TeleMOVE!? Abso-Positively!

In April, 2007, Peggy Cleveland was at a personal-and physical-crossroads. Facing not only the dissolution of a difficult marriage and a host of physical ailments, Peggy was doing it all while supporting 300 pounds on her petite five-foot two-inch frame. A two-year Veteran as a Navy engineman, Peggy was used to-and even thrived on-challenges. On July 4 that year, an innocent, casual, and caring challenge by her future new husband was all it took to spark a powderkeg of change in Peggy's life.

Abso-Positively!
"I had tried just about everything to lose weight," Peggy explains now. "But when Randy challenged me to fit into a pair of his jeans by Christmas time, I said, 'Abso-positively!' He had no idea what he'd done!"

What Randy saw as a passing comment, Peggy saw as the challenge she needed to start her weight-loss journey. With crystal clear determination, Peggy's already strenuous work running errands across a large car dealership took on a whole new level of importance. "I had more fire in my step," she laughs now. An ex-competitive swimmer and "natural fish," she also returned to the pool, starting out with just a couple laps a day. "They were baby steps," she admitted, "but it felt great getting back into the water."

Additionally, Peggy combined her increased physical activity with a commitment to better eating patterns, paying careful attention to when, why, and how much she ate at any given time. She made it a priority to monitor sugar and carbohydrate intake and to eat higher proportions of protein.

That Christmas morning, Peggy marched confidently into Randy's closet, stepped into a pair of his jeans, and easily zipped them up. In just 6 months, Peggy dropped an incredible 130 pounds. "That first 130 just came right off," she explained, clearly a testiment to her commitment, motivation, and what you get when you challenge a "bull-headed red-head," as she happily describes herself.

Peggy maintained her weight at 170 pounds until two sets of surgeries in one year pushed her back up to nearly 190 pounds. While the surgeries were successful, moving back toward her goal weight wasn't. In December, 2010, Peggy recognized that she needed more help and guidance if she were to reach her weight-loss goals-and she asked for it. With her primary care provider's referral, she attended the MOVE!^® weight management intake class.

Once enrolled, Peggy eagerly took advantage of every MOVE!^® program offered at the San Diego VA. She met one-on-one with the dietitian, faithfully completed food and activity logs, and used the VA-provided pedometer every day. However, freshly out of surgery, the one-hour drive to her local VA just wasn't feasible. That's when she learned about the new TeleMOVE! 90-day program that provides individualized weight self-management support at home and at times convenient to her. She signed up that day.

TeleMOVE!
Kathy Ober, FNP, MS, PhD, VISN 22 MOVE!^® Coordinator describes TeleMOVE! as an additional attempt within the greater MOVE!^® program to provide one more level of customized support to Veterans. "We try to offer a variety of services, and TeleMOVE! in particular meets the needs of many Veterans who, due to any number of constraints, cannot get to the VA medical center during business hours." And she points out that TeleMOVE! popularity is on the rise. "Our increasingly young and active Veteran population can now fit the weight management education and support they need into their own busy schedules-not ours."

Specifically, TeleMOVE! participants weigh in regularly through an electronic scale attached to a messaging device and report their behavioral goal, weight loss, dietary change, and physical activity progress. Care coordiantors help patients solve problems and reset goals, as needed, while also providing encouragement and support.

For Peggy, the communications, tips, and guidance she received from her TeleMOVE! Care Coordinator, combined with the daily interactions of the TeleMOVE! home-messaging devices, provided the perfect combination of support. Particularly helpful to her were the scale and messaging device, "so I didn't have to check in at the hospital, but could do the program from my house."

As Peggy explains, "MOVE!^® gives me the structure, discipline, and consistency I need. They don't force you to do anything, but give you the tools to do everything-and you need to be mentally ready to use those tools! Every time I got stuck or needed encouragement, I could pick up the phone, and Julie and I together would figure out solutions. One important concept she worked me through is accepting that you plateau at different steps and that it's not all going to be downhill. I can't beat myself up or be hard on myself. I weigh myself every morning and mark it on my calendar. It's gratifying, but also a kick in the butt."

Peggy's care coordinator Julie Wiese is also quick to elaborate on Peggy's determination and success. "Peggy is an incredibly motivated and determined individual, and one of the smartest things she did was ask for help when she needed it. That determination helped her maintain a two pound-per-week weight loss rate for nearly every week of her six-month participation in TeleMOVE!, clearly making her health a priority."

Support
In addition to the support from MOVE!^®, her doctor, and Julie, Peggy accepted the unwavering support of her new hubby Randy, her son, friends, and even that of her manager at work. "Let me get this right," he said to her the morning she asked for a schedule change. "You want to come in earlier, so that you can have longer lunch periods-to exercise?!" "Abso-positively!" replied Peggy, and so it was.

Today
Now, after two series of the TeleMOVE! program and proudly sporting her goal weight of 135 pounds (plus or minus two pounds), Peggy eagerly lists the things she can do now that she wouldn't have attempted before. She swims 40 laps in 45 minutes-daily. She walks four miles in an hour. "I can walk up a flight of stairs without running out of breath, I'm no longer on blood pressure medication, and my medical conditions have either disappeared or gone into dormancy. I'm healthier! I can do my job better and even have the energy to take five-mile bike rides with my husband."

In fact, when she was recently asked to participate in the swimming portion of an upcoming triathlon relay, she responded with her characteristic optimism: "Abso-positively!" "I'm certain I'd have never received that invitation while still at 300 pounds."

What advice would Peggy give to others working to lose weight? "Persistency, persistency, persistency," she said, "Hands down-stick with it. It's not an overnight thing, but a day-by-day challenge. Anything worth having is worth working for; if you're not ready to make it work, it's not going to work."

Abso-positively.

BEFORE	AFTER