Dr. Now is older than you think
Dr. Younan Nowzaradan, M.D., F.A.C.S., known as "Dr. Now" on My 600-lb Life, is the no-nonsense surgeon from Houston, TX who performs the gastric bypasses that change people's lives on the program.
The Iranian-American is in his 70s but looks younger. He graduated from Tehran University in Iran in 1970 with a doctorate in medicine, then moved to the United States to continue his training, and has been in the U.S. ever since. He performs both general and vascular surgery. Patients on the show who do not live within driving distance of his practice, move to Houston for the year-long duration of the program, in order to receive treatment.
The show performs surgery on "untreatable" patients
Dr. Nowzaradan is a pioneer in laparoscopic surgery, particularly as part of bariatric weight-loss surgery. He specializes in the "super-morbidly obese," those with BMIs of 50 or more. Given that every participant on the show is at least 600 pounds, that means many patients have BMIs of 100 or more.
Some doctors who perform gastric bypass surgery have a maximum limit for a client's starting weight. For example, the University of California at San Francisco Medical Center has a weight limit of 450 pounds, due to that being the biggest weight their x-ray machines can measure. Also, the more somebody weighs, the more the risks increase, as with any surgery. This is what sets Dr. Now, and the show, apart, as those who may not be able to get bariatric surgery elsewhere come to his office.
However, candidates for gastric bypass surgery are generally required to lose some weight on their own in order for the doctor to do the surgery. That isn't about the weight limits, but to evaluate whether the patient is really serious about changing their lives.
Dr. Now's son is the reason the show exists
Jonathan Nowzardan is a TV producer for Megalomedia, an Austin, TX-based production company. In 2007, the company filmed a documentary about Renee Williams, a local woman who weighed 841 pounds.
Dr. Now, his father, performed weight loss surgery on Williams after other doctors said no, because she was too much of a risk due to her weight. Unfortunately, she died two weeks later, of cardiac arrest. This show became Half Ton Mum in the United Kingdom, which led to the Half Ton Dad, Half Ton Teen and Half Ton Killer? documentaries on TLC, as well as the A&E show Heavy.
Megalomedia also filmed a number of gastric bypass patients for seven years, which was edited into the first season of My 600-lb Life. Since then, the show only covers one year in people's lives, although they also air update shows.
Weight loss surgery is no quick fix
There is a perception that weight loss surgery is cheating, or a quick fix. And some people go on My 600-lb Life with that attitude, thinking that getting a gastric bypass will make them thin without them having to make lifestyle changes.
A few patients on the show didn't change their lives for the better because they kept on gorging and refusing to move. There was an infamous participant named Penny Seager who whined on the show, "Where's my yellow brick road?" because she didn't lose much weight. Meanwhile, she refused to even get out of bed.
Weight loss surgery is a tool, for use toward a greater goal. For example, if you use a food processor instead of cutting vegetables by hand, you still have to make the dinner. While bariatric surgery will shrink the size of your stomach, lowering the capacity of food that it can hold, that alone will not automatically make you thin. You still have to eat less and exercise in order to achieve success.
Participants have been featured on fat fetish sites
When it comes to sexual fetishes, there is really something for everyone. To that end, there are a variety of fat fetish sites, where women get paid to eat on camera and do sexually suggestive poses. At least two people on the show had their photos on these sites.
Before she got picked for My 600-lb Life, Zsalynn Whitworth was posting her lingerie photos on fetish sites, in order to finance her weight loss surgery. Then she met her future ex-husband Gareth, who was "shopping for a fat girl" to marry, on one of the sites. And Pauline Potter was Paulee Bombshell at the SuperSizedBombshells site.
Dr. Now had a messy divorce
Dr. Nowzardan married his wife Delores in 1975. She was a stay-at-home mom and they had three children together. The kids were adults when Delores filed for divorce in 2002, before her husband's TV fame. The divorce dragged on for years and was finalized through a trial in 2004. Dr. Now then appealed the division of property and lost in 2007.
The appeals court opinion is online, and it contains details on how Dr. Now was accused of all sorts of shenanigans, including allegedly hiding assets, claiming to be retired, and reportedly obstructing the discovery in the divorce. The court document states that "the trial court attributed fault in the breakup of the marriage to Younan, dissolved the marriage on grounds of cruelty and insupportability, and concluded that Younan committed waste of community assets." Ultimately, his wife won and received 70 percent of their assets.
A few participants are real media hounds
While the show did note that Steven Assanti, who appeared on the show in 2017, had made YouTube videos, they didn't show that he was featured on Dr. Phil's "House of Hate" episode in 2007 as "John Assanti."
Before landing a spot on TLC, Pauline Potter was also on Dr. Phil. And she got herself named as the Guinness Book of World Records' "Heaviest woman — living" at 643 pounds, even though the actual heaviest woman in the world tipped the scales at over 1000 pounds. Potter even appeared on Dr. Drew claiming she lost weight through marathon sex.
Oddly enough, though, My 600-lb Life didn't address any of these things when they aired her story. Nor did they talk about her super-size modeling on a fetish site, although they did reference Zsalynn Whitworth's own modeling photos. Potter's propensity for seeking out the spotlight, as well as her identity as a super-obese person, seemed to be important parts of the puzzle of her life, so it seemed strange to leave them out.
Patients are even less healthy than people realize
Most people are familiar with the fact that obesity can cause diabetes, heart problems, stroke, and high blood pressure. But My 600-lb Life also shows how other things like lymphedema (where the person's body parts can swell up), cellulitis, sleep apnea, and depression, among other health issues, are also common in the super-obese.
For example, Tracey Matthews, who was on the show in 2017, had lymphedema and cellulitis so bad in her legs that they looked like elephant trunks. The International Business Times notes that of the 605 pounds she weighed, 400 were in those legs, that were so heavy "her husband, Anthony, would have to lift them up so she could get out of bed."
There's more physical pain that meets the eye
Some of the people on the show have been so heavy they literally could not walk — or in some cases, even get out of bed — because of their own weight. Like Lupe, in the clip above, who hasn't walked in 10 years. Even things like terrible chafing from their body parts touching each other, like legs banging against each other from walking, is a common occurrence on the show.
Another thing the show illustrates is severe pain. None of the people on the show are elderly or terminally ill, yet they feel some sort of physical pain from the moment they get up in the morning, until they go to sleep at night. Some can't even walk across the room without pain.
Many of the participants experienced childhood trauma
If you've ever watched the TV show Intervention, you see the clear link between childhood trauma, and addiction to drugs and alcohol. My 600-lb Life shows that food addiction, which is what the participants all appear to be afflicted with, also results, in many cases, from terrible things they endured during their childhoods.
Sexual, physical, and mental abuse when they were young, were facts of life for most of the people on the show. Some were raped as teens and put on the weight as a protective mechanism. Others ate to make themselves feel better. One example on the show was Ashley, whose uncle allegedly raped her when she was 12. "I didn't know what to do," she said on the show (via The Wrap). "I didn't know how to feel safe. So I would eat to gain back whatever little happiness I could."
This is why when they start losing weight, emotions come into play. Dieting and weight loss surgery is taking away their coping mechanism, and not everyone can handle that. For example, it was only when Ashley went through therapy after the surgery to deal with the abuse that she started to really lose weight.
No one on the show gets fat without enablers
Everybody on My 600-lb Life has at least one enabler, if not more, bringing them the food. You might think they would simply stop bringing them fast food, or going to the grocery store and buying a cart full of junk, but it's not so simple.
In some instances, the obese participants will make their caretakers' lives miserable by hollering and throwing fits until they get what they want. In other cases, the enablers are also heavy, albeit not as heavy, and they don't want to change their own diets. In other cases, the enablers seem to want to be in a caretaker role.
Marla McCants, who reached 800 pounds at her heaviest, called herself a "junk food junkie" and even cooked fried chicken in bed. She had three children she bossed around from bed, and who brought her food.
Participants usually don't know their real weight
Most of the people on the show don't know exactly how much they weigh until they see Dr. Now, as bathroom scales generally don't measure over 300 pounds. Even scales in a typical doctor's office don't go that high. According to TLC, the scale in Dr. Now's office goes up to 900 pounds.
Not every patient serves up an inspiring story
There are many heartwarming stories and weight loss journeys on My 600-lb Life, like Paula, who, after some struggles, lost hundreds of pounds and became a motivational speaker.
But then there are patients like James K., who ordered his family around from his bed. Not only did his daughter have to quit school to take care of him, but he got his father to refinance his house to pay for transport to Dr. Now's Houston office. He also manipulated his girlfriend Lisa. In turn, she gave in to his food demands, and he gained over 150 pounds on the show when he was supposed to be losing weight in order to qualify for weight loss surgery. Dr. Now finally "fired" him as a patient and never performed the surgery because James didn't take it seriously.
Steven Assanti gained notoriety in 2015, before he was on the show, when a Rhode Island hospital kicked him out for ordering pizza while he was a patient there. He was reportedly abusive to the nurses during previous hospital visits, living up to his reputation on My 600-lb Life. His lowest moment may have been when he "accidentally" knocked a plastic bottle filled with his urine on the floor for the nurse to clean up.
Most of the participants have significant others
You would think that being super-morbidly obese would limit your love life, but many of the participants on the show have husbands, wives, or live-in partners. One woman, Tanisha Cleveland, had a husband, but when he left her during the show because he wasn't interested in helping her lose weight, she even found a new boyfriend — while still bedridden.
Most of the relationships on the show change — some for the worse — after weight loss surgery. Some of the partners are overweight as well, and their partners' weight loss threatens them. In some of the relationships, the partner doesn't want their "loved one" to change. Others want to feel needed, so the weight loss threatens them. Christina, a young woman on the show, lost over 500 pounds, along with her husband, because he preferred the caretaker role to supporting her new life.
Some of the partners are so-called "fat admirers" who have a fetish for fat women, and want them to stay fat. In one extreme case, when Zsalynn Whitworth's husband drove her back home after weight loss surgery, he took them through a fast-food drive-through first. Even their own daughter asked her on the show why she stayed with him. They later divorced.
The show has really humiliating bathroom scenes
Washing or using the bathroom is a struggle at 600 lbs. Some participants only do sponge baths. Some have a hard time just trying to squeeze into the bathroom. Genital areas are censored on the show, but viewers still get a full view of the patients' rolls of fat.
Maybe the most embarrassing instance was in an episode featuring Nicole Lewis, whose story aired in 2017. Both of her parents were drug addicts, and she ate her pain away. She got so big, she couldn't fit in the shower. So she had to be hosed-off like an animal outside on the porch.
It's not just what you eat, it's what eating you
The saying "it's not what you eat, it's what eating you" is an applicable adage for the show and its patients. In its earlier seasons, My 600-lb Life didn't provide much in the way of therapy, but they've been emphasizing that more. Without this, it seems like the participants won't make the breakthrough to change their lives.
For example, Kirsten Perez was gang-raped as a teen, something she blamed herself for. She wasn't doing well in losing weight, even after gastric bypass surgery. Finally, Dr. Now ordered her to therapy, refusing to treat her any more if she didn't go. He said, "She needs a wake-up call."
Perez went to a therapist, who told her, "You have written a narrative in your mind where you're just as culpable as the perpetrators." She told her to "let go" of such "responsibility," and said that "it's important that you skew your thinking toward the positive." The patient listened, and lost 170 pounds by the time the show was over, something that pleasantly surprised her family.