Health isn’t about luck — it’s about intentionality. But even if you’re doing and saying all the right things, you might not be any closer to your goals.

I know because I was there.

As a heart surgeon, I was very good at following the rules.

But I was still morbidly obese.

I followed the food pyramid to a T.

I exercised for the recommended amount of time each day.

I thought I was doing everything right. And yet, my heart was at its breaking point.

I knew there had to be something more. So in 2015, I started digging into what modern science had to say about maintaining metabolic health.

And it changed my life.

As of today, I’ve lost 100 pounds — and kept it off. Not only was it sustainable, it was simple to follow. You can do it too.

Here’s how you can stay off my operating table and achieve peak metabolic wellness.

1. Reframe your health as a system rather than a goal. You’ve heard it before, but it bears reminding: health isn’t a goalpost. It’s a journey.

This was key in my health journey. Once I reframed my thinking, I was able to overcome these hurdles between myself, my mindset, and the imaginary finish line in my head.

Try thinking of your journey as a gradual change rather than some short-term fad. Instead of saying, “I can’t have sugar anymore,” you can say, “I get to eat all these new foods that are better for my body.”

Push past the boundaries of a single, gigantic goal and supplement it with smaller, more attainable milestones.

You’ll be glad you did.

2. Make one sustainable change at a time. Going all-in on metabolic health is likely to be overwhelming. Worse, it will make you feel like quitting before you see tangible results.

Start small with your healthy changes. I recommend switching out your foods just a little at a time. Start with 15 minutes in the gym, then expand to 30 minutes, 45 minutes, or even an hour.

You owe it to yourself to stay in the game. If you want additional community or accountability, metabolic health coaches are a great place to start.

3. Daily movement. Thirty minutes per day is enough to make a difference.

And you don’t have to be a gym rat to start.

Move throughout the day. Start doing resistance exercises rather than cardio alone. And if you can’t stay consistent, at least stay focused and catch up when you can.

You can even start exercising today. Take a 15-minute walk around your home, neighborhood or apartment complex. You may not see or feel changes right away, but you’ll feel them soon enough.

4. Eat real whole food. Healthy diets don’t have to be smoothies and salads. Food that comes from the ground or is raised on the ground should have a place in your system of nutrition.

I’ve found the most success with whole, real foods like:

Animal proteins

Nuts and seeds

Fruits and vegetables

Whole, real food will kick your metabolism into hyperdrive. For me, it was one of the biggest keys to losing excess weight and keeping it off.

5. Sleep enough. Sleep plays more into metabolic health than we realize.

Too little, and you put a great deal of stress on the heart. Too much, and you might experience some troubling side effects.

I’m not going to give you a hard number to follow. Your body might be happy with 7 hours of rest, while others need 8 or 9. This is largely trial and error.

In either case, practice good sleep hygiene however you can. Try to reduce or limit electronic light for 30 minutes before you sleep. If you’re concerned about underlying factors like insomnia or sleep apnea, see a doctor. And most importantly, wait three hours after eating before you sleep.

6. Relieve stress. Stress is one of the biggest reasons why people end up on my operating table.

Being stressed increases your risk for heart disease. It also makes it harder to lose weight, maintain a healthy lifestyle, and get results from your diet and exercise regimes.

When you’re stressed, your body goes into fight-or-flight mode. Cortisol forces your metabolism to slow down, which means you don’t digest food as well and may store more fat.

In other words, you need to find ways to destress — today. This means taking up a new hobby, finding time to relax, and taking a much needed vacation.

And no: You’re not being lazy. Your body needs this to survive.

So seek stress relief accordingly.

7. Get a doctor who gets it. Your primary care provider needs to be partnered in your health goals — and not an obstacle to your success. They should be supportive of your journey toward metabolic wellness and interested in pushing you closer toward your goals.

Not all doctors see it that way. There’s a lot of outdated science and faulty conventional wisdom that hasn’t caught up to modern research. And if your doctor isn’t committed to your goals, you may want to look elsewhere.

I suggest shopping around for a new doc as you have time. You might also want to work with a metabolic health coach to get more personalized suggestions for your health goals.

You need to start today:

These seven steps are only the beginning. Truthfully, the principles are just a starting point for your upcoming journey. While they might seem daunting, they’re really not that complicated, and you’ll quickly find yourself in a groove.

If you want to make lasting changes to your metabolism, you have to start somewhere. The best time to start making improvements is today — not tomorrow.

So get serious. Move forward.

And for what it’s worth, I look forward to not seeing you on my operating table.

Philip Ovadia is a cardiothoracic surgeon and author of Stay off My Operating Table: A Heart Surgeon’s Metabolic Health Guide to Lose Weight, Prevent Disease, and Feel Your Best Every Day.

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