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An essay published in Harpers Bazaar in 1897 refers to fatness as a crime and a deformity, and argues that a fat woman will not be a social success unless she burnt-cork herself, don beads, and then go to that burning clime where women, like pigs, are valued at so much a pound. People have been pushing back against fat stigma since at least the nineteen-sixties, when activists staged a fat-in at the Sheep Meadow in Central Park

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Pautler approaches these procedures thoughtfully and strategically, often combining surgeries in ways that reduce operating time, minimize blood loss, and limit the number of recoveries a patient has to go through