A patient in a Manhattan oncologist's office was scheduling a follow-up appointment when she realized that she hadn't seen a familiar face behind the desk. "Where's that really fat girl who works here?" the tactless woman asked—which was heard by the "really fat girl," Laura Prescod, standing only a few feet away and unrecognizable after having lost more than 200 pounds. Her reaction was resignation—just as it had been to a kind of invisibility in the world when she was obese. "People can be cruel and insensitive," she says, remarkably free of bitterness. "Weight is truly the last accepted prejudice." Considering the high failure rate of dieting, Prescod's success may have less to do with what she ate, or didn't eat, than the fact that her weight loss was a team effort. She had not only a doctor and nutritionist to guide her but two office colleagues whose attitude about weight loss was: It takes a village. Obesity has been a lifelong issue for Prescod. She was raised in the housing projects of Queens, New York, in a family where food equaled love and where cultural traditions—Southern on her mother's side, West Indian on her father's—meant that meals were usually deep-fried, starchy, and served in volume. While still in grade school, she became so large she could only fit into men's shirts. ("One day I came home in tears because my teacher was wearing the same shirt," she remembers.) In high school, she fasted on diet sodas for a month and lost 30 pounds, but she regained all the weight after she started to eat again. Relatives would poke her in the stomach at family gatherings, and at 16, when she attended her mother's funeral, an aunt told her she should be wearing a girdle. But despite such humiliation, she felt the weight was a layer of protection. "I'd built a brick wall," she says. "If I didn't let you through that barrier, you wouldn't hurt me. I used the weight as an excuse not to compete, not to be accepted, and in some ways to stay a child."

With the help of a good scholarship, Prescod graduated from Vassar College, but she put aside her aspirations for medical school when she was unable to get a job in a lab to earn tuition. (Although she was well-qualified, she was keenly aware of the expressions on her interviewers' faces once they saw her in person, finally giving up after 10 tries.) Eventually, she landed the job she's now had for 20 years, running an oncologist's office, and ironically, while working in healthcare, managed to neglect her own health. No matter what diet she tried—cabbage soup, protein shakes, smaller plates—the weight crept upward on her 5'7" frame, topping out at 409 pounds. And it circumscribed her life. She stopped driving because she could no longer fit behind a steering wheel. She barely made it through subway turnstiles, finding it easier to use the gate that's designated for large equipment. Her fatigue was so persistent, she often spent weekends in bed, and on frigid winter days, she stayed home from work, afraid that her painful knees might give way on icy sidewalks. She saved enough money for a time-share in Florida, but when she went on vacation (her first plane ride), she had to book two seats and ask the flight attendant for a seat-belt extender. Laura's Daily Plan

  • 4 a.m. Half hour on the exercise bike or working out to an exercise video.
  • 5:30 a.m. Breakfast—bowl of fiber-rich dry cereal or oatmeal, with flaxseeds, fresh fruit, and light soy milk; cup of coffee with skim milk.
  • 6 a.m. Walk to the train station rather than using jitney. Wear a pedometer, trying to tally 10,000 steps a day.
  • 9 a.m. Snack—soy protein powder mixed with light soy milk and a cup of black coffee.
  • 12 p.m. Lunch—if brought from home, 6 ounces of lean protein such as chicken, fish, or tofu with steamed vegetables; if ordered in, turkey burger (no roll) and salad with low-fat dressing.
  • 4 p.m.  Snack—one cup of low-fat yogurt or cottage cheese with apple or other fresh fruit bought from the stand on the street corner.
  • 6 p.m. Shop at the health food market on the way home from work. If a food craving hits, wait 15 minutes—chances are it will subside.
  • 7:30 p.m.  While making dinner, have a Wasa cracker with nut butter to avoid nibbling. Dinner is soup prepared on the weekend or perhaps rotisserie chicken, skin removed, bought at the market and added to salad with vegetables such as carrots and broccoli. Dessert is fruit salad.

    Drink 2 liters of water throughout the day. On weekends, get an extra half hour of exercise and perhaps have an occasional glass of wine.
As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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