In 8,800 operations over my career, I've seen every complication that exists. Leaks, bleeding, strictures, hernias — I've managed them all. The ones that become dangerous are not the complications themselves. They're the patients who waited too long to tell us something was wrong. A leak caught in 24 hours is manageable. A leak caught in 5 days is a crisis.

Now compare that to doing nothing. Untreated morbid obesity means: Type 2 diabetes that destroys your kidneys, eyes, and nerves. Hypertension that attacks your heart and brain. Sleep apnea that stops your breathing — 13 million Egyptians have it. Joint destruction that puts you in a wheelchair. Infertility. Depression. Reduced life expectancy by 10 to 15 years. Tell me which is more dangerous: a 1.5 percent surgical risk, or all of that?

We have one rule that we give every patient, and I say it looking them in the eye: call me at 2 AM if something feels wrong. A false alarm costs me five minutes of sleep. A missed complication costs everything. The patients who call us at the first sign of trouble are the ones who have the best outcomes — because we intervene early.