Original subtitles

[Julian] When I look in the mirror, I feel disgusted.

I mean, why would you get this way, you know, look what you've become.

Please! Just a little glimmer of hope.

I just want to be a normal person.

[breathing heavily]

You can't do it and then I just get mad.

If I don't make a change now, I'm scared it's gonna be too late.

[groaning] No! It hurts!

I refuse to stop fighting. I have to do this for my children.

[Julian] It's basically my nightmare.

It's a pinche tornado.

- Baby, we can't take all the boxes. - We have to!

[Julian exhales]

[Julian] My life has been seriously impacted

because of how high my weight is now.

With how big I am, it's hard to do much of anything.

With all the weight that's just on my legs,

each step I take is painful for me now.

So I have to go slow to manage them.

So that I don't get out of breath.

Because that can lead me to passing out.

So my breathing is limited. So I have to be careful to just do anything.

So I only get up for limited things really.

The main one being to cook. That's one of my passions.

And it's something I'm good at.

So, usually what I do when I first get up is make breakfast with my wife.

[Irma] Julian's probably the best cook I know.

I mean, I love everything he makes for me.

But I would have to say that my favorite meal that Julian cooks for me,

it's salmon when he cooks it in butter

and then he makes asparagus next to it and brussels sprouts

[Irma] He's very good at making meals that taste good.

But getting more worried about him.

So I do want him to eat better.

But the dynamic right now is that he makes whatever he wants

and that's what we eat.

[Julian] Me and Irma also live with my grandmother and my mom.

So I also cook for them at times too.

But I mostly cook for Irma. Because we're always together.

I wait until around 12 o'clock to eat lunch

and then I'll snack until dinner.

But I feel the best meal of each day is usually the first.

Once I have that ready, I have a lot of excitement about it.

Because it's something that brings me great pleasure and happiness.

Eating is a big joy to me in my life.

Because it's a time when nothing bad can touch me.

Eating makes me feel better, so there's no moment in my day when I'm not wanting that.

And eating is an activity I do most of the day now.

So, food has a central point in my life and it's what I follow.

And I know it's what led me to decide that I am now.

Oh, that was good.

- All right, you want to take the plate? - Yeah.

[Julian] But even knowing that hasn't slowed my eating down.

But I know I need to somehow.

Because how difficult it is now to do the things I need.

But I try to do all that I can on my own still, you know.

Because it makes me feel less of a man when Irma has to help me.

[Julian exhales] Okay.

[Irma] Julian has gotten to a point where I have to help him in ways

that I know he wishes I didn't.

I'll call you when I am ready for you to do my back.

I'll come.

[Irma] Like, with showering and then if he uses the restroom.

I might have to help him with that too.

But I know that it hurts him that I have to do that, you know.

[shower hisses]

I do think that Julian gets embarrassed.

On asking me to, like, to help him wash his backside.

Like, he does try to do as much by himself.

But I'm just afraid that he's going to push himself too hard,

and get hurt.

That's one of my fears.

- Babe! - Yeah.

- Can you come clean my back? - Yeah.

[Julian] I wish I can do more on my own,

but sometimes, I have no choice anymore.

And I hate that I'm like this now with my body.

And how I let it get like this.

When I look in the mirror, I feel disgusted.

I feel like, "Why would you get this way?" You know?

"Wow, look what you've become."

So, food has made me get like this.

But it's something that's helped me through a lot of bad in my life.

And it's been like that for a long time.

- Is that it? - Yes.

[Julian] Things were good for my early life.

I grew up with my mom and my two younger sisters.

And we had the best of times that we can make it, you know,

growing up in Detroit, Michigan.

My father wasn't part of the picture.

And so my mom had three jobs just to put a roof over our head.

But we didn't have a lot.

And a lot of times, me and my sisters

didn't know when the next time we was going to get food.

So when we finally did get food, I ate a lot of it.

So food started to be a comfort for me.

Because if I had it, I felt better.

But I really didn't start my gaining until my mom married my stepdad.

He treated us nice at first, but he was a mean person.

Like, who he really was started to come out.

So it turned into a nightmare, having him as a stepdad.

I think Julian, he always felt like he was the man of the house.

But then he had to fight the battle

of being not the man of the house because the husband came in.

So they had their little battles.

[Julian] But I had tolerated him.

And one of the main ways I knew to do that was to eat.

And that's when my eating got worse and I started to gain weight.

From being around 50 to 60 pounds when I was seven,

to being and 170 pounds when I was 10.

That's when I started to stand out as "the big kid."

So I started getting bullied and beaten up.

So, middle school was a terrifying place for me.

So I ate a lot to deal with the bullying through middle school.

And that just made me bigger.

And so I was around 400 when I started high school.

That's when things started to change.

Because in high school, that weight came as an advantage in football.

Because I was a big guy, I was football ready.

So when I started doing that, I didn't get picked on or bullied as much.

So that made school better for me.

And for a while, you know, they didn't know me as that fat kid.

They knew me as the kid that played football.

But my size also helped me at home

because things kept getting worse at home with my stepdad.

You know, he tried to beat me with a bat one day when I was 17.

That's when I realized, you know, I was bigger to him now

and I saw that as a positive.

But when my mom found out,

she said, "Well, this can't happen and you're gonna have to go."

And I was like, "Oh, so you're kicking me out for him?

And he the one who's beating me with the bat?"

And she was like "No, I'm not doing it for him, I'm doing it for you."

She feared for my safety at that time, so she kicked me out of my home.

So then we called my grandma and she was like, "Get him on a bus.

I'll pay for it right now. He'll stay with me."

And in three days, I got to Arizona.

I hated Arizona, and I was upset against my mother, you know.

Because she was the one who caused me to lose everything.

My school, my friends and football.

And it was hard for me because I was alone and starting over.

But when I was eating, that's when the hatred of Arizona went away.

'Cause I was able to just eat.

So I've gained up to 540 by the time I finished high school.

But eventually, my step dad would get arrested on a gun charge.

And he spent a good three years in jail.

Right after that, my mom and my sisters moved down.

And I felt like at that time, when I was about 20, 21,

we started to be a family again.

Just me, my mom and grandma and my sisters.

Felt a lot of responsibility to them at that time.

So I took it upon myself to get into a trade.

So I got my certification to become an electrician.

And I ended at the top of my class when I graduated.

And because of that there was a really good electric company that was willing to hire me.

But when they saw me,

they didn't offer me the position. Because of my weight.

I had to take another job, and it was a call center.

I ended up just going back to my old eating habits.

So, you know, I was up to about 580 pounds over the next year.

I was like 23 then, but I did also want to try to meet someone.

And I tried to better myself for that.

So I was starting working out.

But the working out led to me getting a hernia.

So that was another disappointment for me.

But I didn't let that stop me from dating.

I did think to myself that my weight problem could be an issue.

Me personally, I never thought I would have found a wife anyway.

But I did.

And, it was the best thing that ever happened.

When I found my wife, I just knew she was the one.

My first thought when I met Julian, I wanted to hug him.

I always tell him "I just wanted to tell you I love you right then and there."

And I'm like you probably would have thought that I was like a psycho or something.

But yeah.

- I'm gonna go ahead and get the grill started. - Okay.

[Julian] Around that time, I lost my job

because they were discriminating about my weight.

And I was on the verge of losing my apartment.

I had nothing to offer for their security at that moment.

But I asked her to move in with me. And she did that.

At the time, her grandad, he didn't like me very much.

Irma was his first grandbaby.

And you know, this new man coming into your family.

I can understand his hesitation to me.

But what I didn't understand was when I stayed the night,

he must have just got pissed off,

and cussed me out royally in Spanish.

I didn't think I did anything wrong, so I left.

I didn't expect her to choose me over her family,

but 20 minutes later, while I'm waiting at the bus stop,

she comes running right after me.

And she's like, "I'm going with you. He's not about to do this."

That's when I knew she was going to be my wife.

So we got married,

but we couldn't have the wedding that we wanted.

Because of my size.

Since then, I continued to gain even more.

I crossed into the 700s.

And I was 790.

So my weight has taken every bit of my life away.

But the biggest is that it's keeping me and Irma

from having a family of our own.

You know, at my size, my chance to have kids could pass me by.

And that's the most heartbreaking for me.

So, I know I have to lose the weight.

But that's easier said than done.

My life revolves around what I'm going to eat next.

It's what drives me through the day.

But I'm getting very scared about how much time I have left at this size.

And I know Irma is getting scared for me too.

- I checked on the potatoes, they are not done yet. - Okay.

[Irma] I'm scared that I could lose him if he doesn't do something about it.

I want to grow old with him. I don't want to grow old with anybody else.

But I'm so scared right now that one morning I will wake up

and he won't.

[Julian] I tell Irma that I want to lose weight as much as she tells me.

And I know she has other fears about it.

You know, she also scared about me losing weight too.

Just to the simple fact that she thinks I'm gonna leave her for somebody else.

But I'm not.

[Irma] It's hard not to be afraid that things will change if he doesn't need me anymore.

[Irma speaking]

[Julian] I love you too.

[Irma] Once he loses the weight, and I tell him that fear,

well, he's all like, "Babe, I am not going to leave you."

He's all like, "Just because I get smaller does not mean

that I'm not gonna wanna be with you, like, I'm not about to do that to you."

[Irma] But it's still a fear, even if it is a stupid one.

But even if he did, you know, I would rather him be alive.

So I do hope that he is able to lose his weight.

Even if he doesn't, I'll tossing him to the side.

- You want me to help you with the plates? - Yeah.

[Irma] Well, just hand me mine, you can take yours.

[Julian] I'm looking to change to be a better husband.

Because I know I'm letting Irma down.

Because I promised her something better when we got together.

He knows how sad I feel that we can't go out on date nights.

Because I vent it to him all the time.

But he won't go out. I mean, if he does it's for food, not me.

And that's upsetting.

- Was they finished? - Yeah. I'm fixing them now.

- All right, I like a lot of sour cream. - I know.

[Julian] So with the breaking point I'm getting to,

I'm going to go out of my comfort zone to try to get help from Dr. Now.

Irma has been pushing me to do that.

And I know I'm at a point where that's the option I need.

So I'm going to try to go to him and get his help.

I just have a lot of worries still about my ability to succeed.

You know, I'm ready to do what I have to.

If somebody can give me guidance.

And help intervene with something like weight loss surgery.

If I can have the chance for that path,

then I'm ready to do whatever it takes to make it happen.

So I can make for a better life for me and Irma.

Here, take this too, cause I'm not eating it.

Honestly, our intimacy has changed a lot.

[Irma] We can't be together, like, we were because he's too big,

I mean, like, I really do love him.

But it frustrates me to the core that he has not lost the weight yet.

Because I have no doubt that he can do it if he really wanted to, you know.

And I need him to start trying before it's too late.

[Julian] I know the odds of something very bad happening to me.

So I tell myself everyday.

You know what, "Forget the dangers outside.

I'mma just go ahead and get up at 6:00 in the morning and go walk."

And start eating right like I should be doing.

But then I wake up and I give in right away.

Because the cravings are too strong, you know. It's too much for me.

But that has to change now. Because I know I need help to lose all the weight.

And I know if I don't get it, I'm not going to make it.

And I'm hoping that Dr. Now will it be able to give me the help I need.

Because if I don't get that, I'm very scared about the future.

And what's gonna happen to me soon.

I'm nervous about this trip, this long ride.

Thanks for taking me.

- I love you, boo. - I love you too, baby.

[Julian] Today, we're gonna start heading to Houston.

And me and Irma are just looking at our route we're gonna have to take.

And how long it's going to be for me on the road.

And that's my first fear. Being shoved into a small space for a long time.

And how that's gonna be on my whole body?

And then also just all the things that could go wrong.

I almost had a panic attack. Thinking about, like...

[Irma speaking]

I was just thinking about... What if something happens? on our way there.

We in the middle of the road and I gotta be rushed to the hospital.

Something happens to me on the road and I get stuck, like...

You know, I have a huge panic attack where I think I'm having a heart attack.

Or I can have a natural heart attack.

And not have any help nearby because there won't be an ambulance

that I can fit in, in an emergency.

That's the most thing I'm afraid of.

You know I'll be thinking.

- I think the luggage is in the refrigerator. I mean-- - In the refrigerator? [laughs]

- In the closet sorry. - All right, baby.

[Julian] This is scary. But I know it's a fear that I have to face.

Because there's no help for me here.

- If you could grab my shoes. - Okay.

[Julian] So my only option is to go where there is help.

And that means I have to travel what looks to be a 15 hour drive

according to the maps.

It's just gonna be very hard on me.

Even doing what we have to do to get packed, I'm getting sore, you know.

Already my legs and back is hurting.

So I'm just worried about how this is gonna go.

- Okay. - Okay, push it down.

But I'm hoping by doing this I get the help I need from Dr. Now.

[Irma] Julian is very afraid right now.

He's had some panic attacks throughout the night, worrying about the trip.

About, what could go wrong.

But I've been trying to calm him

and telling him that everything's gonna be okay, you know.

- That's good. - We did it.

I feel like it's going to be very tiring.

And I know being in the car for that long, it's going to be hard for him.

But I know he can do this and will be okay.

I think what he's worried about the most is

that we are going to make it all the way to Houston and once we get there,

Dr. Now is going to reject him because of his hernia.

[Irma] That's his big fear. But I'm not worried about that, you know.

I'm just glad Julian is doing this and he is trying for this help.

I'm feeling optimistic about the appointment with Dr. Now.

I do have good hopes. Hopefully he is able to tell him

like "You know what, yeah, let's go ahead and get you approved."

I know it might not happen on the first try, but,

and hopefully he'll just like say yes.

And hopefully there is no medical emergencies or no car emergencies or anything.

And just wanna have a good trip.

[Julian] My plan is to sit in the back and get as comfortable as I can.

I'm making a little palace so I can lay down.

And try to stretch out to keep as much strain off my body as I can.

[Irma] You're gonna come in through here, Baby?

- No, I'm setting up all the pillows. - Oh okay.

[Julian] So we can keep going as long as possible.

Our goal is to go between six to eight hours at a time with as few stops as possible.

- You need help now? - No. I'll get in.

[Julian breathes heavily]

[Julian] So we can get there in two days.

But that all depends on how I'm handling the trip.

[Julian breathing heavily]

- Do you need me to get my seat up? - [Julian exclaims] No.

- You sure? - [panting] No. I'm okay.

[Julian] And how Irma is handling the driving

because it's all on her for that, you know.

And I wish I can drive too, myself,

but if everything goes well, I should be behind the wheels soon.

[Julian breathing heavily]

[sighs heavily] Oh God.

[Irma] I know, baby.

Trust me, it will be all worth it, my love.

Okay.

I'mma try to just listen to my music in my headphones,

try to keep myself calm.

[Julian] Okay. Go ahead.

And depending on how my body is doing,

see how far we can make it before we have to stop and rest.

I'm already exhausted, but I'm gonna try to hold out as long as I can like this.

You know it's tight, but I think I can manage.

Our plan is to be able to get there in two days if I can handle that.

But we added an extra day in case I need a little more time.

So my appointment is in four days,

and if it all goes well, I'll have a full day of rest in Houston.

But we'll see!

- [Irma] How you feeling, my love? - My butt is getting numb.

You said we have about 20 minutes left?

Now we have 11 minutes.

- I'm pretty sure tomorrow will be longer. - Yeah.

- That's when the real test of time will come in. - Oh yes, sir!

[Julian] I made it as far as I could,

but my whole lower body is in a lot of pain.

So I need to get out and rest before we can continue.

- I just need your help with getting my shoes on. - Okay.

[Julian groans]

[panting]

- My baby, you're all sweaty. - Yeah. It is hot.

[Irma] Watch it with the door. It's really heavy.

Oh, there you go.

- Oh, this is nice. - It is nice.

[Julian sighs heavily]

Oh! Oh, yes! [Julian exhales]

[Julian] What do you think this guy's gonna say?

I don't think he's gonna say a lot, baby. I think he's just gonna say like, 750?

I wanna say 752.

Like, what if the scale is more than what we think it is?

- Like... I know baby. - That's gonna be a shocker, you know.

I am not letting you mess this up, baby. Hell no!

Like, I know, that he ain't gonna approve you "right now" right now.

No, no.

- But I mean like the next time, you have no excuse. - Yes, ma'am.

[Julian breathing heavily]

Valentine?

[Julian] It's been awhile since I was on a scale,

but my highest weight I've been at was 798.

I'm hoping I'm down closer to the 750s and not still in the 790s.

If I had to guess, I think his weight is probably like, around 730, maybe.

[Julian] So I'm looking for some weight loss right now.

Okay, you can step up on the scale.

Because the bigger I am, The less I have time to change things.

[Julian] I'm at Dr. Now's, for my first appointment.

And I'm about to find out what my weight's up to.

Your weight is 830.

[Julian] That's crazy.

- We're going to Room 5. - Okay.

[Julian] I was scared that I was close to 800,

and now I find out I'm over that amount.

So it's worse, and I know that's hard for Irma to absorb.

And I know it's just a shock for her. It's a shock for me, too.

[Julian speaking]

[knock on door]

-Hello, how are you'll doing? -We're doing good. how you doing?

- [Dr. Now] Good! - Good.

- All right, you must be Julian? - Yes.

- And who is this with you today? - My wife, Irma.

- Hi. - All right, nice to meet you guys.

- You are coming from Arizona? - Yes.

- Tucson, Arizona? - Mm-hmm.

Well, you are 830 pounds. So doing all that puts a lot of strain on your body.

So that's gonna be as issue with you coming here.

But before we get into all that,

tell me what brought you all the way here?

I want to take control back of my life and I hope I can get this weight loss surgery.

Well, doing surgery on someone your size is going to be difficult.

- But listen. Your BMI is 112. - Yes.

And, do you know what the normal BMI is?

I think around 60.

- It is 18 to 25. - Oh! 18 to 25.

So, you're way over that.

And you're almost the highest BMI we have seen.

- And you are what, 33 years old? - Thirty-three.

Okay. You know the risk of people have a sudden death

- with this BMI is very high. - Yes.

So every day you wake up is the roll of the dice.

- Whether that day will be that your heart is gonna give up... - Mm-hmm.

And if it does, there is nothing anybody can do to resuscitate

or bring you back.

- Yes. - Okay.

- Your body is made to be 200 pounds. - Yes.

And you're 800. You're killing yourself with food for a while now.

And you still haven't stopped overeating.

So what is different today after 33 years that's gonna make you change

that hasn't, up to today?

[Julian sighs]

Um, I wanna have children.

Okay, well, that's good then. But then the question is,

why haven't you tried to change to have kids before now?

I have. I just couldn't stick to it.

So, your gonna stick with it?

- I'm sticking with it 110%. - That's what your telling me?

- I'm telling you I'm sticking with it. - Okay.

Well, I hope that's true because if you continue like that,

then you won't be around much longer.

- You understand that? - Yes.

- So, at this point, since you live so far away... - Mm-hmm.

I don't want you to come back until you lose the weight loss goal I'm going to give you.

Because there is no reason to put that strain on your body

if we're not gonna move ahead with you.

So, we'll set up an appointment at a clinic in Tucson for you

to get your weight checked.

And if you've made it to your goal,

then, the next step is you're gonna have to move down to Houston to do the program.

So, is that something that you can do?

[both] Yeah. We can do that.

Okay, I'm gonna give you instructions that will show you

- how to lose 100 pounds in two months. - Two months.

So, you're gonna have a diet that is low-carb, high protein

that limits you to 1200 calories a day.

And if you comply with it,

you're gonna be able to lose more that 200 pounds in two months.

But the goal I'm giving you is to only lose half that in that time.

- So, there is no excuses, okay? - Okay.

So, stick to that and what it says.

And if you stick with it from here on out,

then, you're gonna be able to lose 600 pounds in a period of 18 months.

Okay.

- That's almost about three to four big people. - Yeah.

So, that's all. But you can do it if you stick to what we tell you. Okay?

- Thank you. - Any questions?

No. I'm, I'm okay. I'm good.

All right, I've seen your chart.

You've had the hernia repair in your stomach?

Yeah. I do have an umbilical cord hanging.

Let me see what kind of scar that ended up in there.

- Well, you still have a hernia. - Yeah. I still have it.

- All right, let me go get some stuff for you, okay? - Okay.

[solemn instrumental music playing]

My biggest concern for Julian right now is how high his weight and BMI is.

[Dr. Now] Thankfully, he is not bedridden at this point.

And he is still able to have some level of activity.

It would be much worse if that wasn't the case.

But the amount of strain that is on his body from his weight is very dangerous for him.

To where it is just a matter of time before something happens

that pushes his body to a breaking point, and he doesn't survive.

All right, let's go over some things.

- This, um, first six pages explain what metabolism is. - Mm-hmm.

- And what healthy eating habits should be. - Okay.

Julian is the only one who can start to make the changes needed

to avoid his body getting to a breaking point.

So, it's very important he understands that.

And starts to lose as much weight as he can. As fast as he can.

Reduce the strain he has on his whole body

before he let's it get to a point

where something happens and he runs out of time.

And until he does that, everyday for him is a roll of the dice.

Where he might not make it.

And this is... my book.

- And in chapter 12... - Uh-huh.

You've got a list of exercise, and to build up your stamina.

- Okay. Okay. - Okay?

I'm going to give you two months to lose 100 pounds.

We will check that at a local clinic with you

- to see where you are and go from there. - Okay.

- You think you can do that? - I can do that Dr. Now.

- Under 700 pounds. - Under 700 pounds.

- Okay? - Gotcha.

All right, I'll see y'all later.

- [Julian] See you later. - See you.

- All right, take care. - [both] You too.

Yeah. I'mma get started. I'm gonna do this, babe.

- I'm gonna have to do it too. - That's good. I was hoping you would do it with me.

Yep.

[Julian] This could be my last chance to live longer.

So, I'm gonna do everything Dr. Now says from here on out.

And I know it's gonna be hard. Maybe the hardest thing I ever do.

Thank you.

But I'm in a fight for my life now.

So, from here on out, there's no tomorrow.

I either do this, or I'm not gonna make it.

- I love you. - I love you too.

I hope it's good.

[Julian] I've been spending the past month working hard at making progress.

I started it all as soon as we got back home since the road only had fast food options

But since then, I've been sticking to Dr. Now's diet.

And doing all his exercises. And I'm feeling pretty good about my progress so far.

All right babe, let's get to working out.

Especially with my exercises. Because I've been doing some boxing with a punching bag.

And Irma's been doing it with me.

[Irma] You got this, baby. Come on.

When we first got back,

the first thing we did is went to go buy that punching bag.

- Holy [bleep] - Sorry.

You're good, you're good. Keep going.

[panting]

[Irma] Don't forget to inhale, baby.

- [Irma] Three, two... - [Julian whispers] One.

- Your turn. - Okay.

[boxing bell rings]

Jab, jab, cross.

Jab, cross.

- Oh, I'd hate to get hit by you. - Ha-ha.

Okay. I'm done.

[Julian] So, I'm gonna keep working at this over the next month.

So that when I go to the doctor and get my weight,

I'm where I need to be so I can move to Houston.

And be ready to take that leap when we have to,

if it means I'm gonna get the chance for surgery.

But I know it's gonna come down to me meeting my goal by next month.

So that's what I'm working my hardest to do.

Oh, Lord in heaven.

Me and Irma are headed to the local clinic today.

Dr. Now said it at first to go there to get my weight.

And if I made it to my goal, he said he was gonna tell me I could move to Houston,

to be a part of his program. And get weight loss surgery.

Julian!

[Julian] In my last appointment two months ago, I was 830 pounds.

And Dr. Now told me to lose 100 pounds.

If I succeed, I'll be under 730 today.

Okay, you must be over the weight limit.

Um. it's not reading your weight.

Oh, okay.

-[nurse] Okay. Follow me to the room. -Okay.

[Julian] I don't think that's right.

I know how hard I worked for the past two months.

You know, I've done the diet and I've done the workouts everyday.

So, there's no way I'm over 800 still.

You know, now I have to tell Dr. Now "I'm over the limit."

It's upsetting me because he's not gonna think I've been working as hard as I have

when I know I did.

So, I'm just frustrated right now.

- Hi Dr. Now. - Hi, Julian, how are you doing?

I'm doing good. And yourself?

- Good. - That's good.

So, what's going on with you?

- Where's your weight at today? - Um, well, the scale couldn't read my weight.

Well Julian, the scale that you got over there, goes up to 800 pounds.

If it could not read your weight, that means that you're still over 800 pounds.

The changes I have made, um, the diet I was stuck to... I wanna say--

I don't want to say perfectly. But I've stuck to it. I started doing meal preps.

- Well, how many times you eating in a day? - I only eat twice a day.

Well, you should have lost weight, but you didn't.

So your eating more than you think with your meals.

Sometimes I have pork rinds. I see those are 70 calories with no sugar.

I am. I'm going to do it. I only ate pork rinds one--

Then how come you haven't lost any weight?

I really can't tell 'cause of the scale.

I know you said it goes up to 800. But I don't know. Like I said, I could be 801.

And the scale cannot read your weight because your weight

is still over 800 pounds.

So, what is the point of coming back in here and see us?

Because I'm sticking to it.

Well, if you're sticking to it, then you're gonna show some positive changes.

Oh yeah. I'm definitely gonna show it.

I believe if I was there, it'll be a different story than here.

Well, you're not showing it on the scale.

So, there's not much we can do if you don't start changing your eating habits.

So, whatever you're eating, cut back and eat less,

and I'm going to give you another two months

to lose 100 pounds from 830.

So if you lost 30 pounds, you have a leg up.

And then we'll bring you back here and check your weight again.

And if you make it to your goal,

then you can move to Houston to do my program.

If you want to continue. But until then,

there's no point for you to be coming down, okay?

I got you.

And if you don't make it to your goal this next time,

then I don't know what else we can do for you.

[Julian] Okay.

So go on the diet again.

And if you need anything, give me a call.

Okay, thank you.

- All right, bye-bye. - Bye.

Well, I felt like I lost weight.

Well, I mean, you already cut down quite a bit? I don't know.

Like, are you supposed to eat like, air now?

Yeah. I don't know. We will see.

I'm just frustrated, you know. For him to say I'm not trying.

It's just like a slap in the face.

Because I know I could have probably done better.

But at the same time, I feel like I've had progress

that's not being accounted for with that scale.

And just because it's not showing up doesn't mean I haven't made progress.

So I'm pissed off because of the scale.

I can understand if I stepped on his scale and it said 830.

Yeah, I'll take all criticism there is. But this scale... I can't trust this scale.

I know Dr. Now says it reads 800 pounds.

But maybe that scale doesn't work, I don't know.

Maybe it doesn't work at its highest potential.

And it reflect on me pretty horribly right now.

For me, to not to say I'm not trying,

which I am. I know I'm trying.

And I just feel I've not been given the credit for that.

So, that's why I'm pissed off.

I just have to try harder, I guess.

Because getting weight loss surgery from Dr. Now is my only chance I have left.

[Julian] For the past month

I've been doing what I said in my last appointment, when I had talked to Dr. Now.

And I've been working on cutting back my eating even more.

And it's been tough, I'm not gonna to lie.

You know, I feel like I'm barely eating to the point where I'm just starving.

To the point where I feel weak at times.

So, because of that, my workouts have decreased.

Because I don't have the energy.

And there have been times that feeling has made me give in

to eat something I shouldn't.

But for the most part, that has not happened.

Just because I feel like I have less energy

doesn't mean I have been giving up on my exercises, though.

I'm still getting in my walking everyday.

And I know I'm making progress with that.

Because I can do the whole distance of the block now.

When I could barely make it 10 or 15 feet from my driveway when I started.

And I'm pushing myself to do more each day.

- Good morning. - Hey, Rose.

I don't care if you drop. Walk up to the corner.

[Julian breathes heavily] Come on Rose.

[Julian] That helps me feel like I'm not in such isolation.

Because I'm out, and I get to see people I haven't seen in a while.

-Guess what? -What's that? [Julian breathes heavily]

You ain't walking fast enough.

- Ah, well, that's these slippers. - [Rose laughs]

'Cause I don't want to trip. They like to fold under me.

That feels good.

So, I'm already seeing the ways my progress is benefitting my life.

And making improvements for me.

Next month, when I check my weight again,

[Julian] I have to be at my goal then

if I want to get the go ahead from Dr. Now

to move to Houston and get my surgery.

[exhales]

- [Julian] Babe, drive with two hands. - [Irma] Shut up.

[Julian] I just hope I haven't gained any weight.

But we'll see how it goes.

To see if this scale works.

- That's what I'm a little skeptical about. - [Irma] Mm-hmm.

- [Julian] So... - [Irma] Not like last time.

[Julian] See if Dr. Now is ready to chew me another [bleep] oh...

[Julian] And if we can, you know, get the ball moving on gettin' down to Houston.

[Irma] Mm-hmm.

[Julian] I'm headed to another local clinic to check my weight again.

But I'm still a bit nervous, you know...

because I'm ready to start having bigger progress for myself.

And that's not gonna happen until I move to Houston.

[Julian sighs]

So I know I have to have the results

that Dr. Now is looking to see from me today...

because I don't know what more I can do at this point.

[nurse] Julian.

- [Julian] Yes. - [nurse] Come on back.

Bye, baby. Love you too.

[Julian] All right.

There you go.

Can you turn around?

714.2.

Thank you!

Oh, my goodness. Thank you.

Thank you.

[Julian] Thanks.

[FaceTime ringing]

Hello.

Hey, Dr. Now.

Hi, Julian, how are you doing?

I'm doin' good. I'm doin' real good.

[Dr. Now] Great!

So what is your weight doing now?

I'm down to 714 pounds.

Oh, so you lost some weight, huh?

Yes, sir, I sure did!

That's great! You lost over 100 pounds, huh?

116 pounds to be exact.

Yes, sir!

Okay, great.

And moving in the right direction.

And once you move down here, if you continue to lose weight, then

- Perfect. Thank you, Dr. Now. - Okay.

Continue with your progress that you're making.

- Yes. - And continue to lose more weight, okay?

Yes, I am. I'm gonna continue doing everything that you told me to do.

You've done a good job and, uh... I'm proud of your progress.

So keep up the good work.

- Don't relax and go back to your eating habits. - Mm-hmm.

And if you gain weight, then we're not gonna move ahead

with weight-loss surgery with you.

- Okay. - In the meantime, if you need anything give me a call, okay?

All right, thank you, Dr. Now.

All right, buh-bye.

[Julian] Dr. Now is gonna go ahead and approve me to move to Houston.

I didn't lose the amount that he wanted me to,

but I lost enough.

He was excited about my progress. He was happy for me.

And I-- I didn't get chewed out like last time.

After hearing that response from Dr. Now,

we're gonna go ahead and start gettin' to packing so we can move.

If I lose more weight, continue just eating

the correct way that I'm supposed to eat,

he'll end up approving me for weight-loss surgery.

That's the main thing I'm looking forward to.

- [Irma] What? - [Julian] Dr. Now, he approved us to move to Houston.

So we gotta get home and start packing

so we can move.

- Okay. - ASAP.

But he says as long as I'm stickin' to my diet,

he's allowing me to move so we can move to Houston.

Okay, um...

Um, I'm kinda freakin' out, baby, 'cause we don't have anything packed up.

I know. So we gotta get to it!

[Irma] So we're really leavin', huh?

Yes, we're really leavin'.

[Irma speaking]

Now, we're in Texas.

[Julian] This is our second day on the road.

And so far, things are going better this time.

And I think the weight I lost and the stamina I have now

that's helping me handle the road a lot better.

With this minivan, helping me be more comfortable too.

I have more room.

We just made it into Texas.

And we're hopin' to make it all the way to Houston by the end of the day

if I can handle it.

And so far, I'm feelin' good still.

So as long as I can hold out, we should be arriving in our new place

and starting a new life here very soon.

[dramatic music playing]

[Irma inhales] Brother!

It melted off?

[Irma] Yeah.

- [beep] - [Irma] I kept tellin' Julian. I'm like,

"There's something not right."

I'm like, "There's something going on."

I'm like, "I don't see my brother. I don't see my brother." "He's fine."

I was trying to call you. And the [beep] call wouldn't go through.

But I said, "I told you that I felt somethin' wasn't right."

[Julian] Why do you keep sayin', like, I'm the one

who was goin' against your intuition or something?

[Irma] 'Cause you were!

- You were like, "Baby, everything's fine." - No, babe.

[Julian] How I'm supposed to know?

What am I supposed to go with the worst? I'm trying to calm you down.

And you makin' it like I'm just goin' against you.

[Irma] Um, 'cause you... That's a new slipper.

[Julian] But I knew it. But that's not how you say it.

Man.

[Julian] This is basically my nightmare.

[Julian speaking]

[Irma speaking]

[Julian] Alejandro's trailer is not fixable.

We're in Texas.

And we have horrible service.

We was doin' fine until this happened.

We might just leave this trailer and leave our stuff.

Who even knows if there's, like, a rental place around here?

[Irma] I found out what happened 'cause my brother called me.

He's all like, "Hey, the tire went out."

So I was just, like, imagining the worst.

He's all like, "But I'm okay. I'm okay. I'm okay."

'Cause he knows I, like, freak out for anything.

The longer we're here, the more in danger we are.

And I don't wanna be a [beep] sticker in the middle of the road.

[Julian] This is absolutely the last situation

someone who's my size wants to be in.

You know, I can't handle the heat for long.

The only positive thing is that I still have air conditioning.

So I'm okay for now.

But if we stay here long, my fear is the car could overheat.

And we could run out of gas.

And if that happens, it's gonna be very bad for me.

[Julian] Me and Irma have tried to get a hold of a trailer rental place.

So far, either no one nearby has one, or it's too far to go get.

And they can't bring it to us.

So we're still not sure what we're gonna do.

Do you think we could get it somewhere safer?

I mean, we can get new stuff.

We just can take, like, the bare necessities and that's it.

We can't leave our bed!

Uh-uh, I'm not gonna sleep on the floor. Are you crazy?

But it's still just stuff.

But it's a bed.

- I'm not gonna sleep on the floor. - It doesn't matter.

- All right. - Yeah, just get it in the dirt, brother.

All right.

[Julian] I guess we're out of options at this point.

We just have to figure out what we can get in the truck and the van.

And then we just have to abandon the rest.

And that's what it comes down to now.

We just can't stay out here.

And if we don't have another trailer, there's no other options.

[Julian] This is extremely disappointing.

And I'm very frustrated

because we're having to choose

between what we need to survive and all our personal things.

So this is just heart-wrenching for me.

[Julian] Just one more bad thing to pile on me right now.

When I'm tryin' to do right and work all that I can to get better.

So this is just upsetting.

[Irma] No, it's no use.

[Julian] But we'll do what we have to do

because that's our only option.

[Irma] And this.

Are you okay with leaving the punching bag or no?

[Irma] I'm sorry.

Hey.

[Irma] It's a... tornado. It looks [beep] scary.

[Julian] It's not a tornado!

[Julian] Some bad weather's rolling in.

And there's a tornado warning for this area!

So as soon as we can, we gotta get back on the road before that happens.

- [Julian] Shut the car off. - [Irma] I am.

[Julian] And, hopefully, it'll pass us by.

[sighs] It just sucks that we have to get rid of everything!

We're gonna have to leave [beep] deep freezer.

[Julian] We can't leave that!

- Why not? - There's food in there.

Julian, we have no other choice!

[Julian] We're figuring out what we can take and what we can't

so we can get outta here.

But it's just not an easy process.

Baby, we can't take all the boxes!

We have to!

But we can't!

But we have to. The boxes are priority.

Baby, most of those boxes are just [beep] paperwork!

There're not [beep] paperwork, Julian.

Baby, we can't take every--

Fine, then you go see what's [beep]... Go ahead.

[Julian] My stress level is just high right now.

And I'll be honest. If I had food, I'd probably be eatin' right now.

But I don't, so my focus is on just figuring all this out.

I mean, we have to take all the boxes.

We have to.

[Julian] But it's like a lose-lose situation

because there's so much we need that we just can't leave.

[Irma] Baby, let's go back inside.

[Julian] We gotta get on the road soon because when night-time comes,

we're not gonna have the light to do this.

I gotta-- We gotta look through this.

[Irma sighs]

[Julian] We're pretty much out of time at this point

because it's late and we have to get off the road.

A road utility person saw us

and they stopped to put on their lights

to make sure no one doesn't see us in the dark and hit us.

So, thankfully that's one thing we don't have to worry about right now,

but we're just gonna have to take a hit with our stuff

because that issue we can't figure out.

We can't agree on what we need to take between me and Irma,

and what we do agree on, we can't find.

So we're just loading up what we can

based off what we think is in each box.

And hopefully when we get to Houston and open everything up,

we have a lot of what we need.

If not, then I guess we'll just have to figure it out.

And if I don't get the surgery and all this doesn't pay off,

and then all the pain and suffering we went through

was for nothing.

- [Alejandro] Right here? - [Irma] On Meadow Drive.

It's this next street right up here.

[Julian] We're finally in Houston.

We're heading to the apartment to get the keys and stuff.

[Irma] We're your future residents.

[Julian] This has been a long journey,

but I'm thankful to be here.

It looks like a nice neighborhood.

We'll see exactly how everything goes

once we get in and get the place.

- We did it. Mm-hmm. - Got it.

- Let's go check it out. - All right.

[Julian sighs] Oh, this is gonna be...

Yeah, we're upstairs.

Oh, baby, you're gonna hate this.

Go ahead, bro, it's gonna take me a minute.

[Irma] Dude, there's mosquitoes in here!

[chuckling] Help.

[Irma chuckles]

Okay.

- Okay, I can work with this. - All right, babe.

Okay, babe!

[Julian] After losing most of our stuff on the road,

at that time I was second-guessing it, and I wanted to just go back,

but I figure God didn't make me go this far to just turn around.

It's probably his way of saying we don't need that stuff

or it's the devil's way of trying to make us not fulfill this journey.

So, it's just materials. We can get that stuff back.

Ew, there's a bug right there! [Irma squeals]

It's okay. We'll get him out.

Oh, this has got a closet, too!

- Look how huge it is. - Damn!

I'm gonna go check the other room.

I can work in there. I can work in both.

Let's do the test.

Look, babe!

Holy [bleep]

I like the window.

I like the carpet, man. The carpet is like...

Let's see how it feels with no shoes on.

[Julian] So we're gonna head to Dr. Now's

once we get done here.

I feel a lot better now that we're here

and we're able to see the place.

We called Dr. Now yesterday to give him an update

and I asked him if we can come see him when I got here today,

so I can get my weight and he can verify my progress

so I can see about hopefully getting approved for my weight-loss surgery.

[Julian] It's been a tough three months since this last weigh-in,

but I've been able to work hard so I know I'll see some progress.

The question is, if it's gonna be enough for Dr. Now.

So that's the only thing that has me a little nervous.

It's gonna be all right, baby.

Julian.

[Julian] At my last appointment, I made it down to 714.

And Dr. Now told me to keep losing.

And I think I've done that,

but I'm hoping I made it to at least the 600s at this point.

Your weight is 792.

[somber piano music playing]

[Julian] Just in shock right now.

I'm scared to how Dr. Now's gonna react.

I know he's gonna say I haven't been trying, but I have.

I kept my focus on working to get surgery because how bad I need it.

And I'm worried because getting the surgery

is the whole reason why we gave up our life to come here.

-Hello -[Irma] Hi.

- How you all doing? - All right and good.

[Dr. Now] Good. All right.

Well, I'm sorry to hear about all the trouble you said

you had coming back down here.

But you finally made it in one piece.

Yeah, we finally made it in one piece and we got our apartment

and it's beautiful and we made it.

All right, so the issue now is your weight gain you had over the last three months.

You gained almost 80 pounds, so what happened to your eating habits?

My eating habits has been okay. I mean, it's...

I've been really stressful

and, like, I know it's not an excuse to eat more and everything, but, um,

my father-in-law passed and it's just been real hard trying to find, you know,

a place for my mom and my grandma and all that.

But my eating habits are back to where they need to be now.

No more cheating, no more eating,

you know, things I'm not supposed to eat.

What do you mean no more cheating,

because you were cheating before?

You said you think you were eating good.

No, I won't say it's cheating, you know, it's no excuse.

You know, well, like, what happened with my father-in-law

and all that stress I was going through, I just...

You say that, but at the same time,

that's the excuse you are giving me right now.

And I get that. You have had a lot of hard things happen,

but life is full of hard things, and it's okay to struggle,

but not to use it as an excuse

to justify damaging your health.

[Dr. Now] That's never okay.

[Julian] I know, I know, and I'll do better.

So you need to get back on track now

because you're back in just the dangerous place you were

when you first came to see me.

You're almost back to the 800s.

So you need to decide if you're gonna do this like you said when you told me

you're 100% committed.

- [Dr. Now] So here's what you need to do, Julian. - Yes.

I want you to stick with the original goal I gave you

and lose 100 pounds over the next two months.

You're still where you could easily lose 200 pounds in that time

if you stick to the diet.

If you do that, then I will schedule you for weight loss surgery.

If not, then we're not moving ahead with you, okay?

And, Irma, are you doing this with him and losing any weight?

Not much.

Then you have to both motivate each other. That's important,

- especially if you're thinking of having a family. - Yeah.

- And that's gonna be some important thing for everybody. - Yes.

And so get back on track and work together to do that.

And I want you to lose 100 pounds in two months

if you want to move ahead, okay?

[Julian] Yes, sir. I'm gonna do that.

- Okay. Well, I'm glad you made it to Houston... - Mm-hmm.

and let's concentrate on doing what you need,

and let's see how things go over the next two months, okay?

- Okay. - All right, see you all later.

See you later, Dr. Now.

- [Dr. Now] Okay, take care. Okay. - Thank you.

[Dr. Now] It's obviously very disappointing to see such a big move

back in the wrong direction with Julian,

and it's also disappointing that he's making excuses for that.

I understand that things have been really hard for him,

but the big question for Julian is

if food is worth his life.

Because at this point, that's what he's risking

every day his weight stays as high as it is.

So hopefully he gets how serious this is

to get back on track,

to lose like he did before,

because his body can't keep going like this.

[Julian] I'm disappointed,

very disappointed,

because I was hoping and expecting

to be able to move ahead with my weight-loss surgery

once I got down here.

So that's a bit of a blow.

But at least I'm still in the game.

And so, as long as I am,

I still have a chance to fight,

and that's all I can do.

So, whatever it takes, I'm gonna do it.

All right, babe, I'm gonna go

do my workout.

We'll be starting dinner when I get back.

- Okay, baby. Be careful. - Not gonna take me long.

[Julian] The past month has been good as far as I'm concerned.

I've been able to give my full focus

to get back on track

like how I need.

And I've been working hard at that.

You know, I lost my punching bag

because I had to leave it on the side of the road coming here.

But what I got to replace it now is stairs,

so I've been using those

to do my exercises every day.

When I first started, when I first got here,

I would have to go down the stairs

just one leg at a time

and then come up

one leg at a time,

but now I can go down both legs at a time,

and come back up both legs at a time.

Because it's getting easier,

so I'm gonna probably add

another go up and down the stairs.

So that'll be three times I go up and down.

[Irma] You done, baby?

[out of breath] I'm getting faster.

Good.

[panting] I might up it to... three.

How was it, baby?

It was good, I think it was getting easier.

I'm proud of you.

I started going down just one at a time,

but now I can do both legs.

- Oh! - Yeah.

- For real? - Mm-hmm.

Nice!

[Julian] But right now, after my second one,

I go inside

and do my upper body exercises

and Irma usually helps me, like a trainer.

You need to work on your legs, too.

[Julian] She's trying to give me

as much support as she can.

So we're doing this as a team right now

because she wants to see me succeed at this

as much as I want to.

If you want to, you can relax a little bit

and then do the rest of the ten.

[exhales sharply] Okay.

[Julian] So she's being a big help with me like this with my exercises.

And with the diet,

because we're both eating the same

from Dr. Now's diet.

forty, okay.

[Irma] Do this one, the leg one.

How about this one?

This one don't have me extended.

[Irma] No. Do this one.

[Julian sighs] Okay.

So I'm feeling good about how we're both doing

and our progress

because I'm more serious

about getting to where I need now,

more than I've been up to at this point.

And my hope is that

when I go back to see Dr. Now in a month,

that it'll be enough for me to make it

and get approved for surgery.

[pants and sighs]

Good job, baby.

Whoo!

Do one more... I'm just kidding.

[laughs] I'm kidding, I'm kidding.

Do you want me to start cutting up the stuff now, or?

Yeah. Um, the onions? Yeah.

How do you want me to cut the onion,

my way or your way?

You can cut 'em your way.

You sure?

'Cause you don't like it when I cut it that small.

No, it's okay.

[soft guitar music]

I'mma come do the chicken.

Okay.

[groans]

I like a little salad with my onions.

[laughs]

- It's really good. - Yeah, it is.

Yeah, it's like, 10 minutes.

Man, believe it or not, I am getting full.

- Good. - Mm.

That was a really good dinner, babe.

- Yeah, it was. - I'm satisfied.

Me, too.

[Julian] Irma started her new job

and she couldn't take off today,

so I'm having to go to Dr. Now's

on my own today.

And I'm excited for myself

because I can finally drive again!

And it feels good.

It feels good to be behind this wheel.

It's been going on eight or nine years

since I've been able to fit behind the wheel

and I feel good.

But I'm still nervous

because I don't know where my final progress is at.

But I know I'm lower with my weight

than I've been in a long time.

And I've been working my hardest to get back on track.

[sighs]

And I'm hoping

that's been enough for me

to finally be approved for weight loss surgery.

The last time I was here two months ago,

the scale said I was 792

and Dr. Now told me my goal

was to lose 100 pounds from that.

That means I need to be down to 692 today.

Julian?

[anticipatory music]

[nurse] We can step up on the scale.

Your weight is 705.

Thank you.

That's a big loss, and I feel good about that.

But I'm still nervous

because this appointment can go one way or another.

You know, Dr. Now could either see this amount

as a positive or a failure.

So I'm just nervous because I'm not sure

how this is gonna go and what's gonna happen.

[knocking on door]

- Hello. - Hey, Dr. Now.

Hi, Julian. How are you?

I'm doing good, and yourself?

Good.

All right, so, where's Irma today?

She had to work.

So she miss your big weight loss, huh?

Mm-hmm.

All right. And the last time, you gained a little over 70 pounds.

So I was a little bit concerned,

but this time it looks like

you lost almost 100 pounds, huh?

Yeah, I guess I'm doing something right.

Well, you still need to get back more.

At your weight, you should be losing more

if you're doing the diet.

But 90 pounds is a good loss

and shows me you're back on track.

And since you're doing better

and you're losing some weight,

I'm gonna go ahead and approve you for weight-loss surgery.

- Thank you. - But I want you to stick with the diet.

And I'm gonna schedule your surgery

for one month from now.

And at that time,

I want you to lose 30 more pounds

- Okay? - All right. Yes, sir.

If you don't do that,

we're not gonna move ahead with you

because the last time we made good progress,

you went back to overeating right after.

So you need to show me

you can stick with it for a little longer.

- Okay. - Well...

So far, you have lost 125 pounds.

Yeah.

So that's a pretty good effort that you're doing with your eating habits.

So keep it up

and we're gonna see what we can do with you, okay?

All right, thank you.

All right. I'll see you, then.

- See you. - Okay.

[Dr. Now] I'm proud of Julian

for putting forward the effort he has

over the past two months.

It's not quite another 100 pounds,

but it's close enough to show me

he is willing to take back some control of his life.

And as long as he shows me he's gonna stick with the changes he's made,

to lose another 30 pounds this next month, and his tests look good,

then we will move ahead with him.

But if he repeats history, and start to slip again, I will cancel his surgery.

But Julian doesn't have any more time to waste, risking his health.

So hopefully, he continues to take his situation seriously,

to stay on track.

[Julian] Irma's gonna be excited to hear the news of my surgery.

So I feel really good right now.

You know, this time, I'm not letting nothing

lead me back to the wrong direction,

because I'm not letting anything get to me, to where I lose this surgery.

[Julian] I'm feeling good right now. A little nervous, but good,

because Dr. Now said he's moving ahead with my weight-loss surgery today.

I stayed on track enough this month, and I'm finally in the 600s.

And that feels good, coming down from the 800s.

So Dr. Now says I'm ready for this, and I agree with him,

because this has been a long time coming.

So I know I'm very ready for this.

[Irma] I think Julian's gonna do very well,

because he's stuck to his diet,

even though he was like, "Babe, I'm so hungry. I'm so hungry.

Like, I want to eat something." I'm like, "Baby, well you can't.

You have to stick to it." And he did, and I was surprised.

I did not think he was gonna lose that much. But hey, he did it.

- I love you. - I love you, too.

[Julian] I'm thankful for the chance to take a step like this,

so I can start to get my life right.

I wanted to be able to keep my promises to Irma and my family,

by losing the weight.

And now I'm gonna finally have the big tube to help me do that.

So I'm very happy right now,

and I'm looking forward to the life this is gonna help bring me.

[nurse] All right, Julian. This is your room.

[Dr. Now] Today, we are attempting to do weight-loss surgery on Julian.

But this is going to be a more difficult operation than usual,

because of the severe hernia that Julian still has.

And because he is still at a very large size,

so the first issue we have to manage with him

is securing him safely on the table.

Now that we have secured Julian safely, we can begin the operation.

But the second big issue we have with him is his hernia,

and whether it prevents us from doing what we need, at any point.

Okay.

So first, I'm gonna attempt to fix his hernia as best as possible.

[surgeon speaking]

[Dr. Now] Then, I will move ahead,

and attempt to do a gastric sleeve procedure on him.

- All right, bring the robot. - [nurse] Yes.

[Dr. Now] And if we are able to complete that,

then that will give Julian an important tool to help him continue to lose weight.

Because what the surgery does is reduce the stomach by 90%,

leaving a small narrow tube that looks similar to a sleeve.

So the patient's food intake is physically limited.

And the patient is less hungry.

So this operation will give them an opportunity to lose even more weight.

So this will be a big help to keep Julian on track

while we work with him to get him to where he is able to maintain his progress

for the long-term.

But my concern right now is not having enough time to do both surgeries.

If the situation with his hernia is too severe,

because at his weight, this is a high-risk surgery,

and because of that, we want to limit the time he is under anesthesia.

Because it could start to put too much strain on his system,

if we keep him under too long.

So we'll have to see what's possible to do safely with him today.

His hernia is extremely severe.

There is a lot of mess from a previous repair that failed,

and there is a lot of pressure on it,

from all the weight Julian still has on his body.

So to repair it fully and do the gastric sleeve

is gonna keep him under anesthesia too long.

So I'm gonna have to do a partial repair of the hernia,

and then move on to perform the gastric sleeve,

to prevent Julian's body from being pushed to any limits.

Because, at his weight, that would be a very dangerous situation.

Okay, I've finished a partial repair of the hernia,

So now I'm gonna complete the sleeve.

All right, we are almost done removing his stomach.

[Irma] I'm feeling tired, I'm feeling worried.

Mostly worried than tired.

They've been updating me every hour, to see how he's doing.

Um, and I guess they did find the hernia,

but I don't know if they actually repaired it yet or not.

Um, and yeah. I've been waiting here.

I feel nervous, because, like, I don't know how he's doing in there, and...

I'm very anxious to see Julian,

because that's the only way I'm gonna know that he's okay.

[equipment beeping]

What a long stomach.

Okay, all finished.

Julian's surgery went very well.

It was challenging, because he has a, that big hernia was in the way.

So we have to get a lot of adhesion done,

and get the pipe to the stomach, and be able to do surgery.

So it was more complicated than usual, with all his issues,

but we managed to get the sleeve gastrectomy done,

and we will finish his hernia repair down the road,

after he has lost more weight.

But this will be a big help for Julian,

to help keep him on track with his weight loss, while we work with him,

and get him to where he will be able

to maintain healthy weight for the long-term.

Right now, he'll be on a liquid diet for the next month.

And he should be able to lose another 40 pounds in that time.

Then he should be able to lose between 25 to 30 pounds a month,

until he starts to get closer to his target weight.

But overall, I think Julian has done well.

And I'm optimistic that we will be able to work with him,

to get him to his target weight over the next year.

And in a place where he will be able to maintain that for the long-term.

[groans softly]

[optimistic guitar music plays]

I'm so excited that we can go out.

It's been years.

Years since you took me out.

[Julian] Me and Irma are going out tonight.

And with all my progress, I'm ready.

So we're gonna go to a dinner and a movie tonight,

and finally have a normal date.

You always look pretty, baby. Even without makeup.

Are you driving? Please tell me you're driving, please.

- Yeah, I'll drive. - Here, help me with this.

[Julian] The weight is starting to come off fast right now,

so I'm excited about that.

And I know I'm still big.

[sighs] Let's go.

And I'm still worried about fitting into the same places other people can.

But with all I've lost, I'm feeling better about how I'm doing.

So I'm excited about that, and I'm gonna keep working hard,

because I don't wanna slow down.

Thank you.

You're welcome, baby.

This past year has had a lot of trials in it,

and there was moments I wasn't sure about doing this.

But I'm so thankful that Irma kept pushing me forwards, so I didn't quit.

- [Irma] Thank you. - [Waiter] Thank you.

Oh, wow.

[Julian] But now I'm looking at a life where I can take my wife out.

I was really sceptical that we're gonna be this good.

[man] Here you go.

- Theatre two, second door on the left. - [Irma] Thank you so much.

- [exhales] Is it good? - Yeah, it's good.

- Good. Okay. - This is good.

And I can go out, on my own, and get a job,

and start taking care of things.

But the biggest thing is, this is gonna give us a chance to start a family.

I would do anything for that to happen.

But whatever the future has in store for us...

I'm excited to be able to do more.

And sharing things with Irma, and have a life I get to enjoy with her.

So I'm gonna keep my focus, and keep working hard

so I can make her happy by being the husband she deserves.

And I'm looking forward to being able to do that.