- We're at a critical stage here. - Yeah. You're gonna die. Pretty soon. - Today, we're watching Family by the Ton. I'm not gonna lie, not
a huge fan of the title but let's see what the show has to offer and learn something along in the process. Let's get started. - I would just eat until
I'm dead, probably. A normal day for me is wake up around 12, figure out something I'm
gonna eat immediately. TV, video games, bed. - So it's interesting that
you see him drying himself off with a towel of that specific way. When you have excessive body weight and you have excess
skin, excess fat tissue, you have to be really
thorough about drying yourself because it's really easy for
a candida infection to begin. And as a result, you can
get really bad redness, irritation of the skin. It can then become a full on cellulitis where bacterial infection sets in. So it's really important to dry skin folds in order to decrease the
likelihood of this happening. - I never would have thought at 34, I'd be living with my father. And I'd be, have no job, have no real money and just be
playing video games all day. And eating. - When you're trying to
address someone's situation where they're morbidly obese, you have to look at
the patient as a whole. You have to look at what are the reasons that contributed to this occurring. What can you do in order to
prevent it from recurring? Look at triggers. Look at mental health factors. Look at sleep schedules. Daily activities. Like in general, I'm not against gaming. I love gaming. I consider myself a
gamer, but there are times when we can take something that can be potentially beneficial and make it into something that it's not. And this can happen with anything. I mean, it's really the
dose decides the poison. So having an unhealthy relationship
with food, with gaming, all of this can contribute to this ultimate unhealthy lifestyle which will ultimately decrease lifespan and decreased quality of life. And that quality of life is
really what I like to focus on. 'Cause yes, we wanna extend life span. We want patients to live a long
life, but at the same time, I want them to live that life comfortably. I don't want them to be in pain. I don't want them to be in mental anguish because they don't feel like they're connecting with the outside world. And that's what a good doctor,
nutritionist, or like I said any other health professional looks at when addressing these types of problems. - Casey, I have your food.
- Okay. - I'm gonna tell him what to get him and I'll come right back in a long time, just in case he has too much food. But I'll get it for him and bring it to the house and put it
right in front of him. - [Casey] I don't wanna call
him an enabler, but I mean, sometimes it's really the way like it seems that it is. I'm not buying the groceries. I'm not buying the frozen pizzas. I'm not buying the chicken wings. There's someone facilitating
the food coming in. And it's not me. - I mean, there's partial truth in that. I don't think that's a valid
excuse for someone to make. If my patient told me, hey,
look, it's not about me. I'm not the one doing the shopping. At the end of the day, there's a level of personal responsibility
involved in all of this. But to solely placed the blame at the foot of others is
not a healthy pattern. Not because it's right or wrong but because it takes
away control from you. And when you take away control from you, you actually create more of a problem. Where you feel like you're helpless, you have to do it. And there's nothing you
can do to change it. When that is not in fact reality. There are things you can do to change it. There are conversations to be had with your 'enablers" because the foods that are being consumed
are A, unhealthy foods. B, there's salt being added
to already very salty foods. The portion sizes are tremendous. And I saw the father mentioned tea. That tea has so much excess calories from the added refined sugars. Like that's even worse than eating a huge amount of food because at least when you eat the food, you can feel satiated. And there's some fiber and
other nutrients in there. But when you're just drinking sugar water, which is essentially what a
lot of these sweet teas are, in mega amounts, you're
just adding weight. - So I bathe outside of
this trough currently because I cannot physically bathe in a sit-down bathtub
or stand up shower area. Because I'm a bigger guy
with like folds and flaps, I have to move around, like
almost like a pig in a way and wallow and roll over to
get like the back of my leg. I have to lift up literal
like pieces of skin. It's just a super difficult process. - There's a lot of
adjustments that are needed to be made in someone's home when they are of this excessive weight. There's also adjustments
that need to be made in the hospital. I've had patients who are morbidly obese who unfortunately did not fit in our CAT scan machines
and our MRI machines. And then those scenarios, A, you try and look at
the facilities around you if there's an option
to transfer the patient to someone does have a
larger piece of equipment. And then there's sometimes been situations who we literally have
to contact our local zoo who have really large machinery for some of their larger
animals and we use those. It's not a pleasant conversation
to have with patients but it goes to show how there's
a lot that needs to be done in order to make sure that we're keeping
folks like this healthy. - This is our icebreaker. We do have to take your weight first. - This was coming. When I weigh myself in my
house, I do it butt naked. Just use the bath in
number one, number two. And I've like tried to
throw up the last meal I ate so I can lose any pounds. Now I'm there wearing clothes. I'm kicking off my flip flops. Anything I can get off of
my body to lower the number. 'Cause I know it's
gonna be shockingly big. - [Woman] It's 711.8. - Now I know bariatric offices that try and save this step for later in the visit. Reason being is whether this
patient is approximately 500, 600, 700 pounds, we know that
there's gonna be a benefit to doing the procedure. So we can already lead
with that assumption. A lot of times it's traumatic to step on this scale and look at the number. So we try and perhaps save it for not the first first
thing you do when you walk into the office 'cause that alone can cause people to not wanna come in to see the doctor in the first place. - We're at a critical stage here. - Yeah. - You're gonna die. Pretty soon. Unless something happens here. - Now I know that's jarring to hear. I understand why. I agree with this approach. I think this is the
most successful approach 'cause it's honest. Whether you have a patient
who is morbidly obese and is over 700 pounds
or you're recommending a do not resuscitate
order for a family member. Those are difficult conversations. The truest, most honest,
non-judgemental way you could deliver that news is gonna be the most successful way you could deliver that news. - With you, the route
we're gonna go down towards is a sleeve gastrectomy. Okay, all right? So this is your stomach. All right. What we're gonna do is we're gonna go in and we're gonna remove this outer portion of your stomach right here. There'll be a metabolic
switch that gets flipped in your body when you have this surgery. Your body will wanna lose weight. - When Dr. Proctor was
going over to surgery, it was pretty scary only because
I fear surgery in general. - Understandable that he's apprehensive. Surgery comes with
legitimate, legitimate risks. Even if it's bariatric surgery. That being said, being 700 plus pounds carries way more risks than the surgery. And that's how we decide
whether or not a procedure, a medication, a treatment
is good for a patient. - Why don't you tell me
what does a normal day of eating look like for you prior to when you saw Dr. Proctor? - So like, we're waking up at like 12. And then probably ordering
food from the hot dog house. - What do you usually order?
- On like a normal day, it might be like 20
wings or like 10 tenders. And then it would be like a small order of tater tots and a large sweet tea. - This size cup? - Yeah.
- Okay. So we're doing 32 ounces of sweet tea. - My lunches were either a
taco salad or like tacos. But it was, you know,
not a lot of sour cream. And then the rest of it. - Then what do you have in dinner? - It could be anything from like a big thing of fried chicken or pizza we'd have like, not
occasionally but sometimes. - So Dr. Proctor wants
you to lose 60 pounds by the time he sees you next. - The reason why all of
these guidelines are in place about having patients lose
a certain amount of weight before the surgery, having
them see a psychologist, running blood tests is you wanna set the patient up for success. If we just willy nilly
did bariatric surgeries on everybody who is obese,
it would be problematic because what happens is
when you do the surgery, there's very specific
protocol you have to follow. If you overeat with a smaller stomach, you can actually cause surgical issues. You can rupture your stomach. You can cause vomiting. It can cause mental havoc. It can lead you to going
into a dark depression. We really try and select our patients that we think are gonna
have the best outcome from the bariatric surgery instead of just recommending it for all. - So I've hired a personal trainer for the first time in my life. This is the first time I've
been to the gym in a long time. And I am a little bit nervous. - Hey, what's up man? - Casey, right? - Yeah, yeah, Dex?
- Yes, sir. - When I watch programs like this on TLC, my one issue that I have is this is a lot of this is
not reality for most Americans. I don't want someone who
is potentially wanting to lose weight to look at this and think that unless I have
this, I can't lose weight. It's not true. You don't need the diesel personal trainer in order to lose the weight. Any kind of physical activity when you're going from zero will help. Also, being kind to yourself and not pushing yourself too hard in the beginning is also really important. With someone who is 700 plus pounds, you really wanna make
sure that you're focusing on injury prevention. It's very easy to overload
joints, to pull and hurt muscles. And as a result, you can set someone back. So it's really about starting slow - Do you arm rotation. - All right, gotcha. - Good. And we'll go back the opposite way. I like Casey to move his own body weight so he can establish a correlation between what he's accomplished already and when he can expect
himself to do in the future. - See, someone might look at that and say, that's not exercise. Yes, it is. His heart rate's going up, his breathing rate's going up. This all automatically
kicks up the metabolism, helps them prepare to meet the challenge. And he's been sedentary. You can't push too hard, too fast. You can put too much strain on the heart and even cause a heart attack. There's actually a type of heart attack called the type II myocardial infarction. That happens as a result
of not a pure blockage, but simply because
there was so much strain on the heart that there wasn't
enough circulation going that actual damage has occurred. - It's been three months since
my surgery and I feel good. Little things are changing in me that I didn't really expect
to change so quickly. As I accomplish more, my
self-esteem is rising. So I feel like I can do more. So it's just a good feeling. (crowd cheering and applauding) I started this journey at 711 pounds and today, I'm happy to say that I'm 545. - I think it's great when you start seeing your goals pan out and that's how motivation happens. It's seeing your hard work be paid off and it might not happen off the
first, second or third time. But as you continue, you keep seeing that
you're making improvements. Whether it's after a week,
after a month or after a year. And even for myself, I had a buddy that was in the ICU recently and had a lot of neurological deficits. And as he was solely recovering, he would call me each day upset the fact that he wasn't making progress. And I had to remind him. Write down what your deficits are today. Do it next week, do it the following week. And then each time you're upset, look back and see how
much you've improved. When you look in every
hour by hour, day by day, sometimes it's easy to lose sight of how much you've accomplished. But when you really spread
it out and think in scale, which we, as humans are not good at doing, you get to see that accomplishment. You get to feel motivated. You get to see that you're making moves in the right direction even if it's three steps
forward one step back. - Well, I'm trying to
get my license renewed. - This is him now?
- This was last month. Because in my other license, I'm huge. I'm a whale. So there we go. That's me. I don't know if you
can see that real well. I don't know, but that's me. It's really weird too,
because like 2020 Corona is like the worst year
of some people's lives. Like it's really been awful for people but like, it's gonna go
down in the record books. It's like one of the best
years of my life probably. Life for me, is blossoming. - What's he's experiencing right now is almost like a form of
post-traumatic growth. It's looking back at your accomplishments. There's nostalgia there. And the fact that he's
in fact reached his goal. He's in fact, improved
his quality of life. It goes to show that
everything that we discussed at the beginning of this
episode, where it comes to extending life and
improving quality of life, he's a walking testimonial
for, really proud of him. Check out this video of
me taking a career test. Do you think I got
doctor or something else? As always, stay happy and healthy. Compose or arrange music? I have no creativity in my body. So if you ask me to draw you something, compose you something, it's gonna come out looking like the trapped version
of the happy birthday song.
