The weight was out front, so to speak, like a constant companion, an extra person accompanying Greg Ray on his daily rounds.
The Type 2 diabetes, on the other hand, could be controlled by a pill.
Pop. Swallow. Nothing to think about.
But it was the diabetes that lingered there in the background like a nightmare that might appear at any time.
"I could live with the weight gain and the embarrassment," said the Ringgold, Ga., resident, who has lost 160 pounds following weight-loss surgery in March. "[The diabetes] was nothing to play with. That scared me into [the surgery]. Diabetes was the catalyst."
Two studies earlier this year showed that obesity surgery can reverse diabetes and keep it away for many years, possibly for good, according to a recent Associated Press story.
A new study, published recently in the New England Journal of Medicine, showed that such surgery might prevent or lower the incidence of diabetes.
Since Ray lost his weight, his diabetes has disappeared.
Before his surgery, even with the pill he took, his blood sugar level was around 200, the level diabetes is diagnosed. Today, he said, it is consistently 80, and he no longer has to take a pill.
Ray, 37, said he began to put on weight in his late 20s. Over the years, he said, no diet plan or exercise plan did the trick for him. He even tried walking to Subway to engage in a diet promoted by restaurant spokesman Jared Fogle, who had lost weight doing the same thing.
"You name it," he said, "I tried it."
Ray was in misery, said his mother-in-law Carolyn Phipps.
"What was terrible was the weight," he said. "Besides being an embarrassment, I'd go on vacation and [regulations at certain attraction would indicate] you can't do that with the kids because you're overweight."
Even walking "from here to there" became a chore.
Ultimately, Ray's weight ballooned to about 380. "I was fixing to start taking insulin," he said.
Initially, he said, he was scared of any kind of weight-loss surgery. But the more he read, the more convinced he became of his disease. When he was diagnosed with diabetes -- about a year before his surgery -- he learned that losing weight, and in turn sending his diabetes into permanent remission, might add 15 years to his life.
Phipps, who said her weight-control method was to "just shut your mouth," was still leery.
"I said, 'Please don't put yourself in that situation,'" she said.
But Ray, whose insurance company said it would cover the $16,000 surgery after he was diagnosed with diabetes, was ready. He chose gastric bypass surgery rather than lap band surgery because it "had been around longer" and would involve one procedure instead of two.
He even lost down to 365 pounds as part of the pre-surgery regimen.
Ray said there was "tons of" risks with the surgery, such as his stitches opening up or a hernia forming, and a number of things he's had to adjust to after the surgery.
One of those, he said, was going to 350-calorie meals. "Are you kidding me?" he said he asked the doctor beforehand, "that's not even a good start."
Yet, all in all, "it's been so unbelievably easy," Ray said.
The constant support from his surgeon, Dr. Jack Rutledge, and his staff was "wonderful" and "shocking -- that a doctor cares so much," he said.
"What's left of his stomach," Ray said, "is really small. I no longer have a stomach. I have a pouch."
As such, he said, there is a learning curve on what he can eat and how much he can eat. If he eats too much, he said, he will get sick.
Ray said he knows people have gained weight back after such surgery but finds it hard to believe.
"You'd have to eat all day," he said, "but I don't see how it's possible."
Ray, who is 6-foot-1, now weighs 202 pounds and would like to weigh between 185 and 188 pounds.
"It's a relief for me and my family," he said. "[With the surgery,] you can add years to your life. How could I not do that for my kids?"