Danny Naranjo was still several years from his 40th birthday, but he was increasingly aware of that milestone on the horizon.
His body mass index (BMI) was about 80. He had back pain and struggled with lymphedema. His knees hurt when he had to walk even short distances for his job at Elitch Gardens, and he did it only with a steady stream of Tylenol, ibuprofen, and sometimes tramadol. As 40 approached, he knew these concerns might only get more acute, with new ones possibly joining them. He wanted to change what was beginning to feel like an inevitable future.