My 600-Lb Life: How Are Participants Selected For The TLC Series?

From "The Bachelor" to "90 Day Fiancé," most reality shows have some sort of selection process to choose entertaining cast members. But what about a series like TLC's "My 600-lb Life," which is about an individual's life-or-death journey to wellness, and not relationship drama?

While there are occasional casting calls, all one needs to do to see bariatric surgeon Dr. Younan Nowzaradan is fill out a patient information form on his website. During the 2016 ObesityHelp National Conference, which welcomed Dr. Now as the keynote and Fireside Chat speaker, he stressed that obesity is a disease that patients are metabolically and genetically predisposed to. Therefore, he doesn't turn away anyone who's asking for help out of fear they won't make for intriguing television. 

He said during the conference, "When it comes to my patient process, I don't have a selection process like most doctors have. I don't have any selection process. Everybody comes and we take care of them." Of course, as regular viewers of "My 600-lb Life" may know, staying on as a patient of Dr. Now isn't guaranteed, and it requires following a certain diet and exercise regime to qualify for surgery.

Dr. Now accepts patients who were turned away elsewhere

Most times, "My 600-lb Life" features individuals who have been turned away by other bariatric surgeons, who feel that operating on them is too risky. According to Dr. Younan Nowzaradan during the 2016 ObesityHelp National Conference, he's often judged for taking on these individuals. He explained that other doctors feel these people ate themselves into this predicament and don't see obesity as a disease.

"That's the reason I started the television series, to make an impression on the medical community that they should take care of these patients," he said. "Another reason important to me was to have a show that provided inspiration for people and for the medical community, with my hope to change biased opinions about morbidly obese people."

Ultimately, everyone featured on "My 600-lb Life" is in desperate need of Dr. Now's help. It's a unique casting process that doesn't select people based on looks or the drama they'll bring, but on the sole fact that they're out of options to reclaim their lives.