William Stewart Sr. is pleased to say that at age 69, the 5-foot-11 resident of Bensonhurst, Brooklyn, weighs pretty much the same as he did in high school: 179 pounds. His pride stems not from vanity but from comfort—the comfort of feeling and looking trim, of being able to keep up with his two young grandchildren, and of knowing that his own motivation is what spurred him to shed the 269 pounds he had packed on over three decades.

Stewart doesn’t take full credit for this triumph. Though it required self-discipline, the achievement was made possible by the surgical expertise of bariatric surgeon Akuezunkpa O. Ude Welcome, MD, chief of surgery at NYU Langone Hospital—Brooklyn. After a one-hour robot-assisted procedure performed on October 25, 2023, Stewart emerged from the operating room feeling relieved. In time, he reminded himself, he would no longer bear the burden of being classified as morbidly obese. He was on his way to becoming, according to plan, half the man he used to be.

An estimated 42 percent of American adults are obese, defined as having a body mass index (BMI) of 30 or higher, and the prevalence has tripled over the last five decades, according to the Centers for Disease Control and Prevention. In Brooklyn, the obesity rate is 26 percent. “In the hunter-gatherer days, if you were not out constantly looking for food, you weren’t going to eat,” notes Dr. Welcome. “Now we can order food without getting up from the couch.”

Only 1 percent of people who are eligible for weight loss surgery—those with a BMI of 30 or higher and medical comorbidities—ever have it. Among patients who do opt for surgery, Dr. Welcome explains, “the ones who are most successful have a high level of mindfulness. They develop a new relationship with food, learning not only what to eat, but how.”

NYU Langone Hospital—Brooklyn launched its bariatric surgery program in 2004, becoming one of the first in the US to be accredited as a national Center of Excellence by the American Society for Metabolic and Bariatric Surgery. Dr. Welcome and her team of three other bariatric surgeons perform an average of 330 operations annually. More of these cases are done robotically than at any other hospital in Brooklyn, employing a minimally invasive approach that reduces pain and scarring, resulting in shorter hospital stays, fewer wound complications, and lower infection rates.

For Stewart, the upward spiral was a slow but steady one. As an athletic youngster, he played a variety of sports that kept him fit. He remained active in the early years of his marriage to Aida, his wife of 43 years. Raised in a home where meat and potatoes were the staples, he delighted in the savory cooking of his Italian mother-in-law and the dishes she taught Aida to make. “Sundays were big eating days, with about 15 people around the table,” he recalls. “The food just kept coming.”

By the time Stewart was in his late 30s, he and Aida had two children, William Jr. and Stephanie, and their lives had become home-centered. “That’s when the weight started going up,” he says. What didn’t help was that eating soothed his anxiety. “I’m a worrier by nature,” he says, “and I used food as a crutch.”

For many years, Stewart’s weight gain was one of the few things he didn’t worry about. His two physically demanding jobs kept him strong and mobile. By day, he hoisted trash for the New York City Department of Sanitation; by night, he shoveled coal and ashes in public school buildings for the Department of Education. On those rare occasions when he visited a doctor’s office, he simply declined to step on the scale.

When Stewart retired in 2015, “things really started to get out of hand,” he recalls. Years of arduous labor had led to arthritis in his hips and shoulders, and as his waistline expanded, the pain in his knees became intolerable. In June 2023, Stewart’s family physician, Mario J. Manna, DO, referred him to Dr. Welcome, a colleague at NYU Langone Brooklyn Medical Associates—Dyker Heights.

“All of my numbers were out of whack,” recalls Stewart. “Glucose, cholesterol, blood pressure—you name it.” When he stepped on the scale in Dr. Welcome’s office, another number stood out: 448 pounds.

“William had a strong ‘why’ for bariatric surgery that was based on functional goals as opposed to appearance or size,” says Dr. Welcome. “He wanted to enjoy retirement.”

After Dr. Welcome discussed the surgical options, Stewart chose to undergo a sleeve gastrectomy. By essentially converting the stomach from a balloon into a narrow tube, the procedure greatly limits food capacity and promotes a feeling of fullness.

Prior to surgery, Stewart lost 60 pounds by following a strict diet. “My wife found low-calorie recipes that were as tasty as possible, and she ate what I did,” he says. As a result, Aida lost a good deal of weight herself. “That’s what we call the halo effect of a weight loss journey,” says Dr. Welcome.

Two years after the surgery, Stewart looks and feels like a new man. “All of my vitals are normal,” he reports. “My diabetes is in remission, and I have no more knee pain. I don’t deprive myself of any favorite foods. I just eat less.”

Dr. Welcome considers Stewart an “amazing” success story. “He took all of our recommendations to heart,” she says, “and was totally committed to losing weight and not gaining it back.”

The patient has equally high regard for his doctor. “I think the world of Dr. Welcome as a surgeon and as a person,” says Stewart. “She made me understand that it’s a process and it’s hard work, so you have to be all in. I’m so grateful to her.”

On Easter Sunday, William Jr. visited his parents with his girlfriend for a holiday meal. Having not seen his father in a while, he asked his mother, only half jokingly, “Where’s Dad?”

“What are you talking about?” said his father. “I’m right here!”