Trapped in Too Much Skin

Fifty-five year-old British citizen Paul Mason once weighed 70 stone. 

For those of you aren't familiar with the old English measurement system, that's the equivalent of 980 pounds or about 450 kilograms.

CBS reporter Julie Loncich reported him as saying "It was so bad, that the thought of one day, me walking into the kitchen full of food just horrified me, scared me. It's like an alcoholic walking into a bar."

What Drives Someone to Eat Enough to Weigh Nearly 1000 Pounds?

In other interviews, Mason traced back the emotional issues that caused him to overeat to verbal abuse by his father and sexual by a female relative when he was a child. Classmates tormented him. He tried working as a mail carrier for several years, but his weight left him disabled. He had to quit his job and go on welfare, moving in with his mother after his father died. 

Mason ate himself into oblivion, eat, nap, eat, nap, eat, sleep some more. Eventually he had to have round-the-clock nursing care. Attendants had to lift him with a hoist to change his undergarments. When Mason had to have a hernia operation in 2002, he was removed from his mother's house only after a demolition crew took out a wall of the house, and he was taken to the hospital by forklift. He then was given a housing association house with extra-wide doorways. Mason's attendants cost the National Health Service an estimated £1,000,000.

Mason, however, was not resigned to his fate. In 2010, in the UK, he had gastric bypass surgery. As viewers of the extremely popular Discover program "My 600 Pound Life" would understand and many bariatric physicians attest, gastric bypass surgery is not enough to guarantee weight loss. Mason also found the willpower to eat less so that his bypass surgery would enable to lose weight and keep it off.

READ Who Should Consider Bariatric Surgery To Lose Weight?

By 2015, Mason had lost a staggering 650 pounds (nearly 350 kilograms). By working hard at improving his health over five years, he had lost nearly 2/3 of his previous body mass. With his extreme weight loss, however, he acquired another problem. Mason was enshrouded in a robe of skin.

What Is It Like to Live with Excess Skin?

For Paul Mason, excess skin became an extreme disability. It encircled his thighs. It draped his midriff like the folds in a curtain. It hung down from his arms. Mason had difficulty taking more than a step or two at a time, so in spite of his success with his diet, he had to use crutches or a wheelchair. The folds in his skin often became infected. "It's like carrying a couple of children around," Mason was quoted in the New York Times.

Physicians in Britain declined to perform Mason's skin surgery, but he had an astonishing series of strokes of luck. An article about Mr. Mason appeared in the New York Times. A doctor who saw the article called her daughter who is also a doctor, a plastic surgeon. The physician mother told her physician daughter Dr. Jennifer Capla, "You have to help this man."

Dr. Capla tracked down Mason at his home in Ipswich, England. If he could get to America, she would perform the surgery and waive her fees. Dr. Capla specializes in skin removal surgery after extreme weight loss, and has performed the operation on contestants on another popular American television series, The Biggest Loser. But Mason would be the largest patient on whom she had ever operated.

At the same time, an American woman named Rebecca Mountain began talking with Mason on Skype. She had not been in a serious relationship in several years. Mason had not been in a serious relationship in 25 years. Ms. Mountain supported herself by making cat furniture and was not wealthy. However, she managed to save enough to travel to England and meet Mason in person. Of her trip, she told the New York Times "It was like seeing an old friend, because you’ve already built up that level of conversation and trust.” Then both of them were brought to New York for an appearance on the ABC morning program The View, and Ms. Mountain proposed on air, live.

What Is It Like to Go Through Skin Reduction Surgery After Extreme Weight Loss?

Even people who have been successful at losing huge amounts of weight much achieve their goal weight before they can have skin reduction surgery. And even people who achieved a stable, desirable weight may need to deal with nutritional problems before they can be sent to the operating room. The process of severe calorie reduction may lead to deficiencies in iron, calcium, phosphorus, folate, and vitamin B12, and fat-soluble vitamins that have to be remedied  before the procedure can be considered.

Another issue in skin reduction surgery is that stubborn fat deposits may persist even after weight loss. These are sometimes removed by liposuction. Yet another issue is that removing skin affects circulation. The surgeon must ensure that changing pressures on internal organs does not cause loss of circulation.

When these hurdles are cleared, the surgical procedure usually runs something like this:

• During the first surgery, or the first hours of a very long surgery like Mr. Mason's, the surgery addresses excess skin on the abdomen and torso.
• During the second surgery, or the middle hours of a very long skin revision surgery, the surgeon works on the hands, feet, arms, legs, and breasts.
• During the third surgery, or the final hours of a very long skin revision surgery, the surgeon removes excess skin from the face and neck.

If there is a universal response to skin reduction surgery, it is that patients are almost always in severe pain when they come to from the anesthesia. Patients will have a tendency to get cold after they lose their "robe" of skin. Hypothermia is a real concern during the first days after recovery. So are blood clots. To prevent deep vein thrombosis patients are fitted with compression stocking or leg compression sleeves that pump blood through the legs when they are in bed, and they are encouraged to get up and walk as soon as possible after surgery. About 15 percent of people who have the procedure have a condition known as antiphospholipid antibody syndrome, which requires the doctor to take additional precautions against the formation of blood clots.

It's usually a few days to a week before the recipient of skin revision surgery can walk normally. It's usually a week to a month before patients can carry 10 to 15 pounds (5 to 7 kilos). It can be a year before they feel fully normal. But nearly all recipients of the surgery report vast improvements in quality of life.

READ Weight Loss Surgeries

There is a footnote to Paul Mason's story. His skin surgery was successful. He was able just a few weeks later to take a stroll in New York City's Central Park. His relationship with his fiancée, however, came to an end, when he realized that the many changes in his life left him "unmotivated" to pursue romance. He and Rebecca Mountain report that they have parted on good terms.

If there is anything that people who have the stamina and willpower to lose massive amounts of weight sometimes fail to consider, it is that others get used to them the way they are. Changes for the better sometimes leave old relationships behind. A new weight can lead to a completely new life in unpredictable ways.