RALEIGH, N.C. (WTVD) -- While there's no questioning James Sampson's culinary chops, the task of navigating a food truck at over 800 pounds is burdensome.
"I couldn't stop and pity myself because I had gotten so big. I still had to go. I still had a mortgage to pay. I still had bills to pay," said Sampson.
Growing up, Sampson was active, but his weight began to spiral as a young adult. Efforts to cut weight were often fruitless; he'd lose some weight, but gain more, a cycle that would continue for years.
When he launched Corner Boys BBQ in 2015, he weighed 700 pounds. Medication for heart issues led him to retain water weight, eventually leading him to his high-mark of 819 pounds.
"At that weight, you deal with death on a daily and you don't really focus too much on everything else," said Sampson.
A fall in his shower spurred him to take serious action.
"I was so obese, it took me 3 hours to get off the floor just to get in my bed. And that broke me," said Sampson.
"Most of our patients come to us as a last resort," explained Dr. Linda Youngwirth, a bariatric surgeon with UNC Rex Health, who worked with Sampson.
Dr. Youngwirth said causes for obesity are wide-ranging, and in many cases expand past dietary decisions.
"There are so many factors that are completely out of a patient's control, like their hormone levels. Most of our patients constantly feel hungry and never feel like they can get full. They're constantly thinking about their next meal because of their hormone levels. With Mr. Sampson, genetics played a part of it as well. We're learning more and more every year about obesity genes, and he has a family history of that," said Dr. Youngwirth.
Changes to medication and lifestyle helped him drop about 200 pounds before undergoing bariatric surgery.
"It's a surgery on the GI tract that does many things. There are three kind of fundamental concepts of bariatric surgery. The first one being restriction, meaning the patients can't eat as much as they could before surgery. The second one is hormonal. So every time we operate on the gut, we impact their gut hormones and typically with bariatric surgery, what that means is that we increase their full hormones and decrease their hunger hormones so they don't feel as hungry as they did before surgery. And then three is malabsorption. They don't absorb as many calories or as much fat as they did before surgery," said Dr. Youngwirth.
What the surgery does not do is remove any weight.
"The weight doesn't fall off because you've had the surgery. You still have to abide by the rules. You still got to eat a certain way. You can't just go back to doing what you used to do," Sampson said.
That's meant a major change to his dietary preferences, including an unthinkable choice for a Pitmaster.
"I don't eat a lot of red meat, like, hardly ever any," said Sampson.
Sampson now weighs 315 pounds, the lowest total in more than two decades.
"I'm only giving patients a tool to help them achieve their goals. They're doing all the hard work. I don't take any credit for Mr. Sampson's success. He did everything. He made all those hard choices," said Dr. Youngwirth, who added she works alongside a team of nurses, PAs, dietitians, and psychologists.
Doctors continue to monitor Sampson to ensure he is receiving enough vitamins and avoids malnourishment, a process that will continue throughout the rest of his life.
"When I look in the mirror now and I see the real me versus the overweight me. It's crazy. This diet for me has (had) more of a mental (effect) than physical," said Sampson.
The weight loss has given him more energy and allowed him more independence. While thanking his son and daughter-in-law for taking a large role in the business as he focused on his health.
"I hope this story reaches somebody where it helps them say, you know what? If he did it, I can do it, because you can," said Sampson.