When Susan Blech's doctor told her she could suffer a stroke just by walking across the street because she was obese, Blech knew she had to lose the weight before it killed her.
She had not always been overweight, but after turning to food as an emotional crutch in her early 30s, Blech was tipping the scales at a dangerous 468 pounds. Blech didn't like the idea of gastric bypass, which creates a smaller stomach and rearranges the small intestine through surgery and costs about $26,000.
"I felt it was a shortcut," Blech, 39, said. "I knew I had to make behavioral changes." But Blech's solution was almost as extreme as gastric bypass, and more than three times as expensive.
She sold her office supply business in New York City, relocated to Durham, N.C., the "Diet Capital of the World," and invested $70,000 into losing weight on the Rice Diet Program.
For Blech, the investment has paid off. In a year and four months, she lost 220 pounds and has 50 more to go before she reaches her goal weight of 200 pounds.
"You can always get a job," Blech said. "There are always jobs … but not if you're six feet under. To me, getting healthy was the best investment."
As the weight slowly crept onto Blech's body, she stopped eating around friends, couldn't fit into her car and at one point, could not walk. But she didn't realize how big she really was until she went out on a date. She thought she and her date had a wonderful time, but he called the next day to let her know that she was too big for him.
"That was pretty eye-opening to be rejected and really not realize why," Blech said. "You don't realize it because your life becomes smaller and smaller as you become larger and larger."
But the final motivation was the visit to her doctor, when she heard she could suffer a heart attack or a stroke just from crossing the street. It was a frightening moment for Blech, whose mother had died of a stroke when she was just 1 year old, and it convinced her to totally rearrange her life in order to get healthy.
"I was scared out of my mind to do what I did," Blech said. "I was terrified every single day. But you have to find the courage to put aside your fear."
Durham has been nicknamed the "Diet Capital of the World," with about 4,000 people traveling to the city each year to seek treatment in one of three major diet centers: the Rice Diet Program, the Duke Diet and Fitness Center, and the Structure House.
Blech opted for the Rice Diet Program, which was created by Walter Kempner in 1939 as a way to treat patients with severe hypertension. He later used it to treat people with diabetes, kidney disease and other health problems that are aggravated by obesity.
The diet includes low-fat, low-salt, high-carbohydrate foods and is combined with a regimented daily exercise routine.
In the first month Blech lost 40 pounds, and after 16 months, she dropped 220.
"It is an amazing, amazing program," Blech said.
Although she couldn't even walk when she was at her highest weight, today Blech works out six days a week, doing weights, pilates and cardio. Her social life is full, going out to see friends, and she is dating once again.
"It gave me my life back," Blech said. "After 10 years of isolation, I am out enjoying myself."
She's also changing careers. While working for the office supply company she sold, Blech is also substitute teaching and hopes to become a special education teacher. But for now, her primary focus is losing the weight and getting healthy.
Losing weight "is my job, for sure," Blech said. "It's a big part of my life."