I was doing the same thing, over and over, and expecting different results. I was tired of living in that insanity.
— Dan McAfee · Rivas Patient
Background
“I was sick and tired of being sick and tired.”
I’m Dan. I work at an apartment complex in Frederick, I have five kids, and I’m on my feet pretty much constantly. On a normal workday, I’d hit fifteen to seventeen thousand steps before I got home. By any measure, I was an active guy.
But the weight kept coming.
Every morning I’d walk up to the office, and there’s this big glass mirror right at the entrance. Every single day, I’d catch my reflection. And I watched myself get bigger, and bigger, and bigger.
I had to start looking at 2XL stuff, shirts and sweatshirts. And I thought to myself, I never thought I would be this big. I’m not happy with how I look.
— Dan
Here’s the part that frustrated me most. I’d never tried weight loss treatments before, just the typical diet and exercise. I just couldn’t hang with it. With five kids in the house, you’ve got chicken nuggets and hot dogs and macaroni and cheese sitting around constantly. You’ve got five minutes to eat before you have to take someone to dance class or violin or somewhere. You scarf something down, you run.
It was, in a phrase: I was doing the same thing, over and over again, expecting different results. That’s the definition of insanity. And I was tired of living in that insanity.
The Research
He researched it the way a skeptic researches anything.
I’m the kind of person who, if a medication has a side effect listed, I’m going to get it. Doesn’t matter if it’s a Tylenol. If there’s a one percent chance of nausea, I’m in that one percent. So when I started looking into this, I researched everything I could find.
There’s a woman who lives at the apartment complex where I work, and she’d lost a lot of weight. So I asked her. My sister-in-law is a PA and she’d been on a GLP-1 for about a year with great results. So I asked her too. They both pointed me toward GLP-1 medications.
From there I did my own digging. Compared the options. Read about side effect profiles. Picked the option with the cleanest track record. Then I did a simple Google search and found Rivas.
I procrastinated. I made every excuse not to go. Whether it was money, or this, or that. And then I just decided: it’s time. I need to change who I am. I can’t keep going like this.
— Dan
That decision is the part nobody talks about. The actual moment when you stop researching and pick up the phone.
Walking In
“I didn’t feel judged. That was a huge thing for me.”
The moment I walked through the door of the Frederick clinic, everyone was warm and welcoming. I was my own worst critic. Every time I looked in the mirror, I judged myself. So walking into that office and feeling none of that judgment back at me, that mattered.
Then I sat down with the physician. I had a lot of questions. She answered every single one of them. And here’s the part I wasn’t expecting: she explained the science behind the medication in language I could actually understand.
My provider explained the science behind it in layman’s terms. I’m not a scientist. I’m not a doctor. She explained it to me in a way I could understand. Other physicians I’d talked to about weight management, they’d just sit me down with a nutritionist and talk about portion control and calorie counting.
— Dan
That comparison stuck with me. Compared to the medicine and knowledge we have today, the old portion-control-and-calorie-counting approach felt like the stone age. Like we were trying to fix a modern problem with an ancient tool.
The first visit itself was a ten-minute process. Sometimes I do my appointments over my lunch break now. They check on me, weigh me, take my blood pressure, talk through how I’m doing, and that’s it. See you next week.
Dialing It In
The side effect he was sure he’d get? Resolved in one visit.
Like I said, I’m wired to expect side effects. So when I started getting some nausea early on, I almost just accepted it as the cost of doing business. Instead, I told my provider at my next weekly visit. They dialed back the dose. I’ve been fine ever since.
That’s the part I want people to hear. Because when you’re getting medication from somewhere that doesn’t have weekly visits, where you can’t actually sit with a real person and tell them what’s going on, you don’t have that option. You either grit through it or you quit.
That’s the important thing about going to a clinic that’s weekly. You can actually tell them what’s happening, and they can dial it back. You sit and talk with a person.
— Dan
I’m now on every-other-week dosing as part of a transition phase. The first time I went two full weeks between visits, I was nervous I’d lose progress. I lost three more pounds. I’m down to two hundred from two seventy-three. And I’m honestly past my goal. I went in thinking two-ten or two-fifteen would be the dream. Now I’m down to two hundred and I’m tired of buying new clothes.
The Results
The numbers speak for themselves:
From 273 pounds down to 200. That’s 73 pounds gone, twelve pant sizes lost, and an entire decade of blood pressure medication left behind.
He’d been on blood pressure medication for ten years. Off it now. He can walk a flight of stairs without getting winded. The food noise that used to fill his head went silent. He gets through workdays at the apartment complex with energy left over, and gets home wanting to actually engage with his five kids, not collapse on the couch.
He’s now in maintenance, on every-other-week dosing. Weekly visits at the Frederick clinic took ten minutes and often happened over his lunch break. The most surprising part? He didn’t change his diet. He didn’t add a new exercise program. With five kids and a job on his feet, neither was realistic. He just changed what was missing.
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Life Now
“This is the second life-changing thing I’ve ever done.”
Years ago, back in 2009 or 2010, I got LASIK. That was the first time a medical decision genuinely changed my life. I no longer had to wear glasses. It was that significant.
This is the second.
I’m completely off blood pressure medication. I’d been taking it for ten years. I can walk up a flight of stairs without getting winded. When I get home from work, I’m not lethargic anymore. I have five kids, and now we go on hikes. We go for walks. We run around the backyard. And the most surprising part? I don’t feel like I just spent everything I had to do it. I have energy left over.
Don’t wait. I procrastinated. I made every excuse. You’re given the opportunity to have a life-changing event in the positive direction. Just do it. You only get one life.
— Dan
Dan’s ongoing care
- GLP-1 Medication (Maintenance Phase)
- Every-Other-Week Visits
- Provider-Adjusted Dosing
- Long-Term BP Discontinuation
Nine Months, Start to Now
How Dan got from 273 pounds to a size 32.
Before · The trigger
The mirror at the office
Working at the apartment complex, walking 15,000–17,000 steps a day, and watching himself grow in the entrance glass every morning. Hits 2XL. Decides he never thought he’d be this big.
The research
Talks to his sister-in-law (a PA) and a coworker
Both are on GLP-1 therapy with strong results. Dan researches options, weighs side effect profiles, settles on a tirzepatide-based GLP-1 for the cleanest tolerability data.
June 2024 · The decision
A simple Google search leads him to Rivas
Picks the Frederick clinic. Walks in expecting judgment. Gets the opposite. The provider explains the science in language he understands.
Early weeks
Some nausea. He flags it. They dial it back.
The kind of side-effect adjustment that requires a real provider, not a website. After the dose adjustment, no further issues.
Months 1–6
Steady weekly visits, steady weight loss
Hangry feelings disappear. Food noise goes quiet. Weekly visits take ten minutes, often done over a lunch break. No diet changes. No new exercise program.
Around month 6
Off blood pressure medication for the first time in 10 years
Hits 62 pounds lost. Posts a Google review.
Month 9 · Today
Down 73 pounds. From a 44 to a 32. Past goal weight.
Now in maintenance phase with every-other-week dosing. Still losing on the new schedule. Plays with his five kids, hikes, and feels like he has his life back.
A Message From Dan
If you’re sitting at home dealing with what I went through: don’t wait. I procrastinated. I made every excuse not to go. Money, timing, all of it. And the entire time, I kept doing the same thing over and over and expecting different results.
You only get one life. Just do it.
— Dan McAfee, Rivas patient since June 2024
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