New Zealand ` clean, green... (SIGHS) ...and fat. In the last year, nearly 70,000 extra New Zealanders became obese. Now most of us are fat. You are... morbidly obese. You know what the word 'morbid' means? It means 'deathly'. Premature death. (DRAMATIC MUSIC) 65% of adults are dangerously overweight, and South Auckland is the ground zero of our obesity explosion. The Manukau SuperClinic is on the front lines of this epidemic, treating over 1200 patients with controversial weight loss surgery. We remove about 80% to 90% of the volume of the stomach. Not much room for food. We've now spent two years with the most at-risk patients, and the specialist doctors and nurses dedicated to helping them through the highs and the lows of their weight-loss journey. I'm anxious and scared; that's what I feel. And I did this because eating was my safe place; it's where I went. Why are you doing it? For myself. I wanna do it for myself. I can't wait to tell people,... 'Stick it up your arse,' really. (CHUCKLES) (MONITOR BEEPS STEADILY) (MONITOR FLATLINES) New Zealand's largest hospital, Middlemore. The staff are dedicated to their mission of healthcare... Kia ora. Middlemore Hospital, how may I help you? ...but even angels struggle with mortal temptation. Thank you. You're welcome. Bye. (PLAYFUL, JAUNTY MUSIC) It's food time. It's scone time. Switchboard worker Elizabeth's fondness for baking has seen her weight rise by a baker's dozen ` she's gained 13 kilos since starting the job. I'll get me two scones. Elizabeth and baker Suzy have formed an unholy union. Here we go, sir. Thank you. What can we do for you, Elizabeth? Suzy, um,... two scones. And she lets me pick mine. And I'll have that one. Want them in the same bag? Yes, please. And that one. This one. Going to back the lunchroom, and I'll prob` Cos I actually brought my lunch, but I still have a scone. Do you think you'll be able to give up scones forever? Um... I think so. Oh, I don't know. At 145 kilos, Elizabeth suffers many of the health issues of the patients around her. She has type 2 diabetes, sleep apnoea and weight-related arthritis. What's the best way of having a scone? (SIGHS) You heat it up. Get it warm so that the butter melts. That's it. It's so nice. What are the characteristics of a perfect scone? Well, first, the size. (CHUCKLES) And a scone that is fluffy and light. OK. I reckon it's naughty, the butter, eh? But I can. It's better than margarine. But never mind. Good? Mmm. The scones taste yummy. You like food, don't you? I think I'm a foodaholic. (JAUNTY MUSIC) You all right? Elizabeth's best mate is William. At a year short of 70, he's the oldest patient currently waiting for weight loss surgery. I'd like to stop taking insulin. And I really think, like, I'm struggling now with my breathing, and I'll be able to exercise more, you know? I'm keen on exercising more. You know, and I... (LAUGHS) I believe, I believe if I exercise more, I'll get more life, a longer life. And he wants Elizabeth to join him. You all right, baby? Yeah, just doing my ankles cos they hurt a bit. But that's my weight, you see? It won't be long. Few months, and then we'll be streaking up these pathways, and people will be saying, 'Is that the same couple that we used to see those few months ago?' Yeah, 'He's lost a lot of weight, but I don't know about her.' Whatever! (LAUGHS) They've lost a good customer. Yeah. I haven't had fish and chips since I've started. Tipping the scales at 145 kilos, he and Elizabeth share more than the exact same weight. They also have a deep love of the fryer. Elizabeth. Yes. How often? Three or four times a week, and I think when I used to come over, he used to use me as an excuse to get fish and chips. Cos I'd always used to have two pieces of fish and two crab sticks. I was two pieces of fish and four mussels. And, yeah, that was my... Yes. That's, 'Bye-bye, fish and chip shop.' Yes. I'm afraid so. Yes. Bye-bye, fish and chip shop. Their fish was so yummy and fresh. All right? Yay. I always get happy when we get in through those gates. (PANTS) SING-SONGY: Breakfast, breakfast. (SIGHS) The relationship is based around love of food. Elizabeth loves cooking it,... When I cook, my food is made with love. ...and William likes telling her just how he likes it. Who's the boss in this food-based relationship? I am when Elizabeth's at work. I don't have to speak. (BOTH LAUGH) Silence is golden. Oh dear, oh dear. William has already been given his target weight loss by the clinic ` 10 kilos. At my heaviest, I was 160... 162 I think, I sort of plateaued at 137 to 140. 10 weeks ago, I didn't feel great. I was struggling to walk, and I was walking with a stick, and my breathing was terrible. People have a habit of giving you nicknames ` I'm Big Bill. And I was Big Bill, and I've been Big Bill for quite a while. But life... You know, the thing is I've been given the opportunity, I think, to do something about it. Elizabeth, what are your health concerns? Heart disease and that, you know, runs rampant in my dad's family and diabetes, so my dad and my two brothers, they died from diabetes. My dad was 61, and my... One brother was 42 and one was 45. And plus, my grandchildren ` I want to be able to see them graduate from university and, yeah... and just know that they're OK, you know? Three quarters of a century of bad habits are going to be hard to turn around. Having each other could either make or break their resolve to change. You're thinking that mine is bigger than yours, eh? Yeah, well,... Well, you're right! (SERENE MUSIC) 40-year-old housewife Mel is struggling. The sacrifices of weight loss are taking on biblical proportions. In my notes to help me stay focused, I tell myself that, 'Remember, God is good all the time.' 'You can do this. He believes in you.' And I then I put underneath it, 'I control what I eat. I make the choice. I will make better choices.' Second-time-around weight loss patient, her first attempt failed when she regained 50 kilos. The strawberry, chocolate, cream cheese muffin. Sugar has been mummy's little helper for the last 10 years. Oh my God, that's a good muffin. She's making changes. The sugar is off, but caffeine is on. (JAUNTY MUSIC) (MUSIC CONTINUES) Can you feel the caffeine? Yeah, you can feel the caffeine. I don't drink coffee so I wouldn't know how coffee actually feels, but it feels like a Mountain Dew. Mountain Dew usually does that to me as well. But I don't really like the sugar-free Mountain Dew. It's OK, but it doesn't` it just doesn't taste right, so I don't drink a lot of it. But what goes up... ...must come down. Scrubbing showers, scrubbing floors. Anything that I have to do where I have to work my arms or squat down or anything like that will be so much easier when I don't have to push all this weight back up. I want to be the best me I can for the second half of my life, I mean, and I can't do that at this weight. But her attempts at weight loss are being sabotaged by an unlikely culprit. So, I woke up, and... it was early in the morning, and I walked into the closet to get dressed, and I looked down... and low and behold, there were... wrappers all over the ground. My mother was kind enough to send us these Hershey Chocolate Kisses from the States ` for the children. For the children. I keep 'em in my bedroom to keep them safe from the children. And apparently not safe from myself, because this is what I found on the floor. So I'm like, 'I wonder who's been in the Hershey Kisses?' And so I open the box and I'm assuming this was not just one night, because if so, I'd have been very sick, because this is what's left of our Hershey Kisses. And there are lots of empties in here. So I threw 'em back in the box. So I must've stood right here and opened one, ate it, and put the wrapper back in. Opened it, ate it, and put the wrapper back in, so... And I did all of this in my sleep. Mel knows she needs help and books in an emergency clinic appointment. She brings her family along for support, but even they are not fully aware of the scale of the problem. I was just fixing to tell Mark, um, last night I took sleeping tablets, because I've been having such a hard time sleeping. And when I woke up, I had made myself a pancake with a peanut butter, and I was sitting on the couch fixing to eat it. Yeah. And I wound up last night also having, um... What did I eat? My mum sent me some Slim Jims , and I must've gotten that as well, because I woke up this morning with it in my hand. Mel's sleep-eating. Yeah. This is the first time I've heard of it. Melissa. Oh yeah. Right. How are you? A little sick, but I'm OK. Cold? Yeah. So we'll check on the weight, see where that is up to. Yeah, sounds good. Look at that. I'm almost where I started. 104.8. Right. Come on, then. So how much have you put on? 4 kilos. SOFTLY: Oh shit. Oh dear. I do think it's... I'm sleep-eating. When you say you're sleep-eating... In my sleep, I'm getting up. Have you seen this? Yeah? She just told me now that she went downstairs last night. Last night I woke up and I had made pancake with peanut butter. I'm on the couch and I look down and I'm thinking, 'What the hell am I doing with this?' If you're wanting to succeed with bariatric surgery, you've got to get that headspace right. Putting those foods out of sight, out of mind. If the kids are gonna have chocolates, then you don't need to know where they are. Because I think you need that temptation taken away from you. I do. I do. And actually using your hubby as well a little bit. I know, but I can get quite agro when he gets involved with the food. I can. I get quite ugly about it. Then that's the choices that you're making, and then you can't blame anybody else about the foods that you eat and the weight that you put on. Well, no, no, I can't. You need to allow me to be the bouncer, but you're not allowed to be mad at me. You have to accept that I am the bouncer. That's not gonna work. If you don't accept it, you get your arse kicked, don't you? You know what I mean? Well, here's the thing, though ` it's not your job. I've got to do it for myself. You need to allow me to do my job. If you're not there... They're doing it because they love you. I can tell you what happens to me ` I go into hiding. And then I wait until he goes to bed or he goes to the toilet or he's distracted or I go for a 'walk', and I steal food, and I take it and I eat it out of his sight. So this is why we do need to get the psychologist involved with you. (LAUGHS) Yeah, send in the shrink. No, we do. Seriously. If you have that bariatric surgery, if you've not sorted out the big issue, you'll have the surgery and you'll come back years later and go, 'I've put the weight back on again,' because you haven't sorted out what's going on with your headspace. (LAUGHS) All right, Melissa. Thank you. Are you worried about her? Yeah. Yeah, personally, I wonder whether bariatric surgery is the right challenge for her, cos if she hasn't got this headspace and it's always the food, always the food, she's gonna be in a worse space once she's had that surgery. And it's hard. * (GENTLE MUSIC) For most of us, the happiest day of our life doesn't happen in hospital. But Josephine is unique. Weight loss surgery has been her number one goal for every minute of every day for the past two years. Come here. Josephine's journey to surgery has been about more than just weight loss. Reclusive and housebound, food filled the gap. My number one is peanut butter sandwich. But faced with the prospect of an early death,... I know you didn't want me to end up like you. But I did. ...Josephine swapped out the deep-fried chicken,... Boom. Breakfast. ...for a more well-rounded option. She's on fire! Yeah! Whoo-hoo! She got herself a veg-ucation... A cabbage. (LAUGHS) ...and a sense of self. I feel alive and... I know what I wanna do now. Finally, her day has come. Just lay on your back. Feel the side of the bed. While the anaesthetic team prep Josephine, surgeon Richard Babor lays out the risks. I'm a little bit worried that her liver will be big, and being a Polynesian lady, her frame's a little bit bigger. Those patients have a bit more abdominal obesity, you know? And their organs are surrounded by a bit more fat. All right. A small jab. Ah, I think we may have lost it. As Richard feared, Josephine's size is already a problem. The anaesthetic team can't find a vein. Even though she's lost 26 kilos, she's still morbidly obese, and her weight is constricting her arteries. The doctors have to bring out the ultrasound machine to locate a viable vein. If the doctors can't find a vein, Josephine can't have an anaesthetic. And that means no surgery. So just that there. So when I press on it, it flattens. A vein is located. You've been very patient. Very good. Thank you. Surgery can begin. How you doing? (MACHINE BEEPS) When I was a kid, I couldn't stop smiling. I'd run and play, and I felt so free. Walking felt like flying. I used to roam everywhere, free as a bird. I want out of this cage of my body. And I just pray that, for my mother, I make it through the surgery. This is Josephine. She's been a long time getting here, so let's take care of her. OK. All good to go, eh? Mm-hm. Local. Knife. Gas on. Top lights off. OK, cool. She's actually OK inside her abdomen. It's quite good. She's done quite well with her weight loss. She's burnt off a lot of her intra-abdominal fat. She's done extraordinarily well, remarkably well. Much better than I expected. I think it would've been verging on technically impossible to do her surgery unless she lost this significant amount of weight, which she's done ` to her credit. You know, it's really good. She's gonna lose a lot of weight, and she might get her diabetes under better control and she might have a better profile of her cholesterol, and she's probably gonna not have sleep apnoea, and it will reduce her risk of getting cancer or dying of a heart attack or stroke. It might make the quality of her life better, because she's gonna be able to exercise more easily, or just get around, you know? Get in and out of cars and buy clothes and feel better about herself as well. She doesn't know it yet, but Josephine's life has changed forever. She's a fraction of the woman she once was ` at least on the inside ` with only 10% of her stomach left, the coming months should see her burn off her excess weight. I'm just glad she's made it, because she's just got something about her personality. I think, uh, she displays this kind of vulnerability that, um,... endears her to a lot of people. How you going? Everything's gone really well. No problems at all. Oh! Can I give you a hug? Yeah, I know you always need a hug. (LAUGHS) It's good I like your hugs. (LAUGHS) You guys have worked really hard, you know. I'm really pleased that you made it, so that's good. Aw! (GROANS SOFTLY) It's done now. (GROANS SOFTLY) How are you? I'm good. Thank you. Oh, thank you very much. Hold my hand. Thank you, Father. Thank you. Because of you. In Jesus' name, amen.