The "4 by 4"--four hamburgers and four slices of American cheese stacked in a hamburger bun with all the sauce and trimmings, plus the deep-fried fries and 16-ounce Coke--contained 1,400 calories and 100 grams of fat, but that didn't bother Dr. Nick a twit. In his mind, the drive-thru forays were just a snack, something to eat before dinner.
He was hungry -- and fat. Dr. Nick had been gaining mounds of weight ever since medical school, when he fortified his late-night study sessions with Ding-Dongs and heaping bowls of Rocky Road ice cream. During interminable forty-hour shifts as an intern, he kept up his energy by raiding the hospital canteen, where someone had set out a plate of sweets to be shared by the attending staff.
When he entered the public health arena as a family physician, he could be best described as "corpulent." He couldn't tell you how much he weighed, though, because he had stopped weighing himself. His expanding girth actually turned into an occupational blessing: his patients viewed Nick as a larger-than-life advocate for the poor, the big man with a big heart who cared for his community in a big way.
Overweight patients loved Dr. Nick because they knew they would receive tea and sympathy from someone who also shopped at Mr. Big and Tall. From a doctor's perspective, he was always gracious with people who struggled with their weight. More than a few times, he looked a heavyset woman or fat fellow in the eye and said with a smile, "Do as I say, not as I do."
Jolly St. Nick
Shortly after he turned 30 years of age, however, Dr. Nick began experiencing declining health and a host of unusual symptoms that led him to a doctor's examination room. A week later, he learned the bad news: he had testicular cancer.
The surgical excision of the right testes and aggressive radiation over 12 weeks saved his life--and caused some soul-searching. The way Nick saw it, he had dodged the cancer bullet, but there was another round in the chamber: his gargantuan weight had to be causing incredible amounts of stress on his organs--heart, lung and liver, as well as his skeletal frame. He wondered how much stress he was putting on his knees, which were bearing such a severe load.
One day, Nick stood on two scales--one for each foot. Each needle came to rest on "233 1/2." A fourth-grader could do the math: Dr. Nick Yphantides, the jolly doc with the Santa Claus-like image, weighed in at a hefty 467 pounds. Nick was scared. His cancer had forced him to face his mortality, and now he was sure that each bite of an In-N-Out 4x4 brought him one swallow closer to the grave.
Something needed to be done. Nick was tired of dressing in XXXXL T-shirts and tent-sized gym pants, tired of booking uncrowded red-eye flights so that he wouldn't have to buy a second seat, tired of gawkers staring at his monstrous midsection in restaurants. Ahead of him was a future filled with high blood pressure, high cholesterol and debilitating diabetes--unless he made a radical lifestyle change and lost a ton of weight. Well, maybe not a ton, but 200 pounds would be a good start, he figured.
In April 2000, Nick gave a one-year notice that he would be stepping down and leaving the Escondido Community Health Center. Then he began formulating a game plan. Since he wasn't going to work, he needed something to do--a diversion to keep his mind off being so hungry. That's it! Nick loved baseball (or was it those ballpark franks?), so he decided to drive around the country and visit all 30 major league ballparks and watch baseball games. He calculated that he had been consuming 5,600 calories a day to maintain his weight. To lose weight slowly but surely, he would embark on a liquid fast--drinking a protein supplement offering just 800 calories a day.
On April 1, 2001, Nick sailed off in a used RV -- a vehicle he christened the USS Spirit of Reduction -- with the intention of becoming half the man he used to be. His father rode shotgun. Going cold turkey from food gave Nick the shakes, just like any junkie coming down off a high. "I was so hungry that I would have eaten a cigarette butt dipped in mustard," he said.
Two cities known for their gastronomical delights were particularly painful to visit: Kansas City, for its butter-fried steaks; and New Orleans, for its Cajun-style fish and shrimp. At times the only thing that kept him going, he said, was knowing that hundreds of people back home had pledged varying amounts of money for every pound he lost--money that would go to the Escondido Community Healthy Center and the California Center for the Arts. That unique accountability contributed toward helping Nick accomplish the goal he set out for.
Battling His Lowest Point
At first, the pounds melted off Dr. Nick like a snowman standing in the Sahara desert--seventeen pounds in the first week. After that initial surge of encouragement, his weight loss went from a gusher to a steady drip-drip as he continued to drink protein shakes flavored with diet root beers and diet Orange Crush soft drinks. In Seattle on July 2, he had his weekly weigh-in under a doctor's supervision. That day, he learned that he had lost 103 pounds in three months, or an average of 1.1 pounds per day.
While that was a lot of weight, it didn't feel like much to him. When he looked in a mirror, he couldn't even detect a difference in his appearance. He was still wearing the same "Dr. Nick" T-shirts that he wore Opening Day at Dodger Stadium. He had to admit they were a bit looser, but all he saw in the mirror was the same old mound of human flesh. Nick fell into a funk.
On July 4, he found himself in Sitka, Alaska, where he had planned a daylong fishing trip with his brother John and two friends. He woke up at 4:30 a.m. feeling sorry for himself. He resented skinny people. Why were they thin and he was fat? What had he done to deserve his fate? Why did he feel such despair?
With a dark cloud following him, Nick and his brothers boarded a fishing boat at dawn to fish for salmon and halibut. After catching their limits of salmon inside the bay, the boat motored into deeper waters to catch the really big fish--Alaskan halibut. Leaving the safety of the bay, Nick thought that day, was a metaphor for what he was going through with his weight-loss odyssey. His weight had become such a monumental dilemma in his life that he had to leave the comfort of the bay and drive toward deep, choppy waters to seek the big catch of a healthy existence.
No one caught a big one until late in the afternoon, when . . . Nick had a strike! His rod bounced off the railing, but he held on tight. He yanked with all his strength and cranked the reel as fast as he could. For the next forty-five minutes, he kept dipping the rod and reeling, dipping and reeling.
Finally, the captain gaffed the monster halibut and helped Nick pull it onto the boat. Nick, his last reserves of energy spent, leaned against the rail, wowed by the excitement of catching a fish that size.
The captain weighed the fish, which was nearly as tall as Nick--59 inches. "It's 103 pounds," he announced.
Nick was stunned. "What did you say?"
"One hundred and three pounds."
The weight of that Alaskan halibut --103 pounds-- exactly matched the weight Dr. Nick had lost since April 1. Everything came together for him at that moment because something unspeakable had occurred. To Nick, it was a confirmation that he was on the right track, that he was right where he needed to be in his weight-loss journey.
As pictures were snapped, he felt the same sense of awe that he felt when he stood in front of Michelangelo's David and the Sistine Chapel on a trip to Italy. He couldn't even articulate what was going through his mind, but it was a jumble of bewilderment, love, confirmation and validation. He knew he had been lifted from the depths of despair. This experience became the deciding moment of his trip, but more than that, the defining moment of his life.
When Nick returned home in time for Thanksgiving, his mother was shocked by his appearance. Some of his nieces and nephews didn't even recognize him. Nick, now weighing 269 pounds, had shed nearly 200 pounds. He ate his first solid food in nearly eight months on Thanksgiving Day: some vegetables and a baked potato.
He continued to lose weight as he returned to solid food and his medical practice. Nick reached his low-water mark the following summer, when he weighed a svelte 197. The end of his long weight-loss trip was just a beginning, Nick learned. Now he would have to work at keeping the pounds off.
Today, Nick weighs 220 pounds, and he has remained steady at that weight for three years. Everywhere he goes to tell his story, people clamor for advice how they can lose weight as well.
In response, Dr. Nick developed the following bedrock principles:
Dr. Nick's Seven Pillars of Weight Loss
I. Change the way you see before you change the way you look.
Fundamental to addressing one's health issues is addressing the cause. Permanent weight loss is impossible without a permanent lifestyle change.
II. Slash your calories by eating for the right reasons.
Why we eat and how we eat are more important than what we eat. Learning why and when to eat and how to stop eating at the right time is key.
III. Fill your tank with the right amount of the right foods.
Diets do not work. Eating the right foods the right way does.
IV. Burn calories like never before.
Weight reduction and maintenance are impossible without sustained and vigorous physical exertion. The muscles of your body are designed to be used.
V. Plan a radical sabbatical.
There is magic in combining doing something you love with something that is great for your health. Dr. Nick calls it the "distraction from deprivation."
VI. Don't travel alone.
The path to a healthy life cannot be accomplished solo. Being accountable to others and putting it on the line with others are essential.
VII. Realize that your weight-loss journey is for a lifetime.
Losing the weight is not the real issue. Keeping it off and never finding it again is.
"What happened to me was a big fat Greek miracle," Nick says. "It was as though I'd been born again and given back my life. There's no other way to explain it, except to say that what happened to me happened by the grace of God.
"Please consider your future. Do something before it's too late. Don't wait until tomorrow, because you can change the way you see so you can change the way you look."
Dr. Nick Yphantides is an advocate for those in his community who need it the most. For eight years, Dr. Nick served as medical director of the largest network of Community Clinics in San Diego. In 2001, Dr. Nick temporarily retired from all of his job commitments to address his own personal health needs. Over the course of a year he drove 38,000 miles, visiting every state in America, and in the process achieved an enduring transformation of his personal health becoming less then half the man he used to be. His book 'My Big Fat Greek Diet' was released in September 2004. His story has been featured in People Magazine, Readers Digest, Washington Post and the New York Times, as well as on CNN, Fox News and the Discovery Channel. He is currently advocating with the many others in the community who also have a struggle with their personal health and fitness. He serves as a medical consultant for many medical and non profit community organizations as well as doing part time urgent care work.