Do you ever wonder how TLC's Dr. Younan Nowzaradan gets such dramatic weight-loss results from his gastric bypass patients on "My 600-lb Life"? Thanks to the good doctor, show participants like Chad Dean and Sean Milliken (to name recent ones) have shed hundreds of pounds. The reality television surgeon dished up his famous baratric surgery diet. And what's on the menu might surprise you!

Weight-loss before bariatric surgery?

Before gastric bypass surgery on "My 600-lb Life," patients must lose weight. Does this shock you? Many people think Bariatric Surgery will fix obesity in one fell swoop.

They don't realize that there is "homework" before they can have a gastric sleeve (or other device) implanted. The purpose of this is two-fold. Most patients come to the reality TV show far too overweight to safely undergo surgery. Steven Assanti weighed 853 pounds. Losing weight before surgery is also an act of good faith. It proves to Dr. Now that patients will follow through.

Dr. Now gets serious about calorie counting

With the morbidly obese, the bariatric surgeon doesn't have time to mess around. They are dying of infections like cellulitis. Crippling lymphedema tumors destroy joints and become infected, and not one vital organ isn't hurt by extra weight. Diabetes, high cholesterol, hypertension, heart failure and other diseases compound health risks.

Dr. Now is well nicknamed as he literally has to act now. He expects patients to lose 50 pounds a month, and they do on his rigid 800-calorie a day diet.

TLC doc's extreme weight-loss plan

Patients often think that Dr. Nowzaradan expects them to lose weight too fast. 50 pounds in a month is a lot for a normal sized person. But these are abnormally obese people whose weight is snowballing.

They can shed 50 pounds in a month because they gain that fast, eating 5-10 times what the average person eats. 800 calories is extreme but only temporary while they're in the hospital. Patients are allowed 1,200 calories daily living independently prior to surgery. Those who follow the bariatric surgery diet, like Chad Dean, lose.

Those that don't, like James K, don't.

Dr. Now's surprise diet

The diet focuses on daily nutrient quantities as much as calories. Dr. Now talks in ounces of food, recommending 6-8 ounces of protein for men and less for women. But he also makes patients eat 60 grams a day. So protein sources have to be lean and efficient. He encourages dairy for protein and calcium. Bread sources need to contain high fiber to burn fat. The diet cuts soda, refined sugar and transfat and boosts MUFAs (monounsaturated fatty acids). But Nowzaradan realizes that patients need some sweets or they'll never manage. He recommends fruits with seeds (blueberries and strawberries) for fiber. After surgery, patients avoid vegetables as they add bulk without curbing hunger. Later, veggies are added in.