Patient Loses Weight, Gains New Sense of Well-Being

In early 2024, Judy Garafalo was feeling desperate. Her body weight had reached 228 pounds, and she was experiencing chronic back pain, asthma and lipedema.

Judy had battled with her weight for years, trying countless diets and weight-loss programs without long-term success.

“My weight has yo-yoed my whole life,” she says. “Some people can eat in moderation. I couldn’t.”

“I surprised myself. I didn’t think I could do it. I've made lifestyle changes that I plan to maintain the rest of my life.”

Judy’s weaknesses include a love of Italian food, baking and cooking. She looks forward to preparing a special dinner for her family every Sunday.

Since being referred to Manisha Chand, MD, board-certified Lifestyle & Obesity Medicine specialist at Cleveland Clinic Weston Hospital, Judy’s life has changed significantly. In one year, she has lost 70 pounds, 25 percent of her body weight.

But what she gained is just as significant. Judy has made incremental lifestyle changes that have improved her overall quality of life.

“Habit Stacking” contributes to overall success

“After I review my patients’ current eating habits and dietary patterns, we discuss what their daily meals should include,” says Dr. Chand. “I want to be sure they are getting optimal fuel for taking on their activities. At the same time, I suggest healthier options to replace refined carbohydrates and ultra-processed foods.”

During the first month, Judy added more protein and vegetables to her diet. “As I started to eat more protein and fiber, I found I wasn’t as hungry and had fewer cravings,” she says.

Dr. Chand encouraged Judy to try “habit stacking,” a technique of attaching a new habit to one you already engage in consistently. Making small changes every few weeks helped prevent Judy from feeling overwhelmed.

“Habit stacking allowed Judy to maintain her discipline as she began to make better choices and choose healthier alternatives,” says Dr. Chand. “Being able to see the results of her efforts kept her motivated.”

Judy appreciated Dr. Chand’s ability to make recommendations without imposing restrictions on her eating habits and social life. She made changes in her diet and lifestyle without compromising; Judy continues to prepare a large family meal on Sundays and doesn’t restrict herself.

Self-awareness helps guides next steps

At each visit with Judy, Dr. Chand checked in by asking, "What do you want your next step to be?"

“This approach provides me with a sense of where Judy sees herself in her journey and what she feels she is ready to do next,” Dr. Chand says. “I believe my patients know themselves best, what they can or cannot commit to. I am there to guide the discussion, encourage and challenge.”

Judy learned that setbacks are a normal part of the process. When she gained back 10 pounds between the Thanksgiving and Christmas holidays, she didn’t feel defeated.

“On January 1, I renewed my commitment and was able to get back on track,” she says.

Improved quality of life is primary goal

Dr. Chand’s patients learn to focus on their overall well-being as an indicator of success, rather than just the weight loss.

“Judy’s main goal was to improve her quality of life, back pain and lipedema,” says Dr. Chand. “She now reports having more energy and improved function, balance, and sleep patterns. Her food cravings have drastically improved as well.”

One year after seeing Dr. Chand regularly, Judy is extremely proud and pleased with what she has accomplished.

“I surprised myself,” she says. “I didn’t think I could do it. Dr. Chand was very motivating and easy to talk to. I’ve made lifestyle changes that I plan to maintain the rest of my life.”

Manisha Chand, MD, is committed to addressing the complexities of obesity and its related conditions. Her approach to obesity management is multifaceted, incorporating nutrition support, exercise and fitness programs, appetite control techniques, stress management, sleep management, and prescription medication management.