“So you’re fat!”— this was the subject line of the e-mail I received from Erin Riley, founder of our formidable moms’ group, the Clitorati. The e-mail wasn’t directed at me in particular, but to each of us who was losing the battle against keeping the belly bulge inside our jeans. Summer was here, and our illustrious leader wanted to inspire us to rediscover our bikini bodies before we re-embarked on our traditional “Beach Fridays.” I usually don’t hit the sand along with my lady friends, but that didn’t hinder my mutual desire to rediscover my “thin self” within.

The loss of that self has been a slow, gradual journey for me. When I checked out of the hospital after sustaining a spinal cord injury that left me an incomplete quadriplegic at the nubile age of 19, I weighed a glorious 112 pounds.

One way to look at it is, I’ve really only gained about 1.5 pounds a year — or two ounces a month — since then.

But that was 28 years and a full 42 pounds ago. Sure, 112 pounds was too thin for my five-foot, seven-and-a-half-inch frame, but 154 is a bit much. Although the Body Mass Index disagrees with this assessment, a comparison of then and now leaves little question as to the truth: at 112 pounds I looked like a bobble-head doll; at 154 my torso looks frighteningly like Homer Simpson’s face. Add to that the health risks of being overweight, and joining the Clitorati’s quest to lose pounds and get fit wasn’t an option for me, it was a necessity.

The Plan
Like the rest of the ladies, I started the first week with a clear plan and a high degree of motivation. I uploaded the Live Strong App onto my iPhone so I could count calories consumed and burned in a variety of activities — working out, cooking, talking or having sex. At the end of the day I was able to see my net caloric intake. And just to make sure I stuck to my plan, I also went to stickK (www.stickk.com) and announced my weight loss goal to the world: two pounds a week over the course of the next eight weeks.

I even checked online for other tips that might ensure success and found that when people put either their money or their reputation on the line, they are far more likely to achieve their goals. Since I had little to lose reputation-wise at this point, I put up $5 a week betting myself I could lose those two little pounds. Each week I met my goal, I’d get to keep my money; each week I didn’t, I had to fork it over to Ms. Riley, whom I’d appointed to referee this particular wager.

I kept my money that first week by meeting my goal. I arm-cycled two miles on Monday, powered through 1.75 miles on the Nu-Step recumbent cross trainer on Wednesday, swam for 50 minutes on Tuesday and Thursday, and even went to an hour of yoga on Friday. I ate six small snacks a day and cut down on my nightly glass of vino. I dropped two pounds, had more energy and felt great.

The second week (same routine) was just as successful as the first. I lost another two pounds, and 10 of the bucks I’d wagered were mine. The five-day-a-week workouts, however, were taking their toll, physically and mentally, and I was burning out fast.

I tried to stay motivated. I focused on the commitment of other group members. I re-read Annie’s e-mail, “I shall continue to count every stinking calorie I put in my mouth. I shall exercise every day, and do weight training at least twice during the week and I shall drink at least two liters of water every day, three if I’m exercising hard!”

I celebrated Martina’s achievement and dedication: “Still happy with my two pounds off. New commitment to a Monday a.m. spinning class. Whoa, baby, not done that in six months. I stopped eating before I was full tonight and then drank a fiber drink. That did it. Whew!”
I was determined to stick with it. My arms were toning up. My face, fingers and butt were slimming down. But the image of Homer Simpson still haunted my mirror. I couldn’t stop now.

But maintaining my workout-crazed schedule proved unsustainable. I may have lost four pounds, but I’d also been spending most of my life going to and from the gym. I was forsaking work projects, my family and household chores to keep up with the pace, and everything was piling up. I had to revise my plan. I figured if I continued my dietary restrictions, I could limit my workouts to three days a week and still see results.

I was wrong.

The Lesson
Once I eased off the workouts, I stopped losing weight. In week three, I not only failed to reach my goal, I actually gained a pound and had to give Erin my five bucks. Most of my friends were only working out two to three days a week and they were shedding pounds, no problem. Why not me?
Turns out that people with disabilities face different obstacles than their nondisabled counterparts when it comes to weight loss.
The largest obstacle is muscle mass. Muscles require more calories to survive than fat. The more muscles you have, the higher your metabolism … and the higher your metabolism, the more calories you burn, even when you’re at rest.

The problem for people with SCI or other mobility impairments is that we have lost most of our lean muscle mass. There are about 650 skeletal muscles in the human body, and most of them are located below the chest. Skeletal muscles are the voluntary muscles that we can consciously control and use when working out. When you’re only working out with your upper body, you’re only using a small percentage of the muscle mass you’d be building if you were able to use all of your appendages. So, while the other members of the Clitorati were hiking, running and biking their way with great success toward the skinny finish-line, I was arm-cycling myself in circles and getting nowhere.

Week four: I stepped up the workouts to four days a week and upped my total to five pounds lost. Less than my original goal of eight, but I was back on track.
The following week I was derailed again — life, work and family demanded some serious attention that subsequently never let up. I had to cut my workouts down to two vigorous days a week and stuck with interval swimming, water weights or at least one mile on the Nu-Step Cross Trainer, but they weren’t enough. By week six I’d gained another two pounds.

Everyone tried to comfort me with the reminder that muscle weighs more than fat. I had to remind them that the only muscle weight I was gaining was in my arms, and that those were simply not big enough to account for what I’d gained. And, of course, there was always Homer’s face looking back at me.
Undaunted by having entered this competition ignorant of my own inherent physical disadvantage, I persevered. I lost another pound in week seven, and maintained my overall four-pound loss through week eight as well. It may have been a far cry from the original 16 pounds I had hoped to lose, and Erin may have ended up with $25 out of the $40 I wagered, but I rolled away with something much more important than the svelte figure I’d been hoping for in the first place: In the vain effort to simply look better, I learned how to live better.

The Cost of Extra Poundage
What we eat, and how much, is important. A diet high in lean protein and complex carbohydrates will lead to a healthier system as well as weight loss, while processed foods, sugars, saturated fats and refined carbohydrates increase the chances of Homer staring you down in the mirror.

Finding your “thin self within” isn’t just about looking good. Extra pounds means extra stress on your heart. Research indicates that people who survive a spinal cord injury are twice as likely to die if they have a cardiovascular event, and that coronary artery disease is a contributing factor in nearly one-quarter of all SCI deaths. Extra fat makes your heart work harder and places harmful stress on other organs.

Excess poundage also increases your chance of developing serious decubitus ulcers. More weight equals more pressure. Transfers become harder, kidney function is at risk, and the power it takes to push around an extra 20 pounds puts additional stress on your shoulders, increasing the chance of injury.

Extra pounds can cause serious health problems for everyone, but for people with disabilities, they can be deadly. The best course of action is to avoid gaining weight in the first place, but that’s a difficult task for anyone. Rarely do we gain the extra weight overnight. Generally, it sneaks up at a rate of just a few ounces a month.

The only way to banish Homer’s fleshy grin forever is to make a commitment to some major lifestyle changes. Eating healthy is the first step, but the real key for people with mobility impairments is a daily bodily jump-start to burn calories. The amount of energy needed to sustain the involuntary activities of the body at rest is considerably lower in gimps. We aren’t tapping our toes, fidgeting in our seats or feeding large quantities of lean muscle mass, so we burn fewer calories. To compensate, we need to increase our daily levels of physical activity. Even if the best we can do is passive exercise, it is better than none. It may mean spending money on equipment.

For me, I need to work out at least five days a week, if not everyday, to lose weight and stay fit. But hitting the gym that often is unrealistic. I have opted to purchase equipment for home use. Thirty minutes a day can provide some measure of range of motion, strengthening, burning calories and improving my overall cardiovascular fitness.

The cost of most exercise equipment is substantial, but compare it to the cost of poor health. And don’t forget to eat with your head instead of your stomach.