Battling obesity

| February 01, 2007

Overweight drivers at risk for loss of career and even life.

Dirk van Wyngaarden was 43 years old when the 340-pound trucker fell out of his cab in 1996 and landed on his right ankle, shattering his tibia and changing the course of his life. The Appleby company driver from Brantford, Ontario, Canada, lay on the icy ground in excruciating pain and wondered if it was his excess weight that had caused such damage.

The 6-foot-4-inch trucker had not always been overweight. In fact, he weighed 165 pounds when he graduated from high school. But 25 years and 175 pounds later, he was classified as obese. Because of his weight, he was at risk for major diseases such as diabetes, heart disease, hypertension, stroke, sleep apnea, cancer and joint injuries like he suffered in the fall.

It’s been a tedious process to deal with his injuries and adopt a healthier lifestyle, but at 53, he’s back to driving.

More than 60 percent of adult Americans (about 127 million) are categorized as being overweight or obese, according to the most recent Centers for Disease Control studies. Each year, obesity causes at least 300,000 deaths in the United States and costs approximately $100 billion in health care. The statistics are even worse for truck drivers.

Studies show that approximately 73 percent of drivers are overweight and more than 50 percent are obese.

Weight issues – especially those brought on by poor eating habits and lack of exercise – can lead to serious health problems, resulting in a shortened life span and low quality of life. The costs associated with obesity-related health issues in sick days and out-of-pocket expenses can add up to thousands of dollars per year for a trucker and even rob you of the ability to make a living in trucking.

The more stringent blood pressure rules have already forced some drivers off the road, and now the Federal Motor Carrier Safety Administration plans to create a National Registry of Certified Medical Examiners to make passing the Department of Transportation-required physical a more rigorous process. Obesity-related diseases will be more carefully scrutinized, and there will be more emphasis on driver health and fitness. Drivers who have skated under the more lax requirements will find themselves scrambling to address their health issues.

Getting fit for the road can be a difficult, heartbreaking battle that encompasses what may seem like overwhelming obstacles. But the good news is carriers, trucking associations, truckstop operators, medical professionals and Truckers News want to help truckers meet those challenges and become more healthy and fit.

“The journey to better health and fitness begins with baby steps,” says Wendy Sullivan, a registered nurse and occupational health manager for Schneider National. “Even small improvements in diet and activity level can result in health benefits such as lower cholesterol and blood pressure, along with increased energy and improvements in appearance, better quality of sleep and longer life span.”

Companies are putting more emphasis on wellness as they explore ways to help their truckers adopt a healthier lifestyle. Susan Deetz, human resources director for Marten Transport, says their in-house Weight Watchers program has been well received and they are exploring ways to expand the program (or another established weight-loss program) to include drivers in 2007. “We realize how difficult it can be for truckers to exercise and make healthy food choices on the road and want to help them make informed choices,” Deetz says.

Dr. John McElligott, medical director for Professional Drivers Medical Depots (PDMD), agrees that even small weight loss can result in health benefits. McElligott says his plan to open health clinics at truckstops will make regular health care a more convenient option for truckers battling obesity-related issues and will include wellness programs.

“Obesity-related complications exclude no organ system in the human body,” he says. But the good news, McElligott says, is that consistent weight loss can slow or even reverse the progression of weight-related diseases and reduce reliance on medications.

Ready, set, go!
Getting started is the biggest step, and the motivation to change is different for everyone. Tom Lee, an owner-operator from Mt. Vernon, Wash., says he’s about 100 pounds overweight and is haunted by the early death of his trucker father, Harry Lee. The senior Lee was only 37 years old when he had a fatal heart attack in his truck cab, and Lee says he’s never gotten over the devastation of becoming fatherless at age 12.

“I want to do something about my weight,” he says. “I don’t want what happened to my dad to happen to me.”

For Albert Morales, the early loss of his mother to obesity-related diabetes is a grim reminder that he’s on the wrong path. He says he will do anything to become healthier for the sake of his wife and four daughters. “I want them to be proud of me, and I want to be there for them,” says the Port St. Lucie trucker.

Others hate the shame and stigma of being overweight. Dalton Shackelford, from London, Ky., says he and his partner love amusement park rides, but he’s humiliated when he sometimes can’t fit in the seat. He wants to lose weight so he can look and feel better.

Van Wyngaarden says his turning point came as a gradual realization that he no longer wanted to drag around the pounds that almost destroyed his life. After the fall, doctors surgically inserted a metal plate into his ankle and issued him crutches. His excess weight made the crutches impossible to manage, and he spent the next six months in a wheelchair.

Then the news got worse. The metal plate was too small and had to be replaced with a larger one, resulting in six more months in the wheelchair and a total of four surgeries. After finally getting back to work, van Wyngaarden says he spent about a year on the road in a state of inertia. He knew he had to lose weight, but he felt paralyzed by the obstacles facing him.

Shame, embarrassment and low self esteem led to hopelessness and despair. Too large for his bathroom scale, he sometimes stepped on the loading dock scale for an accurate accounting of his weight. “I’ve seen guys do that,” he says. “They look around, hoping nobody will notice. It’s a terrible thing to be that overweight.”

His blood pressure began to creep out of control, and he feared he would soon lose his commercial driver’s license. “I love being a truck driver. It’s what I do. The thought that I could lose everything is what pushed me into taking the first steps,” he says.

With blood pressure hovering around 160/93, a 54-inch waistline and at 342 pounds and climbing, van Wyngaarden was desperate. “I had very little energy, couldn’t stay focused on the road and my sleep was more fractured than ever,” he says. “It was the worst-case scenario.”

And then one day, he parked a little farther from the truckstop than usual. “It was a short walk from the truck to the truckstop. I was drenched in sweat, exhausted and out of breath,” he says. “But something inside just clicked. I decided to walk a little bit more the next day.”

Back then he had “the constant memory of being helpless, in a wheelchair from the ankle injury and facing a very bleak future,” he says. “Something happened inside that made me decide to fight back.”

It was the beginning of a remarkable journey. Soon, he began to look forward to his daily walks. “Walking became a reward rather than an obligation,” he says.

At the same time, he began slowly changing his food choices. Without a formal diet plan, van Wyngaarden began packing a cooler of fresh fruits and vegetables. Then he started substituting water for sugary sodas and began cutting back on his meal portions. He even stopped packing his favorite snack, cookies. An ironic decision since he hauls Voortman cookies for Appleby Trucking.

Despite limited food choices, lack of regular exercise and the sedentary and psychological aspects of trucking, the pounds began to melt off. “I had to make do with the reality of trucking, from the boredom of the road to figuring what food to order at truckstops,” he says. “I didn’t have a health club in the back of my rig or a treadmill in the trailer. It required a lot of changes.”

Fill ‘er up
Limited food choices can be an enormous challenge for truckers trying to lose weight. Pam Whitfield, a registered dietician from Chicago, works with truck drivers to help them make better food choices. She believes that a healthy diet does not have to be restrictive.

“I don’t try to eliminate favorite foods,” she says. “I try to teach better ways to make diet decisions with available options.”

She’s realistic about the life truckers lead, and her recommendations reflect her research into the lifestyle and health issues of truckers. The first change a trucker must make is to drop the traditional, one-giant-meal-a-day habit.

“Waiting all day to eat an enormous meal results in over eating,” Whitfield says. Instead, she recommends three moderate meals and healthy snacks throughout the day to keep blood sugar steady. For snacks, she recommends nuts, fruit, vegetables, yogurt and water. Off limits are fried and fatty foods and sugary drinks. “A 12-ounce can of pop has 150 calories with no nutritional value,” she says.

Her real work comes with helping truckers navigate portion control. “Reduce the amount of food you put on your plate,” Whitfield says. “Don’t make additional trips to the buffet bar. Cut portions in half.”

Mindful eating, the latest buzz in the weight loss industry, is the subject of a new book, Mindless Eating: Why We Eat More Than We Think, by author Brian Wansink, director of the Food and Brand Lab at Cornell University. Wansink says a person makes about 250 food decisions per day. Whole milk or skim? Wheat or white? Sugar or Splenda? He says people are unaware of the influences on their decisions, and something as simple as choosing a smaller plate or dish makes a big difference.

“I’m increasingly convinced that our stomach has only three settings: 1) we feel like we’re starving, 2) we feel like we’re stuffed, or 3) we feel like we can eat more,” Wansink says. “Most of the time we’re in the middle; we’re neither hungry nor full, but if something’s put in front of us, we’ll eat it.”

And food marketers know this. Food portion sizes have increased, as have the actual size of dinner plates, bowls, cups and coffee mugs.

“Most people think they are too smart to be influenced by candy dishes, television or the shape of a glass,” Wansink says. “When I show someone that they ate 31 percent more because we gave them a large scoop at the ice cream social, they will deny it. That’s what is so astonishing. No one wants to admit they were tricked.”

He recommends putting snacks in small baggies and never eating out of a box of goodies bought in bulk.

Whitfield agrees that lack of awareness of one’s eating habits is a big factor when making food choices. She requires clients to keep a food diary and says they are shocked at how much they eat vs. how much they think they eat.

But what about truckstop food? All the major truckstop restaurants offer healthy options, including salad bars, but the key is to make good choices.

Mindy Long, director of communications for NATSO, an association representing truckstops and travel plazas, says it’s important for truckstops to offer drivers a wide variety of food.

“Restaurants have the responsibility to offer choices to their customers, but it is the customers that make the final decisions on what to order,” she says. “We’re seeing more and more that ‘healthy alternatives’ doesn’t mean drivers can only choose salads.” Long says the trend among NATSO members is to offer options, including a section of the menu dedicated to low-fat choices and a wide variety of ethnic foods.

David McClure, marketing director for Petro Stopping Centers, says the chain’s Iron Skillet restaurants offer broiled chicken and a broiled ground beef patty and cholesterol-free egg substitute choices for breakfast.

“Most of the healthy eaters head straight to the soup and salad bar,” he says, which contains more than 60 items, including fresh fruit, nuts and cottage cheese. Petro is also considering using frying oil that is low in trans-fat for most of its fried foods some time next year.

Even fast-food restaurants in truckstops offer grilled chicken, wraps and fresh salads. But the healthiest approach is to supplement over-the-road dining with pre-bought and pre-planned snacks and smaller meals.

“A plug-in cooler full of fruit snacks, cut up veggies and low-fat, low-calorie healthy snacks can round out a healthy diet,” says Whitfield.

Burn the fuel
Truckers have fewer choices when it comes to exercise. The key to success is to make it a regularly planned part of your day. Walking is the most convenient and easiest way to begin a fitness program. Sullivan says a Schneider National health counselor calculated 32 trips around the rig equals one mile.

“Breaking things down into small parts makes everything, even exercise, more accessible,” Sullivan says. “Always begin with modest expectations and then gradually increase your goals.”

Feeling more alert and less tired from his daily walks encouraged van Wyngaarden to plan them into his schedule. Soon, he began to pick up his pace and gradually started running. He now runs almost every day and has completed one marathon and numerous half-marathons. When the weather is too snowy to run, he puts on snow shoes and hikes through the woods or nearby trails. Some of his favorite trails back up to truckstops like the Flying J in Des Moines, Iowa.

“I get to see some of the most beautiful parts of the country by hiking, running or biking,” he says.

When the weather is warmer, he carries his bike on a rack mounted between the truck and trailer. He began with short distances and built up endurance and mileage with incremental increases. His work paid off, and he’s recently completed a 100-mile “century” bike ride.

Since beginning his exercise program, van Wyngaarden says he’s seeing more truckers biking and walking – and even some running – around truckstops.

“I used to get all kinds of looks and was even once questioned by a policeman when I entered the truckstop on my bike,” he says. “After all, that’s not a common scenario. Fortunately, that seems to be changing.”

Change your mindset
You can’t change how you eat and exercise without changing how you think about health and fitness. Terry and Carey Hill are married team drivers from San Antonio, Texas, who have tried numerous weight loss plans together only to gain it all back.

“We know that a diet is not going to fix us. We have to completely change our lifestyle to be successful. We both want to set realistic goals to lose pounds and keep the weight off. How do we accomplish this?” they asked in their essay application to the Truckers News Fit for the Road program.

“First, you have to figure out other ways to alleviate the boredom on the road,” says van Wyngaarden. He began listening to audiobooks and eventually satellite radio stations.

Whitfield agrees. “You have to figure out other ways to satisfy cravings for variety and interest,” she says. “Where food once filled that need, try to substitute creative, interesting activities into your life.”

Mandel recommends humorous movies, CDs and audiobooks to her trucker clients. “Laughter takes your mind off the next meal,” she says.

The solitary trucking lifestyle makes accountability a huge problem for truckers. “You don’t have someone watching what you eat, how often you snack or even offering support in small decisions, as other professions might offer,” says Sullivan.

That’s one reason Schneider’s health coaches have been so popular. Thousands of Schneider drivers call the health coaches on site to ask diet, fitness or health questions. The 24/7 nurse hotline also gets plenty of use, and more companies are putting resources into wellness programs.

Even if you don’t drive for a fleet that offers these services, you can set up a buddy system or ask a family member or friend to team up with you in your weight-loss efforts.

But ultimately, it’s got to come from within.

Kathleen Ashton, a psychologist with the Cleveland Clinic Foundation, works with obese truckers in their struggle to control their weight. She says truckers who have been successful with weight-loss surgery and non-surgical means tend to have common characteristics, including ways to minimize isolation.

“They use their break time to connect with their friends and family,” Ashley says. “Extended family support is helpful as a trucker makes lifestyle changes.”

They also don’t obsess over setbacks or “bad days” and take obstacles in stride.

After van Wyngaarden lost the first 50 pounds, it hit him that he was actually making progress. Soon, the scales started tipping the other way, and he began dropping pant sizes. In about 18 months, he lost more than 110 pounds. His blood pressure was back to normal, he was sleeping better and felt more energetic, professional and focused.

“It was amazing how much confidence I gained after losing all that weight,” he says. “I love how alert and fit I feel. A 3-mile run is more rejuvenating than a 30-minute nap used to be.”

It’s been 10 years since he lost his weight, and his zeal for exercise and eating well has not decreased. As Whitfield recommends, he doesn’t deprive himself of things he enjoys eating. “If I eat some of my favorite foods at a holiday gathering, I don’t sweat it,” van Wyngaarden says. “I know that I’ll be back to my regular routine, and any extra pounds will soon come back off.”

He’s diligent about planning his meals, preparing snacks like fruit and vegetables and carrying only enough money into truckstops to pay for fuel and a cup of coffee.

It’s hard to believe that the fit, energetic athlete once dragged himself breathlessly from truck to buffet line, where he loaded up his plate three and four times in one sitting. You’d never know he used to down a case of soda or six McDonald’s cheeseburgers in one day. But there’s little doubt he’d never go back to that way of life.

“I’ve got so much to look forward to,” he says. He wants to run another marathon, ride in more bike races and start training for a triathlon. “Anything is possible now that I’ve accomplished the impossible.”

Losing weight and increasing overall fitness doesn’t have to be an impossible dream. Arm yourself with realistic goals, load up on good nutritional information and take the first steps toward a gradual fitness program. Your health depends on it, and soon, so will your livelihood. It’s one area where the biggest losers will come out winners.


Truckers News Launches Fit for the Road Program
About the program: Fit for the Road is a year-long project designed to shed light on the weighty issues of obesity. Early last year, Truckers News began asking interested truckers to participate in the program.

Who was chosen? More than 350 applicants filled out a health form and wrote an essay about why they wanted to lose weight and adopt a healthy lifestyle. The judges agreed that the final candidates showed the determination and motivation needed to make the commitment to follow the program.

When will they be announced? A website, fit4theroad.com, will go live mid-January. You’ll get to meet the participants and follow their progress as they begin their diet and fitness plan.

What’s the plan? The participants received a thorough medical evaluation by Dr. John McElligot, with Professional Drivers Medical Depots, which operates clinics in truckstops. Registered dietician Pam Whitfield set them up with an eating plan designed for their individual needs. In the March issue ofTruckers News, you’ll meet them and see how they are doing. Truckers News will follow their progress throughout the year.


Interval Training
“You have to burn off the calories, and sitting in a cab for 10 hours isn’t going to do that,” says trucker Dirk van Wyngaarden, who has lost more than 100 pounds by incorporating regular exercise and healthy eating into his lifestyle. Exercise is also a great stress reliever, he says. “Nothing clears my mind, calms me down and helps me focus like a good half hour of hard exercise.”

But the trucking lifestyle makes getting regular exercise difficult. It’s easier to start an exercise program if you incorporate short intervals into your day, says Debbie Mandel, author of Turn on Your Inner Light. She offers these recommendations:

  • Keep some dumbbells in the truck and do two sets each of 10-12 repetitions of shoulder presses, biceps curls, triceps extensions and one-arm low rows. Then kick it up with a one- to three-minute interval of jogging in place, jumping jacks or marches. End with some calf raises to get the blood pumping in your legs and help avoid blood clots.

  • Do squats or lunges. Get adventurous and do walking lunges.
  • Lean against the truck and do push-ups. Change up the arms from shoulder width apart to hands touching so you target not only the chest, but the triceps. Do another interval or take a walk to elevate your heart rate.
  • While you drive, suck in your abdominals toward your spine like someone punched you, and then breathe out and release. Do two sets of 20 repetitions.
  • Do a couple of sets of knee lifts to work the quadriceps. Then do an interval of jogging, jumping jacks or marching in place.

“The great thing about intervals is that they are explosive bursts of energy and are highly effective for the brief time they take – you really get a bang out of your workout,” Mandel says. The strength-training exercises build muscle, which burns more calories at rest, Mandel says. She encourages truckers to add five minutes of exercise into their day whenever possible. “You will see immediate improvement in energy levels, which will motivate you to continue,” she says. Her final piece of advice: “Hold in your abdominals tightly with all the exercises, so that you are always working them.”


Surgery Options
Truckers defined as morbidly obese (a body mass index of 35 or more) or with one or more illnesses such as diabetes, hypertension, heart disease or sleep apnea, may be candidates for surgery to help them lose weight.

Dr. Karen Cooper, an osteopathic surgeon with Cleveland Clinic, says the surgery can often be life-saving in situations where the well-being of the candidate is dependent on good life-style changes.

The two procedures most commonly used in the United States are laparoscopic gastric banding and gastric bypass. Both will allow the individual to lose weight, but the weight loss is slower and less (approximately 40-50 percent of excess body weight) with the lap band procedure as compared to the gastric bypass procedure (60-70 percent of excess body weight). Additionally, the gastric bypass has been shown to put diabetes in remission even before excess weight has been lost.

Follow-up after surgery is crucial to ensure minimal post-operative complications. Post-operative visits begin within the first week after surgery, progress to the first month, then every three months for one year. During that time, doctors evaluate a patient’s nutritional status, reinforce lifestyle changes, and address any psychological issues. Patients should continue to be followed annually after the first year, for the next five years.

Although these procedures can eliminate or improve obesity-related problems such as diabetes, hypertension, sleep apnea and coronary artery disease, they are only part of the solution. Patients must still follow a healthy, low-fat diet and incorporate regular exercise into their lives to attain the best outcome.


What is Your BMI?
Overweight and obese are labels for two ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems, according to the Centers for Disease Control.

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the body mass index.

  • An adult who has a BMI between 25 and 29.9 is considered overweight.

  • An adult who has a BMI of 30 or higher is considered obese.

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