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The weight of obesity

Life on the scale

Continued from Page 3

She's lived on disability insurance since a car accident in 2004, so instead of work, Ms. Sliwa's weekdays are full of health appointments: twice a month with Dr. Wharton; weekly trips to physiotherapy and counselling. A nurse makes weekly home visits.

The rest of her days are spent napping, scrapbooking or messaging friends. Mr. Burke only manages a visit every couple of weeks.

She also attends a prayer group. Lately, she's leaned on its spiritual support.

"The last while it's not been good," she sighs. "Life and the scale. But life affects the scale."

It's been that way since childhood. She was born the only child in a home where spaghetti sauce simmered on the stove all day and disputes were soothed with Dairy Queen. Once, the kids at school put tacks on her seat to see if she would pop.

She weighed more than 200 pounds in high school, and by the time she reached adulthood she had tried every diet, from cabbage soup to Weight Watchers. But each 50- or 60-pound victory was erased by the binges that followed crisis after crisis, including the death of both parents in her 20s - her father in a car accident and her mother, who was her closest confidante, to cancer. Car accidents in 1999 and 2004 left her with painful nerve damage and ruined knees.

At her heaviest, after the crash four years ago, she weighed 537 pounds.

"It was horrible," she says. "I couldn't breathe."

After the Valentine's Day dance, Ms. Sliwa continued to shed pounds, hitting a low of 404 pounds in April. She hasn't been weighed since, but May has delivered another series of setbacks: the 20th anniversary of her mother's death, and news that she may have to declare bankruptcy.

She's terrified of losing her house. And even though her fridge contains only strawberries, yogurt and bottled water, the comfort of Swiss Chalet is a phone call away. She manages an Optifast drink about once a day, but most of her meals are regular food now.

She feels frustrated and embarrassed by each setback, but also powerless to overcome the demons that drive her to eat. "I feel like a failure; a disappointment," she says. "It's not how I wanted my life to turn out."

In the afternoon, a social worker arrives to fill out an application for community housing.

She asks Ms. Sliwa what she should write about her weight.

"Say what you want to say. The weight has been a major problem and is a vicious cycle," Ms. Sliwa replies.

She mentions she's lost 133 pounds since her high of 537.

"Wow, that's amazing! Don't you think that's amazing?" the social worker exclaims.

Ms. Sliwa says she's too stressed out to concentrate on her diet. It's a phrase she will repeat often in the coming months, and it will bear out in her weight. Over the next two months, she will put more than 20 pounds back on.

But the social worker fixes on the positive.

"What that tells me, Juliann, is if you can do 133, I should be able to do that 10 I put on in Italy."

Ms. Sliwa deadpans. "Ten is my elbow."

Of Dr. Wharton's patients, Chris Dukarich and Andy Murphy represent where Ms. Sliwa aims to be.

Mr. Dukarich, a Hamilton plant worker with big ears and an even bigger laugh, bursts into the Wharton clinic's boardroom on a hot day in July holding a year-old photo of himself dressed in a rented tuxedo - with a 60-inch waistband.

Today, which happens to be his 27th birthday, those pants would drop off his 40-inch waist.

"It's more than a celebration," he says of the party planned that evening. "It's a celebration of new life."

The summer has been a series of emotional highs. He went on his first real date, he took off his shirt at the cottage and wasn't embarrassed. He bought cool clothes at regular stores - no longer forced to take what he could find in XXXL.

He calls himself a "reformed eater." Guided by Dr. Wharton's staff, he's gone from living off Slurpees and fast food to meticulously measuring every low-fat meal for its fibre, protein and carbohydrate content.

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