My latest obsession is “My 600-lb Life” on TLC. With my Discovery+ subscription I have access to ALL of the episodes and I watch them on the treadmill. I’m by no means a doctor, nutritionalist, or anyone who should give weight loss advice but I have a few thoughts – as a lay person.

First a HUGE shout-out to Dr Nowzaradan – the doctor that is the center of this show. He works with morbidly obese patients to help them lose weight through surgery and other methods. Most people assume a surgeon wants to cut (to a hammer everything looks like a nail) but Dr “Now” takes a more wholistic approach and requires his patients prove they can lose weight on their own first through better eating habits and exercise. The emphasis being on taking control and proving you aren’t just looking for a quick fix.

As Dr Now explains, the gastric bypass surgery will reduce how much you can eat in one sitting. But if you haven’t learned to control your appetite you will still be able to eat several times a day and gain back the weight after the surgery. The surgery is a jolt to help you maintain progress you’ve already started – not a silver bullet.

Now that we have some of the particulars out of the way – my observations:

First, America has problems. SO many problems. America leans REAL heavy on the “personal responsibility” trope that we should have ALL the dangerous things in the world available 24/7 and it’s up to YOU to not partake. This goes for food, too. Here in Houston it doesn’t take more than 2 minutes in a car to find fast food. It’s EVERYWHERE. And I’m here to tell you fast food tastes good, is reasonably priced, and it’s fast. All the things that add up to “easy street”. And fast food once or twice a week isn’t a problem – particularly if you make better choices at fast food restaurants (Chick-Fil-A has a great cobb salad you can get with grilled chicken that’s MUCH better than a #1, for example). The problem is many Americans have now turned to fast food for EVERY meal. Hashtag personal responsibility fail!

Americans aren’t taught how to eat right. In school we’re told about food but we aren’t told HOW to eat. How to portion control. How to make better decisions in the grocery store. What exactly to look for on the nutrition labels. For example: something might be “fat free” and you might think that’s the go-to because it’s good for you. Wrong. It likely means they pumped it full of sugar or corn syrup to make up for lack of taste and it’s actually worse for you! Our schools are failing us.

If you’re like me and grew up as a “latchkey kid” there’s a good chance your parents failed you, too. When a kid comes home from middle school to an empty house they’re going to eat whatever they damn well want to eat. For me it was frozen waffles for breakfast and PopTarts when I got home. And because I was skinny nobody ever told me these were bad foods for me. Our parents are failing us.

So back to the show – there are a few trends I see on this show.

1 – food is an addiction. No different from drugs or alcohol – food is addictive. Most of these folks are addicted to food. Most of them will flat out tell you eating food is the only happiness in their life and for that 10 minutes they’re eating all their cares fade away and they’re comfortable. Just like drugs!! These folks are struggling with an addiction.

2 – which leads to how you treat an addiction. I see these folks be sent home from the doctor and they have 3 months to lose 50 lbs. Here’s some paperwork to help – figure it out. If you haven’t lost 50 lbs in 2 months no surgery for you! I get where Dr Now comes from with this but you have to wonder how often this works with heroin addicts? Would a treatment center turn you away and say “prove to me you can stay off heroin for 2 months and we’ll accept you into a rehab program”? Um… that’s WHY they’re there – they can’t do it themselves. Many of Dr Now’s patients figure it out and manage to lose the weight but I can’t help but feel for the ones that don’t.

3 – most of these folks need in-patient treatment. You see the best results on the show when Dr Now immediately admits a patient to the hospital for a month and puts them on a controlled diet. I think this is the way to go for most of his morbidly obese patients. For a month the patient is taught how to eat by trained staff. Most of them lose a good bit of weight in that month.

4 – but here’s what’s missing from that month of in-patient care: family/caregiver training and mental assistance. They treat the patient’s eating issue by controlling the food they get. But that shouldn’t be the end. They should also have classes for the caregiver to teach them how to stop enabling and how to make better choices at fast food and grocery stores. They also should have a therapist working with the patient to address their mental issues around food or what started them down destructive behaviors.

5 – many times on this show people “stall out” and stop losing weight. You see Dr Now get frustrated with them and sometimes he sends them to a therapist. After the patient has a few sessions with a therapist suddenly they’re back on track with the weight loss. Many times our issues around food are as much mental as they are physical. I don’t understand why therapy isn’t just built-in as a condition for gastric bypass surgery.

As I’ve watched so many of these shows I’ve decided on what I’D do if I had all the money to do it. I’d create a bariatric in-patient facility much like St Jude’s or Ronald McDonald House. Many of these folks are near death and this is their last chance to get it right. Many of these folks are poor and don’t have the means to afford the surgery. So create a 100 bed facility where all of their care if provided. Each bed comes with an attached micro-apartment for the family or caregivers. Each admittance to the facility comes with a medical staff to address medical concerns, a nutritionist to put you on a controlled diet, and a therapist with required sessions. Each patient gets one month and assuming they do everything right they get their gastric bypass surgery and are sent home with real tools to be successful after the surgery.

On a personal note I, too, struggle with my weight now. I was 130 lbs up till I turned 25 and moved to Houston and discovered Mexican food. Now at 5′ 10″ I’m 230 lbs which is technically obese. I’m by no means as bad off as some of the people on “My 600-lb Life” but I admit I’ve pulled helpful tools from the show that I’ve applied to my own life.

I didn’t know diet soda was bad for you. It has zero calories or sugar – how could it be bad? Well the carbonation inflates your stomach which keeps it large and you hungry. I’ve learned not to snack between meals. I’ve learned you have to reduce calories to reduce weight. I’ve learned carbs are bad and protein is good.

But more than anything I’ve learned that it’s NEVER too late to take control of your food issues and lose the weight. The most important part of that process is finding the tools to help you and to stop lying to yourself. Again, food can be addictive and people tell themselves all kinds of things to keep feeding the addiction.

But anyone can do it. You just have to start somewhere.

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