How would you help this man lose weight?
The cabbie who drove me from the airport to the hotel on my last business trip probably weighed 400 pounds. We made small talk during the trip. He told me he was hoping to leave Nevada soon and move to Oregon. But, he said, it was tough getting the time and resources to make the move.
He works 12 hours days, six days a week. The cab company deducts chunks of his pay for their share of his revenues and to cover his health insurance premium and a tax on his tips. His take home pay is $500 every two week pay period.
As we started talking about his health insurance, the conversation naturally drifted to health. He is prediabetic, he told me, and his brother is a type 2 diabetic who has already had some toes amputated. He knows he is facing the same future if he doesn't lose weight, but how can he do it?
When you drive a cab 12 hours a day, you often eat on the run. That means fast food, high fat, and lots of calories. Also, how do you fit in exercise? Should he try to walk before the 12 hour shift or, perhaps, go out in the middle of the night when his shift is over?
I found myself wondering what I would do if I were his doctor. Of course, I would recommend he lose weight, alot of it. And, I would tell him to get moderate to vigorous exercise 30 to 60 minutes a day. I would prescribe any needed medications. And, I would tell him to join PEERtrainer (www.peertrainer.com) (which, of course, I did).
Chances are, in my 15 minute office visit, I wouldn't have learned about the challenges presented by his daily schedule. I wouldn't understand that my recommendations were unlikely to be followed -- not because he wouldn't, but rather because he couldn't.
If something doesn't change, his prediabetes will most likely become diabetes. He will probably have a heart attack or stroke or maybe, like his brother, he will end up with toes or feet amputated -- all potentially preventable if he could change his lifestyle.
At the end of the ride, all I could think of to say was that he needed to get a new job -- one that is less stressful and would allow him to exercise and eat better. But I knew this too would be a daunting task given the long hours he already works and the meagerness of his financial resources.
I keep mulling over his story and wondering, how could you help this man? I haven't come up with an answer. Can you?