Journey & Protocol
By Michael Calcagno
J O U R N E Y
My struggle with obesity and mental health started around age ten. By 17 my scale hit 265 pounds. My weight would yo-yo up and down as I would diet and exercise in fits and starts with such temporary outcomes and bouts of hope and despair. In the past four years I have finally achieved a stable and healthy weight of 150 pounds — a body mass index today of 22 down from a BMI near 40 as I began my senior year of high school.
In grade school my increasing weight gave peers an easy target in their merciless verbal and physical bullying. That traumatic influence set me on a path of self-loathing I still struggle with today. As a young pre-teen, emotional anguish and tears came nearly nightly, which rooted deep in my soul a firm personal commitment: Should I ever discover some secret map for success, I had a responsibility to share guidance with others who are struggling as I did. The following is an attempt to honor my childhood pledge. Helping others is my sole motivation in sharing these habits and recommendations on nutrition, sleep and behavioral health. But first, my story may give light and credence to the advice I give:
Born in 1988, I grew up the third of five children. My parents provided a privileged home full of opportunity. My mom provided endlessly to nurture our young spirits and growing minds while my dad’s livelihood allowed for much material comfort. My preadolescence ended sharply with severe emotional turbulence as I entered middle school and my parents divorced after several years of intense interpersonal conflict. That experience introduced me to depression. It marred my developing personality and spiraled my dysfunctional eating habits. It blunted any ambition for physical activity. My body ballooned so quickly stretch marks typical of pregnancy developed all over my stomach, legs and arms—lifelong physical scars that represent the pain and self-harm of extreme overeating. Locker rooms and swimming pools were torturous as peers and even family members showed little mercy.
Frequent suicidal ideation dominated my thinking, and exacerbated my disordered eating. I often channeled my pain as anger and cruelty toward myself and often at others. Still today this causes deep sorrow and intense regret on which I continually reflect as I work to heal. As a boy and young man, I hurt many kind people in my life as a result of my frequent and intense swings from inferiority to superiority—this maltreatment of others would spiral my shame and self-loathing and snowball to yet more abuse of both food and later drugs and alcohol. It underpinned a lonely young adulthood of isolation and depression followed by periods of egotistic grandiosity and reckless behavior.
As a started high school the accidental death of my older brother Johnny added an entirely new layer of pain, regret, fear and insecurity. The comfort food provides me, and later alcohol and abuse of prescriptions, was how I coped with the pain of such heartbreak. The journey from obesity and mental illness to health lasted far too long because I became fixated with death, fascinated by sleep deprivation and caught-up in bizarre crash diets. I felt crippled by my lack of traditional masculine interests and abilities, and I divorced myself from my emotions in logical Spock-like fashion, literal self-alienation.
I was heaviest my final two years of high school, eating myself into a would-be early grave. What took just six years to gain would take twice as long to lose. Today I feel truly fortunate to be on the other side of severely poor health. Given correct information, adherence to a sound protocol and a personal commitment to make difficult life changes — I believe anyone can make this a reality if you truly feed well your body and mind. It’s not easy but neither is persistent despair that success is out of reach.
I’ve listed below my top ten insights. These are my best pieces of advice to others who are dedicated to achieving lasting weight loss and mental health results. These strategies have been crucial to my success and I hope you try to implement them in small steps over time. Even if I had immediately followed each protocol simultaneously I doubt the results would’ve held. Lifestyle changes take time, perseverance and habit-forming: adopt these slowly and sustainably. At first try to meet a few strategies a couple times a week. Gradually phase-in more days and more ways. The strategies are also on a spectrum that might require some titration—gradually taper (alcoholic or sugary drinks) or amplify (fasting windows) and your success will fuel your routine.
Also, please indulge in your favorite foods on occasion even if they don’t fit the protocol. I’ve purposefully avoided portion size suggestions, calorie counting and strict rules about treats and sweets. If your mindset toward food is similar to mine, you know well deprivation doesn’t last long and can cause unfortunate overindulgence rebounds. Food has always brought me comfort and joy when I’ve felt lost. The journey we walk is a constant balance between appropriate indulgence and the discipline to proactively choose the protocol’s guidance. No one enjoys being a square in social situations and I certainly do have sweet treats and alcohol in moderation from time to time. This isn’t all-or-nothing. Your commitment to the protocol requires a sustainability mindset and smart rule-bending. You have permission to be human.
Finally, most of the credit for my success belongs to my wife Katie who’s been my loyal, dedicated friend and champion. I couldn’t have done it alone. She’s consistently given me the encouragement and support to keep working at this commitment week after week going on four years of a stable healthy weight. I strongly encourage you to find a companion within an existing, loving and trusting relationship. Don’t shy away from the vulnerability of asking for help — interdependency is a bidirectional gift that strengthens your heart and renews your social-emotional health — don’t deny yourself that base need we all must satisfy to feel connected and truly find personal growth.
PROTOCOL
Fast Past Noon. Delay eating food and drinking caloric beverages until lunch. Only consume water and unsweetened tea or black coffee. Do not snack between lunch and dinner or after dinner. Hunger is healthy and building up your appetite is key. Recommended reading: The Obesity Code by J. Fung MD
Fixed on Fiber. Every meal should include high fiber foods for satiety and as prebiotics for gut health. Nuts, berries, seeds, edamame, broccoli, asparagus, beans, lentils, peas, chickpeas, oatmeal, rye, barley, wasa crispbread.
Nourish your Microbiome. Prioritize fermented foods with live and active cultures as probiotics. Eat yogurt/kefir, miso, kimchi, cheese, fermented pickles, beets, and cabbage. Dark chocolate, kombucha and sourdough bread all contain beneficial nutrients derived from fermentation. Avoid all prepackaged convenience foods. Recommended reading: The Good Gut by J. & E. Sonnenburg PhDs
Dietary Fat Focus. Avocados, olives, eggs, cheese, nuts, seeds, extra virgin olive oil, whole milk Greek yogurt. Never consume foods or beverages labeled low-fat or fat-free. Get omega-3 from grass-fed dairy, meats and cold-water fatty fish: salmon, mackerel, tuna, sardines or by supplements.
Drink Water Not Sugar. Drink six glasses of water per day minimum. Unsweetened tea, black coffee, bone broth all count. Avoid anything else liquid: sugary coffee drinks, juice, alcohol, energy drinks, artificially sweetened ‘zero-calorie’ and diet sodas. Recommended viewing: Sugar: The Bitter Truth by R. H. Lustig, MD
Daily Walks. Low-intensity, sustained, 30-minute elevated heart rate activity especially after mealtime. Don’t fixate on aggressive exercise, heavy weightlifting or intense cardio. Recommended reading: The Blue Zones by D. Buettner
High Quality Sleep. Set consistent sleep and wake times and adhere every day within one hour variance. Avoid eating or drinking anything caloric (including alcohol) at least three hours before bed. Pitch black room. Cool temperature below 67º F. At least nine hours total time-in-bed sleep opportunity. No screens two hours before bed. Get lots of daytime sunlight exposure and/or vitamin D supplementation, drink chamomile tea after dinner for high quality deep sleep. Recommended reading: Why We Sleep by M Walker, PhD
De-stress. Understand dangers of high cortisol. Increase hobbies and enjoyable, no-agenda experiences: cats and dogs, nature, sauna, art, music, laughing, gardening, cooking, reading, breathing, gratitude, friends. Distance with healthy boundaries the people and situations that trigger anxiety. Recommended listening: R. Sinha, MD The Peter Attia Drive Podcast #69
Esteem Yourself. Shame, guilt and depression trigger dysfunctional behavior and revert healthy commitments. Overindulgence and disassociation derail progress and reinforce negative self-perception. Practice daily acts of self-relational maturity to nurture and contain your inner child insecurity. Find professional guidance for past emotional trauma. Recommended reading: I Don't Want to Talk About It by T. Real
Brush and Floss. Good oral hygiene habits reduce inflammation and the risk of heart disease, and they promote beneficial gastrointestinal bacteria.