The Book Is Finished!

Time to Party!
Time to Party!

The manuscript is back from the editor and I have to admit to getting a little weepy after reading through the finished product. Thank you all for your donations, words of encouragement and patience with me through this process. As promised, I have attached a sneak peek of the foreword which was written by my good friend Dr. Kevin Ronneberg. Enjoy taking a peek behind the curtain!


For anyone who has contemplated making a meaningful change in their life, you know that behavior change, and in particular weight loss, doesn’t happen easily. In book 1 of 100 Small Steps, my friend Mr. Keith “Temple” Trotter invites the reader to join him as he breaks down his weight loss experience into digestible bites.

Keith and I were introduced to one another during my work as a medical director at a regional health plan where he was also employed. At the time, I was piloting an effort at our mutual employer in partnership with Activ8 Mobile to address health through a holistic mind-body-spirit approach addressing awareness, choice, and accountability in our daily life. The day we met, Keith shared his story of 100 Small Steps with me over lunch. He spoke of how he had figured out a way to address his own habits that were unhealthy and was well on his way to his current weight and healthier life. What he shared with me that day was nothing short of inspirational.

Throughout my 16-year career as a family physician I have been struck by how difficult it can be for individuals to change habits for the benefit of their health. Early on as a young physician, day after day, I would tell my patients with diabetes, obesity, and many other risk factors to change their lifestyle if they wished to avoid significant health problems down the road. As my practice evolved it became more and more apparent, not surprisingly in hindsight, that my approach was not overly successful. I had focused on managing chronic disease with appropriate prescription therapy yet wanted so badly to help through lifestyle intervention and removing physical barriers to activity. My own journey of learning how to support my patients in their lifestyle choices was humbling as I discovered how little I knew about making these difficult changes.

Since that time, I have walked alongside and supported many individuals in their efforts to change daily eating and activity habits as well as those who have successfully improved their health through weight loss, improved fitness, lowered blood pressure, and improved cholesterol results. While their personal gain—physically, emotionally, and financially—is important, the impact they are having on those around them, their children, and our healthcare system is not trivial. Poor behaviors in areas such as nutrition, physical activity, stress management, and tobacco use are contributing to chronic illnesses and unsustainable expenses in our healthcare system. These expenses ultimately are paid by you through higher health insurance premiums needed to cover the rising costs of caring for the population.

In the United States today, according to the Centers for Disease Control (CDC) 2009-10 data, 35.7 percent of adults were obese and 16.9 percent of children were obese. In addition, $149 billion spent on healthcare in 2008 were directly related to obesity. The average obese adult spent $1,429 dollars more on healthcare than their normal weight counterparts. The CDC reports:

  • More than one-third of all adults do not meet recommendations for aerobic physical activity based on the 2008 Physical Activity Guidelines for Americans, and 23 percent report no leisure-time physical activity at all in the preceding month.
  • In 2007, less than 22 percent of high school students and only 24 percent of adults reported eating five or more servings of fruits and vegetables per day.1

Many organizations currently are addressing and will continue to address population health by providing opportunities for you to improve your own health habits through policy changes, employer sponsored wellness programs and incentives, physician or provider-led services, among others. In spite of these efforts, finding your individual desire to make sustainable changes in your own life based on what is important to you will be more effective than any organizations efforts.

This is why 100 Small Steps is so important. The authentic nature of how Keith shared his experiences with me at lunch was inspiring and thought-provoking and shows up powerfully in this text. His approach is practical and shows how several simple, achievable actions lead to a significant impact on one’s health. Most important, he shares his “aha” moment that allowed him to get past his own self defenses that were “protecting” him from seeing his own state of health. Do you know of someone else who had their “aha” moment? Have you missed yours or intentionally avoided it like Keith did for so long?

Trotter focuses on some common themes through the book; “food is fuel” and should not be confused with something to sooth emotional distress, needing to be honest with oneself and identify where you are creating self-protective barriers to self-honesty. He shares real examples that are raw and authentic in discussing the role of social support and addressing mental health.

Those who are successful tend to have a few things in common: achieving awareness of their own condition or state, setting a clear goal, and choosing small sustainable steps that continue to move them towards achieving that goal.

As a result, I am excited and honored to be writing the foreword to Trotter’s book. Throughout my healthcare career I’ve seen the need as well as the difficulty in enacting behavior change: one on one during patient care, working at a health plan with a focus on employer health, and now with a large retail health care provider. My own career path has led me closer to where individuals make their daily decisions, where they buy their groceries, fitness equipment and apparel, prescription medication, as well as over-the-counter products for self-care.

While I hope to be able to provide better opportunities for individuals to engage in healthier behaviors, Trotter provides a reminder there is not an easy path or quick fix. There will continue to be convenient excuses available every day, and you can choose to shape the reality around you to be detrimental to or supportive of your own health. While you read 100 Small Steps, choose to identify and address your own habits that are limiting your short- and long-term health. Make your plan public, engage your support network, family, friends, and coworkers in holding you accountable.


Kevin Ronneberg, MD, Medical Director, Target Corporation