Thank you Dan for your considerate comments. Like PHM, I am a very fat man and am not getting on with my life. Relatives and friends who have had bariatric surgery advise me to look into it, but I'm reluctant to do that because it is risky -- although much less risky than being 180 pounds overweight.

Like hundreds of ivy league educated actor-waiters here in NYC, I am not living up to my potential. I'm getting by, but I'm not getting ahead. I know I could benefit from therapy, but just don't like going to the social workers prescribed by my insurance plan. I'd prefer to see a psychiatrist who's experienced for psychotherapy, not just for prescriptions, like people used to do 35 years ago.

I'm worth about a million and I have a part time job that provides health insurance benefits, although it's not good for mental health benefits. To see a psychiatrist for therapy like I'd like, I'd probably have to pay him without reimbursement something like $200+ per hour once or twice a week for a year or two -- which would still be cheaper than having a gastric bypass or having my stomach banded. That could be good for me, but I can't get myself to move towards doing much of anything.

What makes a difference for me now is just getting up and walking around the block some. That small amount of exercise has big benefits. I'm in Forest Hills in Queens where there are sidewalks all around. Even though I get some stares for being a fat guy, I manage to move along. Also, I'm a tour guide aboard the buses here in NYC so I'm going up a flight a stairs more than ten times a day, at least five times a week, which guys over 360 pounds don't do so often.

PHM, what I think could really help you now is to go to a support group. You need friends, or at least well-meaning people who will try to act like friends. Overeaters Anonymous and nearly all the other support groups are not just dealing with addictions, but are also dealing with the mixed up thinking and emotions that enable people to become addicts. The emotional support from a support group can help you get back on your feet. Getting a sponsor in OA, speaking with someone everyday at a regular time, who's independent and not a relative, can help you to see yourself differently than you see yourself now. Obtaining a workout partner, someone to walk around the block with you everyday at first, and later someone to lift weights with you at a gym 2 or 3 times a week for an hour or so could end up happening from OA too.

There's a fellow in AZ named David Smith who weighed over 600 pounds who got thin without surgery. What made him successful was making a friend. Smith called up a TV fitness guru who became his mentor. http://getfitslowly.com/2008/01/31/david…

What a bunch of fatphobic, ableist bullshit in these comments. Yeah, everybody you know who used to be fat = everybody who's fat. Selling your car = TOTALLY realistic for people who don't live in densely urban areas. Walking everywhere = same, and TOTALLY realistic for people with mobility-related disabilities. Not eating for a day = TOTALLY smart! I mean, it's not like a lot of people initially got fat in reaction to parents who used to starve us because we were a little chubby, not the slim, willowy kids they wanted and thought they deserved!

Never mind all this "doctor-assisted" stuff, plus suggestions to go see "naturopaths" (i.e., quacks) and go to gyms. Do you privileged assholes have any idea how many people don't have healthcare in this country?

There's nothing kind or compassionate about suggesting someone mutilate an internal organ via a surgery that often kills, destroys the body's ability to absorb nutrients from food, and doesn't always work because, hey, guess what? Eating a certain amount is NOT entirely a matter of "willpower."

Fuck Savage, and fuck all you urban "progressives" with giant fucking blind spots when it comes to body shape, class, and ability.

agree with #22. dieting is hard (I'm obese right now, so I know how it feels) but the LW readily admits he eats tons of junk food. try life without the junk food. keto diets, like atkins and mark sisson's version of paleo, can make huge changes... and even take the cravings for junk food totally away. that's right, you'll be craving broccoli and salad. don't jump right to the surgery until you've tried this.