Losing weight can be hard work. CYCLE MACHINE SQUEAKS LIGHT TWINKLY MUSIC For some, it's hopeless. So hungry. I had fettuccine, and then I just ate it. And I got potato salad, chop suey and sausages. 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, like heroin or sex. We'll share their highs... (LAUGHS) 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... Oh my God. BOTH LAUGH I've never done this stuff before. ...for a new body. This is... BOTH: ...awesome! www.able.co.nz Copyright Able 2019 Stay-at-home dad Pasione had an enormous appetite... This is the same combo I've been buying for about the last four years. ...and a large problem,... You are morbidly obese. ...and at 180 kilos, an even bigger reason to sort himself out. She's probably the biggest thing ` her, and my partner as well. Desperate for weight loss surgery, the 29-year-old former lifeguard is throwing himself in the deep end. I'll` I'll probably get puffed at 100m, which is two laps. With partner Keita, the pool lifeguard, watching on, the stakes are high. UNEASY MUSIC OK, keep swimming. Keep going. QUIRKY MUSIC With eight weeks left to lose 8 kilos, he's smashed it. He showed his daughter, Sophia, that exercise isn't always a pain in the back. I want her normal mode to be active. Um, I don't want her to have any... habit of, like, sitting around and not really doing anything. I want her to think that exercise is a part of life. Uh, for me, I feel, like,... happy just seeing them being active together. As a mum, like, to see your partner and your daughter, you know, trying to be active and having fun is... is good. (YELPS) Let me go. Pasione has to lose the weight, and there's no substitute for hard work. The pounds are disappearing. HARP GLISSANDO A new, confident and happy Pasione is starting to emerge. HARP FLOURISH TWINKLY MUSIC Former beach lifeguard Pasione wants to share his new motivation with his family. KEITA: Ready? On your marks, get set, go! (SQUEALS) Whoo! Yeah! (LAUGHS) It was here at Muriwai that he learnt how to swim and to save lives. Now it's his own life he wants to save. (SCREAMS) INTERVIEWER: Do you want to be a lifeguard again after surgery? Oh, definitely. Oh, I'd love to` I love to be out here and work out here in, uh, the sun and the waves during the summer. And then you're also saving people's lives, especially in a place like this. It's` It's mean. It's really really fulfilling, and those are the feelings that I get when I come back here. We've really been counting on this, counting on the surgery to... heal, yes, but more so, like, help me. Yeah, really need it to help me. LIVELY PIANO MUSIC Time's up for Pasione. It's weigh-in day at the SuperClinic. If he hasn't dropped 8 kilos, he'll be dropped from the surgery list. And he's not taking any chances. Oh, sweat. That's what's meant to happen. INTERVIEWER: So, tell me, what's the theory behind the plastic bag? Raises your body temperature, helps you burn body fat, and it` yeah, it just increases your heat. It doesn't let you, um` your skin breathe, so you're constantly sweating. That's... a bad way to lose weight, but it's a weight loss technique. Bariatric nurse Kate has seen over 5000 patients, but this last-minute tactic is new to her. Never seen that before. That's a first. Excellent. OK, so firstly, well done. You've lost weight. You've clearly got significant commitment to your health. I'm really comfortable to move forward and give you surgery. UPLIFTING PIANO MUSIC Surgery is in the bag. He's lost 8 kilos in eight weeks. I'm really happy. I don't know if my face shows it, but I'm really happy. But, yeah, pretty much, I'm` I'm gonna have bariatric surgery. But is he? Did you go to your GP about that blood pressure? Hmm, no. Did we have a conversation about you going to the GP and getting it checked? Um, I've been to my GP before. He didn't` He said that my blood pressure was all right. OK, all right. Let's check it again today. Um, but it was very high last time, and if it's still high, we're going to need to, um, delay, cos we can't go to the waiting list if it's high. If Pasione's blood pressure is too high, he could die on the operating table. AIR RELEASES SLOWLY Yep, still 140/100. It's just too much of a risk to put you on the waiting list, sir, with it being that high. And just like that, surgery is taken away. (SIGHS, CHUCKLES) That's funny. (CHUCKLES) It's back to square one. MELANCHOLIC PIANO MUSIC 1 BIRDS CHIRP You want chop suey, Kimiora? Yep, please. One scoop or half a scoop? Um, one. Across town, in Papakura, Kimiora is enjoying a family lunch. I love fettuccine. I love it. Kimiora is 20 years old. A law student, she lives at home with her parents and 10 other extended family members. Tell us who. What are you making? Like, a feijoa fudge. Weighing in at 132 kilos,... So hungry. I had fettuccine, and then I just ate it. And I got potato salad, chop suey and sausages. ...she's tried every diet in the book. I don't think the way my family eats is bad, but just the portions are big. I mean, the food we have isn't, like, deep-fried and all that kind of thing. I wanna go outside. On my dad's side, the females, especially, are really big ` looking like late 100s or, like, early 200s. Every diet since she was 14 is documented in her secret diary. I wrote, 'So, today was our fourth day doing the water fasting, and I've actually coped really well. 'Didn't help that Bradley brought effin' KFC over.' (CHUCKLES) I wrote, 'I've never known what it feels like to be completely happy with how I look. 'I've always been self-conscious and insecure. I'm sick of looking at other girls and thinking, '"Oh, if only I was skinny." Goodnight. Yours sincerely, Sexy Bitch.' That's what I wrote. (LAUGHS) Oh my Gawd. When you weigh 132 kilos and are a size 23, shopping can be tricky. So, like, when you're looking for clothes, you just immediately go straight to the back of the rack. INTERVIEWER: What's at the back of the rack? The biggest sizes. And the thing as well, like, I always have to be mindful of stuff that might be too clingy ` like, cling to all my bumps. And jeans, as well, is a struggle, cos I do have a bit of a bum too, (CHUCKLES) so` and a stomach. So if you have a stomach and a bum, you can just imagine how hard it is to find stuff that fits around here. Well, something like this? Oh, yeah. Is there any...? It's plain, but it's lace, so it's got a little bit of detail. I think these would go well with the jeans too. OK, well, I'll try it on. Yeah. See how you go. (CHUCKLES) See how it goes. (CHUCKLES) I think I was dreaming when I grabbed the 18. (CHUCKLES) Oh. (LAUGHS) We could still dream. OK. So... Oh. Let me just slip this... (MURMURS) How do you like the top, though? It's, uh... (SIGHS) BOTH: I like the jeans, yeah. I'm gonna go with a different top. Yeah. FAMILY CHATS INDISTINCTLY But Kimiora's obesity is a little more serious than wardrobe dilemmas. Kimiora's health is deteriorating. At 20, she has the health of a woman twice her age and is suffering from early diabetes. Surgery could help, but it's not just about her. As a young Samoan-Maori woman, it's a decision she'll make with her whole family, including Dad. At the moment, I'm still sitting on the fence. My belief is that, um, anything that, you know, is unnatural, it's not good. But then on the other side, I mean, um, we're churchgoing people, and we're always praying for miracles and all these things, and, you know, to my mind, um, perhaps this is one way that God shows his miracle to us. Kimiora is having a` is going for an operation. What the operation is is basically to halve her stomach, so then she doesn't eat too much, and so she can finally get to walk on the catwalk. (LAUGHS) Yay! Whee-hee! I know we all have our own personal views of this kind of thing, but I know too that, as a family, we all support one another. Now, I know some of you guys have all turned gay, and I fully support you. And we'll support Kimiora through what she's going through as well. LIGHT PIANO MUSIC Today, at the SuperClinic, it's Kimiora's first appointment with the surgeon. Her mum, Rachel, wants to be sure she knows what she's getting into. Do you know anything about what the actual operation involves? Yeah. Have you looked that up? Yes. Do you know what a sleeve is? Yes. You sure? Yes. So you know they have to cut something? Yes. OK. (SIGHS) (KNOCKS ON DOOR) Hi. Hi. Hello. Kimiora. Hi. (CHUCKLES) Hi, I'm Richard Babor. I'm one of the surgeons here. Hi. Hi, Richard. So, you wanna have a weight loss operation? Yes. Why is that? Um, I've always struggled with my weight. Nothing was working for me. He mentioned the surgery, and then he referred me. Do you understand about sleeve gastrectomy? Cos I think that's probably the operation that we need to offer you. Um... That's where we remove 90% of your stomach. Yeah. And it's permanent. It's not reversible. It won't be easy for you. You won't be able to eat very much afterwards. You understand that? Yep. Um, I know my dad has some concerns about, like, pregnancy and stuff. Like, how would it affect that? Your dad won't fall pregnant as part of this operation, so... BOTH LAUGH Yeah. No, so, it's very important that a young woman like you` that you have a reliable form of contraception on board if you're sexually active, right, because sometimes obesity can make you a little bit subfertile ` not so easily fall pregnant. And it's bad to fall pregnant within the first 18 to 24 months after surgery. I'd like you to carry on doing what you're doing and aim to lose, sort of, 5 kilos to 10 kilos before the day of the surgery. So, anything else? Nah. INTERVIEWER: How do you think it went? I think it went really well. He was really really good, and, um, I don't think I quite understood what the surgery was, cos I was thinking the band or the sleeve` Oh, wait, this` Is this the sleeve? This is the sleeve, eh? But he, um, just explained about the staples and everything and how it's not reversible. So, like, the band one I was` I had been looking at, it was reversible, and it could be taken off and that your stomach would go back to its normal size, but he said that this is permanent, so, um... But I think this is a risk I'm willing to take so I can have a better life, and, yeah, it was really good. 1 SIREN WAILS It's the day before surgery, and Pasione is enjoying a last-minute workout. It's been four weeks since his blood pressure scare struck him off the surgery list. Now he's on medication, and surgery is back on. And the former fast-foodie gets to enjoy a final meal with a twist. INTERVIEWER: What's for lunch? I'm having broccoli and tomatoes and, uh, Big Mac sauce. Here goes my Big Mac broccoli. Better than a Big Mac? Yeah, but not better than a Boss, though. Boss is the winner. What's a Boss? (CHUCKLES) It's a` the burger up from the Big Mac. Do you think you can eat like this for the rest of your life? Yeah. It's really cheap. MELANCHOLIC PIANO MUSIC It's taken Pasione a year to walk through the surgery centre doors. Now I'm anxious. Anxious` Anxious to get it done. I'm all nervous. I'm just nervous. It's an operation. I think it wouldn't be human not to be nervous for him. INTERVIEWER: Are you nervous about being weighed in today? Yeah, I am. I'm hoping that I've done enough to at least be under 170. Do you wanna come with me? If he doesn't weigh in under 170 kilos, he'll be too big for a safe anaesthetic. QUIETLY: Oh no. He'll be sent home. SCALES BEEP Yeah-yah. Very good. Yeah. Pasione's last-minute efforts have worked. He's lost 8 kilos in eight weeks. Now all he needs is normal blood pressure. UNEASY PERCUSSION MUSIC MONITOR BEEPS 153/89. His blood pressure is normal. It's all right, babe. Now the success of the operation is in the hands of the surgery team. All right, welcome to theatre. Gonna get you to pop up on here for us. MONITOR BEEPS STEADILY When I was a kid, I was fit, active. I could do what I wanted to, when I wanted to. I'd love to be able to do that again. I hope this surgery gives me the ability to be fit and able to work again. I love the water. I wanna be working around the water again. Lifeguarding sounds like the dream. But the big one ` able to support my family, able to be a better father, a better partner. I want my daughter to be proud of me. I want her to say, 'Oh, yeah, I wanna be like my old man when I grow up.' MONITOR BEEPS STEADILY We're all happy? Yep. OK. Cool. So, he's got quite a nice, floppy, little healthy-looking liver. INTERVIEWER: What will he need to do to do well after surgery? Gradually progress his diet, stay off carbs, moderate amount of physical activity. Let's hope that there is some very strong, beneficial effect on his cognitive function and his taste perception that allows him to avoid dipping all his vegetables into Big Mac sauce. If he continues to dip everything he eats into Big Mac sauce, then he'll` he'll lose a substantial amount of weight after this surgery, but over a period of years, he'll regain it all. You know, the operation's not like a magic bullet. It's quite a hard road to go down. Surgery's just a` kind of a stopgap to try and help people who can't have anything else done. I mean, really, if we wanna tackle obesity on a population basis, we have to change the quality of our food supply. We can't be all eating noodles and Tim Tams and muffins and... 2-litre buckets of coffee. How's the surgery going? How's it going? It's looking pretty awesome, actually. But I shouldn't jinx it by saying that. After three hours, Pasione's surgery is successful. AIR SPUTTERS 90% of his stomach has been removed permanently. The remainder is now the size of a pencil. At 6'5", this giant of a man will have to eat like a baby. Now he'll go straight into intensive care and remain in hospital for the next 24 hours. Hi. KEITA: Hi. Hey, everything's gone really smoothly, so, um,... you know, Pasione's gonna be in the recovery room for half an hour or so, just until we're comfortable that he's... comfortable and he's awake enough and breathing independently, and then he'll go to the ward. But everything went very smoothly, and we just thought we'd come and let you know. Thank you very much. SOFT PIANO MUSIC Hi, babe. Pasione's big challenge will be in the coming months. Surgery has given him a leg-up, but up to 40% of patients will put all the weight back on. SOFT PIANO MUSIC CONTINUES INTERVIEWER: Does it feel like you're missing most of your stomach? Nah. Missing the` the thought of eating. (CHUCKLES QUIETLY) He's going to have to stay off the Big Mac sauce if he wants a permanent fix for life. Captions by Able. Captions were made with the support of NZ On Air. www.able.co.nz Able 2019