I New Zealand ` clean, green... (MUSIC WARPS) ...and fat. (DRAMATIC MUSIC) In the last year, nearly 70,000 extra New Zealanders became obese. Now most of us are fat. You are... morbidly obese. Do you know what the word 'morbid' means? It means 'deathly'. Premature death. (OMINOUS 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. SOBS: But 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 RUEFULLY) Copyright Able 2018 Oreo shake, banana split, banana fritter, brownie a la mode. Mmm, yum, my favourite. Lisa and Chris are recently married second-time-rounders. Their courtship involved lots of eating. Bread-and-butter pudding. Yum. Chocolate steamed pudding. And with both now weighing almost 130 kilos, they are truly partners-in-food crime. Hmm. I always had eggs Benedict. I always have eggs Benedict. No, you have pancakes. How important was food in your courtship? Our first date was at a pub for a meal. Yep. And we never looked back. (CHUCKLES) We just eat, um,... together. It's what we do. Yeah. Part of our ritual, really is, 'Let's go and have something to eat.' Hello, guys. How are you today? Hi. Good, thank you. Good, thanks. I'll have the classic Bene, please, and curly fries... Sure. ...with aioli. Yep. And can I get the Grand Slam? Anything else? CHUCKLES: No, thanks. Thank you. Does eating make you feel better than anything else you do? Absolutely. Yep. There is nothing better. Some people, it's alcohol; some people, it's drugs. For me, it's food. And if it's bad food, it's even better. Chris has actually seen me before I start a meal, and I know there's a great meal in front of me, and I actually get the shakes. Hello. Hello. Your large pancakes, sir. Here you are. Thank you. (CURIOUS MUSIC) Oh God. So good. 'Chris' eating is down to unabashed enjoyment.' That's a heart attack on a fork. 'For Lisa, her eating comes with a dark side.' Why do you want weight loss surgery? So I can be... me again. I can be healthy, and food doesn't control me. It's also to get mentally healthy. I've suffered from chronic depression since I was a young teenager. Probably only three or four years ago, psychosis was added to that mix, which is the auditory hearing of voices and things like that ` negative voices. Apparently, having the surgery will make my symptoms so much easier, so much lighter. And my psychiatrist is... 100% behind me doing it, mainly for the fact of how much it will alleviate the symptoms and make my life just a hell of a lot better. So good. There's always room for curly fries. I mean, the physical side really isn't that huge to me. Mentally, I want to be normal. I want to hold down a job. I want to be able to do the things that normal people do and take for granted. So if this is your favourite thing to do, and it's also your favourite food to eat, do you think you're really cut out for weight loss surgery? Well, we'll just replace it with sex, won't we? (BOTH LAUGH) But for Chris, sex is the furthest thing from his mind. Helping Lisa through her highs and lows is almost a full-time job. For the relationship to flourish, he needs Lisa to get weight loss surgery just as much as she does. You do it for love. You love this person. And you see the ups and the downs as well, where it's like, 'I don't want to be this way any more. 'I want to be normal.' And that keeps you going. You want to help. You want to make it... to make her better, to give her a better way of life. Lisa's depression can rear up with little warning. And a couple of weeks later, she's crashed. (OMINOUS MUSIC) (EXHALES DEEPLY) SOFTLY: Damn. Dr Jai is Lisa's treating psychiatrist. She's been seeing him for two years, and he's supporting her through her weight loss journey. How did it work on Tuesday when you were in that spell? Woke up on Tuesday morning and felt really down. Don't know why. Mm, mm. There was no reasoning for it. Mm. Um,... and... you know, negative thoughts, negative voices saying not so nice things. So the Tuesday when it started, was it unexpected? Yeah. Were you a bit surprised with how it came on? Yeah, I was. I was, because Monday was fine, and then woke up Tuesday and... just bang. And you just know that it's not going to be a good day. And you said that the some of the negative thoughts started coming back again. Yeah. And voices? Yeah. Feelings can get really, really strong, and you get overwhelmed and anxious. Night before last, I couldn't sleep. I was hearing things underneath the bed. Mm, mm, mm. It's so bizarre. Was it the same kind of male voice? Yeah. OK. Yeah, yeah. Yeah. So I was kinda terrified through the night. Sounds a pretty dreadful night. It wasn't a good night. And what were your thoughts about the surgery and the plan? Do you still, kind of, have that motivation to keep going with it? Yeah, absolutely. Yep. What's the exercise plan at the moment? Any bit of exercise that you manage to do... ...is beneficial for my head. ...helps with your mood. I think it's about moving and making sure that you're getting` even if it's a little bit of exercise. Yeah. Good. Exercise is the medicine. But for Lisa and her current state of mind, she can barely leave the house. It's all in your mind. Your body... feels so heavy. And it's hard to lug the body around and hard to make it do things. I mean, just for me to get out of my room and into the lounge here was an achievement. (CHUCKLES) So... you either can't sleep or you sleep too much. And it's usually a role reversal, so you can't sleep at night, and you're awake all night with masses of thoughts going through your head, and you're getting catnaps during the day to catch up on the sleep you haven't got at night. In the morning, when you wake up, you have to actually talk yourself into getting out of bed. And you weigh a ton. Everything weighs so much more and so heavier. Your whole body is heavy; your brain is heavy. All those basic things. Just` It's overwhelming. I've got a heap of room in here. If you could just hold the leather up. William and Elizabeth are best mates... Got a heap of room over here. It's better than forcing` Just hold that there. ...and weight loss buddies. Come on, Speedy Gonzales. William is a few months ahead of Elizabeth. To qualify for surgery, he has a goal weight loss ` 10 kilos. What's for lunch? I'm gonna have salmon and, um,... tomatoes with cottage cheese on... a wrap. A retired butcher, he's finding the sacrifices of weight loss hard to stomach. I really miss sausages and mashed potatoes and peas and a heap of gravy... on a big plate. That's what I'm really missing. Today, Elizabeth is hoping to join William and get a target weight loss of her own. Surgeon Richard Babor will decide whether Elizabeth is fit for surgery. Only 158 patients get through a year from a pool of hundreds. As the hospital phone operator, Elizabeth's hoping she's got a good chance. Are you one of the phone operators here? At Middlemore. At Middlemore? So we must've talked on the phone many times before. Yeah. Yeah. Awesome. So this means, like, when I ring up in the future, you're gonna be like, 'When's my operation? (LAUGHS) 'I know you're working, but I've already lost...' (BOTH CHUCKLE) Oh, good. So you've got plenty of reasons, Elizabeth, to have weight loss surgery, don't you? Why do you want to have it? When you've been as overweight as I have for the years... It's always been a battle for me, right from when I was young. And it's not that I haven't really tried, but I've tried and, um,... yeah, I just keep falling off the bandwagon. And then this opportunity's come up for a second lease of quality of life. Yeah. And... And... And I want to do it for me first. And, um` Yeah. Good on you. Cos I've worked hard and that over the years, and I've, you know, catered for my family over the years ` my daughter and my grandchildren ` so it's, sort of, come the time when it's about me now. You've got diabetes, high blood pressure, high cholesterol. You've got a bit of arthritis as well. Mm-hm. Can I examine your tummy, please? Mm-hm. Elizabeth, can you lose a little bit of weight for me? Yep. Can you lose 10 kilos for me? Yep. Awesome. Do that, and we'll be all` all systems go. (WATER RUNS) I was excited about this moment. OK, good. Because it was like` it felt like the cogs would start turning once I see you, so, yeah. Definitely. Cogs are turning. And we're going to get you there. SOFTLY: Thank you. My pleasure. Do you think you can do it? Yeah, I think I can do it. But it's` Maintaining it is going to be the hardest thing and keeping it off and just... Yeah. Elizabeth gets her weight loss target of 10 kilos. William hits the pool. Just walk as many times as I can ` as much as I can for an hour. And Elizabeth heads up north to her family marae. (ENGINE WHIRRS) It's the six-month anniversary of her sister's death, and the family are celebrating her life. (PLAYS GUITAR) Because Elizabeth's sister died of weight-related illness, she's using the opportunity to spread the bariatric gospel. When they talk about lifestyle changes, we've got to make that lifestyle change, eh? It's up to you. Yeah, you don't want to go back there again. And I don't want to. You know? Cos I want to have an awesome retirement, you know? And be able to retire and do things. However, it's not a case of preaching to the converted. (BELL TOLLS) READS: 'E te atua kaha rawa, e tuwhera ana nga ngakau katoa ki a koe, 'e mohiotia ana nga hiahia, aiti hoki to matou ariki. 'Amine.' ALL: Amine. ALL: # ...uru ki # nga waiata. # Amine. # (ALL CHATTER) Celebrating at the marae means a big feed of boil up, cakes, fizzy drinks ` all foods that Elizabeth can no longer eat... (OMINOUS MUSIC) ...or turn down. (HUMS HAPPILY) A gentle nudge, and Elizabeth is off the wagon. The food here ` just the smell alone does it for me. (CHUCKLES) Like most of us, she's powerless to resist the temptations of the comforts of home. * Serial weight-loss offender Jackson has broken a few clinic rules. Did you have a late night? Is that why the sunglasses are on? Yeah. He's been partying. Sunglasses are on, so we don't know what the pupils are looking like. (GROANS) Yeah, yeah. At 20 years old and 217 kilos, he has a massive weight problem. It seems his troubled history is catching up with him. Oh, I was all prepared to go to jail and stuff, eh? Like,... yeah. Unmotivated, he's a no-show at the clinic, forcing Cecilia to discharge him. He didn't arrive at the clinic appointments, and it's something that we're really clear about from the start ` non-attendance, rescheduling. We eventually will discharge you back to your GP. Jackson is not going to get weight loss surgery. It's kind of pissed me off. It's kind of really pissed me off. (SOMBRE MUSIC) Well, you could probably do something about it if you wanted to. Yeah, if I wanted to, but... (CHUCKLES RUEFULLY) Uh, so what I just` Yeah, they just told me. It just kind of (BLEEP) me off. (PLAYFUL MUSIC) (CAR BEEPS) Over the next two weeks, Jackson's forced to take a good, hard look at himself and realises his life is on the line. (TRAIN WHIRRS) Embarrassed at his behaviour, it's back to Cecilia, cap in hand. I actually care this time. I didn't really care last time. I didn't really give... two hoots last time. Attitude's changed towards it. It'd be life-changing for me, so that's why. (TRAIN WHIRRS) (SOMBRE MUSIC) What made you care? What made me care? Um,... oh, family. They changed my mind. My mum and my dad, they changed my mind... on life and stuff like that. How? Just told me I couldn't keep doing the stuff I used to do... and, um,... But yeah... Jackson, good to see you. Thanks for coming in. Right, I know that you were upset when you got the letter and you heard from the team that we'd discharged you. Yeah. The history that you're showing us at the moment on paper, with all the rescheduling and seeing that the weight goes up, and then we just get a couple of kilos go down, and then we see it go up again, is that we're looking and going, 'How committed is Jackson in moving forward to lose that weight?' We've got hundreds of patients that want this surgery and that are on the phone to me on a regular basis saying, 'I've had the GP refer me. When can I come in for the clinic? I'll come in tomorrow.' But I absolutely want to give 100%, and it costs 20,000 plus to have the surgery in itself. We've kept you on with us since 2011. The reason why you're still with us is you're a young, fit, healthy man. You've got your life ahead of you. You don't have all of the health conditions that you will get because of your obesity. We're willing to help you again if you're willing to step in and come with us. Do you want to do that? Do you want to work with that? Yeah. I'm happy to work with that. Yeah? The goal I'm going to give you is 4kg to 8kg over eight weeks. Yeah. You're the one that's driving this. Yeah, yeah, I know. Sweet as. It's last chance saloon for Jackson. He's back on the waiting list by the skin of his teeth. And now he has to make up for lost time. I've been here for, like, six years trying to get on this thing. So it's time to get a move on. Hard. Finally... Time to finish it... finally. (FAST-PACED MUSIC) Yeah, nah, they'll do. They do? Yeah. Hard. No baby steps for Jackson. He's going straight to the top... of Mangere Mountain. It's a supersized goal for an extra-large man. (SUSPENSEFUL MUSIC) (COUGHS) (PANTS) (PANTS) (COUGHS, SNIFFS) (PANTS) You did it. (EXHALES DEEPLY) Did it pretty fast. (BREATHES DEEPLY) Jackson's family have given him the push he needs. (LAUGHS) You're smiling. Yeah. Yeah, it's all good. So, what next for you? Just be like my dad ` be a truck driver. Did you used to ride in his cab when you were a kid? Yep. In the holidays and things like that? Yep, all the time. Every holiday. I never used to spend the holidays at home. Always with Dad in the truck, so, yeah... Is that why you love the idea of it? Yeah. I got to see all of NZ in a passenger's side of a truck ` that's pretty cool. So truck driving is, like, what I know. I don't know anything else. (CHUCKLES SOFTLY) SOFTLY: Yeah. Big dreams? Big dreams.