In the beginning it wasn't easy for Don Avila.
He was a binge or two away from life in a motorized scooter. Even walking had become tough. The 400-pound Mercedian faced a choice:
Eat or change.
Avila set out to become half the man he used to be. His journey started with better food choices: small meals every two hours. Meals made with healthier options. Water, lots of it. And walking around the house a little bit more.
Changes didn't happen fast, but he stuck to the plan, mostly. "Someone told me, as long as you're doing 85 percent good a day and then you do that for a week, then a month, you're doing awesome. And you are going to lose the weight. You don't have to be perfect, but you've just got to keep working," he said.
And it's working. Avila is down to 249 pounds, and the weight is still coming off. He's active, played in a tennis tournament for the first time a few weeks ago and has been crowned "Biggest Loser" three times at a Merced College community fitness class.
Unlike many forms of disease, obesity is one health issue that can't be hidden. It affects all parts of your life. You become the target of taunts and scorn from utter strangers. Studies have found a link between obesity and depression, making it psychologically daunting for sufferers to get fit.
More than 64 percent of U.S. adults are overweight, and 21 percent of California adults are obese, according to a 2009 report to the California Legislature.
When you add in those who are overweight -- a category between healthy and obese -- 56 percent of California's 18- to 64-year-olds weigh more than they should. The number is even higher in the Valley: 65 percent.
Some 1.8 million residents statewide suffer from diabetes, which is commonly linked to excess weight.
In Merced County, 22 out of every 10,000 adults over 40 died from a diabetes-related cause from 1998 to 2006, according to data from the Central Valley Health Policy Institute.
The institute will release a report this fall that analyzes how many years of productive life are lost in the Valley, linked to your zip code. The report focuses on available data from 1998-2008.
In preliminary findings, the institute reported between 17 and 74 years lost for every 1,000 people. More productive years of life were lost in the Central Valley because of environmental and health issues than in California as a whole.
Poverty was the main determinant for years of "productive life years lost" in the study.
"It is evident that health and quality of life are linked to where people live. Broad inequities are associated with accumulated challenges in poverty, housing and transportation, air quality, access to jobs, schools, and recreation," Dr. John Capitman, executive director of the Central Valley Health Policy Institute and lead author of the report, said in a news release last month.
A 2009 report by the state's Task Force on Diabetes and Obesity recommended that "because the population shifts in the prevalence of overweight (people) and diabetes may be explained more by our physical, social and economic environment than by our genes and personal preferences, significant shifts in our public sectors are required to truly reverse the trends of the past decades."
In another recent study, the Robert Wood Johnson Foundation found that better education is related to better health. Adults with as little as one year of higher education were more likely to have better jobs and better opportunities to live healthier.
In Merced County, 40 percent of adult residents have some exposure to higher education, but degree attainment is much lower. If 61 percent of county residents enrolled in college -- the state's average -- 55 deaths could be averted each year, according to a simulation created by the foundation.
The University of California founded a campus in Merced to address educational inequity in the Valley. Next year the campus will enroll its first students in a minor course of study that will examine health disparities. The campus' professors and graduate students will research Valley-centric issues at the "Center of Excellence for the Study of Health Disparities in Rural and Ethnic Underserved Populations."
The UC Merced agenda will join other Valley programs with similar concerns: the Central Valley Chronic Disease Partnership, the Central California Regional Obesity Prevention Program and the Central Valley Health and Nutrition Collaborative.
The organizations have launched several programs to tackle health issues headlong in Merced. And they're making progress:
Healthy South Merced was created two years ago when Golden Valley Health Centers received a grant from the Tides Foundation. The program brings together residents and officials from the health center, city, county and schools. The goal is to find community-driven projects to increase the overall well-being of residents south of Highway 99.
An action plan created by the group of concerned residents underscored the need for specific services in the area: curb cuts so moms could push strollers along neighborhood sidewalks, a better system for crossing Highway 59 to get to the flea market and a grocery store in the area were all on the list. Each of the three items is already done, or in the works.
The city of Merced is planning to rebuild Flanagan Park, an abandoned stretch of land north of Cone Avenue. The city is using $250,000 in state and federal funding for the project, along with a $200,000 grant from The Stewardship Council. Alexander Hall, director of Parks and Community Services, said he first learned of the grant from Claudia Corchado, a program coordinator at the Central California Regional Obesity Prevention Program.
The new park will feature walkways, a playground and baseball, basketball and volleyball facilities, city spokesman Mike Conway said.
The year-old Building Healthy Communities project is funded through The California Endowment, which grants money to needy communities. Up to $9 million will be spent over the next three years to test ideas for creating healthier communities in South Merced, Planada, Franklin-Beachwood and Le Grand. Though the eventual programs are still in the planning stages, the project's organizers have already identified the top three priorities local residents would like to see changed about their communities -- reduce violence, create youth programs and stimulate economic development.
Don Avila wants to make a difference as well.
He's trying to carve out a career path to help others overcome food addiction, as he describes his lifelong affliction. "I was addicted to food. At my biggest, after a plate of food, those endorphins just kick off," Avila recalled. "I'd think, 'Why am I feeling good? Why is this giving me pleasure?' There really wasn't much joy in my life then. Basically, that was it -- eating."
He might be on to something with his career goal -- and ahead of the curve.
In February, the American Psychiatric Association considered the inclusion of "Binge Eating Disorder" as a new diagnosis in the DSM-5, the manual psychiatrists use to identify mental disorders. The addition didn't make it into the new edition of the book, but did spark serious discussion about over- and binge eating.
Even before he graduates, Avila wants to share his story to encourage others to become healthier. "I'd like to think that I could touch someone that's like me. That this will hit them and spur them on," Avila said. "Wherever you can get the inspiration from, use it."
His last words of advice: put in fewer calories, not more. And have fun.
Reporter Danielle E. Gaines can be reached at (209) 385-2477 or firstname.lastname@example.org.