By John Perry

Matt Russell awoke with a start.

He’d had that dream again. The one where he is no longer seen as different. Where he has no physical limitations. No high blood pressure pills. No diuretics. No stressed, aching joints. No mail-ordered oversized clothing. Where little kids don’t point at him. And where women consider him for something more than friendship.

But that’s only a dream.

Accustomed to waking often, Russell didn’t check the time. He instinctively knew it was some ungodly hour of the morning.

Besides, there was a timepiece whirring inside him. It was his mortal clock. And he felt it ticking toward breakdown.

Russell, 38, is severely obese.

“My weight is somewhere over 450,” said Russell, an affirmative action specialist and Americans With Disabilities Act coordinator. “Can’t be sure because the scale in my doctor’s office maxes out at 350.

“To get my exact weight, I’d have to use the industrial scale in a meat storage locker.”

Russell has carried this heavy, unhealthy burden on his 6-foot, 1-inch frame his entire adult life. And it has taken its toll.
“I’ve got lower back pain, creaky knees and swollen feet,” Russell said. “Sometimes just walking is an effort.”

Russell knows the health hazards that accompany his condition.

Obesity raises blood pressure and cholesterol to dangerous levels. It increases the risk of coronary artery disease, congestive heart failure, Type 2 diabetes, kidney disease, problem pregnancies and stroke. These are among the top 10 city employee diseases, and the leading cost drivers of the health plan. (Sources: The American Obesity Association www.obesity.org and BlueCross BlueShield of Texas. www.bcbstx.com)

Childhood start
“At age 10, I first noticed I was overweight when I wore husky-size jeans,” Russell said. “But even though you’re carrying extra pounds, you’re still a kid and you can get away with it.”

Though he earned an Eagle Scout badge, he never made a habit of regular exercise.

“My motto was ‘Don’t run unless you’re being chased,’” Russell said.

He played a Sousaphone in the Spring Woods High School marching band and was excused from physical education classes.

“Unless they’re informed, kids don’t make rational decisions about their eating habits,” Russell said. “And it can easily become a lifelong bad habit.

“I always ate pretty much whatever and whenever I wanted,” he said. “And had a 40-inch waist my senior year.”

Men with 40-inch or more waists and women with 35-inch or more waists are at serious risk for developing Type 2 diabetes, hypertension and cardiovascular disease. (Source: The American Obesity Association.www.obesity.org )

Russell’s gradual accumulation of pounds and inches continued for the next 20 years.

“Most people say, ‘Omigosh, I’ve gained 10 pounds! I’ve got to lose this weight,’” Russell said. “But I never had those feelings of shock. I never really cared about my weight increase until it was time to go to my next pants size.”

In the summer of 1998, Russell began a strict regimen of 1,500 calories or less a day. By eating “a lot of salads” he dropped 60 pounds by Christmas. But an emotional upheaval derailed his diet, he said.

Overeating started.

“There’s some kind of mental cross-wiring in me that equates overeating with comfort,” Russell said.

The weight crept back
“Today, my body mass index is somewhere in the high 50s,” Russell said. “Being this size impacts your life in ways a slender person would never imagine.”

He avoids air travel because the seats are too narrow. When he chooses a restaurant, he doesn’t make his decision on the food or service, but on the size of the chairs. He goes early to the movies because it’s more comfortable to have an aisle seat.

He’s considered gastric bypass surgery, but ruled it out as too expensive and dangerous.

On March 6, a 29-year-old woman died of a heart attack in Houston’s Renaissance Hospital following gastric bypass surgery.

“I’d rather give traditional dieting one more college try,” said Russell, who knows he must make lifestyle changes.

“Nobody really knows where their body’s point of no return is, but I’m nearing mine,” he said.

His primary care physician, Barry Troyan of the Renaissance Physician Organization, has prescribed the drug Byetta.

Derived from Gila monster saliva, Byetta controls blood sugar levels and suppresses appetite. It has proven successful in weight loss studies.

“Who would’ve thought that lizard spit would help me lose weight?” Russell asked.

Byetta is a Tier III drug in the city’s formulary. Russell mail orders his 90-day supply of the self-injectable pens for a $90 copayment.

Heading into the summer with Byetta and a 2,500-calorie-a-day diet, Russell has set reasonable goals.

“First, I want to stop the weight gain. Then begin a mild exercise regimen I can stay with. But most of all, I plan on staying alive,” he said.

What is obesity?
“Being obese and being overweight are not the same thing,” said Dr. Harriet N. Hilliard, family medicine physician at Kelsey-Seybold’s Spring Medical and Diagnostic Clinic. “An overweight person has a large amount of extra body fat, but people who are obese are so overweight they risk serious health problems.”

Women with more than 30 percent body fat and men with more than 25 percent body fat are considered obese. Women deposit fat primarily in their hips, abdomen and thighs. Men usually build up fat around their abdomen, said Hilliard, who has treated hundreds of patients for obesity-related complications.

“Obesity is the most common nutritional disorder in western industrialized countries,” Hilliard said.

Overweight and obesity affect 64.5 percent or about 127 million adult Americans. It accounts for approximately $100 billion of the nation’s health care costs with about half paid by taxpayers through Medicaid and Medicare. At least 300,000 deaths a year are linked to obesity in the United States. (Sources: The American Obesity Association www.obesity.org and the National Conference of State Legislatures, January 2007. www.ncsl.org)

The bathroom scale measures your weight, but is not the best way to determine if you are obese, Hilliard said.

Body mass index, a measure of body fat based on weight and height, has been used for more than 20 years. Numbers corresponding to body-fat measurements determine if a patient is underweight, normal, overweight, obese or severely obese.

A person is considered obese with a BMI of 30 or greater. Someone with a BMI of 40 is twice as likely to die prematurely as an average-weight person. (Source: Centers for Disease Control.)

Check your BMI by using the calculator sidebar.

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Photo by John Perry
Fearing an untimely death, Matt Russell of Affirmative Action is battling his obesity with drug therapy and lifestyle changes.