Original subtitles

Ashley: I LIVE IN THIS CONSTANT SHAME.

HOW DO I FIX THIS?

**

Man: NOT FOR ONE MINUTE THAT I THOUGHT MY LIFE

WOULD END UP LIKE THIS.

OW! MY LEGS!

Ashley: I'M SO FAR GONE.

Woman #2: I ABSOLUTELY NEED HELP,

OR I AM GONNA DIE.

-I CAN'T DO THIS. -I'M RIGHT UNDER YOU.

-[ Crying ] I NEED OVER! -YOU'RE FINE. YOU'RE FINE.

Woman #3: I FEEL LIKE I LET MY KIDS DOWN.

INSTEAD OF ME TAKING CARE OF THEM,

THEY'VE BEEN TAKING CARE OF ME.

IT'S YOU -- YOU ARE THE ONE KILLING HIM.

Ashley: I DON'T HAVE THE STRENGTH TO MOVE FORWARD.

Dr. Nowzaradan: WE HAVE TO FIND OUT WHAT'S GOING ON WITH ASHLEY.

HER LIFE COULD BE ON THE LINE.

Ashley: SOMETIMES THE SAFEST-LOOKING PATH THROUGH LIFE

CAN LEAD TO THE MOST DANGEROUS PLACES.

WHEN I IMAGINED MY LIFE AT 30,

I THOUGHT I WOULD HAVE MY WHITE PICKET FENCE

AND HAVE KIDS.

BUT MY LIFE IS NOTHING LIKE THAT.

IT'S A NIGHTMARE.

MY ENTIRE BODY IS IN CONSTANT PAIN.

I'M COMPLETELY MISERABLE.

IT'S A STRUGGLE TO JUST MOVE AT THIS WEIGHT.

YOU NEED ME TO HELP YOU UP?

I CAN'T DO ANYTHING ON MY OWN,

SO MY HUSBAND AND I HAVE TO LIVE WITH MY PARENTS AND MY SISTERS.

I'M ASHAMED OF LIVING WITH MY PARENTS AT THIS AGE.

THEY HELP TAKE CARE OF ME.

I FEEL LIKE A 30-YEAR-OLD CHILD.

WHEN I LOOK IN THE MIRROR, I SEE A MONSTER.

I SEE SOMEONE WHO'S HIDEOUS.

I DON'T RESEMBLE A HUMAN FORM.

I CANNOT STAND FOR MORE THAN FIVE MINUTES.

SO EVEN WHEN I SHOWER, I HAVE TO SIT DOWN

AND, LIKE WITH EVERYTHING ELSE IN MY LIFE,

I HAVE TO ASK FOR HELP.

YEAH.

IN ORDER TO NOT HAVE THE ROUGH PATCHES ON MY SKIN,

MY MOM HAS TO SCRUB ME REALLY, REALLY HARD

WITH AN ABRASIVE SPONGE.

IT'S OKAY.

I CRY IN THE SHOWER BECAUSE IT'S JUST PAINFUL.

IT IS PAINFUL SITTING THERE.

IT IS PAINFUL HOLDING MYSELF UP.

IT IS PAINFUL WHEN MY MOM SCRUBS MY BACK.

Blanca: IT'S REALLY HARD FOR ASHLEY TO TAKE A SHOWER.

I HAVE TO HELP HER BECAUSE IF I'M NOT THERE,

SHE HAS TO ASK HER HUSBAND TO DO IT.

AND SHE DOESN'T WANT TO DO THAT.

I THINK ASHLEY DESERVES A BETTER LIFE.

THIS WEIGHT PROBLEM HAS KEPT HER

FROM DOING EVERYTHING SHE WANTS TO DO.

I CAN'T BELIEVE I WEIGH THIS MUCH.

I CAN'T BELIEVE THIS IS MY LIFE. THIS IS MY REALITY.

I'M UNCOMFORTABLE IN MY OWN SKIN.

OKAY.

I CAN'T LIVE LIKE THIS ANYMORE.

HOW DO I FIX THIS?

I FEEL LIKE...

I'M SO FAR GONE.

I LIVE IN THIS CONSTANT SHAME.

I DON'T KNOW HOW TO FIX IT ANYMORE.

WHEN I WAS LITTLE,

I THOUGHT THINGS WOULD BE A LOT DIFFERENT FOR ME.

I REMEMBER BEING A HAPPY TODDLER.

I WAS ACTIVE AND RUNNING,

JUMPING, PLAYING WITH MY FRIENDS.

I DIDN'T REALIZE I WAS ALREADY A LITTLE OVERWEIGHT.

I STARTED TO NOTICE ASHLEY'S WEIGHT PROBLEM

WHEN SHE WAS IN KINDERGARTEN.

SHE WAS THE CHUBBIEST IN THE CLASS.

BUT I ALWAYS ASSUMED IT WAS BABY FAT, YOU KNOW?

IT'S GONNA GO AWAY.

Alan: BACK IN THE DAY, WE DIDN'T THINK

THAT THERE WAS SOMETHING WRONG WITH ASHLEY.

WE THOUGHT THAT WAS JUST PART OF LIFE, THAT SHE WAS HEALTHY.

WE NEVER THOUGHT THAT THAT WAS GONNA BE A PROBLEM

LATER ON IN HER LIFE.

Ashley: I GAINED SOME WEIGHT AS I GOT OLDER,

BUT I REALLY STARTED TO GAIN AROUND SEVENTH GRADE,

BECAUSE WHEN I WAS 12 YEARS OLD,

MY UNCLE SEXUALLY ASSAULTED ME.

AND I DIDN'T KNOW WHAT TO DO.

I DIDN'T KNOW HOW TO FEEL SAFE,

SO I WOULD EAT TO GAIN BACK

WHATEVER LITTLE HAPPINESS I COULD.

FOOD FILLED THE VOID THAT I WAS FEELING ON THE INSIDE.

AND AT FIRST, I DIDN'T SAY ANYTHING

BECAUSE I FELT LIKE AS LONG AS HE WAS DOING IT TO ME,

HE WASN'T DOING IT TO MY SISTERS.

I WASN'T GOING TO ALLOW ANYONE TO RUIN THEIR CHILDHOOD

AND TAKE AWAY THE INNOCENCE THAT THEY HAD.

WHEN I FINALLY TOLD MY MOM, SHE CONFRONTED MY UNCLE.

Blanca: WHEN IT HAPPENED, I WENT OVER THERE.

AND I SAID, "HOW DARE YOU BETRAY US?

HOW DARE YOU DO THIS TO MY LITTLE ONE?"

EVEN THOUGH I TRIED TO GET HELP FOR HER,

IT WAS VERY HARD FOR HER.

I THINK ASHLEY LOST CONTROL OVER HER EATING.

MY WEIGHT BALLOONED. IT REALLY PILED ON.

I GRADUATED HIGH SCHOOL AT ABOUT 350.

AFTER THAT, I WENT TO SCHOOL TO BE A MEDICAL ASSISTANT.

AND I GRADUATED,

BUT NOBODY WOULD HIRE ME BECAUSE OF MY WEIGHT.

BY THAT TIME, I WAS OVER 430 POUNDS.

AND THEN I MET MY HUSBAND, DANIEL, AT A PARTY.

AND WE GOT TO TALKING, LIKE TRULY TALKING TO EACH OTHER,

AND I FELL IN LOVE WITH HIM.

Daniel: WHEN I FIRST MET HER,

ASHLEY'S SIZE DID NOT BOTHER ME AT ALL.

WHAT I REALLY LOVED ABOUT HER WAS HER SENSE OF HUMOR,

HER CHARISMA, HER EYES.

Ashley: WE DID THINGS. IT WAS LIKE A NORMAL COUPLE.

BUT EACH YEAR, I KEPT GAINING MORE WEIGHT,

SO WE HAD TO STOP OUR OUTINGS.

WE HAD TO STOP DOING WHAT WE NORMALLY DO

BECAUSE I WASN'T ABLE TO DO IT ANYMORE.

UNFORTUNATELY, MY WEIGHT HAS NOW MADE HIM MY CARETAKER.

HERE'S YOUR SODA.

Daniel: SOMETIMES I FEEL HELPLESS,

LIKE I DON'T KNOW HOW TO SAY NO.

I WANT TO MAKE HER COMFORTABLE AND HAPPY.

WHAT MAKES ASHLEY HAPPY IS WHEN SHE'S ENJOYING FOOD.

-THAT THE ONE YOU WANTED? -MM-HMM. THANK YOU.

Ashley: IN MY FAMILY, WE ALL ENABLE EACH OTHER.

WE ALL LIKE TO EAT.

BUT IT'S NOT LIKE I HAVE A CHOICE.

I HAVE TO EAT. EVERYBODY HAS TO EAT.

YOU CAN'T STARVE YOURSELF.

BUT I KNOW THAT I EAT TOO MUCH.

I FEEL GUILTY ABOUT NOT BEING ABLE TO SAY NO TO FOOD.

BUT I STILL DO IT.

AND THE LAST TWO YEARS, I PUT ON ANOTHER 150 POUNDS.

AND WHEN WE GOT MARRIED LAST YEAR,

I COULDN'T HAVE THE DRESS OF MY DREAMS.

I DEFINITELY COULDN'T HAVE THE HONEYMOON OF MY DREAMS.

SO I SETTLED FOR THE WEDDING THAT WE HAD.

BECAUSE WHEN YOU'RE AS BIG AS I AM,

YOU JUST HAVE TO GIVE UP ON MORE AND MORE OF YOUR LIFE.

AND I DON'T KNOW HOW MUCH I WEIGH AT THIS TIME,

BUT I'M THINKING AROUND 650.

SO I FEEL LIKE I DON'T GIVE HIM THE FULL EXPERIENCE OF A WIFE,

OF A REGULAR, NORMAL WIFE

BECAUSE HE'S TOO BUSY TAKING CARE OF ME.

AND I HATE BEING A BURDEN TO ANYONE.

SO I TRY TO MAINTAIN SOME INDEPENDENCE.

BUT BEING OVER 600 POUNDS, I CAN'T DO VERY MUCH.

SO I HAD TO GET A JOB THAT DOESN'T REQUIRE ME TO BE ACTIVE.

I DO CUSTOMER SUPPORT ON THE PHONE ALL DAY

SO I DON'T HAVE TO GET UP.

THIS WORLD IS NOT MEANT FOR PEOPLE MY SIZE.

I CAN BARELY FIT INTO MY CAR,

AND DANIEL DOESN'T HAVE A LICENSE,

SO IT'S THE ONLY WAY WE'RE ABLE TO GET AROUND.

DRIVING IS ONE OF THE ONLY THINGS I CAN STILL DO ON MY OWN.

BUT I'M SCARED I WON'T BE ABLE TO DO IT MUCH LONGER.

I'M AFRAID OF EVERYTHING RIGHT NOW.

I'M AFRAID THAT -- IS THIS THE LAST TIME

I'M GONNA BE ABLE TO COME INTO WORK?

AND THE MORE STRESS I GET,

THE MORE I WANT TO EAT.

I WANT TO FEEL COMFORTED.

CAN I GET A LARGE WAFFLE-CONE ICED CAPPUCCINO?

AND THE SAUSAGE AND CHEDDAR BREAKFAST SANDWICH.

EVEN THOUGH I'VE ALREADY HAD BREAKFAST,

I STOP AND GET SOMETHING.

-HERE YOU GO. THANK YOU. -THANK YOU.

I EAT SWEETS ABOUT FOUR TO FIVE TIMES A DAY.

EATING CALMS ME.

IT MAKES EVERYTHING OKAY,

EVEN THOUGH I KNOW IT'S NOT.

AS I'M EATING, I FEEL NUMB,

AND IT'S BETTER THAN FEELING STRESSED.

[ HORN HONKS ]

EVERY TIME I GET OUT OF THE CAR,

MY STOMACH IS SO LARGE THAT IT PRESSES ON THE HORN.

I FEEL GUILTY FOR DOING THIS TO MYSELF,

AND I'M ASHAMED OF WHAT I'VE BECOME.

I'M BARELY EVEN MAKING IT TO WORK AT THIS POINT.

AND I KNOW I'M NOT EVEN GOING TO BE ABLE TO DO THIS SOON.

MY FAMILY DOESN'T JUST EAT. WE FEAST.

NO, I'M GOOD.

Blanca: FOOD HAS ALWAYS BEEN A COMFORT FOR ALL OF US.

I ALWAYS MAKE A TON OF FOOD BECAUSE THERE'S SO MANY OF US,

AND THEN ASHLEY ALWAYS WANTS SECONDS.

Ashley: EATING JUST SOOTHES ME.

IT ALWAYS HAS.

AND ESPECIALLY WHEN I'M REALLY STRESSED OUT AND I'M EMOTIONAL,

I JUST WANT TO EAT.

GOOD.

Lindsay: I NEVER TALK TO ASHLEY ABOUT HER WEIGHT

BECAUSE IT'S A SENSITIVE SUBJECT.

BUT I AM SAD FOR HER.

I FEEL LIKE ONE DAY, ASHLEY WON'T WAKE UP,

AND I COULDN'T EVEN SAY BYE TO HER.

Alexis: IT'S HARD TO WATCH ASHLEY GAIN MORE WEIGHT.

IT'S NOT EVEN SO MUCH ABOUT WHAT SHE'S EATING.

IT'S ABOUT HOW MUCH SHE'S EATING.

IT'S GETTING TO THE POINT

THAT I MIGHT NOT HAVE AN OLDER SISTER NEXT YEAR.

I'M STARTING TO SEE A LOT OF SADNESS,

A LOT OF PITY,

A LOT OF HELPLESSNESS IN ALL OF THEIR EYES.

MY ENTIRE FAMILY IS AFRAID OF ME DYING.

I FEEL GUILTY BECAUSE I KNOW I'M HARMING MYSELF.

I'M CUTTING THE TIME I GET TO SPEND WITH THEM SHORT.

I KNOW I'M TRADING A FUTURE WITH THE PEOPLE THAT I LOVE FOR FOOD.

THANK YOU, BABY.

Daniel: I DON'T THINK ASHLEY REALIZES HOW MUCH SHE'S EATING.

I FEEL THAT SHE'S CLOSE TO THE EDGE.

Alan: FOOD IS KILLING MY DAUGHTER.

IT IS VERY PAINFUL TO SEE MY DAUGHTER

GETTING WORSE EVERY DAY.

COME ON, BABE. CAN YOU HELP ME?

Ashley: I FEEL COMPLETELY HELPLESS.

I KNOW MY HUSBAND WORRIES ABOUT ME CONSTANTLY.

IT'S BEEN SUCH A LONG TIME THAT HE'S TAKEN CARE OF ME

THAT I CAN'T GIVE BACK.

I FEEL DISGUSTED BY MYSELF.

AND HOW COULD HE NOT FEEL THAT FOR ME, TOO?

IT STRAINS MY MARRIAGE THAT I CAN'T BE ROMANTIC WITH HIM,

THAT WE CAN'T EXPRESS OUR LOVE THE WAY WE WANT TO.

BUT I JUST DON'T WANT HIM TO SEE ME.

ONE OF MY BIGGEST FEARS IS THAT HE IS GOING TO WAKE UP ONE DAY

AND BE LIKE, "I DON'T WANT TO DO THIS ANYMORE.

I DON'T WANT TO TAKE CARE OF HER LIKE SHE'S A PATIENT."

GOOD NIGHT.

Daniel: WE HAD PLANS ABOUT HAVING A FAMILY.

BUT IF MY WIFE DOESN'T LOSE THE WEIGHT,

ALL THOSE HOPES AND DREAMS ARE GONNA BE SHATTERED.

Ashley: I WORRY IF I'M GONNA WAKE UP TOMORROW.

I FEEL LIKE MY BODY CAN'T TAKE IT ANYMORE.

BUT IF I GIVE UP,

I'M NOT GONNA LIVE TO GROW OLD WITH MY HUSBAND.

Ashley: I THINK THAT'S IT.

I HOPE SO.

Ashley: I FINALLY DECIDED TO MAKE A CHANGE IN MY LIFE,

AND I'M SCARED.

BUT I'M MORE SCARED OF WHAT WOULD HAPPEN IF I DON'T GO.

MY HUSBAND AND MY SISTERS AND MY DAD

ARE GOING TO BE STAYING BEHIND,

AND JUST ME AND MY MOM ARE GONNA GO.

DANIEL HAS TO STAY BEHIND AND WORK,

AND WE'VE NEVER BEEN APART LIKE THIS.

SO THIS IS ALL SO HARD TO DO,

BUT I HAVE TO TRY.

JUST WORRYING ABOUT THE TRIP, YOU KNOW?

-I KNOW. -IT'S LONG.

I HAVEN'T SEEN ASHLEY STAY IN A CAR

FOR LONG PERIODS OF TIME SINCE SHE WAS 16.

HER BACK MIGHT GIVE OUT.

HER LEGS ARE GONNA GET CRAMPS.

AND IT'S SCARY BECAUSE MY MOM BY HERSELF, SHE CAN'T HELP HER.

Ashley: IF I DON'T TAKE THIS RISK

TO SEE THE DOCTOR SO THAT HE CAN HELP ME,

I DON'T KNOW HOW MUCH LONGER I HAVE LEFT.

NOTHING COMES EASY, BUT IT'S GONNA BE GOOD FOR HER.

Ashley: I'VE LIVED LIKE THIS LONG ENOUGH

FOR ME TO BE TIRED OF BEING LIKE THIS.

Alexis: I'M A LITTLE NERVOUS BECAUSE I KNOW

THIS IS THE LAST CHANCE FOR MY SISTER.

Daniel: I'M GONNA MISS HER A LOT,

AND I AM SCARED OF WHAT THE DOCTOR'S GONNA TELL HER.

I HOPE THAT IT WILL BE

A LIFE-CHANGING EXPERIENCE FOR HER.

LOVE YOU. [ SMOOCHES ]

IF I FEEL NERVOUS, I WONDER HOW YOU FEEL.

MY STOMACH IS IN KNOTS.

Ashley: THERE ARE NO OTHER OPTIONS.

DIET AND EXERCISE ALONE

IS NOT GONNA HELP THE SITUATION THAT I'M IN.

I NEED THE MEDICAL INTERVENTION.

I NEED TO GET MY LIFE BACK.

I'M WILLING TO DO WHATEVER IT TAKES,

BUT IT'S AT LEAST A THREE-DAY TRIP TO HOUSTON,

AND I'VE NEVER SPENT THAT MUCH TIME IN THE CAR.

I DON'T KNOW HOW MY BODY'S GONNA HANDLE IT.

-YOU'RE TIRED? -YEAH.

YOU BARELY DID AN HOUR.

MY NECK'S GETTING STIFF. MY BACK'S KIND OF ACHY.

I'M SORRY, MOM.

-YOU NEED ME TO HELP YOU? -KIND OF STIFF.

YOU GOT IT?

BE CAREFUL.

Ashley: I'M KIND OF EMBARRASSED.

I WANTED TO GET A LOT FURTHER TONIGHT,

BUT MY BODY JUST WON'T LET ME.

I FEEL HEAVY AND TIRED.

AND MY BACK IS HURTING.

I DON'T KNOW IF I'M GONNA BE ABLE TO DO THIS.

AND I FEEL GUILTY THAT MY MOM HAS TO DO EVERYTHING.

SHE ALWAYS DOES EVERYTHING.

SO, TOMORROW, I'LL DRIVE THE FIRST COUPLE OF HOURS.

BUT JUST LET ME KNOW IN CASE

BECAUSE I DON'T WANT YOU GETTING ANY CRAMPS OR ANYTHING.

I'M REALLY NERVOUS ABOUT THIS TRIP.

WE BARELY STARTED,

AND I JUST DON'T KNOW WHAT TO EXPECT.

OKAY, MIJA, THE CAR'S PACKED UP.

LET'S GO. CAREFUL.

I'M GONNA SEE IF I'M ABLE TO SIT IN THE BACK SO I CAN RELAX.

Ashley: OKAY.

OW.

I'M NERVOUS THAT I'M NOT GONNA BE ABLE TO DRIVE

AS LONG AS I THINK I CAN.

AND I REALLY WANT TO HELP MY MOM DRIVE

BECAUSE I KNOW IT'S A LONG, TEDIOUS ROAD.

I FEEL LIKE I NEED TO DRIVE TO NOT FEEL SO HELPLESS.

I'M AT A POINT WHERE IF I GET ANY BIGGER,

I'M NOT GONNA BE FITTING INTO THIS CAR.

SO I'M TRYING TO HOLD ONTO THE VERY LAST LITTLE BIT

THAT I CAN OF INDEPENDENCE,

SO IT'S IMPORTANT FOR ME TO JUST HELP.

BECAUSE SOON I MAY NOT BE ABLE TO DO EVEN THAT.

OW.

I GOT TO PULL OVER. I'M GETTING A CRAMP.

MY LEG'S KILLING ME.

I THOUGHT I WAS GONNA BE ABLE TO DRIVE A LOT FURTHER,

BUT I STARTED GETTING A CRAMP, SO I WASN'T GONNA RISK IT.

I WAS LIKE, "OKAY, MOM, JUST TAKE OVER."

WHEN I SIT TOO MUCH, I GET HORRIBLE CRAMPS.

THEY HURT SO BAD.

AND SOMETIMES MY LEGS GO COMPLETELY NUMB.

AND I WAS JUST SCARED I WOULD WRECK THE CAR.

Ashley: THANK YOU FOR TAKING OVER.

YOU'RE WELCOME, MIJA.

MY FOOT WAS NOT --

IT WAS STARTING TO HURT, AND I DIDN'T WANT TO PUSH IT.

THE LAST THING I WANT TO DO IS HAVE AN ACCIDENT.

I'M EMBARRASSED THAT I CAN'T HELP MY MOM MORE ON THIS TRIP.

SOMETIMES IT SEEMS LIKE ALL I CAN REALLY DO ANYMORE IS EAT.

WE SHOULD STOP AND GET SOMETHING TO EAT.

YEAH.

DO YOU WANT TO GO INSIDE?

THERE'S TOO MANY PEOPLE.

-YOU'RE NOT UP TO IT? -NO.

NO, LET'S GO BY THE TREE.

-THIS ONE? -YEAH, THIS ONE.

THIS ONE'S YOURS.

I DON'T WANT PEOPLE TO SEE ME EAT.

WHEN I'M OUT IN PUBLIC, I FEEL LIKE I'M AT A CIRCUS

AND I'M THE ONE BEHIND THE CAGE.

I FEEL LIKE I'M AN ANIMAL.

WE'VE GOT TO GO.

I CAN'T KEEP LIVING THIS LIFE.

I JUST WANT TO GET HELP.

Ashley: WE'RE HERE, MOM.

MY STOMACH HURTS. IT'S THE NERVES, MIJA.

I KNOW.

OH, MY GOD.

Ashley: I'M SCARED TO SEE THE DOCTOR.

I DON'T KNOW WHAT HE'S GOING TO SAY.

WHAT IF I'VE COME ALL THIS WAY

AND HE TELLS ME THAT HE CAN'T HELP ME?

THERE REALLY IS NO PLAN "B."

EVERYTHING IS RIDING ON THIS.

MY ENTIRE LIFE IS AT STAKE.

Ashley: I'M SEEING DR. NOW FOR THE FIRST TIME TODAY.

I'M NERVOUS AND ANXIOUS.

I HAVEN'T BEEN ON A SCALE IN SUCH A LONG TIME.

I DON'T KNOW WHAT IT'S GONNA READ, AND I'M AFRAID OF IT.

Woman: 668.

THAT'S A REALLY, REALLY HIGH NUMBER.

HOW IS IT THAT I'M STILL ALIVE AT THIS POINT?

I'M TERRIFIED NOW THAT I'M BEYOND HELP...

...THAT IF HE CAN'T HELP ME, I'M GONNA DIE.

I KNEW IT WAS BAD, BUT I DIDN'T KNOW IT WAS THAT BAD, ASHLEY.

AND NOW I AM CERTAIN THAT IF YOU DON'T GET THE HELP,

I WON'T HAVE YOU LONG.

AND THAT SCARES ME.

I DON'T KNOW WHAT TO DO, MOM.

[ KNOCK ON DOOR ]

-HELLO. -HELLO.

I'M DR. NOWZARADAN. YOU ARE ASHLEY, HUH?

-YES. -ALL RIGHT.

AND TODAY YOU WEIGH 668 POUNDS?

-YES. -OKAY.

WHAT IS THE HIGHEST WEIGHT YOU HAVE BEEN?

THIS HAS BEEN MY HIGHEST WEIGHT.

SO WHAT SEEMS TO BE BIGGEST CHALLENGE

WITH YOUR EATING HABIT?

I'M USUALLY JUST SNACKING ALL DAY LONG.

SO WHY ARE YOU DOING THAT?

'CAUSE I'M HUNGRY.

I KNOW I SHOULDN'T EAT LIKE I DO.

BUT EVERYTHING I EAT -- I FEEL SO GUILTY ABOUT EATING IT.

YOU KNOW, I KNOW THAT I'M NOT

SUPPOSED TO BE EATING SWEETS OR SUGARY THINGS,

BUT I CRAVE THEM.

AND AT THIS POINT,

I KNOW THAT I NEED WEIGHT-LOSS SURGERY.

SO YOU ALREADY FIGURED THE SOLUTION,

BUT YOU NEED TO FIGURE OUT THE PROBLEM.

THE SURGERY IS GONNA ONLY AFFECT

HOW MUCH YOU'RE GONNA EAT AT ONE TIME.

THE SURGERY WILL NOT AFFECT YOUR FREQUENCY OF EATING,

WOULD NOT EFFECT THE TYPE OF FOOD THAT YOU EAT.

AND UNLESS YOU HAVE A HANDLE ON THAT,

WEIGHT-LOSS SURGERY IS NOT GONNA BE A GOOD OPTION.

Dr. Nowzaradan: ASHLEY'S SAYING THAT SHE HAS A PROBLEM,

BUT ALSO SHE'S ACTING LIKE

SURGERY IS GOING TO FIX EVERYTHING.

THAT'S NOT HOW IT WORKS.

SHE'S GOING TO HAVE TO SHOW ME THAT SHE CAN DO THIS

AND SHE'S WILLING TO WORK

AND NOT JUST TRUST IN A MAGIC PILL.

YOU ARE AT HOME WITH HER? OR WHO'S AT HOME WITH HER?

EVENING IS THE ONLY TIME WE'RE TOGETHER.

AND SO WE HAVE DINNER EVERY NIGHT.

SO YOU ALL EAT THE SAME FOOD,

AND YOU ALL SORT OF ENABLE EACH OTHER.

AND THAT MAY BE VERY DIFFICULT

TO BREAK THAT DYNAMIC IN THE HOUSEHOLD.

BUT YOU HAVE TO BE PROACTIVE WITH YOURSELF

AND YOU NEED TO ADJUST YOUR EATING HABITS

BECAUSE OTHERWISE, YOU'RE NOT GONNA LAST TOO LONG.

SO, NOW YOU'RE 30.

WHAT IS GONNA HAPPEN WHEN YOU'RE 40?

I DON'T THINK I'M GONNA MAKE IT TO 40 IF I CONTINUE THIS WAY.

YOU'RE ABSOLUTELY CORRECT.

YOU'RE NOT GONNA MAKE IT TO 40.

YOU'RE ACTUALLY KILLING YOURSELF WITH THE FOOD.

Dr. Nowzaradan: ASHLEY HAS TO UNDERSTAND

THIS IS GOING TO BE A LONG, HARD PROCESS.

SHE'S CLOSE TO 700 POUNDS,

AND THE HUMAN BODY

IS NOT DESIGNED TO OPERATE AT THAT WEIGHT.

THERE'S NO WAY THAT SHE WILL SURVIVE

A FEW MORE YEARS UNLESS SHE STARTS TO CHANGE NOW

AND START TAKING DRASTIC ACTIONS TO SAVE HERSELF.

YOU'RE 668 POUNDS.

YOU'RE NOT A CANDIDATE FOR SURGERY,

BUT YOU HAVE POTENTIAL FOR IT IF YOU SHOW ME

THAT YOU'RE WILLING TO TAKE CONTROL OF YOUR SITUATION

AND TRY TO CHANGE.

AT THIS POINT, YOUR PRIORITY

IS THAT YOU'RE GONNA STICK TO A 1,200-CALORIE DIET.

YOU'RE GONNA AVOID ALL THE HIGH-CALORIE

AND CARBS IN YOUR DIET.

AND YOU'RE GONNA START MAKING A DIFFERENCE

IN YOUR EATING HABIT.

START INCREASING YOUR ACTIVITY WITH WALKING.

AND I WOULD EXPECT THAT YOU'LL BE ABLE

TO LOSE 50 POUNDS IN ONE MONTH.

OKAY?

ALL RIGHT? NICE TO MEET YOU GUYS.

NICE MEETING YOU.

LET'S GO.

Ashley: I'M DISAPPOINTED, BUT AT LEAST THERE'S HOPE.

I THINK THAT I'VE CONDITIONED MYSELF

TO ALWAYS EXPECT THE WORST OF EVERY SITUATION.

SO FOR HIM TO AT LEAST GIVE ME THE HOPE THAT,

"HEY, I CAN HELP YOU,

AND WE CAN TOGETHER GO TO THE NEXT STEP,"

THAT'S REALLY NICE TO HEAR.

AND EVEN THOUGH I'M KIND OF SAD

THAT I WASN'T A CANDIDATE AT THIS TIME,

I KNOW THAT I'M GONNA TRY REALLY, REALLY HARD.

THIS IS A DO-OR-DIE SITUATION

WHERE I DO IT OR IF I DON'T, I DIE.

-YOU READY TO GO? -YEAH, LET'S GO.

Ashley: I'VE BEEN HOME FOR A COUPLE OF WEEKS,

WORKING HARD TO LOSE WEIGHT.

WE'LL BE BACK, YOU GUYS.

OKAY.

I'VE BEEN TRYING TO WALK EVERY DAY,

AND EACH TIME I'M ABLE TO GO A LITTLE BIT FARTHER.

MY SISTERS HAVE BEEN HELPING ME

BECAUSE THEY REALLY WANT ME TO BE ABLE TO DO THIS

AND GET SURGERY.

-YOU GOOD? -YEAH.

I'M SCARE OF DISAPPOINTING THEM,

BUT I'M TRYING TO STAY FOCUSED

ON WHAT I NEED TO DO FOR MYSELF.

ONE STEP AT A TIME. IT DOESN'T MATTER HOW SMALL.

I'M IN THIS MIND-SET NOW

THAT I'M GONNA DO EVERYTHING I POSSIBLY CAN

TO GET TO MY GOAL.

DON'T LET IT GO.

I KNOW. I GOT IT. I GOT IT.

10.

I'M GOING TO DO EVERYTHING IN MY POWER TO MAKE THIS HAPPEN.

BEING MORE ACTIVE, I KNOW I CAN DO LONG-TERM.

I CAME TO HELP.

CHANGING THE FOOD I EAT IS REALLY THE TOUGHER THING.

EVERYONE IN MY FAMILY

IS WILLING TO MAKE THIS CHANGE WITH ME.

BUT I KNOW A LOT OF IT'S ON ME, TOO.

-THANK YOU. -YEAH.

SO SHE WON'T FEEL LEFT OUT.

NO MORE SODA. NO MORE, YOU KNOW, SWEET STUFF.

I'M GONNA START PLATING MINE, BABE.

Ashley: STICKING TO 1,200 CALORIES A DAY

IS GOING TO BE REALLY HARD.

BUT I MEASURE OUT EVERYTHING I EAT.

5.25.

I'M GOING TO EAT WHAT I'M SUPPOSED TO -- NO CARBS.

IF I WORK THIS HARD,

AM I REALLY GONNA THROW EVERYTHING AWAY FOR A COOKIE?

I TAKE A LOOK BACK TO WHAT I WAS EATING BEFORE

AND TO WHAT I EAT NOW,

HOW I'M NOT SNACKING IN BETWEEN,

HOW I'M NOT EATING ANY JUNK,

AND I'M PROUD OF THE FACT

THAT I HAVEN'T CHEATED AND I HAVEN'T GIVEN UP,

NO MATTER HOW HARD IT'S BEEN, AND IT'S BEEN HARD.

Blanca: I'M REALLY PROUD OF YOU.

YOU'VE DONE VERY WELL.

Blanca: IT'S A LIFESTYLE CHANGE --

NOT JUST FOR HER, IT'S FOR EVERYBODY.

BECAUSE WE CAN'T SUPPORT HER

IF WE'RE NOT GONNA CHANGE OURSELVES, EITHER.

WE WILL TRY TO DO OUR BEST AS A FAMILY TO BE THERE FOR HER.

HERE YOU GO, BUBBA.

-IT'S PROTEIN. -IT'S PROTEIN.

EVEN THE CAT'S ON A DIET.

[ LAUGHTER ]

THAT'S ONE. THAT'S DONE.

TODAY, WE ARE PACKING UP TO MOVE TO HOUSTON.

DANIEL AND I DECIDED WE HAVE TO MAKE THIS CHANGE

IF I'M GOING TO BE FULLY COMMITTED.

SO WE'RE GONNA LIVE IN HOUSTON FOR A WHILE

TO BE CLOSE TO THE DOCTOR.

THIS STUFF HERE IS GOOD TO GO.

-ALL OF THIS? -YEAH.

YEAH.

I'M SAD 'CAUSE I HAVEN'T LEFT YET

AND I'M ALREADY MISSING MY FAMILY.

IN THE LONG RUN, I KNOW THIS IS THE BEST THING

THAT COULD HAPPEN FOR ME,

BUT RIGHT NOW

I HAVE A LOT OF ANXIETY AND I'M SCARED.

AND I'M STRESSED OUT,

AND I'M JUST REALLY SAD TO LEAVE.

MY DAD'S GOING TO DRIVE US DOWN,

BUT THEN HE HAS TO GO BACK AND LEAVE DANIEL AND ME ALONE.

MY MOM AND MY SISTERS

HAVE BEEN THE ONES WHO MOSTLY TAKE CARE OF ME.

NOW IT'S GOING TO FALL ON DANIEL.

YEAH, YOU CAN TAKE THAT.

THERE ARE SOME THING I HAVE NOT WANTED HIM TO DO.

IF I HAVE TO LET DANIEL HELP ME TAKE A SHOWER,

I'M WORRIED THAT IT'S GONNA HAVE

A NEGATIVE EFFECT ON OUR MARRIAGE.

I'M CHANGING EVERYTHING I KNOW.

THIS COULD BE GOODBYE FOR A WHILE.

Blanca: THIS IS THE FIRST TIME THAT SHE'LL BE ON HER OWN,

BUT I HONESTLY DO THINK IT'S HER LAST CHANCE.

AND I REALLY HOPE THAT SHE SUCCEEDS.

Alexis: IT'S JUST HARD TO HAVE TO LET HER GO.

BUT IF I HAVE TO LOSE HER TEMPORARILY

FOR HER, YOU KNOW, TO MOVE TO TEXAS,

THAT'S BETTER THAN PERMANENTLY LOSING HER.

[ SOBBING ]

Lindsay: ME AND ASHLEY ARE VERY CLOSE,

AND SHE DEPENDS ON OUR FAMILY SO MUCH

FOR HER TO EVEN GET AROUND THE DAY.

SO IT'S SCARY BECAUSE IT'S SO FAR AWAY.

IT FEELS LIKE MY HEART IS BEING RIPPED IN TWO

AND I'M LEAVING HALF OF IT BEHIND.

AND NOT THAT DANIEL DOESN'T MAKE ME FEEL WHOLE,

BUT IT'S DIFFERENT.

I'M LEAVING EVERYTHING THAT I KNOW.

AND WHAT IF I FAIL?

WHAT IF I AM NOT STRONG ENOUGH TO DO THIS?

Ashley: WHEN YOU WORK HARD TO ACHIEVE SOMETHING,

YOU MAY NOT REALIZE

WHAT YOU THOUGHT WAS THE GOAL WAS REALLY JUST THE FIRST STEP.

FOR THE SECOND TIME IN ABOUT A MONTH,

I'VE MADE THE TRIP BACK TO HOUSTON.

MY DAD TOOK TIME OFF WORK TO HELP US DRIVE,

SINCE I CAN'T DO THE WHOLE DRIVE ON MY OWN

AND DANIEL DOESN'T HAVE A LICENSE.

-RIGHT HERE? -RIGHT HERE.

I THINK THAT THIS ROAD TRIP TOOK A TOLL ON MY BODY, ON MY MIND.

IT WAS IMPORTANT FOR ME TO GET TO HOUSTON

TO BE CLOSER TO THE DOCTOR.

BUT WE LEFT EVERYTHING.

WE LEFT OUR FAMILY. WE LEFT OUR FRIENDS.

DANIEL AND I ARE TAKING A BIG GAMBLE,

AND I DON'T EVEN KNOW

IF DR. NOW IS GONNA APPROVE ME FOR SURGERY.

AND I HOPE THIS PAYS OFF.

THERE'S SO MANY UNKNOWNS AHEAD.

AND PART OF ME IS WORRIED I'VE MADE A BIG MISTAKE.

IT WORRIES ME THAT ASHLEY IS REALLY STRESSED OUT.

WHEN SHE'S REALLY STRESSED OUT, THAT'S WHEN SHE EATS.

UM, YOU GUYS CAN EAT. I'M NOT HUNGRY.

DAD, REALLY, I'M NOT HUNGRY.

Ashley: I AM COMPLETELY DRAINED.

I AM EMOTIONALLY SPENT.

I AM PHYSICALLY EXHAUSTED.

AND ALL I WANT IS FOOD, BUT I CAN'T MESS THIS UP.

MY OLD EATING HABITS WERE TO EAT WHATEVER I WANTED

WHEN I WAS STRESSED TO COMFORT MYSELF

AND MAKE IT BETTER.

I DON'T WANT TO GO BACK

INTO THE HABIT OF STRESSING OUT AND THEN EATING

BECAUSE THIS IS WHERE IT GOT ME.

WHAT A DAY TODAY.

TOMORROW, MY FATHER FLIES BACK HOME,

AND DANIEL AND I WILL BE ALONE.

AND THEN WE GO SEE THE DOCTOR

TO FIND OUT IF I'M APPROVED FOR SURGERY.

-WE CAN GO. -OKAY.

-ALL RIGHT? -YEAH.

NOW THAT HE'S HELPED US MOVE AND GET SETTLED IN,

MY DAD'S FLYING BACK HOME TODAY.

Alan: JUST THINK...

DANIEL'S GONNA BE HERE ALL THE TIME WITH YOU, YOU KNOW?

-YEAH. -YOU CAN CALL US ANY TIME.

YEAH, I KNOW.

LIVING IN HOUSTON IS GONNA BE OKAY,

BUT I THINK THAT AT THE BEGINNING,

SHE'S GONNA MISS HER FAMILY.

IT'S GONNA TAKE TIME FOR HER TO ADJUST.

-WANT ME TO DRIVE? -YEAH.

CAN'T BELIEVE YOU'RE LEAVING TODAY, DAD.

Alan: ASHLEY -- THIS IS THE FIRST TIME SHE'S AWAY FROM HOME,

AWAY FROM US, FROM THE FAMILY, FROM EVERYTHING.

AND I THINK THAT'S WHAT'S MOST TOUGH FOR HER,

TO LET GO OF US.

-HAVE A SAFE FLIGHT. -ALL RIGHT.

I'LL SEE YOU THEN.

TAKE CARE, ALL RIGHT?

Ashley: I MISS THEM.

I MISS HOME.

I AM SO FAR AWAY FROM MY COMFORT ZONE AT THIS POINT.

BUT MY DAD SAID, YOU KNOW, THERE'S CERTAIN SACRIFICES

THAT YOU HAVE TO DO IN ORDER TO GET WHERE YOU WANT TO GET.

AND YOU JUST GOT TO BE STRONG.

TODAY, WE ARE ON OUR WAY TO SEE DR. NOWZARADAN

TO CHECK ON MY PROGRESS AND THEN TO SEE

IF I'M GOING TO BE A CANDIDATE FOR SURGERY OR NOT.

I KNOW THAT I'VE BEEN DOING WELL,

AND I KNOW THAT IT'S BEEN HARD.

AND I'M NERVOUS TO SEE WHAT THE SCALE SAYS NOW.

I NEED THE SURGERY SO BAD.

THIS IS THE NEXT STEP IN THIS JOURNEY,

AND HE HOLDS THE KEY TO THAT.

THANKS, BABY.

Woman: ASHLEY REYES?

Ashley: THE DOCTOR TOLD ME

I NEEDED TO LOSE 50 POUNDS TO BE A CANDIDATE FOR SURGERY.

SO EVERYTHING DEPENDS ON THIS WEIGH-IN.

Woman: 614.

AT LEAST I MET THE 50 POUNDS

THAT THE DOCTOR WANTED ME TO LOSE.

BUT I'M NERVOUS IT'S NOT GOING TO BE ENOUGH.

I WONDER WHAT HE'S GONNA SAY.

YEAH, BUT IS IT GOOD ENOUGH? THAT'S THE QUESTION.

-HELLO. -HI.

-HOW Y'ALL DOING? -GOOD.

-SO YOU LOST 54 POUNDS. -YES.

SO HOW IS YOUR EATING HABIT NOW?

I MEASURE EVERYTHING. I WEIGH EVERYTHING IN OUNCES,

MAKE SURE THE PORTIONS ARE UNDER CONTROL.

I ADD MORE PROTEIN, AND NOW I DON'T SNACK AT ALL.

OKAY, SUPER.

Dr. Nowzaradan: ASHLEY'S DONE WELL THIS MONTH.

LOSING 54 POUNDS HAS DEMONSTRATED

THAT SHE'S ABLE TO CONTROL HER EATING HABIT.

SHE'S SHOWN ME THAT SHE'S WILLING TO WORK HARD FOR THIS

AND NOT JUST TRUSTING IN THE MAGIC PILL.

YOU'RE DOING GOOD, AND YOU LOST SOME WEIGHT.

SO I'M GONNA APPROVE YOU FOR WEIGHT-LOSS SURGERY.

Ashley: OKAY. THANK YOU SO MUCH.

YOU FIGURED OUT HOW TO DEAL WITH THE PROBLEM.

NOW THE SURGERY WILL HELP YOU EVEN MORE.

I'M GOING TO SCHEDULE YOUR OPERATION FOR NEXT MONTH.

UNTIL THEN, STICK WITH THE DIET

SO YOU CAN LOSE EVEN MORE WEIGHT.

IF YOU DON'T, WE WON'T BE ABLE

TO MOVE FORWARD WITH YOUR SURGERY.

SO KEEP AT IT. GOOD JOB.

Dr. Nowzaradan: THIS IS ENCOURAGING.

IT'S NOT A GUARANTEE

THAT SHE WILL BE COMPLETELY SUCCESSFUL,

BUT HER HEAD SEEMS TO BE IN THE RIGHT PLACE.

SHE'S SHOWN ME THAT SHE'S READY FOR THE NEXT STEP.

ALL RIGHT. I'LL SEE YOU LATER.

-OKAY. -ALL RIGHT.

-THANK YOU SO MUCH, DOCTOR. -ALL RIGHT.

FEELING GOOD?

YEAH.

Ashley: TO GET A YES FROM THE DOCTOR MEANS EVERYTHING.

IT MEANS THAT ALL MY EFFORT --

THE MOVE, LEAVING MY FAMILY,

LEAVING EVERYTHING THAT I KNOW BACK IN CALIFORNIA --

IT'S WORTH IT.

I CAN'T WAIT TO TELL MY FAMILY THAT I'M APPROVED.

I'M PROUD OF MYSELF THAT I DIDN'T WAVER

AND I DIDN'T LET MYSELF DOWN

BY GOING BACK TO MY OLD EATING HABITS

WHEN THINGS GOT REALLY STRESSFUL OR REALLY BAD.

I FINALLY GET TO SEE THE LIGHT AT THE END OF THE TUNNEL.

**

I'M EXCITED 'CAUSE MY FAMILY IS ARRIVING IN HOUSTON TODAY.

IT'S BEEN TWO MONTHS SINCE I'VE SEEN MY FAMILY.

I'M THANKFUL I HAVE DANIEL HERE WITH ME.

BUT I REALLY NEED THE SUPPORT

OF MY WHOLE FAMILY GOING INTO SURGERY.

I'M JUST REALLY SCARED.

-HI! -ASHLEY!

ASH! WE MISSED YOU.

DANIEL! WHAT'S UP, DANIEL?

YOU CAN SIT, MIJA.

I'M TIRED OF SITTING DOWN, THOUGH. ALL THE WAY HERE.

DUDE, YOUR FACE LOOKS SMALLER!

-THANKS. -SHE LOOKS SO GOOD.

I HAVEN'T NOTICED A DIFFERENCE YET.

I'M SO EXCITED FOR THE LITTLE MINOR THINGS.

SO, HOW LONG ARE YOU GOING TO BE IN THE HOSPITAL?

-DID HE TELL YOU? -HE SAID ABOUT 3 TO 4 DAYS.

AND THERE'S NO MORE TESTS THAT YOU NEED TO RUN OR ANYTHING LIKE THAT? OR THAT'S IT?

NO, HE DID RUN A BUNCH OF TESTS ALREADY.

-OH, YEAH? -YEAH.

-AND THEY CAME OUT GOOD? -YEAH, THEY CAME OUT GOOD.

-YOU KNOW, UM... -HOW'S THE BLOOD WORK?

I'VE BEEN STRESSING OUT A LITTLE BIT,

SO MY BLOOD PRESSURE WENT UP.

Blanca: I DON'T WANT ASHLEY TO SEE ME WORRIED ABOUT HER,

BUT I'M SCARED FOR HER.

I'M SCARED FOR THE FACT THAT IT'S NOT A LITTLE SURGERY.

IT'S A MAJOR SURGERY.

BUT I JUST KEEP THINKING IT'S FOR HER OWN GOOD.

I'M HAPPY,

AFTER ALL THIS TIME, AFTER ALL THE SACRIFICES.

BUT IT'S SCARY, AND I'M VERY NERVOUS.

BUT YOU KNOW WHAT? YOU'RE CLOSING THE BOOK

ON THIS PART OF YOUR LIFE.

YOU'RE GONNA HAVE A WHOLE NEW SET OF OPPORTUNITIES

THAT YOU DIDN'T HAVE BEFORE.

THAT'S WHAT MAKES THIS ALL WORTH IT.

NOW WE'RE GETTING THE CHANCE

AND ASHLEY'S GETTING THE CHANCE TO SEE A FUTURE FOR HERSELF.

THAT'S WHAT I KEEP TELLING MYSELF.

Ashley: I'M SO GLAD MY FAMILY'S HERE

BECAUSE I'M REALLY SCARED ABOUT TOMORROW.

AND I'M JUST NOT SURE IF I CAN DO IT WITHOUT THEM.

TODAY I AM FINALLY GETTING

WEIGHT-LOSS SURGERY AFTER SO LONG.

I'M SCARED, BUT IT FEELS GOOD TO KNOW

MY FAMILY WILL BE THERE WHEN I WAKE UP.

I THINK I'M MORE NERVOUS THAN YOU.

SEE YOU IN A BIT. LOVE YOU!

Ashley: I AM REALLY NERVOUS.

IF THERE WAS ANOTHER WAY, I WOULD'VE DONE THAT,

BUT THERE'S NO OTHER CHOICE.

Dr. Nowzaradan: TODAY WE ARE GOING TO TRY

TO DO A GASTRIC BYPASS PROCEDURE ON ASHLEY.

BUT I AM CONCERNED ABOUT

HOW MUCH OF HER WEIGHT IS AROUND HER STOMACH.

AND THAT'S GOING TO BE VERY DIFFICULT

TO MANIPULATE THE INSTRUMENT.

BUT ONCE I AM ABLE TO SEE INTO HER ABDOMEN,

WE'LL SEE IF WE HAVE ROOM TO DO A GASTRIC BYPASS

OR IF WE NEED TO DO ANOTHER PROCEDURE.

GASTRIC BYPASS IS THE MOST EFFECTIVE TYPE

OF WEIGHT-LOSS SURGERY.

AND IT'S A PROCEDURE THAT NOT ONLY REDUCES

THE SIZE OF THE PATIENT'S STOMACH,

BUT BYPASS SOME OF THE INTESTINES

SO THEY WILL ABSORB FEWER CALORIES.

I CAN'T WAIT FOR HER TO OPEN HER EYES AND BE OKAY.

I DON'T KNOW HOW I WOULD LIVE WITHOUT HER.

AND IT'S VERY SCARY TO THINK THAT THERE COULD BE

A POSSIBILITY THAT THAT WOULD HAPPEN.

Dr. Nowzaradan: WE DON'T HAVE ROOM IN THE ABDOMEN,

SO WE'RE GONNA HAVE TO DO A SLEEVE.

A GASTRIC SLEEVE IS AN OPERATION --

WE REMOVE THE MAJORITY OF THE STOMACH,

LEAVING IN 20% TO 30% OF ORIGINAL STOMACH.

THE BENEFIT AFTER GASTRIC SLEEVE SURGERY

IS THAT THEY CAN EAT ONLY A SMALL AMOUNT

AND THEY GET FULL REAL QUICK,

WHICH WILL HELP THEM TO LOSE WEIGHT.

SHE HAS A VERY BIG STOMACH.

SO WE ARE REDUCING IT A GREAT DEAL.

ALL RIGHT. ROOM LIGHT ON.

ASHLEY'S SURGERY WENT VERY WELL.

MAKING HER STOMACH THIS SMALL

WILL CAUSE HER TO EAT MUCH LESS.

HOWEVER, IF SHE PUSH HERSELF TO OVEREAT,

SHE CAN STRETCH HER STOMACH BACK OUT

AND ESSENTIALLY UNDO THIS SURGERY.

Woman: TIME TO WAKE UP. SURGERY'S ALL FINISHED.

THE SURGERY IS A VERY EFFECTIVE TOOL.

BUT FOR HER TO BE SUCCESSFUL LONG-TERM,

SHE NEEDS TO MAKE SURE THE EMOTIONAL ISSUES

THAT SHE USES FOOD TO AVOID ARE ADDRESSED.

BUT RIGHT NOW SHE SHOULD BE ABLE

TO LOSE 20 TO 30 POUNDS A MONTH ONCE SHE RECOVERS.

Blanca: I FEEL A SENSE OF RELIEF THAT ASHLEY'S ALIVE,

THAT SHE CAME OUT GOOD AFTER THE SURGERY, YOU KNOW?

BUT AT THE SAME TIME, I'M STILL NOT AT EASE.

I'M HOPING THAT SHE'LL BE FINE.

[ ASHLEY GROANING ]

-WANT ME TO LIFT YOU UP? -PLEASE.

Blanca: BREATHE.

Ashley: YOU TRY TO PREPARE YOURSELF FOR THE PAIN

'CAUSE YOU KNOW THERE'S GOING TO BE PAIN.

BUT NOT UNTIL YOU'RE THERE DO YOU ACTUALLY REALIZE

HOW MUCH PAIN IT WAS ACTUALLY GONNA BE.

I'M SORRY, ASHLEY. I CAN'T STAY.

WHAT AM I SUPPOSED TO DO?

YOU KNOW WE CAN'T STAY ANY LONGER 'CAUSE WE HAVE TO DRIVE.

IT'S A REALLY, REALLY FAR DRIVE.

DON'T DO THAT. I CAN'T. I CAN'T GO LIKE THIS.

IT'S JUST SO MUCH HARDER THAN I THOUGHT IT WAS GOING TO BE.

I DON'T KNOW HOW I'M GOING TO DO THIS WITHOUT THEM.

Ashley: TRYING TO AVOID THE PAIN AND HURT IN OUR PAST

CAN CONSUME US SO COMPLETELY,

IT STARTS KILLING OFF THE FUTURE.

Ashley: LET'S GO FOR A WALK.

AND THAT WAY, I CAN STRETCH MYSELF OUT A LITTLE BIT.

ONE, TWO...

PULL.

THAT'S MY GIRL.

IT'S MY FOURTH DAY IN RECOVERY, AND I'M STILL REALLY SORE.

IT'S BEEN HARD TRYING TO WALK AGAIN.

BUT YOU GOT TO WALK THROUGH THE PAIN.

I FEEL LIKE MY STOMACH'S COMPRESSED,

AND WHEN I STAND UP, IT SLOWLY RELEASES.

THAT'S GOOD.

IT'S JUST I GUESS BABY STEPS AT THIS POINT.

I WISH I HAD MY ENTIRE FAMILY HERE,

BUT I HAVE DANIEL NEXT TO ME.

WATER BREAK.

I DON'T KNOW IF I COULD DO THIS WITHOUT HIM.

LET ME GET SOME...

HE LOVES ME SO MUCH.

HE'S ALWAYS BEEN THERE FOR ME.

[ GROANS ]

I WISH I COULD GUZZLE MY WATER, BUT I CAN'T.

Daniel: ASHLEY NEEDS SOME HELP BASICALLY ON EVERYTHING NOW,

BECAUSE I GOT TO PREPARE HER FOOD,

MAKE SURE SHE DRINKS HER LIQUIDS THAT SHE NEEDS TO BE DRINKING.

OH, IT'S BEEF.

Ashley: RIGHT NOW I'M NOT CRAVING ANYTHING,

I DON'T HAVE AN APPETITE.

IT'S AN ODD SENSATION

'CAUSE I EAT 'CAUSE I HAVE TO BUT NOT 'CAUSE I WANT TO.

I NEVER FELT THIS WAY BEFORE IN MY LIFE.

I'M DONE WITH BROTH.

Daniel: I'M GONNA BE IN CHARGE OF ASHLEY'S RECOVERY AT HOME,

AND I'M WORRIED THAT WHEN SHE GETS HOME

SHE'S GONNA BE IN PAIN.

NOBODY WANTS TO SEE A LOVED ONE IN PAIN.

Ashley: I'VE BEEN HOME FROM THE HOSPITAL ALMOST A MONTH,

AND I THOUGHT I WAS GOING TO GET BETTER A LOT SOONER.

BUT THE PAIN REALLY TOOK ITS TOLL.

AND I FELT REALLY SICK AND WEAK,

AND I'M SCARED SOMETHING'S WRONG.

OKAY.

I'LL SEE IF I CAN HAVE A FEW BITES OF THAT.

RIGHT NOW I'M STILL ON A LIQUID DIET,

SO I'M MOSTLY JUST EATING SOUPS.

I KNOW DANIEL FEELS GUILTY EATING SOLID FOOD OR NORMAL FOOD

THAT WE USED TO EAT TOGETHER.

BUT IT'S OKAY. I'M NOT HUNGRY.

Daniel: I'M REALLY PROUD OF ASHLEY 'CAUSE IT'S BEEN HARD,

BUT I SEE A LOT OF DETERMINATION IN ASHLEY

THAT SHE WANTS TO DO THE BEST SHE CAN

AND THAT SHE WILL... AS FAST AS SHE CAN,

BUT I STILL WORRY ABOUT HER.

-THAT IT? -THAT'S IT, BABY.

I DON'T THINK I'M GONNA BE ABLE TO FINISH THAT, BUT THANK YOU.

Ashley: I DON'T KNOW IF MAYBE THE FOOD

THAT I'M EATING RIGHT NOW, I'M NOT ENJOYING IT

BECAUSE IT'S THE SAME THING OVER AND OVER AND OVER.

UM, NO. I JUST FEEL REALLY FULL.

[ GROANS ]

I'M JUST NOT FEELING THE ENERGY TO DO ANYTHING.

YOU KNOW, BEFORE, I WANTED TO GO OUTSIDE AND WALK,

I WANTED TO FEEL THE SUNSHINE, AND I WANTED TO BE MORE ACTIVE.

NOW IT'S LIKE I WANT TO WALK, THE WANT IS THERE,

BUT THE ABILITY TO DO SO IS HARD.

OKAY.

NOW IT'S LIKE EVEN IF I WANT TO, IS MY BODY ABLE TO HANDLE IT?

I THINK I'M LOSING WEIGHT, BUT I'M STILL REALLY WORRIED

THAT THERE'S SOMETHING WRONG FROM SURGERY.

I WANT MY LIFE JUST TO BE BACK TO NORMAL --

YOU KNOW, WHATEVER "NORMAL" IS NOW THAT THE SURGERY IS HERE.

I'M JUST READY TO FEEL GOOD AGAIN.

I'M LIGHTHEADED.

[ BREATHES DEEPLY ]

-HELLO. -HEY, DOCTOR.

-HOW ARE YOU DOING? -I'M, LIKE, QUEASY.

SO, YOU'VE BEEN HAVING NAUSEA.

AND HAVE YOU ACTUALLY VOMITED?

YEAH, I VOMITED TODAY, BUT IT'S JUST FOAM.

IT'S NOT FOOD OR ANYTHING.

OKAY. YOU HAVEN'T EATEN ANYTHING?

NO.

OKAY, WE'RE GONNA GO DOWN AND DO AN ENDOSCOPY ON YOU,

LOOK INSIDE THE STOMACH, MAKE SURE EVERYTHING'S OKAY.

FIGURE OUT WHAT'S GOING ON WITH YOUR STOMACH.

-PLEASE. -OKAY.

-THANK YOU, DOCTOR. -ALL RIGHT.

I'M REALLY WORRIED RIGHT NOW.

MY WORST FEAR IS THAT THE DOCTOR'S GOING TO TELL ME

THAT I NEED FURTHER SURGERY.

I REALLY DON'T WANT SURGERY AGAIN.

I DON'T WANT TO BE IN PAIN.

I NEVER IMAGINED MY RECOVERY WOULD HEAD ME DOWN THIS PATH.

BY NOW I THOUGHT I'D BE BETTER, IN MY NORMAL ROUTINE.

WHAT IS GOING ON WITH ME?

AND IT SCARES ME 'CAUSE IT COULD BE ANYTHING.

Dr. Nowzaradan: ASHLEY HAS BEEN FEELING WEAK AND NAUSEATED.

THIS MAY BE ROUTINE DISCOMFORT FOR ASHLEY AFTER SURGERY.

BUT SHE'S CONCERNED ENOUGH TO COME INTO THE HOSPITAL.

WE NEED TO TAKE ANY LONG-TERM DISCOMFORT SERIOUSLY

TO MAKE SURE THERE IS NO LIFE-THREATENING ISSUE

THAT WE'RE NOT AWARE OF.

SO WE'RE GONNA GO AHEAD AND DO ENDOSCOPY.

ONE OF THE MOST DANGEROUS COMPLICATIONS

OF GASTRIC SLEEVE SURGERY

IS THE STOMACH LEAKING AT THE STAPLE LINE.

THIS CAN LEAD TO THE INFLAMMATION OF THE ABDOMINAL WALL

AND SEPSIS AND POTENTIALLY DEATH.

WE HAVE TO FIND OUT WHAT'S GOING ON WITH ASHLEY RIGHT NOW.

HER LIFE COULD BE ON THE LINE.

**

Dr. Nowzaradan: ASHLEY HAS BEEN WITH SOME NAUSEA

AND NOT BEEN ABLE TO KEEP FLUID DOWN,

SO WE'RE DOING AN ENDOSCOPY

TO SEE WHAT'S GOING ON INSIDE OF HER STOMACH.

WE HAVE TO MAKE SURE HER STOMACH IS INTACT

AND THERE IS NO LEAKAGE AT THE STAPLE LINE

THAT COULD POTENTIALLY DEVELOP INTO A FATAL CONDITION.

CAN YOU LEVEL THE TABLE?

COME ON THIS SIDE. LIGHT UP HERE. LIGHT UP HERE.

OKAY, NOW HOLD.

PULL IT BACK. PULL IT BACK ONE SECOND.

OKAY, NOW YOU HOLD THIS.

OKAY, ALL RIGHT, THAT'S GOOD.

OKAY. WE'RE OKAY.

ALL RIGHT.

Man: ASHLEY, OPEN YOUR EYES. THERE YOU GO.

OKAY. BREATHING TUBE'S COMING OUT.

WE'RE ALL DONE. EVERYONE WENT WELL.

IT ALL LOOKED GOOD, OKAY?

Dr. Nowzaradan: IT'S GOOD THAT WE CHECKED TO MAKE SURE

THERE'S NOTHING PHYSICALLY WRONG WITH ASHLEY.

BUT WHAT'S HAPPENING IS SHE'S DEVELOPING

PSYCHOSOMATIC SYMPTOMS,

WHICH MEANS HER FEAR IS MAKING HER PHYSICALLY SICK RIGHT NOW.

HER DISCOMFORT IS EMOTIONAL.

SO FOR NOW I'M GOING TO SEND HER HOME

TO KEEP WORKING ON HER DIET

AND TRANSITIONING TO SOLID FOOD.

BUT I THINK THAT SHE'S GOING TO NEED TO START THERAPY SOON

AND START TO DEAL WITH HER EMOTIONS.

Ashley: I WAS REALLY SURPRISED WHEN THE DOCTOR

DIDN'T FIND ANYTHING WRONG WITH MY STOMACH.

HE TOLD ME THAT I NEED TO START DEALING WITH MY EMOTIONS.

I'M GETTING BACK TO EATING SOLID FOODS.

LET'S GO. COME ON.

I HAD PICTURED RECOVERY A WHOLE DIFFERENT WAY

THAN IT ACTUALLY HAS BEEN.

HI.

ENH. I JUST DIDN'T WANT TO BE IN MY ROOM ANYMORE.

I CAN KEEP FOOD DOWN NOW,

BUT EVERYTHING MAKES ME NAUSEOUS.

THE NAUSEA COMES IN WAVES,

AND IT DOESN'T REALLY ANNOUNCE WHEN IT'S COMING.

IT JUST COMES.

OOH. I'M QUEASY.

I KNOW THAT THE FOOD THAT I'M PUTTING INTO MY BODY

IS FOR ENERGY.

IT'S FOR NUTRIENTS.

IT'S SOMETHING THAT -- IT'S GONNA HELP ME RECOVER.

BUT I JUST DON'T ENJOY EATING ANYMORE.

[ GROANS ]

I FEEL LIKE I CAN NO LONGER PROCESS THE WORLD.

AND I DON'T KNOW WHAT TO DO WITH MYSELF.

FOOD WAS A COMFORT AND A JOY.

AND IT'S NOT THAT ANYMORE.

AND I'VE GOT NOWHERE TO GO WITH MY EMOTIONS.

AND I JUST FEEL LOST RIGHT NOW.

Woman: ASHLEY REYES?

Ashley: TODAY I'M GETTING A CHECKUP FROM DR. NOW.

AND I HAVE BEEN TRYING REALLY HARD,

BUT I HAVEN'T HAD THE ENERGY TO EXERCISE MUCH.

AND I DON'T KNOW HOW MUCH PROGRESS I'M MAKING.

SO I DON'T REALLY WANT TO CHECK MY WEIGHT RIGHT NOW.

Woman: 531.

ENH.

THANK YOU.

I'M DISAPPOINTED WITH THAT.

I KNOW AT THIS POINT

I SHOULD BE AVERAGING ABOUT 30 POUNDS A MONTH.

I DON'T KNOW WHY I'M NOT MAKING THE PROGRESS I SHOULD.

-HELLO. -HI, DOCTOR.

HOW ARE YOU ALL DOING?

-GOOD. HOW ARE YOU? -DOING OKAY.

ALL RIGHT.

SO TODAY YOU ARE DOWN TO 531, HUH?

YOUR WEIGHT LOSS SHOULD BE

APPROXIMATELY ABOUT 30 POUNDS A MONTH.

AND OVER THE LAST TWO MONTHS,

YOU ONLY LOST 15 POUNDS PER MONTH.

SO HOW IS YOUR LEVEL OF ACTIVITY?

HOW MUCH YOU CAN DO?

I'VE BEEN DISAPPOINTED WITH MY OWN ACTIVITY LEVEL

JUST BECAUSE BEFORE THE SURGERY WHEN YOU HAD ME ON THE DIET

AND EXERCISE, I WAS DOING SO MUCH MORE.

AND NOW I'M THINKING I'VE LOST WEIGHT.

I SHOULD HAVE THE ENERGY AND THE ABILITY TO MOVE AROUND.

BUT I'VE JUST FELT SO TIRED.

EVERY DAY, EVEN IF YOU DON'T WANT TO,

YOU NEED TO GET UP AND WALK.

OKAY.

EXERCISE IS CRITICAL TO YOUR CONTINUED WEIGHT LOSS.

YOU HAVE TO PUSH YOURSELF, OKAY?

YOU'RE LOSING WEIGHT ONLY BECAUSE THE SURGERY

IS LIMITING THE AMOUNT OF CALORIES YOU CAN TAKE IN.

A YEAR DOWN THE ROAD, IF YOU DON'T CHANGE THIS BEHAVIOR,

YOU WILL START GOING BACK TOWARD 600 POUNDS.

Dr. Nowzaradan: ASHLEY HAS DONE VERY WELL,

BUT HER WEIGHT LOSS HAS SLOWED

BECAUSE SHE'S HAVING TO DEAL WITH THE CORE ISSUES

OF HER EMOTIONS.

IT IS NOT UNTIL A COPING MECHANISM IS REMOVED

AND THAT LOSS IS FELT

BEFORE PATIENT IS READY TO START ADDRESSING THAT.

I WOULD LIKE YOU TO SEE A THERAPIST TO GET BACK ON TRACK.

OKAY.

GO AHEAD AND INCREASE YOUR PHYSICAL ACTIVITY.

AND IF YOU HAVE ANY PROBLEMS, CALL US.

WE'LL SEE HOW YOU'RE DOING IN ONE MONTH.

OKAY. SOUNDS GOOD.

-OKAY. NICE TO SEE YOU. -THANK YOU, DOCTOR.

THANK YOU. SEE YOU THEN.

Dr. Nowzaradan: ASHLEY'S AT A TURNING POINT.

FOR THIS TO BE A LONG-TERM SUCCESS,

SHE HAS TO WORK REALLY HARD

ON BOTH THE PHYSICAL AND MENTAL ASPECT OF THIS PROCESS.

IF SHE DOESN'T,

THE SURGERY MIGHT NOT BE SUCCESSFUL FOR ASHLEY.

Ashley: I FEEL LIKE I LET DR. NOW DOWN.

I KNOW I NEEDED TO BE MORE ACTIVE.

AND I KNOW THE DOCTOR'S RIGHT

WHEN HE TELLS ME TO PUSH MYSELF MORE.

IT'S HARD, BUT WHAT I REALLY DON'T WANT

TO HAVE TO DEAL WITH RIGHT NOW ARE MY EMOTIONS.

AND THAT SCARES ME.

BUT I'M WILLING TO TRY IF THAT'S WHAT I HAVE TO DO RIGHT NOW.

OKAY. HERE'S YOUR SWEATER. YOU READY?

YEAH.

Ashley: I'M TRYING TO PUSH MYSELF TO BE MORE ACTIVE

LIKE DR. NOW WANTED.

I'M GOING ON WALKS EVERY DAY, EVEN WHEN IT'S RAINING.

I'M HOPING, BY DOING MORE EXERCISE,

I CAN MAKE THE PROGRESS I NEED

BECAUSE I DON'T REALLY WANT TO GO TO A THERAPIST.

I DON'T WANT TO TALK ABOUT ANYTHING

THAT STRESSES ME OUT RIGHT NOW

BECAUSE THAT MAKES ME WANT TO RUN TO FOOD.

AND I'M TRYING TO AVOID THAT.

OH, MY GOD!

SOMEONE DECIDED TO STEAL MY TIRES.

[ BLEEP ]

ALL FOUR OF THEM.

WE'RE BY OURSELVES, AND WE HAVE ONE CAR.

AND I HAVE TO DEAL WITH THAT NOW,

ON TOP OF EVERYTHING ELSE.

IT'S THE LAST THING WE NEED, DANIEL. [BLEEP]

OTHER THAN THE SURGERY,

NOTHING HAS GONE RIGHT SINCE WE'VE BEEN IN HOUSTON.

I THROW UP ALMOST EVERYTHING I EAT,

AND NOW WE DON'T EVEN FEEL SAFE IN OUR OWN HOME.

ALL RIGHT. I CAN'T. I CAN'T EVEN.

I'M GETTING STRESSED IN ALMOST EVERY ASPECT OF MY LIFE.

NO, I'M NOT OKAY.

OKAY. I GOT TO SIT DOWN.

I CANNOT DO THIS.

I HAVE ENOUGH STRESS GOING ON AS IT IS.

MAYBE I'M NOT MEANT TO BE SUCCESSFUL.

**

Ashley: I'M IN A VERY DARK PLACE.

AND I KNOW MY WEIGHT LOSS IS SLOWING.

THANK YOU.

SO I'M GOING TO SEE A THERAPIST TODAY.

I'M HOPING THAT HE'S ABLE TO GUIDE ME

IN THE RIGHT DIRECTION AS FAR AS FINDING WAYS

TO COPE WITH FEELINGS I HAVE ABOUT WHAT I'M GOING THROUGH.

BUT I'M NOT LOOKING FORWARD

TO DISCUSSING THINGS I'VE BEEN AVOIDING.

Dr. Paradise: SO, WELCOME TO MY OFFICE.

TELL ME A LITTLE BIT ABOUT YOURSELF AND YOUR SITUATION

AND HOW YOU ENDED UP HERE.

WELL, I'VE BEEN BATTLING WITH MY WEIGHT MY ENTIRE LIFE.

AND I HAD WEIGHT-LOSS SURGERY. OKAY.

HOW'S IT BEEN FOR YOU SINCE THE SURGERY?

I FEEL LIKE I'M DISAPPOINTED IN MYSELF, IN MY BODY,

IN THE WAY THAT I'M RECOVERING

BECAUSE BEFORE MY SURGERY,

I WAS EXERCISING AND I WAS SO ENERGETIC.

SURE.

AND NOW I'M JUST REALLY UNCOMFORTABLE

WITH THE NAUSEA AND THE FATIGUE.

AND THAT MAKES EXERCISE ESPECIALLY HARD TO DO.

YEAH, AND THEN WHEN I GET SICK,

WHEN I EAT SOMETHING MY BODY DOESN'T LIKE,

IT'S LIKE I'LL GET SICK, I'LL VOMIT, WHATEVER,

AND IT JUST GOES BACK AND FORTH, BACK AND FORTH.

SO THAT'S TIRING.

I JUST DON'T WANT TO DEAL WITH IT ANYMORE.

YEAH.

I DIDN'T EXPECT ALL THE COMPLICATIONS.

I DIDN'T EXPECT ALL THE MENTAL,

YOU KNOW, PROBLEMS WITH IT.

LET'S TALK ABOUT THE MENTAL STUFF.

I MEAN, MY RELATIONSHIP WITH FOOD HAS CHANGED COMPLETELY.

BEFORE THE SURGERY,

WHETHER IT WAS FEELINGS OF HAPPINESS

OR I WAS SAD OR I WAS STRESSED OR I WAS ANGRY,

IT WAS ALWAYS STRAIGHT TO FOOD.

SO IT WAS YOUR GO-TO COMFORT.

-IT WAS MY GO-TO, YEAH. -OKAY.

NOW THERE'S NO ENJOYMENT IN EATING.

IT'S A TASK. IT'S SOMETHING THAT I HAVE TO DO

TO FUEL MY BODY SO THAT I DON'T GET SICK.

SO FOOD WAS LIKE A HUGE THING.

I MEAN, IT WAS LIKE LOVE FOR YOU, RIGHT?

MM-HMM.

I'M SORRY.

DON'T APOLOGIZE.

THIS IS A GOOD PLACE TO LET THINGS OUT.

AND I UNDERSTAND IF YOU CAN'T.

YOU KNOW, ONE OF THE THINGS THAT MIGHT MARK SUCCESS FOR YOU

IS FOCUSING MORE ON OTHER ASPECTS OF YOUR LIFE.

SO WHAT ARE GOOD THINGS IN YOUR LIFE RIGHT NOW?

-MY HUSBAND. -WHAT'S YOUR HUSBAND'S NAME?

-DANIEL. -DANIEL, OKAY.

SO, LIKE, IF YOU WERE GONNA FOCUS ON YOUR RELATIONSHIP

AND YOUR MARRIAGE, WHAT WOULD YOUR GOALS BE THERE?

WHAT I WANT TO DO IS JUST BE MORE ACTIVE WITH HIM.

MM-HMM.

YOU KNOW, BECAUSE BEFORE, WHEN WE FIRST STARTED DATING,

WE WERE ALWAYS OUT -- WE WERE NEVER HOME --

AND DOING FUN THINGS.

AND THROUGHOUT THE YEARS, THAT'S STOPPED.

YEAH.

WE WANT TO IMAGINE A DAY

WHERE HE DOESN'T HAVE TO TAKE CARE OF YOU.

SO WHAT WOULD MAKE YOU MORE SUCCESSFUL?

JUST NOT FEELING SO BAD. YOU KNOW WHAT I'M SAYING?

AND HAVING CONTROL OVER HOW --

MY ANXIETY, YOU KNOW? MM-HMM.

'CAUSE THAT'S ONE OF THE BIGGEST THINGS I THINK, RIGHT NOW,

YOU KNOW, AS FAR AS THE MENTAL ASPECT,

IS MY ANXIETY.

SO ONE THING WE WANT TO DO IS MAKE SURE

THAT YOU HAVE THE GREATEST SENSE OF CONTROL OVER THAT.

IT'S THE REASON THEY GIVE THE PEOPLE

THE BUTTONS TO ADMINISTER THEIR PAIN MEDICINE.

THEY DON'T GET ANY MORE MEDICINE

THAT THEY WOULD IF THE NURSE GAVE IT TO THEM,

BUT BY GIVING THEM CONTROL OVER IT,

IT SEEMS TO HELP.

SO ONE THING WE MIGHT WANT TO DO

IS FIGURE OUT WAYS FOR YOU

TO HAVE THE GREATEST SENSE OF CONTROL

IN DEALING WITH YOUR SYMPTOMS.

GOING OUT MORE, DOING MORE STUFF.

AND AS THE WEIGHT COMES OFF, THAT'LL BE EASIER AND EASIER,

RIGHT? YEAH.

SO A GOOD DAY MIGHT BE THE DAYS

WHEN YOU PUSH THROUGH.

AND I THINK YOU'RE GONNA FIND THAT YOU'RE GONNA PUSH THROUGH.

-IT WAS REALLY GOOD TO MEET YOU. -THANK YOU.

IT WAS REALLY GOOD TO MEET YOU, TOO.

-TAKE CARE. -THANK YOU.

Ashley: IT WAS HARD TO TALK ABOUT SOME OF MY ANXIETY.

I KNOW I RUN TO FOOD TO COPE.

BUT I DIDN'T REALIZE HOW DEPENDENT I WAS ON IT

AND HOW HARD IT WAS GOING TO BE

TO LOSE THAT FEELING OF HAPPINESS AND LOVE.

AND I THOUGHT DOING THAT ONLY DAMAGED MY BODY,

BUT I KNOW THAT THERE IS A LOT FROM MY PAST

I'M GOING TO HAVE TO FACE

IF I EVER WANT MY ANXIETY TO GET UNDER CONTROL.

I'VE BEEN WORKING THROUGH A LOT OF MY EMOTION

AND TRYING TO DO WHAT THE THERAPIST TOLD ME.

[ CHATTER ]

ONE OF THE BIGGEST THINGS

THAT I KNOW HAS AFFECTED ME MY WHOLE LIFE

IS GETTING HURT AS A CHILD.

RAISE IT UP! CONTROL!

EVER SINCE THAT MOMENT,

I'VE NOT FELT LIKE I'M IN CONTROL,

AND I'VE LIVED IN FEAR.

EVEN THOUGH I'M BIGGER, IN THE BACK OF MY HEAD,

I'M SCARED OF SOMEONE HURTING ME.

SO I'VE DECIDED I DON'T WANT TO FEEL WEAK AND SCARED ANYMORE,

SO I'M TAKING A SELF-DEFENSE CLASS.

YOU READY TO JUMP INTO A CLASS?

[ BOTH LAUGH ]

-HI, I'M MICHAEL BY THE WAY. -ASHLEY.

ASHLEY, NICE TO MEET YOU.

SO MICHAEL AND I HAVE BEEN TRAINING TOGETHER

FOR PROBABLY 10 YEARS.

AND A BIG PART OF BEING ABLE TO PUNCH AND KICK

AND DEFEND YOURSELF IS BEING FIT.

WOULD YOU LIKE US TO SHOW YOU

A FEW THINGS THAT YOU COULD DO AT HOME?

-AS LONG AS I DON'T OVERDO IT. -RIGHT.

-IT'S OVERWHELMING TO WATCH... -UH-HUH.

...JUST 'CAUSE I'VE NEVER HAD THAT TYPE OF PHYSICAL ACTIVITY.

YOU KNOW, AND THAT'S STRONG, BUT IT'S --

I MEAN, IT'S EMPOWERING AT THE SAME TIME.

ALL RIGHT, DO YOU HAVE ANY CLEARANCE

FROM YOUR DOCTORS

ON ANYTHING THAT YOU'RE ABLE TO DO?

I MEAN, I CAN PRETTY MUCH DO EVERYTHING.

STAIRS ARE A PROBLEM RIGHT NOW.

-LET'S GO. -ALL RIGHT, COOL.

-LET'S GIVE IT A SHOT. -OH, MAN.

SO BEING ABLE TO GET UP THE STAIRS --

THAT'LL BE YOUR GOAL.

WANT ME TO GO WITH YOU?

OR DO YOU WANT TO GO BY YOURSELF?

-I WANT TO GO BY MYSELF. -OKAY.

**

GOOD JOB! YOU'RE THERE!

I KNEW YOU COULD DO IT!

Ashley: I CAN'T EVEN REMEMBER THE LAST TIME

I CLIMBED THAT MANY STAIRS.

IT'S BEEN TOO LONG.

I DON'T THINK I WOULD'VE EVER DONE THIS

HAD IT NOT BEEN FOR JUST THE PUSH SAYING,

"WHY DON'T YOU TRY?"

Woman: GO FORWARD. BOOM, RIGHT?

NOW GIVE ME A SCOWL.

MEAN FACE. -I CAN'T.

Woman: ALL RIGHT? OH, YOU GOT IT!

WE ARE GONNA SHIFT OUR WEIGHT BACK AND FORTH.

I WANT YOU TO JUST BEND YOUR KNEES

AND JUST SHIFT YOUR WEIGHT FROM SIDE TO SIDE.

AFTER THE STAIRS, YOU KNOW, IT'S WHAT ELSE SHOULD I TRY

THAT I THOUGHT I COULDN'T DO?

IF YOU'RE GONNA BE ELBOWING SOMEONE,

YOU NEED TO KNOW WHERE YOU NEED TO HIT THEM, RIGHT?

-BREATHE OUT LOUD. -REMEMBER TO BREATHE.

BREATHE OUT LOUD.

SHH!

-YES, GOOD! -GOOD!

LOOK AT THAT, YOU'RE KNOCKING ME OVER.

-SHH! -GOOD!

Ashley: I'M FEELING REALLY EMPOWERED.

I CAN PUNCH THINGS AND ACTUALLY MOVE.

HANDS UP.

I KNOW LEARNING SELF-DEFENSE DOESN'T CHANGE THE PAST,

BUT I FEEL LIKE THIS IS THE FIRST STEP

FOR ME TO FEEL EMPOWERED...

-OH, MY GOD! -THAT WAS GREAT!

GOOD JOB. GOOD JOB.

Ashley: ...AND LIKE I'M TAKING BACK CONTROL OF MY LIFE.

**

[ Ringing ]

IT'S BEEN ABOUT FIVE MONTHS SINCE I'VE SEEN MY FAMILY.

I'VE NEVER BEEN AWAY FROM THEM SO LONG.

-Hi, mija. -HI, MOM!

Ashley: OOH, I LIKE YOUR HAIR, YOU CHANGED THE COLOR?

Yes!

-Give me your look. -CAN YOU SEE?

Oh, look at you! [ Whistles ]

You look good, mama. How've you been doing?

I'VE BEEN OKAY. I'M ABLE TO MOVE AROUND MORE,

COOK DINNER, WHICH IS REALLY GOOD.

YOU DON'T HAVE TO WORRY ANYMORE.

Yeah, I was super, super worried about you.

I KNOW.

I wish I was there all the time, but I can't.

I KNOW.

WELL, I MEAN, NOT TO TAKE CARE OF ME,

BUT JUST FOR YOUR COMPANY.

-I know. -[ CHUCKLES ]

I am so, so proud of you, my love.

You've done a lot of things that are so hard,

and I'm so happy for you.

I'm thinking of you. Love you.

OKAY. LOVE YOU, TOO.

-Bye. -BYE.

Ashley: I MISS MY FAMILY SO MUCH.

BUT FOR THE FIRST TIME IN MY LIFE, A SMALL PART OF ME

IS STARTING TO SEE THE POSSIBILITY

OF DANIEL AND ME HAVING A LIFE OF OUR OWN.

**

OKAY.

**

I DON'T WANT TO STAY IN HOUSTON LONG-TERM,

BUT DANIEL AND I HAVE NEVER REALLY HAD A CHANCE

TO HAVE A REAL MARRIAGE...

BECAUSE EVERYONE'S HAD TO TAKE CARE OF ME.

AND WITH THAT CHANGING,

I KNOW I NEED TO FOCUS ON OUR MARRIAGE

AND GET OVER MY FEARS OF INTIMACY.

I LOVE HIM.

AND MY SITUATION HAS NOT BEEN FAIR.

I WANT TO BECOME THE WIFE HE DESERVES...

AND THE WIFE I WANT TO BE.

**

Ashley: SOMETIMES LETTING GO

OF WHAT YOU'VE HELD ON TO SO TIGHTLY

IS THE ONLY WAY TO MOVE FORWARD.

**

TONIGHT, I'M GOING ON A DATE WITH DANIEL.

IN THE PAST, WE'D NEVER GO ON DATES

BECAUSE I WOULDN'T WANT TO GO OUT IN PUBLIC.

AND I COULDN'T WALK THAT FAR.

**

AND I JUST DIDN'T WANT TO DEAL WITH THE ANXIETY OF IT ALL.

SO I ASKED DANIEL IF WE COULD GO ON A DATE.

**

I WANT US TO WORK ON OUR MARRIAGE,

AND I WANT US TO GROW CLOSER TOGETHER.

I'M REALLY HAPPY WE GOT TO GO OUT TONIGHT.

I'M STILL SCARED ABOUT SHOWING HIM MY BODY,

BUT I'M WORKING ON THAT.

CAN I HAVE THE GRILLED BIG PLATE?

AND THEN I'LL HAVE THE GRILLED CHICKEN BOWL.

I'M STICKING WITH THE DIET

AND WORKING HARDER THAN EVER TO BE ABLE TO --

TO DO THIS.

I'M EXCITED TO SEE WHAT ELSE WE CAN DO.

IT'LL BE LIKE BEFORE.

CAN'T WAIT TO GO TO THE BEACH AGAIN.

I WANT TO GO TO A LAKE AND HAVE A PICNIC.

I DON'T KNOW WHAT I WOULD'VE DONE IF YOU WEREN'T HERE.

HONESTLY.

MY SISTERS AND MOM, EVERYBODY,

THEY'RE SUPPORTING ME FROM FAR AWAY,

BUT YOU HAVE TO PHYSICALLY HAVE SOMEONE THERE WITH YOU,

ESPECIALLY WHEN IT GETS REALLY, REALLY TOUGH.

YOU KNOW WHAT I MEAN?

I COULDN'T IMAGINE YOU NOT BEING HERE.

THERE'S NO WAY.

**

THANK YOU.

IT LOOKS DELICIOUS. THANK YOU.

I LOVE DANIEL, AND I'M SO HAPPY TO HAVE HIM IN MY LIFE.

SO I'M GOING TO WORK HARD

TO CHANGE EVERYTHING THAT I WANT TO CHANGE.

I'M OKAY. YEAH, I'M GOOD.

YEAH.

**

I SAW A LITTLE SPARKLE IN HER EYE THAT SHE WAS HAPPY.

SO, YOU KNOW, AS LONG AS SHE'S HAPPY, I'M OKAY.

I'LL TAKE THIS.

YOU'LL TAKE IT FOR ME? OKAY, THANK YOU.

I'LL TAKE THIS ONE. I'LL TAKE YOUR BAG.

Ashley: A YEAR AGO, MY HUSBAND WAS MY CARETAKER.

NOW I'M NO LONGER HIS PATIENT.

AND IT FEELS MORE LIKE WE'RE A NORMAL MARRIED COUPLE.

HONESTLY, AT THIS POINT, I JUST LOOK FORWARD

TO ALL THE FUN THINGS THAT WE'RE GONNA DO TOGETHER NOW.

IT'S BEEN ALMOST A YEAR SINCE I'VE STARTED ON THIS JOURNEY.

IT'S BEEN HARDER THAN I COULD'VE IMAGINED,

BUT I'M SO GLAD I STUCK WITH IT.

**

AND FOR THE FIRST TIME,

I'M ACTUALLY EXCITED TO GET ON THE SCALE.

DANIEL AND I HAVE GROWN EVEN CLOSER,

AND I FEEL LIKE I'VE BEEN DOING THIS FOR HIM AS MUCH AS FOR ME.

**

I CAN'T REMEMBER THE LAST TIME I WAS IN THE 400s.

THIS IS SO INCREDIBLE.

-HELLO. -HI.

-HI. -HOW ARE Y'ALL DOING?

-PRETTY GOOD, HOW ARE YOU? -ALL RIGHT.

ASHLEY, YOU'RE DOWN TO 462 POUNDS.

HOW DOES IT FEEL TO LOSE 200 POUNDS?

HONESTLY, I'M HAPPY,

BUT I FEEL LIKE MY RECOVERY HAS BEEN REALLY SLOW.

AND I JUST WISH IT WAS MORE.

[ LAUGHS ]

YOU DID NOT GAIN THIS WEIGHT TO BE 668 POUNDS

IN A SHORT PERIOD OF TIME.

SO IF YOU LOSE AT 30 POUNDS A MONTH,

IN A YEAR, THAT'S ALMOST 400 POUNDS.

WELL, IF YOU PUT IT THAT WAY, THEN IT MAKES IT --

YOU SEE?

YEAH, IT MAKES IT BETTER.

ALL RIGHT, SO WITHIN THE NEXT YEAR,

YOU'RE GONNA BE UNDER 200.

-OH, THAT'S... -OKAY?

I CAN'T EVEN IMAGINE IT.

Dr. Nowzaradan: I'M REALLY PROUD OF ASHLEY.

WHEN I FIRST SAW HER, I KNEW THERE WERE A LOT OF ISSUES

THAT NEEDED TO BE ADDRESSED WITH HER.

BUT SHE'S CONSTANTLY FORGED AHEAD

AND DONE WHAT SHE NEEDS.

AND I HAVE GREAT CONFIDENCE

SHE'S GOING TO MAKE IT TO HER TARGET WEIGHT NEXT YEAR.

YOU'VE DONE VERY WELL, AND I'M PROUD OF YOU.

JUST STICK WITH THE PROGRAM,

AND YOU'RE GETTING VERY GOOD PROGRESS, OKAY?

I'LL SEE YOU SOON.

**

Ashley: I'M SO EXCITED ABOUT MYSELF.

A YEAR AGO, MY FAMILY HAD TO HELP ME DO ALMOST EVERYTHING.

NOW I'M ABLE TO BE MORE INDEPENDENT,

AND I'M BUILDING THE LIFE I'VE ALWAYS WANTED.

THERE ARE SO MANY POSSIBILITIES THAT I CAN BELIEVE IN NOW.

AND I'M EXCITED TO SEE WHAT THE FUTURE HOLDS.

**

I'M REALLY PLEASED WITH THE WEIGHT I'VE LOST.

SO IN CELEBRATION,

TODAY, I'M TREATING MYSELF TO A MAKEOVER.

OH, MY GOD! OH, MY GOD!

[ GASPS ]

I JUST GOT OUT OF THE CAR, AND THE CAR DIDN'T HONK.

IT'S BEEN A LONG TIME SINCE THAT'S HAPPENED.

YOU KNOW HOW LOUD THAT WOULD'VE BEEN BEFORE?

Daniel: YEAH.

I'VE BEEN PUSHING MYSELF AND FACING A LOT OF THE THINGS

THAT HAVE MADE ME FEEL OUT OF CONTROL

AND ANXIOUS ABOUT LIFE.

-YOU EXCITED FOR TODAY? -I AM.

AWESOME. WELL, WE'LL GET YOU STARTED.

WE'RE GONNA MAKE YOU LOOK WONDERFUL.

-THANK YOU. -COMFORTABLE HERE.

-I FIT! -YAY!

-ALL RIGHT. -AWESOME!

Ashley: I WANT TO BE THE PERSON THAT I SHOULD

FOR THE PEOPLE I LOVE.

AND I'VE NEVER BEEN PROUD OF MYSELF

FOR ANYTHING I'VE DONE -- OR FOR HOW I LOOK.

AND THAT'S CHANGING NOW.

**

ALL RIGHT. EXCITED?

I'M EXCITED. I'M EXCITED.

LET'S DO THIS.

[ GASPS ] OH, MY GOD!

SOME NICE CURLS, SOME REALLY NICE MOVEMENT.

-WOW! -YOU'VE GOT BODY ON THE TOP.

HOW DO YOU LIKE YOUR LASHES?

-I HAVE LASHES! -I KNOW!

[ BOTH LAUGH ]

Ashley: I LOVE IT.

HI! [ LAUGHS ]

IT'S BEEN AWHILE SINCE DANIEL HAS SEEN ME LIKE THIS.

Woman: IT'S BEAUTIFUL, RIGHT?

THANK YOU GUYS SO MUCH.

YOU'RE VERY MUCH WELCOME.

THE GIRL IN THE MIRROR IS SOMEONE THAT I'M FAMILIAR WITH

BUT I NEED TO GET TO KNOW.

SHE'S NEW.

I'VE NEVER WANTED TO TAKE PICTURES OF MYSELF,

BUT I'M STEPPING OUT OF MY COMFORT ZONE

AND WE'RE GETTING PORTRAITS MADE.

HI!

-I'M SHANNON. NICE TO MEET YOU. -NICE TO MEET YOU.

-WELL, COME IN! -THANK YOU.

SO WHAT KIND OF PHOTOS ARE WE LOOKING FOR TODAY?

JUST, LIKE, REALLY FLATTERING, ROMANTIC TYPE OF...

OKAY! WELL, THEN, LET'S GET STARTED.

Ashley: THIS IS A TOTALLY NEW EXPERIENCE FOR ME.

IF YOU TOLD ME A YEAR AGO

THAT DANIEL AND I WOULD BE OUT ON A DATE GETTING PHOTOS DONE...

I LOVE THAT. AWESOME.

Ashley: ...I WOULD NEVER HAVE BELIEVED YOU.

DANIEL HAS BEEN BY MY SIDE AT MY ABSOLUTE WORST.

AND HE'S HERE NOW AS THINGS ARE GETTING BETTER, DAY BY DAY.

THERE'S NO WAY I COULD'VE DONE THIS WITHOUT HIM.

[ LAUGHS ]

I'M PROUD OF HOW I FEEL AND HOW I'M STARTING TO LOOK.

MY MOM IS GONNA LOVE THESE.

SHE HASN'T HAD PICTURES OF ME LIKE THIS IN LIKE YEARS.

Daniel: ASHLEY IS FEELING MORE COMFORTABLE,

AND SHE'S STARTING TO REALLY GO OUT INTO THE WORLD.

I DON'T REMEMBER HOW LONG I'VE SEEN HER SMILE LIKE THIS.

**

Ashley: I'M FINALLY STARTING TO FEEL

LIKE I HAVE A MARRIAGE AND A LIFE.

I'M SO HAPPY, AND I JUST WANT TO SEE WHAT THE FUTURE HOLDS.