Ashley Herrick was just 12 years old and 100 pounds overweight when she - somewhat nervously - joined Weight Watchers for the first time.
That year of carefully planned school lunches was the start of nearly 20 years struggling with her weight, which at her heaviest reached 355 pounds.
Time after time, Ms. Herrick, now 32, would commit to counting calories and succeed in losing 30 or so pounds, only to lose her motivation. Doctor after doctor told her she had to get fit, but none offered any real guidance.
"They just said, 'You need to lose weight,' and it was like, 'Well, no kidding!'" said Ms. Herrick, a payroll and benefits administrator at Stellar Therapy Services in Brainerd.
Then a year-and-a-half ago, Ms. Herrick got a stern but caring warning that struck her deeply. Her gynecologist, Dr. Patricia McLelland, told her she had to lose weight and even offered to run a three-mile race with her when Ms. Herrick had built up the strength.
"She said, 'If you don't do this in five years, you're going to have diabetes,'" Ms. Herrick recalled. "She didn't sugarcoat anything. But she did it in a way that said, 'I care about you, I'll do whatever I can to help you and I want you to succeed.'"
Startled and moved, Ms. Herrick did the unthinkable: She started running.
"I would run one minute and I thought I was going to die," she said.
So embarrassed that she'd wait until 9 p.m. to run at the nearby track, Ms. Herrick worked up to running two minutes at a time. Then three.
Now, she can run 36 minutes, has lost 138 pounds and has run two races with her doctor beside her. Weighing in at 216 pounds, she aims to lose 50 more and maintain it for a lifetime.
"I've tried it 175,000 times, but this is the time I'm going to do it," she said.
In a society rife with cheap and plentiful junk food, and low on easy ways to exercise, a commitment to healthy living often takes more than sheer force of will, experts say.
An intellectual understanding that eating more calories than one expends equals weight gain doesn't mean much in real life, said Graham Brannan, clinical social worker at Memorial Hospital's Weight Management Center.
"Everybody knows how to lose weight. It's keeping it off for the long term and making that decision," he said.
Something must click internally for a true lifestyle change to take place, and that decision often involves overcoming years of shame, self-neglect and deeply entrenched habits, Mr. Brannan said.
Dr. McLelland, Ms. Herrick's gynecologist, said she often offers to run a race to help motivate an overweight patient, but few actually take her up on the offer.
"I think a lot of times with weight loss, you have to have somebody walk with you," she said.
And she's "absolutely so proud" that Ms. Herrick not only made the commitment, but has stuck with it.
"It has made not just my day but my year that she took the challenge and we've worked together."
MOMENT OF CLARITY
The decision to get fit is often precipitated by a medical crisis, a tough word from a doctor or a casual comment from a friend, or a glimpse at an unflattering photo that makes it impossible to deny reality any longer, Mr. Brannan said.
The decision to make a change also can hit someone like a bolt of lightning in a moment of clarity or self-reflection, he said.
For 60-year-old Beth Lambert, that epiphany came in May, when she was on the first cruise of her life and was struck by an unusual sense of freedom and self-worth. At 5 foot 1, she weighed 220 pounds, and the weight hurt her ankles and knees, giving her a severe limp and exacerbating her arthritis.
For most of her life, the Chattanooga resident has been a caregiver, working alternately as a social worker and nurse. She still comes home from work every day and wakes up every morning to care for her 86-year-old mother, who lives with her and is in a wheelchair, Ms. Lambert said.
But on the rare excursion with friends, Ms. Lambert said she felt the message that had been repeated for two years in her weight-loss support group finally come into focus.
"I am worth the time and the effort to make a change," she said. "I never thought of that, that it was OK for me to put so much effort on myself. I was always taking care of somebody else."
When she got home from the cruise, she signed up for a personal trainer at the Rush Fitness Complex and began to carve out time for her own body and pay attention to calorie counts.
Now Ms. Lambert said that, for the first time in years, she has a waistline. She can think more clearly, she has more energy and she barely walks with a limp now.
"I just am excited because this is it. I am changing my life for good," she said.
FITTING IT IN
For Timothy Hodge, 25, working the night shift at Shaw Industries from 11 p.m. to 7 a.m. left him with little time or energy for exercise in the daytime, and few options for nutritious eating after-hours.
After 10 p.m., "there's not much to choose from that's healthy. Wendy's, Taco Bell, McDonald's. You name it, I was probably there," he said.
A year ago, the Dalton resident weighed 318 pounds. As Mr. Hodge watched his mother taking medicines to control diabetes and hypertension, and thought of his uncle who died young from heart disease, he knew he wanted to be different.
He started walking on the treadmill at the Bradley Center for Wellness at Hamilton Medical Center, and began baking chickens and making big bowls of salads. He's lost 90 pounds.
"There are times when you're just like, 'This is too much,'" Mr. Hodge said. "With me, it was people seeing results that made me want to work harder and harder."
For 27-year-old Jennifer Kirby, the frustration at not being able to keep up with her outdoors-oriented friends hit a breaking point six months ago.
At 271 pounds and 5 foot 4, she had loaded on 130 pounds since high school. She felt tired and weak.
"I realized how many times I've let myself down in my life, and I just wanted to be proud of myself for something," she said.
She started eating small portions every four hours and began working out at the Bradley Wellness Center in Dalton. Six months later, she's lost 80 pounds.
"I may not have the best job, car or house, but I have a really good weight-loss record, and that makes me pretty proud of myself," she said.
Still 50 pounds shy of her goal weight, Ms. Herrick said she's gotten nothing but support from loved ones thrilled at how happy she is today.
"I've learned that there's nothing that I can't do. I've got a lot more to do, and it's definitely going to be a life-long (commitment)," she said. "But I have people that will remind me every day and support me every day."