The brutal reality of life at over 600 pounds

In this video, Mikhail Varshavski, DO, who goes by “Dr. Mike” on YouTube, reviews the reality show “My 600-lb Life” and gives his thoughts from a medical perspective.

Here is a partial transcription of the video (note that errors are possible):

Varshavski: We’re going to react to another episode of “My 600-lb Life.” Again, I’m not a fan of the title, but ultimately I think even with episodes like this there are some good lessons that we can all learn from.

Just watching her wake up in the morning, you can tell she’s going through a tough time with mobility, and when we talk about helping patients lose weight, part of what we’re thinking about is their quality of life. So yes, we want to reduce the risks of cardiovascular diseases and the development of metabolic disorders like diabetes, but we also want to make them comfortable. We want to allow them to fully enjoy their daily lives. And as they get older, we want to make sure they can maintain their independence.

Cynthia: When I wake up in the morning, I start to hurt because the pain is intense.

Varshavski: Remember it’s exponential. The weight you carry in your abdomen is going to be exponentially higher on your hips, on your knees, on your ankles. The number one thing proven to help reduce osteoarthritis pain and other related symptoms is weight loss.

Cynthia: It hurts and it’s hard to reach my body.

Varshavski: It’s difficult, but it’s very important, because when you have excess fatty skin tissue, it’s a place where bacteria and fungus can live. As a result, you can actually develop skin conditions that are not only dangerous but also very uncomfortable and painful.

Cynthia: Once I get out of the shower my daughter comes in and she cleans the back of my legs because my arms are too short to reach.

Ukiah: Mom, she tries to do everything. She tries not to be lazy and she tries to do a lot of things, but she can’t.

Varshavski: It is important to not only clean the area, but also dry it thoroughly, as a moist environment, again, harbors bacteria and fungus.

Family member: Height was something that was considered a sort of birthright in our family. We loved to eat. It was sort of a running joke that if you were tall, you were fine.

Varshavski: Culturally, eating is so important to people that discussing one’s diet should be done very thoughtfully and carefully. You never know what food means to someone or what their daily family meals mean to someone. I have seen this happen in my clinic with members of the Latino community and how important it is for them to have regular meals with their families consisting of rice and tortillas. Some of these foods, when consumed in excess, can actually be harmful to the patient, especially when suffering from metabolic disorders like diabetes.

Cynthia: I was gaining weight from a young age and by the time I was in middle school, I already weighed 250 pounds. Then I started having seizures. Every time I had a seizure, it was while I was watching TV or a movie.

Varshavski: I wonder if this has something to do with epilepsy triggered by flashing lights or perhaps lack of sleep. In fact, when we have children who have had a seizure, they come to our inpatient department where we put an EEG cap on which we monitor their brain waves and we try to induce the seizure, either through sleep deprivation or by flashing lights. . When we do this, we can ensure that the crisis occurs in a safe and controlled medical setting. But then we’re able to see what parts of the brain it’s coming from and we could then treat the individual, get them to a place where they won’t have seizures and hopefully can go home safely .

Cynthia: When I was 28, a situation arose where I had to take custody of three of my cousin’s children.

Varshavski: Wow! It’s awesome that she did this for her family.

Cynthia: I didn’t want to give up having my own children. I came out to my two youngest children and got pregnant. I was too big to weigh on the office scale, so I had to go to the freight scale. At that time I was around 480 years old and spent all my time caring for others rather than myself.

Varshavski: And I know some people say, “Why did they weigh her?” This doesn’t seem to be sensitive. » It is actually very important during pregnancy to monitor your weight to make sure there is no fluid buildup or the baby is having some impact on the body. Those who are so overweight not only have problems with the scales, but they also have problems with the stools in our offices. They have difficulty adapting to MRI and CT scan machines. It is by no means an easy life.

Cynthia: My weight limits me so much, so I want to lose weight. But when the cravings come, all I want to do is eat.

Varshavski: I’m sure this was filmed before the introduction of GLP-1 drugs like Ozempic and Wegovy (semaglutide). The reason these medications have been so successful is that they work on metabolism to some extent, but the biggest benefit they bring to people is that they reduce food cravings. It slows gastric emptying, which slows down the process of passing food through the digestive system, making the individual feel full and therefore experience fewer cravings.

Cynthia: Being a teacher requires being on your feet all day. But when I get to work, I can’t even walk through the building to my class without stopping. I kind of plot my route to where I know there are chairs I can sit on.

Varshavski: Yeah. The fact that she is so out of breath is concerning from a cardiovascular standpoint. For example, is her heart able to keep up with the weight she currently has? For her own safety, you want to make sure she is able to walk around without posing a risk to her heart.

Watch the video above to learn more.

Mike Varshavski, DOis a board-certified family physician and social media influencer with over 12 million followers.