Why I Do What I Do

The short answer is, I do this because I have a solution that has proven effective. In over 20 years, I have helped more than 7,000 patients successfully reshape their lives.

After attending college for engineering and biology, I was accepted into the University of Minnesota School of Medicine. My formal education in weight-loss surgery started there (Minnesota was one of the first medical centers in the world to perform surgery for weight loss, in 1951), and I was first introduced to the science of obesity and metabolic disease in 1990. Professor Henry Buchwald, M.D., Ph.D., had just published a landmark study on intestinal bypass surgery to treat high cholesterol. I read it and realized right away how significant this was.

To me, it was enormously significant that an intestinal operation could have such a profoundly positive impact on a genetic disorder where lifelong use of medications was the only alternative. Although I wanted to go into cardiac surgery where surgeons bypass clogged arteries, it seemed that controlling the underlying disease up front, rather than waiting until it had progressed, was more logical.

People around the world develop coronary artery disease and have heart attacks as a result of unhealthy levels of cholesterol. To prevent this, patients are prescribed expensive medications with numerous side effects, and often times mediocre results. Intestinal bypass surgery seemed far more effective.

A watershed event occurred later in my residency, when I met a ruggedly built six-foot-four fireman named “Frank.” The man was about 240 pounds and clearly strong as an ox. I figured he must have been one heck of a lineman for his high school football team, and I thought to myself, “This is exactly the kind of guy I want climbing up a ladder to carry me out of a burning building!”

He was there for an annual check-up, and I immediately assumed that he must have had some type of hernia repair. Surely this guy had never been sick in his life. When my professor stopped in the room to say hi, tears came to Frank’s eyes and he bear-hugged him, nearly lifting him off the floor. After my professor and Frank had their reunion the man explained to me his story.

For most of his career, Frank had weighed about 230 pounds. He had always been a “big” guy, he said, but after about ten years with the fire department the stress seemed to catch up to him and he started having trouble with his weight. A promotion had landed him in a desk job with minimal exercise, and a bad diet had resulted in an expanding waistline and a host of medical problems.

The impact on his life was disastrous. Once he failed a routine physical, he was put on disability. He tried “every diet known to man” but eventually got to 350 pounds. This made him depressed and he gained even more weight. The financial stress resulted in his wife leaving him and taking away his two children. Divorced, alone, broke and over 400 pounds, he had considered suicide. But then he read something about surgery for weight loss and figured he’d give it one last try. His primary care doctor told him that he was “crazy” but he came to the clinic anyway, and later underwent a gastric bypass.

Now, three years later, he had lost close to 200 pounds and had been able to go to the gym (now that “everything doesn’t hurt anymore”). He credited my professor with giving him his life back.

“I feel great!” Frank beamed. He explained how now that his extra weight was gone, he was fit and exercising, he was on good terms again with his children, was back to work as a fireman, and even had a girlfriend. This entire clinic visit took about fifteen minutes, and I walked out of the room amazed at what I had just seen.

With his story, Frank introduced me for the first time to the mental and personal toll of severe weight gain. He had been desperate to turn his life around, had tried multiple diets, and had been close to suicide. I remember feeling incredible empathy over what he endured as he lost the life he loved. I was dismayed by how he had been so alone in his struggle, with even his primary care doctor telling him that he was “crazy” to consider surgery. It was an epiphany for me, realizing that people like Frank are out there and they need help finding an answer.

One other incident in the weight-loss surgery clinic really impressed me. It was the case of a woman who had undergone gastric bypass surgery, but had regained the majority of her weight. She had undergone testing that showed everything about the surgery was working the way it was supposed to work, but the dietary survey had shown that she was now unemployed and sitting around at home all day eating potato chips and cookies. She was very sedentary and had never exercised, even after she had first lost a lot of her excess weight after surgery. I saw her three times in the clinic and every time she had gained more weight, and every time she explained earnestly how none of it was her fault. The “surgery just isn’t working, doctor” she would say. She ate junk food all day because, as she put it, “It’s the only thing that makes me happy.”

I realized then that the difference between the highly successful bariatric patients and the profound failures was rarely the surgery itself, but was mainly what patients did to make the surgery work long term.

It seemed like what I was witnessing was a surgical field where specialized operations were being used to help people alter their lifestyle in healthy ways. Bariatric surgery was a mechanical modification that forced certain changes in eating patterns, but was dependent upon the patient using these changes to alter their behavior to be successful. Over the next several years of my training I saw similar stories, and learned as much as I could about bariatric surgery, or what I call Behavioral Modification Surgery.

The complexity of this field, the dramatic success when everything worked together, and the lack of understanding about what it really involved, all convinced me to devote my career to helping people manage their weight, not just through surgery or dieting, but through a comprehensive approach to weight management and wellness that would set patients up for permanent success. I didn’t know it at the time, but this comprehensive approach was the foundation of The N.E.W. Program: Nutrition, Exercise and Wellness.

Now, 20 years later, I’ve treated everyone from celebrities and elite athletes to average Joes and Janes. I’ve studied the physiology, lifestyle patterns, and psychology of obese people and healthy-weight people. And I have come to understand that people who are successful at maintaining a healthy weight often don’t appreciate all they really do to maintain that weight. It’s not just diet, but an entire lifestyle that leads to fitness.

One goal in writing the book “World’s Greatest Weight Loss was to educate the community on what’s really required to achieve substantial, permanent weight loss and provide some guidelines for using weight-loss surgery effectively. Through insight from highly successful patients, you will see how people who have used surgery as effective leverage to get in shape have not had to adopt a lifestyle they hate in order to stay fit. Instead, they have found the lifestyle that they wanted all along, and which they genuinely like. They’ve lost the weight by having the strength to pursue the life they longed for and have stayed fit because they like the lifestyle that keeps them there.

This is why I do what I do. It’s more than just a surgical procedure; it involves working with hopeful and determined people that want to improve their lives. Bariatric surgery is a field that combines highly technical operations, science and lifestyle modification in order to achieve amazing results.