University of Chicago Medicine

Celebrity chef reshapes his connection with food and health

Graham Elliot (right) is interviewed on Fox Network about his remarkable weightloss.

More than one-third of Graham Elliot – renowned in the United States as a chef and judge on the Fox Network’s popular competitive-cooking show, “MasterChef” – has gone missing.

People become chefs because they appreciate food. Elliot’s appreciation, and his waistline, kept pace with his culinary reputation. He joked that “no one trusts a skinny chef”. By 2013, however, his trustworthiness had grown a little too apparent. No one would accuse him of skinniness. He weighed almost 400 pounds (181kg).

The weight brought health problems. He had inherited a family history of heartattacks and strokes. The excess weight piled on new issues.

“We had exhausted all options.”

“I was suffering from hypertension, sleep apnea, gout, constant aches and pains,” Elliot said. “I was physically unable to do things a father, husband and parent should be able to do. I was headed for disaster if I didn’t make tough decisions, take drastic measures.”

Most frustrating for him was his inability to run and play sports with his three young sons (ages 7, 3, and 18 months at the time). After years of testing various standard and imaginative diets, working with a dozen personal trainers and joining multiple gyms, he knew he had to make a change. “We had exhausted all options,” said his wife, Allie.

Making the commitment
Elliot, 40, had considered weight-loss surgery, but was hesitant to take the next step. He asked a friend, fellow chef Grant Achatz, who spoke highly of his care at the University of Chicago Medicine. “So that was where I focused,” Elliot said.

At his initial appointment, he met Vivek Prachand, MD, an expert in minimally invasive abdominal surgery. “We immediately connected,” Elliot said. “He totally understood my unique situation as a chef who happens to be on a food-related TV show. I was worried about not being able to do either, so Dr. Prachand being a foodie was defi nitely a bonus.”

After an extensive multidisciplinary evaluation, followed by a series of discussions and counselling, Elliot underwent obesity surgery.

The changes have been remarkable. Before surgery, Elliot could barely run. It was diffi cult for him to get in or out of a car, tie his shoes or play with his kids. He would have had trouble walking a mile, had he tried. Four months after his operation, he was able to fi nish a fi ve-kilometre race. He covered the course in less than 35 minutes.

“Running that first 5K was awesome,” Elliot said. “Allie was right there beside me, my nurse and cheerleader.”

Six months later, Elliot no longer required a machine to keep his airway open while he slept. By nine month following the surgery, his weight had dropped from 396 to less than 250 pounds, his blood pressure was nearly normal and his cholesterol levels had radically improved.

“I thought it would take two or three years to do this,” he told a reporter from People Magazine back then. He expected to lose just 60 or 70 pounds the fi rst year. Losing up to 100 pounds would be more typical, according to Prachand, associate professor of surgery, director of minimally invasive surgery, and surgery quality chief at the University of Chicago. But Elliot was not typical.

He did his research, Prachand said. He knew all of his options. He had his family to support and motivate him and was “absolutely committed to making the necessary lifestyle modifications that allow his procedure to work most effectively.”

A switch in time: Nothing up my sleeve
There are several surgical options for obese patients; the UChicago Medicine team has significant experience with all of them. When Elliot fi rst came to the clinic, he saw himself as a candidate for a duodenal switch (DS), a procedure that combines a gastric sleeve with a realignment of the digestive tract that helps patients limit their food intake and decreases calorie absorption.

“The duodenal switch is generally the best option for patients with a body-mass index of 50 or more plus metabolic problems associated with severe obesity,” Dr. Prachand said. “Graham technically fit those criteria, but as with all of our patients, we had to carefully consider his circumstances, particularly as they related to his career.”

Duodenal switch patients lose some of their capacity to process and absorb dietary fats. Even small servings of fatty foods can trigger cramps, bloating, and other intestinal distress.

“Obviously this could interfere with his role as a chef and as a judge of dishes created by contestants on MasterChef,” Dr. Prachand said. Multiple small tastings is central to Elliot’s work.

So Dr. Prachand suggested a less extensive operation, called the gastric sleeve, which is one component of the DS. A gastric sleeve makes the stomach about 80 percent smaller, the size and shape of a small banana, but it doesn’t interfere with nutrient uptake or digestion.

“It was a reasonable way to start,” Dr. Prachand said “If it wasn’t suffi cient by itself; we could follow it with the rest of the DS at a later time.”

“Fortunately, Elliot turned out to be an optimal patient,” Dr. Prachand said. Surgery went smoothly. Elliot recovered quickly and has since been a role model for healthy eating and exercise.

Once a patient commits to surgery and is encouraged by their initial progress, they find it much easier to engage in long-overdue lifestyle changes, Dr. Prachand said. Elliot began exercising at least every other day, including longer and longer runs.

“The key is for movement and exercise to become an inherent and enjoyable part of what we do in our everyday lives,” Dr. Prachand said, “not a set-aside item that is ‘nice to do’.”

Elliot has changed the way he eats at home and on the job. No more late-night burgers and Cheez-Its. Now it’s salmon or chicken, with salad or vegetables. His desserts are more likely to include fruit with cottage cheese, or apple slices dipped in peanut butter.

“I now look at food as fuel and focus on my protein intake,” he said. “I’m in love with ‘pure’ flavours, things that are natural and delicious, minimally fussed with, that showcase the season. I combine that with portion control.”

Dr. Prachand, who has done more than 1,000 minimally invasive weight-loss operations is proud of the collaborative process with the patient. “Our team does a phenomenal job of educating patients,” he said. “But our patients also have to educate us as to what they want to accomplish and what they anticipate.”

Watch video

Graham Elliot on the TODAY show: Being healthy for my family was the trigger to losing 130 pounds (59kg).

Date of upload: 22nd Nov 2017

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