Dr. Younan Nowzaradan (a.k.a. Dr. Now) has contributed decades to bariatric surgery by taking on the highest-risk obesity cases other surgeons turned away. In this episode, he challenges the idea that obesity is a failure of discipline, arguing instead that it is a chronic metabolic disease driven by genetics, gut health, and modern medicine. He breaks down why bariatric surgery is often misunderstood, why its effects can fade over time, and why no single operation should be treated as a lifetime cure. The conversation confronts uncomfortable truths about discrimination in healthcare and the systems that leave the sickest patients behind. Dr. Now talks with host Dr. Greg Burzynski about curiosity, responsibility, and the reality of caring for patients when progress is slow, outcomes are uncertain, and judgment has no place in treatment.
🎧 Episode Highlights
● [00:23]: Why Dr. Now operated on patients other surgeons refused to treat
● [14:29]: Obesity as a metabolic disease, not a failure of discipline
● [21:00]: How gut bacteria and modern chemicals may be driving obesity
● [29:27]: Why bariatric surgery is not a permanent cure
● [47:58]: What decades in medicine taught Dr. Now about life and responsibility
🔑 Key Takeaways:
● Obesity is not a personal failure but a chronic metabolic disease shaped by genetics, gut biology, and environmental exposure. Dr. Now argues that appetite regulation, insulin resistance, and weight gain are driven by complex biological systems, many of them outside individual control, making stigma and moral judgment not only inaccurate, but harmful to effective care.
● Bariatric surgery is a tool, not a cure. While surgery can reduce intake and improve short-term outcomes, it does not eliminate genetic predisposition or permanently alter metabolic drivers, which is why weight regain is common and long-term management remains essential.
●Healthcare systems often fail the sickest patients by prioritizing risk avoidance over responsibility. By turning away high-risk obesity cases, institutions reinforce discrimination and leave the most vulnerable without care, forcing progress to come from clinicians willing to accept uncertainty, complexity, and imperfect outcomes.
👤 Guest Spotlight:
Dr. Younan Nowzaradan
Dr. Younan Nowzaradan, also known as Dr. Now, is a board-certified bariatric surgeon and one of the world’s most recognized experts in the surgical treatment of severe obesity. Based in Houston, he has spent decades helping patients with complex, high-risk cases reclaim their health through evidence-based weight-loss surgery. He became widely known for his show My 600-lb Life, where he combines clinical rigor with direct, no-nonsense compassion. Dr. Now is also a vocal advocate for treating obesity as a chronic metabolic disease, not a moral failure.
Stay Connected:
https://www.linkedin.com/in/drgregoryburzynski/
https://www.linkedin.com/in/younan-nowzaradan-97ab6079/