Start with end goal in mind: Extreme Weight Loss medical director blogs about Cassie's Journey

AURORA, Colo. - Editor's note: ABC's Extreme Weight Loss is back for season four and this year participants will start their journey with a three-month boot camp at the University of Colorado’s Anschutz Health and Wellness Center (AHWC).

The non-competitive TV show follows super-obese participants through a 365-day journey as they try to safely loose half of their body weight.

The participants are guided by trainer/transformation specialists Chris and Heidi Powell.

Dr. Holly Wyatt, Medical Director at AHWC and Medical Director for the show, reflects on episode nine featuring Cassie:

"In this episode of 'Extreme Weight Loss,' Cassie finally owned her weight and her life. She met her son and lost an amazing 176 pounds in just 356 days. We all felt joy and pride watching Cassie stand at her finale and shared her sense of accomplishment. But, I can’t help but wonder what the odds are that she will succeed at keeping the weight off. What happens when the lights of the camera fade and the motivation of being watched by millions is only a memory?"

Read on for Dr. Wyatt's observations on Cassie's Journey:

-- Questioning the future --

This is a tough question that I find myself asking every week.

When it comes to lifestyle change, we all know that initially losing the weight is only part of the battle.

Cassie’s real fight begins now, at the conclusion of her season 4 journey.

The hard truth is that most people who lose weight aren’t able to keep it off over the long term. While losing weight is frequent, keeping it off is rare.

I explain to my patients at the University of Colorado Anschutz Health and Wellness Clinic that there are complex reasons why maintaining weight loss is so hard. Those reasons include your hormones, metabolism, genetics, environment and mindset. Your external motivation can change over time as the excitement dwindles.

-- Out of the spotlight --

When you think about it, losing weight is actually kind of sexy. People say great things. They cheer for you, they’re proud of you, you’re super popular.

But, maintaining the weight loss, keeping it off, is like watching paint dry.

Maintaining weight loss is boring -- nothing changes. You will never hear people telling you it’s great that you look exactly the same as you did six months ago.

For these reasons keeping the weight off is really something to celebrate. 

Knowing the difficulty in keeping weight off, I can’t help but wonder about Cassie.

Will the lessons she learned on her weight loss journey really stick? Will she be able to maintain both her new reduced body weight and 'I can do anything attitude' in the day to day real world?

Is it possible for anyone to maintain the transformation Cassie experienced?

-- Optimistic --

Only time will tell for sure, but I’m optimistic about Cassie’s future. 

There are already some hints about her journey that make me think she has a real chance to make her new lifestyle and massive weight loss become her forever story.

One of the biggest indicators that Cassie will succeed is that she started her journey with the end in mind.  She not only spent time doing everything she needed to do to lose weight today, she also spent a significant amount of time changing her environment.

Those changes will support her new weight and her new lifestyle in the months and years ahead. 

-- Defaulting to healthy --

Cassie removed her nine televisions and replaced them with exercise equipment and eliminated the beer and items that made it easy to eat junk food and be sedentary.

Prior to this year, Cassie’s lifestyle had defaulted to unhealthy. Now that she’s created a new healthy environment, she’s stacked the deck in her favor.

Cassie made healthy her default instead and increased the chances that her new lifestyle will stick.

I often tell my clients at the CU Anschutz Health and Wellness Center that they need to reengineer their home so that NOT being active is hard work.

Things like getting rid of the remote controls and the riding lawn mowers, adding standing desks and replacing TVs with treadmills can all make a difference.

In addition to reengineering her physical environment, Cassie also worked on creating a supportive social environment.

She finally got her husband on board and living the lifestyle that supported her long-term success.

She developed new routines and rituals that will help make her new lifestyle easier in the long run.

The “new” Cassie does things like working out in the morning, not buying junk food, and weighing herself frequently.

-- Fix your environment --

All of Cassie’s changes increase her odds for long-term success.

So, what about you? What are the little things you can adjust in your personal environment to help make healthy your new default?

Yes, celebrate success like Cassie did, but realize an even bigger challenge is ahead. 

Even while you’re losing weight, think about the changes you can make to set yourself up to succeed forever.

Begin with the end in mind.

Think about the kind of physical and social environment you can create that will make the healthy choices easier and the unhealthy choices harder. 

Fixing your environment will significantly increase your odds of winning the battle of the budge forever.

Watch Cassie's story: http://abc.go.com/shows/extreme-weight-loss/episode-guide/season-04/409-cassie

Extreme Weight Loss airs Tuesdays on ABC and Channel 7, KMGH-TV, in Denver.

Learn more about the University of Colorado’s Anschutz Health and Wellness Center.

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