When Will Power and Knowledge Aren’t Enough

Bruce Sachais, MD, PhD, is an associate professor of pathology and laboratory medicine at Penn Medicine. In December 2010, he attended an informational session and decided to have weight-loss surgery. His Roux-en-Y gastric bypass surgery was performed at Penn by Noel Williams, MD. In this article, he discusses his struggle with weight, and why even as a physician, losing weight alone has been challenging. 

Read more about how Bruce lost 121 pounds.

As a physician, I should know better. I understand the importance of healthy eating and maintaining a healthy body weight. I understand biochemistry; how the molecules in the food we eat are extracted and used for energy, building up our bodies, and how they are stored (mostly as fat) when we consume more calories than we burn. I understand the importance of regular exercise, not only for burning calories, but for keeping many of our body tissues, such as our blood vessels, is a healthy state (which helps decrease the risk of heart attacks and strokes). So if it were just a matter of knowing, I should have been thin and healthy, but I was not.

To become an academic physician, one who both cares for people and performs research to improve the ability of medicine to care for people better, I am used to doing things that are difficult. Many years of education and training, long hours in the hospital, fighting for funding to support my scientific ideas all take time, dedication and determination. So if it were just a matter of willpower, of trying harder, I should be thin and healthy.

The fact is, for some people, it is more than that. Knowing what to do and having the determination to do it is just not enough for everyone to lose meaningful amounts of weight over the long haul. It was not for me. That is NOT an excuse by any means, and I want to stress that both knowing and determination are required (even after weight-loss surgery) they were just not sufficient. It was when I finally came to terms with this, that I took a serious look at surgery as a means to finally achieve my weight loss and health goals.

Through the education and information provided by the doctors, nurses and dieticians at Penn Metabolic and Bariatric Surgery Program, I learned about what gastric bypass could offer me, and what it could not. As a physician myself, I read some of the primary scientific literature, which supported all I had learned from the program. I learned how gastric bypass (as well as other surgical options) was most likely the tool I needed to allow me the success I needed, and deserved, to become a healthier and significantly smaller man. I learned that after surgery, both the anatomy of my digestive track (stomach and intestines) and biochemistry (chemical reactions and signals in the body) that control digestion and hunger would change. It is a combination of these changes, with my knowledge of healthy eating and exercise habits, and my determination (will-power) that have given me my success (down 121 pounds from a high of 322 pounds) to date.

I have chosen to write this because I want others to know that it’s okay to ask for help; that knowing what to do does not always allow a person to be successful in life, and that weight loss surgery, at least for me, has been the additional piece of the puzzle to allow me to meet my weight loss and health goals.

My life has changed for the better in so many ways, but that is a story for another day.

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