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Prakash Chandran (Host): When a patient is in a situation where they need surgery, often there is little time to get to know much about their doctor. But today we'll take a step back, relax and take some time to get to know one doctor at Garden State. This is Winning Through Losing, a weight loss surgery podcast from Garden State Bariatrics and Wellness Center.

Our guest today is Dr. Michael Bilof, Bariatric Surgeon and Partner at Garden State Bariatrics and Wellness Center. My name is Prakash Chandran. So, Dr. Bilof, really great to have you here today. I'd love to just get started by learning a little bit more about yourself and how you got into the field of bariatrics.

Michael Bilof, MD (Guest): Yeah. Great. Nice to meet you Prakash. I have a bit of an interesting origin story in my previous life, before I started doing bariatric surgery, I was actually a vascular surgeon, which for those of you who don't know, is the type of surgeon who basically operates to restore blood flow to various parts of the body, the arms, the legs, and the brain actually.

So, that's interesting stuff. And you know, I was quite happy doing it. And then at one point a couple of years into my practice, I was talking to a colleague who mentioned that this bariatric surgery, which this is back in 2000, cures diabetes. And I was like, wow, I didn't know that. How do I not know that?

And at the time, most of my patients were diabetic, you know, diabetics get really bad vascular disease. So, I was like, wow, if I could go sort of and cure this thing before they end up needing my services, that would be great.

And so essentially, that's what I did. I stopped doing my vascular surgery practice and retrained as a bariatric surgeon. And this was back in 2002 and 2003. And then in late 2003, I actually started doing bariatric surgery as my primary focus. So, it was an interesting and a bit of a unusual route into the specialty. To a lay person, I'm not sure that sounds, but going from vascular surgery to bariatric surgery is sort of like going from a plumber to an electrician. They're just totally different skill sets. You know, it's just, you know what I mean? So, it was a big deal and not so easy to retrain. It was really quite an arduous thing at the time, but it's been well worth it.

Host: What was really the thing that pushed you over, right. I know you mentioned that bariatrics, you found out that you could cure diabetes, but was there a certain moment or incident that made you say I really need to go all in, restudy, retrain myself to switch my specialty?

Dr. Bilof: Yeah. I wouldn't say there was necessarily an aha moment, but there was an aha process. So, one was just sort of finding out that this thing called bariatric surgery was incredibly effective at resolving, improving, curing diabetes. So, that was number one. But number two was in speaking with this colleague of mine was just how incredibly satisfied and grateful his patients were. These patients, they would call them up and be in tears at the things they were doing that they could never do before. One guy, I think was on the top of the Empire State Building and he'd climbed 20 flights of stairs, he could never do that.

And just these amazing things that really turn people's lives around and I was like, wow, that's kinda what I got into medicine for. I really want to, if I can, turn or have a really big impact on a person's life and it seemed like this was the way to do it. It's kind of funny. When we first started discussing this, it was actually my wife who said, you know, you should go into that. You should do that stuff. That's what you got into medicine for. I was like, that's crazy. I spent all this time learning to do vascular surgery. I just can't walk away from it. Who does that?

No one does that. She's like, you should do that. She just kept at me for like six months. And finally I was like, you know, I guess I should do that. And then, you know, retraining and stuff took a while but it was definitely worth it. Yeah. The, these really are the most grateful patients that I've ever experienced. And it's great. It's great to have people who, appreciate what you do and are really grateful.

Host: Yeah. So, it seems like within medicine, at least, you've had two lives. You've had the life of as a vascular surgeon. And now what is it? Almost 18 years as a bariatric surgeon?

Dr. Bilof: Yeah, exactly.

Host: And so I'm curious if medicine didn't work out for you, did you have like a plan B profession?

Dr. Bilof: I'm a bit of a math geek actually. My undergraduate degree was in engineering, which is also kind of another weird way into medicine. Most people are pre-med or biology and I was an engineering major. So took a lot of math classes, a lot of physics. And then as I was going through that process I was like, eh, this isn't really people enough, I really want something where I kind of feel like I'm making a difference in people's lives. So, I pivoted into medicine. I guess I'm sensing a theme here in my life. Had I not gone into medicine, I probably would have went to business school. I actually ultimately went to business school after I got into practice, but I probably would have went to business school and probably would have ended up on Wall Street somewhere. If I take a guess, you know, or maybe got a degree in math and ended up on Wall Street because I do find that stuff interesting. Just intellectually interesting. It's not quite the same as operating on people and saving their lives, but it's intellectually interesting.

Host: Yeah, absolutely. And you know, one of the reasons I really like having these conversations is because so often, you know, especially when we go to see our healthcare providers, or our surgeons, we do, I think that they live in the operating room or live in the hospital and they don't have any personal aspirations of their own.

So, this gives us a chance to get to know you a little bit more. Talk to us a little bit, maybe about the hobbies outside of your work. We know you're a math geek. We know that you might have maybe ended up on Wall Street. But as of today, what are the things that keep you occupied outside?

Dr. Bilof: One of my "hobbies" put that in little quotes, I guess, but is really just staying educated and informed about health, wellness, longevity, maximizing health span. At some point, you realize you're not going to live forever. You're not bulletproof we'll call it euphemistically playing the back nine, for those of us who are golfers and one day wake up and you realize, yeah, I'm playing the back nine here. And I, you know, I'm not gonna live forever and I gotta really take care of myself.

And so that's become a bit of an obsession hobby for me is just, you know longevity and health span and how to sort of maximize those things, which, you know, goes hand in hand with what I do professionally. A patient who comes to me, who you know, is a candidate for weight loss surgery, clearly the first and most important thing they need to do to maximize their health span and longevity is to get down to a more healthy weight.

So, it does go somewhat hand in hand with what I do my day job, if you will. But I guess if I was gonna say a hobby that's just purely recreational and really has nothing to do with anything that I do professionally, I would say I've definitely gotten obsessed lately with golf. So, hence the golf analogy. Yeah. I never played golf ever my entire life until about two years ago. And for my birthday, my wife and I took some lessons and I am like obsessed with this game. So, I'm on a continuing mission to become a scratch golfer, which is quite an intimidating thing. It's not so easy to do.

Host: I totally get it. I actually went on vacation with my wife last year to Torrey Pines it's kind of in the San Diego area.

Dr. Bilof: Yeah, yeah.

Host: And they have that golf course in

back. And I was like, this is the most beautiful thing I've ever seen. And people are outside. Every golfer I saw just looked like they were having the time of their life. It's something my uncle's always been into. So, at some point I think that itch is going to grab me and I'm going to have to get into it myself.

Dr. Bilof: The one nice thing about it is, it's something you can do in your eighties, if you're still relatively fit, and yeah, you're outside. They're always in beautiful places. It's good to get the fresh air. There's a social aspect where you play with other people, which is good, you know?

Well, actually one of the dovetailing, what the whole health span and longevity conversation, one of the things that clearly helps people live longer is having a social connection, and having a social network and people in their lives. And actually in a weird way for me, golf does that. It's a social game, you're outside. And there's exercise. I mean,

not like getting on an exercise bike, but walking a golf course clearly has health benefits. So Yeah. I would say that's my current hobby and my current obsession hobby.

Host: Yeah, that makes a lot of sense. And just kind of before we move to the next topic, you know, on the topic of longevity, because this is something that you're into, it's something that I've also done a little research on. I know the benefits of fasting and cell rejuvenation. Of all the research that you have done, if there's one thing you can share with the audience, that's listening, something for them to do besides make those social connections, what would that be to help give them more longevity in their lives?

Dr. Bilof: Yeah, that's a tough one. If I was going to say one thing for the average American, it's going to be eat real food. I used to think this was sort of nonsense, but you know, you hear like the food system is toxic and I used to be like that's not really true, but actually the more I kind of delve into this thing, I think there is some truth to that. And you can avoid a lot of that toxicity just by eating real food.

So, just eliminate processed foods, I think for the average American that's the low hanging fruit, and that would go a long way towards improving their overall health. And we'll say metabolic state.

Prakash Chandran (Host): Yeah.

Dr. Bilof: Yeah,

Host: Great advice. So, when you're not busy being a bariatric surgeon or figuring out how to help people live longer, and when you're not on the greens, are you a normal human, like the rest of us that like to come and relax and watch Netflix or TV shows to unwind?

Dr. Bilof: Sure. Yeah. My wife and I have our, you know, little Netflix binge watching episodes.

Host: Give us a top three shows for Dr. Biloff.

Dr. Bilof: Shit's Creek. ridiculously funny. my God. And if anyone watches it, very first episode is not so good. Just go to the second one. Don't judge it on the first episode. If you've watched five episodes, you don't like it, then it's just probably not for you, but by the fifth episode, you're going to be hooked. And I, you know, given the last year we've all been through, we definitely needed something funny. That's definitely, that's a laugh out loud funny. What else? The Ozark. So, then going to the dark side where we definitely got into Ozark, which is a I don't know if that's Netflix.

Host: I love Ozark.

Dr. Bilof: Yeah. But that's the other side, very dark. That's a good show. I can't wait til the next season comes out. Another show. Billions, we love. Billions.

Host: I love billions. I, I secretly wish that I was Bobby Axelrod.

Dr. Bilof: Right? So everyone, everyone who I always ask anyone who watches Billions, do you root for Ax or do you root for Chuck? Because it's a very, it says a lot about your psyche, depending on who you root for.

Host: Yeah, but you know, are you allowed to root for both? Like, I feel like you root for like Ax and Chuck at different times. Like through the seasons, you know?

Maybe I, Is, is definitely,

Dr. Bilof: you know, it's kind of like we're at war, you got to pick a side at some point.

Yeah. Fair

Host: enough. Fair enough.

Dr. Bilof: Yeah, I'm definitely, I'm definitely an Ax guy.

You're an

Host: Ax guy. Yeah. I am too, most days. So let's maybe talk about, you know, after you've kind of served your term, being an amazing bariatric surgeon and even maybe discovering ways to help us live longer, do you have a bucket list or things that you think about that you really want to get done before you leave this earth?

Dr. Bilof: Not really. I never really think of it in those terms. I kind of just have things I want to do, you know, this year kind of I guess one thing that was on my bucket list was climbing Mount Kilimanjaro, which I did a few years ago. And that was great. At one point maybe climbing Mount Everest would have been on my bucket list, but I'm not so sure after Kilimanjaro, I think that scratched that itch pretty well. I guess one thing I would say is if commercial space flight becomes a thing, I would definitely want to do that. Yeah.

it

Host: looks like it's, it, it is quickly becoming a thing with the in space recently.

Dr. Bilof: Yeah. So, hopefully, you know, in five or 10 years, it will be something that our average folks can do for a, not a crazy amount of money. That if that, if that becomes something then I would say that would probably be on the bucket list.

Host: Yeah, for sure. It seems like a lot of your passions really revolve around, you know, helping people get better and helping people live longer in a more healthy way. Specifically in the field of bariatrics, what vision do you have right, for your own practice and where you want to see things in the next five, 10, or even 20 years?

Dr. Bilof: Well for my own practice, I mean, we're doing fine. And just at some level, just kind of keep doing what we're doing. It's interesting, as a surgeon, one patient at a time. Right? And that's incredibly satisfying work that I really enjoy. But on the other hand, it's one person at a time.

And, the health of the average American are going to require a fix bigger than that. You know, more a system-wide problem if you will. So, I guess I don't know if this would be a thing for the practice, but this idea of food as medicine, and that there is something about the US food system, that there is a bit of toxicity there. And if we can get that out, that's something that would help millions of people versus the patient I'm seeing right now, who, yes, I will have a very big, impactful, effect on their life, but that's just one person, some other way. I know.

Host: Yeah, that makes a lot of sense. You know, I think it's just really giving people awareness so they can help themselves. And, you know, someone told me the other day, you know, when we watch, have you seen that show Mad Men?

have you Yeah. Yeah.

Dr. Bilof: Yeah.

Host: You know, when people watch that they see the amount of smoking and drinking that happens on a daily basis. And they're like, oh my God, I can't believe that we used to live like that. Right? Even though that was like very normal, not that long ago. And in that same way, one of my friends was like, I think that if we start to be a little bit more mindful about what we eat and how we treat ourselves, that when we see movies where people are like eating lots of sugar and like things that are damaging to the body; we're going to look back in the same way that people look at Mad Men today and say, wow, I can't believe that we used to eat that way.

Dr. Bilof: Yeah. That's an interesting analogy that I think is exactly what I was talking about. Yeah. So Yeah. When the Surgeon General Report came out in 64, I think it was, the initial one that said, you know, smoking causes lung cancer. I think 55% of people over the age of 18 smoked at that point, know, roughly half. And today it's down to, I think 18%, you know, rough numbers. So, basically from one half to one 5th over the course of whatever that is, 50 years or so. So, these things take a while clearly, but that's tens of millions of people who aren't smoking are avoiding all of the problems that come from smoking.

So, it's going to require something similar, I think with the whole obesity and diabetic problem in the United States, which is massive,

and while an operation will help the individual patient, I don't know that that's the solution at the society level where it's affecting tens of millions of people.

Host: Yeah. Last question, Dr. Bilof, what do you enjoy most about what you do? And this can be personally or professionally or both, but what do you feel like at the end of the day, really, you know, just motivates you and gives you the passion that you need to keep doing what you're doing?

Dr. Bilof: Well, it's kind of what we started the conversation with bariatric patients. These are the most grateful. I can't imagine do anything other than bariatric surgery, but different strokes, different folks, I guess. It's just that these are the most grateful patients that I've ever dealt with. I often describe it this way. Imagine you had a problem. It doesn't matter what it was or what it is, but you've had this problem for years, perhaps, even decades, perhaps even since your childhood. And then this person comes along and does something. And the problem is solved. I mean, you're going to be grateful to that person.

It's just in human nature, right? I mean, these are patients who've had these problems for many, many years, have tried many, many things that clearly haven't worked, or they wouldn't be in my office. And then we do this operation that has a very high, not a hundred percent, but a very high success rate. And it solves the problem for many, many of these patients, and they're just incredibly grateful. We have a holiday party every year where we invite all our patients to come and bring their, you know, friends, family, coworkers, and really just to kind of celebration of what they've been through, what they've accomplished in their whole journey.

And, so me and Dr. Yurcisin are there and just, you know, it's like we're rock stars for the night. Cause all the patients are coming up and thanking us and you know, talking to us about their family and how it's changed their life. And it's just amazing. So, yeah, for me, that's what keeps me going essentially.

Host: Well Dr. Bilof, thank you so much for your time today and for everything that you do to help people. I truly appreciate it.

Thanks Prakash.

That's Dr. Michael Bilof, a Bariatric Surgeon and Partner at Garden State Bariatrics and Wellness Center. For more information, please visit the Garden State Bariatrics and Wellness Center website at gsbwc.com. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.

This was Winning Through Losing, a weight loss surgery podcast with Garden State Bariatrics and Wellness Center. My name is Prakash Chandran. Thanks so much. And we'll talk next time.