“Tony Soprano” Commentary With Dr. Michael Bilof

June 25, 2013

James Gandolfini aka "Tony Soprano" Dies at the Age of 51

I assume most of you have heard the news (it was on the front page of the Star Ledger) but James Gandolfini (aka "Tony Soprano") died last week.  He was born in Westfield, NJ, graduated from Rutgers University and of course is best known for his role as the head of a NJ crime family on the iconic HBO series "The Soprano's".

For the record I loved that series, it was always fun for me to watch (as someone who has lived his whole life in NJ).  It was entertaining to see places I've been to or are familiar with.  I would highly recommend renting the DVD's if you have never seen the series.

However as a physician and specifically a bariatric surgeon I wanted to look at this from the medical angle...

If you haven't been following the story, let me get you up to speed (in case any lawyers are reading, let me start with a disclaimer...I never treated James Gandolfini as a patient, in fact I never met him and everything I am writing I read in a newspaper or other source), now with that out of the way...

James Gandolfini was 51 years old!!  Let that sink in for a minute...FIFTY ONE  years old!!  He was rich.  He was famous.  He presumably had access to the best medical care money could buy...and he died at 51 from a heart attack!

Mr. Gandolfini was almost certainly Morbidly Obese (again I never treated him as a patient) but I can say with almost complete certainly that he was Morbidly Obese.  I don't know what other risk factors he had for a heart attack..whether he had High Blood Pressure, Sleep Apnea or Diabetes and I don't know his family history.  But I can say this... the most easily reversible risk factor for a heart attack he had was his weight.  If he had a gastric bypass 10 years ago would he still be alive today, no one can say for sure, but I have to think it would have helped his chances of still being with us.

Heart disease is the No. 1 killer of American men, according to the Centers for Disease Control (CDC). At 51, Gandolfini was 13 years younger than the average male heart attack victim, but about one in 10 heart disease deaths occurs in people under the age of 55, the federal agency says.  Obesity is a key risk factor for heart disease, and people with an "apple-shape" body are particularly prone, according to the National Institutes of Health. Click here for the NIH article .

I spend a great deal of time when I talk to patients about the risks of surgery (which is entirely appropriate) but I think it also appropriate to consider the risks of NOT doing the surgery (like having a fatal heart attack at the age of 51).  There is absolutely no doubt (and I mean NO DOUBT) that if you are morbidly obese the best thing you can do for your own  health is to lose weight.  There is also no doubt (and again I mean NO DOUBT) that if you are morbidly obese the most effective way to lose weight is bariatric surgery.

If you have not had surgery but are still "on the fence" I would ask you to consider what happened to Mr. Gandolfini.  Since he is famous we all heard about it but there are thousands of people who die prematurely under similar circumstances every year that you never hear of...please don't be one of them.



Michael Bilof practices bariatric surgery with Garden State Bariatrics in New Jersey with offices in Millburn, Toms River and Browns Mills, New Jersey. He is currently the President of the NJ Chapter of the ASMBS and section chief for Bariatric Surgery at St. Barnabas Medical Center in Livingston, and Deborah Heart and Lung in Browns Mills, New Jersey. Read more articles by Dr. Bilof!