J.B. Flemming M I Was Going to Do Whatever It Took to Live

“It’s not easy, but it is rewarding. The best is still to come. You haven’t seen anything yet.”

Four years ago, J.B. Flemming McNeill weighed nearly 700 pounds when his primary care physician delivered a warning he would never forget. “She said to me, ‘If you do not make a change, you’re going to die,’” says the 37-year-old Linden resident. “It was the first time I had heard those words.”

The warning was a wake-up call for McNeill, who had struggled with his weight since childhood. Obesity-related health issues, including high blood pressure and body pain, had forced him to stop working at the time. “My life was so miserable,” he says. “I was on the way to an early grave.”

To save his life, McNeill decided to have weight loss, or bariatric, surgery at Robert Wood Johnson University Hospital (RWJUH). Surgery helped him lose hundreds of pounds, and he now wakes up at 5 a.m. to exercise with a personal trainer five days a week. It’s a dramatic transformation for McNeill, who at one point could barely walk without struggling to breathe.

Ragui Sadek, MD, FACS
Ragui Sadek, MD, FACS

“His outlook on life has completely changed,” says Ragui Sadek, MD, FACS, Director of Metabolic and Bariatric Surgery at RWJUH and Clinical Assistant Professor of Surgery at Rutgers Robert Wood Johnson Medical School. “He’s been cured of a life-threatening disease that diminished his quality of life.”

Making A Change

McNeill’s family has a history of obesity due to poor diet and lack of exercise, and while growing up, he coped with trauma and verbal, physical and sexual abuse by eating. “I took comfort in food,” he says. “When I was sad, happy, mad or glad, I would eat.” He developed severe health issues linked to being overweight, such as sleep apnea, liver failure and chest pain.

When McNeill’s mother and uncle passed away from obesity-related medical conditions, he began to consider bariatric surgery. “They made me want to do better for myself,” McNeill says. “I was going to do whatever it took to live.”

His physician’s warning a few years later finally pushed him to act. His sister, who also has weight challenges, suggested meeting with Dr. Sadek. At the first appointment, McNeill tipped the scales at 696 pounds.

“Having a body mass index [BMI] that high is a life-threatening condition,” Dr. Sadek says. “Every day causes irreversible damage to the body.”

Bariatric surgery would jump-start McNeill’s weight loss and help prevent deadly obesity-related complications. Because of McNeill’s unusually high BMI, Dr. Sadek recommended a two-stage process: a gastric sleeve operation followed by gastric bypass surgery a few months later. “Depending on a patient’s BMI and overall health, doing a staged approach can be a safer way to get patients to their goal weight,” Dr. Sadek says.

Both procedures change the way food is absorbed by the body, decreasing appetite and food intake. Gastric sleeve surgery would remove a portion of McNeill’s stomach and shrink the remainder so it could hold no more than 4 to 6 ounces of food. Gastric bypass surgery would reroute food to a smaller portion of McNeill’s stomach and small intestine to further reduce hunger and calorie consumption.

Before he could safely undergo surgery, however, McNeill needed to lose around 50 pounds on his own through a weight loss plan of exercise and diet changes guided by RWJUH experts. “He was very motivated and keen on changing his lifestyle, getting healthy and regaining control over his medical condition and life,” Dr. Sadek says.

Lifesaving Outcomes

Bariatric surgery is a safe and highly effective way to address obesity, Dr. Sadek says. Both gastric sleeve and gastric bypass procedures provide significant health and social benefits. “Over the 16 years I’ve done this, I’ve never heard anything but patients saying they would do it all over again,” Dr. Sadek says.

After undergoing the surgeries in 2019, McNeill dropped more than 300 pounds—44 percent of his original body weight. Just as important as the physical transformation was the improvement in McNeill’s daily life. “I can wear a seat belt now with no extender,” he says. “I can fit in chairs with arms. It’ s amazing being able to do things that I never could do before.”

Ensuring the surgery’s success required long-term lifestyle changes. “Bariatric surgery is not an easy way out,” Dr. Sadek says. “It’s a way to give patients control over obesity, but they have to work to maintain that.”

Following his recovery, McNeill joined a nearby gym and created a healthy eating plan with a nutritionist. He also started a Facebook page to track his progress and inspire others struggling with obesity.

“It’s not easy, but it is rewarding,” McNeill says. “The best is still to come. You haven’t seen anything yet.”

Support Before and After Surgery

Weight loss surgery entails extensive evaluation, education and post-op followup. The Bariatric Surgery Program at Robert Wood Johnson University Hospital develops a personalized care plan that taps numerous specialties including:

  • Pulmonology: Lung function tests and sleep studies diagnose any existing sleep apnea—an important condition to be aware of before surgery.
  • Gastroenterology: An endoscopic examination of your esophagus and stomach assesses your everyday digestive system.
  • Cardiology: Tests such as an echocardiogram and cardiac stress test help doctors determine what your heart can handle.
  • Endocrinology: Do you have diabetes? A doctor who specializes in metabolic disorders will find out.
  • Psychology: Counseling helps you transition to lifestyle and dietary changes that help ensure the best health outcomes and need to be continued long after surgery.

Award-Winning Care

The Bariatric Surgery Program at Robert Wood Johnson University Hospital has received widespread recognition for excellence in care. Honors include:

  • The Healthgrades Bariatric Surgery Excellence Award
  • Center of Excellence in Metabolic and Bariatric Surgery designation by the Surgical Review Corporation
  • The Joint Commission’s Gold Seal of Approval
  • Recognition for excellence in patient care from insurance or care providers including Aetna, Cigna, Optum and Blue Cross and Blue Shield

Learn more about weight loss surgery at Robert Wood Johnson University Hospital, call 732-640-5316.