New Zealand ` clean, green... (MUSIC DWINDLES TO SILENCE) ...and fat. (MOODY ACOUSTIC GUITAR) 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. (RACING STRING MUSIC) 65% of adults are dangerously overweight. And South Auckland is the ground zero of our obesity explosion. The Maunukau 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. 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... (SNIFFLES) to stick it up your ass, really. (LAUGHS) (HEART MONITOR BEEPS STEADILY, FLATLINES) 40-year-old stay-at-home mum Mel has battled with weight for over a decade. I wanna be strong and have willpower. And I wanna say, 'You know, I'm gonna eat this tasteless, sugarless stuff.' But I don't want. I'd rather not eat than eat stuff that's good for me. Peaking at 117kg, she opted for lap-band surgery as a way of shrinking her stomach. Best description I can give you ` this is my oesophagus, this is my band, and my stomach's down here. Let's try to fit coleslaw through it. Did anything go through? That's what it feels like. Hello. Problem ` it didn't shrink her appetite. And a binge-and-purge cycle put Mel on the warpath to weight loss surgery. There is a chance today he will say he can't do it. Mm. Oh, well, if he says that, you're gonna have to turn your camera off, or you're gonna have to go 'beep, beep, beep, beep,' because I'm gonna lose my... All right. But she did make the surgery list. (GASPS) Yay. Oh my God. Double figures. Today could mark the end of Mel's weight loss struggle. (APPREHENSIVE PIANO MUSIC) Here we go. I'm just` I'm just worried. I just` Y'all know how I am. I just` You'll be fine. I'd love to drink a gallon of water right now. But that's only because I can't. Yeah. If they told me I could have water, I probably wouldn't even want any. But I just` I'm so thirsty. (INTRIGUING MUSIC) Surgeon Richard Babor will take Mel's band out and give her a gastric bypass. Gastric bypass is an operation for weight loss where we staple off a little pouch on the stomach, and bypass most of the stomach by bringing a loop of bowel up and stitching it on to the pouch. She won't be able to eat very much, because this will fill up with food. It's not the size of a big stomach. And then it'll empty into this. And it won't be filling her big part of her stomach, which is left behind, but disconnected or bypassed. Mel will lose a lot of weight with it, but she will have some issues. It's gonna change profoundly the way that she eats. And I think she might struggle with that a little bit. (DEEP SIGH) WHISPERING: Oh my gosh. I cannot believe this is happening. I am so freaking out. I mean, I know I've waited, like, a year and a half to do this. And I just` WHISPERS: Oh my God. I cannot believe, like, in the next 20 minutes I'm gonna be in there, and they're gonna be taking this horrible band out of me and... giving me my bypass. And when I wake up, then it's all over. It's just... It just seems unreal right now. It's like a trip to Disneyland, in a way, Disney World. How are you guys feeling? Good. Yeah. Yeah, no. Feeling very upbeat. I'm still surprised how upbeat your mum's feeling, eh? She is holding it together. Holding up well, yeah. Yeah, no. We were just having a chat before, but, um,... no, we're very happy. (DEEP, RINGING PIANO CHORD) WHISPERS: Amen. (SIGHS) Never hurts to give a little prayer. A little 'thank you' for all the good things He's done. (SIGHS) And all the things that He's going to do. (LAUGHS SOFTLY) It feels a little real now. (LAUGHS) (SIGHS) (LAUGHS SOFTLY) (POIGNANT PIANO MUSIC) Just been a long time coming. I'm excited but I'm really scared. Mm. I know I'm making the right decision by doing this. It just... It feels so scary to put your life in someone else's hands. (SNIFFLES) (INDISTINCT CHATTER) All right. Hi. This is it. This is it. It's it? Yep. Love you. Love you too. See you when you come out. On the other side. (LAUGHS) Hi! Hi. (RACING AMBIENT MUSIC) Just gently over your face. (MUSIC SWELLS AND FADES) Gas on, Arpie? Lights on. Camera lights on; top lights off, thanks. Kind of wanna set it up. We might be able... (SPEAKS INDISTINCTLY) Stop. I can see the band tubing in the background there. There it is. Undo this one, then. So, this is the, kind of, first step of the bypass where we take the band out, or release the band. Sometimes you can just undo the band by undoing this buckle. But quite often we just have to cut through it to get it out. Come on, baby. There we go. We've kind of undone the band now. This was sitting around the top of the stomach, like that. And it's got some fluid in there still. And then this was connected to the port which sits under the skin which you can inject more fluid into. And it blows this band up and tightens it or releases it. We're just gonna cut through the buckle there to release it. And it's come off. Now we've just got to free up the stomach, and then we can start the actual gastric bypass that we're gonna do. Why not just do a sleeve on her? Firstly, she wanted a bypass, cos she's done a little bit of research on it. This will help her get much better control than she would with a band, because it'll take away her urge that she has to` I don't think she had much appetite, sort of, suppression. And the band doesn't really have much of a hormonal effect on appetite. And so she's always been tempted to liquidise Mars bars and stuff. And this operation doesn't just work by restricting mechanically the thing; it's got a hormonal effect, which hopefully will stop her from wanting to do that. (SPARSE, TENSE MUSIC) We're talking about two minutes away from finishing now. Last stitch. OK, level the patient. Awesome. A remarkably smooth operation. Mel's band is out, and she's off to recovery. We'll see how she goes, you know? She's kind of... you know. She'll struggle with it a little bit. But hopefully not too much. Because actually, patients who've had a band before have already been through that, 'Ew, can't eat.' Often they do... They don't find it as hard to adjust to a bypass as someone who's just had a sleeve from a normal stomach. So, hopefully she'll be quite good. (BOUNCY, RINGING MUSIC) That pink top in the window. At 18-years-old, Lauren is a typical Kiwi Teenager. Would you wear that? Yeah. Oh my God. She love shopping and is a passionate foodie. My favourite's lasagne or bacon-and-chicken fettuccine. Lauren has been overweight since she was 4 years old. And now, at 18, her weight is causing strain on her whole body. So, do you live at home with Mum? Yes. Lauren became the youngest patient currently waiting for weight loss surgery. I'll set your goal today of 10 kilos. But once on the list, found it hard to get moving. So what do you think you should do for exercise? Should we go and do swimming? No. Lots of enthusiasm. With only a few weeks to lose her target 10 kilos, Lauren was referred to a child psychiatrist. What kind of bullying did you get? Name-calling and just stupid... What sort of stuff? She said, 'Fat Albert.' And she's like, 'Oh, that's your character on TV. It was just the breakthrough she needed. Just having someone, like, there to talk about everything. I'm a bit more comfortable with everything. It's gonna get lots easier now. And now, four weeks later, Lauren's committed to achieving her weight loss target. So, gonna, like, get the weekly planner and all that. And start doing all that, and feel much better, yeah. So what are you gonna plan out weekly? So, exercise, more, like, sturdy meals. Like breakfast, lunch, dinner. Just following more goals and everything. Family focused on her goal, she's got herself a gym membership and a personal trainer. Today I'll run you through exactly how this programme works. OK. But what I want you to do is I want you to increase your level to about level four. I was worried about what people were gonna say. Previous experiences with other people is just, like, feel real intimidated by this and insecure. But this one's really nice, they're friendly, motivating. So that's eight. So that's half-way. So we've ticked that first box. You do another eight. (LAUGHS) Is it good or is it hard? No, it's good. Like, it's comfortable. Like, not too hard, like, that I'm struggling. Chin up, chest up. So pull it below the chin into the neck. Good. It would be nice to walk past some people and give them something to double-look for the right reason not the, 'Oh, look at that, yeah.' What's the right reason? Just, like, more confident in my step, feeling better, look healthier. Good. Keep pushing all your weight back. No longer happy with how she looks or feels, Lauren's stepping outside her comfort zone. Not only is she exercising in public, she's sweating the hard stuff. In the last two months, Lauren's dealt to her personal and physical demons, in a monster effort to get through the surgery. Today it's weigh-in with Cecilia. So what we wanted` When you were last with us your weight was... 162. Yep. So... And the weight today was... 155, 155.8, which is 7kg, so that means that you've nailed it, and then gone beyond, which means that we can then get you on the waiting list and get you through for surgery. (BOTH LAUGH) Well done. The biggest thing is ` how've you found it? Like, I've been nervous. Like getting a nervous rash and everything. Yeah, just excited as well. But nervous. Keep going, keep going. That's it. And you're gonna watch that weight go down and down and down. Yeah. So for the first year, we see lots of weight loss. That's good. Exciting. Then you'll have to go and get a new wardrobe of clothes, won't you? (BOTH LAUGH) Start saving now. (LAUGHS) So far, any questions, any concerns? Any...? Nah, I think we're good. Look at Mum, she's... (LAUGHS) Yeah. Nah, I've had some concerns. But I've been talking to people to try and deal with it. But those are my personal... Just as an outsider, looking in. Yeah. Yeah, just for her. Just feeling for her, really. And just this journey for her. All right. So, I'll catch up with you after the event. All right? So she's made it through to surgery? Made it through to the surgery. She's done really well. Just absolutely been determined, and you can see that at her last visit, that she got it. Really nailed it. (LAUGHS) So, you over the moon? Yeah. She goes, 'I'm gonna cry. I thought you were gonna cry.' I was. I thought you were gonna cry, and I started tearing up a little bit. And then I thought, 'No, control it.' (LAUGHS) No, that's awesome. Are you gonna do anything to celebrate? Uh, no. Oh... Oh, we were meant to be going to the movies tonight. Oh, yeah. We were too. Yep. Supposed to be, should be. Take my carrot sticks along and my water. (BOTH LAUGH) After 18 years of being overweight, Lauren's time of gaining weight could be behind her. As the clinic's youngest patient, she has the most to gain throughout a lifetime. (WARM STRING MUSIC) * (DREAMY MUSIC) At the Manukau SuperClinic, there's no such thing as an ordinary patient. But Josephine has been extraordinary. Nicki Minaj ain't got nothing on us. We've been following her weight loss journey for three years. At the moment, I can't even feel your ribs. At 35 years old, she's barely left the house. And she tipped the scales at 176 kilos. Because the food made me happy, I just saw it as my other friend. She suffered type 2 diabetes, high blood pressure, sleep apnea, and sought solace in food. Coconut cream. Mmm. She suffered setback... You're pretty much the same weight. ...after setback. My aunt says cranberry juice. It's actually full of sugar. I've been drinking a lot of this. She discovered her favourite foods... Yum. Breakfast. ...were her frenemies. With her mother Naomi firmly at her side, Josephine made baby steps. She's on fire! Yeah. Whoo-hoo. (EXCLAIMS) It was time to make new friends. When have you ever get to see a red cabbage before? Josephine threw herself into her new 'vegucation'. I'm making a banana, kiwifruit, mixed berries smoothie. After a year and a half of hard graft, Josephine made the surgery list. Let's start working you towards surgery now. OK? (LAUGHS) (SQUEALS, LAUGHS) Really?! (LAUGHS) Her operation was a success. (LAUGHS) I'm glad you've made it, you know? Thank you. You've been a long time coming here, eh? Yeah. That's awesome. The experience has not only changed Josephine, it's inspired her. Josephine is training to be... a nurse. Hey, I'm Josephine. I'm an enrolled student. The first thing I'm going to do is take your temperature. My dream is to become a nurse. And finally, I'm doing it. My dream was to be a nurse because I've been a patient before. And I've seen the care and understanding the nurses had for everyone. It doesn't matter who you are. Because, at the end of the day, you're there, cared for, looked after, and to get well for your family members and yourself. (OPTIMISTIC MUSIC) My previous weight was 176, and now I am 121. The weight differences between each other are huge. Like, when I was 176, I couldn't even move. Now, at the weight that I am right now, 121, I can walk. I feel like I'm floating. It's changed everything ` how I live today. My mind has changed as well. I know that I'm deserving of a life. How happy are you now? (LAUGHS) Big happy, 100% happy now. I feel free. Obesity put Josephine's life on hold. Now she has a long bucket list of things she can finally do. (BOTH LAUGH) Josephine, have you ever been to a ball? No. Never, I've never been to any social event. No balls, no nothing. This will be my first. And my hair and make-up ` first time. First time ever? You've never worn make-up before? Nah. Josephine's sister, Tee, is on hand to help with the transformation. (HAIRDRYER HUMS) That feels nice. What's that? This is a blush. What does this do? Look down. Just thickens your eyelashes. Feels funny. (LAUGHS) For Tee, it's clear the changes in Josephine are more than just skin deep. She's much more happier in herself and in her own body. She's smiling every day. So she's got a new lease of life. Yeah. Just seeing a different glow about her. Yeah. Very different. Different person compared to what it was a couple of years ago. I feel like a lady. (LAUGHS) Oh. My hair... I like it. (LAUGHS) Smile. (LAUGHS) That's so cute. Captions by John Gibbs. Edited by Ingrid Lauder.