It was a press photograph, taken from a low, unflattering angle while he was addressing a nursing conference, that convinced Tony O’Brien things had to change.
The picture from 2012 shows a jowly middle-aged man, his facial features almost obscured behind rolls of flesh. The man’s bulk is hidden under a conventional business suit but there is no mistaking he is, in his own words, significantly obese.
Nothing unusual there in today's society, you might say, except this man had just been appointed as director general of the Health Service Executive.
“The photo was a bit of a shock. I’d have felt very self-conscious continuing that way as head of the health service.”
What he calls “my wake-up call” propelled O’Brien on a five-year journey in search of better health and fitness. A visit to the doctor told him what he already knew – he was morbidly obese and had high blood pressure. Dietary changes kick-started his weight loss and, later, a daily fitness regime helped to accelerate it.
Today, without following any particular diet, O’Brien has lost more than one-quarter of his body weight – up to 35kg. He feels healthier and more energetic, even if he believes his personal weight journey is still “a work in progress”.
“I was at a crossroads,” the 54-year-old recalls. “I was either going to end up with high blood pressure, going on statins and having a lifestyle conditioned by that. Or I was going to take a different turn.”
He says he wanted to “walk the walk as well as talking the talk” as a leader in health, but there were other, more personal reasons. His father had died at 62. “You want to be there for your loved ones. I’m a husband, a father, a son. I want to be around for a while, to outlive my father.”
He had to hasten slowly, due to an underlying health condition. O’Brien has late onset myasthenia gravis, an auto-immune condition that can make exercising difficult due to muscle weakness. “It meant an already sedentary lifestyle became even more sedentary.”
Slipping into obesity
Like many people, he hadn’t realised he was slipping into obesity. “I was slimmer, fitter and a gym-goer in my 30s. I could run up a hill and beat teenagers. Then, in my 40s, I gained a bit of weight. Gradually, it creeps up on you.”
It was just a “personal notion”, he says, to give up bread and potatoes. “One day I said to my wife ‘I’m not in a good place, health-wise. I’m just going to give them up and see what that does for me.”
“When you’re in this job, you’re bouncing from meeting to meeting. Wherever you go, everyone thinks they have to feed you. Usually there’s a tray of sandwiches, or a basket of scones. I just stopped eating those things.”
He shed over 5kg quickly and that weight loss allowed him start an exercise programme to consolidate his gains. “I started to go to the gym but not to do stupid stuff. I wanted to do a tailored programme that I could complete in 45 minutes, four or five times a week.”
“That’s important to me as I can control the start of my day but I can’t predict the end. Also, with an underlying condition, you can’t predict how tired you might be later in the day.”
He hasn’t eaten bread since June 2012 and says he feels “way better” as a result. “I’ve always loved hot toast with jam, but modern bread is rubbish. It’s full of things like preservatives that bread didn’t use to have.”
He found he was eating “more food, but better food”, especially salads, vegetables and cold meats. “I was very conscious not to replace potatoes with copious amounts of rice and pasta.”
Building on this foundation, and now attending early-morning gym sessions almost daily, he started shedding the pounds dramatically.
About a year ago, his weight loss became evident and tongues started wagging. “The initial reaction was ‘are you not well? There must be something wrong, maybe the job is getting to you’?”
In fact, the opposite was true, but the experience prompted O’Brien to be more open about his regime. He is now about fives sizes smaller in a suit than he was five years ago. “As I’ve gone down in size, I’ve consistently given away clothes that no longer fit. I’ve had to adopt a policy of buying relatively cheap clothes because they don’t last me that long.”
If he does gain a few pounds, he takes corrective action by cutting out all desserts for a few weeks
O’Brien did not suggest this interview, and he is anxious that it doesn’t look like self-promotion. “I’m not casting judgment on anyone. Everyone has their own reason why they are the weight they are.
“Some people are blessed with metabolism that allows them to eat a horse and never be overweight. Others are unfortunate in their circumstances, or have eating disorders for which they need assistance.”
Neither does he want to seem fanatical about dieting or exercise. “I don’t want to appear like a zealot. Everybody is different.”
Willpower
“Lots of people ask me how do you have the willpower to do it and I tell them it’s the reverse. If I had real willpower, I’d have cut down on [some] foods and continued to eat them. For me, it’s easier to just not eat some food groups.”
“But everything I’ve done has made me feel better – cutting out different food groups, not feeling bloated. There is simply no incentive to go back.”
Weight loss doesn’t always progress “in a straight line”, he stresses. “At any time you can go up again in weight and you have to accept that. It happens. The year and your life have their own patterns – Christmas, a wedding – you can’t be obsessive.”
If he does gain a few pounds, he takes corrective action by, for example, cutting out all desserts for a few weeks.
Still, he believes anyone can tackle their weight issues by identifying the most influential components of lifestyle and diet, and then making changes. “It’s all too easy to be defeated by the mountain, but those two changes could lead to two other things. It would have been all too easy for me to say when I weighed 120kg ‘this is a mountain and I’ll just not bother’.”
“Recognise it takes time, and don’t beat yourself up. Ask, what is it you are eating most of? Are you physically active and, if not, what exercise might be suitable for you?”
One of the images that drives him on, he says, is that of six 5kg bags of potatoes. “I tried carrying six of them around and it ain’t easy – but that’s the weight I used to carry around in body fat.”
Tony O’Brien’s top tips for weight loss
1. Start from where you are by doing one or two things with your diet likely to give you the best return.
2. Stick to mealtimes, but if you need to snack try things such as raw carrots or tomatoes.
3. Take advice on how to begin exercising safely in a way that you can build into a routine that suits your life – don’t focus on things you can’t sustain.
4. Don’t deny yourself some treats but make it part of meals such as dessert on Sunday or whatever works for you.
5. Track your progress but be patient and recognise there may be occasional setbacks. Don’t give up.
