Like many physicians, Nick Yphantides regularly advises his patients to eat healthfully and get plenty of physical activity. Yphantides used to add: "Do what I say, not what I do."

That's because in 2001, this then 35-year-old doctor weighed -- hold onto your belt -- 467 pounds.

Not anymore.

Dr. Nick, as his patients call him, has whittled himself down to 220 pounds, a much healthier weight for his 6-2 frame. Better, he's achieved that weight loss without surgery, although he is the first to underscore that his unusual regimen -- a combination of attending baseball games and using liquid protein diets during a one-year sabbatical from his professional life -- is not appropriate for most. (More on that below.)

Yphantides planned his weight loss odyssey to last a year, beginning April 1, 2001. "I didn't lose the significance of April Fool's Day," he said. "I was a fool for getting to where I was and would have been a fool not to do something about it. But I would have been a monumental fool to put my career and my finances on the line. So failure was really never an option for me."

Like many, Yphantides watched the weight creep on through the years. "The San Diego media used to call me the big man with the huge heart," said Yphantides, a physician to the medically uninsured and former executive director of the Escondido Community Health Center in Southern California. "I even incorporated this idea into my political slogan: Big problems need big solutions."

But all that extra weight was taking a toll. Yphantides, a testicular cancer survivor, found himself at age 35 with borderline-high blood cholesterol and blood pressure. He teetered on the brink of diabetes. He experienced sleep apnea -- brief periods of stopping breathing during the night -- and the beginnings of pulmonary hypertension, a chronic and potentially fatal condition. Plus, his knees and ankles were so arthritic that they could barely support his weight, making it difficult to get out of bed in the morning.

So after a huge "last meal" at Ruth's Chris Steak House with his father and two brothers -- who were overweight but not obese -- Yphantides put himself on an 800-calorie-per-day liquid diet. He notes that this kind of regimen is only for very severely obese people who are under close medical supervision.

To distract himself from the diet and deprivation, Yphantides then set off on a year-long trip in a converted van, dubbed the U.S.S. Spirit of Reduction, to watch every Major League Baseball team play and to visit all 50 states. Baseball and travel distracted him from hunger pangs -- and provided rewards for his new habits. Along the way, he also had regular physical exams, including blood tests to monitor his progress. A friend gave him a one-year membership to the YMCA that could be used at any facility in the country.

By the spring of 2002, Yphantides had watched 109 Major League Baseball games and was half the man he was the year before, weighing in at 210 pounds. After reaching his goal, he gradually reintroduced food over four weeks, beginning first with soft vegetables.

Since then, he's added about 10 pounds back, but keeps his weight steady at 220. He doesn't count calories, but he does limit portion sizes. He consumes a modified low-carbohydrate diet rich in fruit and vegetables, low-fat protein and foods that are as unprocessed as possible.

He's returned to a modified work schedule that allows him to exercise a couple of hours daily. And he found love: He got married in May. The couple is expecting their first child.

As both a physician and a former extremely obese person, Yphantides says he is uniquely qualified to provide counsel on the challenges of successful weight loss. He has put his thoughts into a new book: "My Big Fat Greek Diet" (Nelson, 2004). "I'd prefer to have called it my 'Big Fat Greek Miracle.' But my publisher won out."

Here's what Dr. Nick learned:

Set new priorities. Yphantides walked away from a medical practice and refinanced his house to pay the bills for the year he stopped working. Beside his loss of income, he figures he spent $50,000 on health insurance, medical school loan repayments and other necessary costs. "I realize that not everyone is in a position to do something as drastically as I did," he said, but notes that others can find plenty of less extreme ways to redesign their lifestyle.

Find ways to be accountable. An elected local official in Escondido, Calif., Yphantides went public with his plan in a local newspaper so that he couldn't back out. Others, he said, can announce their intentions to friends, family or colleagues. Or join groups, such as TOPS, Food Addicts, Overeaters Anonymous or Weight Watchers, where regular attendance or weigh-ins help to create accountability.

Fill up with activities, not food. Baseball -- his passion -- was Yphantides's diversion. "The notion of distraction while experiencing [food] deprivation was a very, very powerful combination for me," he said.

Examine why you overeat. "Loneliness, boredom and anxiety were the reasons I ate," he said. "The busier life got, the more stressed, the more pressure I had, the more I resorted to food." During his year of weight loss and reflection, Yphantides realized that he didn't need food to be happy. "Food is not Valium on a plate, which is how so many of us treat it," he said. "The key to losing weight is having the motivation and getting to the point of realization is that this is a matter of life and death. . . . I had to come to the realization that this is a slow, perhaps unintentional form of suicide."

Overcome denial. Yphantides had avoided seeking to learn his true weight for years, which was one way to avoid the problem of his growing girth. He simply assumed that he weighed about 350 pounds -- the peak weight on his scale at home -- and was shocked to learn on April 1, 2001, that he weighed 467 pounds. "It humbled me to tears and gave me an even greater sense of resolve," he said. "But it helped dial me in [to the process.]"

Find new ways to stay motivated. "Being healthy for me is a deliberate act of love for the people in my life that I care about the most," Yphantides said.

*

Share Your Tips or ask questions about healthy nutrition and activity when Sally Squires hosts the Lean Plate Club online chat, from 1 p.m. to 2 p.m. today, on www.washingtonpost.com. Can't join live? E-mail leanplateclub@washpost.com anytime.

New To The Club? The Lean Plate Club is devoted to healthful eating and boosting activity. To learn more, and subscribe to our free e-newsletter, visit www.washingtonpost.com/leanplateclub.

Physician Nick Yphantides, shown at the beginning of his weight-loss odyssey (467 pounds) and one year later, when he weighed 220 pounds.