I’ve watched quite few of these. The doctor is horrible at dealing with/treating the psychological part of his patients’ issues. On camera, he pretty much just says “You’re a lazy liar.” and then repeats it more insistently when the patient fails to lose weight. The patients also don’t seem to get counseling until deep into the process - sometimes several months after they’ve had weight loss surgery, rather than before (there’s often a “first meet” with a counselor filmed.)
His approach does work for some patients, but I did just see an episode where the patient didn’t lose weight until she found a different doctor, probably someone who was able to communicate more productively.
We are seeing only a tiny percentage of the process, carefully edited to entertain us. I wouldn’t assume too much based on what we are shown.
That said, the good doctor does have an interesting bedside manner. 
mmm
Is Dr Now at his ideal weight? He seems pudgy to me.
He needs to lose 40 lbs. in the next month. Who’s bringing him food?
mmm
The only one I remember was Melissa, and she ended up being successful and became a counselor to people who were attempting lose weight as well. (I just hope she ditched that asshole husband of her’s)
There was a previous version of this show that featured Dr. Now, his son (also a bariatric surgeon) and a therapist. The therapist was very involved in the process and I thought she had the most interesting insights. Now with this iteration, the son is a producer (I think) and the therapist is nowhere. I hope she’s still doing the same thing for these people.
Tonight was the episode with Milla, and I must say, she was the most promising of them all. No whining, no cheating, she made sure she ate right and exercised, and finally got outside of her head so she could stand for the first time in nearly three years. The episode only showed her getting her weight down enough to remove a lymphedema, which was nearly 40 pounds, and get down low enough to get the gastric bypass surgery.
I wonder how she’s doing.
I like this show. We go on occasional binge-watchings of it before it all gets too sad and we have to try something else. It’s good anthropological material, and occasionally uplifting. My favorite so far is Olivia. I don’t know what it was about her, but she had me rooting for her from the start. I’m glad she found the success she did.
Yep! Like I said, “I learned how to eat better and what my target calorie intake should be, and how to start exercising effectively.” I’m doing both cardio (with a treadmill) and some simple weight training (with a dumbbell set). This morning I walked a mile. 
I know objectively that’s not far/much, but for me it’s awesome!
We all started somewhere. Congratulations! You’ll be running marathons in no time!
I did see the one with Randy, who lost weight TOO fast and ended up in the hospital. He had an enlarged heart and Dr. Now was concerned he wouldn’t be strong enough for surgery. That’s the first time I’ve ever seen Dr. Now tell someone to slow down their weight loss.
Technically, that program was about John Keitz, and predates the 600-lb life series by a number of years.
If I can remember the details. . . .
He was bedridden, and he and his wife lived in the house previously owned by his parents. They were unable to pay the taxes on it, so it was seized, and they were evicted.
He had a handicapped daughter that he and his wife took care of, also several siblings (none of whom were mentioned in the doc), who would have nothing to do with him or his wife.
Last night was Brandi and Kandi, morbidly obese twins.
I am confused by something. If these people can lose 30-50 pounds in a month with diet and exercise, why don’t they just continue to do that instead of getting the surgery?
I have wondered this myself.
Also, months after the surgery, people are shown eating a normally sized plate of food. I thought the reduced size of the stomach made that impossible.
I wonder about this as well. Maybe it’s more of a psychological exercise so patients have a taste of losing weight and practicing overcoming pathological issues with food.
Do really big people rapidly lose weight when their calories are radically cut down? Even if I starved myself, there’s no way I could lose 12 pounds a week!
I liked Brandi and Kandi’s episode last night, it was interesting to see the dynamics between them.
This episode brought to mind how many of the folks on the show seem really immature for their ages, as if – like drug taking at a young age can cause – they are developmentally arrested in childhood, when parental care shielded one from most of the big, bad world (or should have had parental care; many of the participants have really screwed-up parents).
I’ve also noticed that many people on the show seem to have really deep-seated anger related to traumatic childhoods. If the old saw that depression is internalized anger is true, I sure hope they do get appropriate after care that may include antidepressants.
Yes, the food itself acts as a drug. If every time you feel depressed, or anxious, or bored, or any emotion, you deal with it by eating, you never learn any skills about how to regulate your emotions or deal with your real world problems. That leaves you in the same position as a very young child who doesn’t know how to handle being upset except by throwing a tantrum.
Not necessarily impossible, although I’d have to wonder how many months after the surgery they were able to eat a “normal-sized” meal without discomfort.
My wife had bariatric surgery years ago, before we even met. It was a fairly invasive procedure, and had a long recovery time - something that has been reduced considerably with more modern laparoscopic methods. I’m sure Dr. Now has these newer techniques under his belt, which might explain how quickly his patients were able to get back to the dinner table.
During her recovery, she went from not being able to eat anything, to being able to consume only liquids, then on to soft foods, and finally on to “real” foods. Today, roughly 15 years later, her ability to eat is somewhat limited at the top end - “all-you-can-eat” Brazilian steakhouses like Fogo de Chão would be a waste of money for us - but a normal meal is … well, normal.
Interesting side effects have arisen as well, though - she now has trouble absorbing certain B-vitamins, and dairy products cause a reaction similar to lactose intolerance - not that she ever really enjoyed drinking milk like I do anyway.
It’s my understanding that the heavier you are, the easier it is for you to have substantial weight loss in the beginning. For people who are just overweight, not obese, losing 1-2 pounds a week is safe and reasonable. But if Dr. Now is expecting 30-50 pound weight loss in a month, that’s 7-12 lbs a week. His patients are capable of doing that if they stick to his regimen.
A 600 lb person may be burning 6000-10000 calories a day even if sedentary. if they cut down to 1000 calories a day, that is a 5000-9000 calorie a day deficit. So in those situations, losing 60 lbs of fat in 2 months is possible. But for most people, you can’t lose that much weight and have most/all of it be fat. But if you are 300 lbs (especially if a guy since they have more muscle mass) you can probably lose 1 lb of fat a day in the beginning since you’d be burning 4000+ calories a day. Penn Jillette lost something like 100 lbs in 3 months by eating 1000 calories a day.
Christina did an episode, hereis what she looks like 2 years later. She looks a lot better but sadly is still crippled by body insecurities.
The main problem with obesity treatment isn’t weight loss, it is weight maintenance. The human body is designed to survive famines and starvation, and it does that by regaining lost weight after you lose it by increasing the appetite and decreasing metabolism (among other things). So you lose 100 lbs, but then your body tries to get you to regain it (because your body is trying to prepare you for the next famine, it wants you to get fat again) and most people end up back where they started.
Bariatric surgery helps suppress the appetite which makes it easier to not only lose weight, but keep it off. W/o the surgery people would lose less weight and they would keep less weight off.