it up for 1-5-10 years or as long as you want.

I’m pursuing a lifestyle change that will result in my desired weight loss, so I need to suck it up for the first month and hope it gets easier for me to eat healthier and be more active. I’m hoping some of my OCD tendencies will help me. A little obsessive focus could be very helpful.


I know this post is long and it focuses less on HA HAs and more on my AHAs, but the topic warranted a more-sober-than-usual tone. I’ll up the sarcasm and wit quota in my next post to balance it.

In the meantime, wish me luck! I’m off and running!! (okay, maybe it’s more like walking…errr…crawling)


About Barbara

Married to Greg, the nicest Greek man in the world. No kids - just two hyperactive Maine Coon cats - Griffin and Harper. Independent consultant. News and political junkie. Diehard social progressive. Movie lover. Book reader. Blog writer. Overweight. Underpaid. Open-minded about everything except closed-minded folks. Occasionally witty. Sometimes wise. Always wise-ass.
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4 Responses to Just the Physical Facts, Ma’am!

  1. Nicole says:

    Barb, I just love your head-on approach to this. I’m not sure you think you do this, but I’ve always thought that you do–and I really admire you for it. I’m really enjoying your blog posts.

    • Barbara says:

      Nicole –

      Thanks so much for the kind words! I’m glad you enjoy the posts. They’ll likely remain pretty random and with a heavy reliance on stream-of-consciousness “babble”. 🙂 I figure putting this stuff out there increases my accountability and reinforces my commitment to my goals. Plus, as time passes, it will be an interesting record of my efforts and progress. That being said, I’m sure I’ll take many detours into the world of current events, movies, and anything else that distracts me on any given day.

      No rules. Just writes. (heh heh – a little too pun-dalicious).


  2. Alice Malice says:

    Have you considered the Homeopathic route? You could have gotten your TSH (also sometimes called Thyroid Stress Hormone) under control with Iodine and/or Iodine Chelation Therapy; chelation therapy if you wanted to also detox some of the more harmful Halogens like Fluoride and Bromide. TSH numbers tend to put MD’s to sleep, if the number is below five (5). They won’t test anymore beyond that and you usually get the ‘talk to the hand’ response when you try to convince them there is still something wrong. My TSH was well below five (5) and I was still hypothyroid. They way this was found was with my basal body temperature. I had difficulty keeping my body temperature above 96 degrees. After a year of Iodine therapy my body temperature is consistently in the 98.6 range. My TSH went from below 2 to as low as it can go without generating thyroid cysts. Take a look at Dr. Brownstein’s work.

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