Original subtitles

-- Captions by VITAC -- www.vitac.com

Milla: I CAN'T EVEN TAKE CARE OF MYSELF.

MY CHILDREN HAVE TO DO EVERYTHING FOR ME.

Charity: I FEEL LIKE SOME MONSTER.

Nikki: I'M IN SO MUCH PAIN.

[ Crying ] IT'S MISERABLE.

Brittani: MY BODY IS THE MOST DISGUSTING THING IN THE WORLD.

**

Woman: I'M TERRIFIED RIGHT NOW.

June: I'M RISKING MY LIFE FOR A BETTER LIFE.

I LOVE YOU, MOMMY.

-OOH, CHILD! -PULL. GOOD. THERE YOU GO!

GOOD JOB.

Teretha: I'M GETTING STRONGER, BUT I KNOW I HAVE A LONG WAY TO GO.

Paula: I CAN'T WAIT TO SEE WHAT THE FUTURE HOLDS.

**

Susan: I AM NOW EXPRESSING MYSELF AND LIVING MY OWN TRUTH.

Milla: I'M SO HAPPY ABOUT THE PROGRESS I'VE MADE.

June: I AM LIVING LIFE, AND I'M LOVING EVERY SECOND OF IT.

Joe: IT FEELS LIKE I'M LITERALLY LIVING A DREAM.

-THANK YOU SO MUCH. -OH!

CAPTIONS PAID FOR BY DISCOVERY COMMUNICATIONS

[ GRUNTS ]

I FEEL LIKE A PRISONER INSIDE THIS BODY,

AND I WOULDN'T WISH THIS ON MY WORST ENEMY.

DAMN IT.

[ SIGHS ]

I GOT TO GET THIS WEIGHT OFF OF ME.

IF I DON'T, I WILL BE CONFINED UNTIL I DRAW MY LAST BREATH.

I'VE GOT TO FIGHT FOR MY LIFE, SO WE'RE MOVING TO HOUSTON.

MY MOM IS LEAVING BEHIND EVERYTHING

TO COME AND HELP TAKE CARE OF ME.

ON THE ROAD WE GO.

THIS IS GOING TO BE A TEST.

DO I HAVE WHAT IT TAKES TO GET THIS DONE?

[ PANTING ]

OHH.

Dr. Nowzaradan: BEING 800 POUNDS,

YOU ARE BY NO MEANS IN CONDITION

TO CONSIDER ANY KIND OF WEIGHT-LOSS SURGERY.

I NEED TO YOU TO GET DOWN TO 650 POUNDS

OVER THE NEXT COUPLE MONTHS.

I'VE BEEN TRYING TO EAT LESS,

BUT I'M NOT SURE HOW WELL I'M DOING.

[ PANTING ]

I SAW YOU A COUPLE MONTHS AGO AND GAVE YOU A CHANCE.

YOU STILL GAINED WEIGHT.

AND YOU ARE ON BORROWED TIME HERE.

TRY AGAIN.

MY FATHER, HE WOULD IGNORE ME COMPLETELY.

I ASKED MYSELF,

"WHY DOESN'T THIS MAN WANT TO PAY ATTENTION TO ME?"

SO I ATE TO DEAL WITH MY FEELINGS.

AND IF I'M TO BECOME COMPLETELY BETTER,

THEN I HAVE TO DEAL WITH THIS.

Rachel: YOU HAVE THE KIND OF OPTIMISM

AND THE STRENGTH THAT YOU NEED, I THINK, TO GET THROUGH THIS.

YEAH.

Joe: I EITHER GET APPROVED FOR THE SURGERY,

OR MY JOURNEY IS OVER TODAY.

THIS IS MY LAST CHANCE,

AND EVERYTHING IS RIDING ON WHAT THE SCALE SAYS.

Woman: 652.

HOW DO YOU FEEL ABOUT SETTING YOU UP FOR SURGERY NEXT WEEK?

Joe: [ Chuckling ] I CAN'T BELIEVE IT!

HE FINALLY APPROVED ME FOR SURGERY.

WE DID IT!

WE WAITED SO LONG TO HEAR THIS HAPPENED

AND IT'S FINALLY HERE.

Joe: TODAY IS THE MOMENT I RETAKE MY LIFE

AND SAY, "NO MORE."

Dr. Nowzaradan: JOE'S SURGERY WENT VERY WELL.

JOE IS GONNA START TO LOSE WEIGHT REAL QUICK NOW.

THERE ARE SO MANY POSSIBILITIES FOR MY FUTURE NOW.

FOR THE FIRST TIME IN A LONG TIME,

I FEEL LIKE I HAVE HOPE.

THE BIGGEST CHANGE IN MY LIFE RIGHT NOW

IS THAT I'VE MET SOMEONE ONLINE,

AND WE'VE BEEN TALKING ALMOST EVERY DAY.

I CAN DEFINITELY SAY YOU ARE DEFINITELY BEAUTIFUL.

NOW I'M FLYING ON A PLANE FOR THE FIRST TIME,

AND I GET TO MEET THE WOMAN I LOVE IN PERSON

OHH! [ CHUCKLES ]

NO MATTER HOW HARD IT IS, I'M GOING TO MAKE IT TO IOWA

TO SEE SARAH FOR THE FIRST TIME.

FOR YOU...MA'AM. THANK YOU.

WOW. YOU LOOK BEAUTIFUL.

KISSING SARAH FOR THE FIRST TIME,

IT'S LIKE A LITTLE SPARK GOING.

OH, MY GOD, IT HURTS.

I FELT LIKE MY LIFE WAS FINALLY TURNING AROUND.

I JUST HOPE I'M NOT ABOUT TO LOSE EVERYTHING

BECAUSE I PUSHED MYSELF TOO HARD.

**

NOW I'M WORKING OUT AS HARD AS I CAN

TO TRY AND GET MY SKIN SURGERY.

YOU LOST ANOTHER 100 POUNDS,

SO I'M APPROVING YOU FOR SURGERY.

WHAT'S WAITING FOR ME ON THE OTHER SIDE OF THE SURGERY

IS A BETTER LIFE.

HE'S GONNA DO MUCH BETTER WITH THIS NEW ABDOMEN HE GOT.

I CAN SEE MYSELF FINALLY STARTING TO LOOK SEMI-NORMAL.

WHEN I MET YOU, I MET MY DESTINY.

WILL YOU MARRY ME?

YES.

I THINK I LOOK GOOD RIGHT NOW, SO I'M KIND OF SURPRISED.

AND I'M JUST NOW PICTURING MYSELF STANDING THERE,

WAITING FOR SARAH TO COME DOWN THE AISLE TO ME.

**

BRAINS!

I COULD'VE NEVER IMAGINED THAT

MY LIFE WOULD BE SO MUCH BETTER IN JUST TWO YEARS.

[ LAUGHS ]

I'VE GONE FROM BEING TRAPPED IN MY HOME ALL DAY LONG

TO HAVING THE LIFE I HAVE NOW,

WHERE I'M ABOUT TO MARRY THE WOMAN OF MY DREAMS,

AND WHO HAS AN INCREDIBLE 8-YEAR-OLD DAUGHTER

I'M GOING TO BE A FATHER TO.

I WOULDN'T HAVE EVEN DARED TO DREAM FOR WHAT I HAVE NOW,

SO I'M JUST THANKFUL BEYOND WORDS,

AND I'M NOT TAKING ANYTHING FOR GRANTED.

AAH!

[ LAUGHS ]

I KNOW BEING A HUSBAND AND A DAD IS GOING TO BE HARD WORK,

BUT I'M READY FOR IT.

COME ON!

Sarah: JOE IS ONE OF THE MOST CARING AND POSITIVE PEOPLE

I HAVE EVER MET,

AND I'M SO BLESSED TO HAVE HIM IN MY LIFE NOW.

-HA, GOTCHA! -[ LAUGHS ]

Joe: EVEN JUST A YEAR AGO,

I COULDN'T EVEN TAKE CARE OF MYSELF.

BUT ALL OF THAT HAS COMPLETELY CHANGED NOW.

FIRST BIG CHANGE IS THAT I NO LONGER HAVE TO CALL ANYBODY

TO GET ME OFF THE FLOOR OR OFF THE GROUND.

NOW I CAN JUST PLOP RIGHT UP.

I DEFINITELY CAN WALK FURTHER AND DON'T TIRE AS EASILY.

ALL RIGHT, LET'S GO INSIDE.

OKAY. [ CHUCKLES ]

Joe: BUT THE GREATEST THREAT TO MY NEW LIFE

IS THAT I COULD START GAINING AGAIN.

**

I'M GONNA FINISH UP OVER HERE REAL FAST, OKAY?

SO I'M GONNA DO EVERYTHING I CAN

TO MAKE SURE I DON'T GO BACK THERE.

WITH OUR WEDDING DATE ONLY A FEW MONTHS AWAY,

I'VE BEEN SPENDING MORE TIME UP HERE IN DUBUQUE, IOWA.

SARAH'S BEEN LIVING WITH HER MOM,

AND I'VE BEEN STAYING WITH HER

UNTIL WE CAN FIND A PLACE OF OUR OWN

AND I CAN OFFICIALLY MOVE UP HERE.

THIS LOOKS REALLY GOOD.

AND WE ARE DONE.

HOT, HOT, HOT, HOT! WHOO!

BUT RIGHT NOW, I'M JUST GETTING TO KNOW HAYLEY

AND SARAH AND I ARE PREPARING FOR THE WEDDING.

I STILL HAVE ABOUT 150 POUNDS TO GO

BEFORE I HIT MY TARGET WEIGHT.

AND I STILL NEED AT LEAST TWO MORE SKIN-REMOVAL SURGERIES,

AND I'M HOPING TO HAVE THEM THIS YEAR

AND GET TO MY GOAL WEIGHT.

SO EVEN THOUGH I'M UP HERE IN IOWA,

I'M STILL COMMITTED TO DR. NOW'S PROGRAM,

AND I'M GONNA BE TRAVELING DOWN

TO SEE HIM FOR MY APPOINTMENTS.

BUT ONCE SARAH AND I GET MARRIED,

WE NEED TO FIND A PLACE OF OUR OWN

AND I NEED TO START PROVIDING FOR THEM,

SO I NEED TO HAVE A JOB.

I KNOW THIS NEXT YEAR ISN'T GONNA BE EASY.

-READY FOR BED, KIDDO? -YEAH.

BUT NO MATTER HOW HARD IT'S GONNA BE OR HOW STRESSFUL,

I'M GOING TO MAKE SURE IT HAPPENS.

NOW THAT SHE'S IN BED,

WE CAN TALK ABOUT THE WEDDING A LITTLE BIT.

YEAH.

Joe: I SEE DR. NOW AGAIN IN MONTH,

AND I'M HOPING THAT WE CAN COME UP WITH A PLAN

FOR WHEN WE CAN GET MY EXCESS-SKIN REMOVAL

IN A TIMEFRAME THAT WORKS FOR MY WEDDING.

SO I'M NOT SURE HOW IT'S ALL GONNA HAPPEN,

BUT WE CAN FIGURE IT OUT TOGETHER AS A FAMILY.

Pauline: I AM ABSOLUTELY TRAPPED IN THIS BODY.

I'VE LET MYSELF GET WAY OUT OF CONTROL.

I JUST WONDER IF I'LL EVER HAVE A NORMAL LIFE.

I CAN'T EVEN MOVE WITHOUT HELP,

AND HAVING MY SON TAKE CARE OF ME

IS ONE OF THE WORST THINGS EVER.

Dillon: I LOVE MY MOM, BUT SINCE SHE'S THIS HEAVY,

WHATEVER I'M DOING, I HAVE TO STOP

AND JUST TAKE CARE OF HER AND HELP HER.

Pauline: I POSSIBLY COULD RUIN MY SON'S LIFE.

I GOT TO GET THIS UNDER CONTROL.

[ Crying ] I THINK THAT BY ME GETTING RESCUED,

IT'S GONNA RESCUE HIM, TOO.

OH, GOSH.

UNLESS WE GET A HANDLE ON THE COMPULSIVE EATING,

WE'RE NOT GONNA BENEFIT FROM SURGERY.

I WANT YOU TO LOSE 50 POUNDS OVER THE NEXT COUPLE MONTHS.

I AM HAPPY THAT HE'S WILLING TO GIVE ME A CHANCE,

SO I'M GONNA LOSE THE WEIGHT I NEED TO GET THIS SURGERY.

IT'S BEEN A HARD MONTH.

I'VE BEEN TRYING TO EAT BETTER,

BUT THERE STILL IS MOSTLY JUST FAST FOOD AROUND,

SO THAT MAKES IT TOUGH.

I SEE THE DOCTOR NEXT MONTH,

AND I'M GONNA TRY AND DO WHAT I CAN

TO LOSE THE WEIGHT I NEED.

BUT IT'S HARD.

[ WHIMPERING ]

OKAY.

I FEEL NAUSEOUS.

PAULINE, YOU GAINED WEIGHT

AND YOU'RE GETTING TO BE 700 POUNDS,

SO I'M ADMITTING YOU TO THE HOSPITAL RIGHT NOW.

I'M GONNA PUT YOU ON A MONITORED DIET

BECAUSE SOMETHING DRASTIC HAS TO BE DONE.

I'VE BEEN IN THE HOSPITAL FOR A WHILE NOW,

AND THERE ARE TIMES

I FEEL LIKE I'M BEING PUSHED A LITTLE TOO HARD.

Dr. Nowzaradan: PAULINE'S LOSING WEIGHT

BECAUSE OF HER CONTROLLED DIET,

SO I'M GONNA GO AHEAD AND DO A BYPASS ON HER.

BUT SHE STILL HAS TO MAKE DECISION

TO BE HEALTHY ON HER OWN,

BECAUSE THIS IS PAULINE'S LAST OPPORTUNITY

TO TURN HER LIFE AROUND.

Pauline: THE DOCTOR CAN'T TELL ME WHAT'S GOOD FOR ME,

SO I'M REALLY NOT WORRIED ABOUT

HOW MUCH CRABS IS IN THE RICE 'CAUSE I KNOW MY BODY.

THE WAY THAT YOU'RE SITTING HERE AFTER SURGERY

AND YOU WANT TO GO ROLL WITH THIS THING INSTEAD OF WALKING?

I CAN'T WALK THAT FAR WITHOUT GETTING DIZZY.

DO YOU REALIZE THE ONLY WEIGHT YOU HAVE LOST

HAS BEEN WHEN WE PUT YOU IN THE HOSPITAL?

THIS IS NOT WORKING FOR YOU.

THIS IS [BLEEP]

Dr. Nowzaradan: SHE'S PUSHED HER BODY TO THE LIMIT SO LONG

THAT I'M CONCERNED

SHE MAY NOT BE ABLE TO LIVE ANOTHER YEAR LIKE THIS.

Pauline: I FEEL LIKE I'M MAKING THE PROGRESS I WANT,

AND I DO HAVE TO TAKE IT AT MY OWN PACE.

**

PAULINE WAS SO ADAMANT ABOUT THE PAINKILLERS LAST TIME.

MY CONCERN RIGHT NOW IS SHE HAS BEEN ABUSING THAT MEDICATION.

OHH!

I NEED SOME PAIN MEDICINE, PLEASE.

AND AN EXCESSIVE AMOUNT OF PAINKILLER

WILL CAUSE AN ULCER TO FORM IN HER STOMACH,

WHICH EXPLAINS HER LACK OF APPETITE OVER THE LAST MONTH.

WE HAVE NOT BEEN ABLE TO STABILIZE PAULINE'S CONDITION,

SO WE HAVE NO OTHER CHOICE BUT EMERGENCY SURGERY

AND TRY AND REMOVE HER STOMACH ULCER

AND CLOSE UP ANY LEAK IN THE ABDOMINAL CAVITY.

THIS IS HER ONLY HOPE TO SURVIVE.

**

Dr. Nowzaradan: I'M SENDING YOU TO A PHYSICAL-THERAPY CONSULTANT

TO WORK WITH YOU AND GET YOU UP AND MOVING AGAIN.

HOW AM I GONNA DO ANY PHYSICAL THERAPY

IF I DON'T HAVE ANY MEDICINE FOR MY KNEES?

YOU DO NOT NEED MEDICINE TO STAND UP.

OKAY.

YOU NEED TO GET UP AND MOVE.

Pauline: MOVING AROUND IN THE POOL ISN'T SO BAD,

SO I'M LOOKING FORWARD TO DOING MORE.

WHEN YOU LEFT THE HOSPITAL, YOU WERE 333 POUNDS.

YOU GAINED 20 POUNDS.

THIS IS NOT ACCEPTABLE.

I HAD REALLY BAD KNEE PAIN, AND...

PAULINE, YOU'RE GETTING THAT MUCH AWAY

FROM ME FIRING YOU FROM MY CARE.

BUT WHAT HAVE I DONE WRONG?

IF YOU'RE NOT GONNA START LISTENING HERE,

I'M NOT GONNA TAKE CARE OF YOU.

Pauline: I'VE TAKEN WHAT DR. NOWZARADAN HAS SAID TO HEART,

AND I'VE BEEN TRYING TO EAT HEALTHIER.

AND I'M TRYING TO GET UP,

AND I'M TRYING TO STAY MORE ACTIVE

AND DO MORE ON MY OWN.

ALL RIGHT!

SO, WITH THIS PROGRESS, I'M APPROVING YOU FOR SKIN SURGERY.

-CAN I HUG YOU? -SURE.

[ LAUGHS ] THANK YOU SO MUCH, DR. NOW.

-YOU'RE WELCOME. -I APPRECIATE YOUR HELP.

**

Pauline: THE PAST TWO YEARS HAVEN'T BEEN EASY.

THERE HAVE BEEN SETBACKS AND DIFFICULTIES,

AND IT'S TAKEN SO MUCH FOR ME TO MAKE THE PROGRESS I HAVE.

I'VE HAD TO WORK HARDER THAN I EVER IMAGINED I WOULD,

BUT I WOULDN'T CHANGE ANY OF IT

BECAUSE IT GOT ME THIS FAR.

AND TODAY, I'VE LOST ALMOST 370 POUNDS

AND I'M ABLE TO TAKE CARE OF MYSELF

AND DO EVERYTHING I NEED ON MY OWN.

SO I'M PROUD OF HOW FAR I'VE COME,

BUT THERE ARE DAYS IT'S NOT EASY.

AND IT'S LIKE THERE'S TWO PARTS OF ME --

ONE PART THAT WANTS TO GET HEALTHY

AND DO MORE EVERY DAY,

AND THERE'S THIS OTHER PART OF ME

THAT JUST WANTS TO GIVE IN AND EAT EVERYTHING I WANT.

I FEEL LIKE THE FAT GIRL IN ME IS ALWAYS SABOTAGING ME,

AND I CONSTANTLY HAVE TO REASON WITH HER AND TELL HER, "NO."

BUT SHE'S ALWAYS GOING TO BE THERE,

AND IT'S A CONSTANT BATTLE.

I'VE BEEN DOING A LOT OF THINGS I'M HAPPY ABOUT,

ESPECIALLY VOLUNTEERING WITH THE PET SHELTER.

SO, MY LIFE IS GETTING BETTER.

DILL, DINNER'S READY.

MM.

BUT EVEN THOUGH I'M WORKING ON LETTING THINGS IN MY PAST GO,

YEARS OF EMOTIONAL BAGGAGE

ISN'T GOING TO JUST GO AWAY AND NEVER COME BACK.

SO, I STILL HAVE MY HARD DAYS, AND DURING THOSE TIMES,

IT'S MORE OF A LOGICAL CHOICE I'M MAKING.

I JUST KNOW, IF I GIVE IN,

I'M GOING TO PAY FOR IT DOWN THE ROAD.

AND THESE LAST COUPLE OF WEEKS, I'VE BEEN REALLY DOWN.

**

BUT WHAT'S SCARING ME ABOUT THIS MONTH

IS THAT DR. NOW APPROVED ME FOR EXCESS-SKIN REMOVAL SURGERY

AT MY LAST APPOINTMENT WITH HIM.

AND I KNOW, IF I GAIN RIGHT NOW,

THEN HE'S NOT GONNA LET ME GO AHEAD WITH IT.

AND I DON'T WANT TO LOSE THAT

BECAUSE I HAVE A SIGNIFICANT AMOUNT

OF EXCESS SKIN ON MY BODY,

AND I WANT IT ALL GONE.

THE DAY BEFORE SURGERY, I'M SUPPOSED TO GO TO HIS CLINIC

FOR TESTS TO GET READY,

AND I'M TRYING TO STAY ON TRACK.

I FEEL LIKE I WENT THROUGH A LOT OF STUMBLING BLOCKS

AND A LOT OF TROUBLES.

NOW THAT I AM HALF OF WHAT I USED TO BE,

I REFUSE TO GIVE UP.

I'VE OVERCOME TOO MUCH TO NOT KEEP FIGHTING.

AND I KNOW RIGHT NOW MY GOAL HAS TO BE TO KEEP LOSING WEIGHT,

SO WHEN I SEE DR. NOW NEXT, THAT I DON'T GIVE HIM ANY REASON

NOT TO MOVE AHEAD WITH MY SURGERY,

AND FIGHT TO MAKE ENOUGH PROGRESS

BECAUSE A SETBACK LIKE THAT

IS GOING TO BE SO DISCOURAGING TO ME.

[ DOGS BARKING ]

**

Pauline: RIGHT NOW, I'M HEADED TO SEE DR. NOW

FOR MY PRE-OP APPOINTMENT

WHERE HE'S GONNA CHECK ON ME AND SEE HOW I'M DOING.

I'M ALWAYS NERVOUS ABOUT STEPPING ON THE SCALE.

THAT'S SOMETHING THAT NEVER GOES AWAY.

IT'S JUST A NERVE-WRACKING THING.

BUT I'M WORRIED ABOUT WHAT MY WEIGHT LOSS IS

BECAUSE MY LEGS HAVE BEEN REALLY HURTING,

AND I'M STILL STRUGGLING A LOT...

SO I KNOW I'M NOT DOING GREAT.

PAULINE POTTER?

WHEN I WAS HERE LAST MONTH, MY WEIGHT WAS AT 308.

AND I'M SUPPOSED TO BE LOSING 20 POUNDS A MONTH,

SO I NEED TO BE DOWN TO 288

FOR DR. NOW TO BE HAPPY RIGHT NOW.

BUT I'M JUST HOPING FOR ANY PROGRESS TODAY.

Crap.

[ BREATHES SHARPLY ]

I CAN'T BELIEVE IT.

THAT'S REALLY NOT GOOD.

I'M REALLY FRUSTRATED RIGHT NOW,

AND I'M NOT LOOKING FORWARD TO WHAT DR. NOW IS GOING TO SAY.

[ KNOCK ON DOOR ]

HELLO.

HELLO.

-HOW ARE YOU ALL DOING? -GOOD. HOW ARE YOU?

ALL RIGHT.

SO, YOU'RE BACK UP TO 327 TODAY.

I KNOW.

YOU WERE DOING SO WELL.

WHAT HAPPENED?

I HAVE REALLY BAD KNEE PAIN.

SO, WHAT ARE YOU DOING FOR YOUR KNEE PAIN?

NOT A LOT.

I KNOW YOU TOLD ME TO PUSH THROUGH THE PAIN,

BUT IT'S REALLY HARD TO GET THE RIGHT MIND-SET

TO PUSH THROUGH THE PAIN

WHEN IT HURTS SO MUCH.

YOUR LEGS ARE HURTING

BECAUSE YOUR JOINTS ARE ABSORBING ALL THE SHOCK

WHEN YOU WALK AROUND,

SO IF YOU GET SOME SHOES AND BECOME MORE ACTIVE,

THEN YOUR PAIN WILL START TO DECREASE SIGNIFICANTLY.

MAKE SENSE?

YOU'RE RIGHT.

BUT LET'S TALK ABOUT YOUR WEIGHT RIGHT NOW.

IT'S BEEN A YEAR AND NINE MONTHS SINCE YOUR GASTRIC BYPASS.

AT THIS POINT, YOU SHOULD BE DOWN TO 200 POUNDS,

BUT YOU'RE NOT.

SO, WHY IS THAT?

I THINK THAT YOU FIXED MY TUMMY,

BUT YOU DIDN'T FIX MY HEAD

AND SO I STILL HAVE 700-POUND THINKING.

I STILL WANT TO EAT WHEN I'M NOT HUNGRY

OR I STILL WANT TO KEEP EATING EVEN AFTER I'M FULL.

SO, WHAT DO YOU THINK IS DRIVING YOU

TO EAT MORE OFTEN AND OVEREAT?

I THINK IT'S JUST WHATEVER HAS BEEN IN MY HEAD FOR 53 YEARS

IS STILL IN THERE.

Dr. Nowzaradan: I'M VERY CONCERNED

ABOUT PAULINE RIGHT NOW.

SHE HAS HAD MOMENTS WHERE SHE LOST A LOT OF WEIGHT AT ONCE,

AND THEN SHE STARTS TO GAIN AGAIN.

BUT IT'S BECOME SO FREQUENT THAT, AT THIS POINT,

I AM WORRIED SHE'S JUST GOING TO SPIRAL OUT OF CONTROL.

WELL, YOU'RE STARTING TO GAIN AGAIN.

AND WHAT'S GONNA HAPPEN IN FOUR OR FIVE YEARS

IS YOU'RE GONNA BE BACK TO 600 POUNDS.

NO. I'M REALLY GONNA TRY NOT TO LET THAT HAPPEN.

YOU'RE STILL DEALING WITH THE SAME ISSUES

THAT LED YOU TO THIS POINT.

HAVE YOU STILL BEEN GOING TO THERAPY?

NO.

YOU NEED TO GO BACK TO SEEING THE THERAPIST.

NOTHING'S GOING TO CHANGE

UNLESS YOU KEEP MAKING PROGRESS WITH THAT, TOO.

OKAY.

BUT RIGHT NOW, YOU'RE NO LONGER IN A PLACE

THAT IS SAFE TO DO YOUR SURGERY,

SO I'M CANCELING IT FOR TOMORROW.

SO, GET SOME SHOES AND GET MORE ACTIVE

SO YOU CAN KEEP LOSING 20 POUNDS A MONTH.

AND IF YOU WANT SKIN-REMOVAL SURGERY,

THEN GET BACK TO AROUND 300 POUNDS.

OKAY.

YOU'RE HERE TO IMPROVE YOUR HEALTH

-AND HAVE A MEANINGFUL LIFE. -RIGHT.

AND THAT'S GONNA BE THE GOAL FOR YOU, OKAY?

OKAY.

SO, YOU NEED TO STICK WITH THAT.

OKAY.

-ALL RIGHT, I'LL SEE YOU SOON. -OKAY.

-ALL RIGHT. -THANKS, DR. NOW.

Dr. Nowzaradan: PAULINE

IS ON A VERY UNFORTUNATE TRAJECTORY RIGHT NOW,

BUT I'M HOPING

THE THERAPIST WILL BE ABLE TO HELP HER DEAL WITH THE ISSUES

THAT ARE DRIVING HER TO EAT RIGHT NOW.

[ SIGHS ]

Pauline: TODAY WAS PRETTY MUCH A WORST-CASE SCENARIO FOR ME.

I FEEL LIKE I LET DR. NOW DOWN, AND I LET MYSELF DOWN.

AND I JUST HAVE TO TAKE RESPONSIBILITY FOR THAT.

I HAVE NO ONE TO BLAME BUT MYSELF,

SO I KNOW I HAVE A LOT OF WORK TO DO.

BUT ALL I CAN DO IS GO AND TRY AGAIN.

**

Joe: TODAY, SARAH AND I

ARE GOING TO TRY AND PICK OUR WEDDING CAKES,

AND I'M EXCITED ABOUT ALL OUR WEDDING PLANNING.

THE ONLY THING THAT I HAVE ANY HESITATION ABOUT

IS THE PLANNING THAT REVOLVES AROUND FOOD.

THERE'S A PART OF ME THAT WANTS TO SAY, "YOU KNOW WHAT?

WE'RE GONNA BE DIFFERENT,

AND WE'RE NOT GONNA HAVE CAKE OR CANDY OR UNHEALTHY STUFF."

BUT THE REALITY IS THAT GOOD TIMES AND FOOD

JUST SEEM TO ALWAYS GO TOGETHER FOR EVERYONE.

-HI. HOW ARE YOU GUYS TODAY? -GOOD MORNING.

WE'RE HERE FOR A WEDDING-CAKE TESTING.

OKAY, COOL. SO, IF YOU WANT TO TAKE A SEAT,

I'LL BE RIGHT WITH YOU.

-AWESOME. THANK YOU. -OKAY.

Joe: WE CELEBRATE THINGS WITH FOOD,

AND THAT MAKES IT HARD TO DEAL WITH ANY BIG EVENT

BECAUSE THINGS LIKE CAKE AND CANDY

AREN'T A PART OF MY DIET ANYMORE.

SO, THESE ARE JUST SOME OF OUR MOST POPULAR WEDDING FLAVORS.

WE HAVE OUR CLASSIC WHITE CAKE, OUR CLASSIC CHOCOLATE.

THESE ARE FROSTINGS, AND THEN FILLINGS.

WE HAVE STRAWBERRY, RASPBERRY, AND LEMON.

OOH.

SO, I'LL LEAVE YOU GUYS TO IT,

AND MIX AND MATCH AND SEE WHAT YOU LIKE BEST.

-AWESOME. THANK YOU. -OKAY. YEP.

WHAT DO YOU WANT?

I'M GONNA TRY CHOCOLATE FIRST.

OF COURSE.

I'LL GIVE YOU A CHOCOLATE.

YEAH.

WELL, I CAN'T HAVE MUCH. YOU KNOW THAT.

Joe: FOR THE WEDDING, WE HAVE TO HAVE A DINNER

AND THERE HAS TO BE CAKE.

AND THERE'S APPETIZERS AND CANDY OR SNACKS

THAT HAVE TO BE OUT AT THE RECEPTION.

AND SO, I KNOW

THAT THIS IS GOING TO TAKE A LOT OF SELF-CONTROL.

SO I HAVE TO BE REALLY CAREFUL RIGHT NOW

BECAUSE I SEE DR. NOW AGAIN IN A COUPLE OF WEEKS,

AND I DON'T WANT TO MESS UP MY PROGRESS.

THIS IS A MILESTONE FOR ME JUST BECAUSE, YOU KNOW, BEFORE,

I WOULDN'T HAVE ANY CONTROL OVER WHAT I WAS EATING.

CAKE WOULD BE LIKE, "OKAY,

I'M JUST GONNA GO AND GO AND GO AND GO NOT STOP."

NOW, I HAVE ENOUGH CONTROL TO BE LIKE,

"OKAY, WELL, WE'RE JUST GONNA HAVE JUST A LITTLE BIT,

AND THE REST OF IT CAN GO SOMEWHERE ELSE."

SO, WHAT DID YOU GUYS THINK?

IT WAS VERY GOOD.

WE WILL BE BACK IN THE NEXT WEEK OR SO TO ORDER.

ALL RIGHT. WELL, IT WAS NICE MEETING YOU GUYS.

THANK YOU. [ CHUCKLES ]

**

I DON'T WANT OUR BIG DAY TO BE TAINTED

WITH THE FACT THAT I STARTED TO GAIN AGAIN THROUGH ALL THIS,

SO I'M GOING TO FOCUS ON DOING WHAT I NEED.

**

I'M BACK IN HOUSTON FOR MY NEXT APPOINTMENT WITH DR. NOW,

AND I'M NOT SURE WHAT TO EXPECT TODAY.

I'M STILL EATING HEALTHY,

BUT THERE'S BEEN A LOT OF PLANNING

REVOLVING AROUND FOOD.

AND A LOT OF THE TIME,

I DON'T KNOW HOW MANY CALORIES ARE IN SOMETHING

THAT'S BEING PUT IN FRONT OF ME.

SO I'M JUST A LITTLE CONCERNED ABOUT ALL THAT.

I STILL HAVE A LOT OF EXCESS SKIN AROUND MY LEGS AND ARMS,

AND I DO WORRY ABOUT WHAT SARAH'S GOING TO THINK

AS I LOSE MORE WEIGHT AND IT GETS WORSE.

JOE WEXLER?

SO IT'S IMPORTANT TO ME TO GET DOWN TO WHERE I NEED,

BUT THE LAST TIME I WAS HERE, I WAS 374,

AND I NEED TO BE AT 324 TO STAY ON TRACK.

IF I'M NOT, THEN I'M GONNA BE

NOWHERE CLOSE TO MY NEXT SURGERY.

365.

OKAY.

YOU CAN GO AHEAD AND GO TO THE ROOM.

-THANK YOU. -MM-HMM.

IT'S NOT THE BEST NUMBER, BUT IT'S STILL A LOSS.

BUT I'M NOT SURE WHAT THAT MEANS ABOUT MY SKIN-REMOVAL SURGERY.

[ KNOCK ON DOOR ]

HEY, JOE. HI. HOW'S IT GOING?

I'M DOING OKAY. HOW ABOUT YOURSELF?

GOOD, GOOD.

SO, YOU LOST OVER 400 POUNDS, HUH?

YES, SIR.

WHICH IS GREAT, BUT WHY IS YOUR WEIGHT LOSS SLOWING?

WELL, I MEAN, THERE'S BEEN A LITTLE BIT OF STRESS

AND JUST GETTING READY FOR A WEDDING, SO...

COME ON, JOE.

YOU KNOW WHAT'S GOING ON IN YOUR LIFE

CAN NEVER BECOME AN EXCUSE TO BE UNHEALTHY.

-RIGHT. -OKAY?

YOU NEED TO UNDERSTAND NOT TO LET

THIS STRESS PROJECT ON YOUR EATING HABIT,

AND YOU NEED TO KEEP AN EYE ON YOUR CALORIE INTAKE.

SURE.

TO LOSE ONLY FOUR TO FIVE POUNDS A MONTH AT YOUR WEIGHT

MEANS THAT YOU'RE STILL TAKING IN AROUND 3,500 CALORIES,

AND YOU'RE NOT REALIZING IT.

OKAY.

Dr. Nowzaradan: AFTER JOE'S LAST SKIN SURGERY,

HE STARTED TO LOSE SOME MOMENTUM WITH HIS WEIGHT LOSS.

AND RIGHT NOW, I'M CONCERNED

THAT HE'S GETTING MORE AND MORE DISTRACTED.

A LOT IS CHANGING VERY QUICKLY FOR HIM,

AND AS TIME GOES ON, THE EXCITEMENT WILL WEAR OFF

WHILE HIS RESPONSIBILITIES CONTINUE TO GROW.

SO IF HE DOESN'T LEARN HOW TO HANDLE THAT STRESS NOW,

HE'S NOT GOING TO HAVE A CHANCE LATER ON IN HIS LIFE.

ALL RIGHT.

LET ME LOOK AT THE EXCESS SKIN.

RIGHT.

SO, LIKE, RIGHT HERE.

YOU CAN SEE, LIKE...

THERE STILL TOO MUCH FAT AROUND THAT AREA,

SO WHAT WE NEED TO DO

IS WE NEED TO CONCENTRATE ON GETTING YOUR WEIGHT DOWN...

MM-HMM.

...AND GET YOU TO UNDER 300

BEFORE WE CONSIDER DOING ANY SKIN SURGERY.

SO YOU NEED TO KEEP LOSING MORE WEIGHT.

SURE. THANK YOU.

OKAY, JOE. NICE TO SEE YOU AGAIN.

NICE TO SEE YOU, TOO. ALL RIGHT.

JOE STILL HAS A GOOD WAYS TO GO

TO GET TO HIS FINAL GOAL WEIGHT,

SO HE NEEDS TO GET BACK ON TRACK NOW

IF HE WANTS TO HAVE A CHANCE TO GET THERE ANY TIME SOON.

**

Joe: TODAY'S APPOINTMENT DIDN'T GO EXACTLY LIKE I HOPED,

SO THAT'S A LITTLE BIT OF A DOWNER RIGHT NOW.

I HAVE TO GET UNDER 300 NOW

TO GET APPROVED FOR SKIN-REMOVAL SURGERY,

AND THAT'S 65 POUNDS AWAY.

SO THAT'S WHAT I HAVE TO LOSE QUICKLY

IF I WANT TO BE ABLE TO GET THE SURGERY.

WITH THE WEDDING AND ALL, I'M NOT LETTING ANYTHING HAPPEN

TO MAKE ME WAIT A YEAR OR SO

TO KEEP MAKING THE PROGRESS I NEED.

SO IF I HAVE TO WORK HARDER, THEN I WILL.

**

**

WE'RE ON OUR WAY TO A SHOE STORE

TO SEE IF THERE ARE ANY WALKING SHOES

THAT WILL FIT THESE WIDE, SWOLLEN FEET OF MINE.

I THINK I'M MOSTLY JUST NERVOUS THAT

THERE'S NOT GONNA BE ANYTHING THAT FITS ME,

WHICH IS WHY I HAVEN'T WORN SHOES FOR SO LONG ALREADY.

Pauline: FOR YEARS, I HAVEN'T EVEN TRIED TO WEAR SHOES.

BEING AS BIG AS I WAS AND WITH THE LYMPHEDEMA,

THERE WAS JUST NO WAY I COULD GET ANY SIZE SHOE ON ME.

AND IF I COULD, I'M SURE IT WOULD'VE BEEN SO UNCOMFORTABLE

TO EVEN TRY TO WEAR.

BUT DR. NOW THINKS THEY'LL HELP WITH MY LEG AND JOINT PAIN,

AS WELL AS MAKE IT EASIER FOR ME TO BE MORE ACTIVE.

SO I'M WILLING TO GO SEE IF IT'S POSSIBLE

FOR ANYTHING TO FIT MY FOOT NOW.

OF COURSE IT'S PACKED.

**

WHAT CAN WE HELP WITH TODAY?

[ SIGHS ]

I HAVEN'T WORN SHOES FOR QUITE A WHILE,

AND I HAVE LYMPHEDEMA SO IT HANGS --

MY LEGS HANG OVER MY ANKLES AND STUFF,

WHICH IS WHY I STOPPED WEARING SHOES.

I DON'T KNOW IF I'M GONNA BE ABLE TO FIT IN A WOMAN'S SHOE.

OKAY. LET ME SEE WHAT WE GOT BACK THERE,

AND I'LL BE RIGHT BACK.

[ CLEARS THROAT ]

I DON'T REALLY LET ANYONE SEE MY FEET --

NO MATTER WHAT -- BECAUSE OF THE LYMPHEDEMA,

AND I JUST CAN'T TAKE THE COMPRESSION SOCKS OFF.

ALL RIGHT, HERE WE GO.

PUTTING ON CLOSED-TOE SHOES USUALLY, YOU KNOW,

CAN BE DIFFERENT IF YOU'RE NOT USED TO IT.

SO, HERE. I'LL HELP YOU OUT HERE.

OH, YEAH. THIS IS NOT GONNA...

I DON'T THINK THAT ONE'S GONNA FIT.

IT'S ALREADY TOO TIGHT.

IS IT TOO TIGHT?

OKAY.

LET'S TRY THIS AGAIN.

LET'S SEE.

HERE WE GO.

YOU JUST TELL ME WHEN. OKAY.

I'LL JUST PUT A COMFORTABLE AMOUNT OF PRESSURE THERE.

THAT'S PROBABLY OKAY.

YOU WANT TO STAND UP AND SEE HOW THEY FEEL?

SURE. I THINK I CAN DO IT.

[ GRUNTS ]

OH, LORD.

I DIDN'T THINK ANYTHING WOULD ACTUALLY FIT,

BUT IT'S BEEN A LONG TIME SINCE I'VE HAD SHOES ON,

AND IT FEELS REALLY DIFFERENT THAN I REMEMBER.

HOW'S THE CUSHION FEEL? CAN YOU TELL IT?

THE CUSHION FEELS PRETTY GOOD.

THE SHOES LOOK NICE, BUT MY FEET LOOK BAD.

[ CHUCKLES ]

I THINK THEY LOOK JUST FINE.

MY LEGS LOOK TERRIBLE.

IT'S A LITTLE SCARY

BECAUSE I CAN'T FEEL WHERE MY FEET ARE AS MUCH,

AND IT MAKES ME FEEL LIKE I'M GOING TO TRIP.

SO THIS IS GOING TO TAKE A LOT OF GETTING USED TO

AND JUST SOME TIME WALKING WITH THEM.

BUT IT'S EXCITING BECAUSE THIS MEANS

I'M GOING TO BE ABLE TO DO MORE

AND START WALKING AROUND WITHOUT AS MUCH PAIN.

-THANK YOU SO MUCH. -YES, MA'AM.

-HAPPY TO HELP. -APPRECIATE YOUR HELP.

VERY HAPPY TO HELP.

**

GOOD LUCK WITH EVERYTHING.

THANKS. YOU HAVE A GREAT DAY.

SO, I PLAN TO START WEARING THEM A LITTLE BIT EVERY DAY

UNTIL I GET USED TO THEM,

AND THEN I'LL START TO GET MORE ACTIVE

AND START WALKING AROUND

WITHOUT AS MUCH PAIN.

**

[ TRAIN WHISTLE BLOWS ]

**

Joe: TODAY, I'M GETTING BACK TO THE GYM AND WORKING OUT.

WITH PREPARING FOR THE WEDDING AND TO MAKE A MOVE,

IT'S BEEN HARD TO KEEP UP WITH WORKING OUT.

BUT IF I WANT TO KEEP MAKING MORE PROGRESS,

THEN I KNOW I HAVE TO WORK HARD AT IT.

SO NO MATTER WHAT I HAVE GOING ON

OVER THE NEXT COUPLE OF MONTHS,

I'M STAYING ON TRACK.

I DESPERATELY NEED TO GET MY SKIN-REMOVAL SURGERY.

AS MY WEDDING GETS CLOSER, IT'S ON MY MIND MORE.

BUT MY WEDDING IS IN TWO MONTHS, SO THERE'S NO TIME

FOR ME TO HAVE IT AND RECOVER BEFORE THEN.

SO I CALLED DR. NOW AND TOLD HIM

I'M NOT GONNA MAKE IT TO MY NEXT APPOINTMENT,

BUT I WON'T MISS THE NEXT ONE FOR ANYTHING.

**

I'M GONNA SHOW UP AND WOW HIM WITH MY WEIGHT LOSS,

AND THEN HE'LL APPROVE ME FOR MY EXCESS-SKIN SURGERY.

HE TOLD ME HE HOPES SO

AND EXPECTS ME TO STICK TO MY MONTHLY GOALS

UNTIL I COME BACK,

SO THAT'S EXACTLY WHAT I'M GONNA DO.

IT'S AMAZING TO ME --

THE DRASTIC 180 THAT I'VE MADE FROM WHERE I WAS

WHEN I STARTED THE WEIGHT-LOSS JOURNEY TILL NOW.

DR. NOW SAVED ME, AND I OWE HIM EVERYTHING.

HE'S DONE SO MUCH FOR ME, SO I'M NOT GONNA LET HIM DOWN.

IT WILL BE FOUR MONTHS WHEN I SEE DR. NOW AGAIN,

SO THAT PUTS MY WEIGHT-LOSS GOAL AT 100 POUNDS.

AND I KNOW THAT I CAN DO IT IF I WORK HARD.

AND I'M SO MOTIVATED RIGHT NOW THAT NOTHING'S GONNA STOP ME.

IT'S NOT JUST MY LIFE RIDING ON IT ALL NOW.

IT'S SARAH AND HAYLEY'S, TOO.

SO NO MATTER WHAT I HAVE GOING ON IN MY LIFE,

THEY'RE MY PRIORITY,

SO THAT MAKES MY HEALTH A PRIORITY.

SO I'M MAKING SURE I HIT MY GOALS, NO MATTER WHAT IT TAKES.

**

Pauline: I'VE BEEN TRYING TO GET MORE ACTIVE

OVER THE LAST COUPLE OF WEEKS.

AND FOR THE FIRST WEEK AFTER GETTING MY SHOES,

I TRIED WEARING THEM AT LEAST AN HOUR EVERY DAY.

BUT I JUST COULDN'T GET USED TO THEM

BECAUSE I'M AFRAID OF TRIPPING AND FALLING.

SO IT WAS PRETTY SCARY TO STAND UP AND HAVE THE SHOES ON,

BUT I'VE ACTUALLY STILL BEEN ABLE

TO START WALKING AROUND THE BLOCK WITH DILLON

TO GET EXERCISE,

EVEN WITHOUT MY SHOES.

IT'S A BEAUTIFUL DAY OUTSIDE.

HOW 'BOUT IF WE GO FOR A W-A-L-K WITH THE DOGS?

Dillon: OKAY.

I DON'T HAVE A WALKER. I ONLY HAVE MY WHEELCHAIR.

BUT I CAN USE THE HANDLES ON MY WHEELCHAIR

TO GO SHORT DISTANCES,

SO I HAVE NOTHING TO LEAN ON

TO ALLEVIATE THE PAIN OF MY WEIGHT ON MY LEGS AND JOINTS.

THE PAIN IS JUST SO BAD, AND THEY SWELL EASILY.

LIKE, IF I TRY TO LIVE ANY KIND OF A NORMAL LIFE,

THEY START SWELLING, AND WATER POOLS IN THEM.

BUT DILLON HAD A REALLY GOOD IDEA.

HE WENT AND FOUND A SHOPPING CART,

SO I HOLD ONTO IT SO I CAN LEAN ON IT

WHEN THE PAIN GETS TO BE TOO MUCH.

WE GO OUTSIDE, AND THERE'S THE CIRCLE SIDEWALK,

AND I'M TRYING TO WALK IT A FEW TIMES A WEEK

AND SEE HOW MANY TIMES I CAN MAKE IT AROUND.

SO FAR, MY RECORD IS THREE LAPS,

AND MY GOAL IS TO BE ABLE TO DO ONE LAP WITHOUT THE CART.

I KNOW I HAVE TO PUSH THROUGH THE PAIN NO MATTER WHAT

IF I WANT TO START MAKING PROGRESS.

DR. NOW THINKS WHEN MY WEIGHT LOSS STARTS TO SLOW DOWN,

IT HAS MORE TO DO WITH MY EMOTIONAL ISSUES.

BUT I KNOW WHAT I NEED TO WORK THROUGH, AND I HAVE BEEN.

BUT THAT'S SOMETHING I REALLY WANT TO DO AT MY OWN PACE,

SO I'VE BEEN HESITANT TO GO BACK TO THERAPY.

I DON'T WANT TO UPSET DR. NOW,

BUT I DON'T THINK HE UNDERSTANDS HOW HARD IT IS

TO TALK ABOUT ALL THE PAIN AND EMOTION

THAT HAS BEEN BURIED FOR YEARS

AND TO DO IT CONSTANTLY.

SO I JUST NEED SOME TIME BEFORE I'M READY TO DO THAT.

I KNOW THAT MAY MEAN I'M RISKING GAINING EVEN MORE WEIGHT,

BUT IT'S JUST BEEN A LOT HARDER

TO DEAL WITH ALL THAT STUFF THAT'S IN ME,

SO I'M GOING TO DO IT ON MY TIMETABLE

OR NOT AT ALL.

AND UNTIL THEN, THERE'S NOTHING ANYONE CAN SAY

TO GET ME TO DO IT.

**

**

Joe: I'VE BEEN WORKING REALLY HARD TO LOSE MORE WEIGHT,

AND I FEEL LIKE I HAVE BEEN.

AND WHEN I LOOK IN THE MIRROR,

IT DOES ALL LOOK LIKE IT'S HANGING LOWER.

SO IT SHOWS ME THE NEED TO HAVE SKIN REMOVAL.

YEAH, I DEFINITELY THINK THE LEGS ARE THE PRIORITY NEXT

BECAUSE THEY FEEL LIKE WET SANDBAGS.

THEY'RE REALLY HEAVY AND JUST KIND OF, LIKE, GROSS.

SO I HOPE DR. NOW WILL TAKE THAT OFF THERE,

AND THEN I HEAL UP, AND THEN WE'LL SEE.

I WOULD WANT ALL THIS OFF NO MATTER WHAT,

BUT GETTING MARRIED AND BEING MORE INTIMATE NOW

MAKES IT EVEN MORE A CONCERN OF MINE.

I KNOW SARAH LOVES ME NO MATTER WHAT,

BUT I STILL WANT MY BODY TO LOOK GOOD FOR HER.

AND RIGHT NOW, I DON'T FEEL LIKE IT DOES.

AND I DON'T WANT THAT HOLDING ME BACK

OR MAKING ME HESITANT TO BE WITH HER AT ANY TIME.

SO I'M GONNA KEEP LOSING THE WEIGHT

AND GET DOWN TO THE 300s

BY THE TIME I SEE DR. NOW AFTER MY WEDDING.

AND UNTIL THEN, I HAVE TO KEEP WORKING OUT AND EATING RIGHT

THROUGH ALL THE STRESS

AND THE PREPARATIONS FOR THE WEDDING

AND NOT GIVE IN TO ANY OF IT.

BUT WHAT'S BEEN THE MOST STRESSFUL THING FOR ME RIGHT NOW

IS GETTING MY MOM TO THE WEDDING.

SHE'S BEEN SAYING SHE DOESN'T THINK SHE CAN MAKE IT,

AND THE THOUGHT OF THAT MAKES ME REALLY SAD.

BESIDES SARAH AND HAYLEY,

SHE'S THE MOST IMPORTANT PERSON IN MY LIFE,

AND I CAN'T IMAGINE MY BIG DAY WITHOUT HER.

HI, MOM. HOW'S IT GOING?

DOING FINE, THANKS.

SO, ARE YOU GONNA BE ABLE TO COME TO THE WEDDING,

OR WHAT'S THE STORY THERE?

IF YOU'RE ABLE TO COME, I WOULD LOVE TO HAVE YOU HERE,

UM, YOU KNOW,

BECAUSE WITHOUT YOUR HELP,

I WOULDN'T BE HERE NOW WHERE I AM.

RIGHT.

ALL RIGHT. LOVE YOU.

[ CELLPHONE BEEPS ]

SHE'S NOT ABLE TO COME

BECAUSE SHE SAYS SHE HAS NO HELP TO GET HERE,

SO I FEEL BAD BECAUSE I'M NOT THERE TO HELP HER.

BUT SHE'S SUCH AN IMPORTANT PART OF MY LIFE,

AND I NEED HER TO BE THERE TO SUPPORT ME FOR THAT DAY.

IT'S TIME FOR ME TO MOVE ON TO THE NEXT CHAPTER OF MY LIFE.

I JUST HOPE SHE'S ABLE TO BE THERE FOR IT.

**

Pauline: AS HESITANT AS I AM,

I DECIDED TO GO BACK TO A THERAPIST AGAIN.

IT'S NOT THAT I DON'T THINK IT HELPS,

BECAUSE I KNOW I NEED TO WORK THROUGH

A LOT OF MY EMOTIONAL ISSUES

AND I STRUGGLE WITH DEPRESSION AND FEELING DOWN RIGHT NOW.

I WANT TO HAVE A MORE POSITIVE OUTLOOK.

I JUST WANT TO DO THIS PART AT MY OWN PACE,

BUT DR. NOW WANTS ME TO GO RIGHT NOW, SO I AM.

-HI, PAULINE. -HI.

-COME ON BACK. -OKAY.

ALL RIGHT, PAULINE. WELL, LET'S GET STARTED.

SO, WHY DON'T YOU TELL ME A LITTLE BIT

ABOUT HOW THINGS ARE GOING FOR YOU RIGHT NOW?

WELL, I GOT THE GASTRIC BYPASS.

-AND I'VE LOST OVER 300 POUNDS. -OKAY.

BUT I STILL HAVE ABOUT 150 TO GO,

AND I SEEM TO BE KIND OF AT A STANDSTILL

FOR THE LAST SEVERAL MONTHS -- LIKE, MAYBE FIVE MONTHS.

IN FACT, I'VE ACTUALLY GAINED.

SO, HOW DO YOU FEEL ABOUT WHERE YOU ARE RIGHT NOW?

HOW DO YOU...

I FEEL I'M DISAPPOINTING EVERYBODY, INCLUDING MYSELF.

ARE YOU DISAPPOINTED, OR IS THERE SOMETHING ELSE?

-LIKE, MAYBE... -I DON'T KNOW.

LIKE, I FEEL LIKE I DON'T HAVE A GOOD EXCUSE

WHY I EVEN WAS AN OVEREATER TO START WITH.

I NEVER HAD ABUSE. I WAS NEVER MOLESTED AS A KID.

DID YOU GET A LOT OF VALIDATION GROWING UP?

YOU KNOW WHAT I MEAN BY VALIDATION?

-I DON'T KNOW. -"HEY, YOU DID A GREAT JOB,"

OR "YOU'RE REALLY SMART," OR...

I DON'T THINK MY MOM KNEW HOW TO DO THAT, YOU KNOW.

WE HAD SEVEN KIDS.

AND WHERE DID YOU FALL IN THE MIX?

I WAS THE VERY OLDEST.

SO IT SOUNDS LIKE YOU WERE BUSY

TAKING CARE OF OTHER PEOPLE'S NEEDS AS THE OLDEST,

HELPING OUT YOUR MOM AND, YOU KNOW...

SO, I WONDER IF SOMEHOW YOUR WEIGHT WAS A WAY OF SAYING,

"OH, I GET TO DO WHAT I WANT."

AND SOMETIMES WHAT THAT SHOWS UP AS

IS NOT REALLY KNOWING HOW TO TAKE CARE OF YOURSELF.

BUT, INSTEAD, YOU WERE FEEDING YOUR NEEDS THROUGH FOOD.

LIKE, FOOD IS LOVE.

I FEEL THAT WAY SOMETIMES NOW.

LIKE, EVEN AFTER SURGERY, MY FIRST EXCITEMENT IS,

"WHAT ARE THE SNACKS GONNA BE?"

EVEN IF IT'S SOMETHING I CAN'T HAVE.

SO, WHAT HAPPENS --

LET'S SAY YOU DO LOSE THE WEIGHT AND YOU MEET YOUR GOAL.

DO YOU HAVE ANY FEARS OF WHAT THINGS WILL BE LIKE THEN?

I'M NOT THAT 700-POUND PERSON STUCK IN BED ANYMORE.

MM-HMM.

BUT I ALMOST HAVE SOME OF THOSE SAME FEELINGS,

LIKE, I ALMOST FEEL STILL,

LIKE, LEFT OUT OR NOT GOOD ENOUGH.

[ Voice breaking ] IT'S ALMOST LIKE

MY FEARS ARE HOLDING ME BACK FROM REALLY EVEN TRYING,

BECAUSE BEFORE WE EVER GOT HERE I WAS WORRIED ABOUT

IF THERE WAS STAIRS. THE STAIRS.

YEAH, OR IF THERE'S A CHAIR. YOU CAN'T DO IT.

YEAH. YOU CAN'T DO IT.

I'M CONSTANTLY WORRIED

BECAUSE I'M NOT AS GOOD AS EVERYONE ELSE.

I MESSED UP AGAIN.

YOU'RE ALWAYS AFRAID THAT YOU'RE NOT GOOD ENOUGH.

I WANT YOU TO FOCUS ON GIVING YOURSELF APPROVAL,

GIVING YOURSELF ACCEPTANCE.

YOU KNOW, YOU DON'T HAVE TO BE SO HARD ON YOURSELF.

I ALWAYS SAY THE FAT GIRL IN ME --

-"THE FAT GIRL" COULDN'T DO IT. -SHE CAN'T DO IT.

I'M NOT SURE THAT I'M REALLY COMFORTABLE

WITH YOU CALLING HER "THE FAT GIRL."

YOU'RE INSULTING YOURSELF.

SO, WE NEED TO CREATE MORE LOVE ON THE INSIDE,

MORE SELF-LOVE.

SO I WOULD LIKE FOR YOU TO TRY TO MAKE A COMMITMENT

WHERE MAYBE EVERY DAY YOU WRITE DOWN

FIVE POSITIVE THINGS ABOUT YOURSELF,

THINGS THAT HELP YOU JUST TO FEEL GOOD.

RIGHT. SO IT NEEDS TO BE,

"I WANT TO DO THIS FOR ME 'CAUSE I DESERVE THIS.

I DESERVE TO FEEL GOOD."

THAT'S WHAT I GOT TO KEEP TELLING MYSELF.

-OKAY? -OKAY.

-ALL RIGHT. -WELL, THANK YOU VERY MUCH.

THANK YOU.

Pauline: I KNOW I HAVE A LOT OF FEAR --

A FEAR OF FAILURE, A FEAR OF LETTING PEOPLE DOWN,

A FEAR OF REJECTION.

BUT I DIDN'T REALIZE

IT'S ALL COMING FROM THIS FEELING ABOUT MYSELF.

I SEE MYSELF AS A FAILURE, AND WHEN I LOOK AT MY DAY,

I DON'T SEE WHAT I COULD DO OR WHAT'S POSSIBLE.

I ONLY SEE WHAT I CAN'T DO.

I KNOW I NEED TO TRY

AND FIND WAYS TO SEE THE THINGS I'M CAPABLE OF

AND WHAT I CAN DO WHEN I PUT MY MIND TO IT,

AND TO SEE MYSELF IN A POSITIVE WAY.

BUT I DON'T KNOW HOW TO CHANGE THAT RIGHT NOW.

**

**

Joe: RIGHT NOW, WE'RE GOING TO THE REHEARSAL

TO PREPARE FOR TOMORROW.

AND THEN, WE HAVE THE REHEARSAL DINNER TONIGHT.

WE'RE BOTH REALLY EXCITED RIGHT NOW

BECAUSE IT MEANS OUR BIG DAY IS TOMORROW,

AND WE JUST CAN'T WAIT.

THIS IS GOING TO BE A REALLY HAPPY TIME,

AND WE GET TO SHARE IT WITH SO MANY PEOPLE IN OUR LIVES,

INCLUDING MY MOM.

SHE CAME STRAIGHT TO THE CHURCH FROM TENNESSEE,

AND I'M SO EXCITED FOR HER TO SEE ME.

I'M GLAD YOU COULD MAKE IT.

OH, THANK YOU.

I DIDN'T THINK I WAS GOING TO.

YEAH? WELL...

I CAN'T BELIEVE YOU.

I'VE CHANGED THE HAIR, TOO.

-IT AIN'T GRAY NO MORE. -YEP.

WANT TO GO IN AND LET'S GET THIS THING GOING?

WE GOT TO GET YOU HITCHED.

YEAH. [ CHUCKLES ]

ARE YOU CARRYING HER, OR DO YOU WANT ME TO?

-COME ON. -COME HERE, LITTLE GIRL.

[ GRUNTS ]

Joe: I JUST CAN'T BELIEVE THAT THIS ALL HAPPENING,

THAT I WOULD FIND SOMEONE LIKE SARAH IN THIS WORLD.

IT'S JUST A DREAM COME TRUE

THAT I GET TO SPEND THE REST OF MY LIFE WITH HER.

SO THERE REALLY ARE NO WORDS FOR HOW HAPPY I AM.

I WAS LIVING A NIGHTMARE JUST A COUPLE OF YEARS AGO,

TRAPPED IN MY HOUSE AND MY BODY

WITH SOMEONE HAVING TO TAKE CARE OF ME ALL DAY.

AND NOW I'M ABOUT TO HAVE A FAMILY,

AND I'M GONNA BE THE ONE PROVIDING FOR THEM.

SO I'LL HAVE YOU GUYS WALK UP,

AND YOU CAN STAND RIGHT THERE.

AT THIS POINT, I'LL HAVE YOU FACE EACH OTHER.

I'VE HAD TO WORK SO HARD TO GET HERE,

AND I'M PROUD OF WHAT I'VE ACCOMPLISHED IN THAT TIME.

EVEN THOUGH I HAVE A WAYS TO GO, I'M HAPPY RIGHT NOW.

AND I'M EXCITED

ABOUT ALL THE WAYS IT'S GONNA GET EVEN BETTER.

Sarah: JOE IS SUCH A KIND AND CARING MAN,

AND I AM SO LUCKY TO HAVE FOUND HIM.

AND I'M EXCITED FOR THE WEDDING, BUT I HAVE SOME BUTTERFLIES

ABOUT TALKING IN FRONT OF SO MANY PEOPLE.

IT'S DEFINITELY KIND OF STRESSFUL,

AND THERE'S JUST A LOT OF TENSION

WITH MY MOM PREPARING FOR THE WEDDING.

BUT I'M REALLY HAPPY,

AND I'M REALLY LOOKING FORWARD TO STARTING MY LIFE WITH JOE.

[ LAUGHTER ]

WHEN ARE YOU GOING TO HAVE KERAH AND STEVIE WALK?

-RIGHT BEFORE. -LONG AS THEY'RE SEATED.

AND THEN I INTRODUCE YOU

AS MR. AND MRS. JOE AND SARAH WEXLER,

HUSBAND AND WIFE.

AND THEN, AT THAT POINT, YOU CAN KISS.

-YEAH! YES. -[ LAUGHS ]

PRACTICE, COME ON. IT'S A DRILL.

Joe: PART OF ME CAN'T BELIEVE THAT THIS DAY IS ALMOST HERE,

AND I'M JUST SO HAPPY RIGHT NOW.

**

**

-I NEED TO TALK TO YOU. -YES.

[ SARAH CRYING ]

[ CRYING CONTINUES ]

[ SIGHS ]

[ SNIFFLES ]

Joe: THE TENSION OF LIVING WITH SARAH'S MOM

IS STARTING TO TAKE ITS TOLL.

IT'S NOT A SOLUTION THAT'S GONNA WORK ANYMORE.

WATCH YOUR ARM.

SO I HAVE TO FIND A JOB VERY SOON,

BECAUSE I HAVE TO START TAKING CARE OF MY FAMILY.

AND TOMORROW, THEY COMPLETELY BECOME MY RESPONSIBILITY.

Sarah: I HAVE A FEELING THAT I'M JUST GONNA GET CORNERED.

LIKE EVERYBODY'S GONNA BE LIKE, "WHAT THE HELL?"

AND IF SHE'S THERE,

IT'S GONNA MAKE IT EVEN WORSE FOR ME RIGHT NOW.

IT'S HER FAULT THAT WE'RE RUNNING BEHIND,

AND I'M -- I FEEL SO GUILTY.

I'M NOT LETTING THE STRESS OF ANY OF THIS GET TO ME.

WE'RE JUST GONNA FOCUS ON OUR WEDDING DAY RIGHT NOW,

AND THEN I'LL FIGURE OUT OUR LIVING SITUATION

AND GETTING WORK SO I CAN DO WHAT WE NEED.

BUT I CAN HANDLE IT,

AND I'LL STILL STAY FOCUSED

ON LOSING WEIGHT AND GETTING MY SKIN SURGERY,

NO MATTER HOW MUCH IS ON MY PLATE.

BUT THERE'S STILL SO MUCH TO BE THANKFUL FOR.

WE GET TO SPEND THE REST OF OUR LIVES TOGETHER,

AND WE GET TO CELEBRATE THAT

WITH OUR FRIENDS AND FAMILY, NO MATTER WHAT.

AND I'M SO THANKFUL MY MOM IS HERE

AND SHE'S WITH ME ON THIS BIG DAY.

SO, YOU LIKE IT, LIVING UP HERE?

EH, IT REMINDS ME OF JOHNSON CITY.

EXCEPT WE GOT A MISSISSIPPI RIVER HERE.

HOW DID YOUR INTERVIEW GO?

GOOD, GOOD, YOU KNOW?

WITH THE CITY?

YEAH. THEY SAID THEY'D LET ME KNOW IN A WEEK.

MM. THAT WOULD BE GOOD.

IS SARAH NERVOUS?

EH, SO-SO.

TOMORROW IS THE BIG DAY.

CLOSE THE CHAPTER OF ONE THING

AND OPEN IT TO THE BEGINNING OF A NEW ONE.

I'M PROUD OF YOU, SON.

IT'S A BIG STEP.

YEAH?

I KNOW YOU'LL BE A GOOD DADDY AND A GOOD HUSBAND.

MM-HMM.

I LOVE YOU, TOO.

THANK YOU.

[ GRUNTS ] [ SMOOCHES ]

I'M READY TO FULFILL MY RESPONSIBILITIES

TO BE THE HUSBAND AND FATHER I NEED TO BE,

BECAUSE THAT'S THE MOST IMPORTANT THING RIGHT NOW.

-BYE, EVERYBODY! -iADIóS!

AND NO MATTER WHAT,

I'M GONNA DO WHAT I NEED FOR MY FAMILY.

**

Pauline: RIGHT NOW, I'M HEADED BACK

FOR MY NEXT APPOINTMENT WITH DR. NOW.

I'VE BEEN TRYING TO WORK ON THINGS,

BUT IT HASN'T BEEN EASY.

IT WAS SUCH A SETBACK TO LOSE THAT APPROVAL.

AND I KNOW, IF I COULD WORK TO GET TO THAT POINT AGAIN,

IT'LL BE A HUGE ENCOURAGEMENT TO ME.

BUT WHEN I FEEL LIKE I WORK HARD AND IT'S STILL NOT ENOUGH,

IT'S HARD NOT TO JUST FEEL LIKE A FAILURE.

I DON'T WANT TO KEEP LIVING IN THIS PLACE

WHERE I KEEP FAILING,

BECAUSE, AT SOME POINT,

I THINK THAT'S ALL I'M GOING TO SEE.

SO I'M JUST REALLY HOPING THAT I MADE SOME PROGRESS TODAY.

**

Pauline: I'M AT DR. NOW'S OFFICE AGAIN,

AND I'M ABOUT TO FIND OUT WHAT MY WEIGHT IS

TO SEE IF I'VE MADE ANY PROGRESS.

I HAD GAINED LAST TIME AND WAS UP TO 327,

SO I NEED TO BE AT LEAST 287 TO GET BACK ON TRACK TODAY.

AND I'M NOT SURE IF I'M CLOSE OR NOT.

YAY.

**

IT'S NOT AS MUCH OF A LOSS AS DR. NOW WANTED,

BUT I'M JUST HAPPY IT'S NOT A GAIN RIGHT NOW.

6 POUNDS IS STILL A LOSS, AND I'M PROUD OF THEM.

AND I REALLY HOPE DR. NOW IS PLEASED.

[ KNOCK ON DOOR ]

-HELLO. -HELLO.

-HOW ARE YOU ALL DOING? -GOOD.

-HOW ARE YOU? -ALL RIGHT.

SO, YOU'RE DOWN TO 321 TODAY.

YEAH.

I'M GLAD THAT YOU'RE NOT GAINING WEIGHT,

BUT THAT'S NOT VERY MUCH LOSS AT ALL.

SO, WHAT HAVE YOU BEEN DOING?

I'M -- SERIOUSLY, I AM ON THE RIGHT TRACK.

I'VE BEEN USING MY LEG PUMPS, BEEN EATING GOOD,

BEEN DRINKING LOTS OF WATER.

BUT YOU STILL HAVEN'T GOT ANY SHOES.

I'VE TRIED, BUT I'M STILL FIGHTING WITH LYMPHEDEMA,

AND IT'S TAKING A LITTLE WHILE TO GET USED TO THEM.

SO, I'M WORKING ON IT.

HAVE YOU BEEN SEEING THE THERAPIST?

YEAH, YEAH.

I HOPE THAT MEANS THAT THE SHIP IS TURNING AROUND

AND THAT YOU'RE ABOUT TO GET A LOT MORE MOMENTUM

AND START LOSING AT LEAST 20 POUNDS A MONTH.

PAULINE HAS REPEATEDLY LOST AND THEN GAINED AGAIN,

SO UNTIL SHE SHOWS ME MORE CONSISTENT WEIGHT LOSS

OVER MULTIPLE APPOINTMENTS,

I AM NOT CONVINCED THIS CHANGE IS HERE TO STAY.

AND SHE STILL NEEDS TO KEEP SEEING HER THERAPIST

TO MAKE SURE SHE'S ADDRESSING THE CORE ISSUES

TO KEEP MAKING PROGRESS.

I'M DOING SO GOOD, AND I LOST SOME WEIGHT,

SO I'M ON MY WAY THERE.

DO YOU THINK I'M READY FOR SKIN-REMOVAL SURGERY AGAIN?

NO, NOT UNTIL YOU GET BACK DOWN TO AROUND 300 AGAIN.

OKAY.

SO, KEEP AT IT, AND YOU SHOULD BE ABLE

TO LOSE 20 POUNDS EACH MONTH.

OKAY, GREAT.

OKAY, SEE YOU SOON.

AND DON'T GIVE UP ON THE SHOES, OKAY?

OKAY. [ DOOR OPENS ]

[ SPEAKING INDISTINCTLY ]

Pauline: I THINK TODAY'S VISIT WENT OKAY.

DR. NOW WASN'T UPSET WITH ME,

BUT HE WANTS ME TO TRY HARDER.

I GET ALL OF HIS CONCERN FOR ME RIGHT NOW,

BUT IT'S JUST HARD TO DEAL WITH EVERYTHING EMOTIONALLY

THAT I'M SUPPOSED TO.

BUT ALL I NEED TO DO IS LOSE ANOTHER 20 POUNDS

TO GET APPROVED AGAIN.

SO IF I WORK HARD,

I KNOW I COULD DO THAT BY MY NEXT APPOINTMENT.

**

[ INDISTINCT CONVERSATIONS ]

-YOU LOOK SO PRETTY! -I LOVE YOU.

**

Joe: SO, THE DAY I DREAMED OF HAS FINALLY COME.

[ GRUNTS ]

AND I'M EXCITED, BUT I'M INCREDIBLY NERVOUS, TOO.

AND I CAN'T BELIEVE IT'S REALLY HAPPENING.

IT WAS JUST A YEAR AND HALF AGO

I FINALLY GOT APPROVED FOR MY GASTRIC BYPASS SURGERY.

[ SIGHS ]

SURGERY'S NEXT WEEK.

-NEXT WEEK? -YEP.

WHOA!

WE DID IT!

WE'VE WAITED SO LONG TO HEAR THIS HAPPENED,

AND IT'S FINALLY HERE. [ SNIFFLES ]

Joe: AND NOW MY LIFE IS A COMPLETE 180

FROM WHAT IT WAS THEN.

AND MY MOM WAS THERE FOR ME THE WHOLE TIME THROUGH IT.

**

[ SMOOCHES ]

Joe: IT MEANS THE WORLD TO ME

THAT SHE'S HERE WITH ME RIGHT NOW.

-HOLD STILL. -YEAH?

SOMETHING'S -- HERE. YOU NEED TO TUCK THIS PART IN.

[ SNIFFLES ]

Joe: THERE'S NO WAY I COULD HAVE DONE THIS WITHOUT HER.

**

I'M PROUD OF YOU, SON.

THANK YOU.

WELL, I COULDN'T HAVE GOTTEN THIS FAR WITHOUT YOU.

I LOVE YOU.

[ SNIFFLES ]

[ CRYING ]

**

ALL RIGHT, LET'S DO IT.

AS NERVOUS AS I AM, I'M JUST HAPPY

AND I'M READY FOR THIS HUGE STEP IN MY LIFE.

I HAD COMPLETELY GIVEN UP ON ANY CHANCE

OF EVER BEING ABLE TO FIND SOMEONE.

THAT'S JUST SOMETHING YOU GIVE UP ON

WHEN YOU'RE OVER 700 POUNDS.

**

BUT LOSING ALL THE WEIGHT AND MEETING SARAH

CHANGED ALL THAT.

**

Officiant: PLEASE BE SEATED.

DEAR FRIENDS, WE'VE COME TOGETHER

TO WITNESS THE MARRIAGE OF JOE AND SARAH,

TO SURROUND THEM WITH OUR PRAYERS,

AND TO SHARE IN THEIR JOY.

JOE AND SARAH HAVE WRITTEN THEIR OWN VOWS FOR THIS SERVICE.

[ SIGHS ] THE MOMENT I MET YOU,

I KNEW YOU'D BE SOMEONE I COULD RELATE TO.

I PROMISE TO LOVE YOU FOREVER

AND BE YOUR BEST FRIEND AND YOUR CLOSEST COMPANION

ALL OF THE DAYS OF OUR LIVES.

**

YOU HAVE TAUGHT ME WHAT IT TRULY MEANS

TO LOVE SOMETHING MORE THAN MYSELF.

YOU'RE THE ANSWER TO EVERY PRAYER THAT I'VE EVER PRAYED.

I LOVE YOU WITH ALL MY HEART.

**

SARAH, I GIVE YOU THIS RING AS A SYMBOL OF MY VOW.

WITH ALL THAT I AM AND ALL THAT I HAVE, I HONOR YOU.

I KNOW INTRODUCE TO YOU

MR. AND MRS. JOE AND SARAH WEXLER,

HUSBAND AND WIFE.

[ CHEERS AND APPLAUSE ]

Joe: IT FEELS LIKE I'M LITERALLY LIVING A DREAM.

IT'S JUST AMAZING TO ME. [ CHEERS AND APPLAUSE ]

IT'S LIKE I WAS TELEPORTED OUT OF MY LIFE

AND INTO SOMEONE ELSE'S,

BECAUSE I JUST CAN'T BELIEVE

THIS IS ALL HAPPENING TO ME.

Man: LADIES AND GENTLEMEN,

THE TWO HAPPIEST PEOPLE ON THE PLANET...

[ BOTH LAUGHING ]

I CAUGHT YA! ...SARAH AND JOE WEXLER!

[ CHEERS AND WHISTLING ]

Joe: THIS AMAZING LIFE IS MINE NOW,

SO I'M WILLING TO DO WHATEVER IT TAKES

TO BE THE MAN I NEED TO BE.

AND THAT INCLUDES MAKING SURE I GET A JOB

AND THAT I GET TO A HEALTHY PLACE WITH MY BODY

AND THAT I DON'T QUIT UNTIL I GET TO MY TARGET WEIGHT

AND HAVE ALL MY FINAL SKIN-REMOVAL SURGERIES,

BECAUSE SO MUCH IS RIDING ON IT.

THERE'S NO FOOD OR TEMPTATION GREAT ENOUGH

TO MAKE ME WANT TO RISK LOSING THIS LIFE I HAVE NOW.

**

Pauline: I'VE BEEN THINKING ABOUT WAYS

I COULD START TO FEEL MORE POSITIVE ABOUT MYSELF

AND HOW TO GET OUT OF THIS FUNK I'VE BEEN IN.

SO I STARTED TO MAKE A LIST OF ALL THE THINGS

I WANT TO IMPROVE ABOUT MYSELF TO FEEL BETTER,

AND MY TEETH HAVE BEEN A BIG ISSUE FOR ME.

I SPENT YEARS NOT TAKING CARE OF MYSELF VERY WELL,

AND THAT'S DAMAGED MY BODY.

AND MY TEETH ARE NO EXCEPTION.

WHEN YOU'RE 600 POUNDS,

YOU CAN'T EXACTLY GET UP AND GO BRUSH YOUR TEETH,

SO I WANTED TO GET THEM FIXED FOR A WHILE.

I NEVER SMILE BECAUSE I'M EMBARRASSED ABOUT MY TEETH,

SO I'M DOING SOMETHING ABOUT IT.

PAULINE? GOOD MORNING.

-YOU READY? -YEAH.

AND WHAT I THINK I'VE REALIZED IS

THAT I DON'T SEE MYSELF AS SOMEONE WORTH INVESTING IN

AS LONG AS I HAVE THIS WEIGHT ON ME.

IT'S LIKE I PUT MY LIFE ON HOLD

AND I'M TREATING MYSELF AS IF I DON'T DESERVE IT...

OR I'M NOT WORTH IT

UNTIL I LOSE ALL OF THIS WEIGHT OFF OF ME.

HELLO. HI.

HOW ARE YOU? I'M DR. ALANI.

HI. NICE TO MEET YOU.

YOU ARE PAULINE? YES, I AM.

WELCOME TO THE OFFICE. THANK YOU.

-HOW ARE YOU? -GOOD.

FEELING GOOD TODAY? A LITTLE NERVOUS...

OKAY. ...BUT I DON'T KNOW WHY.

I'VE NEVER BEEN NERVOUS,

BUT I JUST WORK MYSELF UP A LITTLE BIT.

YOU'RE AT THE DENTAL OFFICE. [ LAUGHS ]

SO, LET ME SHOW YOU WHAT WE'RE GOING TO DO, OKAY?

[ CHUCKLES ] OKAY, TURN TOWARD ME.

BITE DOWN.

YOU SEE THAT YOU'VE GOT A LOT OF DECAY HERE?

SO WE NEED TO TAKE OUT THE DECAY, BUILD THE TOOTH UP,

AND, ALSO, PUT A CROWN.

SO BASICALLY, WE'LL JUST CROWN

EVERYTHING THAT YOU HAVE EXISTING UP HERE.

AND THEN, I THINK YOU'RE GONNA LOOK REALLY GOOD.

YOU'LL BE EXCITED.

WHAT WE WANT YOU TO DO -- JUST RELAX.

YOU KNOW MY SHOTS DON'T HURT, RIGHT?

-YEP. -OKAY.

I'M GONNA GO REALLY SLOW.

JUST A LITTLE PINCH.

-YOU OKAY? -MM-HMM.

OKAY.

[ AIR RUSHING ]

Pauline: I'M GOING TO START DOING THINGS NOW

THAT MAKE ME FEEL BETTER ABOUT MYSELF.

THERE'S NO REASON I SHOULD BE WAITING ON THE SIDELINES

LIKE I AM

AND MAKING EXCUSES

BECAUSE I'M AFRAID OF FAILING.

SO I'M TAKING THIS STEP TO BE HAPPIER WITH MYSELF.

AND HOPEFULLY, THIS IS JUST THE FIRST STEP OF MANY

THAT I TAKE ON MY JOURNEY TO FIND THE POSITIVE.

OPEN BIG.

SO PRECISE.

NOW JUST STAY CLOSED.

DON'T MOVE. DON'T MOVE.

-HER BITE LOOKS REALLY GOOD. -IT DOES.

ALL RIGHT, DONE!

OKAY. SO, HANG ON.

WE'RE GONNA SIT YOU ALL THE WAY UP.

[ CHUCKLES ]

OH, MY GOD.

[ GASPS ]

[ Voice breaking ] THANK YOU SO MUCH.

[ CHUCKLES ] [ SNIFFLES ]

-YOU DID A GREAT JOB. -NO PROBLEM. OH!

IT'S GONNA BRING TEARS. WHERE'S KLEENEXES?

-[ Laughing ] I KNOW. I KNOW. -I'LL START CRYING.

IT'S JUST SO REWARDING TO SEE THE RESULTS.

IT REALLY IS.

I FEEL LIKE I'M JUST BEAMING, LIKE I CAN'T STOP SMILING.

-HIGH FIVE, GIRLFRIEND. -[ LAUGHS ]

OKAY. THANK YOU.

Pauline: I'D LOST MY SMILE,

AND I FIGURED IF I COULD GET THAT BACK

AND I START TO FEEL LIKE SMILING,

THAT'S GOING TO START TO HAVE AN EVEN BIGGER EFFECT

ON ME AND MY LIFE

AND HOW I SEE MYSELF AND THE WORLD.

I HAVE TEETH AGAIN.

WOW, THEY LOOK REALLY GOOD. [ CHUCKLES ]

AND I'M HOPING THAT, THE MORE I SMILE,

THE MORE THAT'S GOING TO BECOME CONTAGIOUS

AND IT'S GONNA START TO EVEN AFFECT MY WHOLE DEMEANOR.

**

Joe: SARAH AND I HAVE BEEN MARRIED FOR A MONTH NOW,

AND I'M LOVING EVERY MINUTE OF IT.

AND ONE OF FAVORITE THINGS THAT WE'VE STARTED DOING TOGETHER

IS TAKING WALKS A FEW TIMES A WEEK TO STAY ACTIVE.

REMEMBER THE LAST TIME WE WERE UP HERE?

OUR WEDDING DAY?

YEP.

AND WE LOVE WALKING IN THE PARK

WHERE I MET SARAH IN PERSON FOR THE FIRST TIME

AND WHERE WE HAD OUR FIRST DATE.

BACK THEN, I STILL WASN'T ABLE TO GET AROUND MUCH

AND I'D HURT MY KNEE COMING BACK UP THE STAIRS.

'CAUSE EVEN THOUGH I'D LOST A LOT,

I HAD SO MUCH WEIGHT ON MY BODY STILL,

I ALMOST COULDN'T HANDLE ALL THE WALKING.

SO IT'S FUN TO BE HERE

AND REMINISCE ABOUT OUR LIFE NOW COMPARED TO THEN.

-YAY! -[ GRUNTS ]

GOOD JOB, JOE!

[ LAUGHS ]

[ LAUGHS ]

**

ENGAGE. ALL RIGHT.

Joe: IT'S FUN WORKING OUT WITH SARAH

JUST BECAUSE HAVING MY SOUL MATE WITH ME,

IT MAKES ME FEEL GOOD

KNOWING THAT SHE'S THERE TO SUPPORT ME,

ENCOURAGE ME TO PUSH

THAT LITTLE BIT FURTHER AND LITTLE BIT HARDER,

AND KNOWING THAT, NO MATTER WHAT,

I HAVE HER THERE TO PICK ME UP IF I FAIL,

BUT, ALSO, SEE ME SUCCEED.

AFTER THE WEDDING, I OFFICIALLY MOVED UP TO IOWA.

AND WE WERE PLANNING ON FINDING A PLACE OF OUR OWN,

BUT IT'S TAKING A LITTLE LONGER FOR ME TO FIND A JOB.

AND WE'VE BEEN DISCUSSING A REALISTIC TIMELINE

WITH EVERYTHING BEFORE US.

THERE'S A LOT OF THINGS ON THE HORIZON,

SO WE TALKED ABOUT IMMEDIATE PLANS

AND EVERYTHING THAT I HAVE TO JUGGLE.

GETTING SKIN SURGERY IS A REALLY BIG DEAL TO ME.

IT'S SOMETHING I REALLY WANT TO DO,

BUT I CAN'T HAVE IT IF WE'RE MOVING

AND I'M STARTING A NEW JOB.

SO WE DECIDED THAT I'D HAVE TO HIT MY GOAL

OF GETTING UNDER 300 POUNDS

AND APPROVED FOR SKIN REMOVAL

AT MY NEXT APPOINTMENT IN A COUPLE OF WEEKS.

IF I DO, I'LL HAVE MY SKIN SURGERY.

AND THEN, WE'LL FOCUS ON ME GETTING A JOB

AND US MOVING OUT ONCE I RECOVER.

BUT IF I DON'T HIT MY GOAL THIS TIME,

THEN WE DECIDED THAT I'D WAIT AT LEAST A YEAR

TO GET THE SKIN-REMOVAL SURGERY.

SO I HAVE TO HIT MY GOAL, AND I'M DETERMINED TO DO IT,

BECAUSE IF I DON'T DO IT THIS TIME,

THEN I DON'T KNOW WHEN I'M GONNA BE ABLE TO.

**

Joe: SARAH AND I FLEW INTO HOUSTON TOGETHER

FOR A WEEKEND AWAY

AND SO I CAN HAVE MY NEXT DOCTOR'S APPOINTMENT.

HER MOM'S WATCHING HAYLEY,

SO WE'RE GONNA TAKE ADVANTAGE OF SOME TIME TOGETHER.

BUT, FIRST, I HAVE MY APPOINTMENT,

AND "NERVOUS" WOULDN'T EVEN BEGIN TO DESCRIBE

HOW I FEEL RIGHT NOW.

SO MUCH IS RIDING ON THIS WEIGH-IN

AND WHETHER OR NOT I HIT MY GOAL

TO QUALIFY FOR MY NEXT SKIN REMOVAL.

IT'S BEEN FOUR MONTHS

SINCE I'VE BEEN HERE TO SEE DR. NOW,

AND I WAS AT 365 THE LAST TIME I WAS HERE.

SO IF I STAYED ON TRACK, THAT WOULD PUT ME AT 265 TODAY.

BUT I'LL BE HONEST.

ALL I CARE ABOUT IS GETTING UNDER 300 POUNDS TODAY

TO HIT MY GOAL FOR SKIN REMOVAL.

-304. -YAY!

PROGRESS.

**

I'M JUST A FEW POUNDS AWAY,

BUT I HAVE NO IDEA

IF I'M CLOSE ENOUGH TO GET APPROVED.

[ KNOCK ON DOOR ]

Dr. Nowzaradan: HELLO.

HI, DR. NOW. HI.

-HOW ARE YOU ALL DOING? -DOING ALL RIGHT.

-HOW ARE YOU? -I AM DOING OKAY.

CONGRATULATIONS TO YOU BOTH.

THANK YOU VERY MUCH.

JOE, YOU'RE LOOKING GOOD.

THANK YOU, SIR.

SO, YOU'RE DOWN TO 304 TODAY.

YES, SIR.

WHEN I SAW FIRST TIME, YOU'RE SEATED THERE,

WOULD NOT RECOGNIZE YOU.

[ CHUCKLES ] NO.

I FEEL DIFFERENT, TOO.

WELL, ANY EXTRA SKIN BECOMING AN ISSUE FOR YOU?

YEAH, DEFINITELY THE LEGS.

IT'S, LIKE, RUBBING AND STUFF,

AND VERY UNCOMFORTABLE AND HURTING AND WHATNOT, SO...

SO, LET'S TAKE A LOOK AT YOUR LEG

AND SEE WHAT'S GOING ON WITH THAT.

SURE.

YOU'VE GOT A LOT OF EXTRA SKIN ON BOTH LEGS,

BUT MORE ON THE RIGHT, HUH?

YEAH.

I THINK WE CAN TAKE THE EXTRA SKIN OFF IN BOTH LEGS

AND MAKE THEM A LITTLE BIT MORE TIGHT AND SMALLER

SO YOU DON'T HAVE ALL THAT EXTRA SKIN IN YOUR WAY.

AWESOME.

SO I'M APPROVING YOU FOR SKIN SURGERY FOR BOTH LEGS.

AWESOME. THANK YOU.

ALL RIGHT, JOE. YOU'RE DOING GREAT.

SO I'M GONNA SET YOU UP FOR SURGERY NEXT MONTH.

OKAY.

AND I'LL SEE YOU IN THE HOSPITAL.

OKAY, SOUNDS GOOD. OKAY?

THANK YOU SO MUCH. NICE TO SEE YOU.

NICE TO SEE YOU AGAIN. THANK YOU.

ALL RIGHT. I'LL SEE YOU ALL LATER.

ALL RIGHT. THANK YOU.

Dr. Nowzaradan: JOE IS NOT COMPLETELY ON TRACK

WITH HIS MONTHLY GOALS,

BUT HE'S STILL MAKING GOOD PROGRESS,

IN SPITE OF ALL THE EVENTS AND RESPONSIBILITY

IN HIS LIFE NOW.

HE'S NOT LETTING THE STRESS GET TO HIM,

AND HE'S MAINTAINING A POSITIVE OUTLOOK WITH EVERYTHING.

SO I THINK HE'S GOING TO DO WELL.

Joe: I'M BEYOND EXCITED RIGHT NOW.

DURING THE WEDDING AND ALL THE EVENTS AROUND IT,

WITH ALL THAT FOOD,

IT WASN'T EASY, BUT I WAS DETERMINED.

AND NOW I CAN'T WAIT TO HAVE MY SURGERY.

I KNOW RECOVERY ISN'T EASY,

BUT I'M GONNA HAVE THE BEST WOMAN IN THE WORLD

TAKING CARE OF ME,

SO I'M READY FOR THIS.

**

Pauline: I'M CONTINUING ON MY JOURNEY

TO BE MORE POSITIVE.

WHEN I WAS AT MY HEAVIEST, I ALWAYS THOUGHT,

"IF I COULD LOSE ALL THIS WEIGHT,

ONE THING I WOULD GO WOULD BE TO HELP OTHER PEOPLE OUT,

OR TO JUST DO SOMETHING TO LIFT THEIR SPIRITS."

SO THAT'S THE NEXT ITEM ON MY LIST.

DILLON AND I HAVE MADE THESE LITTLE BAGS

WITH SOME FOOD AND ESSENTIAL ITEMS IN IT,

AND WE'RE GOING TO GO OUT AND JUST FIND PEOPLE IN NEED

TO GIVE THEM TO.

I KNOW WHAT IT'S LIKE TO BE IN NEED AND TO BE IGNORED.

IT'S FUNNY HOW INVISIBLE YOU CAN STILL FEEL AT TIMES,

EVEN WHEN YOU'RE 600 POUNDS.

PEOPLE EITHER STARE AND POINT OR IGNORE YOU,

AND BEING HOMELESS IS PROBABLY NOT A LOT DIFFERENT.

GOD BLESS YOU.

THANK YOU, MA'AM. I APPRECIATE IT.

YOU'RE WELCOME.

I KNOW HOW EASY IT IS TO END UP SOMEWHERE IN LIFE

THAT YOU NEVER THOUGHT YOU WOULD,

AND YOU START TO LOSE HOPE AND GIVE UP,

AND YOU JUST ACCEPT YOUR SITUATION.

WOULD YOU GUYS LIKE A TREAT BAG?

GOD BLESS YOU.

THANK YOU AGAIN, ALL RIGHT? THANK YOU.

YOU'RE WELCOME.

-HERE YOU GO. -OH, THANK YOU SO MUCH.

GOD BLESS YOU. THANK YOU.

THERE ARE SO MANY PEOPLE IN THIS WORLD

THAT WOULD GIVE ALMOST ANYTHING FOR A SECOND CHANCE AT LIFE,

SO ME DOING THIS TODAY REMINDS ME OF THAT.

IN A WEIRD WAY, DOING THIS IS HELPING ME

JUST AS MUCH AS IT HOPEFULLY HELPS THEM.

I'M TRYING TO BRIGHTEN THEIR DAY AND REMIND THEM

THERE ARE PEOPLE OUT THERE THAT SEE THEM AND CARE

AND NOT TO GIVE UP HOPE.

GOD BLESS YOU.

I'M SO BLESSED TO HAVE WHAT I HAVE,

AND I CAN'T LET MYSELF DO ANYTHING

TO TAKE THAT FOR GRANTED.

AND WHEN I GIVE IN AND EAT WHAT I SHOULDN'T,

THAT'S EXACTLY WHAT I'M DOING.

**

Joe: TODAY IS THE DAY

OF MY SECOND EXCESS-SKIN REMOVAL SURGERY.

TO KEEP LOSING THE WEIGHT

AND HAVE THIS PAINFUL MASS ON YOU, JUST PULLING YOU DOWN

IS MISERABLE TO LIVE WITH.

SO, NO MATTER HOW HARD THE SURGERIES ARE,

I'D TAKE THEM OVER A LIFETIME OF EXCESS SKIN ON MY BODY

IN A HEARTBEAT.

SO I'M REALLY HAPPY TO BE GETTING THIS OPERATION TODAY.

I JUST HOPE IT ALL GOES WITHOUT COMPLICATION.

Dr. Nowzaradan: TODAY, THIS EXCESS-SKIN REMOVAL

IS GOING TO HELP JOE TO BECOME MUCH MORE MOBILE

AND MAKE A SIGNIFICANT DIFFERENCE

FOR HIS OVERALL QUALITY OF LIFE.

BUT THIS OPERATION IS GOING TO BE A LONG ONE.

OKAY, STARTING THE FIRST INCISION.

SKIN REMOVAL IN THE LEGS

REQUIRES MORE ATTENTION TO SYMMETRY,

BECAUSE BOTH LEGS HAVE TO MATCH.

WE'RE PROBABLY GONNA HAVE TO TIE CLOSE TO 400 BLOOD VESSELS

BEFORE WE GET THROUGH,

AND THE BIG CHALLENGE WILL BE, IF ANY OF THEM GET LOOSE,

HE'S GONNA HAVE A BLEED.

AND THAT'S GONNA BE A SERIOUS PROBLEM,

SO WE NEED TO WATCH FOR THAT.

**

Sarah: I HAVE BEEN A NERVOUS WRECK ALL DAY.

THE WORST PART, I THINK,

IS NOT KNOWING EXACTLY WHAT'S GOING ON

AND NOT BEING ABLE TO SEE HIM.

AND I'M A LITTLE WORRIED IF THERE'S GONNA BE COMPLICATIONS.

JOE MEANS EVERYTHING TO ME,

SO I'M TRYING TO BE OPTIMISTIC

THAT EVERYTHING IS GONNA GO AS PLANNED.

Dr. Nowzaradan: AFTER THIS OPERATION,

IT WILL TAKE JOE ABOUT A MONTH AND A HALF TO TWO MONTHS

TO FULLY RECOVER

BECAUSE ANY REMOVAL ON THE LEGS IS A VERY DIFFICULT RECOVERY.

BUT ONCE HE RECOVERS,

HE WILL BE VERY HAPPY WITH THE CHANGES IN HIS BODY.

AND WE'RE DONE.

JOE'S SURGERY WENT VERY WELL TODAY.

Man: HEY, JOE, WE'RE ALL DONE.

SO, THIS IS THE SKIN WE TOOK OFF OF HIM.

IT'S A LITTLE BIT OVER SEVEN POUNDS.

AFTER THIS OPERATION, JOE SHOULD BE UNDER 300 NOW.

HE STILL NEEDS TO LOSE AROUND 100 POUNDS

TO GET TO HIS TARGET WEIGHT,

AND HE WILL NEED A COUPLE MORE SKIN REMOVALS STILL.

BUT HIS RECOVERY IS NOT GOING TO BE EASY.

BUT I HAVE NO DOUBT THAT JOE IS GOING TO GET THROUGH IT.

**

Pauline: DILLON AND ME ARE IN GALVESTON

BECAUSE WE ARE GOING ON A DOLPHIN SIGHT-SEEING TOUR.

**

I'VE NEVER BEEN ON THE WATER,

AND I'VE NEVER SEEN DOLPHINS UP CLOSE.

AND IT'S SOMETHING I'VE ALWAYS WANTED TO DO,

SO I'M DOING IT.

AND THIS IS ANOTHER THING I WAS WAITING TO TRY AND DO

AFTER I GOT TO MY TARGET WEIGHT,

BUT I'M DOING IT NOW.

IT'S NEXT ON MY JOURNEY TO DO THE THINGS I'VE DENIED MYSELF

AND TO BECOME MORE POSITIVE THROUGH THAT.

SINCE I'VE DECIDED TO START DOING THESE THINGS,

I'M NOT LIVING IN FEAR.

I DO FEEL I'M NOT AS DOWN WHEN I START EACH DAY.

SORRY.

IT'S NOT THAT I'M NOT STRUGGLING RIGHT NOW

OR THAT I'M NO LONGER LIVING IN ANY SHAME OR FEAR.

BUT I DO FEEL AN IMPROVEMENT,

AND THAT HAS HAD AN EFFECT IN EVERY ASPECT OF MY LIFE.

SO I'M REALLY PROUD OF MYSELF.

AND IT'S SLOW, BUT I'M GETTING THERE.

**

I'VE LIVED IN SHAME FOR SO LONG, AND I DIDN'T REALIZE IT.

IT WAS JUST FEAR TO ME,

AND I DIDN'T THINK I DESERVED

TO HAVE THE LIFE THAT I WANTED.

AND I'M WORKING ON CHANGING HOW I SEE MYSELF.

I'M GLAD I CAN SEE THAT STARTING TO CHANGE IN ME,

AND THAT IS GIVING ME HOPE.

Dillon: IT MAKES ME PRETTY HAPPY

THAT SHE'S TAKING THESE STEPS AND PROGRESSING FURTHER

AND DOING STUFF THAT SHE HASN'T BEEN ABLE TO DO.

AND I DIDN'T THINK SHE WAS EVEN GONNA BE ABLE

TO MAKE THIS STEP TODAY, BUT IT'S PRETTY EXCITING.

[ Voice breaking ] A DAY LIKE TODAY MAKES ME, UM...

REALLY GRATEFUL THAT I MADE THIS MOVE, YOU KNOW?

I'M REALLY HAPPY. [ SNIFFLES ]

IT WAS A BIG STEP TO UPROOT MY KID

AND MOVE FROM ANOTHER STATE

AND LEAVE ALL MY FRIENDS AND FAMILY,

AND IT'S BEEN HARD.

BUT I THINK I WOULD DO IT AGAIN.

I FEEL LIKE NOW THAT I'M ON THE GOOD SIDE OF IT

AND ALL THE BAD IS BEHIND ME,

AND I FEEL LIKE THERE'S NOTHING BUT GOOD TO COME.

**

TODAY, I'M HEADING BACK TO SEE DR. NOW

TO SEE IF I'M MAKING PROGRESS AGAIN.

I HAVE NO IDEA WHAT THE SCALE'S GONNA SAY.

I'M HOPING I'M BACK ON TRACK LIKE I THINK I AM.

I'VE HAD TO MISS A COUPLE OF APPOINTMENTS WITH DR. NOW,

BUT I WAS AT 321 THE LAST TIME I WAS HERE.

SO I SHOULD BE DOWN TO 221 IF I STAYED ON TRACK,

AND I'M JUST HOPING I'M DOING BETTER THIS TIME.

I THINK SO.

HELL, YEAH.

YOUR SCALE'S WRONG, OR I LOST A LOT OF WEIGHT.

[ CHUCKLES ]

IT'S NOT NEAR DR. NOW'S GOAL, BUT I'M LOSING MORE WEIGHT.

AND THIS IS THE FIRST TIME SINCE I WAS A CHILD

THAT I'VE BEEN IN THE 200s,

SO I HOPE HE'S HAPPY WITH THAT.

AND HOPEFULLY, I'M IN A GOOD PLACE AGAIN

TO GET APPROVED FOR MY EXCESS-SKIN REMOVAL.

TWO YEARS AFTER A WEIGHT-LOSS SURGERY,

YOU REALLY HAVE TO WORK HARD FOR EVERY POUND YOU LOSE.

SO FOR 29 POUNDS TO JUST FALL OFF THAT EASY,

I'M JUST FLABBERGASTED.

[ KNOCK ON DOOR ]

HELLO. HELLO.

HOW ARE YOU ALL DOING? GOOD.

HOW ARE YOU? I'M DOING OKAY.

SO, I SEE YOU LOST SOME WEIGHT TODAY.

I LOST A LITTLE BIT. YES, I DID. [ CHUCKLES ]

SO, HOW DO YOU FEEL?

IT FEELS GOOD.

I FEEL LIKE I'M A LOT BETTER

AND I'M A LOT MORE POSITIVE ABOUT THINGS.

SO, THAT TELLS ME THAT, IF YOU WANT TO,

YOU CAN LOSE WEIGHT AND STICK WITH YOUR DIET, HUH?

-YEAH. -THAT'S GOOD.

SO, LET ME SEE YOUR EXCESS SKIN ON YOUR STOMACH.

ALL RIGHT. SO, IT'S LOOKING VERY LOOSE.

OKAY, ALL RIGHT.

SO, YOU'RE DOING GOOD, AND YOU'RE MAKING PROGRESS.

SO, I THINK YOU'RE READY ONCE MORE

FOR EXCESS-SKIN REMOVAL.

SO I'M APPROVING YOU FOR THAT.

-OKAY. -OKAY?

I'M SCHEDULING YOU FOR THE NEXT MONTH,

AND WE'LL DO THE OPERATION THEN.

SO, IT'S THE SAME DEAL AS LAST TIME.

IF YOU GAIN, I'LL CANCEL IT.

SO, DON'T LET THAT HAPPEN, ALL RIGHT?

-KEEP IT UP. -ALL RIGHT.

-YOU'RE DOING GREAT. -THANK YOU.

I'M PROUD OF YOU.

Dr. Nowzaradan: I'M HAPPY TO SEE PAULINE IS LOSING MORE WEIGHT

AND FEELS MORE POSITIVE ABOUT THINGS,

BUT SHE HAS HAD TIMES THAT SHE WILL START TO LOSE,

AND SHE GAINS AGAIN.

SO NOW THAT SHE IS HEADING IN A GOOD DIRECTION AGAIN,

SHE NEEDS TO MAKE SURE SHE MAINTAINS IT

BECAUSE THIS COMING YEAR IS GOING TO BE PIVOTAL FOR HER.

IF SHE STARTS FALLING BACK INTO OLD HABITS

TWO YEARS AFTER SURGERY,

HER BYPASS WILL START TO FAIL.

AND THIS NEXT YEAR

WILL BE EITHER THE YEAR THAT SHE MAKES IT TO HER GOAL

OR WILL BE THE YEAR

THAT SHE WILL GAIN ALL HER WEIGHT BACK.

SO I'M HOPING THIS POSITIVE CHANGE IS HERE TO STAY FOR HER.

Pauline: I'M REALLY HAPPY RIGHT NOW.

I'M FAR FROM WHERE I NEED TO BE, BUT FOR THE FIRST TIME,

I BELIEVE THAT I NOT ONLY CAN GET THERE,

BUT THAT I DESERVE TO BE WHERE I WANT.

AND EVEN IF I'M NOT, I SHOULDN'T LIVE LIFE IN THE FEAR I HAVE.

MY LIFE IS CHANGING FOR THE BETTER DAY BY DAY,

AND "THE FAT GIRL" IN ME IS DEAD

BECAUSE SHE'S LOST HER VOICE.

THE PERSON I WANT TO BE IS WHO HAS A VOICE IN MY LIFE,

AND I'M ONLY LISTENING TO HER NOW.

AND I CAN HEAR HER LOUD AND CLEAR.

**

Joe: IT'S BEEN AROUND SIX WEEKS SINCE MY SURGERY,

AND I'M STARTING TO FEEL LIKE MY OLD SELF AGAIN.

IT HASN'T BEEN AN EASY RECOVERY,

BUT I HAD SARAH BY MY SIDE THE WHOLE TIME,

TAKING CARE OF ME,

SO I WAS IN GOOD HANDS.

AND I CAN'T BELIEVE HOW MUCH EASIER IT IS TO GET AROUND

WITHOUT ALL THE EXCESS SKIN ON MY LEGS,

SO I'M LOVING HOW I FEEL RIGHT NOW.

AND WITH THE EXCESS SKIN REMOVED AND MY CONTINUED WEIGHT LOSS,

I'M DOWN TO 287.

AND I'M JUST ENJOYING GETTING BACK

TO BEING A HUSBAND AND A FATHER.

I'M JUST SO THANKFUL FOR ALL THE JOY IN MY LIFE.

AAH!

[ LAUGHTER ]

OH, AND BY THE WAY -- YOU'RE IT.

-WHOO-HOO-HOO! -[ LAUGHS ]

I FEEL COMPLETE NOW.

WHEN BEFORE, I WAS WILLING TO JUST LET MYSELF DIE

BECAUSE I HAD NOTHING TO LIVE FOR AND I HAD NO LIFE,

AND NOW I HAVE EVERYTHING TO LIVE FOR.

BUT THERE'S NO TIME FOR ME TO SLOW DOWN

BECAUSE I STILL HAVE A TARGET WEIGHT TO GET TO

IN THE NEXT SIX TO EIGHT MONTHS.

**

AND RIGHT NOW, I HAVE WORK TO DO.

I WAS ABLE TO START A JOB AS AN I.T. SPECIALIST,

AND SARAH AND I ARE STARTING TO LOOK FOR PLACES OF OUR OWN.

BUT WE HAVEN'T FOUND THE PLACE YET.

WE WANT IT BIG ENOUGH TO GROW OUR FAMILY

AS WE GET TO THE PLACE TO MAYBE HAVE ANOTHER CHILD.

JOE, I ASSUME?

HI. HOW'S IT GOING?

GOOD TO SEE YOU GUYS.

HI.

Joe: DEFINITELY ENJOYING THE PROCESS OF LOOKING FOR A HOUSE.

WANT TO CHECK OUT THE BACKYARD?

-SURE. -SURE.

IT'S A LITTLE STRESSFUL TO THINK ABOUT THE FINANCES,

BUT I'M GONNA WORK ON THAT

AND MAKE SURE MY FAMILY HAS WHAT THEY NEED.

THE JOB I HAVE NOW ISN'T THE HIGHEST-PAYING JOB,

BUT THERE'S A LOT OF POTENTIAL TO GROW IN MY ROLE.

AND I KNOW THERE'S A LOT TO DO IN THE NEAR FUTURE,

AND THAT ALL OF IT'S NOT GONNA BE EASY.

BUT I GET TO DO IT WITH SARAH AND HAYLEY,

AND WITH THEM, I CAN FACE ANYTHING.

I CAN DEFINITELY SEE HAVING DINNER AS A FAMILY HERE.

MM-HMM.

SO, WHAT DO YOU GUYS SAY

WE CHECK OUT THIS PLACE THAT'S NOT TOO FAR FROM HERE?

-SURE. -SURE, YEAH.

I'M NOT TAKING ANY PART OF MY NEW LIFE FOR GRANTED

EVEN FOR A SECOND.

TO FIND SOMEONE TO LOVE LIKE I LOVE SARAH

IS AN AMAZING THING.

I GOT MY PERFECT SOUL MATE ALREADY

AND PERFECT LITTLE 8-YEAR-OLD KIDDO.

NOW WE JUST NEED A PLACE TO CALL OUR OWN.

AND WE'LL SETTLE DOWN,

AND WHO KNOWS WHAT THE FUTURE HOLDS FOR US?

I JUST WANT A PLACE FOR US

WHERE I WANT TO BE ABLE TO GROW SARAH A GARDEN.

SHE WANTS FLOWERS --

LILAC BUSHES AND ROSES AND STUFF.

THAT'S SOMETHING I WANT TO DO FOR HER.

Sarah: I COULDN'T BE HAPPIER ABOUT LIFE WITH JOE.

AND I'M SO PROUD OF HIM

NOT BECAUSE OF ALL OF HIS PROGRESS,

BUT BECAUSE OF THE MAN HE IS.

AND I KNOW WE'RE GONNA HAVE A GREAT LIFE TOGETHER.

Joe: I'M MORE MOTIVATED THAN EVER,

AND I'M NOT LETTING ANYTHING GET IN THE WAY

OF ME BEING THE BEST HUSBAND AND FATHER I CAN BE.