With the improvement in living standards among people in Taiwan, trying to keep one's weight down has become a hot topic of conversation. This is contrast to the past, when the main consideration was more likely to be how to secure sufficient food to maintain a balanced diet. People suffering from the more normal forms of obesity are usually told to go on a diet and do more exercise. In the case of people suffering from pathological obesity, however, more radical treatment may be necessary. Such was the case with Liu Chang-chung, the first person to undergo surgery at the Veterans General Hospital in Taipei, of a type which was later to prove beneficial to many more patients.

Five years ago, at the age of 19, Liu had a burden to bear which was rare in medical history. Only l74 centimeters in height (about 5 ft. 8 inches), Liu weighed an incredible 256 kilograms - about 563 pounds and was gaining weight at a rate of a pound a day. He was truly pitiful. He could no longer walk unaided. Breathing was difficult. He dare not sleep on his back in case the pressure of his huge bulk stopped his heart.

When the boy was admitted to the Veterans General Hospital for observation and tests, he had to be transported from his home by truck, because no ambulance was big enough. At the hospital three double beds broke under his weight. He finally had to be placed on thick planks stretched across two beds arranged side by side. It required the combined efforts of six nurses to turn him over in bed.

The doctors were not sure what caused Liu's condition. At birth he weighed a normal three kilograms (6.7 pounds). By age 11, however, he had risen to 80 kilograms (l76 pounds) and had reached 170 kilograms (374 pounds) by the time he was 16. Liu Chang-chung and his family, like the doctors they consulted, knew that his chances of survival were poor.

After days of tests and drug treatments failed to prevent further weight gains, surgeons decided that Liu's only chance lay in a radical intestinal by-pass operation, which had never before been performed in the Republic of China. During three hours of surgery in February 1974, doctors shortened the small intestine from its normal length of 23 feet to only 18 inches. The operation was a success. Liu emerged in good condition both physically and mentally, and from then on his recovery was dramatic. In nine days he had lost 34 kilograms (75 pounds).

As a result of this surgery - regarded as a medical miracle- - Liu has been able to lead a normal life. Though, at about 90 kilograms (l98 pounds), somewhat over-weight, he is happy and optimistic about the future. This is in stark contrast to his grotesque body and pessimistic outlook when he entered the hospital.

Several preconditions are necessary for overweight people to receive this kind of surgery. They must be at least double the standard weight for their age and height; all normal weight reduction treatment must have failed; they must be normal mentally and in glandular secretions, and must not be alcoholics. When it was found that Liu fitted all these conditions perfectly, doctors decided to do the operation for free, on the grounds that it was medical research. Usually, it costs between NT$70,000 to 80,000 for such an operation, which is much cheaper than in most advanced countries (about NT$360,000, or US$10,000). Of all the countries in Southeast Asia, only the Republic of China has the facilities and personnel to perform such an operation. Though the surgery has a history of 15 years internationally, only three of the 200 or so patients undergoing it have been as fat as Liu. The enormous volume of fatty tissue under the skin, and surrounding the intestine, which swelled to seal up the incision, made the operation particularly difficult. Doctors in the Republic of China, however, showed they were equal to the challenge, and have brought new life and hope to Liu Chang-chung.