100 Pounds Down and Counting: Overcoming the Emotional and Environmental Barriers to Sustained Weight Loss
The battle against obesity is a multi-faceted and deeply personal one that extends well beyond the basic concepts of diet and exercise. For those who achieve sustained success, they’ll tell you that weight loss is a journey that requires not just modifications to one’s lifestyle, but rather a fundamentally different attitude when it comes to food, daily routines, social interactions, stress, sleep, environment and more.
For Xabier Berrueta, a 48-year-old operations supervisor living in Burlingame, Calif., his journey to Enara Health — and his subsequent 110-pound weight loss — has been an emotional and winding one. Setting the stage for success required Xabier to not only change his relationship with food, but also to address a number of environmental factors that were contributing to a downward spiral in his physical and mental health and wellbeing. Ultimately, Xabier is a testament to the benefits that can be achieved through a committed, holistic approach to weight management that includes a focus on sleep, diet, physical activity, emotional health, and metabolic health.
Recognizing the Need for a Change
For Xabier — a self-proclaimed social butterfly who speaks four languages and loves to travel — a number of factors in his life contributed to an increasingly unhealthy relationship with food. He grew up and remains deeply steeped in his family’s Basque origins, in which food is a richly celebrated tradition. Though highly active and athletic in his youth, Xabier found that his naturally heavy build gradually transitioned into a weight problem throughout his 20s and 30s. On top of that, his professional path as an operations supervisor — the past decade spent in the go-go-go world of event operations — has always lent itself to long hours and unhealthy food environments.
“My particular job was kind of like being in the engine room of the Titanic — it wasn’t a good place to be health-wise,” Xabier says. “The hours were long, and the food selection was limited and usually unhealthy. I just kept ballooning.”
By 2018, Xabier’s weight has surpassed 380 pounds. For him, the realization that something had to change came in waves. He watched as his aging father battled — and beat — cancer and later underwent a successful heart surgery. “My dad is 86 going on 19,” Xabier says. “He survived what he survived because he’s always been in otherwise excellent health. I found myself wondering quite often whether I would have been able to survive the health challenges that he did.”
On top of his revelations about his father’s health, Xabier found his weight to be of growing concern to loved ones around him. On a trip to Spain to visit family in August 2018, a bout of illness and an infection in his leg sidelined him for the majority of the trip — a consequence of his weight rather than the illness itself, Xabier says.
Not long after, a friend from his youth — a woman who had lost her dad to diabetes and her mom to a heart attack — showed him a photo of himself at a younger age. “Do you know this guy?” she asked Xabier. “I want this guy back.”
It was then that Xabier — miserable both physically and emotionally by that time — decided it was time to make a change. During his next annual physical, he enlisted the help of his physician to address his spiraling weight problem. After a year of calorie-counting and yo-yoing fluctuations in his weight, he and his doctor decided he needed more accountability in order to achieve sustained success. It was then that he came to Enara Health.
Going from a Walk to a Run
When Xabier first came to us at Enara, in September 2019, he was concerned about the impact that a sudden dramatic shift in diet might have on his professional life and volunteer work. Together, we decided to ease him into the program. For the first three months, we focused on getting used to new foods and learning how to cope with stress-related food triggers.
“The problem for me was environmental,” Xabier says. “I was just eating whatever was in my immediate vicinity, and that typically wasn’t health food. So I focused on better meal planning and starting to get my calories under control. By December 2019, my weight hadn’t really gone down, but I wasn’t doing any damage, and I had developed the emotional tools to really go for it.”
Starting in January 2020, weighing in at 356 pounds, Xabier started on Enara’s very low calorie (VLC) program. “For me, it was all about timing and planning,” Xabier says. “At any given moment, I needed to have at least 24 hours of food prepared. If I suddenly found myself without prepared food nearby, I had to have a Plan B or C, so I learned what could work for me at places like Subway and Chipotle.”
Xabier admits it was hard at the start, especially working 15- to 18-hour days on events. “But I stayed focused, and I kept it simple — chicken, fish, veggies. It was plain, but plain worked for me.”
The results came quickly, Xabier says, and the people around him began to notice. But with the success also came social pressures. “There were social events that I just needed to turn down,” he said. “I was very draconian at the start. I behaved like a heroin addict, as though food was my drug. And I completely avoided situations that might lead to relapse.”
And Then Came the Pandemic
Xabier was a couple of months into his VLC program when the world pitched its giant curveball. The COVID-19 pandemic swept the U.S. Events — including those being managed by Xabier — were cancelled, and the nation went into lockdown.
For Xabier, the pandemic shifted the course of his weight loss journey. And in some ways, it represented a silver lining. Gone were the stressors and unhealthy food options of the events world. Instead, he moved in with his parents to help them through the pandemic. He continued his dedication to the VLC program and, on top of it all, began to walk everywhere he went.
“I was like Forrest Gump — except walking instead of running,” Xabier says. This transition to an active lifestyle set the stage for the next phase of his journey at Enara Health. He began working with Michael, Enara’s exercise specialist, to incorporate more exercise into his routine. He became an avid biker and enjoyed seeing the muscle tone of his youth return.
By mid-June, Xabier’s weight was down to 270 — and his positivity throughout the pandemic has been off the charts, he says. In recent months, he’s moved away from the VLC program to a more traditional regimen of healthy eating. His weight continues to improve slowly but steadily, thanks to both the improved relationship to food and his newly reclaimed active lifestyle. These days, he’s at 245 pounds — down a full 110 pounds since walking through the doors of Enara Health a little more than a year ago.
Sustainable Reprogramming
As Xabier has reentered the workforce and resumed his volunteer life, he remains confident that he’s equipped with the tools to sustain his weight loss for the long haul. According to Xabier, he’s been reprogrammed to manage his weight through a new, almost Terminator-esque lens — to quickly identify and eliminate threats and to zero in quickly on the right targets. Those threats are not certain types of foods or cravings but rather emotional, environmental, and behavioral triggers that subsequently lead to poor appetite and overeating. Addressing broader triggers allows for healthier eating to come naturally rather than feel forced.
“The Enara Health program has given me the structure I need to maintain this way of eating and living for life,” Xabier says. “The pandemic helped accelerate the transition and removed some temptations at a time when it was good to have them removed. But I have no doubt I would have gotten here eventually. These days, making the right choices is in my programming.”
Rami Bailony, MD, co-founded Enara Health, which has developed a platform that empowers individuals to take control of their health with confidence and “ get surgical weight loss results without the surgery.”
