2005年，约瑟夫·曼库索（Joseph Mancuso）体重近500磅，享年39岁。当新泽西州（New Jerseyan）与2型糖尿病的诊断斗争时，他发现完成日常任务（例如上班，社交或购物）更加困难。承受如此多的体重的健康后果使他无法过自己想要的全部生活。
他说：“我无法做很多普通大小的人认为理所当然的事情，例如在游乐园骑车。”“有很多例子说明我的肥胖是如何在精神上迫害我的。”
In an effort to get healthier, he tried to manage his condition by taking medication and following the Atkins diet. Unfortunately, the diet wasn’t sustainable and he didn’t like the side effects of the medication. Once he stopped, his uncontrolled blood sugar became life-threateningly high. As the years passed with no clear solution, his condition continued to worsen and he started to wonder if he would ever find a path to better health.
2015年，他在右脚出现了严重的糖尿病性溃疡和骨骼感染。在准备手术以解决感染的过程中，他的医生告诉他，他可能会失去骨骼肿块，或者完全使用脚。在他走到刀下之前，他对自己说：“如果我有幸保留脚的功能，我将尽一切努力再次变得健康。”
当他醒来时，他惊讶地发现自己仍然可以感觉到并利用右脚达到其全部能力。那一刻，他知道要改变他的生活是由他决定的。
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“Once I got home from the hospital, I was unable to exercise for long months, which was grueling,” he says. “The only thing I felt in control of was my diet, so I made sure I stuck to it like my life depended on it. Oh, wait, it did!”
为了帮助监测他的营养，Mancuso下载了MyFitnessPal以跟踪他的卡路里摄入量。After 2 1/2 years using the app every single day to track his meals and workouts, he is 250 pounds lighter.
For Mancuso, now 51, the solution to his success is simple math: calories in minus calories out.
“I know that sounds cliché, but it really can’t be done any other way,” he says.
目前，他每周六天每天消耗约1200卡路里。每周一次，他允许自己一天放松自己的饮食，并享用一两顿作弊。他还将运动纳入了例行活动中，每周六天完成500次俯卧撑，每周30英里骑运动自行车，每周大约8英里。
如今，曼库索的糖尿病已经受到检查，他的目标重量仅为225磅25磅。他的生活不仅充满了活动，而且还回到了社交漩涡中，结识朋友，去海滩并完全拥抱生活。
He’s even learned to embrace humor as a source of strength through the darkest times. “My ability to make people laugh was always the one constant quality of mine that made me feel good about myself. All those years I was grossly overweight made me hate myself physically, but I always had my humor to make me feel I was still worthy especially in social situations,” he says. “Being so heavy made me dread being in social groups because I always felt like people were talking behind my back, making fun of me. Cracking jokes and making people laugh was my way of distracting them from my weight issues.”
他现在正在写一本关于他的经历的书，暂定标题为“我曾经是一半的男人”—no relation to the Stone Temple Pilots’ song, he says. In the book, Mancuso will discuss his lifelong struggles with his weight, beginning when he was just a boy and ever present into adulthood, plus his ongoing battle with his weight — a battle he’s winning thanks to a more positive outlook and a commitment to himself.
While his humor bolstered him on the long haul back to health, his success has also required a good dose of self-love and willingness to make a change. When friends tried to offer him health advice in the past, he ignored them, he says. He had to find the internal motivation to start on the path toward health.
“唯一可以真正帮助您的人就是您自己。有一天，您会睁开眼睛，看着自己和生活，然后说：“我不希望事情再这样。”“每个人都必须撞墙，然后才能进行真正的改变。”
Written by Kim Westerman, a freelance travel, food, coffee and wine writer and a longtime writing teacher with an interest in mindfulness and contemplative studies. She lives with her wife and two young children in Berkeley, California.
