Spring Chicken Page 16

  Indeed, there is growing evidence that our fat tissue itself might literally be shortening our lifespans. In a dramatic 2008 experiment, Nir Barzilai and his colleagues at Albert Einstein College of Medicine in the Bronx surgically removed the abdominal fat from a strain of obese laboratory rats, and found that the animals lived more than 20 percent longer than their still-chubby cousins. Their abdominal fat was, basically, killing them. As Barzilai puts it, “Not all fat is just fat.”

  Phil Bruno knew this all too well. Unfortunately for him, though, surgery wasn’t really an option: In humans, says Barzilai, visceral fat cannot be safely removed, because it is so deeply entwined with our blood vessels and organs. Liposuction only removes “good” subcutaneous fat, which is why several recent studies have linked the procedure with what scientists call “poor health outcomes,” and you and I call “death.”

  So in July 2004, roughly a month after he was diagnosed, Phil Bruno did the one thing that his doctor had not prescribed: He went to the gym.

  You read that correctly: While Phil’s doctor did suggest that he lose weight, he stopped short of actually recommending exercise as a way to do it. Incredibly, surveys show that only about half of diabetic patients are told by their doctors that they should exercise—likely because of the doctors’ belief that their patients won’t actually go to the gym, or that they won’t stick with it, or that they won’t end up losing much weight in the long run. There are studies that support each of these pessimistic points of view, too. But none of their authors had ever met Phil Bruno.

  After a few weeks on his new medications, Phil had felt exactly as miserable as before, only now he was even more tired. Four of the meds carried drowsiness warnings, which meant that some days he felt like crawling under his desk and falling asleep by 11 a.m. He also knew that his medications were not treating the causes of his disease, only the symptoms. He felt trapped, hopeless, and depressed. “Something clicked in my head and said, This is not gonna work,” he says. A devout Catholic, he turned to prayer in search of answers, as he wrote in an account of his struggle that he titled “The Jesus Christ Diet Plan”:

  For me it all started with going to church and sitting slumped over in a pew having a heartfelt, tearful, prayer to Jesus. I just kept saying Jesus, Jesus, Jesus, over and over again. After being there for about an hour a fundamental question popped into my mind, I feel this clarity of thought was the first thing the Holy Spirit did to help me.

  The question was… Do you want to live or die?

  The answer… I wanted to LIVE!!!!!!!!!!!!!!

  He realized that more than anything, he wanted to see his kids get married. The way things were going, it did not look like he would. For motivation, he turned to the Bible, but also to books he’d read by former football coach Tony Dungy and motivational guru Tony Robbins, who reinforced the message that his future need not be dictated by his past. It was what he needed to hear.

  After getting his heart checked out (it was enlarged of course, from working overtime all those years, but his arteries were clean thanks to Grandma’s olive oil), Phil walked into his local Gold’s Gym one Saturday in July 2004. He looked around uncertainly before settling on the one thing that seemed doable for a 450-pound guy: the exercise bike. He hoisted himself aboard and managed to pedal for five minutes before he had to stop, wheezing and panting and feeling self-conscious—yet invisible at the same time. “Everyone looks at the fat guy in the gym,” he says.

  Yet he came back the next day, and the next. Soon he could stay on the bike for thirty minutes, leaving a bigger puddle of sweat on the floor each time. He visualized each drop of sweat as one more blob of fat exiting his body, one tiny step toward his goal.

  On the way to his favorite bike, in those early weeks at Gold’s Gym, he would walk past the glass-walled indoor-cycling studio. With the pounding music and the lithe bodies pumping away on the stationary bikes, it looked cool. It took him another week or two to work up the courage to show up for a Spinning class, and he made instinctively for a bike in the back corner. But he’d been spotted: A beautiful, fit blonde came over and confronted him. “I’m Beth,” she said, smiling. “Let’s help you get set up.”

  She put him in the front row. Her name was Beth Sanborn, and she looked every inch the Ironman triathlete she was. But she didn’t care how much he weighed. He got through the forty-five-minute class, puffing and churning away on his bike. Phil soon became a regular in Beth’s class, three times a week, and being Phil he soon got to know everyone in the room. “I had never seen anybody that big,” Sanborn says. “He was the hardest-working person in my class—a man on a mission, he really was.”

  Phil gave himself Sundays off, but he kept coming in, day after day. He often rode until his shorts were bloody, because they don’t make bike shorts (or bike seats) for people who weigh more than 350 pounds. “It wasn’t pretty,” he says. By September, he decided to take on an even bigger challenge: He would do a century, a hundred-mile charity ride to benefit multiple sclerosis, which his wife, Susan, had been diagnosed with. He hadn’t been on a real bike in twenty years, but he dragged his old Trek out of the basement, dusted it off, and took it to the shop.

  He made it all the way to Mile 63, on a slight uphill, when the road started to wobble and melt underneath him. He had pains in his legs and his chest, and, ominously, he had stopped sweating. The sag wagon was following him, and the event medical staff rushed to his aid, grabbing his arms to keep him from collapsing. “The thought actually went through my mind that if I die here on the road, at least I’m doing something to change my life,” he says.

  Without knowing it, Phil had kicked off a war for control of his body, with fat on one side, muscle on the other. He already knew that fat is stubborn stuff. “I’d been on every diet you can think of,” he says.

  Fat is bossy as well as stubborn. Much of the time, paradoxically, it’s telling you to eat more, which is one reason why diets so often fail. Our fat wants to keep us fat. Although some fat tissue secretes leptin, which tells us to stop eating, very obese people become deaf or insensitive to leptin. So even as Phil Bruno was driving down the Manchester Road with a Quarter Pounder on his lap, his brain would be screaming that he was still hungry. While it would be hard enough for a “normal” heavy person to lose weight, for someone like Phil Bruno it would be next to impossible, says Mark Febbraio, a diabetes researcher at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia.

  “When you’re talking about people who are over four hundred pounds, usually those individuals have a genetic defect in the signals coming from various parts of the body to the brain, that tell us to stop eating,” Febbraio says. “And so they have insatiable appetites. Lifestyle can modify it to a certain extent, but if you’re always hungry, eventually you’ll start eating again.”

  Which makes the story of “A. B.” all the more remarkable. Known to science only by his initials, A. B. was a twenty-seven-year-old Scotsman who showed up at the hospital at Dundee, in northeastern Scotland, more than forty years ago. He weighed 450 pounds, which by the standard of the pre-obesity 1960s was downright freakish. With the encouragement of researchers, A. B. went on the simplest diet possible: He stopped eating.

  He ingested no food at all, only vitamins and brewer’s yeast, while the doctors monitored his health carefully. The weight came off, but more slowly than the scientists expected; after all, the guy was taking in almost zero calories, subsisting solely off his massive fat stores. He should have burned that fat right off himself. In the end, he managed to slim down to a very normal 180 pounds—an astounding achievement by any measure—but it took him 382 days to do it. Even more amazing was that the weight stayed off.

  Phil Bruno wasn’t about to quit eating. Nor did he feel like he needed to. Rather, he made simple, sensible changes to his diet. Rather than starve himself, he started by cutting out fried foods, fast food, and sweet sodas, which had all been major components of his former food intake. He replaced the
m with things like grilled chicken and fish, while snacking on unsalted almonds rather than potato chips. A little common sense made a big difference. “The first fifty pounds just melted off,” he says.

  His initial goal was just to be able to weigh himself on his home scale, instead of at the grocery store. But he also loved food, and once in a while he’d eat an extra chicken breast at dinner, if he felt like it. Better that than a Quarter Pounder with fries. “When you’re eating two Value Meals a day, with apple pie and a chocolate shake, any change is an improvement,” he points out.

  But as he kept exercising, Phil found that he not only lost weight, but also felt less hungry. In addition, his burning thirst was gone, and his long-suffering knees and hips felt better. He threw himself into his Spinning classes; eventually, he would become certified as an instructor, one of the most popular at that branch of Gold’s Gym. “We saw quite a remarkable change,” says Jim Wessely, a friend from the cycling class, who is head of emergency medicine at St. Luke’s Hospital in St. Louis. “When he first came in he was this huge, morbidly obese guy who could barely spin for more than a few minutes; now he would really go at it.”

  As Phil puts it, “Quitting was not an option, because that meant death.”

  Ebullient and enthusiastic, he’s a motivator, not a quitter; no surprise that he’s in sales for a living. As he trained to finish his first century ride, in the spring of 2005, he organized his gym buddies into a cycling team called the Golden Flyers. Now they have more than 150 members who travel to charity rides all over the Midwest. He loved indoor cycling classes so much he trained to become an instructor, and was certified in 2008, four years after he walked into the gym as That Fat Guy. Three mornings a week, he now teaches the very classes he used to fear, leading a madcap, devoted crew of followers who show up at 5:30 a.m. to work themselves into a frenzy; Phil sets the tone with his favorite T-shirt, which reads, TRAMPLE THE WEAK, HURDLE THE DEAD.

  He also belongs to a national cycling group for diabetics called Team Type 2, dedicated to helping people manage the illness through exercise rather than medication, which was how I found him. Phil holds the record for having lost the most weight. “He’s something else,” says Saul Zuckman, one of the leaders of Team Type 2.

  If Phil was relentless, it’s because his enemy was, too. In sedentary, inactive people—whether or not they are actually obese, like Phil—fat actually invades the muscles, slipping in between the muscle fibers like the marbling in fine Wagyu beef. Even worse, fat infiltrates the muscle cells themselves, in the form of lipid “droplets” that make the cells sluggish and may even contribute to insulin resistance, says Dr. Gerald Shulman, a prominent diabetes researcher at Yale.

  According to Shulman, these “pools” of fat, in both liver and muscle, block a key step in the conversion of glucose, thus leading to the insulin resistance that is a prerequisite for diabetes. This also explains why many sedentary normal-weight people are still at risk for the disease. “It’s not how much fat we have, it’s how it’s distributed,” Shulman says. “When the fat builds up where it doesn’t belong, in the muscle and liver cells, that’s what leads to Type 2 diabetes.”

  By exercising so intensely, Phil was vacuuming up those pools of excess fat. As a result, his insulin resistance and his diabetes seemed to be easing. Instead of floating around his body wreaking havoc, his excess sugar was being incinerated in the furnace of his muscles. He was still overweight—his weight fluctuated in the high two hundreds—but he was now in a completely different metabolic state. Recent data shows that while being obese is generally a serious health risk factor, the small category of “fit and fat” people have much less to worry about.

  A year after he was diagnosed, he went back to Dr. Livingston for some routine tests. The doctor was astonished: Bruno’s insulin resistance was gone, and his blood values were almost back to normal. His A1C, which had been 16, was now down to a more normal 5.5. He’d never seen anyone do that. Reluctantly, he took Bruno off all his medications. He had controlled his diabetes, which once threatened his life, by changing his diet and embracing exercise. It had been almost like a second job. “I’m a financial adviser with Wells Fargo,” he says, “but most people think I’m a Spinning instructor.”

  Yet Phil knew he was far from “fixed.” Because of his individual makeup, he’d been primed for weight gain for his entire life—even as a kid, he wore husky-size pants. He had to fight a constant, escalating battle against his morphological fate. He stayed dedicated to the gym, going to Spinning classes four and five days a week; on Sundays, he organized a regular group ride, and he mustered Gold’s Gym fund-raising teams for charity rides like the Tour de Cure (for diabetes), and the MS 150.

  In four years, he had lost more than 200 pounds, whittling his body down below 260, which was a huge accomplishment. He was still big, and he still wasn’t satisfied: He wanted to lose that last fifty, to get down to where he’d been in college. He kept moving, kept riding, knowing that he could never stop. “It’s kind of like holding a beach ball under the water,” he told me. “As long as you keep doing what you’re doing, it’s easy. As soon as you quit, then boom—it’ll pop right up.”

  Chapter 10

  POLE VAULTING INTO ETERNITY

  Men do not quit playing because they grow old; they grow old because they quit playing.

  —Oliver Wendell Holmes

  On a cool, overcast Cleveland summer morning, I stood in the infield of a small college football stadium, watching some of the nation’s top athletes battle each other in an important track-and-field meet. The atmosphere was intense, and in between events I gravitated to the infield, where I met three lanky sprinters preparing for their heats. Their names were Ron Gray, Don Leis, and Bernard Ritter, and they still wore their warm-up suits against the early-morning chill. As they stretched and limbered up, they coolly assessed their competition while, like male athletes everywhere, saving a glance or two for some of the more attractive female athletes.

  Ron, Don, and Bernie had all distinguished themselves in their events. Don had set national records in the triple jump, while Ron was one of the top sprinters in the country, and Bernie was competitive at the state and regional level in his native South Carolina. They had each trained for months in the hope of medaling in this national-level meet; their next stop would be world championships in Brazil later in the year. Don came from the track-and-field hotbed of Pasadena, while Ron hailed from Denver, where he had played running back for the University of Colorado football team.

  Sixty years ago.

  The event was the 2013 National Senior Games, a kind of biannual Olympics for older athletes (“senior” being defined as anyone over fifty). It featured the traditional track-and-field events and swimming, but also triathlon, basketball, volleyball, badminton, and Ping-Pong, to name a few. And of course shuffleboard. The competition in pickleball, a kind of paddle tennis that is becoming hugely popular in retirement communities, was said to be especially fierce. To get here, competitors had to qualify at state and local Senior Games, which meant that Cleveland was playing host to the crème de la crème of older athletes.

  I focused on track and field, because its results are quantifiable—there is a finish line to cross or a crossbar to clear—and because it takes no special talent. Anybody can run and jump. Which is why I found myself in the middle of this stadium at nine in the morning, surrounded by much older people wearing Lycra, track spikes, and very serious expressions. Also hearing aids. It was as intense as any college track meet, just a little more wrinkly.

  I had come here in search of people who were “aging successfully,” in the patronizing lingo of the geriatricians, and I found way more than I bargained for. Over the course of the weekend, I watched a nearly ninety-year-old woman heave an Olympic javelin far enough to clear a double-wide, the long way. The best high jumper in the seventy-through-seventy-four age group cleared a mark that would have won him a silver medal in the 1896 Athens Olympics, and I watched a n
inety-two-year-old man trot down a narrow runway and attempt to pole vault a bar set as high as my head.

  This terrified me. Was he nuts? Who had allowed this to happen? The whole morning had stoked my anxiety, as I stood there watching people my parents’ age sprint and jump so hard they almost puked. I couldn’t even remember the last time I’d run a hard quarter mile. One thing these athletes all had in common was that they were breaking the rules—not the rules of track-and-field competition, but the unwritten rules governing acceptable conduct for so-called old people. Everybody claps for the grandmas shuffling through the local 5K. But when Grandma can smoke her middle-aged kids in the hundred-meter dash, things can get awkward. It just seems wrong, if not downright dangerous. (This seems an appropriate place to add: By purchasing this book, you have agreed to absolve the author of any liability for whatever happens to you while “trying this at home.”)

  But these were not people who cared what their kids think. There in the infield, Ron, Don, and Bernie talked about training and diet like seasoned competitors, which they were. This was Don’s eighth meet this year, and it was only July. Today he was a bit under the weather, thanks to a black eye he had acquired while “chasing my grandkid around the playground.” Ron had the leathery complexion of a man who had spent a bit too much time in the Rocky Mountain sun, which he had. But the rest of him still looked like the University of Colorado football recruit he had been in the early 1950s, with his barrel chest and powerful forearms atop a pair of tapered, spindly legs. He had run track in college, in addition to four seasons as a running back for the Buffs. “Then nothing, for fifty-five years,” he laughed. Although by “nothing,” he actually meant hiking up Aspen’s Highlands Bowl and skiing down its forty-five-degree steeps, on a pretty much weekly basis.