This month's “Size-Up” might more aptly be headed “Size-Down.” David “Dewey” Atkocaitis, EMT-P, joined the River Grove (Ill.) Fire Department eight years ago as a firefighter-paramedic and rose through the ranks, first to lieutenant, then to assistant chief, then to deputy chief, the slot he holds today. That achievement notwithstanding, however, Atkocaits addressed an even greater issue along the way: his weight.

“I've always been big,” he says. “Everyone in my family was big. As a kid in sixth grade, I weighed 185 pounds. I've always struggled with my weight. Over the years, I've tried everything from Weight Watchers to Optifast to some medically supervised diets; with all of them, I'd lose some weight initially, but as soon as the program was over, I'd put it back on and then some.”

What was your peak weight with the department?

I weighed a lot when I joined the department, but once I made the move from the line to a desk, even though I was still active, I could see myself gaining even more weight. By March 2003, I weighed 537 pounds.

Didn't that much weight affect you on the job?

Even at my heaviest, I was still on the fireground as an active firefighter. I had always been able to overcome the obstacle of my weight and adapt.… Someone would always help me find a larger set of gear, and everyone was always willing to help me adapt equipment.

But then one day I was looking for a larger harness, and the representative from the harness company made a comment or two about them not having anything that would be able to fit me, and it kind of set me back. It was the first time I really couldn't find something that would fit. Shortly thereafter, we had a fire where I had to go up a ladder, and the pain in my knees as I climbed that ladder was absolutely killing me. Those things were real eye-openers. I knew I had to do something.

My doctors had recommended gastric bypass surgery in the past, but for a long time I didn't think it was for me. Then a friend told me about a new procedure, the duodenal switch. It's more drastic than traditional bypass surgery, but the long-term benefits seemed worth it. The two key factors of the procedure are reduction and malabsorbtion. They surgically decrease the size of the stomach so you reduce your food intake and reroute the digestive track to curtail the absorption of that reduced intake.

I had the surgery done in March 2003, and a month later I was back in turnout gear. By June I had dropped 140 pounds. By September, I had lost 205 pounds.

Today you weigh 284 — that's 253 pounds less than your pre-surgery weigh-in. How do you feel, and what have been your milestones?

I look at it as a rebirth. After my surgery, I set goals and I challenged myself. As the weight came off, I realized that all those years that I had been trying to “work around” my weight and adapt situations to my weight, I had been kidding myself. I really had been working against myself. Now I follow a workout program. I eat better. And I continue to challenge myself. I competed in my first indoor triathlon in January 2005, and since then I've competed in four indoor triathlons and one outdoor triathlon. Not only does what I've done make me more physically capable on the fireground, but I get the satisfaction of my performance in these competitions.

Would you do it again?

Absolutely. But if someone is contemplating undergoing surgery like this, they should all the research they can, and know it isn't some kind of cure-all. You have to be willing to embrace it, and commit to a lifestyle change. Otherwise, it's going to be a failure, and I've seen that too often.

What thoughts might you offer other chiefs about general physical fitness?

You have to recognize that if you go from an on-the-go pace, on-shift in the firehouse, to a role that has a lot of sitting behind a desk, it is important to take care of yourself. Meetings, training sessions and all the rest of it can eat up a lot of your day. Don't blow off potential “me” time as a lower priority. Do make the effort to eat healthy. Taking some time for fitness gives you a sense of fulfillment and a better mental outlook. Letting yourself go doesn't do anything for you, your family, or your station.