PHILADELPHIA — Sixty-six days after his father died in bed of a massive heart attack, Geno Vento counted backward from 10 in an operating room in southern New Jersey.
Rattled by his father’s death and haunted by a family history of heart disease, Vento had decided to enlist a surgeon’s help in his lifelong battle with obesity.
Heir to one of South Philadelphia’s cheesesteak empires, Vento was 40, 5-foot-8, and 366 pounds. He could not bend over to tie his shoes. He could barely hoist himself off a toilet. And the 30-second walk from his apartment to the elevator left him gasping for air.
“I was dancing with the devil,” he said during an interview in late December at his spotless apartment in a condo complex overlooking the Delaware River.
In the two years since doctors cinched his stomach with a silicone band, allowing only an ounce of food to be consumed at a sitting, Vento has lost 92 pounds.
Among the nearly 80 million Americans who can attribute their morbid obesity at least in part to the constant temptation of cheap and ubiquitous fattening foods, Vento’s plight deserves special recognition.
To make the lifestyle changes necessary to achieve his radical weight loss was to defy history, culture, and tradition.
For Vento was raised in the belly of the beast.
The family’s cheesesteak business goes back two generations. James Vento started Jim’s Steaks in the 1940s. After a falling-out in 1966, his son Joey broke off and opened Geno’s.
Joey’s only son, Geno, was named for the restaurant and, at 17, was put to work, helping out in the gleaming kitchen where the griddles sizzled with greasy meat and onions, the french fry vats bubbled with saturated fat, and Cheez Whiz, practically a heart attack in a jar, was sploshed onto everything with abandon.
According to a Penn Medicine nutritional analysis, the typical Philadelphia cheesesteak contains 900 calories and 40 grams of fat. Cheese fries deliver 870 calories and 50 grams of fat.
“I had a long relationship with cheese fries,” Vento said. “And mac and cheese with Velveeta.” Asked whether he ever ate vegetables, he winks. “Corn counts, right?”
Food had always been Geno Vento’s “go-to” companion, providing emotional solace, he said, and the fatter he got, the more comfort he needed. Caught in this demoralizing catch-22, he weighed 240 pounds by the time he reached high school.
At 21, he walked into a bar and was greeted by mooing. “Some guy said, ‘I didn’t know they let cows in here.’ ”
At difficult times like those, he said, his mother, whom he calls “my princess,” would remind him how much she loved him. “She would give me a hug – or a cookie – to make me feel better.”
Even at his heaviest, he did not eat cheesesteaks every day.
“But you don’t realize how many BLTs you have,” he said, explaining, “BLTs – that’s bites, licks, and tastes. I was unceasingly putting something in my mouth.”
Like many chronically overweight people, Vento had tried just about every diet plan, diet aid, quick fix, and long shot.
“Jenny Craig, Richard Simmons, fen-phen,” he said, rattling off a partial list. “Nutrisystem, shakes, personal trainers. I had signed up for Weight Watchers a million times.”
Nearly everything resulted in modest success before the pounds inevitably crept back on.
Twice, Vento said, he was approached by “The Biggest Loser,” but for several reasons, including a heart condition, he did not compete in the reality-TV weight-loss show.
Which was probably just as well, he said, because the contestants live in an artificial environment where meals are prepared for them and exercise occupies at least half the day.
“People always did things for me,” he said. Although the surgery jump-started his weight loss, he believes his long-term success depends on a change of attitude that can come only from within. “I’m starting to learn to love myself.”
Studies have found gastric bypass is more effective than lap bands, helping patients lose 64 percent of their excess weight on average in the year after surgery, compared to 36 percent for bands.
But the bypass’ more rapid weight loss results in saggier skin, Vento said. “I wanted a more natural look.”
The procedure is relatively low-risk. Still, his mother worried he might die during surgery.
He was willing to take the risk, he said.
Given that he was prediabetic, had fluid on his heart, and suffered from sleep apnea, “I told her, ‘Look, I’m going to die anyway.’ ”
After the surgery, he began working out five or six times a week for at least an hour a day. He hired a personal trainer, swam 100 laps in his apartment building’s heated pool, ran on the treadmill, and lifted weights.
During the first month, he dropped 35 pounds. Over time, the weight loss slowed but remained steady.
“It’s not happily ever after,” he said, noting that if he exceeds the capacity of his constricted stomach, he throws up and feels extremely uncomfortable.
“I’m human,” he said. “I have good days and slip-ups, but I don’t spiral the way I used to.” He is teaching himself “that the first taste is just as good as the last” and allowing himself to order liberally at restaurants, but taking only a bite or two from each plate.