Many famous surgeons lived in Minnesota when I was growing up and, to me, they were heroes. Doing things that nobody else had the brains nor the confidence to do, and saving lives in the process. I made my mind up early to become a surgeon.

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I was in awe of pediatric heart surgery, but it was exposure to Dr. Henry Buchwald’s metabolic surgery that changed my perspective. He didn't attack one disease; he attacked many diseases by performing a single operation. Luckily, my surgical training included bariatric surgery and also coincided with the advent of minimally invasive surgery in the US. As a result, by the time I completed training, I was uniquely suited to enter the new field of minimally invasive weight loss surgery.

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Early in my practice, it quickly became apparent that the foremost goal people had when pursuing weight loss was to be able to participate in life without the obstructions caused by excess weight. The motivation for weight loss touted by the medical profession, “eliminating weight-related disease,” failed to empathize with the physical restriction experienced by severely overweight people. As an avid runner, I knew that even a small amount of excess weight adversely impacted my ability to enjoy running, so it made sense to me that the main goal of weight loss was the desire to be able to do more. I call this "Expanding your range of capability" and wrote about it in my book Permanent Surgical Weight Loss.

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The immediate goal of weight loss, to live a happier life, explains why people refuse to follow unpleasant dieting advice promoted by doctors and dietitians. The "diet control" approach that has been failing for decades is obviously ridiculous, and I call long-term dieting a "personal persecution program." Instead of promoting restrictive dieting, such as calorie counting and portion control, I developed a system of identifying personal eating habits that are satisfying and don't result in weight gain. I call this approach a DietaryRebuild® and have applied this process successfully for decades.

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As a weight loss surgeon, I believe the ideal surgery will help people change their eating habits and not cause malnutrition. Too many surgeons believe that forcing people to eat differently, or causing malabsorption of nutrients, is the answer, and I completely disagree. To provide the leverage my patients need to change their diet, I've developed the S.L.I.M.M.S.® Procedures. The SLIMMS "Lifestyle" Procedure is a modified Magenstrasse-Mill operation, providing a reversible, minimally-invasive procedure for cosmetic weight loss. The SLIMMS "Metabolic" Procedure is a combined gastric bypass and gastric sleeve, designed to maximize metabolic improvement without increasing malnutrition. The SLIMMS Revision of Gastric Bypass is designed to improve the results of a prior gastric bypass in part by decreasing appetite. I've seen excellent success with all three procedures.

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Everyone has a threshold beyond which the negative impact of excess weight becomes unacceptable. The weight management systems I've created, and the surgeries I’ve developed, all focus on maximizing the potential for clients to achieve their personal goals.