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Since last November, he's lost 128 pounds, shaved 15 points off his original BMI of 54.3 and nearly halved his body's fat composition from 44 to 27 per cent. His cholesterol and blood sugar have plummeted to safe levels, too.
Also at the clinic that day is Mr. Murphy, a 48-year-old cement truck driver. Six months earlier, the father of three swapped super-sized burger combos at Wendy's for Optifast drinks, shedding 130 pounds from his 6-foot-2, 589-pound frame before travelling to Detroit for gastric bypass surgery. Since that surgery in May, he has lost 120 more pounds and counting.
Both men tried other options before winding up in Dr. Wharton's clinic. In three sessions with a Dr. Bernstein clinic, a commercial weight-loss program that costs thousands, Mr. Murphy had lost 180 pounds, 90 pounds and 60 pounds, and gained it back each time.
But they both swear this time is different. Like a reformed junkie, Mr. Murphy says he has a self-imposed ban on ice cream, for example, so he's not like "the fool [drug] addict who think he can do one line, and be okay."
Both say the euphoria of their new lives is too great to lose now. "I still wouldn't go kickin' sand down the beach, but I've gone swimming," says Mr. Murphy, now 339 pounds.
But he regrets the lost moments, like his son's hockey games that he spent in his truck in the parking lot, because he couldn't negotiate the bleachers.
Of the 1,000 patients Dr. Wharton has treated, he estimates more than 100 have lost a dramatic amount of weight like Mr. Murphy and Mr. Dukarich. But he says the scales aren't the only measure of success.
For some, even a 20- or 30-pound weight loss can take them off heart medication, he says. Others may learn proper eating skills so that their children don't follow in their footsteps.
But others may never find the radical change they are looking for.
At her weigh-in today, Ms. Sliwa is 412 pounds, having lost more than the 10 per cent that would make her eligible for surgery.
But right now, that option is off the table. The bottom line, Dr. Wharton says, is that she isn't emotionally ready for surgery. She has told him she doesn't want it.
Still, he says, there have been minor victories and there may be more. She's lost about 70 pounds. She continues to make it to her clinic appointments. "She has not given up," Dr. Wharton says.
On a warm evening in late August, Ms. Sliwa, looking pretty in a new dress and fresh burgundy-coloured hairdo, snaps pictures of the orange moon reflected on still water.
Her club, Curvacious, has sold 120 tickets for this cruise in Toronto's inner harbour. Ms. Sliwa bought the first one.
"This is the only thing getting me through these dark days," she says.
She hasn't been weighed since the scales read 423 at a second appointment in July. But she hasn't been eating well and knows the scale has crept up. "I can feel it," she says.
Her diet - and the surgery - are on hold until her financial and personal life can be sorted out. She declared bankruptcy the previous month and she may still lose her house.
"I hope this gets better," she says. "I hope I get my hope and my positivism back."
At dinner she accepts a second helping of Caesar salad and buttered bread with her roast chicken and baked potato, before digging into dessert. And when the DJ blasts the first dance tune, she claims a seat on the sidelines.
Hours later, as the ship plows toward the dock, she heaves herself to her feet. She extends her camera to Mr. Burke so he can snap a photo of them together.
Instead, he grabs Ms. Sliwa's extended hand and lowers his other arm on her side. He leans in and slowly rocks to the tempo. She stands stiffly at first, as if afraid to move.
Finally, after a tense pause, she gives in.