Book Excerpt: Philip Ovadia MD - Stay Off My Operating Table


A Heart Surgeon's Metabolic Health Guide to Lose Weight, Prevent Disease, and Feel Your Best Every Day

What foods to put on your table so you don't end up on mine

For the past century, we've been bombarded with diet ads and advice from gurus and governments. Yet heart disease remains the #1 killer worldwide, and 88% of adults are metabolically unhealthy. Up to 95% of dieters gain back all the weight they lost while following both dietary guidelines and popular fitness fads.

Here's why they fail.

Most diet books teach you to set short-term weight loss goals. Whether low-carb or low-fat, the typical plan goes like this: restrict your food choices, exercise until exhaustion, and swallow stacks of supplements. These "solutions" do a better job of lightening your wallet than lightening you.

Meanwhile, the healthcare industry fails to prevent chronic disease. Rather than showing people how to remain healthy and prevent illness through proper nutrition, the system offers drugs and surgery to manage symptoms.

As a heart surgeon who used to be morbidly obese, Dr. Philip Ovadia has seen firsthand the failures of mainstream diets and medicine. He realized that what helped him lose over 100 pounds was the same solution that could have prevented most of the thousands of open heart surgeries he has performed - metabolic health.

What you eat determines how long and how well you live. Yet most doctors don't learn that in medical school. And pharmaceutical companies and food manufacturers have a vested interest in the public not knowing how to live and eat metabolically healthy.

In Stay off My Operating Table, Dr. Ovadia shares the complete metabolic health system to prevent disease and optimize your health, a system that the diet and drug industries don't want you to know about. Unlike quick-fix, "7-day," radical diets, Dr. Ovadia's approach is a sustainable, long-term solution that works.

This book teaches:

  • How most leading causes of death are rooted in metabolic disease
  • How to measure and improve your metabolic health, from a doctor's perspective
  • How to eliminate your need for most supplements with a nutritionally complete diet
  • How to eat metabolically healthy on any diet, from carnivore to vegan
  • How light, everyday exercises benefit you more than brutal workouts
  • How metabolic health holds the answer to most health, food, and fitness questions

Whether you've suffered from chronic diseases or want to prevent them decades from now, Stay off My Operating Table will help you take back control of your health from the institutions and experts that have failed you.

A doctor's nutrition system to prevent and reverse disease


Excerpt: Chapter 1 Stay off My Operating Table


I couldn't save her.

She should not have needed to be saved.

Two months before I began writing this book, I got called into the hospital for a surgical emergency. Corinne, a thirty-nine-year-old mother, arrived at the ER minutes earlier, presenting symptoms of an aortic aneurysm and dissection. That's when the blood vessel leading out of the heart tears. The torn wall of the blood vessel fills with blood intended for the organs, the limbs, and the brain. Abnormal blood flow like this carries a 30 percent mortality rate before the patient even reaches the hospital.

We had no time to waste. Corinne's only hope was rescue via the operating room, but the outcome looked grim as I spoke with her family. Corinne was still conscious as we wheeled her back for surgery.

"Will I be OK?" she asked me, fists clenched white at her sides.

TV doctors and the screenwriters behind them always know the perfect one-liner to deliver in a rush. Out here in the real world, when someone asks you - a member of the most trusted profession in the world - whether they will survive their medical emergency, no one perfect answer emerges. So you tell the truth. That and my two decades of cardiac surgery experience are all I could offer this woman.

"The damage could be severe, but we won't know until we go in," I said as calmly as I could. "If it is severe, there could also be damage elsewhere."

"Can you fix what's wrong?"

I took a breath and gave my honest assessment.

"I'll do everything I can."


That was Corinne's last word to me. From the start of the surgery, I could see the damage was catastrophic. The tear in her blood vessel was so extensive, no routine repair would work. We knew that the longer we operated, more damage was being done. During parts of the operation, we temporarily interrupt blood flow to the brain and the body. The patient is essentially dead at that point, and we hope that we can bring them back to life.

That's not the harshest truth about the procedure. By the time a patient makes it to emergency surgery for an aortic aneurysm and dissection, it's sometimes too late. Delayed surgery isn't to blame, the tear itself is. Imagine a sailboat headed toward a raging thunderstorm on the horizon. The ship's only hope is its ability to steer away from a sailor's worst nightmare. Now imagine the sail is torn and the rudder broken. Onward the ship bobs in the waves into darkness. Even the world's most skilled navigators shudder at the thought.

That's how I felt with Corinne's life in my hands. For ten straight hours, from nightfall through morning rush hour, my team and I tried every tactic we knew. The mortality rate for aortic dissection surgery is as high as 20 percent, a statistic I failed to keep out of my mind. Of course, without surgery, nearly 100 percent of patients die. Compare these numbers to a more routine open-heart surgery, coronary artery bypass surgery, which carries a 2 percent mortality rate.

The truth had sunk in by dawn. Corinne had already been dying when she walked into the ER. She seemed alert during our conversation, but her body had already been shutting down on her. Still, my team and I fought like mad to give Corinne's heart every last chance medical science had to offer. In the end, no repair held. The high blood pressure and obesity I saw in Corinne's medical history had, years earlier, set her on a course we could not change.

I remember cleaning up after those ten gloomy hours. Minutes before I'd deliver the world's worst news to Corinne's children, husband, and parents, I stood alone in the washroom. I scrubbed my hands. And kept scrubbing. Kept washing, kept rinsing, kept soaping up. Over and over and over. The tactful, compassionate speech I'd give her family wrote itself in my head. So did a tweet. That would have to wait.

Walking toward the waiting area, seeing Corinne's kids shoot to their feet at the sight of me, I swallowed hard. The one message I most wanted to share with Corinne's family was the only one I knew wouldn't help:

It didn't have to be this way.

I offered the most sympathy I could. I'll spare the details and just say this - it was the toughest conversation I'd ever had. How do you explain to a child why her young mother left with you, the doctor, but didn't come back?

I stayed with Corinne's family longer than I usually do. Soon it seemed obvious my presence was no longer helpful. So I quietly exited to look for an empty utility closet. I just needed to think. Process. I also needed to get this all off my chest. So I sent this update to my online following of cardiologists, general practitioners, and healthcare professionals.

Difficult night into morning. Nearly 10 hours of surgery and was unable to save a woman in her 30s who presented after years of untreated hypertension/poor metabolic health with an aortic aneurysm and dissection. Healthcare needs to do better at promoting metabolic health!

I may be a doctor whose specialty is the heart, but I see the whole person. More than anything, what we put in our bodies determines when life itself leaves them. The tear in Corinne's blood vessel was the last in a long series of medical failures that compounded to create a fatal and irreversible problem. Corinne could have saved herself if she'd known how, but the system failed her. She'd been morbidly obese for years, according to her chart. Her doctors had thrown a range of medications at her to manage the high blood pressure. And she'd taken them all. But the doctors and the drugs never addressed the underlying causes. No one had blunt conversations with Corinne about how to take care of herself, how and what to eat so she'd lower her blood pressure, lose the weight, and stay off the surgical table. There were so many opportunities to prevent death at age thirty-nine. At least ... there should have been.

The real life-saving surgery would have been Corinne's own intervention ten years earlier, not a couple of hours after she began having trouble breathing. If Corinne had learned about metabolic health, what was happening inside her body, and how obesity and hypertension can permanently tear the heart, she might have been able to live past eighty. Her children might not have lost their mother so early in life. At the time of their mother's passing, two of them were under the age of four.

Corinne and people like her simply follow their doctors' advice. But it doesn't keep them from the operating table. Corinne had high blood pressure. She was overweight and had diabetes. Yet she was on all the medications and took them faithfully after they were prescribed. Still, she passed away. Heart disease is the leading cause of death in the United States. But the medical establishment just shrugs and says, "These things happen. Next patient."

After speaking with Corinne's family, I drove home bitterly angry. Not at her, no. Not at all. She'd merely done what the system told her to do. She'd followed orders. I was livid because her death was 100 percent preventable. For the first time in my surgical career, I made the heart-metabolism connection. And in an unforgettable way.

Aortic dissections are not necessary, I remember thinking that morning. I had access to information few doctors do because I had been on a health journey of my own.

I'm a surgeon. But I'll be the first to tell you - to beg you - to do whatever it takes to never, ever need me. Please stay off my operating table. Through this book, I hope to write myself out of a career. I want to make lifesaving heart surgeries unnecessary and untimely demises obsolete. I don't want to see even one more preventable death because the situation held off until it was too late to be saved.

This book isn't just about heart health. It's about the whole body and all the diseases that we just take for granted. Someone dies of diabetes, of stroke, of Alzheimer's, and we shrug and say, "Aww, too bad. But hey, it happens." But why? Why does it happen?

Only metabolic health has the answer - and the prevention. The brutal truth is, our medical care system is not built to broadcast that answer, much less comprehend it. The system addresses only the symptoms of metabolic health problems as they arise, rarely if ever resolving the underlying causes.

As you're reading this book, maybe you've been diagnosed with type 2 diabetes or an autoimmune condition. There are signs of inflammation. Your joints hurt due to obesity, and you're unable to play with your grandkids. It could be that you're a survivor of heart failure and are looking for answers on what to do next. Or you're a young person who's struggled with weight and wants to learn how to avoid medical issues later on.

I want you to know I've been on both sides of the office visit, both as a heart surgeon and as a patient. I know what it's like to struggle and wonder if I would one day end up on the operating table.

How I Lost 100 Pounds (and Forgot Everything I Learned about Fat)

I had never heard about the wider world of metabolic health before Gary Taubes gave a speech at a medical conference. The talk was based on his new book at that time, The Case Against Sugar. Taubes lectured not just about obesity, which we all knew was a problem, but also about the causes of it. I'd never heard that there could be a deeper issue than the common-sense "too many calories in, too few calories out" weight gain equation. Hearing Taubes speak about the addictive dangers of sugar, I realized I'd never been given the full picture of how fat works - and why it's so hard for cardiac patients to get their health back.

After the conference, I devoured Taubes's books. I was hungry for more. I needed to learn everything I could about this new, unfamiliar topic - metabolic health. I read low-carb books and keto diet books and everything else I could find with "metabolic" anything in the table of contents. Over time, a new way to help patients emerged, an education program that could teach the patients coming into my clinic how to save themselves before they even needed surgery. My nutrition and wellness coaching practice was born.

Let's stop and define exactly what I mean by metabolic health - it's how your body uses the food you put into it. It affects everything. If the body is not running on the proper fuels, and if there is an excess of toxic substances, that damages all the organs.1 The fact we've become obese is a reflection of other processes that accompany poor metabolic health: inflammation that damages blood vessels, insulin resistance building to the point of needing medication, and so on.2,3,4,5 In fact, we often identify poor metabolic health with insulin resistance, because that's the easiest measurement of it in your body. But obesity, inflammation, and high blood pressure are all indicators as well, along with a host of unseen damage taking place below the surface that doesn't become visible until people are on my table and it's too late.

Insulin resistance has been known and described since the 1960s. That's approximately sixty years, but our treatments still focus on handling the outcomes from long-term resistance instead of addressing the root causes and preventing the damage in the first place.

People come to me with obesity, heart disease, diabetes, and other health conditions. What they - and even their doctors - don't understand is the root cause of metabolic health. Improve that, and everything else improves.

I know this from personal experience. I had been obese since childhood, and by the time I was forty, I was morbidly obese. That's right, I was one of those medical experts who was himself unhealthy. I had followed the advice, and it failed. In this case, it's because the metabolic health advice I had been taught - calories in, calories out - was basically useless. And I didn't yet understand the link between metabolic health and catastrophic outcomes.

Then I heard Gary Taubes's talk on sugar, and it all clicked for me. I cut sugars out of my diet, then carbs, then processed ingredients, then artificial ingredients, then vegetable and seed oils. I dropped one hundred pounds and reversed my prediabetic blood markers. I've maintained the weight loss using the tools I'll teach you in this book. But it all began with learning what I'd never been taught, even in medical school.

I no longer think, stress, or worry about food. When I was overweight I'd worry, "Is the cafeteria going to be open after this long surgery?" Now, if I'm hungry, I prepare my food simply, quickly, and cheaply. I don't spend a fortune on premium ingredients the way that people worry that "clean eating" is going to require. If I am hungry and food is not available, I've stored enough healthy nutrients in my body that I won't be starving. I can drive past all the fast-food temptations on my way home and eat a healthy meal I know will help me rather than threaten my life.

Cardiac Surgeon, Metabolic Health Advocate

Why on earth would I keep this knowledge to myself? Like I said, I'm a heart surgeon, but I'd rather put myself out of a job educating people than lose even one more patient who could have lived. So I've begun helping people ten years before they need surgery. With education, I can prevent them from ending up on my table, or being on insulin, or becoming obese, or any of the other catastrophic outcomes that our medical system just shrugs and accepts. My medical practice focused on metabolic health is my way of keeping people off my surgical table.

Here are just a few examples of changes I've helped coaching students make in their lives through metabolic health education.

One nurse anesthetist, fifty-two years old, lost fifty pounds in one year. He was able to put on his uniform from basic training when he was eighteen, and it fit for the first time since his twenties.

A couple who lost seventy combined pounds in just four months reported having more energy for their six kids. The wife talks about how much better she feels, even though she hasn't lost as much weight as she thought she would have to. The changes were noticeable even with small improvements.

I've worked with a host of men on testosterone replacement therapy. We wean them off their medications without them having low-T symptoms anymore, all because improving metabolic health improves testosterone levels.

Preventing heart disease is a ten- to twenty-year journey, but we've seen improved heart scans as people stop feeding themselves poison and give their body what it needs to thrive.

I've even helped people reverse type 2 diabetes, something the medical system will teach you is close to impossible.

Metabolic health has achieved medical miracles. What can it do for you?

The Lifesaving Power of Metabolic Health

I want to disseminate this information to as many people as possible. This is what medical professionals do with their own research. A book is a more effective way of disseminating this information to larger numbers of people, particularly the general public, who follow the dictates of trusted physicians. A book is also more concrete than a podcast or a talk I could give, though I've done plenty of both.

My objective is to provide the last diet book you'll ever need. This book presents a lifelong framework for healthy metabolic living. But I encourage you to listen to other advisors or read other books, and you may want to gather additional tips and advanced strategies. The reason people are dying young (or younger than they ought to) is that they just don't know what they're doing wrong. Arm yourself with knowledge, educate yourself about the problem, and live a longer, healthier life. I'm begging you: Do not stop educating yourself. Keep yourself off my operating table. Take back control of your health. Don't allow the medical system that no longer allows your doctor to take the time to talk with you to prevent you from being healthy.

The metabolic health plan I teach in this book is not your typical diet advice. That's by design, because we must get away from the typical advice that fails over and over. Instead, I'm going to teach you sustainable life changes to make that can save your life long term. There is no "Week One, Week Two" eating plan. There is no "thirty-day plan to track, then you're done." And I'm not going to give you checklists of specific foods to eat or to not eat. I'm going to give you a system anyone can use.

I see the anger, frustration, and hopelessness at the end of the line. I talk to patients post-op about their metabolic health and am greeted by skepticism, because these patients were already listening to doctors who gave them advice that resulted in them landing on my operating table. Their doctors failed them, probably because those doctors didn't even know the truth.

I wrote this book to make sure no one misses the truth ever again.

How to Use This Book (Like You've Never Used Another Diet Book)

The metabolic health principles in this book work when nothing else has. I know, because I tried everything else myself when I was struggling to lose weight. This is the system that finally helped me get fit, get healthy, and erased my growing medical problems. It's easier to follow and less restrictive than anything else I tried, and it doesn't involve a list of must-buys marketed by the diet designer.

The truth is, if all those other diet plans actually worked, they'd go out of business. All their shakes and supplements and thirty-day programs would cure obesity, and every person would be too healthy to need those products ever again. But obesity is worse than ever before. I tell clients and patients improving their metabolic health that they can also expect to:

  • Lose weight
  • Get energy
  • Find mental clarity
  • Stop feeling bloated
  • No longer need certain medications
  • Become decisive
  • Look good and feel great
  • Enjoy their clothes again
  • Improve their interpersonal relationships, become more themselves, and be more present
  • Suffer fewer hormonal swings than before and enjoy a more stable mood
  • Face no more fighting with their spouse and family about dieting

Consider the subtle benefits of improved metabolic health. When you lose weight, you become more confident. Becoming metabolically healthy has given me the confidence to author this book and start my own private consulting practice, all without being tired.

It feels like a miracle to finally get unstuck. You can get more respect and stop slinking away and withdrawing because you have to admit another diet failure to your family and friends when they see you gained back all that weight you lost. Ending that cycle of shame is almost as big a relief as taking the stress off your joints.

Do you feel tired all the time? When you control your metabolic health, you can maintain predictable, sustained levels of energy throughout the day, with no crashing. When I was overweight, I'd get exhausted just from work and routinely fell asleep at three in the afternoon for a nap. Now I can work in the operating room from eight o'clock in the morning to eight o'clock at night, spend a couple of hours on a live webinar, and work on my business, all without feeling exhausted.

You can achieve all of these effects in your own life. You just need to follow the system I'll present in the chapters ahead.

But First, We've Got Some Debunking to Do

To achieve the full metabolic health overhaul, we need to first unlearn the "facts" about nutrition, fitness, dieting, and the medical system that pushes them. Understanding what is false takes you more than halfway to the truth.

People like Corinne meet the fate they do in part because of the myths we're about to debunk. It's no direct fault of their own. Even family and friends cosign untrue, unhelpful beliefs that ultimately result in long-term medications, expensive surgeries, and golden years consumed by poor health. The pervading narrative is so strong that you need a counter-narrative. That's up next.

1 Romilly E. Hodges and Deanna M. Minich, "Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application," Journal of Nutrition and Metabolism, (2015), https://doi.org/10.1155/2015/760689.
2 Atilla Engin, "The Definition and Prevalence of Obesity and Metabolic Syndrome," in Obesity and Lipotoxicity, ed. Ayse Basak Engin and Atilla Engin (Springer, 2017), 1-17.
3 K. Esposito and D. Giugliano, "The Metabolic Syndrome and Inflammation: Association or Causation?" Nutrition, Metabolism & Cardiovascular Diseases 14, no. 5 (2004): 228-232, https://doi.org/10.1016/S0939-4753(04)80048-6.
4 Johnathan D. Tune,Adam G. Goodwill,Daniel J. Sassoon,and Kieren J. Mather, "Cardiovascular Consequences of Metabolic Syndrome," Translational Research 183 (2017): 57-70. https://doi.org/10.1016/j.trsl.2017.01.001.
5 "Metabolic Syndrome," Health, Johns Hopkins Medicine, accessed August 10, 2021, https://www.hopkinsmedicine.org/health/conditions-and-diseases/metabolic-syndrome.


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Author Bio

Dr. Philip Ovadia is a board-certified Cardiac Surgeon and founder of Ovadia Heart Health. His mission is to optimize the public's metabolic health and help people stay off his operating table. As a heart surgeon who used to be morbidly obese, Dr. Ovadia has seen firsthand the failures of mainstream diets and medicine. He realized that what helped him lose over 100 pounds was the same solution that could have prevented most of the thousands of open heart surgeries he has performed - metabolic health.

In Stay off My Operating Table: A Heart Surgeon's Metabolic HealthGuide to Lose Weight, Prevent Disease, and Feel Your Best Every Day, Dr. Ovadia shares the complete metabolic health system to prevent disease.

Dr. Ovadia grew up in New York and graduated from the accelerated Pre-Med/Med program at the Pennsylvania State University and Jefferson Medical College. This was followed by a residency in General Surgery at the University of Medicine and Dentistry at New Jersey and a Fellowship in Cardiothoracic Surgery at Tufts - New England Medical School.

Learn more about Dr. Ovadia at www.OvadiaHeartHealth.com.

Social Media links:
Twitter: @ifixhearts
Website: OvadiaHeartHealth.com

Written by Dr. Philip Ovadia MD
Published: March 26th, 2022