I agree. Such cases need to be treated with some urgency. Almost definitely they will have a number of medical problems. Diabetes, blood pressure, cholesterol, ischemic heart, hypothyroid, fatty liver... i would take just enough time to medically stabilise all these problem and put him under the knife. Gastric banding or gastric bypass can only get him from 60%+bf to maybe 30%. We can then take our time to decide what is the best way to get him from 30% to 18%.





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