S04.E12: Sean's Story

[mrsjoe]

The point of the pre-op liquid diet is not to shrink the stomach. It's to shrink the liver, in order to provide easier access to the stomach and minimize the risk of accidentally nicking the liver during surgery. A fatty liver is a dangerous obstruction to this procedure. The more obese you are, the more enlarged and fatty your liver is likely to be, which is why the more obese have to do liquids longer.

It only takes about 8-10 hours to empty a stomach for surgery. That's why you're always npo after midnight for next day procedures.

 

Thanks! I felt like I was remembering wrong, but didn't look it up. These people must have huge livers though and access is already an issue with the huge layers of fat everywhere, so I have to think that they are required to have at least a 2-3 week liquid diet, so I still find it odd we have never once seen a patient who was attempting it.  I still think Sean would have gone completely off the edge on it. Maybe though, when we always see them lose that last 50 or 100 pounds Dr. Now requires them to lose to be approved, they are doing it on the pre-surgery liquid diet?

[dahling]

It drives me nuts when Dr. Now throws out obscene numbers like "he must be eating 30,000 calories a day".  I know the conventional wisdom says that a very fat person has to have a very high number of calories just to survive, but in my personal case I have not found that to be true.  I became 380 pounds (and still gaining) by eating probably 4,000-5,000 calories per day.  I was not eating 2 pizzas or even 1 pizza at a time.  In my life of weight loss, weight gain, and counting calories, I can honestly say that I will gain weight even eating 2500 calories a day, if my lifestyle is sedentary.  1500 per day maintains me, even at 200 pounds, and I have to exercise regularly. 

 

On the positive side, when the famine comes, I will be the last woman standing and I will have the last laugh. 

[Elizabeth9]

I think 30,000 calories is not possible. The highest numbers I've ever heard were around 10,000, and that was from bulimics who were purging most of the food.

It wouldn't suprise me if they're eating between 5,000 and 9,000 though. Which is still incredibly high. They do choose higher calorie foods, and a lot of them seem to eat around the clock. Plus, a meal for them is easily 1,500-2,000 calories.

Edited March 22, 2016 by Elizabeth9

[Muffyn]

Dr. Now has two big go-tos:  they must be eating XX,000 calories a day to maintain this weight, and they will be dead within XX months/years if they don't get surgery.  While Sean was certainly eating a lot, as many people have concluded, it was likely not 30,000 calories a day.   Dr. Now does not take into account the level of inactivity.  This is beyond sedentary and is closer to bed bound.  He also doesn't consider how much their metabolism would be altered by this point.  To the second point, I always feel like he is disappointed if the person doesn't have horrible health issues.  

[mrsjoe]

I think 30,000 calories is not possible. The highest numbers I've ever heard were around 10,000, and that was from bulimics who were purging most of the food.

It wouldn't suprise me if they're eating between 5,000 and 9,000 though. Which is still incredibly high. They do choose higher calorie foods, and a lot of them seem to eat around the clock. Plus, a meal for them is easily 1,500-2,000 calories.

 

I don't know, I don't think it's that unrealistic. Based on what I'm seeing, one large pizza is around 3000 calories (more or less depending on crust and toppings) and he ate at least a quarter of another one, so just one meal was almost 4000 calories. Wash that down with a two liter of Coke at 800 calories and just in one meal, you are a fourth of the way to reaching 20,000.  Three meals like that and then snacks and boom.

 

CousinOliver did a great job explaining how that number could realistically be as high as 25,155 on page 2. Granted the fact that Dr. Now says practically every patient must be eating 30,000 means it is likely just his go to number, but with Sean eating all day, every day, he's one of the few who it could have really been true.

 

Something I would love to see is have a TLC employee with one of these patients 24 hours a day for say 3 days and log every item of food that goes into their mouth. We know the patients and enablers couldn't be trusted to do an honest food journal. So then put the logged food out on the table and let them, and us, see how very much it is. Wasn't there maybe a show that did that? I know on Supersize vs. Superskinny, they kind of did it, but spread out on a table would be even more visual I think.

[ethalfrida]

I too am amazed at the 30,000 calorie diet so I looked it up and found a person who had been on Dr. Phil. She ate a 30,000 calorie holiday dinner but I'm telling you, it is over the top. I cannot even imagine Sean being able to down this much food especially the type of food it is. To me, there would be a point where fatique would set in at least. Read it here:

 

http://www.dailymail.co.uk/news/article-1341683/Donna-Simpsons-feast-The-30-000-calorie-Christmas-feast-eaten-worlds-fattest-mum-ONE-hour-sitting.html

Edited March 23, 2016 by ethalfrida

[aliya]

I'm thinking that a lot of the calories come from soda and juices. It's easier to drink than to chomp away on food all day.

 

I used to have a pretty intense Diet Pepsi jones (yes, I know about the problems with diet sodas...). If I had been drinking regular Pepsi, I'd be a balloon in the Macy's parade by now. 

[ClareWalks]

I think for a regular person to gain 100 lb in a month, they'd have to eat 30,000 calories a day, but for a guy like Sean it's probably about half that. I would NOT be surprised at all if he had been eating 15,000 calories daily, especially if he considers a 2,500 calorie feed fest a "snack."

[Elizabeth9]

Gastric rupture is a thing- if you google "gastric rupture bulimia" there's a story about it. WARNING- the article has photos, which are graphic. Proceed with caution.

I don't understand how a) you wouldn't involuntarily vomit at some point or b) your stomach wouldn't burst.

[CousinOliver]

Regarding food intake:

 

I think it's ridiculous to think that any two bodies, even two sedentary, morbidly obese bodies, metabolize calories exactly the same way; the amount of calories consumed for patient X to be 600 lbs isn't going to be the same as it took for patient Y to be 600 lbs.

 

That said, a 100 lb weight gain in a month is going to take either a massive amount of calories or some sort of serious edema.  We've seen Dr. Now treat for edema (Half Ton Killer), and that was not Sean's story.  So, it was a large number of calories. 

 

I think the people who have noted the high number of calories in some drinks have it spot on.  In some cases, this is happening after Dr Now has told them to lose weight, so you know they are making some kind of changes (off topic: I swear this is why we see so much [fried] chicken ordered at the drive through -- they're trying to be "good" for the camera.)  So, they've probably taken out the (obvious) solid carbs, like rice and potatoes, and replaced them with soda and juice.  

 

Many years ago, TLC had a documentary called I eat 33,000 calories a day, which was a little misleading because three of the four people that they showed ate far less than that (around 12,000 - 15,000, which is still a staggering amount of food.) But one of the participants, Paul Mason (of suing the NHS fame, after they literally saved his life) claimed that he ate dozens of candy bars and bags of chips a day on top of daily meals totaling about 12,500 cals/day.  He claims he spent $14,000 a year on chocolate candy bars, alone!  His daily intake came in over the titular 33,000 calories.  

 

I get the irritation with Dr. Now.  He's throwing a number out based on some old school formula that makes presuppositions about peoples BMRs, etc., etc.  But, I do think it's entirely possible for an emotional eater, a food addict, and/or someone with Prader Willi Syndrome to eat and drink a mind boggling 30,000 calories per day. 

[Tabbygirl521]

And this is why I could never be a health care worker--I honestly didn't care if Sean made it. When he kept crying and complaining about how it was so unfair of everyone to make him cut calories, and that he should be allowed to enjoy his food, all I thought was "go ahead, keep eating all that shit". I was almost hoping Dr. Now would stop trying and let this whiny manipulative jerk eat himself into oblivion.

Save the surgery for someone who really wants to change. My reservation in hell now confirmed.

Save me a seat.

I had to struggle to find even a spark of compassion for these two. Mom was well-spoken and apparently intelligent, but delusional. Sean was a rude brat. I think Mom got bigger even when Sean finally did start dropping weight, so you know she was waving pizza under his nose, etc.

Don't they have assistive devices for cleaning one's nether regions? Hell, duct tape a sponge to a broomstick. Criminy.

By the time Sean reaches goal, it will just about be time for him to start tending his morbidly obese mom.

Edited March 24, 2016 by Tabbygirl521

[mamadrama]

Even if they become able to work having lost sons of weight, they can still collect SSI based on being poor. Once they make too much money though, by working, they can't collect anymore- you have to stay poor and not work and not accumulate any assets. This is why not too many people are on it just because they are poor, because you are usually capable of working. 

 

I don't know how it is in other states, but that's not the way it is in Kentucky. In fact, it's just the opposite. SSI isn't based on "being poor". It's either based on how much you've already paid into the system from working in the past or disability. According to the SSA eligibility government page, to draw SSI you have to be

 

WHO IS ELIGIBLE FOR SSI?

Anyone who is:

 (age 65 or older);

blind; or

disabled.

AND who 

has limited income; and

has limited resources; and

is a U.S. citizen or national, or in one of certain categories of aliens; and

is a resident of one of the 50 States, the District of Columbia, or the Northern Mariana Islands; and

is not absent from the country for a full calendar month or  for 30 consecutive days or more; and

is not confined to an institution (such as a hospital or prison) at the government's expense; and

applies for any other cash benefits or payments for which he or she may be eligible, (for example, pensions, Social Security benefits)

 

So you can't just be "poor." You must also be disabled, blind, or older than 65. 

 

The old "welfare" system was demolished under President Clinton. It was replaced with TANF (Temporary Assistance for Needy Families). To be eligible for TANF, you must be under a certain income limit (the "being poor" part) and have a child under the age of 18 and you HAVE to either hold down a job or volunteer for at least 20 hours a week. No work or volunteering=no benefits. I think you can also be a full-time student now and receive the assistance. It's not a forever thing anymore, though, like it used to be. So yes, if he loses the weight and is no longer considered disabled then he WILL lose his disability benefits. My guess is that he has other disabilities, like a learning one, that might still qualify him for something. 

 

Expertise: I was a Crisis Intervention Specialist for the state and it was my job to help families in crises find the government programs that would help them find the things they they needed in terms of food, shelter, child care, and money. 

 

And yeah, save me a seat in hell, too. I have zero patience for people who don't try to help themselves. At one point I was hollering at the TV, "Oh, just let him go!" It's a waste of time, effort, and resources to continuously help someone who doesn't appreciate it and won't help themselves. 

Edited March 24, 2016 by mamadrama

[Jeeves]

On the subject of SSI, yep, being poor isn't enough to qualify. A couple of pages back, Rancide wrote a helpful post about what "disabled" means for purposes of SSI eligibility. Based on that, I'd bet that even if Sean lost significant weight and became something like normally mobile, he might remain eligible unless/until he became employable. Given his many issues, he could be a lifer on SSI. 

[Dharma]

I know the thread is about Sean but I see Dominque is mentioned. One of the fond moments on her episode was when she was enjoying watching her daughter dance. That made me smile. May she rest in peace.

 

I am an avid watcher of this show but new to the forum here although I have been reading it for a few weeks now. I meant to use the quote feature but don't know how yet. I will figure it out along the way. 

[kittle1974]

I figured out what he was reading when the nutritionist was there. I was able to read some of the text on the back of the book cover and it's a book on how to make yarn animal crafts, LOL. It appears to have come from a crafting/knitting kit that he had by his bedside at one point. Mystery solved.

[firecrackerz26]

Looking at some posts here, mind you I'm not an expert on caloric intake, but I think roughly 2,500a day will maintain someone on an average activity lifestyle. I do think you could get up to 10,000 though, and that's not a great thing meaning that could really make someone of any size gain weight. Yes you'd have to eat like a big McDs meal, pizza, sandwiches, lots of carbs, but that's how some of these people get this weight. And yes I definetly believe Sean is on SSI, and his mother probably gets a caregiver and a retirement check.

I still don't know how his mother sat back and let her son get to be 900 lbs, then 1003 lbs! To the point where he'd been confined to bed for close to 10 years and hasn't able to even shower or use the bathroom like a normal person! And it was this form of enablement that's allowed Sean to lay back and behave like a child all this time, he whined to get his way, manipulated everything, like the fake chest pain because he didn't like therapy...I do hope he has a better act on now...

[ResedaDiva]

I liked that Sean crocheted. All of the other 600 pounders mindlessly watched TV all day. At least he was doing something creative while he was immobile. It also made me soft-hearted for him because it just made him seem lonelier; crocheting by himself. I felt so bad for the guy. 

[Pepperminty]

I figured out what he was reading when the nutritionist was there. I was able to read some of the text on the back of the book cover and it's a book on how to make yarn animal crafts, LOL. It appears to have come from a crafting/knitting kit that he had by his bedside at one point. Mystery solved.

Thank you! That book certainly generated a lot of discussion.

I liked that Sean crocheted. All of the other 600 pounders mindlessly watched TV all day. At least he was doing something creative while he was immobile. It also made me soft-hearted for him because it just made him seem lonelier; crocheting by himself. I felt so bad for the guy. 

 

I understand what you are saying.  And you are right, it is nice to see someone not watching TV all day.

[Noirprncess]

While I think 30K in calories is a bit of a stretch, it might not be as hard as you think for a person Sean's size.

For comparison's sake, consider that competitive swimmer Mike Phelps consumed 8,000-10,000 cals daily during his peak training period. Or the Rock (Dewayne Johnson) eats roughly 5,000 cals over 5-7 meals during a day.

Most of the folks like Sean aren't just eating 3 meals a day plus snacks. They literally eat and drink soda all day. So yes the calculations will be skewered higher than most "normal" people are used to eating.

Not sure if anyone here watches Extreme Weight Loss, but there was one episode where Chris Powell agreed to eat for one full day the way his client ate IF she would eat what he ate. She drank a super large soda and ate several donuts on the way to work then turned around and ate fast food for lunch just 2 hours later. Chris was so sick he stopped after lunch but she was already close to 3000 or 5000 cals in. Just imagine where that day ended calorie wise.

[operalover]

I liked that Sean crocheted. All of the other 600 pounders mindlessly watched TV all day. At least he was doing something creative while he was immobile. It also made me soft-hearted for him because it just made him seem lonelier; crocheting by himself. I felt so bad for the guy. 

He says ALL I do all day is lie in bed and watch TV. Just because he knits doesn mean he doesnt watch TV all day. Maybe he knits while watching TV which doesnt make it mindless TV watching I guess.

[dahling]

The Michael Phelps calorie story isn't true.  Link:

 

http://content.usatoday.com/communities/gameon/post/2012/05/michael-phelps-12000-calorie-diet-just-a-myth/1#.VvVP9_krKUk

[notyrmomma]

Did anyone catch the supersize version of this show?  I think they really amped up the whining and crying in this version.  What a freaking baby he is.  If I were his mom during that car ride ("I'm stuck, WHAAAA, my knee, WHAAAA") instead of handing him a turkey leg, I would have been yelling SUCK IT UP BUTTERCUP!

 

Yes, I'm also glad Sean was proficient in arts and crafts, but put down the damn knitting or video game when someone comes in to see you (The cleaning lady, Dr. Now, the nutritionist)!  HOW RUDE!  Why is his mother so afraid of him?  My mom would have slapped that video game/knitting out of my hands if I was still looking down at it when someone was talking to me.

[scootypuffjr]

Can someone explain the difference between the regular show and the supersized version? Is there enough new material to make it worth watching?

eta thanks for the reply. Maybe I'll give one a try and see how it goes.

Edited March 25, 2016 by scootypuffjr

[OSM Mom]

The super-sized version has unaired footage (so called bonus scenes) and little pop ups with extra information about the scene being shown now and then. That's about it really.

[operalover]

WHy am I watching the supersized? He goes into the hospital in a black tee shirt that only goes to his waist with no pants or underwear on. >Flashes his ass at every one..then gets into the hospital bed with his ass and genitals flying around- no shame at all. Back at home his mother says "you made it to your bed BABE" WTF then he flails himself completely naked in front of his mother-- mind you there are cameramen and producers there as well as the people from the hospital helping him..They blurred out his genitals. Well part of the reason he was uncomfortable in the wheelchair was he was sitting on his bare ass. I dont get it.

 

One of the things they explained in the supersized note- his foot is deformed a combination of edema and having torn a angle ligament 8 years ago. Oy vey. When he said "Ive had to do more in the last 20 minutes than I have in...ten years"...he was about to say

[aliya]

Don't they have assistive devices for cleaning one's nether regions? 

Yes, yes they do - http://www.amazon.com/Maddak-Inc-641-2506-2000-Self-Wipe-Toileting/dp/B000PGPPIG  

 

One of the things I noticed about the shows from the UK is that the people don't seem to have assistive devices. They show them with all kinds of workarounds for personal hygiene instead of just having them use a device meant for the purpose. These are items you can get in many large drugstores and certainly from health equipment catalogs online. I didn't need this particular tool, but I had bursitis and tendonitis issues where I couldn't bend down to reach my feet; I just bought a long handled thing with a foot scrubber on it. I also got a thing to help me put on socks and stockings (my friend got one with a hip replacement). No biggie and not expensive. I don't know why they don't seem to have these useful devices readily available in the UK. 

[aliya]

One of the things they explained in the supersized note- his foot is deformed a combination of edema and having torn a angle ligament 8 years ago. 

 

I'm not much of a sports enthusiast, but don't pro athletes tear ligaments all the time? I don't see them walking around with deformed legs/feet. I guess the edema could be from weight and staying in bed, but wouldn't the ligament have been seen to when he injured it?

 

I like the extra info in the supersize shows, but I have to stand in front of the TV to see the small print, and you can't do anything else while you 'look' at the show because you'll miss the info box, so I miss a lot of the new info. 

[Chalby]

Wow - that mom was just something else, without even talking about her son.  Her excuse - when a child says they're hungry, you feed him if you love him - was rank.  ... And yes, I think part of what was going on in mom's mind was to keep him fat enough to keep him separated from the world that might make fun of his emotional, if not intellectual, disability.  And probably ensure that she had company until she died.

m passes.

I apologize up front for thinking this... BUT I feel that Sean has used his mom and his dad's relationship/ divorce as a crutch for years. As a result, mom keeps feeding him in response to the guilt and/or failure she feels as a mom. I don't think she does it to keep him home, I almost think she figured he was so far gone, weight wise, that in another year he wouldn't even be around anymore, and she can finally get on with her life instead of being a 24/7 harassed nurse's aid.

Did anyone catch the supersize version of this show?  I think they really amped up the whining and crying in this version.  What a freaking baby he is.  If I were his mom during that car ride ("I'm stuck, WHAAAA, my knee, WHAAAA") instead of handing him a turkey leg, I would have been yelling SUCK IT UP BUTTERCUP!

I burst out laughing when I saw Sean with a huge drumstick in his hand. It was like a cartoon stereotype, coming to life. Didn't Sean or his mother see how bad that looked?

[Chalby]

I have a feeling that it goes much further than just verbal tantrums too.        

I agree! And when Sean said he'd like to get married, down the road, I just shuddered. Sean never saw a functional husband/ wife relationship, so I imagine he wants someone to replace his mom. Someone to feed and wash him daily. Gross!

[Barb23]

I'm not much of a sports enthusiast, but don't pro athletes tear ligaments all the time? I don't see them walking around with deformed legs/feet. I guess the edema could be from weight and staying in bed, but wouldn't the ligament have been seen to when he injured it?

 

I like the extra info in the supersize shows, but I have to stand in front of the TV to see the small print, and you can't do anything else while you 'look' at the show because you'll miss the info box, so I miss a lot of the new info.

I find this a problem too. You have to constantly watch or you'll miss info. I had to rewind a lot to catch things.

I noticed his foot looked better & less swollen when he walked out on the deck at the end.

Here are some of the additional info that was on super size episode. I hope I remembered correctly& none seemed that newsworthy :

Sean was given ADHD med when he was in daycare. I don't think they gave an age.

Dad blamed Mom for Sean's overeating.

Sean doesn't like confrontation & it upsets him & causes anxiety. (this was shown when Dr Now was yelling at him in his office waiting room, before they sent him to hospital to be weighed. I guess this tidbit was explanation why he ate for comfort.)

Sean wants to get married but knows he needs to become more mobile.

Sean has condition where he can't sweat.

My favorite - they were able to buy more protein with money saved from buying his candy

There was more info but most of it was Mom saying the usual stuff -this is his last chance, we know he has to get better, etc.

Was his Dad still alive? I would love to get his opinion of things.

Operalover-I agree with you about all the flashing they show esp when he was hoisting himself up & getting situated on the bed at home. I'm surprised he didn't scream at the camera men for help. He probably did but I'm sure they are told not to help.

[ClareWalks]

I'm not much of a sports enthusiast, but don't pro athletes tear ligaments all the time? I don't see them walking around with deformed legs/feet. I guess the edema could be from weight and staying in bed, but wouldn't the ligament have been seen to when he injured it? 

 

I am assuming they couldn't get the ligament fixed in time. I'm a personal trainer so I deal with injuries frequently, and a completely-torn ligament or tendon is something you need to get fixed IMMEDIATELY. We're talking within 24-48 hours. A partial tear can heal fully or at least mostly with less urgent intervention, but if you hear/feel a POP, you need to get to the ER stat. I'm guessing his tear was complete and acute, and didn't get fixed (possibly because they didn't have the $$). That being said, it's not necessarily an injury that requires fixing, as oftentimes other soft tissues will strengthen to aid in whatever function the ligament or tendon had. This happens a lot particularly with arm tendon tears, like biceps tears. But in the legs it is tougher because there is no getting around it, you have to walk on those legs. 

[LilyoftheValley]

It seems fairly obvious to me that the "calories in, calories out" is only one factor in how much a person weighs.  I think that carbs - mainly processed food and sugar, as well as a physiological predisposition to super obesity, are the culprits here.  Don't get me wrong, I think these people are taking in a lot of calories, but I think that the math here is faulty.  Like I do not think that for every pound gained there is an excess of 3500 calories or that there is a reduction of 3500 calories for each pound lost.  Clearly, the human body is more complex than that.  Even Dr. Now puts them on a low carb diet to shift a lot of weight fast.  At the hospital it is grilled chicken and steamed veggies.   I do believe that this is one of the reasons that some of his patients are sincerely confused about what their diet should look like.  On the one hand, Dr. Now constantly talks about calories, but on the other hand, his method for weight loss is low carb more than low calorie.  So when the patients "cut back" on what they normally eat, they think they should be losing weight, but they can't lose any weight because even though they might be eating fewer calories than before, their sugar and carb intake is high enough that their insulin stays constantly elevated.   Essentially from we see I do not think that Dr. Now does an effective job of explaining how the body produces and stores fat.  He keeps talking about "calories" so that should mean that eliminating one large pizza from your daily diet would result in a one pound weight loss per day, which of course it doesn't.  So the calories thing really cannot be the entire story here. 

[ClareWalks]

It seems fairly obvious to me that the "calories in, calories out" is only one factor in how much a person weighs.  I think that carbs - mainly processed food and sugar, as well as a physiological predisposition to super obesity, are the culprits here.  Don't get me wrong, I think these people are taking in a lot of calories, but I think that the math here is faulty.  Like I do not think that for every pound gained there is an excess of 3500 calories or that there is a reduction of 3500 calories for each pound lost.  Clearly, the human body is more complex than that.  Even Dr. Now puts them on a low carb diet to shift a lot of weight fast.  At the hospital it is grilled chicken and steamed veggies.   I do believe that this is one of the reasons that some of his patients are sincerely confused about what their diet should look like.  On the one hand, Dr. Now constantly talks about calories, but on the other hand, his method for weight loss is low carb more than low calorie.  So when the patients "cut back" on what they normally eat, they think they should be losing weight, but they can't lose any weight because even though they might be eating fewer calories than before, their sugar and carb intake is high enough that their insulin stays constantly elevated.   Essentially from we see I do not think that Dr. Now does an effective job of explaining how the body produces and stores fat.  He keeps talking about "calories" so that should mean that eliminating one large pizza from your daily diet would result in a one pound weight loss per day, which of course it doesn't.  So the calories thing really cannot be the entire story here. 

 

Although calories are not the entire story, they are a big part of the problem for these folks. Cutting out a pizza a day might not help them lose weight, but that's because a lot of these people eat so much that they are constantly in a massive calorie surplus (see: Sean gaining 100 lb in a month). Generally speaking, though, you are correct that the super-obese eat way too many carbohydrates (and total calories) and their bodies cannot process them properly, on account of the dia-bee-tus. Some people function really well on a high-carb diet, but those people tend to be distance runners or otherwise extremely athletic. But Dr. Now puts his patients on a low-calorie AND low-carb diet, to help them lose weight for surgery and to prepare them for the reality of their new post-surgery diet, which will require them to eat almost exclusively protein just to maintain general health.

[LilyoftheValley]

I do agree that calories is a big problem, but I think that perhaps Dr. Now focuses on it too much and that the patients therefore "do the math" and decide that they can lose a pound a day if they just cut out that midnight XL pizza.  Obviously weight loss just doesn't work that way.  

[ClareWalks]

I do agree that calories is a big problem, but I think that perhaps Dr. Now focuses on it too much and that the patients therefore "do the math" and decide that they can lose a pound a day if they just cut out that midnight XL pizza.  Obviously weight loss just doesn't work that way.  

 

Definitely, I think he just kind of expects that these people can/will read labels and actually limit themselves, too. I remember it was several months into one journey before they had a nutritionist come in and basically telling them everything they ate had loads of sugar, and they were SHOCKED. Well, read the damn label, folks. I guess that knowledge is not as common as I thought. Dr. Now should anticipate that he is dealing with people who have no clue how to read labels or measure portion sizes.

[RCharter]

I don't know, I don't think it's that unrealistic. Based on what I'm seeing, one large pizza is around 3000 calories (more or less depending on crust and toppings) and he ate at least a quarter of another one, so just one meal was almost 4000 calories. Wash that down with a two liter of Coke at 800 calories and just in one meal, you are a fourth of the way to reaching 20,000.  Three meals like that and then snacks and boom.

 

CousinOliver did a great job explaining how that number could realistically be as high as 25,155 on page 2. Granted the fact that Dr. Now says practically every patient must be eating 30,000 means it is likely just his go to number, but with Sean eating all day, every day, he's one of the few who it could have really been true.

 

Something I would love to see is have a TLC employee with one of these patients 24 hours a day for say 3 days and log every item of food that goes into their mouth. We know the patients and enablers couldn't be trusted to do an honest food journal. So then put the logged food out on the table and let them, and us, see how very much it is. Wasn't there maybe a show that did that? I know on Supersize vs. Superskinny, they kind of did it, but spread out on a table would be even more visual I think.

There was a BBC show called "Secret Eaters" where people would say that they were only eating x number of calories a day, so they were shocked that they gained weight or that they were overweight/obese.  The argument was that it was clearly all genetics because they were only eating 1500 calories a day.  So, unbeknownst to them, they would have cameras installed in their homes, at their job, and they would have a PI follow them around and track their calories over a three day period.  They were often eating closer to 4000-5000 calories a day.  I don't think people realize how much they are eating.

[RCharter]

8 minutes in and I have to call slight shenanigans.....he got injured 8 years ago and couldn't finish high school.....you know what they had 8 years ago?  The internet.  That magical thing that allows people to email assignments and do research, so I don't see why the school district would have refused to work with him to finish school.

Edited March 27, 2016 by RCharter

[RCharter]

I have never seen a turkey leg like that outside of a state fair or a movie about King Henry VIII.

every year my friends and I go to the fair and we each get the giant turkey leg.....it does have a very Medieval Times feel to it.  I always feel like I should call for a wench, or clap my hands and demand the court jester.  Either way, my stomach starts to hurt about 1/2 way through, those things are good, but there has to be a weeks worth of sodium.

[RCharter]

"I was wondering if he had Prader Willi Syndrome or something."

 

He does not have Prader Willi.    There are many physical characteristics that are easily identified at birth.

I don't think he has a mental disability at all.  I think he is just an entitled, ungrateful manipulator.  I heard him say "thank you" twice during the entire episode.  And there wasn't a single "thank you" he could spare for the people from his church volunteering to move him out, move him, and drive him cross country.  There was plenty of whining and a warning to "be careful" with his TV, but not a single "hey thanks for taking some time off to come and help me move my shit."

**************************************************************************************************************************************************************************

 I could have stood up and applauded when Dr. Now read him the riot act.  I have type 1 diabetes, and I'm generally not great at managing it.  For years, and years my doctor tried to kindly encourage me to get an insulin pump.  But oh no, not me, I couldn't be bogged down by a machine!  I couldn't be bothered.  I made all the jokes and all the excuses.  He would gently encourage me, give me the number for the pump rep, give me some articles to read at home, tell me about how many advances had been made in the technology and maybe I should just give it a try.

 

Finally, I had an appointment and my A1C was 13.1 (blood sugars averaging over 300).  My doctor came into the room, looked me dead in the eye and said "so which body part do you want to lose first?  A finger?  A foot?  Which toe do you think you can live without?"  There was no laughter, there was no more gentle encouragement....I had an insulin pump within a week and it has not just changed my life, it saved my life.  I'm so thankful to my doctor for taking that tone with me and not coddling me (which is rare, because I do love to be coddled).

 

There is a time and a season for gentle words and sweet tones......that time is not at 1003 pounds and near death.

**************************************************************************************************************************************************************************

Oh....and serious question......given that we have seen so many enablers on the show, how does the staff prevent the enabler from sneaking in food to the patient in the room?  That has to have come up at some point because the relationships are so co-dependent, so I'm wondering if anyone has some knowledge.

Edited March 27, 2016 by RCharter

[operalover]

They have shown a man sneaking in food for his wife. He felt sorry for her in the hospital. He brought her an ice cream sundae. I also think Penny got Edgar to bring her outside food

[Noirprncess]

The hospital staff do not stop family members from bringing in outside food at all. Technically, the patient can eat what they want but those who want the surgery comply or risk losing their chance at getting the surgery.

The only show that had staff put the kibosh on that was Brookdale (?) Hospital which had an inpatient weight loss program. They had the authority to kick people out of the program due to sneaking in food from outside sources.

[RCharter]

They have shown a man sneaking in food for his wife. He felt sorry for her in the hospital. He brought her an ice cream sundae. I also think Penny got Edgar to bring her outside food

 

 

The hospital staff do not stop family members from bringing in outside food at all. Technically, the patient can eat what they want but those who want the surgery comply or risk losing their chance at getting the surgery.

The only show that had staff put the kibosh on that was Brookdale (?) Hospital which had an inpatient weight loss program. They had the authority to kick people out of the program due to sneaking in food from outside sources.

Interesting!  Thank you both.  I had thought if you were admitted to the hospital you had to eat their food.  I'm sure Sean begged and complained so maybe his mother really does want the best for him if she didn't give in and sneak him some food.

[aliya]

I am assuming they couldn't get the ligament fixed in time. I'm a personal trainer so I deal with injuries frequently, and a completely-torn ligament or tendon is something you need to get fixed IMMEDIATELY. We're talking within 24-48 hours. A partial tear can heal fully or at least mostly with less urgent intervention, but if you hear/feel a POP, you need to get to the ER stat.  

Oh Lord, something else to worry about in life. Now I'm going to go around all day listening for pops. 

[Typhoo]

The hospital staff do not stop family members from bringing in outside food at all. Technically, the patient can eat what they want but those who want the surgery comply or risk losing their chance at getting the surgery.

The only show that had staff put the kibosh on that was Brookdale (?) Hospital which had an inpatient weight loss program. They had the authority to kick people out of the program due to sneaking in food from outside sources.

Yes, that was Brookhaven. IIRC they kicked a fellow out because he would not stop ordering fast foods for himself and some of the other residents who wished to cheat The episodes might be on Youtube.

 

Edited to add: They are. Look up Brookhaven Obesity Clinic.

Edited March 27, 2016 by Typhoo

[ClareWalks]

Oh Lord, something else to worry about in life. Now I'm going to go around all day listening for pops. 

 

Normal pops, like an air bubble or cracking your knuckles, are nothing to worry about. When the pop is accompanied by extreme unrelenting pain, get thee to an ER ASAP ;)

[Chalby]

You are so right - I remember Dominique, and her temper when she couldn't get her extra food. If her kids wouldn't bring her food, she'd pay neighbors and strangers to pick up junk food to eat. And that was while she was getting the proper food delivered to her everyday, thanks to Dr. Now. That's when I get really annoyed - when I see people complaining about the food, or having to move their limbs  2 inches, or God forbid, wiping their own butt etc. especially when everything is paid for and supplied to them . They don't even recognize the gift of a new life being offered to them via stomach surgery, and they are dense enough to say - "I'll die of hunger.  As someone else said, they could live months, off their fat stores alone. Most of me prays that they get over their food addiction and end up with a better quality of life. Then I see someone eating so fast that I swear they are not chewing, nor even tasting the food they're shoveling in.I don't see things changing for them. Clearly a medical issue that originates in the mind.

[RCharter]

^^I think the psychological aspect plays a lot into it.  I think by the time you get to 400, 500, 600 pounds you have to come up with some sort of defense mechanism because people are going to tell you what they think...in no uncertain terms.  I remember reading an article written by a overweight/obese woman, and she was saying that people would actively scold her about what was in her shopping cart, and one other shopper went as far to take some cookies out of her shopping cart saying "you don't need these."  And yes, the people are likely right, a 400 pound person does not need cookies, and really shouldn't be buying them, but if you really want the cookies and you don't want to feel like a loser, I guess you have to get defensive.  As they say, the best defense is a good offense, so I think thats where resorting to manipulation and guilting come into play.  If you guilt and manipulate someone before they can point out what you shouldn't be eating -- you kinda win.

[Typhoo]

I remember Dominique, and her temper when she couldn't get her extra food. If her kids wouldn't bring her food, she'd pay neighbors and strangers to pick up junk food to eat. And that was while she was getting the proper food delivered to her everyday ...  

Oh that really pissed me off!! She was sitting there in bed poking her dirty fingers into the diet food meals saying there was too much water in them and no grease and saying that she could not eat the food. The food looked delicious to me and I would have loved to have had the option of getting a diet food plan delivered to me FOR FREE as she got.

[ChristmasJones]

Was this the finale of the season?

[ClareWalks]

Lupe was the finale ep.