Eighteen years ago when I began in bariatrics, I did not know what to tell people. I knew that the existing nostrums were all wrong. So I made up stuff. In my defense, I always checked the results of my advice and discontinued it when it wasn’t working.
For example, I used to tell people to eat when hungry and stop when full. Sounds right, doesn’t it? But it was a disaster. People started gaining weight. I quickly snuffed out the advice. In postgame analysis I realized that fat people assume they are always hungry and feel full only when the overfull stomach is stretched. My advice had given them permission to snack and eat huge suppers, the very things I now oppose.
I’ve got it straight now. All of my advice is battle-tested.
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