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Friday, July 06, 2012 5:29 pm Email this article

​After 16 years 6 months of bariatrics, I finally reached ten thousand patients. That's an actual count. I kept it on my blackboard. And I saw all those patients, individually, myself. 

I can divide my patients into three distinct groups with little crossover. Group C are the patients who hear nothing and read nothing. They wait impatiently for me to stop teaching so they can get their pills and get out. Group C comprises about 20% of my patients. Half of the men are in group C, very few women. These patients always fail in life. Group B are 70% of my practice. These are the salt of the earth, the steady average people, who make changes through the bureaucratic process. The latter is an actual defined term describing how bureaucracies approach change. They make small changes and wait to see if the results are in the desired direction. Then they make another small change and wait to see, etc. Patients do that, too. It's comfortable that way, and after all, why should they trust me completely at first? Every shnook in the valley has a diet program and a pill. The problem for group B is that their weight loss is so slow that it gets canceled out by their back-slides. But I have to love these people, because hey, it's most of my practice. They lose weight and plateau, but they are still better off than they would have been if they hadn't met me. Group A people listen intently to what I say, read everything I write and do exactly as I direct. They lose oodles of weight. Their names glitter on the Famous Person List I have kept since 2000. They (almost) never gain weight back. I love to compare their looks to their old driver's license picture. I live for these people. Except for them, I would retire. There is an easy way to tell, on the second visit, who will be in which group. I merely ask them to recite the Six Lessons. Group C people don't even know there is a thing called the Six Lessons. Group B people know 2-3 of the lessons. Group A people recite all six, word for word, often in order. Group A is only about 10% of my practice.

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