My 600 lb life and weight loss surgery

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According to the folks on my 600 lb life (all of whom are well over 500 lbs and some of whom have reached an all time high of 800 lbs!), surgery is the only way to help them.

 So, on the show, after revealing their naked bodies, they all move down to Houston where WLS surgeon, Dr Younan Nowzaradian does surgery on them, either gastric bypass or in a few cases where he feels the patient would not survive a gastric bypass, he does the gastric sleeve, a surgery in which 90% of the stomach is removed and "sent to pathology".  Dr Now, as his patients call him, doesn't tell the audience much about either procedure but in a gastric bypass, the stomach is drastically reduced in size and then, attached to the small bowel, bypassing the duodenum which is a critical part of the digestive tract.  The gastric bypass is the procedure he prefers, despite the fact that many surgeons no longer do this, due to the high complication rate and low success rate. Even Dr Now admitted in an honest moment that "after 5 years weight loss surgery is ineffective" and how the patient must diet and exercise to achieve success.

And of course diet and exercise work well without any surgery!

But because so few people know much about weight loss (let alone, weight loss surgery), it is likely Dr Now is going to the bank because of that show which is a great advertisement for his services.

The problem with all weight loss surgery is, it's an old fashioned idea that somehow mutilating or changing the stomach or GI tract, is going to cause a reduction in appetite and actually, several studies seem to suggest that after the initial post op healing period, many gastric bypass patients suffer an increase in appetite.

This may be because the appetite centers are in the brain, not the stomach and as they now know, what is happening in the gut has little to do with how hungry a person gets (or doesn't get).

The patients on "My 600 lb life" never with a few exceptions, seem to lose enough weight to get out of the clinically obese range.  Large weight losses like 200-250 lbs, on a 600-700 lb patient still leaves them at an unhealthy 400 or 500 lbs.  Of course, the TV audience is assured by the providers that these patients will undoubtedly reach their "ideal weights" within a year or two, but there is little evidence that many do lose a lot more weight.  Studies found that only 7% of weight loss surgery patients keep all or most of their excess weight  - that's only 2% more (5%) who can do it without invasive surgery.

Interestingly enough, there is a disclaimer on every show, flashed quickly to inform the public of the above.