Losing weight can be hard work. This tastes so good. I'm my own worst enemy. For some, it's hopeless. I love the taste of it coming down my throat. So now with the help of the Manukau SuperClinic,... That there is a cabbage, but it's red, OK? Cabbage? ...these supersized individuals... At the moment, I can't even feel your ribs. ...are about to launch themselves into the controversial world of weight loss surgery. Carbohydrates are very very addictive. We'll share their highs... GIGGLING Nicki Minaj ain't got nothing on us. ...and their lows... I look at the rain, and it's like tears that are deep inside me. ...during their year-long quest... (GASPS) Oh my God. WOMEN LAUGH HEARTILY I've never done this stuff before. ...for a new body. This is... BOTH: ...awesome! MONITOR BEEPING Copyright Able 2016 At the SuperClinic, each patient is a challenge. Stop. Come back. (SIGHS) And every patient brings a lifetime of overeating to the operating table. Has that been since your surgery? Their diet has made them fat on the outside and fat on the inside. And this visceral fat is where the real danger lies. PACY APPREHENSIVE MUSIC If a patient has fatty organs, the surgeons have no choice but to abandon the operation. Today, it's surgery day for Maria, with son Vincent at her side. And for a patient like Maria, a sugar addict, there will be no hiding any secret eating in the lead-up to the surgery. How are you today? SOFTLY: How are you today? Um,... I'm still alive at the moment. Yes, yes. Lovely. Is this the first time you've been here? She struggled with the pre-surgery diet. PRODUCER: Do you think you could live on this sort of food for the rest of your life? No. MUFFLED LAUGHTER Giving up sugar was almost a step too far. I'm questioning myself if I really want this surgery. And her desire for surgery yo-yoed. I look at the rain, and it's like tears that are deep inside of me. Remarkably, she lost 21 kilos. But with half an hour until knife to skin, Maria is more concerned about body image. I just feel that I'm not dressed for the occasion. BOTH CHUCKLE LIGHTLY (SIGHS) I hope I don't have to wear hairnet. That just will not look good. HOPEFUL MUSIC If Maria's operation is successful, she could expect to drop at least six dress sizes in six months. I hope the gown fits me. I don't want my ass sticking out. (LAUGHS SHEEPISHLY) There's nothing worse than that. I had that before when nothing fits. Come and take a seat. Yes. But for now, she's going to have to put up with supersize hospital scrubs ` This is your disposable tie undies. even if they don't quite fit. It goes like this. (SUPPRESSES LAUGHTER) < Look at my hat. (MUMBLES INDISTINCTLY, SNICKERS) (SNICKERS, UTTERS INDISTINCTLY) < Stop it. You looked sexy as you were, eh? Oh, look at that! There you go. That's better. Thank you (!) Sorry. I didn't want you to catch me... Surgeon Richard Babor hasn't seen Maria for three months and cuts straight to the chase. You've lost a lot of weight, eh? I had to lose it. 21 kilos. Yeah, or maybe a bit more. I try not to look at the numbers. Fantastic work. Can I have a look at your tummy? I've got my liver mark. They're still quite... Oh, they should be the least of our worries. Yeah. If you've lost that amount of weight, it'll be nice and... You reckon? ...kind of normal, yeah. Weight loss is the best indicator of a healthy liver. Richard is expecting the surgery to be routine. There's your ribs there. I feel them. Yeah. I have ribs! Good. Felt those lately. You can get up if you like. Grab my hand. Thank you. And hopefully we'll get going in the next 20 minutes or so. ANTICIPATIVE MUSIC Bye-bye! Maria has done well. In the last year, she's burnt off 157,000 calories. She's lost the equivalent weight of a small child, and she's walked more than the length of the Coast to Coast. Now she has one last mountain to conquer. < PRODUCER: Any last regrets? Um... I'm saying goodbye to chocolate now. Yeah. MONITOR BEEPS, BUSY CHATTER Have you been to any tropical islands before? (MUMBLES SOFTLY) What was that? I like` I like the snow. You like the snow? OK. So, right about now we're going to be heading off to Whistler. We're looking at the mountains in Whistler. You've had a wine. Maybe a mulled wine by the fire. You're starting to drift off to sleep now. > We'll see you in the recovery room when it's all finished. > MONITOR BEEPS It's sweet dreams for Maria... and a hopeful ending to the obesity years. As a child, I was thin and happy. HAPPY LAUGHTER ECHOES I would hop on the bike and just ride around the streets down the beach,... SEAGULL SQUAWKS ...and food wasn't an issue; enjoying life and, um, what you could do each day. I'd like to be slim again. MONITOR BEEPS, WHOOSH! BUSY CHATTER, ORGANISED CLATTERING Top lights off. Gas on. White balance. MONITOR CONTINUES BEEPING OK. RUSTLING INDISTINCT CHATTER Huh. Richard starts the surgery. Hold it up like that, please. UNSETTLING MUSIC She's still got a massive liver. And it quickly becomes clear that something is wrong. (INHALES SHARPLY) MUTTERS: Yeah, it must be. Can't be completely... Such a big fat floppy liver lobe. Despite the fact that she's lost heaps of weight, she's still got a massive liver. Richard can't find the space in Maria's stomach to operate because her liver is surprisingly large ` something that can happen if a patient binges on sugar just before surgery. Oh. (SIGHS DEEPLY) So hard. Huh. MONITOR BEEPS, CLOCK TICKS We need to pull out of this one. This'll be the first case ever that I've not been able to do. (SIGHS) And turn the camera off. SOOTHING MUSIC Pasione has three slipped discs in his back, which means he can't work. So he looks after his little daughter, Sophia. That look nice, daughter? (MUMBLES, SHOUTS EXCITEDLY) It's their favourite part of the day ` breakfast time. And the choice at Mangere East Shopping Centre is overwhelming. Easy greasy. Cheap and easy. Chinese stir-fry, egg foo young, sweet-and-sour pork, fried rice. Fish and chips, hot dogs, burgers. (FUSSES GENTLY) Uh,... deep-fried chicken. PERKY MUSIC Then you've got pies at the dairies. Fizzy drinks. This bakery is my jam. I usually get my breakfast from here. PRODUCER: What do you like? I get a roll, a pork riblet roll, and, um, pork riblet sandwich and a can of fizzy drink. And do you think that might have had something to do with your weight gain? Yep. Definitely. Is that one chicken? These are` yeah, yeah. I'll have the` the sandwich one. Yep, I'll take that one. (FUSSES) Which one, daughter? Um, that one. The chocolate doughnut? (YELPS) Come here. Come here, Phia. Good girl. Oh yay! (YELPS EXCITEDLY) GENTLE MUSIC PRODUCER: What have you got? I managed to get the chicken nuggets. Well, the chicken patties, or whatever these are. I usually get the pork ones. Yeah? But this is the same combo I've been buying for about the last four years. Actually, probably seven years. Any good? Not as good as the pork. But it's all right. FIZZ! CRACK! Hold it, please. (MUMBLES INDISTINCTLY) (SWIGS) (GUZZLES NOISILY) (YELLS GIDDILY) > Finish! > (BELCHES) PENSIVE MUSIC Pasione's love of takeaways started five years ago when he went on the sickness benefit. Partner Keita has also been struggling. Now they've realised that their obesity issue is bigger than just the two of them. We've been together for three, nearly going on four, years. And` Four going on five. > (LAUGHS) Oh, four going on five. But` And that whole time, like, you know, we've always been... worried about, like, you know, are we doing enough... to lose weight, or, you know, even just to keep healthy. I said I'd be` I'd be happy if we're just healthy and we're like this, but obviously, the weights in the food isn't helping with keeping us healthy. Right now I've got to start crawling out of the hole I'm in. Even in my mental state as well, I do get down, and it starts to get my attitude, and what we do starts to get... get more negative, more away from training and dieting. My weight affects my` my back; my back affects my ability to exercise. And my ability to exercise affects my` my weight loss. Um... It's a weird circle. It all starts with my nutrition, though. Eating bad, all the things like that are for convenience's sake. She has late shifts. We go pick her up, and I haven't prepared anything at home. There's nothing to eat at home. We're waiting for some money to come in for some food. And then when we're sitting in the car and we say, 'Are we going into Pak'nSave, or are we going through the drive-through?' and that's` that's` that's like the main question that's the start of, 'Are we eating healthy, or are we not eating healthy?' PONDERING MUSIC Pasione is disabled by obesity, a condition that means that Keita works six days a week, leaving Pasione struggling at home. PRODUCER: So, are you not working because of your weight? Because of my back, um,... can't` can't move. The baby's getting bigger, and I can't keep up with her. My partner's just recently taken on full-time employment, so I'm going to have to step up. Weight loss surgery is his only hope of losing weight and keeping it off. It's effective for 60% of all patients, but it doesn't work for everyone. PERTURBING MUSIC GENERAL CHATTER Surgeon Dr Richard Babor is working hard on Maria. MONITOR BEEPS Her fatty liver and scar tissue from previous surgery is making the operation difficult. We're getting to a point where this girl's, kind of` I'm worried that she's at risk of having some complication from this surgery, and it all could turn to custard. TROUBLING MUSIC TROUBLING MUSIC BUILDS Can't be completely... There's kind of a space there. There we go. HOPEFUL MUSIC Richard is in. He's got past Maria's fatty liver and has found the space to operate on her stomach. The hardest part is over. (SIGHS DEEPLY) OK. Scissor. Can you put a port on there? Like there? Or there? Yeah. We're just freeing up the stomach now. Another black 45, thanks. PRODUCER: Richard, how can she have a fatty liver if she's lost her target weight? Having a diet that is too hard and too high in carbohydrates I'd say would be the number one reason. She struggles with sugar. Well, if she knows that about herself, then she shouldn't buy a cake of chocolate. She can't sit and binge on chocolate. That's the` That's the difference. Like, she can't just have` go, 'Oh, I'm gonna have a Tim Tam. Oh no! I've had a Tim Tam. 'That's my giving up chocolate gone out the window. I'm gonna eat the whole packet.' You know? Richard, do you eat it? Yeah, I love chocolate. Are you almost done? Uh,... we're getting there. You can tell by the way we're talking a little bit more relaxedly now. OK. REFLECTIVE MUSIC It was very difficult. It's probably the most difficult one that I've done ever, and I've done over 600` oh, not quite 600 of these kinds of cases. But in the end, it's kind of gone OK. It just took much longer than usual. Maria is wheeled into ICU, where she slowly regains consciousness, and the seriousness of the surgery becomes clear. GROGGILY: Yeah, as I say, I'm always a tricky case. You've gotta make life for the surgeons exciting. Yeah. 1 JITTERY MUSIC On the other side of the SuperClinic, surgeon Dr Habib Rahman can ease Pasione's obesity by offering him weight loss surgery. But first, Pasione has to face up to a few home truths. Are you looking forward to being here today? Yep. Excellent. Now, how long has your weight been an issue for you? Ever since I can remember, I've always been big. Do you know when was your` you were lightest, your lightest weight? How long ago? > Uh, in my adult life, it was 2003. And how much were you then? > I actually cut down to one... 144. You have got a lot of medical conditions. Firstly, you are morbidly obese. You are` You have a weight of 179 kilos. Do you know what the word 'morbid' means? It means deathly. In this case, morbidly obese means obesity causing death, premature death. This is the result of what you put in your mouth. This body of yours is like a car. > You clean it, you service it, you put the oil in it, it lasts you a long time. You thrash it, it's gonna not last you so long. And the way we put this is that... your obesity has caused you at the age of 29 that one of your organs in your body is failing. > The body's ability to control the blood sugar is gone, and this is directly related to your obesity. In your current form at the moment, you'd be struggling to see your 50th birthday. If you do nothing about it and you continue on the same lifestyle, that little girl of yours will not have a daddy in about 10 years' time, or 20, 15 years' time. What we are here about is how we can change this for you. To qualify for surgery, Pasione has to lose 8 kilos in eight weeks. All right. Good. Thank you. GENTLE PENSIVE MUSIC PRODUCER: How do you feel after your chat with Habib? What was the most`? What was the hardest thing to hear? Just telling me that I'm gonna die by the time I'm 50. PONDERING MUSIC Just... Yeah, probably the biggest thing he said was that when she turns 23 that I won't be there, and she'll be asking questions, and it's not fair of me to put those questions on her ` where is my dad? Yeah. But` My dad passed away in 2011, so... yeah, I know what those questions are. He was only 55. Yeah, she` she's probably the biggest thing; her and my partner as well. APPREHENSIVE MUSIC ENGINES REV AGITATED CHATTER It's a few days after Maria's surgery, and she's back at home. And son Vincent and sister Rose have learned that the cause of complications during surgery might be self-inflicted. VINCENT: So, I should grab the stuff out. What should I grab out? > Take all the stuff out that she can't actually have. Yeah, see? Now I can show you` Now I can show you, Mum` MARIA: Can you tell him to shut up, please? > What else is`? Uh... PRODUCER: Can I have a look, Vincent? Of course, yeah. I'm trying to grab it all out to show you. Don't you dare! The family are becoming painfully aware that her sweet tooth is a full-blown addiction. Burger Rings. Just, um, hidden under there. The worst thing is, um` what is this? I dunno, doughnuts with mock cream on them? I won't do it again. Explain yourself. PLASTIC RUSTLES I appreciate having this surgery, and I know it wasn't easy for the surgeon. Um... It's like you're stuck in a corner, and you're just, like` going like this with your arm, saying, you know, 'What can I do?' (SIGHS) Anything I had had such a high consistency of sugar. Not that I've been on drugs, but it was like being` going into rehab or something. I was a mess. Well, you talk about one Moro bar, I can talk about 10 Moro bars are coming off that. So we're going to have to train you in how to eat. Yes. Yeah. SOOTHING MUSIC VINCENT: I don't want to get angry at her. I'm not the bad guy, and yet it's me having a go; me arguing, me getting angry. I feel like I am the bad guy, and these things will continue to happen, I expect, because she's` it's going to take time, but I just don't want to get angry all the time at her, because she's doing a good job. I don't know if it's... PRODUCER: It's tough love. Yeah, it's tough love. It's tough love. That's exactly it. Next time on The Big Ward, Pasione falls off the wagon. My little brother shouted me McDonald's. And Josephine continues her vegetable education. It's egg` Eggplant? Captions by Amy Park. Captions were made with the support of NZ On Air. www.able.co.nz Copyright Able 2019