He was wheeled into the office by a young man, maybe his son, I’m not sure. He overflowed the oversized wheelchair, cradling his oxygen tank in his arms. He did not look comfortable. He did not smell good. He was able to struggle to his feet to step onto the scale: 250 kg (550 lbs)…
His diabetes is out of control. His blood pressure is high. He can barely walk. He is in his 30s and unlikely to see 40. He is not unique.
Mild to moderate obesity is a national health care crisis, affecting millions of people. Extreme obesity is also on the rise. Most people are not clear on just how obesity affects every aspect of someone’s life.
This man is going to die. The only chance at staying alive is radical weight loss. The risk of bariatric surgery is extreme–he has a good chance of dying perioperatively. He cannot get any preoperative workup to help reduce this risk–he doesn’t fit on the table for a stress test or cardiac catheterization; an ultrasound of the heart would be useless because the sound waves will barely penetrate his flesh. He has chronic skin infections in his folds of fat.
How many calories does he have to consume to maintain his weight? Probably about 20,000 a day, or about 10 times the amount you eat. How does he do it? Who brings him food?
The only way he stands a chance is for the whole family to become involved, perhaps an 12-step style intervention. He is not maintaining his weight by acting alone.
This man is going to die young. With obesity on the rise, we need a major public health initiative to save the lives of people like him, and to cut down on the enormous cost of this epidemic.
His son wheeled him back out of the clinic. They received advice on what to do to survive, but like many addicts, his chance of recovery isn’t clear. The clock is ticking, for him, and for millions of others.
