Like many men moving through middle age, I had found my waist widening in a slow but sure manner. Because I am tall and big boned, the excess 20 pounds hardly showed. I told myself that it didn't much matter, because my wife still loved me. As a physician, I should have known better.
When I passed my 50th birthday, I decided it was time to check my cholesterol and I lost 20 pounds fast. My level was elevated, and the "bad" cholesterol (LDL) had risen while the "good" cholesterol (HDL) had fallen.
For a long moment, I stared at the test results in my internist's office. People joke that if you want to live into old age, then you should choose your parents wisely. Our genes powerfully dictate our susceptibility to disease. Every male on my father's side of the family had had a heart attack in his 50s, and my father died at a young age from coronary disease. As I stood nervously on the doctor's scale, I saw the sum of the past year's chocolate-covered peanuts, third slices of rye bread, and homemade brownies.
"I'll give you a prescription for losing 20 pounds," my internist said.
I pocketed the prescription. It seemed to weigh heavily in my jacket.
That night at home, when the kids were put to bed and my wife and I had a minute to talk, I told her about the cholesterol level, my weight, and the prescription.
"Why jump and take medicine right off the bat?" she asked sharply. My wife is a physician specializing in metabolism, but she's something of an oddity in her field: She is old-fashioned and believes in avoiding medication unless it is absolutely necessary.
"But these drugs for losing 20 pounds are so widely used and so well tolerated," I replied. Then I told her I had spoken with several other physicians at the hospital who were taking them. When we discussed losing weight and changing eating habits to lower cholesterol, one doctor said to me, "Do you want to fly from Boston to New York, or walk?"
To this my wife countered, "Every drug has side effects, even if they're rare. Willpower has only one risk--not succeeding. Instead of those fistfuls of junk food you snack on, try eating mostly protein, and get your carbs from fruit."
I pondered her position for the better part of the week. There was something strangely exciting about testing myself to see if I could shed the excess pounds and lower my cholesterol. I decided to inaugurate a new breakfast regimen, with an egg-white omelet instead of my morning bagel. When my stomach started to growl before lunch, I reached for an apple instead of a brownie.
It was awful at first. It seemed that I couldn't think about anything except food. But over several weeks the new diet became easier, and I felt a certain lightness to my step.
Six months later, I called my internist and reported to him that I lost 20 pounds really fast and weighed 202, down from 232 pounds, and that my total cholesterol had fallen from 240 to 181.
"You never filled the prescription?" he asked incredulously. I told him I had not.
It was hard not to think of the proverb. While some may find its meaning corny and outdated, I believe it holds a special truth in this age of advanced medical science. Yes, the medication could have lowered my cholesterol. But there is a special benefit to that apple a day--the feeling that you are in control of your body and, by extension, your world.
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