Half-ton man, losing weight fast on 1,200-calorie-a-day diet

SIOUX FALLS, S.D. -- Patrick Deuel is on a diet. He's down to about 700 pounds now. He hopes to lose 400 more.

When he entered the hospital in Sioux Falls, he weighed more than half a ton -- a disaster Deuel blames on bad genes and his early years in the restaurant business.

He kept eating until he hit 1,072, a weight that could only be determined when he was put on a scale used to weigh trucks loaded with grain. To get him to the scale, a wall had to be knocked out of his home in Valentine, Neb.

From the truck scales, Deuel was taken by specially equipped ambulance to Avera McKennan Hospital about 300 miles away in Sioux Falls on June 4.

"When Patrick came in, he was dying," says Dr. Frederick Harris, who leads a nine-person team caring for the 42-year-old man.

Deuel suffered from heart disease, diabetes, high blood pressure and other obesity-related problems, says Harris. He had trouble breathing and was malnourished because so many of his calories came from foods high in fat and carbohydrates.

Now on a 1,200-calorie-a-day diet, Deuel hopes to hit the 300-pound mark and be healthy enough to have stomach-stapling surgery, which can be risky.

Deuel's weight loss is about eight months ahead of schedule, his doctor says. Recently, Deuel took his first steps in months. He now can walk on his own a short way down the hospital corridor.

He hopes to move into a rehabilitation wing of the hospital, possibly as early as October. And he'd like to get into the swimming pool, but that has complications, too.

"Swimming for me has always been a good way for me to lose weight. But they can't let me in the pool until they can get me out," he said.

Hospital pays the bills

Harris -- who used to be obese himself and had gastric bypass surgery a few years ago -- mounted a vigorous effort to get his hospital to admit Deuel. Much of the cost of his care will probably have to be absorbed by the hospital, the doctor said.

And that care has required "out-of-box thinking," Harris says.

To get to the hospital, Deuel rode in an ambulance equipped with heavy-duty stretcher, winches, ramps and other tools to move and carry him.

At the hospital, the staff set up a custom-made bed reinforced to carry his weight. Workers installed a patient lift system to help nurses and assist with weigh-ins. A hospital room was remodeled to accommodate him, his plus-size bed and the medical staff tending him.

A gregarious man who asks for hugs from nurses and visitors, Deuel says he doesn't mind the attention he's received since arriving at the hospital back in June.

Casually drop his name at the coffee shop in Sioux Falls and people recognize it almost instantly.

"So long as people hear what I have to say," Deuel says, "as long as I am succeeding in getting my message out about weight loss, it doesn't bother me."

Bedridden since last fall, he thought about trying to keep his identity private. But he figured he could do more good by talking about obesity, its stigma and the lack of financial and medical resources available for people his size.

He says most people have been sympathetic and offers as proof dozens of letters and cards taped to the walls of his hospital room and a 2-inch thick stack of e-mails from well-wishers -- some from as far away as Australia.

Only a few people have been critical, he says. One called him a name. Another scolded him for gaining weight in Nebraska and then asking doctors in South Dakota to solve his problem.

Nearly all the rest of the correspondence has offered encouragement, prayers for healing and support, he says.

Deuel, just under 6 feet tall, has always fought his weight. He weighed about 90 pounds in kindergarten and more than 250 pounds in middle school. His father and grandfather were both big, too, each weighing more than 300 pounds.

But he says years of bad eating habits and a career in the food service business pushed him into trouble.

"Some was genetic, sure," he says. But as a cook and restaurant manager who worked long hours and had access to nearly any food, he ate what he wanted, he says.

"You'd think you could cook things that would be diet advantageous," he says. "But it's a lot more difficult than you think to pull something like that off."

The diets he tried over the years never worked. "I'd say just one more day. It won't hurt me." Before long it was just easier to buy a larger shirt or a bigger pair of pants, he says.

He was still in his 20s when he went on disability after a fall 16 years ago and has relied on Medicare to cover his medical expenses. Over the years, he says he asked Medicare to cover weight-loss programs he couldn't afford.

But Medicare, which is funded with tax dollars, did not consider the programs to be medically necessary, says Deuel.

The implication is "losing weight is not something you do for your health. It's something that you do to make yourself look better," he says.

For the severely obese, weight loss has little to do with looks, says Deuel. "There is no way that 1,072 pounds is cosmetic. That's life-threatening."

This summer Medicare announced it would review its policy on obesity. In November, an advisory panel will study gastric bypass and other weight-loss measures to see if Medicare should pay for them.

More than 100,000 morbidly obese people had the stomach surgery in 2003, up from 25,000 in 1998, according to the American Society for Bariatric Surgery.

Deuel's wife Edith, who describes her husband as a "funny, intelligent person" hopes that people who hear his story will be less quick to judge the obese.

"I want people to look at people for who they are on the inside and not by the package on the outside," Mrs. Deuel says. "There are so many people out there who are being shunned because of their size."