Nov - Dec 2022

Three Lessons Learned from My Patients That Made Me a Better Doctor

By Carl A. Weiss, III, MD PhD FACS


As a high-volume practicing bariatric surgeon for 15 years, I have had the unique privilege of interacting with thousands of bariatric patients. Working with them has helped me to expand my medical acumen and make better treatment decisions. Quite frankly, I have learned a great deal from patients over the years and I’d like to share a few of my most important lessons


One of the first things that I have learned is that it is very difficult to predict who will do well. We have had patients who we certainly thought would have had trouble being successful, who have dramatically changed their quality of life and had tremendous success over the short and long term.


On the other hand, we have had patients who appeared to have all the earmarks of success preoperatively (such as high intelligence and motivation) but at the end of the day they have failed to have any success whatsoever. It is very difficult to predict who will do well. We try not to prejudge and strive to give anyone interested in weight loss surgery a chance to have success.


Another lesson learned after talking with thousands of patients is the fundamental importance of insight. Insight implies that a person has the ability to reflect and understand their own behaviors and what they need to change in order to have success. We view bariatric surgery as a tool and different procedures have advantages and disadvantages.


We have learned that sleeve gastrectomy has offered the most consistent success with the fewest complications. However, there is no perfect operation in the absence of behavioral change. Patients with insight understand the importance of protein, portion control and exercise. Those patients who embrace these changes have tremendous success.  Patients who have perfect surgical procedures and are unable to change their approaches to nutrition and exercise will inevitably not have success.


Lastly, I’ve seen first-hand that one of the most important components of success is the value of exercise. Patients seem to have a tendency to choose the options that require the least amount of work in order to have success. Those that rely on medications and vitamin supplements or sedentary approaches to weight loss have disappointing results typically. Patients who are able to embrace some type of regular exercise retain muscle mass and overall have a better quality of life and dramatically improved weight loss success.