Original subtitles

[Margaret groans]

[sobbing]

- [Millie] Every step's gonna make it easier, I promise. - [Margaret moaning]

[woman 1] Somewhere in me is this little glimmer of hope.

I just wanna be a normal person.

[exhales sharply and pants]

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

[woman 2] If I don't make a change now, I'm scared it's gonna be too late.

No. [sobbing] It hurts!

[woman 3] I refuse to stop fighting. I have to do this for my children.

I don't know what went wrong. I don't know.

You wanna argue all that with the scale? Be my guest.

[Dr. Now] A couple hours ago, Margaret and her mom showed up here at the hospital.

Margaret apparently fell yesterday and she went to emergency room.

She was transferred to here because they didn't have any facility

that will take care of somebody that is 750 pounds.

She is 35 years old,

and she managed to become 750 pounds.

She is only 5 foot 4 inches tall, and her BMI is 129,

which is one of the highest BMI I have ever seen.

And that is very dangerous BMI.

That, combined with the fact she is not mobile,

has created a very dire situation for her.

And she can barely stand up from her bed to bedside commode.

When she fell, she was short of breath.

And she and her mom were worried she was having a heart attack.

So we ran some tests on her to make sure she doesn't have any life-threatening issues

we need to address right now.

But regardless, it's clear if Margaret doesn't do something

to turn her life around, it's only gonna be a matter of time

before her body gives out.

But at this point, I'm still not sure she has any intention

to get the help she needs to do that.

Hello.

[Margaret] Hello.

Hi, Margaret. I'm Dr. Nowzaradan.

- [Margaret] Nice-- - How are you?

Doing pretty good. Nice to meet you.

Nice to meet you.

You weigh 750?

[Margaret] Mm-hmm.

So how long have you been at that weight?

I don't know.

I haven't weighed myself in three or four years.

Do you get up and walk?

The last time I was able to really walk was six months ago.

Who take care of you at home?

My mom.

Uh... so... Your mom has any weight problem?

She's had the gastric bypass.

So if she had gastric bypass, uh, why is she providing you

too much food and keep you in, uh, this way?

Because it's easier not to fight with me

and just pacify me.

So if she doesn't bring it to you, what happen?

I get mad at her and I tell her that she doesn't love me.

Okay.

And so what do you think is gonna happen to you if you continue that?

I'm gonna die.

I don't wanna die. I wanna change.

So why haven't you done anything to change your situation up to this point?

I've had abusive...

Abusive life.

What do you mean abusive? By your parents? Or your family or who?

My family. Especially my dad.

I see.

So you ate to deal with that.

Yes.

Food's my comfort. I can hide underneath it.

And nobody knows what's going on in my life.

So how motivated are you to change your life

and do your part and be able to lose some weight?

I'm willing to do whatever I have to

to have my surgery.

All right.

Okay, let's check a couple thing and see how things are.

I think we're gonna have our work cut out for us with Margaret.

She says she wants to change her situation,

but so far she hasn't done anything to change her life.

Can you lift your foot up and down?

Margaret said that she ask for the food but, uh, I think the mother is enabler.

Amazing to me that her mother had weight loss surgery herself,

is continuing to help her to eat as much as she wants,

and get her weight up to 750 pounds.

So this is a very pathological situation,

and I don't see any motivation.

I don't see any goal from Margaret.

But I'm ready to give her all the tools she need to change her life

and try to lose some weight.

Margaret, your BMI is 129.

129 is very high BMI, okay?

So this is very dangerous situation you're in.

So you have to change your life,

and you have to try harder, okay?

While you're here, we can control your eating habit.

But when you go home, you're gonna be on your own.

And this is gonna be the test for you.

If you go home and you're not able to change your eating habit,

there's nothing we can do for you, okay?

So I'm gonna give you some research that I want you to read.

It will break down what you can eat and cannot eat

to do the diet and what healthy eating is.

So you need to follow it to where you have some meaningful changes

in your eating habit that's gonna show on your scale.

Okay? All right.

Right now, we will get her going in the right direction here

in a controlled environment.

But any progress we make with her is going to be short-lived

if she doesn't take responsibility for her life.

So what I want you to do is, uh, every day, you read this.

Three factor that control your weight, your frequency, amount, and type of food.

But she doesn't have any time for playing games.

Because if she doesn't change her situation soon,

then her time is gonna run out.

This is gonna be something that you're gonna have to work harder on, okay?

- Okay. - You think you can make all the changes?

Yes.

You think your mother is gonna be on board1

- with these changes? - Yes.

- So-- - She's on board.

Okay. All right, any questions?

Just please help me.

Well, we're gonna give you all the tools you need, one step at a time.

But you're gonna have to do the hard work. Okay?

I totally understand.

Okay. Stick with healthy eating habit and then try harder.

And if you need anything, give me a call.

I will do, thank you.

All right, I'll be back and see you later, okay?

[Margaret] I'm thankful I made it here.

And that I've been able to see Dr. Now.

It's an answered prayer.

Because I know I've let myself get to a breaking point.

And I could have easily died especially when I fell.

So I have to change now.

Because if I don't, it's going to be too late for me.

[Margaret] I'm here in the hospital.

I've been here for about two weeks,

and that was not part of the plan when I left the house.

But Dr. Now said I might be able to go home today, so I'm excited about that.

I'm ready to get on doing his program

and showing him I can do it.

I need his help because things are bad,

and they're just getting worse.

- Hey, you ready? - [Margaret] Yes.

- Ready to go home soon, baby? - Yes.

I'm ready to go home.

[Millie] I'm just glad to see you.

[knocking at door]

[Margaret] Who?

Hello, how are you all doing?

Hi, Doctor.

Hi, Margaret, how are you doing?

Doing pretty good.

So how is your mom doing?

You finally get to meet me in person.

All right, you doing okay?

Yeah, working 42 hours a week doesn't cut it.

[laughs] I don't get to meet very many people.

Well, you know, Margaret is in very poor shape.

She came in at 750 pounds.

- [Millie] That's the starting point-- - And we kept her on a diet.

In a few days, she lost 30 pounds.

- So that is what we need to continue at home. - [Millie] We are.

But I'm gonna give you a goal of at least 30 pounds each month,

when we wanna see you in the office and get your weight.

I expect that you lose 100 pounds in three months.

- All right? - In three months? Okay.

Yeah. If you continue to lose weight, then we can work with you

and get you to a point that you're gonna be able

to hopefully have weight loss surgery.

[Millie] Margaret, how bad do you want this surgery?

[Margaret] Bad.

- How bad do you want this surgery? - Bad, Mama.

Then we're gonna work at every point to get it,

- are we not? - Yes.

We will order physical therapy and home health to come and see her.

Get her stamina up so she can get up and walk

and perhaps come to the office.

And home health is gonna help with the personal hygiene.

And we already had the dietician come to talk to her.

She has written the stuff that she need to read every day and follow the diet.

If she's not able to follow the diet, we're not gonna be able

- to do anything for her. - We're going to follow this diet.

No sugary drink and a lot of exercise, okay?

And you need to have a positive influence on her.

I had the gastric bypass seven years ago.

All right, so you should know better, right?

- You help her. - Oh, I know all about that.

No, it makes me have the heart palpitations, the dumping syndrome.

It makes me just feel plain miserable.

No, I know my limits.

Okay. So we got a lot of work to do.

And now that you know in one week we can lose 30 pounds in the hospital,

you should be able to do that at home too.

- Is that not awesome? - [Margaret] Yes, it is.

We'll send her home today and in a year and a half,

- we can get her under 200. - Yes.

So this is gonna be the goal, okay?

I want her to be looking like her mama.

All right then. You're all looking good and take care, okay?

- I'll see you later. - 'Cause you got some pretty eyes

and you're a beautiful child.

[Dr. Now] We had Margaret in the hospital for couple of weeks now.

Most of the tests we ran on her when she arrived

didn't show any immediate issues with her except an infection in her leg

that cleared up after we treated it.

While she's been here, we had her on a controlled diet.

And in two weeks, we have been able to get her weight down

67 pounds from when she arrived.

She was 752. Now she's at 685.

So we have made some progress on that front with her.

And we have also been providing her physical therapy

to help her get up and walk.

She pushed back some, but overall she's doing well.

And we have her moving in the right direction now.

So the next step is for her to show me she can do this on her own

if she wants to continue.

Hopefully, Margaret and her mom, Millie,

are as serious as they are telling me.

Because they both need to make a lot of changes

if Margaret is gonna have any chance of success in the long term.

I know it's rough, but guess what?

This is that miracle we prayed for, isn't it? Mm-hmm?

-[sobbing] -We finally got it. Give me a high-five.

- You prove to him you can do it. - [crying]

[Millie] Okay?

You don't have to prove to me, I already know it.

- Prove him wrong. - [crying]

I'll put a picture on the end of the bed

and let you look at it every day when you think about it.

You say, "I'm gonna prove them wrong."

Oh, I need to put some powder right here.

You're rashed.

[Margaret] It's been a week since I've come home from the hospital.

And since then, I've been trying to eat like Dr. Now says

and to do the exercises he wants.

But ever since then, I've been really scared of falling like I did before

because my legs have such a hard time supporting all my weight.

Look, look! Isn't that something?

Yes! Yes!

[Margaret] And I don't wanna let her down,

so I'm doing what Dr. Now told us to do

'cause I know I need to get this surgery

so I can live a life more than this.

Ready, honey? You ready?

One, two, three!

Up, one more time.

Now.

- All right, you want a salad? - Mm-hmm.

[Margaret] But food has always been there for me.

And if you take that away from me,

I'm not sure how I'm supposed to get by.

I've been eating wrong my whole life.

Not just the wrong foods but for the wrong reasons too.

In my kid years, we were starving

because my daddy ate up all the food.

My dad was 1,000 pounds.

I have two other sisters, Becky and Tiffany.

And between us, all we got to do is eat his leftovers.

If we ever complained, Mama would shush us so we wouldn't upset him

because my dad was a terrifying man.

[crying] My dad was very controlling.

And if he said, "You be right here," she had to be right there.

That's how he was.

You'd wanna hide your feelings away from him 'cause if you argued with him,

then he would call us names and just be very mean.

So I learned to sneak into the kitchen

and I ate his food to get back at him.

When I ate my dad's food it was for revenge,

so he wouldn't have it for his self.

[Millie] She'd get up in the middle of the night.

If we had something leftover in the ice box,

she'd go in there and she would make it

look like she didn't eat it, but she did eat it.

[Margaret] That's how I got to 120 pounds by the time I was 6.

That's when I was diagnosed with early signs of diabetes and an eating disorder.

My mom, she started preparing me my own special meals,

just like she did for my dad.

Except mine was healthier.

And it worked, I started to lose weight.

And I was happier because I was getting the attention and the love I was craving.

But my dad did not like not having all the attention on him.

My dad would make my mom leave us and go with him.

[Millie] He demanded that I had to be at the hospital with him every time he went.

I had to go with him to the doctor's.

He had to go to Dallas.

And for two months, I had to be completely away from my kids

and live in Dallas, while they stayed back in Arkansas.

[Margaret] My mom sent us down the road

to live with our grandmother on my dad's side.

She was the reason my dad is as messed up as he was.

I'd call her "Evil Grandma."

Or, "The Wicked Witch."

She's the reason why my dad has so much hate in his heart.

I remember one of the ways that she would abuse me was with food.

She made me eat 10 eggs in a row 'cause I said I was hungry.

But my mama must have figured it out how my grandmother was,

because she sent us to go stay with my aunt Carla.

Oh, Aunt Carla, I really loved her.

I really, really loved her.

When we got to go to Aunt Carla's,

it was the first time in my life where I could eat

without being attacked or ridiculed.

The time we spent there were the happiest times of my life.

We got to be real close.

And then, around when I started high school, I lost my aunt Carla.

She was like a second mama to me, a guardian angel, my hero.

She died very courageously

from a blood-clot that broke off from her heart and went to her lungs.

Losing my aunt Carla took a piece of my heart.

I was crushed.

So again, I resorted to food,

because food was the only thing I had to make the pain go away.

And by the time I was 15, I was pushing 300 pounds.

Everybody was cruel to Margaret about one thing or the other.

By the time she was 16, she was so depressed that she just wanted to die.

It was all due to her needing to feed what was wrong in here.

When she looked in the mirror,

apparently she didn't love who she was even though I loved her.

I don't know why she felt like she wasn't important.

I didn't know how to help her.

[Margaret] I finished my senior year without friends.

And I just kept eating.

So after I left high school, I was about 400 pounds.

I tried looking for a job but nobody wanted me.

By the time I was 20, I was pushing 500 pounds.

It was hard for me to drive or do things for myself.

I went on disability.

My dad became more abusive.

After that, my mom reached a point of no return.

So she packed her stuff

and left with my older sister, Tiffany,

to take shelter with a friend.

I woke up the next morning and my sister and my mama were gone.

So my dad told me she had abandoned me because I was a fat pig and useless

and she couldn't take care of me no more.

Losing her was the most upsetting part of my life.

I didn't care if I lived or died, so I would eat to escape.

I was so terribly lonely.

She would just sit there and urinate on herself

and that's pretty much where she stayed.

I mean, she was always a lonely child to begin with,

and now she was being alienated and thinking,

"Mama don't love me, she's abandoned me,"

then self-destruct.

[Margaret] I found out that my dad told lies to my mama about me.

He was telling her I hated her,

and that I was furious that she left without me,

and that I was glad she was gone.

Hearing all of this for the first time put me in a state of shock.

I never wanted to see my dad again.

I begged my mom to take me back.

[crying] Mama said, "Baby, you can live with me, I never said you couldn't.

I never told you I didn't want you.

I just didn't want your daddy no more."

I was so relieved, I kept eating like I always did.

And before I knew it, I was 750 pounds, dependent on my mama.

My cellulitis infection had gone into my blood stream.

The infection kept getting worse, and that took me down more.

And before I knew it, I had become dependent on my mama.

But this feels like a stroke of luck to be working with Dr. Now.

I know he helps a lot of people like me.

And I have my daddy's voice in my head telling me I'm a no good failure,

and that just makes me wanna give up.

My biggest fear is what if he's right.

So I know I have to do this.

I am just afraid that I won't be able to.

Because if I can't, that's really the end for me.

So I just gotta give it my best

and hope and pray that's good enough.

[Millie] All right, let me get you up and let's get you going.

You want some coffee?

[Margaret] No.

[Millie] One of them days?

My mom woke me up this morning and I hurt in the leg.

All right, get your bearings together.

I'm gonna fix me a cup of coffee and I be in here to get you up.

[Margaret] Everyday is a new struggle.

Today my leg is really bad swollen.

And so it... It just... It hurts.

All right, Margaret.

PT called me and they're gonna be out this morning,

but I need to get you up before they come.

Okay?

So let's get this show on the road.

Today, I'm supposed to go to physical therapy,

but usually I don't have this swollen leg.

And so, I just didn't really want to do nothing today.

I did call and try to get her on the schedule for next week,

and it's just been tough. I mean, it's been tough.

I can't tell you how many times a week she tells me she quits.

[Millie] PT's gonna be in here.

- [Margaret] Shut up! - [dogs barking]

[Millie] Dr. Now, he needs you to get up 'cause of the blood clot.

And every [bleep] damn thing else.

You already have a history of diabetes.

[Margaret] Yeah, I know. But they keep pushing on you, and they keep pushing on me.

[crying] I'm sick of it!

- [dogs barking] - [Millie] We're not coming today.

[Margaret] Told you to just leave me alone, Mom.

[Millie] No, I'm not.

[woman] I'm assuming that was her mom.

[Margaret] It's all about what you want.

[Millie] Okay, fine, I quit. You want that?

[Millie speaking]

[woman] Okay, I don't know how quickly we'll be able to get scheduled next week

'cause we really moved things around to see her.

There's not any way she'll do any PT today

to make sure that she can get scheduled for surgery?

[Millie] Hello.

Hi, Miss Margaret, I'm Mallory.

So I'm the physical therapist.

I think they just wanted us to kind of do a general assessment

and see kind of where you're at.

Um, normally are you able to, like...

Right now, you're not... I'm not gonna make you sit up.

- But if you needed to sit up, are you able to sit up? - Yes.

- You're able to sit up all by yourself? - Yes.

- Not... No help, no nothing? - No help.

- Okay, what about like getting up from sitting to standing? - I can get up like that, too.

- You can? - I can do it by myself.

- Okay, you can do all that part by yourself? - Yes.

- No issues? - It's just I'm having problems walking.

- And so-- - Is it, like, balance problems walking--

- Yes. - or pain problems?

It's balance and pain.

And pain. Okay, where is the pain when you're walking?

- My knees. - In your knees.

- Okay, is it the whole knee, or like-- - Oh, yes. It's the whole knee.

- Everywhere? - Uh, they... I have no cartilage in them.

- Okay, no cartilage in either knee. - So they hurt.

Okay, um, how far are you normally able to walk

before you have to sit?

From here to the computer table.

Okay, can you lift this foot up toward you?

Okay, hold it right there. Don't let me push.

- Does that hurt? - Nope.

No. Okay, can you push down into my hand?

Good what about this side? Can you bring it up?

Hold it up, don't let me push.

- [Margaret groans] - Ooh, that one hurt?

- Or is it hard to do? - It's hard to do it because it's making that knee hurt.

[Mallory] That's making your knee hurt when you try and hold it up?

Okay, can you push down?

- Does that make-- - Mm-mm.

That makes your knee hurt, too? Yeah?

Here. Can you pull like you're trying to pull me?

Okay, what about push? Can you push? Okay.

Okay, can you hold your arm right here? Don't let me push it down.

Hold it right there. Any pain? No?

Can you lift it up above? Yeah, you can? Okay.

- All right, you have any weakness in your arms? - No.

Like, in your hands or anything? No?

We made you kind of a goody bag so you have some stuff that you can do.

'Cause I've got the purple one.

Yeah, so this... This is blue.

I don't know what... They're just...

- Different brands have different colors-- - See?

- Oh, yeah. - But watch.

I can...

- Does that hurt? - Nope.

Okay, when you're standing, do you have to hold on to something?

- Yes. - Yes? Okay.

- If you don't hold on to something-- - I'm wobbly.

I just have to have something to hold on to

because I'm not stable in the feet.

Okay.

- Okay, you have pain in your feet? - No.

-No, only in your knees? No hip pain? -Nope.

- No back pain? - Mm-mm.

Nothing? Okay.

- We gave you a stress ball. - [laughs]

[Mallory laughs] Girl, squeeze away.

- You know how much I'm gonna be using this? - [Mallory] That's okay.

I can give you one of these in each hand.

[Margaret] I feel better after meeting the physical trainers.

They're nice people and they got my best interests at heart.

So they can come back on the right day

and we can work together some more.

That will be good when we do that.

In the meantime, I'll do more on my own and with my mama.

All right, it was good working with you

and we will, hopefully, see you soon.

- Okay, yes. - Okay? All right.

-Bye, nice to meet you. -All right, yeah, you too. All right.

- Thanks. - No problem.

[Millie] Margaret, we have got to get up.

- Come on. - I'm coming, Mama.

No, I don't have a lot of time, Margaret.

[bleeping].

[Millie] Come on.

[exhales]

Push, push, push, push.

It'll be worth it.

Is this not what we've wanted for seven years?

You remember? You were my partner then.

[Millie] I know it's rough.

[Margaret] Yeah, you don't know nothing.

[dog barking]

I got you.

I'm done.

[Millie] I just want you to walk one more time, and then back--

I'm done.

This is really hurting me right now.

Get over this "I feel sorry for Margaret" stuff.

- Mom, shut the hell up! - [Millie] No, I'm not.

It is very important that he sees you're moving.

I've let you get away with this way too long.

Now, it's time to get up.

- [Margaret cries] - Now, come on!

- Why are you pushing me so-- - [Millie] Because I am.

I'm gonna run go get my clothes on.

This is your last shot, so come on.

[sighs]

[groaning]

- Every step. - [Margaret cries]

[Millie] Yes, it will. Every step.

[Margaret] One, two.

Now, because this leg is so edematous,

- scoot over some more in bed. - I will.

It's just swollen and it hurts.

I'm getting sick.

That's that shot.

[groaning]

Oh.

[Margaret] I've been working really hard this past month.

And I've worked out a lot and got a lot more mobile.

But I've had to do it all on my own because PT has not been coming.

But I've been doing fine on my own.

I got a little bit more slower,

and maybe the PT won't like that.

But it's better to me that way because my leg has been hurting me.

And it keeps getting worse.

I don't wanna push myself so far that I injure myself.

But I've been able to get a lot more mobile and that feels really good.

I'm really happy about that.

And I really want Dr. Now to see how much weight I've lost,

and how much I can get around.

But my mom had to work today, so she can't drive me to my appointment.

So I'm not going to the clinic because I had to cancel it.

But Dr. Now set up a video call to see me anyways.

And I'm worried that he's gonna say I'm not taking it seriously.

But I really am.

If it wasn't for my leg hurting so much, then I'd be doing even more.

It's just really that my mama's gotta work.

[video call rings]

Hi, Margaret.

Hi.

How are you today?

In pain.

[Dr. Now] So is that why you're not making it in to see me today?

Because last I talked to you, you said you're gonna be able to come to office,

and frankly, that's not happening.

So give me some idea what's going on with you.

Mom had to work today, and so I had no way of coming.

I'm in pain but I'm willing to deal with that to see you.

Your mom had to work today?

And I didn't have a ride.

[Dr. Now] Come on, Margaret, we had this scheduled for a while now.

And you could have called me to let me know that before today.

So I don't believe that's the reason.

[Margaret] It's the only reason, Dr. Now.

My leg hurts but that wouldn't stop me.

I just need my mom to drive me and she can't.

[Dr. Now] Now, physical therapy says

you haven't been cooperating with them most days.

[Margaret] No, that's not it.

They haven't been coming consistently for physical therapy.

[Dr. Now] They have, but you turn them away a lot of times.

But we're gonna make sure we have physical therapy come to you no matter what.

But right now, I want to see your progress.

So you need to come see me today.

[Margaret] I don't have a ride.

Margaret, you can use METROLift.

I'm not heard nothing about METROLift.

You have to call METROLift and you set a time, they come and pick you up.

I'll get Rosie to give you the information about that

so you can set it up. And you can get in a wheelchair, right?

Yes.

Okay, they can pick you up with the wheelchair and bring you to office, okay?

Okay.

[Dr. Now] You don't have to be up walking the whole way,

but if you aren't able to at least walk around the clinic,

then that's gonna be an issue.

But METROLift can help you.

Okay.

I need to make sure you're making progress

and not gaining your weight back.

Are you feeling that you lost any weight?

- Yes, sir. - You are looking like

you have lost some weight.

So that's good, but you don't look like

you have lost a whole lot in two months.

So what you have done with your eating habit?

I have cut everything down.

I'm... I don't eat nothing but salads, uh, baked chicken, baked fish.

I don't eat nothing... If it don't...

If it don't swim, fly, I don't eat it.

How is your mother, uh, cooperating with your eating?

Oh, my gosh, she's doing good with it.

She... Matter of fact, she's even on the diet with me.

All right, so she's not over feeding you?

No. No, she's not but there is times where I'm not hungry

and she tells me I have to eat something,

but that's just to keep my nutrition up.

So if you're not hungry, you can skip a meal, can't you?

Oh, I can skip a meal if I'm not hungry?

Yeah.

Oh, well, thank you, 'cause we thought we had to put three meals in every day.

[Dr. Now] You... You don't have to eat three times a day,

you can skip a meal if you're not hungry,

but make sure you drink plenty of liquid.

- Okay? - Oh.

You ain't gotta worry about that, I drink a lot of water.

Yeah, that'll... That'll be fine, that'll be fine.

That's all I drink, is water, water, water.

Good and if you not doing anything,

just make sure you do some exercise, okay?

I do that.

All right, so you're going over the instruction I gave you everyday,

and read it and get yourself more efficient with your eating habit?

Yes.

Okay. All right. How is your activity and exercise doing?

It's doing really good, uh...

I'm able to get around a lot more when my leg's not hurting.

We're gonna go out and make arrangement for you to get the transport

to bring you to the office today so we can check your weight

and see how you're getting around.

- Okay? - Okay.

So we can give you the information to call METROLift

and they gonna be able to bring you in,

so you don't have to depend on your mom to take off the work.

- Okay? - Okay, thank you.

All right, and I'll see you in a little bit.

- Okay? - All right, thank you, bye-bye.

[Margaret] My appointment with Dr. Now is today.

After the call with Dr. Now last time, when I missed my appointment with him,

my mom called him back and told him I couldn't go

because my leg was hurting and it was becoming infected.

Then, Dr. Now prescribed me some antibiotics

and gave me more time by rescheduling one month later.

But he was serious that I had to make it this time,

and that I had to be up and walking on my own into the clinic.

So I've been working very hard.

But I'm still scared though,

to find out that I don't qualify for weight-loss surgery.

Margaret?

[Margaret] At the hospital, I was 685.

Dr. Now wanted me to lose at least 60 pounds.

And I know I made good progress.

So I'm hoping I'm at the 625 goal that Dr. Now wanted me at.

But whatever my weight is, I know I've lost a lot.

Come around here.

Ready? One, two, three.

Now, let go of Mom.

- [laughs] It keeps going-- - Don't move, okay? Don't move.

Your weight is 632.

She's lost 100 pounds.

[cheers]

I knew we were eating like rabbits.

- Didn't we, Margaret? - Oh, my God.

[Millie] Isn't it worth them rabbit eatings?

Oh, my God.

[kisses]

Cowabunga! Give me them up! That's it. [laughs]

We did it, didn't we?

Yes.

Yes, we did.

We got it.

Okay, we're gonna be going to room five now, okay?

We gotta walk it, mama.

[Margaret] Oh, my goodness. I can't believe this.

I've never lost that much in my life.

All right, let me get on the other side of you.

And I'll roll up to it.

I just hope that Dr. Now says that's enough

and I'm gonna have weight-loss surgery.

[Millie] One, two, three.

Let me help you get over here, and then I'm gonna get you.

Just tell me how you want me.

[Margaret] This is incredible.

Dr. Now is really a miracle worker,

because I never thought I'd be able to do it like this.

This just changes everything.

I'm gonna prove my daddy wrong and show him I'm good at something.

[knock on door]

Hello, how y'all doing?

- [Margaret] Doing good. - We're excited.

Great.

Well, Margaret, last month I saw you on a video call.

And then, you didn't make it back in.

I never thought we gonna see you in here, so I'm glad to see you here.

- Yeah. - [Millie laughs]

[Dr. Now] Even though it's been a month since you were supposed to be here,

I'm very happy you made it.

And on top of that, you lost weight and you're more mobile.

So you're down to 632.

So you lost 120 pounds.

All right.

So that's positive.

But, uh, we got a long way to go.

So what I wanna do next is talk to you

going to psychotherapy with your mom

to help you to work on your dieting a little bit more.

Then, I want you to get to work with PT,

to get you a little bit more mobile over the next month.

And if you do those things,

providing that you continue losing like you have been

and you stick with the program

and we do some tests and see if you're gonna be safe to do weight-loss surgery,

then we're gonna, um, approve you for that.

- But all those things-- - [cries]

Okay?

You just made her day.

I told her we'd left all the Debbie Downers and we were gonna get this.

Not the same girl you met back at the hospital, is it?

We got it baby, we got it.

Oh, my God.

- We've tried this so many times. - I'd love to give you a kiss.

You are my Godsend.

You're gonna be one of her first dance partners

after she gets down to where she can stand up and walk.

You're my Godsend.

Well, I'm proud of your progress.

And if you keep it up, we can get you to weight loss surgery, safely.

And make sure that everything is gonna be all right for you.

So keep up the good work.

Don't think that you have a made it and relax and go back to eat habits.

- Oh, no! No, no, no. - [Millie] No, no, no, no.

- [Dr. Now] Okay. - I went this far, I'm not going back.

We want to be down to 200 pounds before next year.

That's a good goal.

And weight loss surgery will help her do that.

So, try to work on improving your hygiene if you want your leg to improve.

So keep it up. And stick with the program.

[Margaret] I'm sticking with it.

- All right, I'm proud of your progress. - Thank you.

- Give me a call if you need anything. - [Margaret] Okay.

All right, I'll see you next month.

- Thank you, see you next month. - [Millie] Yeah, yeah.

I'm so excited, I can't stand it, Margaret.

- I'm so excited. Gosh, dang. - Come here, please.

[Dr. Now] I'm very proud of Margaret and Millie despite my concerns.

When Margaret left the hospital, I gave them the benefit of the doubt.

But with her resistance to PT at home,

and after she made excuses and didn't show up last month,

I was very skeptical that she would make the progress she needs.

Or that she would ever show up again.

But it is a pleasant surprise to see Margaret's progress.

And it shows me they are both taking this seriously.

But before we move ahead with weight loss surgery,

Margaret needs to make a little more progress with her mobility.

And it's important that both of them

start the process of going to psychotherapy together.

It's very clear that it was in the disfunction dynamic she has with her mom

is going to be essential to making sure Margaret maintains her lifestyle change

for the long term.

[panting]

[Margaret] This is so exciting.

I'm so excited to be getting surgery from Dr. Now.

And that I have this chance to change my life.

It's an answer to prayer and a dream come true.

So I'm gonna keep working my butt off.

I know this is my last chance to turn my life around.

So I'm not going to mess this up.

I'm a do all the things I should be doing.

And I'm not gonna let up, no matter what.

[Millie] One, two.

Got ya.

[Margaret] Because now I can see the light at the end of the tunnel

and I'm just moving faster towards it.

[Margaret] It has been two weeks since

my last appointment with Dr. Now.

And I've been doing really good with my progress.

I've been doing all my physical therapy every time they come.

I like Brandon, he's good.

- Hello? - [dogs barking]

How are you?

Ready for some fun and games?

All right, go ahead and sit up.

[sighing in exhaustion] Now we're up.

Now, I don't want to wear out the legs with exercise.

So let's walk. Okay, slow. Slow and controlled.

You're doing great.

[Margaret] Walking with my physical therapist still scares me,

but I know he's got me.

He's not gonna let me fall.

Doing great, Margaret.

[Margaret] I am very, very, very determined to get back up on my feet.

And to do it for myself.

I know I can do this and I have a big glimmer of hope.

Good job. Very good.

Great job.

Now, lean forward and press up.

[Margaret] The only thing I haven't had time to figure out

is therapy for me and my mom.

Like Dr. Now wants us to do.

The hard part is momma has to find time to take off from work.

And that's gonna take a whole day.

So when my momma can figure out the schedule we'll be doing that for sure.

But that's the only thing.

Other than that, I've been a good girl.

So I think this is gonna be really good when I get in there to see Dr. Now.

Because there's progress I'm making for sure.

And the best of that is I can move a lot better, hither and yon.

And I can't wait to show him, because I want that surgery.

And it's time for me to get it.

You made it.

All right, you did great.

We'll keep it up. I'll be back on Friday.

All right, ma'am you take care. I'll be back.

Keep up with the exercises, okay?

-Yes, sir. I'll see you Friday. -Okay.

Give me your hand.

All right.

[Margaret] Today, I'm going back to see Dr. Now at his clinic.

Just get behind me.

Okay.

And I'm hoping today's the day that I get scheduled for surgery.

I've worked so hard and it feels so long

that I really think it's gonna happen today.

The last time I was here, I weighed 632 pounds.

If I was still losing at a steady pace,

I would have lost another 50 pounds this month.

That means I would have been down to the 500's.

And I really hope I made it there.

[Millie] And we'll find out what we are today, I hope we're in the 5's.

Wouldn't that be cool?

Wouldn't that be cool?

But even if we're in the low six, we don't care.

But I'm betting we are.

Margaret.

All right.

- Oh, don't dump me out! - I'm not gonna dump you out.

- I just got you through the door. - All right.

Just got to give me a second.

[Millie] Once you get up there you gotta let go.

[sighing in exhaustion] Come on, hurry, calculate. Hurry, hurry, hurry.

Come on, come on, come on.

Your weight is 626.

I didn't lose enough.

Well, we're still doing good.

It's fine.

[panting]

[Margaret] I don't know what happened or how that's right.

I just hope Dr. Now can be happy with what I did.

[Millie] I'm going.

[Margaret] And that he'll see that.

And he'll go ahead and schedule me for weight loss surgery.

I think I'm just having a bad day.

How about that?

[Margaret] I'm all swolled up.

[knocking at door]

Hello, how y'all doing?

- [Millie] Okay. - Doing pretty good.

Good.

Well,

Margaret how's everything going with you?

I'm disappointed.

Well, uh, what do you mean you're disappointed?

Cause I thought I would lose more than what I've lost.

Well, if you were doing your part,

you would have lost 50 pounds this past month.

So, it looks like you backslid.

And you're still not fully cooperating with PT.

And you refused to do psychotherapy.

So, this isn't good.

Because you're still 626 pounds.

Your BMI today is 107.5.

So, you basically, both of you, went back to your old habits.

We don't know what we did wrong.

She's still eating the same way.

- I mean yesterday-- - Okay, hold on right there. Okay?

- Overeating-- - [Dr. Now] Just hold on.

And, like, you don't know what is going on?

There's a simple, simple math.

You're eating too much, you're not gonna lose weight.

Which part of this is very hard to understand?

That she's eating at least four times as much as what she should be eating.

So, why we overeating and playing like we don't know what's going on?

But she didn't overeat.

- She's still eating the same-- - You want to argue that with the scale?

Don't argue with me.

- But she didn't overeat. - You argue that with the scale.

She couldn't overeat I gave her proportioned meals.

And it's the same as I've always given her.

The only thing that we know that might have been different

is she quit eating the vinaigrette and ate honey mustard dressing.

Is she eat, what, a gallon of honey mustard?

Now, I don't know how much she put on her salad.

- [Margaret] The two cups. - But I can tell you that's the only difference.

So she's gaining from thin air, right?

[Millie] Well, I don't know how she done it.

This is what I know.

Now, I'm the one who fixes her meals.

- And unless she's getting up when I'm not there. - No.

I'm not getting up and I promise you that.

I don't know what went wrong, I don't know.

- Did you quit exercising during the day? - No.

For her to be 600 pounds and keep that 600 pounds,

she's eating 5,000-6,000 calories a day.

If she eat a 1,000 or 1,200 calorie

she gonna lose 100 pounds in one month.

Okay?

And don't come and tell me what you're eating.

You want to argue all that with the scale? Be my guest.

Okay?

If she's not losing weight, she's eating too much.

You know, she's eating the food that belongs next five years ahead of time.

Unless you drink your shake in the morning and you drink a shake at night,

and that's only 300 calories a day.

Who said she should be drinking a shake?

You are the enabler in that house.

- You are telling her something that is not correct. - [Millie] A protein shake.

Well, who said protein shake

- was okay to drink? - [Millie] Nobody.

So between you two, whatever is going on, we're killing her.

And if you don't go to therapy and do what you need, and take this seriously,

my bet is you come in next month you probably gain some weight.

- [Millie] We didn't even do a month before we came here. - And give me the same story

that you're not eating very much,

and between you two, you know, was maybe honey mustard, and, you know.

I don't want to hear excuses.

I don't want to see the tears.

I don't want to see any drama in here.

That we don't know what's going on

and all these stories that none of it is believable.

So, from here it is simple.

I want you to lose 35 pounds by next month.

And start seeing psychotherapy.

If not, then we are not moving ahead with you.

Just because we did not lose it Margaret, does not mean we can't--

I want to go home.

That's all I want. I just want out of this office and go home.

Try harder. You can do it.

Like you're mom said.

Okay?

We have faith that you can do this, Margaret.

- We're not quitting. - And you quit, you're never gonna make it.

Okay?

We're gonna get on this horse and we're gonna do what Dr. Now says.

All right, if you need anything, give me a call.

- Sure will. - All right.

[Dr. Now] I'm obviously disappointed

from what I see from Margaret and Millie's choices this past month.

There are elements where Millie tells Margaret positive things.

And pushes her to keep going and not quit.

But those are all cliches.

What matters is action.

And it is very dangerous when you have a dynamic where someone talk's the talk,

but doesn't support it with any of the choices they make.

I have no doubt that Millie loves Margaret and wants the best for her.

She talks supporting then contradicts that with her actions.

So whatever progress they have will be short-lived.

And unless they both start that process,

we won't be moving ahead with Margaret.

[Margaret] I was disappointed.

Let down.

Because I thought I did better than what I did.

I'm angry at myself cause I could have did better.

Just disappointed. [heavy sigh]

But don't give up.

You'll have your disappointments, but don't give up.

Here, wash your face down.

Make ya feel better. Get you started.

[Margaret] It's been a week since my appointment with Dr. Now.

Since then, me and my mom has talked,

and decided that surgery is the most important thing that could happen in my life.

- Through with the wash rag? - Yeah, I just threw it there.

Okay.

[Margaret] So we told Dr. Now we would do therapy.

- [knocking at door] - [dogs barking]

All right, get back.

- [Paradise] Hi there, I'm Dr. Paradise. - Hello.

- I'm Millie, I'm Margaret's mom. - [Paradise] Hi, Millie.

Would you like to sit over here where she's at?

[Paradise] You have a lot of protectors, don't you?

- [Margaret] Yes, sir. - [Millie] All right!

All right, enough!

Enough!

They don't bite. They're all friendly.

- I'm Millie and this is Margaret. - Millie and Margaret, okay.

-I'm Mom. -Good. Hi, Mom. Good to meet you.

So, Margaret, I'm glad to see you.

Um, thanks for having me in your house.

Tell me about growing up in your house. What was it like?

Hell.

You're getting sad pretty quick talking about that.

[Millie] We got this.

Give me your hand.

We got this.

We've got to heal now, do we not?

So you had a tough childhood.

So tough that you can't even talk about it.

When did you start getting big?

[Millie] She was about... In kindergarten she was big.

I was bullied.

Okay. Who protected you?

I didn't have anybody to protect me.

You know, I get the sense that your mom protects you,

even in just a couple minutes talking together,

your mom steps in and says stuff.

She wasn't there.

- What do you-- - [Millie] I had to work.

Did you work all the way through her growing up?

- [Millie] Yes. I still work. - Okay.

- You still work now. - Yes.

What is... Margaret's by herself during the day?

- Yes. - [Millie] Okay.

Um, how do you do when you're by yourself, Margaret?

I talk to her on the phone while she's a work.

So you talk to each other all day on the phone?

[Millie] Yes, we may have a seven-eight hour [laughs] phone call.

- It sounds like you were a very active mother. - [Millie] Yes.

- My babies are my world. - [Paradise] Right.

She's not a baby.

She's my baby.

She's your baby and she's 35.

She's still my baby. She'll always be my baby.

You know, the word "baby" implies a lot of care.

She's my baby, she's the youngest.

[Paradise] I'm a little worried... So yeah, I...

You know, I don't know you very well Margaret, we just started talking.

But I think that's gonna be my theme with you, is making you not a baby.

I think you must believe that the world is a dangerous place.

- It is, and I'm scared-- - [Millie] We don't trust nobody.

- [Dr. Paradise] And that, and that-- - I don't let nobody in.

And that people will hurt you, right?

They'll hurt me.

- That's the thing. - [Millie] And we have a trust issue.

- I have to say, cause I'm there too. - I have trust issues.

That's why I become her comfort zone. Her security blanket.

And I know you've been doing it forever.

But I'm gonna push you guys to be a little bit more independent.

- And, and-- - All right.

[Margaret] How do you do that?

You practice.

I want you guys to practice more and more times of independence for her.

And you get to step back.

And you get to attend to your job,

and your relationships, and you're always gonna be there for her.

But you're gonna be there for her in a way that's healthy

and appropriate for a 35-year-old woman.

[Margaret] So more or less you're saying [voice breaks] that I don't need her.

- No. - [Millie] No, Margaret.

He's not saying that you don't need me.

- He's more of less saying that my comfort zone is gone. - He's saying...

Margaret, you will always--

[Margaret] I need to let go of my comfort zone.

[Millie] He's not saying you need to let go of me.

Let's take the food from her, so that's a comfort zone gone.

Okay, now let's take the mother away from her,

that's another comfort zone gone.

Maybe we'll just keep breaking her,

- and breaking her, and breaking her. - [Mille] Margaret.

Margaret, your mother can be very present.

I'm just, I'm done. [crying]

-I'm done, I'm done, I'm done. -[Millie] We're a team. We're a team.

I'm always gonna love you. Give me a team.

Millie, Millie, do you notice in this moment that you're jumping in?

Because I know how stressful she is and it is a meltdown.

And she will want to resort to food.

And here's an opportunity, even in this little tiny moment.

We're gonna let her have her feelings,

'cause I think she's capable of working through this.

[yelling] You don't know me!

[crying continues]

See the resistance?

Just get out of my house, just go, just go, get out of my house.

I'm done.

-He's not saying Margaret that I'm abandoning you -I'm done. I'm done.

It's interesting she's getting up in response to this.

Isn't it neat that she's getting out of bed in response to this?

But I want you to notice the urge, right now,

that you have to jump in and comfort her.

- And I-- - That's my job.

I think of her as a grown up adult.

And we've gotta let her self soothe.

Work on this on her own, in order for her to realize that.

The solution is to, um... to watch her

- take care of herself. - [Millie] Margaret, do you want your walker?

Margaret, please, do not try to walk without nothing.

She's trying to get away from y'all.

Okay.

But again, I want you to watch she's doing this without anybody's help.

I want her to go in and feel her feelings and be okay.

She's a grown up. She's gonna go deal with her feelings.

She's gonna come out in a couple hours

and I'm sure you guys will have a fine time after that.

And I think this is really good.

This is the push and pull, right?

You may see that as really negative, I'm proud of her.

- She basically said-- - I'm proud of her, in a way.

But I've seen the setbacks.

I don't think this is a setback at all,

I think this is a breakthrough.

She just stuck up for herself.

Somebody pushing her and she got space from it.

[Margaret] It's been a week since my appointment with Dr. Paradise.

I've been trying to think about what he told me to do.

It's been really hard because I'm scared of facing this world alone.

But today I'm gonna try and do some of the homework that Dr. Paradise gave me.

He told me it would be a big improvement,

if I could go longer and longer amounts of time

without needing to call my momma on the phone.

And today's gonna be a good day for me to try that out,

because she's got a new schedule.

So she ain't gonna be home in time for dinner.

And that scares me, but I'm gonna give it a try.

I know it's life or death for me to lose this weight.

So I'm trying it, even if I don't like it.

Because I'm going back to see Dr. Now in a few weeks.

And I don't want the appointment to go like it did last time.

I intend on getting approved for surgery.

So if I've gotta go outside my comfort zone, I'll do it.

Because I know my future depends on it.

I'm really dizzy today.

[panting and straining]

You got it.

Have we not?

[Margaret] I'm nervous about today,

and how it's gonna go.

[Millie] Well, don't scoot it up too much,

I gotta shut the door.

[Margaret] And I know

what it feels like to get my hopes up about it,

and then be disappointed if I didn't reach my goals.

I gotta open the door.

[Margaret] So I've been working extra,

trying my hardest to do everything I can

to make sure it goes better this time.

'Cause right now, Dr. Now will get fed up with me.

Margaret?

So that you can get up.

You're not supposed to be scared.

Foot.

At my last appointment, I was 626,

and I was supposed to lose 35 pounds in a month.

So if I did that, the number I need to see is 591.

I'm on it.

Okay, can I get off?

[softly] Wait, wait.

Momma, get that wheelchair.

Oh my, oh my goodness.

I did it, I did it.

[nurse] We're gonna go to room five, okay?

[Margaret] That's pretty close. I really hope it is.

I hope Dr. Now says it's okay.

I'm only four pounds off.

Oh, boy, I sure hope he says that's okay.

I feel proud of myself for that weight loss.

I'll be devastated if Dr. Now is not happy with that.

[knock on door]

Hello, how you all doing?

Doing good, you?

Good.

All right, Margaret, how you getting along?

I'm doing really good.

I can see that.

You're finally under 600,

- so how does that feel? - [Margaret] It feels great.

[Dr. Now] So, are you getting around easier,

and your stamina getting better?

- Yes. - All right.

We've got her showers down to in about 30 minutes time,

and that's getting up, out of the bed,

walking into the bathroom, getting in the shower,

and getting back out and getting back in bed, about 30 minutes.

Where it used to take us probably an hour and a half.

Okay, well, you're making some improvement, though.

And she fits in this wheelchair now,

and this is your wheelchair.

[Dr. Now] Okay. So going in the right direction.

So, what are you doing different

with your eating habits?

I'm not eating. [chuckles]

You're what?

I'm not eating.

[chuckles] It might be three or four o'clock

in the afternoon before I finally do eat.

[Millie and Margaret] And it's a salad.

[Millie and Margaret] With no dressing.

Well, you lost 31 pounds,

- so this is... - In 14 days.

It's not a whole lot of weight lost when you are 600 pounds.

So what do you mean?

You maybe think you're not eating,

but you're still eating.

Well, like I said, I'm just...

It's three or four o'clock in the afternoon before I eat,

and it's salad with just a handful of protein.

It's mostly salad. It's mostly lettuce and tomatoes and...

[Millie] It's not even an ounce and a half

of baked chicken.

So, what do you call a handful of protein?

That's what, I weigh it out. It's about an ounce of...

'Cause I weight it up,

it's an ounce of baked chicken.

Okay, and what are you drinking?

Water.

Okay.

I will not go from anything but water.

All right. If all that is accurate,

you would have lost

two to three times what you did.

So you're still eating more than you realize.

But you're making some progress.

But let's tighten up a little bit more, okay?

- You're taking the vitamins? - Yes.

[Dr. Now] Okay.

I used to be all about carbs. All about carbs.

I don't care about carbs no more!

- Good. - [Margaret] I don't want them.

I've learned that the carbs and sugars

is what makes you gain the weight.

I don't want that no more.

[Millie] We dropped the carbs, the fat,

and the sugar.

I don't need that in my life no more.

At least we are on the right track now.

We just need to keep pushing, and go harder.

And the most important thing is

that you both started psychotherapy.

So I'm proud of both of you for that.

Okay, thank you.

So, with all your progress, Margaret,

I'm willing to schedule you for endoscopy in one month.

You've still got a long way to go.

Stay focused and don't give up.

And if you lose another 30 pounds

and keep doing the psychotherapy and PT,

and if everything looks good in your endoscopy and tests,

then I will schedule you

for weight loss surgery at that point.

Yes, sir.

Okay. So, have a positive attitude

and work hard, and you're gonna get there, okay?

All righty. Thank you, Dr. Now.

- All right, bye. - [Margaret] All right.

We got that one.

I'm happy to see that Margaret and Millie

have gotten back on the wagon,

and that they both have started psychotherapy.

That may be helping them turn things around.

But they both will need to stick with that

if they expect to make any of these changes.

And before I feel like

Margaret is ready to move ahead,

I need to see a little more consistency from her.

So if she keeps moving in the right direction,

doing what she needs,

by going to psychotherapy and sticking to her PT,

and then loses another 30 pounds by her endoscopy,

we will move ahead and do weight loss surgery on her.

So, we'll see how she's doing next month

and go from there.

But right now, I'm encouraged

by what I'm seeing from both her and Millie.

[Margaret] I'm so happy and excited

to move forward like this.

It feels like I'm so close. I'm almost there.

There's no way in no hell I'm gonna stop trying now.

Not now and not ever.

I'm gonna make Momma and Dr. Now proud

for sticking with me.

'Cause I still got a lot to live yet.

Just you wait and see.

I'm here at the hospital for my endoscopy,

so Dr. Now can look down in my stomach.

'Cause here lately I've been feeling

a lot of pain in my stomach.

At first, I thought it was just because I was hungry.

But Doc says it might be something else,

and that he better check it out,

and to find out if I'm going to be fit to get the surgery.

[choked up] We're gonna get this done.

[Millie] Yes, we are.

But promise me you'll be here when I wake up.

Yes, Margaret, I am not gonna leave you.

Have I left you?

I keep telling you, when I left your daddy,

it was I left your daddy, I didn't leave you.

Look at me.

Who did I leave?

Dad.

I didn't leave you. You had a choice to go, did you not?

- Yeah. - I don't leave my kids.

And I will be here when you wake up.

Uh-uh.

Have I not been with you every step of the way?

So why would I stop now?

Quit them tears.

It's gonna be okay.

I'm gonna be sitting right here

waiting on you when you come back.

Got it?

[Millie] Where am I gonna be when you wake up?

Right here.

[Millie] I'm not going anywhere.

Ah, don't start your bawling.

We got this.

Love you.

I love you.

[Millie] Get back here.

Today, we're gonna do an endoscopy on Margaret

to make sure there are no issues

that would prevent us

from doing weight loss surgery on her.

She started working with psychotherapy,

which was the big step I wanted her to take.

So because of all that,

and the fact that she hasn't started gaining weight,

and she's working with physical therapy

off and on now,

I am willing to start the process with her

to do weight loss surgery,

starting with the testing.

She has been complaining of stomach pain recently,

so the priority is figuring out

what could be causing that,

and see if there is something we need to address with her

before we move ahead with anything.

All right, we can go now.

[woman speaking]

[Dr. Now speaking]

[Dr. Now] We're gonna begin the endoscopy.

We're using the camera, go into her esophagus

and looking at her stomach.

Open.

We got a very huge stomach.

Very big stomach.

And everything for the most part looking good.

The opening of that does look good.

The rest of it looks good.

So she does not have a hernia.

But she has a big stomach.

Okay, everything looks good,

so we're gonna remove the scope.

All right, well done.

Ooh, time to lie down.

All right, you're looking great.

How's everything?

Hey, Margaret.

Are you awake?

All right, your endoscopy looked good.

- [Margaret] Oh, that's good. - [Dr. Now] Okay?

So, everything looked good,

except you got some gall stones.

That looks to be the issue behind your stomach pain.

And probably that triggers

some nausea and abdominal pain.

Just take it easy in what you're eating

to help minimize any discomfort,

and we will address that for you

when we do your weight loss surgery.

The other issue is that

the infection in your leg has come back

because of poor hygiene.

So we need to keep you here to address that.

But it shouldn't take too long.

And keep up your good work.

And since you lost some weight...

Mm-hmm?

[Dr. Now] We're gonna go ahead and put you

in the schedule for weight loss surgery.

[both laughing joyfully]

Told you, teamwork! Come on, gimme teamwork.

We been waiting to hear them words, ain't we?

Pretty good words right there, ain't it?

Pretty good words.

- We got it, Momma! - [Millie] We got it!

That's what we sought.

- We got our surgery. - We got it.

And we're making our way there!

- You in for the ride? - [Millie] I'm ready.

[Dr. Now] But here's the situation.

It's gonna take about a month to make sure that

there are no issues with your infection,

and to be safe before we move ahead with the operation.

So I'm gonna keep you here until next month

to do that, and during that time,

I want you to work with physical therapy

to build up your stamina,

get yourself ready for surgery.

And you did very good with anesthesia today,

so you can do well with that too.

Okay?

You hear what he said?

Thank you, Dr. Now.

Hey, you're welcome.

You did the hard work, huh?

I did.

- I've worked my butt off. - It has been a journey.

[Dr. Now] I'm proud of you.

So far, you have lost 161 pounds.

One adult person she lost.

Yes.

She's done lost as much as I weigh. [laughs]

All right, keep the good work, and we'll get you ready

for weight loss surgery soon, okay?

Thank you, Dr. Now.

Thank you so much.

You're welcome.

You did the hard work, you did the work.

No, thank you, because now my baby's gonna live.

We're gonna get you down to your ideal body weight

in 18 months, okay?

- [Margaret] Thank you. - [Dr. Now] You're welcome.

All right, Margaret, I'll see you later, okay?

Okay. Thank you, thank you, thank you.

You're welcome. Well, take care.

I'm proud of Margaret and how hard she's worked.

But I have a concern that if we schedule her,

she will go back home and relax,

and start to slip a little.

So keeping Margaret here in a controlled environment

will help make sure that doesn't happen.

We will help her to do that,

because she has shown me she's ready,

and putting in the hard work.

So aside from any new issues that come up,

we will move ahead

with her weight loss surgery in one month.

- I love you. - I love you.

I love you.

You got this.

[Margaret] It's been a hard, long month

here in the hospital.

But I feel really good about all my progress.

Especially because today I'm getting my weight loss surgery.

[Millie] I'll be here when you wake up.

[Margaret] It's a really good feeling

after everything I've been through.

[Millie] Well, I have to come back for her wheelchair anyway.

[Margaret] All my trials and tribulations

has led me up to this moment.

[nurse] This is where we say goodbye.

I love you.

[nurse] And no more crying.

- [Margaret sobs] - Love you.

It's okay, Margaret. Promising you.

This is the opportunity

that we've been waiting for forever, isn't it?

Isn't it?

Let's make a deal.

We run the good thing.

It's gonna be okay, Margaret, I promise you.

It's gonna be okay.

Quit crying.

Come on, they've got to go. Everyone's waiting on you.

I love you. And I'll be here when you wake up, I promise.

[Dr. Now] Today we are attempting to perform

a gastric sleeve on Margaret.

We have her weight down to 516,

so we've gotten her to lose another 51 pounds

over the past month on a controlled diet.

And we've been able to get her more active with PT.

So I'm confident that she's ready to take this step today

and get her weight loss surgery.

What the surgery will do for Margaret

is that it will 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 operation will not only help curb her appetite,

but it will limit her ability to eat

so that she stays on track with her weight loss...

MAN: Room lights off, please, guys.

[Dr. Now speaking]

while we continue to work with her

on the emotional and psychological issues

behind her unhealthy eating.

So this surgery will be a big and important step for her

in her journey to get healthy.

All right, we are almost done removing her stomach.

[Millie] On our way here this morning,

I had to just keep reassuring Margaret

she was gonna make it through this surgery,

and I was gonna be fine.

We've had a long time getting here,

we're just glad we're finally here.

She was nervous, she was upset.

And of course I couldn't let her know

that I was just as nervous and as upset,

because, I mean, she cried really bad

going into the OR, scared.

She's scared she wouldn't wake up.

But she was more scared for me.

Because Margaret's afraid

that if something happened to her, that I'd fall apart.

And I probably would.

Mommas don't bury their babies.

[Dr. Now speaking]

[man] Keep pulling, keep pulling, keep pulling.

[Dr. Now speaking]

[Dr. Now] Margaret's surgery went very well.

We were able to do some gastrectomy safely on her.

We didn't have any issues with anesthesia.

There were no complications, and surgery went very well.

With this operation,

Margaret should be able to lose

30 to 40 pounds in one month,

then after that, lose 20 to 30 pounds each month

until she gets close to her target weight.

Margaret, after she recovers from the surgery,

she loses a little more weight,

she's going to need to have her gall stones addressed.

So it's either that, or she's going to need to have

the gall bladder surgery.

But right now, she's doing well

and I'm proud of her.

She has worked hard to make progress,

and to make the important changes she needs.

But we need to make sure

that Margaret is gonna be able to cope

with all the issues that she had

with the household dynamic

if she's going to be able to do this for the long term.

So it's going to be very important

that she keeps going to psychotherapy to do it.

If not, then it will only be a matter of time

before she starts to slip back into her old habits

to undo all her progress, and gain all her weight back.

But up to this point, I am proud of Margaret

for losing the weight she has,

and for getting out of her bed to become more mobile.

That took a lot of determination from her.

And my hope is that she keeps fighting hard

to move forward towards where she needs

more and more each day.

And if she does that, then I'm confident that

we'll be able to get her to her target weight

in the next 18 months,

to give her the chance

to start pursuing all the dreams

she has never been able to pursue and chase,

and a chance to finally start living the life she wants.

[Margaret] It's been about a month since my surgery,

and I'm still recovering,

though I'm feeling stronger

and I'm starting to get better.

And I'm feeling really good,

because my food craving's almost all the way gone.

It's still hard for me to believe

that I made it as far as I did.

And a year ago, I didn't know

if my life was worth fighting for.

But now I'm here, and I'm not only living,

I'm making plans for the future.

One thing, Margaret.

You can tell you had the stomach done.

[Margaret] Yeah.

It's all yours now, you own it.

Now you just gotta rock it.

[Margaret] Dr. Now says I need to keep going to therapy,

and how that's really important

if I wanna be a success story,

so I had one other session with Dr. Paradise,

and it went a little better than the first one.

This time, he was real careful to reassure me

that he wasn't trying to take my mom away from me,

and I started to trust him a little more.

I honestly know that my momma ain't gonna be here forever.

Then one day, I'll be here and she'll be gone,

so I can live my own life.

And it doesn't feel good to say that.

But Dr. Paradise says I need to fake it till I make it.

So here goes nothing.

Hello, world, I'm Margaret.

It took a lot.

You wouldn't believe the stuff that I've overcome

to be here today.

But now I'm an independent woman.

And Momma taught me everything I need to know.

So when she's up and gone, and I'm here all by myself,

I'm gonna do just fine on my own.

And that's gonna be the best gift

I could ever give her.

To live my life for me.

You know what, Momma? I'm gonna thrive.