Original subtitles

[Patrick Macon] I have to get

help with pretty much everything now,

and it shouldn't be that way.

[woman 1] Somewhere in me

is this little glimmer of hope.

I just wanna be a normal person.

[panting]

[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.

[groaning in pain] It hurts!

[woman 3] I refuse to stop fighting.

I have to do this for my children.

[groans]

Is it our fault that we're not doing anything for you?

Is it our fault that we're not doing anything for you?

-No, I didn't say it's your-- -Well, what's your problem then?

-You're overeating. -Okay.

[bed creaks]

[grunts softly]

[Amanda] Did you sleep good?

[Patrick] When I wake up and see daylight,

[Patrick] When I wake up and see daylight,

I'm surprised to still be alive.

Because my weight is killing me.

When I first wake up, I pretty much dread it

every day.

I dread the first time I get up out of the bed,

putting my weight on my legs.

I'm in pain.

My back hurts,

and walking just a few steps makes me get out of breath.

My body has given up on me and I hate it.

My body has given up on me and I hate it.

If I move too fast, I might fall

and hurt myself.

So it's all slow movements.

I have to get help with pretty much everything now.

I mean, just five or 10 years ago,

I wasn't this big then.

It was much easier to shower.

I didn't need nobody to help me.

I could do it myself.

[shower running]

[Patrick] I still try and do the things

that I can do by myself.

Now I'm so big,

my wife, Amanda, she has to

help me do lots that she shouldn't have to help me do.

And it shouldn't be that way.

And it shouldn't be that way.

Hey, babe, could you come help me?

[Amanda] It'll be 20 years we've been married.

Recently,

his health has decreased.

His legs and feet, they're hurting him really, really bad.

So, I try to help him

get up in the morning and

do whatever needs to be done really fast

so he can get breakfast,

and hopefully, he'll feel better, 'cause eating

and hopefully, he'll feel better, 'cause eating

is a relief for him.

[Patrick speaking]

[Amanda speaking]

[Patrick] It's embarrassing that it's come to this point.

It makes me feel bad for her.

But I have no choice, because if I don't shower at least once a day,

I get rashes between my creases and folds.

[breathing heavily]

Getting dressed is the most difficult part of my day.

So Amanda has to do it all for me.

She's got to put my socks on,

she has to help me put my shorts on,

which is just humiliating.

[Patrick speaking]

By the time I'm showered and dressed,

all I can think of is my first meal.

-I'm going upstairs. -[Patrick] All right.

If you need me, yell for me.

[Patrick] Are you gonna fix me something to eat while you're up there?

[Amanda] Yes, I am.

-Thank you. -[Amanda] You're welcome.

[exhales deeply]

[groans]

[smacking lips]

[security system beeping]

[automated voice] Front door.

Hey, Dad.

Hey, Dad.

-[Patrick] Hey, babe. [grunts] -I'm home.

[Patrick] All right, what you 'bout to do?

I'm about to go help Amanda in the kitchen.

-[Patrick] All right. -[both] I love you.

-[Haley] Hey, Amanda. -[Amanda] Hey, Bug. What are you doing?

[Haley] Nothing. Do you need help in the kitchen?

You could actually get the sausage out, if you would like.

Where is it?

[Amanda] It is in the oven and here is the pot holders.

[Patrick] I live with my wife

and my 16-year old daughter, Haley.

and my 16-year old daughter, Haley.

Me and her mother have joint custody of her,

so she's with us half the time.

But on the days that she does stay with her mom,

she'll still come back and forth throughout the day and see me,

knowin' that I needed some help.

[Patrick] Looks good.

You need anything else?

-[Patrick] No, this should be good. -[Haley] I'm good.

-[Amanda] Okay. -[Haley] If he does need the help,

I'm usually eight minutes down the street.

I can come stop by and...

say, "Hey," or

be like, "Hey, I'm here," you know?

I don't like being away from my dad

I don't like being away from my dad

so I always come around a lot.

[Patrick] I have addiction to food,

because nothing makes me feel as good as I do when I have food in my mouth.

In our family, obesity has really been an issue with all of us.

I was the second-youngest of four brothers and two sisters,

and they were all overweight.

Everyone, my mom, my cousins, my aunts, and uncles.

My dad had gastric bypass surgery to try to lose weight,

and it didn't work.

He got sick and they had to wind up reversing it.

Then, around the time I was eight,

my dad had a series of heart attacks.

So he retired early and our family moved to Marion County, Georgia.

My dad's health declined and he wasn't able to do so much.

And that caused problems in his marriage.

And that caused problems in his marriage.

Because even though he and my mom were happy,

she wound up going off with another man closer to her own age.

So that's when my dad decided he wanted to move

even further out into the country to this little ranch,

miles from anywhere,

and I made up my mind to go with him.

Those days, living with him on the ranch were some of the happiest times of my life.

Goin' fishin', goin' to play with horses, goin' ridin' a four-wheeler.

Goin' fishin', goin' to play with horses, goin' ridin' a four-wheeler.

This is the time I first remember gaining weight.

The day dad died, it felt like the whole world crumbled.

And it left a big hole in my heart.

A hole that I've spent the rest of my life tryin' to fill with food.

After my dad passed away,

I came back to live with my mom.

We never talked about him dyin'.

My mom's way of showing her sympathy to me was just like my dad's.

My mom's way of showing her sympathy to me was just like my dad's.

She'd give me anything I wanted to eat.

I mean, all I had to do was pretty much

ask two or three times and she would,

you know, she would do it.

So food became my way of comfortin' myself when I missed him,

because food was my way of keeping the connection

I had with my dad alive.

There literally wasn't nothing during that time

I really found that just

made me super happy. I was just...

made me super happy. I was just...

I was livin' to eat.

I never excelled real big in school because I wasn't real interested in it.

I went to work when I was pretty young,

but I couldn't hold a job very long.

My early 20s, I hadn't really dated much.

I was feelin' lonely.

I went online, lookin' for love,

and I was lucky enough to find Amanda.

You know, we've been truckin' along ever since.

I did screw up along the way.

I did screw up along the way.

I'm not gonna say that I screwed up,

because of my daughter came out of it.

And,

I mean, I wouldn't change that for anything in the world.

I did screw up with her momma that night.

But me and my wife worked things out.

My wife is a good woman. I'm... I'm thankful to have her.

I'm done, babe. That was good.

[Patrick] Yeah.

[Amanda speaking]

Think I probably will.

Think I probably will.

In my 20s,

I was workin' some. I worked some at an electric company.

I mean, I was 300, 400 pounds, out digging ditches.

And I just kinda floated around with the jobs

'cause I didn't really care about none of 'em,

and I decided I wanna be a repo man.

And once I finally got the opportunity to do that, I mean, that was...

my thing there, you know, I pretty much excelled at that.

There was a period of time from pretty much the time I met my wife till

There was a period of time from pretty much the time I met my wife till

my daughter was born

that I pretty much stayed the same weight.

But I was probably around 450 when my daughter came along,

and then,

I did gradually start getting bigger,

had to move up in pant sizes

till I finally couldn't work anymore because I was too big

to perform the job that I was hired to do.

But after I went on disability,

things between me and Amanda kinda shifted

from being romantic to her being more of a caretaker.

from being romantic to her being more of a caretaker.

Our intimacy got lost.

When you get this big, uh, I mean,

unless it hangs down till your knees, I mean,

once you get this big... [chuckles] ...I mean, you just got a problem.

[laughing] I mean, that's just all there is to it.

[Amanda] Do you need or want anything else?

[Patrick] No, I'm good. Thank you.

[Amanda] Last year and a half has been a struggle for him

since his mother has passed away.

He had a hernia and

he had to have an emergency surgery.

And it's just

been a battle since then.

[Patrick] My body was... It was

slowly but surely...

just slowin' me down to where I'm at now.

I think he has the mindset

of now that he really wants to change not only for himself

but for me and for the whole family,

because the whole family would

love to go do things that we've always talked about doing.

So I think that's the big reason that,

So I think that's the big reason that,

you know, his mindset is, "I want to do this."

I have to change the way I live.

I have to make a life change. I have to get my weight under control.

So I can spend more time with my wife and my daughter.

Do you want these or are they no good?

[Amanda] Uh, they should still be good.

[Amanda] Uh, they should still be good.

Just, like, we wanna go visit places and

we want to be able to do things just like any other

dad and daughter would be able to.

[grunting]

His legs and his feet, just, they hurt, they ache.

His breathing, I've noticed he's been having trouble with that.

He wants to be able to

do more things with Haley,

and be able to have a normal life.

and be able to have a normal life.

But his body is tired.

And it's just getting worse.

[Patrick grunts]

-Corn dogs and Tater Tots good for you? -[Patrick] Sounds good to me.

You wanna cook the corn dogs in the oven?

[Amanda] Yes, sir.

[exhales deeply]

[Patrick] They're looking good, babe.

I'm unhappy being this big.

If I don't lose weight, I feel like in a year or two years,

I'll wind up... It'll wind up killing me.

[grunts] Looks good, babe.

[Amanda] Enjoy.

-Oh, I am. -[Amanda chuckles softly]

I got a lot of goals. I wanna

get my daughter through school and grown and

make it to where she don't have to depend on no one to

support her.

She could do it herself.

I'm getting full, baby. It was good.

Think I'm gonna...

finish of this last corn dog and after that, I think I'm going to bed.

My legs are hurtin', my feet are hurtin'.

I'm glad you liked it.

I'm glad you liked it.

[Patrick] I can't go on like this anymore.

I need to change.

Are you nervous?

I am a very nervous.

It'll be all right.

Won't it, Hay-bug?

[Haley] Everything will be fine.

Promise it will.

That's got everything packed up.

I'm hittin' the road, headed to Texas to go see

the doctor about getting weight-loss surgery.

I've never driven this far. Period.

Got 'em.

[Patrick] Know it's gonna be a long trip.

I'mma be hurtin'.

That's Amanda, man. You stay inside.

[Patrick] It's gonna be my legs, from ridin'.

I'm just gonna be uncomfortable once that happens,

until I stop somewhere and get... Be able to get out of the truck and lay down.

I'm nervous, I'm worried.

I'm nervous, I'm worried.

Don't know what's gonna happen, I mean,

I'm goin' to see a doctor I've never seen, goin' to Texas,

I ain't never been to Texas.

It's a long way away.

My daughter is here. A long way away from her.

Just haven't ever been that far away.

[engine starts]

Do you have everything, Dad?

[Patrick] It's looking like it.

I'll see you when we get back.

[Haley] All right.

-[Patrick] You good? -[Haley] Yeah.

-[Patrick] You good? -[Haley] Yeah.

[Patrick] Don't get upset.

I'll be back in a few days.

[Haley sniffles]

[Patrick] Okay?

-[Haley] I love you. -[Patrick] I love you too.

[grunts]

Oh.

Oh!

[Amanda] I love you, Hay-bug.

[Haley] I love you too.

-Be careful. -[Patrick] Yeah.

-Be careful. -[Patrick] Yeah.

-Love you. -[Haley] Love you.

Babe, it's been a while since we've been on a road trip.

I'm nervous about the doctor and going all the way to Texas.

I ain't never drove this far.

[Amanda] How long is the drive?

[Patrick] Eleven hours.

Now that's with zero stops.

We're definitely gonna wind up having to stop so I can lay down and...

get my legs to stop hurtin'.

We're definitely not gonna make it there in one trip.

Oh, Lord.

Definitely gonna be a long ride.

'Cause I'm just tired of being fat.

[Amanda] Do you have anything in mind about what you want for dinner tonight?

[Patrick] Some kind of drive-through. [laughs]

[gps] In 500 feet, turn left onto Wind River Road north.

[woman on speaker] Thank you. Come on up.

[Patrick] Uh...

You ready?

[woman on speaker] Yes.

[Patrick] I want a, uh, number nine.

I want it large-sized.

Then I want another number nine.

No pickles.

I want it large-sized with a sweet tea.

Regular side of red beans and rice.

A regular side of macaroni and cheese.

Just a order of popcorn shrimp.

And a extra chicken sandwich with no pickles.

[woman on speaker] Will that be all for you?

[Patrick] Yes, ma'am.

[woman on speaker] All right. Stop in the lane.

$97.11.

You ready for your food?

Yep!

[Amanda] There's your popcorn shrimp.

And then...

here's your sandwiches.

[Patrick] Um, my legs are hurtin'. My feet are hurtin'.

I'm definitely gonna have a hard time stayin' awake after I eat this, huh?

[Patrick] As long as I can eat, I can keep the pain at a minimum.

Beans and rice is pretty good too.

Beans and rice is pretty good too.

They'd make it better if I had a biscuit to go with it.

[Amanda chuckles]

[Patrick] The doctor, he's gonna want me to eat better, so...

made sure I got me a good, greasy fried chicken sandwich, and,

yeah, kind of like the last hoorah.

I'm getting full.

[Amanda] All right.

[Patrick] We made it to Block C.

[grunts]

I'm tired, worn out.

My legs are hurtin'.

My feet are hurtin'.

My feet are hurtin'.

Gotta try to lay down, get some rest.

[groans]

Oh, [bleep].

It's at the end of the hallway.

Just everything to do with traveling is making my mind kind of exhausted.

Get to see the doctor tomorrow.

I'm interested to see what he's go to say,

and see if he can help me get the weight off of me.

[Amanda] Finally. Thank God.

[Amanda] Finally. Thank God.

[Patrick exhales deeply]

The bed's fat-people-approved.

-[Amanda] Is it? -[Patrick] Cover.

[Amanda] I got 'em.

I don't want none of that now, I'm kinda

warm. [sighs]

[Amanda] Okay.

Well, babe, we're finally here.

We finally made it to Houston. Tired, nervous, happy.

And scared.

I'm kinda scared to see the scale myself.

[Amanda] Are you ready?

[Patrick] Ready as I'm gonna be.

Are you okay?

My nerves are... [sighs]

And me going on this diet, it's probably gonna affect you too.

You gonna do it with me?

Yes, of course, I am.

It's gonna be hard. It's gonna take a lot of work.

[groans]

It is, but we can do it.

Patrick!

[Patrick] I haven't weighed myself in a few years.

But I think I'm over 600 pounds.

And I just hope that I'm not closer to 700 than I am 600.

Okay, you can go ahead and step on the scale.

[Patrick] I'm at Dr. Now's clinic in Houston to get my weight checked,

and to meet with Dr. Now for the first time

to get his help losing weight.

I think I'm over 600 pounds, but I haven't weighed myself in a few years.

[nurse] Okay, your weight is 657.

Okay. We're going to room five.

Okay. We're going to room five.

[Patrick] That's a little bit of a shock, to be honest with you.

That's higher than I was expecting.

[exhales deeply]

[knocking on door]

Hello, how are y'all doing?

Hello, how are y'all doing?

We're doing fine, how about you?

I'm good.

So, you must be Patrick.

-Yes, sir. -Well, good to meet you.

And who did you bring with you today?

My wife, Amanda.

Nice to meet you, guys.

Nice to meet you.

All right. So, where are you coming from?

Columbus, Georgia.

Okay. what brought you down to Houston?

Trying to get help with my weight.

-All right, then, you are 657? -Yes, sir.

All right, so how long you been at this weight?

Well, for a long time, I've been big all my life.

Well, for a long time, I've been big all my life.

I've never been this big though.

Well, your weight is definitely taking a toll on your body.

According to your chart, you have multiple

medical issues I see, like diabetes.

-Yes. -And sleep apnea?

-Yes. -So your body is clearly heading

to a breaking point soon. Now, how is your mobility?

I can get around.

I... I can move around.

So, what do you do all day?

Right now? Sit on my ass.

Right now? Sit on my ass.

You need to make sure you keep your stamina up.

Because with how your body's doing,

if you lose your mobility,

then that is likely gonna be it for you.

But if you lose some weight, that'll help stop your health from getting worse.

So why do you think you're overweight like this?

[sighs] Overeatin'.

I... I eat too much.

You eat too much in one sitting? Or you eat too much all day?

I probably snack all day,

but it's usually one big meal a day,

but it's usually one big meal a day,

and then just snacking throughout the day.

So what do you snack on?

Candy.

Whatever's there. Chips.

-You're diabetic and you eat candy? -Yes.

Did anybody tell you not to?

Yes.

I know I shouldn't do that.

You're 42 and you've been diabetic for five, six years,

and you're eating candy. You remind me of the guy that came in and said,

"My head hurt when I hit it with baseball bat."

"My head hurt when I hit it with baseball bat."

-[laughs] -And I said, "Wouldn't it be easier to stop that

than asking medicine for it?"

[laughs] Yeah.

Yeah, you're probably right, it'd be kinda like

shoving a rocket up my [bleep].

Doesn't mean I can... I know I can go to the moon if I do that.

But we know it's not gonna happen.

Okay, well, my analogy fits your situation better, I think.

Because the issue is, you have known what you're doing to yourself.

So you understand that you're gonna have to change your eating habits.

-Are you willing to do that? -Yes.

Okay. Amanda, should I believe him?

Okay. Amanda, should I believe him?

-Yes. -If you show me how to do it, and it'll get done.

-[Dr. Nowzaradan] All right. -Yes.

Amanda, do you work, or you stay home with him?

I stay at home.

[Dr. Nowzaradan] You stay at home.

So, you said chips and candy. Who buys those?

Okay, so the family enables you and gets you what you want.

And you just sit around eating.

And you say you don't know what to do to get better and lose weight?

-Is that about right? -[Patrick] Yes, sir.

Have you heard the expression, "Eat less and do more exercise"?

Have you heard the expression, "Eat less and do more exercise"?

-[laughs] -Like, you didn't know that?

Uh, I know it.

It's just more of I have to get up off my butt and do it.

Well, yeah, like, this is not your first rodeo here.

You knew all these things and you haven't done much to change it.

So, I don't know if what we're going to tell you is gonna make any difference.

Well, because I need, I need help. I can't get it

all off by myself. I need... [sighs]

Well, you're gonna have to be motivated to stick with a healthy eating habit,

Well, you're gonna have to be motivated to stick with a healthy eating habit,

and get yourself in better shape,

because I guarantee you, you're not gonna live too long like this. Okay?

Yes sir.

Anything happen to you, even if you fall and twist your ankle,

then you can't get up and walk,

then you're gonna get bed-ridden

and you're not gonna be able to pull through out of that, okay?

I'm gonna give you the road map.

But if you don't follow it, there's not much we can do for you, okay?

-[Patrick] Yes sir. -All right. So, I'm gonna give you some instruction,

-[Patrick] Yes sir. -All right. So, I'm gonna give you some instruction,

what to eat, what not to eat.

Then gonna give you some instruction about exercise.

So, if you do those, and change your eating habit,

you should be able to lose 60 to 70 pound in one month.

Okay?

The goal I'm going to give you to prove to me that you're serious

is to lose 100 pounds in two months.

This can be a very easy thing to do if you follow the diet.

-Yes sir. -All right, Patrick, let me bring some stuff for you,

-and then we go over it, okay? -Yes, sir.

-All right. I'll be back. -[Patrick] Yes, sir.

-All right. I'll be back. -[Patrick] Yes, sir.

I just got to get that information from him and just do it.

You can do it. I know you can.

I have a lot of concerns about Patrick right now,

particularly his medical history.

With all the issues he has developed as the result of his weight,

it is clear his size has already taken a big toll on his body,

and as long as he continues to make excuses

and as long as he continues to make excuses

and claim he doesn't know what to do,

that it's only gonna get worse.

So if he wants to prevent his body giving up soon,

then it's important he works to turn things around with his health immediately.

And he's gonna need a lot of family support to do that.

Okay, Patrick, uh, this is a quick reference

Okay, Patrick, uh, this is a quick reference

to what you need to read every night

so you can understand what the issues are.

How Patrick controls his family

is probably by getting unpleasant if they don't bring him the food he wants.

So they enable him to avoid any sort of confrontation with him.

So he and his whole family has a lot of work to do

to turn his situation around.

If they don't, then Patrick

is gonna continue doing what he's been doing,

and getting bigger.

and getting bigger.

And if he does that, in his current state,

it's not likely that it's gonna take long for his weight to kill him.

So the time to change is now.

I'm gonna give you a copy of my book.

And I put a bookmark.

-And this chapter of exercise. -Mmm-hmm.

You start doing these exercises one hour in the morning,

and one hour in the afternoon.

Then several page.

Do all of these exercises.

So this will give you a total understanding

So this will give you a total understanding

what the problem is, what the solutions are.

Any questions?

-No, sir. -All right.

So, if you lose the weight,

and hit the goals I'm giving you,

we will consider weight-loss surgery for you.

And if not, then we won't be able to help you.

-Yes, sir. -Okay?

Okay.

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

-Yes, sir. -And then we go from there.

Yes, sir, thank you.

-All right, I'll see y'all later. -Yes, sir, thank you.

-All right, I'll see y'all later. -Yes, sir, thank you.

Oh!

My visit with Dr. Now is...

It's not easy to just stop eatin'.

I guess what I call normal

and just go to eating 400 calories a day, and then

I have family functions coming up, and they're gonna be wanting me,

that's what we always do, go to eat.

Have a lot of birthdays that'll be coming up, you know.

Have a lot of birthdays that'll be coming up, you know.

Birthday cake, sure that don't fall under 400 calories three times a day.

I don't know. I'm gonna try.

I don't even have a clue what to eat.

I guess I could buy a bag of salad, have a couple leaves of it...

[chuckles] ...three times a day, I mean, I don't know.

I'm hoping the information he gave me has got some more about what,

you know, I can eat to get in that range.

It's gonna be a challenge, but I'm ready to change.

It's gonna be a challenge, but I'm ready to change.

[engine starts]

Are you wanting some turkey bacon too, Daisy Mae?

Hmm?

[Patrick] Why didn't you fix you anything?

I'm just not hungry this morning.

-I'm going for a walk later, you want to come with me? -[Amanda] Yeah.

That sounds like a good idea to me.

[Patrick] It's been kind of a strange time since I saw Dr. Now.

I got his book and started trying to do his diet and all.

I stayed steady on it for about a month after I left Dr. Now's.

And then, chaos kind of started.

-Are you good? -[Patrick] Yep.

-[Amanda] All right. -I'm gonna go through my exercises in my chair.

I have been looking at selling my house for a while.

I have been looking at selling my house for a while.

And the market's kinda good right now.

The house sold.

We packed up all of the dishes. The dishes were gone.

And it started getting harder to do the diet.

[groans softly]

I fell off the exercises with all the stuff that was going on.

Still gotta get Dr. Now's book back out from unpacking.

Still gotta get Dr. Now's book back out from unpacking.

So I can get back on all of the exercises that are in the book.

I remember some of them. I've been doing those.

Uh, most of the exercises I've been doing lately

is just with the moving and the unpacking,

and the... I mean, I've been pretty much going every day.

[Amanda] You're doing your exercises a lot better.

You've been very active.

Very.

The moving and...

I'm sore.

I'm sore.

[Amanda] You want to get ready and go for a walk?

[Patrick] Sure.

[Amanda] Sounds good to me.

[Patrick] I feel much better with my body now, since I went to see Dr. Now.

Mobility has got a lot better.

I'm moving around a lot better.

Go for a walk.

[Patrick] I mean, my legs and my knees still hurt,

but I'm not getting out of breath like I was.

It gives me an incentive to keep going.

And I have something to prove

and it's to prove that I can do this.

and it's to prove that I can do this.

-Thank you, baby. -[Amanda] You're welcome.

-You good? -[Patrick] Yeah.

[Amanda] You're ready for walks with us, Daisy? Come here.

[Patrick] I'm going for walks, and that's something new.

So, you know, we're off to a good start.

No.

-[Amanda] You're doing it. I'm proud of you. -[Patrick] Yeah.

[gps] In another mile, your destination will be on your right.

[Patrick] Well, we made it back to Houston for my follow-up with Dr. Now.

There was a slight delay because of the move.

So I called Dr. Now's office to ask for an extra month.

Dr. Now gave me the extra month,

but he fined me an extra 30 pounds

as a kind of a penalty for taking too long.

So, instead of 100 pounds in two months,

So, instead of 100 pounds in two months,

it became 130 pounds in three months.

And that just seemed kind of impossible.

But I worked hard to lose as much weight as I could.

And I think I did pretty good.

I'm just nervous that if it's gonna be as much as it should be.

Patrick.

[Patrick] At my last appointment, I weighed 657 pounds.

[Patrick] At my last appointment, I weighed 657 pounds.

And Dr. Now told me to lose 130 pounds in three months.

We're gonna weigh you. Just let me zero this out and then I'll let you know.

Okay, step up on the scale.

[Patrick] So, that will put me at 527.

-Go into room five now. -[Patrick] Okay.

I feel like that should be a victory for me

because I lost a lot of weight.

And so, part of me feels good about that,

but since it's not to the goal,

I don't think Dr. Now is going to say I can move ahead with anything.

So, that's just discouraging, considering how hard I worked.

So, I'm not really feeling like this is much of a victory when it should be.

You should be proud of yourself.

That's major. That's nothing little.

[knocks on door]

Hello, how are y'all doing?

-I'm fine, how about you? -[Dr. Nowzaradan] I'm good.

All right, Patrick.

But you're still far from the goal I gave you.

But you're still far from the goal I gave you.

And on top of that, it's been three months,

so you have been losing 13 to 14 pounds a month, which is not a lot.

-Right. -And this is something that

you can lose in one month, not in three months.

Really, you should have lost 140 pounds at that time,

but even with the goal of losing 130 pounds,

you are 90 pounds away from that.

So, you're still not doing the diet like you should.

-You know what the normal weight for your height is? -No.

190 to 200.

190 to 200.

Oh.

That means that you got 400 pounds of extra weight to lose.

That means I got two extra people with me.

But in the way that you're living with your weight, right now,

you're rolling the dice that any day something happens

that will be too much for your body.

It will be the final straw and then, next thing you know,

you won't pull through.

And this is a situation that you have to realize

that this is a very dangerous way to being 600 pounds

that this is a very dangerous way to being 600 pounds

and carrying that weight,

and effective data in your cardiorespiratory system is just significant.

And if you twist your ankle and fall and break it, that will be it for you,

because you end up in a bed that you won't get out of.

So, what are you gonna do to prevent that?

I'm gonna keep... I'm gonna stay on diet and eat like I'm supposed to.

I mean, I'm gonna lose more weight.

And then I'll... When you are...

Tell me when you want me back and how much weight you want me to lose,

and I'll be back and I'll...

Well, you know, it should be very easy for you to lose 50 pounds in one month.

Well, you know, it should be very easy for you to lose 50 pounds in one month.

-Yes, sir. -[Dr. Nowzaradan] Okay?

So, I'm gonna give you another two months to lose 100 pounds.

-Do you think you can do that? -Yes, sir.

Okay, all right, Patrick, I'm glad to see you again

-after you've reached your follow-up appointment. -Yes, sir.

-I thought you would never come back. -[all laughing]

So, I'm glad you've made it back so let's work harder

to make better progress and lose 100 pounds

over the next two months this time.

-This time, you're gonna show up, right? -Yes.

-This time, you're gonna show up, right? -Yes.

[laughing]

All right, before you go, I want to run some tests

to make sure you're doing okay.

So, we'll get some lab work on you, do some tests, and see how things are,

and if there is anything we need to address, we will,

-okay? -Okay.

All right. Well, nice to see you again.

-Nice to see you too. -And we'll see y'all later.

-Yes, sir. -Bye.

I been thinking about it, eggs are 160 calories apiece.

I been thinking about it, eggs are 160 calories apiece.

But it's still too much, so you've gotta cut back more.

I know.

I'm obviously disappointed to see such little progress with Patrick.

I'm glad that he at least started to lose some weight.

But losing around 13 to 14 pounds a month

is not nearly fast enough to reduce the strain on his body, how he needs.

He needs to start doing a lot better right now.

Not only to move ahead with the program,

but to avoid getting his body to a breaking point soon.

but to avoid getting his body to a breaking point soon.

So hopefully, he's taking this seriously enough to do that,

because he doesn't have a lot of time to keep making excuses

and blaming other things instead of taking responsibility like he needs.

[Patrick] It didn't go as bad as I thought it would be because

they didn't give me as hard time as I thought,

because I did lose some weight, just not as much as he wanted me to.

But now, I'm determined as ever and I'm gonna keep at it and do better.

But now, I'm determined as ever and I'm gonna keep at it and do better.

I'm gonna do it, there's no doubt in my mind.

I have too many people that I want to be around for longer

and gonna do stuff with that I'm not gonna let down.

[Patrick] Are y'all ready to go camping?

We ain't been in quite a while.

[Amanda] I'm excited. This is gonna be nice.

[Patrick] Since my appointment with Dr. Now,

[Patrick] Since my appointment with Dr. Now,

the progress has been going pretty good.

I've been dieting, exercising, and getting more active.

I feel like I've lost enough weight.

I can take them camping now.

It's been a really long time since we went and done it,

so it will be something fun for us all to go out and do.

-[Amanda] Right here a good spot for the tent? -[Patrick] Looks good to me.

Camping makes me happy,

because Patrick is getting to where he can

and wants to do the things that he likes to do, again.

and wants to do the things that he likes to do, again.

And he's trying to spend time with Haley and myself.

And I'm just looking forward to it.

It's a good surprise.

-Y'all wanna go for a walk? -Yeah, that's fine.

-[Amanda] Mmm-hmm. -[Patrick] Well, let's do it then.

Oh.

[Patrick breathing heavily]

[Patrick breathing heavily]

[coughing]

It's the congestion, man.

It's kicking my ass.

It's kicking my ass.

[breathing heavily]

[Amanda] Maybe we shouldn't stay the night.

Maybe we should just pack up and go home.

Maybe we should just pack up and go home.

We tried. Next time.

Maybe we'll do better next time.

I think it's a good idea.

-All right. -[Amanda] All right.

You wanna help me pack up, Hay-bug?

-[Haley] Yeah, I'm gonna help you pack up. -[Amanda] Okay.

-Come on. -Let's get you a drink.

-[Haley] Can you fold your chair up? -[Patrick] Yeah.

Try to get the chair.

Try to get the chair.

[Patrick] I was feeling good. I wanted to come camping today.

I've just kind of overdone it. I'm not ready for it yet.

So, we're gonna get back home and eat,

and maybe in a month or so, I'll try it again, once I've lost more weight,

and we'll come back and try it again.

Going to see Dr. Now for the next appointment

Going to see Dr. Now for the next appointment

to see where my weight's at.

I don't know, I've been sick.

I know I haven't done that great on my diet.

I've tried, but I could have done better.

Here we are, back in Houston for my next follow-up with Dr. Now.

Here we are, back in Houston for my next follow-up with Dr. Now.

And we're gonna see how much weight I've lost.

I'm a little worried because I got sick after camping,

and I've been sick, pretty much, the whole month.

So all I could do was rest in bed,

and I couldn't really focus on what I needed to do for the program.

So, I made a little bit of progress,

but I don't know if it's gonna be enough.

Patrick.

[Patrick] Hi, how are you?

At my last appointment, I was down to 616,

and Dr. Now told me to lose another 100 pounds over the last two months.

Step up on the scale.

[Patrick] So, that would put me at 516.

Hm, that's not good.

[sighs]

-We're going to be going to room five. -All right.

Good Lord, that's not okay.

What the heck happened with that?

There's only one way this is gonna go with Dr. Now at this point.

And it's not the way you daydream about.

[knock on door]

-Hello, how are y'all doing? -[Patrick] Fine. You?

[Dr. Nowzaradan] I'm good. Thank you.

All right. Good to see you all again.

How was your trip down here?

It was all right.

Long drive, but it was good.

And how many hours did you have to drive?

Hmm, about 11.

One day or two days or what?

No, we just drive straight here.

No, we just drive straight here.

Well, all that travel puts a lot of strain on your body

with your weight and your condition.

So, I don't think you should make that trip again,

because there is no point if you're not making the changes you need.

Especially at this time, it looked like you almost gained 30 pounds.

-So, what happened? -I've been sick. I had, like, the flu.

-But that's really no excuse. -Some people have flu, they'll lose a lot of weight.

-And they don't gain weight. -No, not me. [chuckles]

Well, make a better story.

Now, I don't really have any excuses, I mean, I wasn't eating right.

Now, I don't really have any excuses, I mean, I wasn't eating right.

So what is your objective coming here,

if you just plan to keep doing whatever you want,

and making excuses and telling me

you didn't follow the diet and you were sick, and...

-Nah. -Why come in

all the way to tell me that?

I don't know.

So what is your objective here? What do you expect

that we can do for you?

There's nothing about my weight that you can do for me. I mean, I need to show that

I can lose the weight. And I can lose the weight.

I can lose the weight. And I can lose the weight.

I just have to get off my own butt and do it.

If you are coming here,

and you, clearly, you're not taking this seriously and think this is a joke.

But there is no magic to save you.

It's not gonna be me that saves you. It's not gonna be your wife or your daughter.

Our magic is you.

And follow the instructions that we gave you.

You don't wanna

follow those and you want me to make you lose weight.

I'mma go do the diet like I'm supposed to and eat like I'm supposed to.

But you didn't do anything about it the last

-six months. -Okay.

-six months. -Okay.

I'm tired of... I'm tired of doing... Whatever.

You keep showing me that you're not serious about saving your life, Patrick.

In six months, you should've been able to lose a whole lot more.

And you got a lot of health issues.

When you do check your heart, make sure

that you have an angio

and see what's going on, because your body is close to giving up.

And this is all a result of overeating and not losing weight.

Do you understand that?

[Patrick] Yes, sir.

How much you can do before you get

that chest pain?

It don't always just come up when I'm doing something. It may come up

It don't always just come up when I'm doing something. It may come up

just out of the blue.

So how often you get that?

Every day.

Every day?

Mostly in the afternoon?

All right, let me get an EKG, see what's going on with your heart.

All right.

All right, Patrick. At this point,

you need to figure out your life,

and you're gonna have to figure out what you're gonna do from this point on.

But in the meantime,

I don't have an answer for you. You have to figure that out.

I don't have an answer for you. You have to figure that out.

So we'll get the updated bloodwork on you and see how

-badly-- -You don't need to do all that, you have

no answers for it.

Answer for what?

You said you have no answers for it.

Well...

[Patrick chuckles]

-Well, what? -We have

answers for you, but you're not following those.

And now, you will come in defensive,

and that is our fault that we're not doing anything for you?

No, I didn't say that.

What's your problem then?

We're giving you the instructions and you're blaming

us that we're not doing anything for you.

I'm not blamin' for ya. I never said you weren't doing anything.

I'm not blamin' for ya. I never said you weren't doing anything.

So, well, you have diabetes because

you're overeating.

What problem with that you didn't understand

the past six months you've been here?

Okay.

And so when I say we needed some lab work for you--

I'll give you lab work.

I'll give you lab work. I'm just tired of listening to it.

Do whatever you need to do to help.

Well, Patrick.

You gotta get your life in order, you gotta get your attitude in the right place.

You gotta make decisions

You gotta make decisions

in your life, what to do, what not to do.

That's true.

And those things are something that you're gonna have to figure out.

Right?

-That's right. -[Dr. Nowzaradan] Okay.

So we're gonna find a local clinic for you to go to in two months

to see if you're actually losing weight.

I'm gonna give you an easier goal to only lose 80 pounds in two months.

And see if that will help your weight. Okay?

[Patrick] All right.

[Dr. Nowzaradan] All right. Any other questions?

[Patrick] No.

[Patrick] No.

[Dr. Nowzaradan] All right.

[Patrick exhales deeply]

[sniffles and sighs]

Anyway, I'll be back and see you after your EKG, okay?

-[Patrick] All right. -All right.

-[Patrick sighs] -[door closes]

-[Patrick sighs] -[door closes]

[Patrick sniffles]

[Amanda] We're gonna get you back on track.

Not with him. I won't be back here.

-Yes, you will. -No, I won't.

He just wants what's best for you and you to get back on track

and do what needs to be done.

This is [bleep]. [sniffles]

He gives you a [bleep] book

and a piece of paper. That's it.

Doctor Now's appointment didn't go very good.

Doctor Now's appointment didn't go very good.

He wasn't happy because I gained some weight.

I'm gonna go back home and hit the diet hard

and come back, and hopefully...

have lost some weight this time.

It is unfortunate

that Patrick has continued his pattern of making excuses,

instead of taking responsibility.

And in the condition he's in, there is no point in him continuing to come down here

and put all that strain on his body travelling, if this is all he's gonna do.

and put all that strain on his body travelling, if this is all he's gonna do.

So we'll set up a local clinic

to check his progress in a couple months.

But if he hasn't started to show me

he's going to get serious and do what he needs by then,

then we won't be continuing with Patrick because it will

be clear he doesn't intend to change.

[Patrick] Whoa.

[Patrick] Kinda nervous about this.

[Amanda] You don't have any reason to be nervous. You're gonna do good.

[Patrick] This month, I decided to join a gym.

So that I can get a trainer and push myself even harder.

It's a little scary and intimidating to go out and do something like this

It's a little scary and intimidating to go out and do something like this

when you've been trapped at home on the couch

for years. So I'm fighting through that.

And I'm happy that Amanda will come with me for moral support.

[woman] Hey, guys! Hi.

I'm Victoria. What's your name?

-I'm Patrick. -Patrick, it's nice to meet you.

So this is our other trainer, Matt. So he's gonna be working with us today.

-How you doing? Coach Matt. -[Victoria] Ready for our workout today?

I guess.

-Follow me. -All right.

All right,

so the first movement is gonna be that sled push right there.

I'm not looking for speed right here. I'm just looking

for you to push it, kinda head down,

and then, again, the other way back.

All right, yep. Start pushing. There you go.

[Matt] There you go. Good.

[Victoria] Very good. All the way down to Matt. Now we're gonna

lean backwards and come back.

Baby steps. Baby steps. Very good. We're gonna go

back over by the straps. How're you feeling so far?

back over by the straps. How're you feeling so far?

-All right. -[Victoria] All right?

I'm just breathin' heavy.

That's okay. You should see our workouts. You'd breathe heavy too.

It's a significant emotional event over there sometimes.

[both laugh]

It's okay.

-You're doing good though. -Yeah.

[Matt] Hold the handles however you feel for the squats.

This thing ain't gonna pull over, right?

Nope. It's good. It's anchored to the floor.

We're gonna lean, okay? Just back a little bit.

Not a whole lot of it. Just a little bit.

Okay? See, we're having fun. That's the whole point of this, right?

Okay? See, we're having fun. That's the whole point of this, right?

It looked like Patrick

was having fun at the gym. If you're not having fun,

or at least, you know, laughing

and enjoying yourself during a session, you're not with the right trainer.

I'm absolutely very proud of Patrick and the fact that he took that first initial step

to kind of set that foundation for himself.

New things are really intimidating.

And like I said, it adds and amplifies the anxiety,

so the fact that he took that step

to be like, "You know what? I wanna be healthier,"

is something to be really proud of.

Yeah, you're gonna be sore tomorrow.

-I imagine. -Probably the next day.

[all laugh]

[all laugh]

That's all right. That just means the muscles are growing.

[Patrick] The workout was good.

I enjoyed it. I was real nervous when we first came in,

but the instructors I had, they made it enjoyable.

All right, we'll see y'all again.

[Amanda] Thank you, see you again.

[Victoria] Now we will see you again, though.

[Patrick breathing heavily]

Yeah, that workout did get my legs.

[panting]

[panting]

[Patrick] We're headed to the local clinic Dr. Now set up for me to go check

my weight and see where I'm at.

I know I've worked to do better the last

two months. And I'm really hoping how I've applied myself pays off today.

[Amanda] Thank you,

[nurse] Hey, how are ya?

-[Amanda] Good. How are you? -[nurse] Good.

Okay, go ahead and step up on the scale.

[Patrick] At my last appointment, I was at 642. And Dr. Now

told me that I need to lose at least 80 pounds

over the last two months. So if I made it

to that, I'll be at 562 today.

-[Patrick] Doing good. -[Amanda] Yeah.

[nurse chuckles]

[Patrick] Yay!

Okay, Patrick. We're gonna

get right into this room right here.

Yes, ma'am.

[Patrick] That's a lot of progress. But I'm not sure if it's gonna be enough

for Dr. Now.

[cell phone ringing]

Hello.

-Hi, how are you? - I'm doing okay.

So how was your appointment today?

So how was your appointment today?

I was 591 today when I weighed in.

[Dr. Now] All right, so you lost 51 pounds.

[Patrick] Yes, sir.

So I know I didn't do as good as you wanted me to do, but I am,

I mean, I am trying at losing weight.

[Dr. Nowzaradan] Well, you're right. You haven't lost the amount

of weight that you should have,

but at least you're showing me you're willing to try and take this seriously.

So, Patrick, at this point,

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

Okay, well, that's great.

[Dr. Nowzaradan] But there are two things you need to do first. Firstly,

[Dr. Nowzaradan] But there are two things you need to do first. Firstly,

you need to move back to Houston.

Then second, I want you to lose 30 pounds while you're still at home

from the last goal I gave you, okay?

Yes, sir.

All right. So let's start working harder on your eating habit,

and let me know when you can get down to Houston.

All right, I will do that.

[Dr. Nowzaradan] It doesn't mean that you can

take that as a victory lap and start eating, okay?

- [chuckles] -So let's

work harder

and stay on track so we can move ahead with you, okay?

and stay on track so we can move ahead with you, okay?

[Patrick] All right, thank you.

All right, Patrick,

let me know if you need anything.

Yes, sir. Thank you.

- All right. Bye now. -Bye.

-Mmm-hmm. -Take care.

You, too.

That wasn't as bad as you thought it was

-gonna be, was it? -No,

not at all.

-Are you excited about it all? -Yeah,

I can get the surgery and lose a whole lotta weight.

[nurse] Okay, we're all ready to walk you out.

[Patrick] I'm very excited to be approved.

I didn't think the call was gonna go as well as it did.

So I'm feeling really good.

-[nurse] All right. -[Patrick] Y'all have a good day.

But it's gonna take a lot for me and Amanda to move to Houston.

So we have to start working on that.

But that's why we got a place with a short-term lease. To prepare for this.

So we'll figure out what we need to make this happen.

Because I've worked really hard to achieve this and get here today.

Because I've worked really hard to achieve this and get here today.

So whatever it takes to keep going

and make it happen, I'm gonna do it.

[Haley] Here, Dad.

[Patrick] You want this to go?

[Haley] Yeah, I want you to take that to Texas, 'cause I want it when I come.

[Patrick] Okay. Well, help me fold it up.

Just, you got kind of a mess here, kid.

I don't have a mess.

Well, where's the damn corners?

[Haley laughs]

[Haley laughs]

[Amanda] It is a mess.

[Patrick] Well, I got my surgery approval.

And that means we're moving to Houston.

We found a place and we're leaving tomorrow.

[Amanda] I'm gonna get the fans.

[Patrick] The hardest, though, is leaving

my daughter.

I'm not gonna see her for a bit.

So she's gonna spend some time with us today.

I'm a little excited, a little nervous.

A lot scared.

Excited about him getting the help that he needs.

Worried about...

leaving home.

[voice breaks] For one, for leaving Haley.

And number two...

bad thoughts about what could happen during the surgery.

And I've been trying to keep it together. But the closer it gets, the harder it's getting.

I'm just trying to stay positive.

[Patrick] Well, there're some dark clouds out here.

[Amanda] Yeah.

[Patrick clears throat]

So you gon' be all right when I'm gone?

-Yeah? -You sure?

Mmm-hmm.

All right.

All right. I love you.

I love you too, baby.

I'll see you out there, okay?

All right.

-Bye. I love you. -I love you too. Please be careful

going to your mama's.

I will.

[engine starts]

-I love you. -[Patrick] I love you, too.

Yeah, this is gonna be a pain in my [bleep] right here.

Well, we finally made it to Houston.

The drive wasn't too bad.

No major mishaps.

Now we're gonna see this place we rented and see what it's like in person.

Never really know what a place can be like until you step into it.

Never really know what a place can be like until you step into it.

We figured we'd get a place that was furnished

so we didn't have to do all that.

And since it's just temporary, hopefully, it's suitable.

[grunts]

Well, bud, this is where we're gonna be staying.

Let me try out the couch.

[grunts]

Well, it slides.

Yeah, this place isn't so bad. I could see us living

here for a little while.

I don't know how long it's gonna be in the end.

I guess it depends on how well I do with my weight loss.

And how quick I can get the weight off.

And whether or not I'm gonna need skin surgery and all that.

Sit here, cool off for a minute.

Then we need to get all the stuff out of that U-Haul, because we gotta dump it off

Then we need to get all the stuff out of that U-Haul, because we gotta dump it off

and then we gotta get ready to go to Dr. Now's tomorrow.

It feels good to be here.

And as long as I'm with Amanda, I can be happy anywhere.

[Amanda] Well, babe. Are you ready to start unloading?

Sounds good to me. It ain't gonna unload itself.

[Amanda] Unfortunately not.

[chuckles]

Yeah, let's do it. Give me a hand up, please.

Let's go. [grunts and exhales in a whistle]

Let's do it.

Let's do it.

Tomorrow, I'm gonna see Dr. Now,

and hopefully, he'll tell me I'm ready for surgery.

Because I know, personally, I'm more than ready.

Just get right inside the door

and I'll start handing you stuff.

Move.

Right now, we're going to see Dr. Now

for the first time since I've moved to Texas.

I hope it goes good, but...

I don't ever know when you go see Dr. Now.

I mean, I haven't weighed myself

since the last time with Dr. Now, so I have no idea what my weight is.

[Amanda] I swear, I feel like I'm gonna be sick.

[Patrick] Why you feel like you're gonna be sick?

[Amanda] My nerves.

[Patrick] Yeah, my nerves are kind of worked up, too.

And I feel a little more nervous than usual,

And I feel a little more nervous than usual,

because keeping my surgery depends on my weight today.

I've been working hard, but I know the move down here,

I was maybe more distracted than I liked.

I didn't go to the gym, like I was supposed to.

And there were times when we couldn't really cook or do the food right.

So we might have chosen some quick options.

[groans]

[breathing heavily]

[Amanda] Thank you, babe.

Patrick.

-[Patrick] How are you? -Oh, I'm fine, thank you.

Hi.

[Patrick] I'm just worried about how much I lost.

If I didn't hit that 30-pound goal by today

and I lose my surgery,

and I lose my surgery,

then the whole reason that we went through all this

and moved here could go out the window.

And I can't have that happen.

[Patrick] I'm at Dr. Now's to find out my weight.

I'm really hoping I made it to my goal.

I was at 591 two months ago, and Dr. Now wanted me to lose 30 pounds by today.

So, I need to be under 561 pounds right now.

It's not the goal Dr. Now wanted, but I didn't gain.

That should really count for something,

because I maintained my progress.

But I'm not sure what Dr. Now is gonna say.

[exhales]

[grunts]

[sighs]

[knock on door]

-Hello. -[Patrick] Hi, how are you?

I'm doing okay, how are y'all doing?

Doin' all right.

So, Patrick, y'all moved here.

[Patrick] Yes. Just got in yesterday, and...

here for my follow-up after that.

So, you haven't lost much weight. What's going on with that?

I've been trying. It's just...

It's just easier said than done. I mean, I've been trying.

Well, if you eat what you're eating,

you're gonna be the same weight.

Uh, so what's the point of coming to Houston

Uh, so what's the point of coming to Houston

if you're not doing what you need and losing more weight?

-[sighs] I don't know. -Uh, so

what is your objective in moving to Houston?

Get weight-loss surgery, lose weight.

That's my... That's my objective. To lose weight.

But we haven't lost anything in the past two months,

so what are you gonna do different now?

[Patrick] But I haven't gained any either.

I haven't gained any more weight.

So, you want to take victory lap with that?

That's a victory lap for me, I'm not back up to 672, yeah, kind of.

Well, you know, that kind of line of thinking, it make me wonder that--

Well, you know, that kind of line of thinking, it make me wonder that--

No, I'm not making excuses.

Just let me finish what I'm saying.

-[Patrick] Yes. -Okay.

That line of thinking make me wonder that

you're not gonna benefit from weight-loss surgery,

because you're not really thinking clear in this situation.

You got to change your behavior and line of thinking.

And that is, if I don't lose that weight, I'm gonna shorten my life.

-Yeah. -That is your life.

And we're trying to save it for you, and you keep making excuses,

"Oh, whoopee-doo, I didn't gain any weight." [chuckles]

"Oh, whoopee-doo, I didn't gain any weight." [chuckles]

Come on, you know, you're killing yourself with the food. So,

I wanna hear what you're gonna commit yourself to.

What are you willing to do to make the changes?

I'm willing to do whatever it takes.

-I mean-- -Well, you keep saying that.

-But that is just-- -No, I've made a big...

I've made a big commitment coming here. I've left my daughter behind.

Um, I've left my home behind.

I mean, I've made a huge commitment

coming here, I mean, a huge commitment.

coming here, I mean, a huge commitment.

Yeah, you've made a huge commitment to change,

-to come to Houston. -To change, to come here.

Okay, so, uh,

and what that translate on doing your eating habit.

So tell me what exactly you gotta change with your eating habit.

So I really know.

The only thing I know to change

is to eat less than what I'm eating.

That's the only thing I know to change.

Okay, what you're doing right now is not working,

-so don't-- -Right. I got to eat less,

that's the only thing I know to do, is eat less than what I do.

that's the only thing I know to do, is eat less than what I do.

Okay, so how many times are you eating now?

I usually eat twice a day. I usually eat breakfast and dinner, that's it.

-And I-- -Any snack in between?

No.

All right.

So, here's what I'm willing to do at this point.

I will schedule your weight-loss surgery for a month from now.

And if you lose 30 pounds in one month,

then I'll move ahead and do your operation.

But if you're not able to lose that 30 pounds,

then I don't think weight-loss surgery

-is gonna help you. -[Patrick] Okay.

[Dr. Nowzaradan] So I'm gonna cancel your surgery and tell you to go home,

[Dr. Nowzaradan] So I'm gonna cancel your surgery and tell you to go home,

if you show up and haven't made that progress.

-Okay? -Mmm-hmm.

[Dr. Nowzaradan] You think you can do that?

Yes.

All right. Back on your diet.

Back on your daily exercise.

-Okay. -Okay.

Any questions?

-No, I'm good. -[Dr. Nowzaradan] Okay.

[door closes]

I'm hoping Patrick's lack of progress this time isn't a bad sign

of the direction he's heading.

of the direction he's heading.

But he is in an important crossroad right now,

because if he doesn't get back on the right end

and lose 30 pounds he needs to show me he's gonna stick with this,

then I'm not gonna move ahead with his weight-loss surgery.

So, he either does what he needs now,

or that's likely gonna be it for him.

The ball is in his court,

and where we go from here is up to him.

[Patrick] The goal that Dr. Now gave me is doable.

[Patrick] The goal that Dr. Now gave me is doable.

I just have to set my mind to it and work hard.

If I don't do it, then it's on me.

[Patrick] We're going to St. Joseph.

I'm definitely nervous, scared.

I'm about to find out...

I'm about to find out...

do I get my surgery this morning?

I'm super nervous about my weigh-in.

I think I did it.

I think I lost the 30.

I know I've put my all into making that progress.

But so much is dependent on this

that I'm just extremely tense about what the scale is going to say

that I'm just extremely tense about what the scale is going to say

and what's going to happen.

I need this surgery, and I can't have done all this and come all this way

to lose the surgery now.

[knock on door]

Hello, how are y'all doing?

[Patrick] All right.

-[Dr. Nowzaradan] Hi, Patrick. -[Patrick] Hi.

[Dr. Nowzaradan] How you doing? How you feel this morning?

[Dr. Nowzaradan] How you doing? How you feel this morning?

[Patrick] Scared.

[Dr. Nowzaradan] Well...

we're gonna go ahead and check your weight,

and make sure you lost that 30 pounds.

If you did, then we go ahead and do your surgery, okay?

-Okay. -[Dr. Nowzaradan] All right.

Let me get you here onto the scale and see what's going on with that, okay?

-Okay. -All right.

All right, let me turn it on.

[Patrick] I'm straight up terrified to see the results right now.

It feels like my whole life is depending on this.

[Dr. Nowzaradan speaking]

563. So, you lost 27 pounds, huh?

All right, close enough.

All right. We go ahead and do your surgery, okay?

All right. We go ahead and do your surgery, okay?

[Patrick] Okay.

All right, let's get you back in the room.

I'm happy to see Patrick took things seriously

this past month to do what he needs.

So, with all his fat loss,

he's ready to move ahead with surgery today.

The surgery itself will take about an hour.

-All right. -All right.

[Patrick] This is huge.

I really felt like I could have gone either way.

And the fact that it went the right way

is just making me feel really blessed right now.

is just making me feel really blessed right now.

This is a big turning point in my life.

And I'm gonna use this opportunity

to do better and make a better life for my family.

And it's a chance to undo what I've done wrong,

and to get myself back on a path I can be proud of.

And I can't wait for that.

We'll take care of you, okay?

[Dr. Nowzaradan] We're gonna attempt to perform

[Dr. Nowzaradan] We're gonna attempt to perform

a gastric sleeve on Patrick today.

But we're gonna face a lot of obstacles,

because of his size,

and the fact that he had a previous hernia surgery.

[Amanda] I love you.

[Haley] I'll see you on the other side.

-[Patrick chuckles] -I love you.

I love y'all. See ya.

They're gonna make it fast.

We did test on him

and determined that his operation was possible.

But he may have some scar tissue around his abdomen

on top of the mesh which was put around his stomach

when he had hernia surgery.

when he had hernia surgery.

So we have a lot to work around,

and this will be a little bit more complicated than usual.

[Dr. Nowzaradan speaking]

But if we are able to complete this operation,

it will be an important tool for Patrick

to help him make more progress.

All right, let's bring the robot.

Because what this surgery does

will reduce the size of the stomach,

and Patrick will be able to control his eating habit much better.

So, this is gonna be an important step for Patrick,

So, this is gonna be an important step for Patrick,

if we are able to complete this operation today.

[man] You got a gap for me?

Patrick's in surgery. I am...

very worried and scared and nervous.

Every minute of waiting...

seems more like a hundred hours. [chuckles softly]

It seems more, way more than an hour.

I'm just ready to see him...

for myself, and see that he's okay for myself.

[Dr. Nowzaradan] All right.

We can remove the stomach.

Keep pulling, keep pulling, keep pulling.

There.

Put that on the table over there.

Okay, we can suture him up.

Patrick's surgery was complicated, but went very well.

We faced some issue with the scar tissue

from his previous hernia surgery and mesh.

But we were able to work around them,

and safely complete gastric sleeve operation today.

So this is gonna be a big help for him.

But for the next month, he's gonna have to stay on liquid diet,

and at that time, he should lose another 35 pounds.

And after that, Patrick should lose 20 to 25 pounds each month,

until he gets close to his target weight.

until he gets close to his target weight.

It took him a little longer, but he's down around 100 pounds,

and he's heading in the right direction.

So I'm confident we're gonna be able

to get him where he needs and down to his target.

It may be just a bit of a struggle to help him do that,

but we will see.

[Patrick] Today, we're going fishing, because it was always

one of me and Amanda's favorite things to do together.

But we haven't done it in forever, since I got too huge to do anything.

So, it feels really good to be getting back

to the basics of what we love to do together.

It's been a month since my surgery

and Dr. Now's happy that I'm staying on track.

I went back on solid foods and he wants me to lose 20 pounds this month,

so I'm staying focused on that.

Well, we're adding on the memories, fishing in Texas.

Yeah, we definitely are.

[Patrick speaking]

-[Amanda] She'd enjoy it. -[Patrick] Yeah.

We're at a lake in Texas. Me and Patrick came fishing.

He's doing really well. I'm very proud of him.

He's definitely looking forward to getting out more,

creating new memories.

Trying to get out and enjoy ourselves a little bit, since I'm losing more weight.

Just trying to get out and do more things.

Fishing's just the beginning. There's a lot more stuff I wanna do.

As I'm getting in better shape,

we definitely gotta try saltwater too.

Since I'm getting in better health,

we gotta try and do whatever we can.

[Amanda] Yes.

It'd be way worse if there wasn't a breeze.

[Patrick] Yeah. [chuckles and pants]

[Amanda] You're doing good, babe. I'm proud of you.

[Patrick] A year ago,

[Patrick] A year ago,

going on a hike like this would have been a distant dream.

And the fact that I'm able to do it today

is like an incredible privilege.

And now that I'm healing up,

I'm hoping to see my daughter sometime soon.

I miss her a lot, and I wanna redo the camping trip,

so that we can do it right this time.

[Amanda] I'm very proud of him.

He's come a long ways, he's lost a lot of weight.

He's gonna be able to spend more time with his family,

He's gonna be able to spend more time with his family,

me and Haley.

So we can continue this journey together.

[Patrick] With these new doors opening for me, everything feels brand-new.

And that's an incredible feeling.

Everything won't feel new forever.

But I'm gonna hold on to how it feels right now.

So, what are you thinking about Houston

since we moved here?

I mean, I'm sure it's not all bad.

There are some nice people here.

This is actually the cleanest, quietest place we've been since we've been here.

Well, I've enjoyed today. It's been nice.

It has.

And I'm never going back to the way I was,

'cause this is too good to let go of.