Obesity: A Patient’s Perspective

TOMMY TOMLINSON was 50 years old when he was forced to face his own mortality and his lifelong battle with obesity. Topping the scales at 460 pounds, the successful journalist was not only at risk for heart disease, diabetes and stroke, he was unable to climb a flight of stairs without having to catch his breath, or travel on an airplane without buying two seats. A simple trip to a local diner required a stressful, advanced assessment of whether there was an available seat that could support him.

Raised in the South by a family that loved food, he had been aware of his health problem for years, seeing doctors and trying diets from the time he was a preteen. But nothing worked, and every time he tried to make a change, it didn’t go the way he planned. Tomlinson says it was his older sister’s sudden death on Christmas Eve in 2014 that provided the wake-up call he needed to address the problem head on. “She died of an infection that was basically caused by her size,” he recalls. “I went to her funeral and I could see my future: I was 50 years old when she died, and guys like me don’t make it to 60. I knew then, in a way I never really felt as deeply and emotionally, that I had to change.”

Tomlinson’s successful career as a longtime columnist for the Charlotte Observer includes being a Pulitzer Prize finalist and a Nieman Fellow at Harvard. Although he has written about everything from music to sports, he only recently tackled the personal and difficult subject of his weight in his first book titled The Elephant in the Room: One Fat Man’s Quest to Get Smaller in a Growing America, published in January 2020. In it, Tomlinson bares the physical and emotional struggles he and millions of Americans face each day. “My weight is the biggest story of my life, but I hadn’t told it because I was embarrassed, because I was afraid, because I knew I didn’t understand myself.”

When putting pen to paper, Tomlinson says the statement “I weigh 460 pounds” was the most terrifying yet cathartic truth to share. “Those were the hardest words I’ve ever had to write. Nobody knew that number — not my wife, not my doctor, not my closest friends. It felt like confessing a crime,” he says. “The average American male weighs about 195 pounds; I’m two of those guys, with a 10-year-old left over. I’m the biggest human being most people who know me have ever met, or ever will.”

In the book, Tomlinson talks about growing up in a culture where food — and lots of it — was considered expressions of both affluence and love. He also describes an addiction to fast food that created a downward spiral for him in terms of weight gain. After the loss of his sister, Tomlinson began confronting his relationship with food and says he believes he’s been successful at losing weight because he finally chose a method that was sustainable for him. He wanted a plan that would bring him slow, steady results, and he describes his regimen as “the three-step diet,” which consists of exercise, using a Fitbit to calculate how many calories he burns daily and then calculating his exact calorie intake. “If I burn more than I bring in, eventually I’m bound to lose weight. It’s very slow and steady,” he says. “I’m still a big guy several years into this plan, but I do think it’s something that I can live with.”

Tomlinson confides near the end of his book that his ultimate goal is to weigh 230 pounds — half his original size, and he’s feeling positive about his weight-loss journey to date. Although reticent to say how much, he admits he’s lost a substantial amount of weight and has kept it off for the first time in his life. He also recently embarked on a book tour and is already contemplating what life will be like as someone who is not defined only by body size.

“I’ve never been anything but fat. One of the things I’m curious about, and a little worried about, is how my personality will change as my body changes. In terms of personality, I kind of like who I am,” he says. “Part of what I feel is positive about my personality is that I’ve always had a lot of empathy for other people. Whatever other strengths I have as a journalist, my ability to step into someone else’s shoes and understand their issues is something I can easily do. I assume that losing weight will not make me less empathetic, because I will remember that person I used to be. But I don’t know.”