My dentist told me they couldn't remove a tooth because of my weight. It was the wake-up call I needed to lose 100 pounds.

• Carol Evans' oral surgeon told her she was too heavy to have her tooth removed under anesthetic.
• It was the wake-up call she needed to lose 100 pounds through diet and exercise.

This as-told-to essay is based on a conversation with Carol Evans, 56, of Birmingham, UK. It has been edited for length and clarity.

My husband, John, sat in the hospital waiting room waiting to drive me home after I'd had dental surgery under sedation.

He looked confused when I returned to the reception so soon after meeting with the oral surgeon before my tooth extraction. "What happened?" he asked.

I was so mortified I could barely answer. The assistant had recorded my height and weight before the procedure. The doctor told me that my BMI — at 5ft 5inches tall, I weighed 231 pounds — was too high for me to go under the anesthetic safely.

"You really need to lose 14 to 20 pounds," she said. "Please make another appointment for three months' time after you've lost weight."

I'm a successful woman who runs my own business growth strategy company. But at that moment in May 2019, I felt totally ashamed.

While it was upsetting and embarrassing, I knew I had to do something about it.

I followed the surgeon's advice and rescheduled the surgery for September. Then I sprung into action, improving my health and losing weight through sensible diet and exercise.

My weight had slowly crept up on me over the years. I'd worked a high-pressure job as the director of a hospital and was on call 24/7. I actually needed my tooth removed due to grinding my teeth at night because of the stress.

It was a wake-up call

Food was a comfort. I'd snack on anything crunchy or chewy, like cookies and bars of chocolate. As for meals, my plate would be laden with pasta and potatoes. Another weakness was bread.

I didn't exercise, apart from walking the dogs. I told myself that it didn't matter because I could hide my size 18 body behind a computer all day.

But after my wake-up call, I followed Jillian Michaels' 30-Day Shred workout plan. I walked more, reduced calories, and stopped snacking.

I lost around 16 pounds ahead of the surgery that September. But, even then, I felt nervous about the sedation. They were very nice, but I could hear the medical team shouting, "Breathe, Carol, breathe," when I came out of the anesthetic. It sounded urgent — as if they were concerned that I couldn't do it on my own.

The fear helped me stick to my guns. I doubled down on my efforts to lose weight. I did intermittent fasting — only eating between 10 a.m. and 5 p.m. — and dropped all carbohydrates four days a week.

After a while, I found that two high-protein, high-fat meals kept me full all day. I'd make dishes such as chicken thighs with sauteed vegetables and cream. They were delicious and satisfying.

I exercised by taking 10,000 steps a day and going to the gym two to four times a week, mostly for strength training.

People started noticing and encouraging me. I became more enthusiastic as the weight came off. To my delight, I went past a size 12 and a size 8 and settled at a size 6. By mid-September 2021, a year after the surgery, I'd lost 100 pounds.

It felt fantastic. I no longer had to take medication for reflux esophagitis, which I'd had on repeat prescription for many years.

I regained some of the weight and lost it again

I kept up the regimen for nearly two years. Then, in July 2023, I spent five weeks on a solo vacation in southern France. I'd had a stressful few months at work, got complacent, and found it hard to resist the food.

Soon, I started eating an excess of things like French bread and custard slices, and my old habits came back. In March this year, I was beginning to burst out of size 8. I'd put on over 20 pounds. "Hold on a sec, Carol," I thought. "It's time to get back to the plan."

I now weigh 138 pounds — to be honest, when I see photos, I think my face looked a bit drawn when I was eight pounds lighter — and my body feels just right. I'm at goal, comfortable in my skin.

I'm not a killjoy when it comes to living my life. I still go out for dinner and drink cocktails. I eat cake. I don't deny myself anything, but I'm much more mindful about taking care of myself.

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