Original subtitles

Karina: MY BODY LOOKS DISGUSTING TO ME.

NO NORMAL PERSON SHOULD BE REALLY LIKE THIS.

**

[ GROANING ]

Woman #1: MY LIFE IS WASTING AWAY, AND I HATE IT.

Karina: I TRIED TO CHANGE, BUT SOMETHING ALWAYS KNOCKS ME DOWN.

**

**

Man: MY LIFE, IT'S LIKE LIVING A DEATH SENTENCE.

[ GROANING ] UH, OH, OW!

THIS IS NO LIFE FOR ANYONE.

**

Woman #2: OH, JUST PRAY FOR ME.

OH, MY LEG!

SIT DOWN RIGHT THERE.

WAIT, YOU'RE MAKING ME MAD.

ALL RIGHT, THIS IS COMPLETELY UNACCEPTABLE.

[ DOOR SLAMS ]

**

Woman #3: YOU'RE OLD ENOUGH TO FEND FOR YOURSELF.

I KNOW.

YOU CAN KNOW ALL YOU WANT,

BUT IF YOU DON'T DO IT, IT'S NOT GONNA MATTER.

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

CAPTIONS PAID FOR BY DISCOVERY COMMUNICATIONS

Karina: DEALING WITH THE STRUGGLES OF THE PAST

CAN HEAL THE PRESENT.

BUT THE ONLY WAY TO GET THERE IS MOVING FORWARD.

**

**

**

**

**

MY FIRST THOUGHT IN THE MORNING WHEN I WAKE UP

IS "I'M STILL ALIVE."

**

"I DIDN'T DIE WHILE I'M ASLEEP."

**

I DREAD GETTING OUT OF BED IN THE MORNING.

**

AND 'CAUSE OF MY WEIGHT,

I FEEL LIKE MY BODY'S ALREADY GIVING UP.

I HAVE LOST MOST OF MY MOBILITY

AND I CAN'T STAND ON MY OWN.

BECAUSE OF THAT, I CAN NO LONGER LIVE ALONE.

[ SIGHS ]

EVEN WORSE, I HAVE TO LIVE IN THE MIDDLE

OF MY PARENT'S LIVING ROOM.

IT IS THE ONLY ROOM WHERE I FIT.

AND IT'S CLOSE TO THE BATHROOM.

I KNOW I SHOULD BE LIVING IN MY OWN HOUSE.

I SHOULD BE WORKING INSTEAD OF BEING STUCK IN THIS HOUSE.

**

**

SHOWERING HAS BECOME SO DIFFICULT.

**

FIRST I HAVE TO PUSH MY SHOWER BENCH INTO THE BATHROOM.

AND THEN I USE ROPES TO TURN IT UPRIGHT.

**

**

I'M TRYING TO DO EVERYTHING MYSELF,

BUT IT'S GETTING HARD.

**

I'M VERY AFRAID OF LOSING MY INDEPENDENCE.

I'M VERY AFRAID THAT HERE IN A YEAR OR LESS,

I WOULDN'T BE ABLE TO WIPE MY OWN BUTT.

ONCE I DO THAT, WHAT IS THERE NEXT? DIAPERS?

I DON'T WANT THAT.

BATHING BECOMES SO TIRING FOR ME

THAT SOMETIMES I DON'T EVEN WANT TO TAKE A SHOWER

FOR THE WHOLE WEEK.

I'D RATHER JUST GIVE MYSELF A SPONGE BATH

IN MY PORTA-POTTY WITH BABY WIPES.

BUT I HAVE TAKEN TO THE SHOWER

BECAUSE I WORRY THAT I'M GONNA START TO SMELL.

I'M GONNA START BREAKING OUT INTO RASHES.

MY BODY LOOKS AND FEELS

LIKE A BIG OLD OF BAG OF JELLY,

JUST SOFT AND MUSHY AND DISGUSTING TO ME.

**

**

I HATE SEEING MY BODY.

I AM SO ASHAMED OF WHAT IT LOOKS LIKE.

I JUST DON'T FEEL NORMAL.

'CAUSE NO NORMAL PERSON SHOULD BE REALLY LIKE THIS.

BY MOVING JUST A FEW FEET, I LOSE MY BREATH.

[ PANTING ]

MY LIFE HAS BECOME A LIVING HELL

BECAUSE MY WEIGHT ISOLATES ME FROM EVERYTHING

THAT I USE TO LOVE DOING.

**

I SAY TO MYSELF,

WHERE'S THAT GIRL THAT USED TO BE HAPPY?

WHERE IS SHE?

**

I FEEL SOMETIMES, CAN I JUST CUT IT OPEN

AND PULL MYSELF OUT OF THERE?

**

WHAT DID I DO TO GET TO THIS?

[ PANTING ]

**

I AM THE OLDEST OF THREE KIDS.

AND MY SISTER AND I ARE ONLY 10 MONTHS APART,

BUT WE DIDN'T SPEND MUCH TIME TOGETHER AS KIDS

BECAUSE I WAS VERY SICK AS A CHILD.

I HAD ASTHMA REALLY BAD.

SO I WAS IN AND OUT OF THE HOSPITAL WITH ASTHMA ATTACKS.

AND I WAS IN AN OXYGEN TENT MOST OF THE TIME.

I REMEMBER THEM HOLDING ME DOWN, PINNING ME DOWN,

STICKING I.V.s IN ME.

I FELT LIKE I WAS SUFFOCATING.

BUT MY FAMILY WAS ALWAYS THERE WHEN I WAS SICK.

AND I REMEMBER LOOKING OVER AT MY MOM

AND SEEING HER SITTING THERE,

CRYING AND WATCHING ME SUFFER.

AND THEN, BY THE TIME I WAS AGE FIVE OR SIX,

MY ASTHMA WAS CONTROLLED.

FOR THE FIRST TIME IN MY LIFE,

I WAS FEELING HEALTHY

AND I THOUGHT THIS WOULD BE A HAPPY TIME.

BUT MY ILLNESS TOOK A FINANCIAL TOLL ON MY FAMILY.

SO MY PARENTS WERE ALWAYS WORKING.

AND MY MOM WAS WORKING TWO JOBS.

SHE WOULD LEAVE EARLY IN THE MORNING

AND WE WOULD HARDLY EVER SEE HER.

MY DAD WAS IN THE MILITARY,

SO HE WOULD BE GONE FOR LONG STRETCHES OF TIME,

AND THAT REALLY STARTED TO MESS ME UP.

BECAUSE WHEN I WAS YOUNGER AND IN THE HOSPITAL,

EVERYONE PAID ATTENTION TO ME.

AND NOW IT WAS LIKE I DIDN'T EXIST AT ALL.

BUT I REALLY JUST WANTED A LITTLE ATTENTION.

I WANTED A HUG.

BUT THEY WERE TOO BUSY TO GIVE IT.

SO FOOD WAS MY HUG.

AND I GOT AWAY WITH A LOT OF EATING

BECAUSE NO ONE PAID ATTENTION.

KARINA'S MOTHER REALLY FEEL A LOT OF GUILT.

BUT WE HAD TO WORK IN ORDER TO TRY

TO PROVIDE A BETTER LIFE FOR THEM.

**

AT THAT TIME, ANY STRESS OR LONELINESS,

I RAN TO FOOD.

I JUST STARTED GAINING AND GAINING AND GAINING.

AND WHEN I WAS 10 YEARS OLD,

I PROBABLY WAS A HUNDRED POUNDS.

BEFORE SCHOOL, WITH MY ALLOWANCE,

I WOULD BUY JUNK FOOD --

CHIPS, SODA, COOKIES, CUPCAKES.

FOOD WAS ALWAYS THERE TO COMFORT ME NO MATTER WHAT.

Marisabel: WHEN WE WERE GROWING UP,

I DID NOTICE THAT KARINA LOVED FOOD.

SHE WOULD EAT ALL THE TIME.

SHE HAS ALWAYS BEEN A LITTLE BIT HEAVIER THAN NORMAL.

AND AS TIME PROGRESSED,

KARINA JUST GOT BIGGER AND BIGGER.

Karina: I WANTED TO BE WITH MY SISTER,

BUT SHE DIDN'T WANT TO BE WITH ME.

AND I DIDN'T HAVE ANY FRIENDS. I WAS REALLY LONELY.

AND WHEN YOU'RE ALONE AND DON'T HAVE NOTHING TO DO, YOU EAT.

NO ONE REALLY GOT WORRIED ABOUT MY EATING

UNTIL I WAS 14 AND I HIT 200 POUNDS.

THAT'S WHEN MY DAD WAS LIKE, "DON'T EAT THAT."

AND THAT JUST MADE ME WANT TO EAT MORE AND MORE.

AND I WOULD.

I SAW THAT SHE WAS JUST OUT OF CONTROL.

AND I DON'T FIND ANY WAY

THAT I CAN STOP HER.

**

AROUND THIS TIME, I WAS JUST STARTING HIGH SCHOOL.

AND I STARTED TO MAKE FRIENDS FOR THE FIRST TIME IN MY LIFE.

AND I FELT HAPPY.

AND THEN, WHEN I WAS 15,

MY WHOLE WORLD TURNED UPSIDE DOWN.

BECAUSE MY DAD MOVED US FROM CHICAGO TO SAN ANTONIO.

**

I DIDN'T WANT TO GO.

FOR THE FIRST TIME IN MY LIFE, I HAD FRIENDS,

AND NOW WE HAD TO LEAVE.

I WAS IN A NEW SCHOOL. I DIDN'T KNOW NOBODY.

AND I HATED IT.

**

I FELT LONELY, SO I ATE AS MUCH FOOD AS I COULD.

AND WITHIN SIX MONTHS, I WAS ALREADY AT 250, 260.

AND THEN JUNIOR YEAR,

I FELL IN WITH THE WRONG CROWD OF PEOPLE.

I WAS BEING REALLY, REALLY REBELLIOUS.

I STARTED SKIPPING SCHOOL, DRINKING, PARTYING.

I WAS EATING TONS OF GREASY, FAST FOOD,

AND THE WEIGHT STARTED PACKING ON.

SO WHEN I WAS 17,

MY PARENTS SENT ME AWAY TO MEXICO TO LIVE WITH MY AUNT

TO TRY TO GET MY BEHAVIOR ON TRACK.

AND TO LOSE WEIGHT AND GET HEALTHY.

IN MEXICO, MY AUNT CONTROLLED MY DIET.

SHE CONTROLLED EVERYTHING.

AND I LOST A 125 POUNDS AND NOW WAS AROUND 175.

AND I CAME BACK HOME. I WAS WEARING JEANS.

I WAS WEARING HEELS.

I FELT GOOD.

BUT THEN I STARTED WORKING IN FAST FOOD RESTAURANTS

WHEN I CAME HOME.

SO FAST FOOD WAS THE ONLY THING I ATE EVERYDAY.

AND I GAINED ALL THE WEIGHT BACK AND MORE.

BY THE TIME I WAS 23, I WAS OVER 400 POUNDS.

I STARTED WORKING IN THE MEDICAL FIELD

AS A NURSE ASSISTANT.

BUT BEING ON MY FEET ALL DAY WAS HARD BECAUSE OF MY WEIGHT,

SO I HAD TO LEAVE MY JOB.

AFTER THAT, I BECAME DEPRESSED

AND DIDN'T HAVE ANY WHERE TO TURN TO.

SO I MOVED BACK IN WITH MY PARENTS.

AND THEN BY THE TIME I WAS 32, I WAS 480.

I STARTED LOOKING AT WHAT I ATE, TRIED SO MANY DIFFERENT DIETS.

I WOULD GO UP AND DOWN, UP AND DOWN.

BUT IT NEVER WORKED.

FOOD OR WEIGHT -- FOOD ALWAYS WINS.

ONCE I WAS OVER 500 POUNDS, I WAS FALLING.

I COULDN'T KEEP MY BALANCE.

I COULDN'T KEEP MY WEIGHT UP

BECAUSE MY LEGS WERE GIVING OUT.

SO THAT'S WHEN I STARTED BEING IN THE WHEELCHAIR.

I FEEL THAT KARINA IS USING THE WHEELCHAIR AS A CRUTCH NOW.

AND SHE STOPPED DOING THINGS FOR HERSELF.

EVERYTHING IS HANDED TO HER.

Karina: I REACHED 600 POUNDS WHEN I WAS 37.

AND I DECIDED TO HAVE A BALLOON PROCEDURE DONE

TO HELP ME WITH MY EATING.

THE SURGEON INSERTED A BALLOON IN MY STOMACH

TO TRY TO CONTROL MY APPETITE

TO MAKE MY STOMACH SMALLER.

HAVING THE BALLOON IN MY STOMACH

HELPED ME LOSE A 120 POUNDS.

BUT THEN I HAD AN ACCIDENT. I FELL THROUGH THE DECK.

BROKE MY LEG, AND EVERYTHING WENT DOWNHILL.

I THEN FELL BACK INTO MY OLD HABITS.

AND STARTED TO GAIN THE WEIGHT RIGHT BACK.

AND NOW I'M AFRAID, I'M ALREADY BACK AT 600 POUNDS

AND I JUST FEEL LIKE I'M TRAPPED AGAIN.

AND I FEEL LIKE I'M A BURDEN TO EVERYONE IN MY FAMILY.

BECAUSE I NEED MY PARENTS TO DO ALMOST EVERYTHING FOR ME,

INCLUDING TAKING ME TO THE GROCERY STORE.

**

IT IS SO DIFFICULT FOR ME TO ACTUALLY GET OUT OF THE HOUSE.

[ PANTING ]

JUST TO GET OUT OF THE FRONT DOOR

IS A HUGE CHALLENGE FOR ME.

AND BY THE TIME THAT I DO, I'M OUT OF BREATH.

[ PANTING ]

BUT I PREFER TO PICK UP MY OWN FOOD AT THE GROCERY STORE

BECAUSE I'LL GET WHAT I KNOW I LIKE

VERSUS IF I TELL MY MOM OR MY DAD,

SOMETIMES THEY WON'T GET IT.

MY PARENTS HAVE TO DRIVE ME.

AND I SIT IN THE BACK OF THE VAN ON THE FLOOR.

SO THEY LITERALLY HAVE TO FOLD THE SEATS

IN THE VAN DOWN, PUT A BLANKET ON THE FLOOR.

**

RIDING IN THE BACK OF THE VAN MAKES ME FEEL LIKE I'M CARGO.

LIKE I'M AN ANIMAL BEING TRANSPORTED SOMEWHERE.

**

AND I FEEL LIKE I AM AN EMBARRASSMENT.

Ezequiel: COME ON, MIJA.

AND GETTING OUT OF THE VAN IS JUST AS HARD,

IF NOT HARDER THAN GETTING INTO THE VAN.

SOME GROCERY STORES HAVE ELECTRIC CARTS

AND I'LL GET ON THE ELECTRIC CART.

SOME OF THEM DON'T.

SO I HAVE TO WHEEL MYSELF.

AND I'M ALREADY EXHAUSTED FROM GETTING IN AND OUT OF THE VAN.

THEN PUSHING MYSELF AROUND THE STORE,

IT'S MORE EXHAUSTING.

OKAY.

I NEED THE PINEAPPLE NECTAR.

...IS JUICE, CHIPS,

MY SNACK CAKES, ICE CREAM.

THOSE ARE THE MAIN THINGS THAT I NEED TO HAVE.

CAN YOU GET BANANA SPLIT?

GET THE DOUBLE STRAWBERRY.

-THAT'S IT? -THAT'S IT.

[ PANTING ]

WHEN I GO THE GROCERY STORE, IT WEARS ME OUT.

AND EVERY DAY'S GETTING HARDER TO BREATH, HARDER TO MOVE,

HARDER TO DO ANYTHING THAT I USED TO DO.

**

Ezequiel: IT'S SAD TO SEE KARINA GETTING BIGGER AND BIGGER.

IT'S GETTING HARDER TO TAKE CARE OF HER.

I REALLY HAVE NO IDEA FOR HOW LONG

MY WIFE AND I KEEP DOING THIS.

I WOULD LOVE FOR KARINA TO BECOME INDEPENDENT.

YOU KNOW, BE ABLE TO WORK AND GO GET HER OWN GROCERIES,

DO HER OWN COOKING, HAVE HER OWN PLACE.

LET ME GET IN FIRST AND PUT THE WHEELCHAIR IN.

-THEN PUT EVERYTHING IN. -OKAY.

BUT IT'S JUST A WISH.

[ GRUNTING ]

**

MY PARENTS, THEY DO ALMOST EVERYTHING FOR ME.

AND I HATE THAT.

IT SHOULD BE VICE VERSA.

MOM, SHE WANTS ME TO GO TO THE STORE

TO GO GET HER SOME EGGS AND MILK.

BUT MY WEIGHT IS COMING BETWEEN ME

AND PEOPLE I LOVE AND PEOPLE I CARE AND EVERYTHING.

**

[ PANTING ]

**

**

**

-OKAY, JUST LOCK THE DOOR. -YES, I WILL.

-ALL RIGHT, BYE. -BYE.

-HAVE FUN. -OKAY.

YEAH, YEAH.

**

Karina: MY FAMILY DOESN'T EVEN ASK ME

TO GO OUT TO DINNER ANYMORE

BECAUSE THEY KNOW IT'S TOO DIFFICULT

FOR ME TO LEAVE THE HOUSE.

AND REALLY, I CAN'T WAIT FOR THEM TO LEAVE.

BECAUSE IT'S THE ONLY WAY I CAN EAT WHAT I WANT WITHOUT SHAME.

[ Ringing ]

MAN: Thank you for calling, Would you like to try

our Two medium sausage pizzas for $6.99 each?

I'LL HAVE TWO MEDIUM PIZZAS WITH PEPPERONI AND SAUSAGE...

Okay.

...ONE ORDER OF YOUR CHEESE STICKS,

24 CHIPOTLE HONEY WINGS,

AND THE DOUBLE CHOCOLATE CHIP BROWNIE.

Delivery or carry out?

UH, THIS WILL BE FOR DELIVERY.

THANK YOU.

[ BEEPS ]

Karina: AROUND MY PARENTS, I TRY TO KEEP A SMALL PORTION.

WHEN THEY'RE NOT AROUND, I EAT WHATEVER I WANT.

I KEEP SNACKS, LIKE, HIDDEN AWAY FROM MY FAMILY TO SEE.

USUALLY I HIDE MY STASH IN THE RECLINER.

CHOCOLATE IS VERY IRRESISTIBLE FOR ME.

I WANT IT ALL THE TIME.

[ KNOCKING ON DOOR ]

**

THAT'S THE PIZZA.

HELLO. HELLO.

HOW ARE YOU?

FINE.

ALL RIGHT, GOT IT.

THANK YOU.

MY PARENTS KNOW I EAT A LOT.

BUT THEY DON'T KNOW I EAT THIS MUCH.

[ SIGHS ] OKAY.

**

WHEN I'M EATING, SOMETIMES I FEEL LIKE I'M OUT OF CONTROL.

BUT EACH BITE IS SO SATISFYING.

IT MAKES ME FEEL WARM AND GOOD INSIDE,

IF ONLY FOR A SHORT WHILE.

BUT I'M AFRAID THAT ONE DAY, I'M JUST GONNA EAT TOO MUCH.

I'M PROBABLY GONNA DIE FROM A HEART ATTACK

OR I'M GONNA SUFFOCATE.

BUT I CAN'T STOP MYSELF.

MY FOOD ADDITION IS KILLING ME, LITTLE BY LITTLE.

I MADE MYSELF GET LIKE THIS BECAUSE OF MY EATING DISORDER

AND EVERYTHING AND I HATE MYSELF MORE

AND THAT MAKES ME JUST WANT TO EAT MORE

'CAUSE THAT COMFORTS ME.

SOMETHING HAS TO CHANGE DRASTICALLY.

I NEED HELP.

**

**

**

[ WATER RUNNING ]

Karina: TODAY WE'RE HAVING OUR WEEKLY FAMILY DINNER,

AND I'M USING TODAY TO LET MY FAMILY KNOW

THAT I'M GOING TO TRY TO GET HELP.

I'VE TRIED A LOT OF THINGS TO LOSE WEIGHT.

SO I'M WORRIED MY FAMILY'S GOING TO THINK

THIS IS JUST ANOTHER THING THAT'S GOING TO FAIL.

THEY ALL PAID FOR ME TO GET MY FIRST WEIGHT LOSS SURGERY

OPERATION WITH THE BALLOON.

AND I KNOW MY SISTER FELT I WASTED MONEY.

SO I'M JUST NERVOUS TO TALK TO THEM ABOUT IT.

BECAUSE I DON'T KNOW HOW THEY'RE GOING TO REACT.

THE CHICKEN'S READY. THE ONIONS, AVOCADOS ARE WASHED.

TOMATOES READY.

DOOR SQUEAKING OPEN ]

[ DOOR SQUEAKS CLOSED ]

-HELLO, GIRLS. -HEY.

MWAH, MWAH.

GO GET YOUR GRANDPA. TELL HIM DINNER'S READY.

**

Marisabel: FAMILY DINNER'S THE ONLY TIME

I SPEND WITH MY SISTER.

IT'S IMPORTANT FOR THE FAMILY TO GET TOGETHER ALL THE TIME

FOR THE CHILDREN'S SAKE.

I KNOW MY PARENTS WILL PROBABLY SUPPORT ME.

BUT I'M NOT SURE HOW MY SISTER WILL REACT BECAUSE SHE ALREADY

FEELS LIKE I'M TAKING AWAY FROM THE WHOLE FAMILY

WITH HOW MUCH EVERYONE HAS TO HELP ME.

BUT THIS IS SOMETHING I JUST HAVE TO DO NO MATTER WHAT.

BEFORE EVERYONE IS FINISHED, I WAS GOING TO SAY,

THERE'S A DOCTOR IN HOUSTON

WHO MIGHT TAKE ME FOR WEIGHT LOSS SURGERY.

REALLY? HOW DID YOU FIND OUT ABOUT HIM?

ONLINE.

MNH.

SO WHAT DO YOU THINK ABOUT IT?

GOOD IF YOU CAN FIND SOMEBODY THAT WILL DO IT FOR YOU, YEAH.

BUT THAT MEANS THAT ONE OF YOU HAS TO TAKE ME

TO HOUSTON WHEN THE APPOINTMENT COMES UP.

WE'LL WORRY ABOUT THAT WHEN THE TIMES COME.

YEAH? WHAT DO YOU THINK?

YEAH.

OKAY.

NO, SHE'S STILL EATING.

YEAH, ON THE LAST ONE.

**

Marisabel: I THINK IF MY SISTER FOUND SOMEONE THAT CAN ACTUALLY

HELP HER, IT WOULD BE GREAT.

BUT WE'VE TRIED SO MUCH AND FOR SO LONG TO HELP HER

WITH HER EATING HABITS THAT I'M JUST DONE TRYING.

COME ON, SAY GOODBYE AND LET'S GO.

ALL RIGHT, BYE. I'LL SEE YOU.

-SLEEP TIGHT. -OKAY, THANK YOU.

Karina: I WAS REALLY HOPING THAT MY FAMILY

WOULD BE MORE EXCITED FOR ME.

I KNOW WE'VE BEEN THROUGH THIS BEFORE WITH MY BALLOON SURGERY.

BUT IF THIS TIME'S GOING TO BE DIFFERENT,

THEN I NEED MY FAMILY'S SUPPORT.

AND RIGHT NOW, IT DOESN'T FEEL LIKE I HAVE IT.

**

**

[ DOG BARKING ]

TODAY IS MY FIRST CONSULT WITH DR. NOW.

AND MY PARENTS HAVE AGREED TO DRIVE ME TO HOUSTON.

I'M A LITTLE NERVOUS BECAUSE

IT'S A THREE-HOUR DRIVE TO HOUSTON.

AND IT'S TOO LONG OF A TRIP FOR ME TO LAY IN THE BACK OF THE VAN

LIKE I USUALLY DO.

-OKAY, MIJA, WE'RE READY. -YEP.

SO TODAY, I'M GOING TO TRY TO GET INTO A CAR SEAT

FOR THE TIME SINCE I BROKE MY LEG ALMOST A YEAR AGO.

AND I'M SCARED THAT I WON'T BE ABLE TO GET

ALL THE WAY UP INTO THE SEAT.

BECAUSE IF I CAN'T,

I WON'T BE ABLE TO MAKE THE TRIP TO HOUSTON.

SO I HAVE TO FIND A WAY TO FIT IN THIS SEAT,

NO MATTER HOW BAD IT HURTS.

IF I DON'T DEAL WITH THE PAIN AND DO THIS,

THEN IT MEANS I STAY HERE AND DON'T GET HELP

AND DIE IN BED SOME DAY SOON.

[ PANTING ]

**

Ezequiel: BE CAREFUL.

**

[ GRUNTING ]

[ PANTING ]

**

**

IT'S A RELIEF THAT I WAS ABLE TO GET IN THE CAR.

BUT NOW, I'M SCARED OF HOW PAINFUL THIS CAR RIDE WILL BE.

-READY? -YEAH.

I JUST HOPE I MAKE IT.

**

I'M THANKFUL MY PARENTS ARE HELPING ME DO THIS.

AND I'M GLAD TO HAVE THIS CHANCE FOR HELP.

BUT I'M REALLY SCARED, TOO,

BECAUSE I TRIED THIS BEFORE AND FAILED.

AND THERE'S A PART OF ME THAT IS TERRIFIED

THAT THIS ISN'T GOING TO BE DIFFERENT.

I HAVE DONE SO MANY THINGS TO TRY TO LOSE WEIGHT.

I LOSE WEIGHT, BUT THEN I GAIN IT BACK.

AS TERRIBLE AS I FEEL WHEN I PUT THE WEIGHT BACK ON,

I KNOW IT HURTS MY FAMILY THE MOST.

THIS TIME HAS TO BE DIFFERENT.

I CAN'T KEEP PUTTING MY FAMILY THROUGH THIS.

**

Ezequiel: DO I EXIT?

YES, IT'S A STRAIGHT ROAD ALL THE WAY

TILL PASSING ALL THIS TRAFFIC.

WE'LL STILL BE THERE WITH EIGHT MINUTES

BEFORE THE DOCTOR'S APPOINTMENT.

HMM.

MY FEAR IS THAT DR. NOW WILL SAY HE CAN'T HELP ME

AND I'LL BE OUT OF OPTIONS.

I SHOULDN'T BE DOING THIS RIGHT BEFORE I SEE THE DOCTOR.

BUT I'M JUST NERVOUS AND I HAVE TO EAT SOMETHING.

I FEEL LIKE I'M AT A POINT WHERE IF THINGS DON'T CHANGE,

BEFORE LONG, I'LL BE BEDBOUND.

I NEED TO GET MY LIFE BACK.

**

DR. NOW IS MY LAST HOPE TO HAVE A LIFE.

IF HE WON'T TAKE ME AS A PATIENT,

WHAT AM I GONNA DO NEXT?

PUSH.

**

KARINA GARCIA?

Karina: IT'S BEEN SO LONG SINCE I STOOD ON A SCALE.

AND I WAS SCARED TO EVEN SEE THE NUMBER.

BECAUSE I STOPPED SEEING WHAT MY WEIGHT WAS A WHILE AGO.

I'VE BEEN IN THE CAR FOR SO LONG THAT I DON'T THINK I CAN EVEN

USE MY LEGS TO STAND RIGHT NOW.

AND IF I CAN'T, I DON'T KNOW IF THAT'S GOING

TO MAKE DR. NOW FEEL LIKE I'M JUST A LOST CAUSE.

ONE, TWO...

[ GRUNTING ]

[ PANTING ]

WHERE'S THE CHAIR?

[ SIGHS ]

**

WHERE'S THE CHAIR?

I CAN'T DO IT.

[ PANTING ]

OKAY, SINCE YOU'RE HAVING TROUBLE WITH THIS ONE,

WE'RE GONNA TRY TO SEE IF WE CAN GET YOU

TO STAND ON THAT ONE, OKAY?

OKAY.

I AM SO EMBARRASSED.

I CAN'T EVEN STAND UP WITHOUT SOMETHING TO HOLD ON TO.

SO I REALLY HOPE THE OTHER SCALE WORKS

AND I'M ABLE TO DO IT.

BECAUSE I DON'T WANT TO START EVERYTHING OUT LIKE THIS

WITH DR. NOW.

I HAVE TO DO THIS.

ONE, TWO.

[ PANTING ]

GOOD.

**

[ PANTING ]

**

THAT'S HIGHER THAN I WAS HOPING.

**

**

BUT PART OF ME KNEW IT WAS GOING TO BE LIKE THIS.

BUT IT'S STILL A SHOCK TO SEE THAT NUMBER

AND KNOW THAT'S REALLY WHAT I WEIGH.

BUT I'M HOPING TO HEAR FROM THE DOCTOR TODAY

THAT HE'LL TAKE ME ON.

AND GIVE ME A CHANCE TO SHOW HIM

THAT I COULD FOLLOW HIS PROGRAM

BECAUSE I WANT TO GET MY LIFE BACK

AND NOTHING ELSE HAS WORKED.

AND IF HE GIVES ME THE CHANCE, YES, I'M READY TO DO IT.

HELLO, HOW Y'ALL DOING?

FINE AND YOU?

I'M DOING OKAY.

I'M DR. NOWZARADAN.

I'M KARINA.

NICE TO MEET YOU.

-EZEQUIEL. -NICE TO MEET YOU.

-MY WIFE. -AND YOU, TOO.

ALL RIGHT. SO, AS OF TODAY,

YOU ARE 633 POUNDS.

YES, SIR.

CAN YOU TELL ME HOW YOU GOT TO THIS WEIGHT?

WELL, I EAT A LOT OF WHAT I SHOULDN'T.

AND IF I DON'T EAT, I START GETTING HEART BURN.

HEART BURN?

SO YOU HAVE TO EAT 8,000 TO 10,000 CALORIES A DAY

BECAUSE IF YOU DON'T, THEN YOU'LL GET HEARTBURN?

SO YOU JUST GIVE INTO YOUR DESIRE TO EAT?

AND YOU HAVEN'T TRIED TO LOSE ANY WEIGHT BECAUSE OF THAT?

I DID TRY TO GET HELP LAST YEAR.

I GOT A GASTRIC BALLOON PUT IN MY STOMACH.

AND I WAS LOSING WEIGHT. AND THEN I HAD AN ACCIDENT.

I BROKE MY LEG. SO I WAS BEDBOUND.

AND SO I STARTED GAINING AGAIN BECAUSE I WASN'T DOING NOTHING,

JUST LAYING IN BED AND EATING,

AND THEY WOULDN'T DO ANY SURGERY ON ME

BECAUSE OF MY ASTHMA.

AND IT JUST NEVER HEALED?

YES, AND I WAS JUST IN BED THE WHOLE TIME.

OKAY. SO ACCORDING TO YOU, YOU HAVE BEEN IMMOBILE.

THEN WHO IS BRINGING YOU FOOD WHEN YOU HAVE BROKEN LEG

AND YOU CANNOT WALK?

MY PARENTS MOSTLY.

OKAY, SO YOUR PARENTS ARE FEEDING YOU,

AND YOU STILL HAVE THE BALLOON IN YOUR STOMACH.

BUT YOU'RE STILL OVEREATING AND GAINING WEIGHT.

YES.

SO YOU ARE MAKING EXCUSES

THAT ARE ACCEPTABLE TO YOURSELF, BUT NOT TO EVERYONE ELSE.

I'M VERY CONCERNED ABOUT THE DEGREE THAT KARINA

IS ABLE TO MAKE EXCUSES.

SHE JUST HAS THIS LONG LIST OF REASONS

WHY EVERYTHING ISN'T HER FAULT.

AND HER PARENTS DON'T SEEM TO CHALLENGE HER ON THAT

WITH ANY REALITY WHATSOEVER.

SHE CLAIMS HER LEG IS BROKEN AND THAT'S WHY SHE CAN'T WALK.

BUT THERE DOESN'T APPEAR TO BE

ANY SIGNIFICANT ISSUES WITH HER LEG.

AND THE FACT THAT SHE ALREADY HAD A WEIGHT LOSS PROCEDURE

AND IT FAILED IS NOT A GOOD SIGN.

SO THERE IS A LOT WE HAVE TO ADDRESS WITH KARINA.

AND THE EXCUSES ARE WHERE WE HAVE TO START.

ALL RIGHT, KARINA.

WE NEED TO REMOVE THE GASTRIC BALLOON

BEFORE WE CAN DO ANYTHING ELSE ON YOU.

OKAY.

THE BALLOON HAS ALREADY BEEN IN YOUR STOMACH

FOR AT LEAST TWICE AS LONG AS IT'S SUPPOSED TO.

WE ALSO NEED TO ADDRESS YOUR LEG.

BUT THE FACT IT HASN'T HEALED DOESN'T MAKE ANY SENSE.

BONES DON'T JUST NOT HEAL.

SO I THINK THESE ARE ALL JUST EXCUSES.

SO NOW, YOU'RE 633 POUNDS

AND YOU'RE 38 YEARS OLD.

HOW LONG DO YOU THINK YOU'RE GONNA LIVE?

I'M NOT GONNA LIVE MUCH LONGER IF I'M CONTINUING THIS WAY.

-I ALREADY KNOW THAT. -SO YOU ALREADY KNOW THAT?

SO, YOU'RE GONNA HAVE TO MAKE SOME CHANGES.

YOU HAVE TO STOP MAKING EXCUSES.

AND YOUR PARENTS HAVE TO STOP ENABLING YOU.

ARE THEY OKAY WITH THAT?

YES. TO ME, IT'S FINE.

I COOK FOR...

FOR US THREE.

SO IN OTHER WORDS, SHE'S NOT GONNA EAT

NO RICE, NO BEANS, NO.

NO PASTA, NO TOMATO AND NO BREAD, NO RICE.

Karina: NO TORTILLAS.

ALL RIGHT, I'M PUTTING YOU ON A 1,200-CALORIE

LOW-CARB, HIGH-PROTEIN DIET THAT YOU NEED TO FOLLOW NOW.

I WANT YOU TO EAT ONLY THREE TIMES A DAY.

THEY'LL BE NO SNACKING, OKAY?

SO WE ARE ALL ON THE SAME PAGE.

OKAY.

IN ONE MONTH, YOU SHOULD BE ABLE TO LOSE

AT LEAST 40 POUNDS, OKAY?

OKAY, 40 POUNDS IN A MONTH.

RIGHT.

**

**

I'M REALLY NERVOUS ABOUT HOW HARD IT'S GOING TO BE

TO MAKE SUCH A BIG CHANGE IN HOW I EAT.

I'M USE TO EATING WHENEVER I WANT.

AND I HATE THE THOUGHT OF NOT BEING ABLE TO DO THAT ANYMORE.

I CAN'T SNACK ANYMORE.

I'M WORRIED THAT I MIGHT SNEAK IN HERE AND THERE

A SLICE OF BREAD OR A SLICE OF CHEESE.

BUT I NEED TO STICK TO THE 1,200 CALORIE LIKE HE SAID.

**

I'M SCARED OF HOW HARD THIS IS GOING TO BE.

**

BUT IF I WANT TO GET THE WEIGHT LOSS SURGERY,

I HAVE TO FOLLOW DR. NOW'S PLAN.

I HAVE TO DO IT IF I WANT TO CONTINUE LIVING.

**

**

IT'S BEEN A FEW WEEKS SINCE I SAW DR. NOW.

AND I'M REALLY TRYING TO STICK TO THE PLAN.

BUT ADJUSTING TO THIS NEW DIET HAS BEEN REALLY HARD.

**

I'M SUPPOSE TO ONLY EAT 1,200 CALORIES A DAY.

SO I CUT OUT A LOT OF STUFF THAT I USED TO EAT,

ALL THE CARBS, ALL THE SWEETS.

I MISS ALL THE FOOD I USE TO BE ABLE TO HAVE.

BUT EVEN THOUGH THIS DIET HAS BEEN SO TOUGH,

I'M STICKING TO IT.

I HAVE NOT CHEATED AT ALL.

AND TRUST ME, THERE'S BEEN TEMPTATIONS.

EVERYTHING I EAT, I CHECK CALORIES.

I WEIGH EVERYTHING NOW.

MY MAIN THING IS EATING PROTEIN

WITH MY YOGURT AND MY 200 GRAMS OF GRAPES.

MY CALORIE INTAKE

FOR THE WONDERFUL LUNCH I'M HAVING.

SO IN TOTAL, IT'S 393 CALORIES.

SO IT'S BEEN A COMPLETELY DIFFERENT LIFESTYLE

BUT I'M TRYING TO ADAPT TO IT.

**

THAT REALLY LOOKS GOOD.

BUT I FEEL LIKE I'M DOING THIS ON MY OWN RIGHT NOW

BECAUSE MY FAMILY HASN'T REALLY BEEN SUPPORTIVE.

AND IT'S NOT THAT I EXPECT THEM TO ONLY EAT HEALTHY LIKE ME,

BUT THEY COULD AT LEAST DO IT AWAY FROM ME.

BECAUSE IT MAKES IT SO MUCH HARDER TO RESIST

GIVING IN AND JUST EATING WHATEVER I WANT.

**

**

IT'S THE DAY BEFORE MY NEXT APPOINTMENT WITH DR. NOW.

AND MY PARENTS ARE DRIVING ME TO HOUSTON AGAIN.

SO IT'S GOING TO BE A LONG DAY.

[ SPEAKING SPANISH ]

MWAH!

Marisabel: I CAME JUST CAME TO SEE IF YOU ARE GOING

TO KATALINA'S LAST GAME TOMORROW.

MY DOCTOR'S APPOINTMENT.

SO YOU'RE GOING TO THE DOCTOR FOR WHAT?

A WEIGH IN. I HAVE TO LOSE 40 POUNDS.

WHAT HAVE YOU DONE TO LOSE THE WEIGHT?

KEPT ON MY DIET.

WHAT IS YOUR DIET?

1,200 CALORIES A DAY.

SO YOU STILL CAN'T WALK OR WHAT?

NO.

HMM.

I'M NOT HERE TO PICK ON YOU.

IT'S JUST THAT, I CAME HERE TO TELL HER

IT'S HER GRANDDAUGHTER'S LAST GAME.

AND THIS IS THE THIRD TIME I COME TO TELL HER

SOMETHING ABOUT THE KIDS AND SHE CAN'T GO

BECAUSE SHE'S DEALING WITH YOU.

AND I'M SORRY,

BUT YOU'RE OLD ENOUGH TO FEND FOR YOURSELF.

IT'S A DOCTOR'S APPOINTMENT.

IF IT WASN'T A DOCTOR'S APPOINTMENT,

I'D TELL HER TO GO THE SOCCER GAME.

YEAH, WELL THIS IS THE LAST ONE.

AND THEN NEXT TIME, IT'S GONNA BE ANOTHER

DOCTOR'S APPOINTMENT OR IT'S GONNA BE,

"I GOTTA TAKE HER THERE. I GOTTA TAKE HER HERE."

YOU'RE OLD ENOUGH TO DO FOR YOURSELF.

I KNOW, BUT IT'S JUST SOMETHING WE HAVE TO DO.

BUT IT'S ALWAYS THE SAME THING, I KNOW.

I KNOW. YOU CAN KNOW ALL YOU WANT,

BUT IF YOU DON'T DO IT, IT'S NOT GONNA MATTER.

SO, WHAT YOU NEED TO DO IS DO IT.

I'M PUTTING EVERYTHING I HAVE NOT TO FALL INTO TEMPTATION.

TRUST ME, THERE'S BEEN A LOT OF TEMPTATIONS HERE.

OKAY. WELL, I HAVE TO GO.

BUT THAT'S WHAT IT IS TO HAVE KIDS.

-YEAH? -TO HAVE RESPONSIBILITIES

WHICH IS SOMETHING THAT YOU SHOULD HAVE

AS AN ADULT, TOO.

ALL RIGHT, LET ME GET THE KIDS.

I KNOW MY SISTER'S FRUSTRATED ABOUT HOW MUCH I NEED HELP.

BUT I DON'T THINK SHE UNDERSTANDS HOW HARD

I'M TRYING TO CHANGE ALL THIS.

I FEEL LIKE SHE JUST WANTS TO TEAR ME DOWN SOMETIMES.

AND WHEN SHE DOES, IT MAKES ME JUST WANT TO GO BACK TO FOOD.

I'M NERVOUS WHAT THE SCALE'S GOING TO SAY TOMORROW.

BECAUSE I DON'T KNOW IF I CAN DO THIS.

AND I JUST HOPE I'M GOING TO HIT MY GOAL.

**

**

**

**

Karina: MY PARENTS AND ME ARE ON OUR WAY TO HOUSTON

TO SEE DR. NOW FOR MY FOLLOW-UP APPOINTMENT.

HE WANTED ME TO LOSE 40 POUNDS IN A MONTH.

BUT I'M NERVOUS.

MY FEAR IS THAT I DIDN'T MAKE THE 40 POUNDS

AND THAT THIS IS MORE THAN JUST ABOUT ME

BECAUSE MY WEIGHT HAS TAKEN A TOLL ON OUR FAMILY.

MY PARENTS ARE MISSING OUT ON SEEING THEIR GRANDCHILDREN

TO TAKE ME TO SEE DR. NOW.

AND I KNOW THAT IS HARD ON THEM

AND REALLY UPSETS MY SISTER.

**

**

I REALLY HOPE I GET APPROVED FOR WEIGHT LOSS SURGERY

BECAUSE I KNOW MY BODY

CAN'T KEEP FUNCTIONING THIS WAY MUCH LONGER.

I DON'T KNOW WHAT I WOULD DO

IF MY PARENT'S DIDN'T HELP ME THE WAY THAT THEY DO.

**

**

KARINA GARCIA?

I WANT DR. NOW TO TELL ME I HAVE LOST THE WEIGHT

THAT I NEEDED TO AND THAT HE WILL ACCEPT ME

AS A PATIENT FOR SURGERY.

BUT I'M A LITTLE NERVOUS

THAT I WON'T BE ABLE TO STAND UP ONTO THE SCALE.

**

OKAY.

ONE, TWO.

[ GRUNTING ]

[ PANTING ]

**

I REALLY NEED TO SEE SOME PROGRESS ON THIS SCALE.

**

[ PANTING ]

YOU GOT 42 POUNDS.

I DID IT.

HE WANTED 40? HE GOT HIS 40 PLUS TWO.

[ PANTING ]

IT FEELS GOOD. IT'S A LOT OF SACRIFICE.

I STUCK TO THE DIET,

AND IT WAS REALLY REALLY HARD,

BUT IT PAID OFF.

[ SIGHS ] 42 POUNDS.

THAT WAS PRETTY GOOD, MIJA.

I WAS KIND OF SURPRISED THAT YOU WERE ABLE TO DO IT, YOU KNOW?

THAT'S ONLY TELLING ME ONE THING,

THAT IF YOU PUT YOUR MIND TO IT, YOU WILL DO IT.

I KNOW THAT MY PARENTS REMAIN VERY SKEPTICAL,

EVEN THOUGH MY DAD SAID IT WAS VERY GOOD,

THEY DIDN'T SEEM EXCITED AS I THOUGHT THEY WOULD,

WHICH MAKES ME SAD.

I WANT THEM TO BELIEVE IN ME.

[ KNOCKS ON DOOR ]

-HELLO. -HELLO.

-HI. -HOW Y'ALL DOING?

-FINE. -GOOD, DOCTOR.

DID Y'ALL MAKE A GOOD TRIP DOWN TO HOUSTON?

YOU CAN SAY THAT. [ CHUCKLES ]

SO I SEE THAT YOU LOST 42 POUNDS.

YES, I DID.

WELL, I'M IMPRESSED.

SO HOW WAS IT ADAPTING TO THE DIET?

GOOD. I MEAN, I'M WATCHING WHAT I EAT.

I'M WATCHING THE CALORIES. I'M WATCHING EVERYTHING.

AND HOW ABOUT YOUR ENABLING PARENTS?

DID THEY HELP YOU DO IT?

HMM, NO, I'M THE ONLY ONE DOING IT.

THEY'RE STILL DOING WHAT THEY WANT TO DO.

THEY STILL EAT IN FRONT OF ME AND EVERYTHING.

I WANT IT, BUT THEN I GO,

THAT'S TOO MANY CALORIES.

YOU DID IT DESPITE THEM?

YES.

OKAY, FOR NOW, YOU HIT THE GOAL I SET,

SO I'M APPROVING YOU FOR WEIGHT LOSS SURGERY.

[ INHALES DEEPLY ]

[ CHUCKLES ]

-OKAY? -SO I'M APPROVED?

IS EVERYBODY IN THE FAMILY AGREEABLE WITH THAT?

YES.

BUT FIRST, WE HAVE TO TAKE CARE OF A COUPLE OF THINGS.

FOR WEIGHT LOSS SURGERY, WE DEFINITELY NEED YOU

TO BE ABLE TO WALK AROUND BECAUSE THE RISK

OF DEVELOPING BLOOD CLOTS IS GONNA BE VERY HIGH.

SO WE'RE GONNA HAVE TO WORK TOWARD

GETTING YOU TO THAT POINT.

SO I'M GOING TO START YOU ON PHYSICAL THERAPY.

OKAY.

AND THEY WILL ALSO BE ABLE TO IDENTIFY

IF THERE ARE ANY ISSUES WITH YOUR LEG

OR IF YOU STILL HAVE ANY INJURIES

THAT WE HAVE TO CHECK OUT.

OKAY.

BUT AFTER THIS MUCH TIME,

I THINK YOUR LEG IS HEALED.

AND IT'S TIME TO LET THAT GO.

BECAUSE YOU NEED TO GET UP AND WALKING.

MM-HMM.

WE ALSO NEED TO DO AN ENDOSCOPY

TO SEE WHAT'S GOING ON WITH YOUR GASTRIC BALLOON.

BECAUSE THAT HAS TO BE REMOVED BEFORE ANY OPERATION.

OKAY.

BECAUSE YOU HAVE THE BALLOON IN YOUR STOMACH

LONGER THAN ANYBODY ELSE HAS.

SO I DON'T KNOW WHAT TO EXPECT.

SO I WILL SCHEDULE THAT, AND WE GET THAT DONE.

AND WE'LL GET P.T. TO START WITH YOU IN A COUPLE DAYS.

-MM-HMM. -OKAY, GOOD JOB.

I'M HAPPY WITH YOUR PROGRESS.

AND I THINK YOU'RE READY FOR YOUR NEXT STEPS.

SO IT'S NOT THE TIME TO TAKE IT EASY.

YES.

OKAY, KEEP IT UP, AND I'LL SEE YOU SOON.

-OKAY. -YES, DOCTOR.

-OKAY? -THANK YOU.

**

Dr. Nowzaradan: I'M HAPPY TO SEE KARINA'S PROGRESS

AND THAT SHE'S WILLING TO SHOW SOME LEVEL

OF SELF CONTROL AT TIMES.

BUT SHE SEEMS LIKE THEY HAVE A DYSFUNCTIONAL FAMILY.

THE VIBE SEEMS TO BE THAT THEY HAVE GIVEN UP ON KARINA.

IT COULD LEAD HER EVEN FURTHER OFF TRACK.

SO THAT IS A SITUATION THAT WE WILL NEED TO ADDRESS.

BUT RIGHT NOW, THE PRIORITY

IS DETERMINING HER SITUATION

AND TRY TO REMOVE HER GASTRIC BALLOON

SO THAT WE CAN DO SURGERY

AND GETTING HER WALKING AGAIN.

**

**

Karina: MY APPOINTMENT WITH DR. NOW

WENT AS WELL AS I COULD HAVE HOPED FOR.

**

BUT THIS IS A BIT OF A SET BACK BECAUSE I NEED TO HAVE

THE BALLOON INSIDE MY STOMACH REMOVED.

AND DR. NOW SAID THERE COULD BE COMPLICATIONS.

Ezequiel: OKAY.

WHICH REALLY SCARES ME.

**

BECAUSE THERE'S A CHANCE

THAT IF THE BALLOON REMOVAL DOESN'T GO WELL,

I WON'T BE ABLE TO HAVE THE SURGERY AND EVERYTHING

I'VE BEEN WORKING FOR WILL ALL BE FOR NOTHING.

**

**

**

DR. NOW APPROVED ME FOR SURGERY,

BUT I NEED TO MAKE SIGNIFICANT PROGRESS WITH MY LEG.

AND HE SET ME UP WITH A PHYSICAL THERAPIST TO HELP ME.

BUT THAT'S NOT GOING TO BE EASY.

I HAVE BASICALLY BEEN WHEELCHAIR BOUND

FOR THE LAST YEAR, AND AS A RESULT,

I DON'T HAVE THAT MUCH STRENGTH.

**

THERE'S BEEN LOTS OF TIMES I JUST WANT TO

THROW IN THE TOWEL AND JUST GIVE UP.

AND THAT'S WHAT MY SISTER EXPECTS ME TO DO.

AND EVEN IF MY PARENTS DON'T SAY IT,

I KNOW THEY EXPECT ME TO QUIT, TOO.

BUT NOW I'M SO CLOSE TO HAVING MY WEIGHT LOSS SURGERY,

I CAN'T GIVE UP.

-READY? -I'M READY.

COME ON DOWN.

GOOD, GOOD.

[ PANTING ]

LET'S GO AHEAD AND LAY FLAT.

WE'LL DO HAMSTRINGS AND HIP FLEXERS

AND ALL THAT GOOD STUFF.

[ PANTING ]

WE'RE JUST TRYING TO LOOSEN UP THOSE HAMSTRINGS

AND THE KNEE RIGHT?

YEAH.

SO IT DOESN'T FIGHT YOU QUITE SO MUCH

WHEN YOU'RE STANDING?

OKAY.

LET ME KNOW IF I'M HURTING YA.

TRUST ME, I'LL LET YOU KNOW.

[ BOTH LAUGH ]

IN MY MIND, I WAS THINKING, "I HOPE IT DON'T HURT.

I HOPE IT DON'T HURT."

AND THEN IT STARTED TO HURT.

OKAY, THERE'S PAIN RIGHT THERE WHEN YOU DO THAT.

-YEAH? -UH-HUH.

-JUST IN THE KNEE? -UH-HUH.

OKAY.

IT IS THE WORST FEELING BECAUSE IN THE BACK OF MY MIND,

I AM SCARED THAT I CAN'T DO THIS

BECAUSE ALL MY LIFE, I HAVE FAILED.

ALL RIGHT, GONNA HIT THE PARALLEL BARS NOW?

-MM-HMM. -YEAH, ALL RIGHT, LET'S DO IT.

BUT I'M DOING THIS FOR A REASON.

I'M DOING THIS TO IMPROVE MY HEALTH.

AND I'M DOING THIS TO GET THE LIFE

THAT I'VE ALWAYS WANTED AND NEVER HAD.

DR. NOW WANTS ME TO BE ABLE TO WALK.

BUT I FEEL I'M STILL A LONG WAYS FROM BEING ABLE TO DO THAT.

NOT TOO SNUG? IT'S OKAY?

-YOU'RE FINE. -ALL RIGHT.

SO STATIC STANDS?

ALL RIGHT, READY TO GO.

ONE, TWO.

[ MACHINE BEEPS ]

KEEP YOUR POSTURE, RIGHT, HEAD UP.

THERE YOU GO.

THERE YOU GO, DEEP BREATHS.

STANDING IS STILL A BIG CHALLENGE FOR ME.

AND I CAN ONLY STAND FOR A LITTLE WHILE.

AND I NEED SOMETHING TO HOLD ON TO.

OKAY.

YOU GOOD? ALL RIGHT.

THERE YOU GO. [ LAUGHING ] GOOD JOB.

[ MACHINE BEEPING ]

COUNT IT. 121, GOOD JOB.

WE BEAT OUR RECORD.

I KNOW IT. THAT'S AWESOME.

LET ME GET THIS OFF OF YOU.

PHYSICAL THERAPY WENT FINE TODAY.

I FEEL GOOD.

THE THERAPIST WAS PROUD OF ME.

BUT I KNOW I'M STILL NOT EVEN CLOSE TO STANDING ON MY OWN.

AND DR. NOW SAYS IT'S IMPORTANT FOR ME TO BE MOBILE

AFTER MY WEIGHT LOSS SURGERY.

SO I'M SCARED THAT IF I HAVEN'T SHOWN ENOUGH IMPROVEMENT,

DR. NOW WILL CHANGE HIS MIND AND DELAY THE SURGERY.

**

**

**

Karina: RIGHT NOW, MY PARENTS ARE TAKING ME TO SEE DR. NOW

FOR MY ENDOSCOPY TO SEE IF THERE ANY ISSUES

TAKING MY GASTRIC BALLOON OUT.

SO WE'RE JUST GOING TO SEE WHAT CAN BE DONE.

AND I'M NERVOUS THAT WORST CASE SCENARIO,

HE FINDS A PROBLEM THAT NOT ONLY PREVENTS ME

FROM GETTING WEIGHT LOSS SURGERY,

BUT CREATES ANY SORT OF HEALTH THREAT TO ME

SINCE I WAS ONLY SUPPOSED TO HAVE THIS BALLOON FOR SIX MONTHS

AND IT'S BEEN MUCH LONGER THAN THAT.

SO I'M A LITTLE SCARED ABOUT WHAT HE'LL FIND OUT TODAY.

**

**

-HI, KARINA. -HELLO.

ALL RIGHT, SO THEY GOT YOUR WEIGHT AFTER CHECKING,

AND YOU'RE ONLY SIX POUNDS SMALLER,

SO THAT'S GOING TO BE AN ISSUE IF YOU DON'T PICK UP THE PACE

BEFORE YOUR WEIGHT LOSS SURGERY.

BUT WE'RE GOING TO SEE IF THAT'S EVEN POSSIBLE TODAY.

HOWEVER, I HEAR FROM PHYSICAL THERAPY

THAT YOU STILL DIDN'T WALK AT YOUR SESSION WITH THEM.

WHY IS THAT?

MY LEG IS NOT STRONG ENOUGH YET

'CAUSE I HAVE ARTHRITIS IN BOTH OF MY KNEES.

YOU SAID YOU BROKE YOUR LEG BEFORE.

AND THAT YOU NEEDED A SURGERY THAT THEY COULDN'T DO.

NOW IT'S ARTHRITIS.

SO IT SOUNDS LIKE A BUNCH OF EXCUSES.

SO AFTER YOUR ENDOSCOPY,

WE WILL DISCUSS YOUR LACK OF WEIGHT LOSS

THIS PAST MONTH, OKAY?

MM-HMM.

I'M NOT TOO HAPPY WITH HOW KARINA HAS DONE THIS PAST MONTH.

SHE HAS QUICKLY FALLEN BACK INTO MAKING EXCUSES.

AND STILL CLAIMING THAT SHE CAN'T WALK

WHEN THERE IS NO PHYSICAL REASON FOR THAT.

BUT MY BIGGEST CONCERN RIGHT NOW

IS IF I'M ABLE TO REMOVE THE BALLOON TODAY.

BECAUSE IT'S GOING TO FREE UP ALL THAT SPACE IN HER STOMACH

AND SHE'LL BE ABLE TO OVEREAT EVEN MORE.

ALL RIGHT, WE'RE GONNA GO AHEAD AND LOOK AT YOUR STOMACH

AND SEE IF WE CAN TAKE THE BALLOON OUT

AND SEE WHAT OTHER OPTIONS WE GOT FOR YOU, OKAY?

OKAY.

ALL RIGHT, WE'LL GET YOU SITUATED SHORTLY, OKAY?

OKAY.

**

I'M FEELING NERVOUS ABOUT WHAT'S GOING TO HAPPEN TODAY.

BECAUSE IF THIS DOESN'T GO WELL,

I WON'T BE ABLE TO HAVE THE WEIGHT LOSS SURGERY.

AND ALL THE HARD WORK I'VE DONE OVER THE LAST THREE MONTHS

WILL BE FOR NOTHING.

ALL MY LIFE, I'VE BEEN A FAILURE TO MY FAMILY.

AND I JUST WANT TO PROVE TO THEM THAT I CAN DO THIS,

THAT I CAN LOSE THE WEIGHT.

BUT FOR THAT TO HAPPEN, I NEED THIS BALLOON TO COME OUT

AND EVERYTHING TO BE OKAY.

**

KARINA HAD HER GASTRIC BALLOON

PUT IN HER STOMACH OUT OF COUNTRY,

SO IT IS NOT DESIGNED WITH THE HEALTH STANDARDS HERE.

A GASTRIC BALLOON IS ONLY INTENDED TO BE

A TEMPORARY SOLUTION FOR WEIGHT LOSS.

AND THE LIMIT TO KEEP IT WITHIN THE STOMACH IS SIX MONTHS.

Woman: ROOM LIGHTS.

AND KARINA RIGHT NOW IS OVER DOUBLE THAT AMOUNT OF TIME,

SO THERE IS NO TELLING WHAT COULD BE WRONG.

**

UH-HUH.

[ MACHINE BEEPING ]

OKAY, 50.

[ AIR HISSING ]

**

[ MONITOR BEEPING ]

OKAY, ROOM LIGHT ON.

**

KARINA'S ENDOSCOPY WENT WELL TODAY.

WHEN SHE RECOVERS FOR A LITTLE WHILE,

THEN, WE'LL BE ABLE TO DO HER WEIGHT LOSS SURGERY.

BUT BEFORE THAT, WE NEED TO ADDRESS

KARINA'S SLOWED DOWN IN HER WEIGHT LOSS.

AND HER BELIEF THAT THERE'S SOMETHING WRONG WITH HER LEG.

SO, I'M GOING TO HAVE AN X-RAY DONE

TO FIGURE OUT WHAT'S GOING ON THERE.

AND IF SHE DOESN'T KEEP LOSING THE WEIGHT SHE NEEDS

OVER THE NEXT MONTH, THEN I WON'T MOVE AHEAD

WITH ANY WEIGHT LOSS SURGERY WITH HER.

**

**

TODAY, I'M HOPEFULLY BEING DISCHARGED FROM THE HOSPITAL.

YESTERDAY, THEY REMOVED THE GASTRIC BALLOON FROM MY STOMACH,

AND WHEN I WOKE UP AND FOUND OUT, I WAS SO EXCITED

BECAUSE I KNOW THAT MEANS I CAN GET MY WEIGHT LOSS SURGERY SOON.

[ KNOCKS ON DOOR ]

HELLO.

HI, GOOD MORNING, DR. NOW.

HOW YOU DOING, KARINA?

FINE.

SO WE GOT THE BALLOON OUT.

BUT I NEED YOU TO UNDERSTAND HOW SERIOUS THIS SITUATION IS.

NOW THAT ALL THE ROOM IN YOUR STOMACH IS FREED UP,

YOU CAN OVEREAT AGAIN

BECAUSE YOUR WEIGHT LOSS SLOWED SIGNIFICANTLY.

SO I NEED YOU TO SHOW ME THAT YOU'RE WILLING

TO WORK HARD LIKE YOU NEED TO.

AND IT WASN'T THE BALLOON THAT DID MOST OF THE WORK

THE FIRST MONTH. SO TO DO THAT,

I WANT YOU TO LOSE 40 POUNDS AGAIN THIS NEXT MONTH.

-OKAY. -AND IF YOU DO THAT,

I WILL MOVE AHEAD WITH YOUR WEIGHT LOSS SURGERY.

AND IF NOT, YOU WILL NO LONGER BE APPROVED

FOR THE OPERATION.

-YOU UNDERSTAND? -OKAY.

BUT I'M GOING TO GET X-RAY IN HERE FOR YOUR LEG.

SO I CAN SEE WHAT'S GOING ON WITH THAT.

AND IN THE MEANTIME, I WANT YOU TO KEEP GOING TO P.T.

AND I WANT YOU TO GET UP AND WALK, OKAY?

ALL RIGHT.

ALL RIGHT, I'LL SEE YOU SOON.

KARINA HAD A HUGE BALLOON THAT PREVENTED HER

FROM HAVING HARDLY ANY FOOD IN HER STOMACH AT ONE TIME.

SO SEEING THAT COMBINED WITH HER LACK OF WEIGHT LOSS

THIS PAST MONTH,

I STILL NEED HER TO SHOW ME THAT SHE'S WILLING TO DO THIS.

BECAUSE IF SHE'S NOT, SURGERY WILL BE A WASTE

BECAUSE SHE WILL FAIL.

SO THIS NEXT MONTH WILL BE AN EVEN BIGGER TEST FOR KARINA.

**

MIJA, YOU READY?

YES, I'M READY TO GO.

THE WHEELCHAIR'S IN THE BATHROOM.

OKAY.

Karina: I'M A LITTLE DISAPPOINTED TO HEAR

THAT DR. NOW STILL NEEDS ME TO PROVE TO HIM I CAN DO THIS.

BECAUSE I FEEL LIKE I DID THAT ALREADY,

AND I DON'T FEEL LIKE THAT'S FAIR.

BUT I DON'T WANT TO LOSE HIS HELP.

-OKAY? -YEAH.

SO I'M GOING TO STICK WITH IT LIKE I DID THE FIRST MONTH.

BECAUSE I'M NOT LETTING THIS CHANCE GET AWAY FROM ME.

**

**

**

[ MICROWAVE BEEPS ]

SINCE MY ENDOSCOPY AND HAVING MY BALLOON REMOVED,

I'M FEELING A LOT BETTER.

I KNOW WITHOUT THE BALLOON, IT'S MUCH EASIER TO OVEREAT.

SO I'M TRYING TO MARK MY PORTIONS OUT.

**

AND I'M TRYING TO USE MY LEGS AS MUCH AS POSSIBLE,

BUT THEY STILL HURT A WHOLE LOT.

**

I KNOW DR. NOW SAYS I HAVE TO GET UP AND OUT OF THIS CHAIR,

BUT I'M REALLY STRUGGLING.

I JUST HOPE THAT I'VE DONE ENOUGH

FOR DR. NOW TO SCHEDULE MY WEIGHT LOSS SURGERY.

HOW WAS YOUR DAY TODAY?

FINE.

SOME VEGETABLE SOUP LIKE WITH BEANS AND CORN

AND CELERY AND CARROTS AND BELL PEPPERS.

IT'S LIKE ONLY 120 CALORIES, LIKE I TOLD YOU.

MM-HMM.

I'M HOPING HE TELLS ME, "LET'S DO THE SURGERY NEXT WEEK

AND LET'S GO."

I'M READY.

THAT AIN'T GONNA HAPPEN... ANY TIME SOON.

I COULD BARELY TAKE STEPS WITHOUT SITTING DOWN.

**

Karina: I KNOW DR. NOW WANTS ME TO WALK,

BUT I'M STILL SO BIG

AND THE LEG INJURY HAS MADE IT SO DIFFICULT

TO EVEN TRY TO MOVE.

AND WHEN I TALK TO MY FAMILY ABOUT MY PROGRESS,

IT USUALLY DISCOURAGES ME.

I KNOW THEY LOVE ME AND WANT ME TO DO WELL.

BUT THE THINGS THEY SAY MAKE ME FEEL LIKE

THEY DON'T THINK I CAN DO THIS.

I NEED THEM TO BELIEVE IN ME.

BECAUSE I'M GONNA DO THIS WITH OR WITHOUT THEM.

**

**

**

TODAY, WE'RE GOING TO DR. NOWZARADAN'S OFFICE.

I'VE BEEN WATCHING WHAT I EAT AND COUNTING CALORIES,

BUT THE BALLOON WAS THERE TO HELP ME LOSE WEIGHT,

AND NOW IT'S GONE.

SO I REALLY DON'T KNOW WHAT THAT SCALE'S GOING TO SHOW.

KARINA GARCIA?

AND I'M NERVOUS BECAUSE I HAVE TO HAD LOST SOME WEIGHT.

OTHERWISE, I DON'T THINK DR. NOW'S GOING TO APPROVE

MY WEIGHT LOSS SURGERY.

BUT IF I KEPT THE WEIGHT LOSS GOING, THEN AT LEAST I STAND

A CHANCE AT HAVING MY GASTRIC SLEEVE SURGERY SCHEDULED.

**

OKAY.

[ PANTING ]

**

I FEEL GOOD ABOUT THAT NUMBER ON THE SCALE.

[ SNIFFLES ] SO HAPPY.

OKAY.

[ CHUCKLES ]

IT'S A RELIEF TO SEE I'M STILL GOING IN THE RIGHT DIRECTION.

BUT AT THIS POINT, I DON'T KNOW IF LOSING MORE WEIGHT IS ENOUGH

BECAUSE DR. NOW WANTED ME TO BE ABLE TO MOVE BETTER ON MY OWN.

AND I'VE BEEN SCARED TO PUSH MYSELF PHYSICALLY.

SO, I'M WORRIED HE'S GOING TO SAY, "LET'S WAIT A BIT LONGER."

AND THAT THIS WEIGHT LOSS WAS OKAY, BUT NOT GOOD ENOUGH.

[ KNOCKS ON DOOR ]

-HELLO. -HELLO.

HOW ARE Y'ALL DOING?

-FINE AND YOU? -ALL RIGHT.

SO, YOU'RE DOWN TO 541 POUNDS.

MM-HMM.

AND THAT'S A WEIGHT LOSS OF 44 POUNDS.

THAT'S EXCELLENT.

HOW YOU FEEL WITH THAT?

LIGHTER ON MY FEET.

BETTER BREATHING, AND I'M ABLE TO MOVE MORE FASTER.

HOW WERE YOU FASTER? YOU'RE STILL NOT WALKING.

AND THAT BRINGS UP ANOTHER ISSUE WE NEED TO DISCUSS.

I'VE REVIEWED YOU LEG X-RAY.

AND THERE IS ABSOLUTELY NOTHING WRONG WITH YOUR LEG.

SO, THIS ISSUE IS EITHER ALL IN YOUR MIND

OR JUST AN EXCUSE YOU HAVE BEEN MAKING.

EITHER WAY, YOU'RE DONE SAYING YOU CAN'T WALK.

IF YOU WANT WEIGHT LOSS SURGERY,

THEN WHAT I NEED FROM YOU IS AN ACKNOWLEDGEMENT

THAT YOU'RE DONE WITH THIS EXCUSE.

ALL RIGHT. OKAY.

ALL RIGHT, I'LL BE EXPECTING A GOOD REPORT

AT YOUR NEXT PHYSICAL THERAPIST SESSION.

IF YOU DON'T KEEP TO THAT,

THIS IS GOING TO BE A SIGNIFICANT ISSUE

IF YOU EXPECT TO STAY IN THIS PROGRAM, OKAY?

OKAY.

I'M GLAD WE UNDERSTAND EACH OTHER.

SO YOU HAVE COME A LONG WAY.

SO WE'RE GONNA SET YOU UP FOR SURGERY IN ONE MONTH.

-OKAY? -OKAY.

Ezequiel: OKAY, THAT'S PRETTY GOOD.

ALL RIGHT, I THINK THIS IS GOING TO BE EASIER FOR YOU

TO CONTROL YOUR EATING HABIT, OKAY.

I'M VERY IMPRESSED WITH KARINA

AND THE PROGRESS SHE MADE SO FAR.

SHE'S SHOWN ME SHE'S COMMITTED

TO THIS PROGRAM AND GETTING HEALTHY.

BUT THIS IS JUST THE BEGINNING OF THE HARD ROAD

KARINA HAS AHEAD.

THE ODDS ARE STACKED AGAINST HER

SINCE THIS WILL BE HER SECOND ATTEMPT

AT A WEIGHT LOSS PROCEDURE.

AND SHE CAN'T STAY AS INACTIVE AS SHE IS

AND EXPECT TO KEEP MAKING PROGRESS DOWN THE ROAD.

BUT OVERALL, I'M PLEASED AND CONFIDENT THAT SHE'S READY

FOR HER WEIGHT LOSS SURGERY.

ANY QUESTIONS?

NO, I'M EXCITED NOW.

-[ CHUCKLES ] -ALL RIGHT, I'LL SEE YOU THEN.

-OKAY DOCTOR, THANK YOU. -MM-HMM.

WOW.

-RELIEF, HAPPY. -GOOD.

Maria: SHE'S FINALLY GET THE SURGERY SHE ALWAYS DREAM OF.

AND I FEEL HAPPY FOR HER.

I'M RELIEVED, BUT HOPEFULLY HER BODY CAN TAKE IT.

AND AFTER THAT, SHE GONNA HAVE TO START

BECOMING A PRODUCTIVE CITIZEN.

**

Karina: DR. NOW HAS APPROVED ME FOR SURGERY.

BUT HE SAID FOR THE WEIGHT TO REALLY COME OFF,

I WOULD NEED TO BE MORE MOBILE.

**

I'VE BEEN WORKING HARD TO SHOW HIM AND MY FAMILY

THAT I'M SERIOUS ABOUT THIS.

AND I KNOW THERE'S A LOT MORE FOR ME TO DO.

BUT I REALLY THINK I'M GOING TO BE ABLE TO STAY ON TRACK

AND USE THIS OPPORTUNITY WITH THE SURGERY

TO MOVE BETTER AND DO MORE THINGS ON MY OWN...

**

...SO MY FAMILY DOESN'T HAVE TO TAKE CARE OF ME.

**

**

**

**

Karina: TODAY, DR. NOW IS DOING MY GASTRIC SLEEVE SURGERY.

AND I'M REALLY NERVOUS BECAUSE IT'S A BIG PROCEDURE.

BUT I'VE BEEN WORKING TOWARDS THIS MOMENT,

AND MORE THAN ANYTHING IN MY LIFE,

I WANT IT TO GO WELL.

IN THE BACK OF MY MIND,

I'M ALWAYS AFRAID SOMETHING'S GOING TO GO WRONG.

BECAUSE BAD THINGS KIND OF ALWAYS HAPPEN TO ME.

BUT IT'S A RISK THAT I HAVE TO TAKE

IF I WANT TO GET MY LIFE BACK.

BECAUSE I DON'T HAVE ANY OTHER CHOICE

AND I DON'T HAVE A LIFE RIGHT NOW.

SO I JUST HOPE AND PRAY IT GOES OKAY.

**

Dr. Nowzaradan: KARINA SHOULD HAVE HAD ENOUGH TIME TO RECOVER

FROM HER GASTRIC BALLOON REMOVAL.

AND, SO, TODAY, WE ARE DOING A SLEEVE GASTRECTOMY ON HER.

PATIENTS HER SIZE ARE VERY HIGH RISK TO DO SURGERY ON.

AND WITH KARINA, THE CONCERN IS WITH THE FACT

THAT SHE CARRIES MOST OF HER WEIGHT

AT THE FRONT OF HER ABDOMEN.

WE CAN TURN THE ROOM LIGHT OFF.

AND THE WEIGHT ALSO MAKES IT EXTREMELY DIFFICULT

TO MANEUVER ANY INSTRUMENT TO PERFORM THIS SURGERY.

SO THIS IS GOING TO BE A COMPLICATED PROCEDURE.

GET THE SUCTION UP THERE SO I CAN SEE WHERE THE BLEEDING IS.

AND ALSO, LAYING HER DOWN ON HER BACK IS GOING TO

PUT PRESSURE ON HER PULMONARY SYSTEM,

AND IF WE AREN'T CAREFUL,

SHE MAY STOP BREATHING JUST FROM THE FACT

THAT THERE'S GOING TO BE A SIGNIFICANT AMOUNT OF WEIGHT

ON HER CHEST AND LUNGS THAT IT CAN'T HANDLE IT.

THEN WE'LL HAVE TO STOP.

BUT HOPEFULLY THAT WON'T BE THE CASE

BECAUSE KARINA WON'T BE ABLE TO MAINTAIN HER PROGRESS

WITHOUT THIS SURGERY.

**

Ezequiel: KARINA MEANS A LOT TO ME.

SHE'S MY FIRST BORN DAUGHTER.

SHE'S AN IMPORTANT PART OF MY FAMILY, OF MY LIFE.

WAITING HERE FOR HOURS, NOT KNOWING ANYTHING

AND JUST WAITING TO SEE WHAT'S GOING ON IS NERVE-RACKING.

ALL RIGHT, KEEP PUSHING FORWARD.

ALL RIGHT, YOU'RE GOOD.

-GOOD? -JUST LEAVE IT THERE.

Man: OKAY.

Dr. Nowzaradan: GASTRIC SLEEVE IS AN EFFECTIVE PROCEDURE

TO LOSE WEIGHT.

IT IS AN OPERATION THAT REDUCES THE SIZE OF THE STOMACH

70% TO 80% AND PATIENT

WILL BE ABLE TO EAT LESS AND WILL BE ABLE

TO LOSE SOME WEIGHT.

**

ROOM LIGHT BACK ON.

**

ALL RIGHT, WE'RE DONE.

ALL RIGHT, KARINA'S SURGERY WENT VERY WELL.

IT WAS A LITTLE BIT STRUGGLE BECAUSE OF HER SIZE

AND HER STOMACH, BUT WE WERE ABLE TO COMPLETE

THE SLEEVE GASTRECTOMY ON HER.

THE SURGERY TODAY WILL HELP KARINA TO STAY ON TRACK

FOR THE LONG TERM.

AND SHE SHOULD BE ABLE TO LOSE 40 POUNDS

IN THE FIRST MONTH AFTER SURGERY.

THEN AROUND 20 POUNDS IN THE FOLLOWING MONTHS

UNTIL SHE GETS CLOSE TO HER TARGET WEIGHT.

BUT EVEN THOUGH KARINA DID WELL WITH HER GOAL BEFORE SURGERY,

THIS IS HER SECOND WEIGHT LOSS PROCEDURE.

AND PATIENTS HER SIZE THAT HAVE FAILED

AT LEAST ONE WEIGHT LOSS OPERATION

HAVE ONLY A 2% CHANCE OF LONG-TERM SUCCESS,

AND TO MAKE HER SITUATION EVEN MORE DIRE,

SHE DOESN'T HAVE STRONG SUPPORT AT HOME.

SO THAT'S NOT A GOOD OUTLOOK.

**

**

**

Karina: IT'S HARD TO BE HERE RIGHT NOW.

I'VE MISSED OUT ON SO MUCH OF MY LIFE

AND IT FEELS LIKE THE CHANCE TO BE BACK OUT THERE

AND ACTIVE AND LIVING LIFE IS SO CLOSE.

BUT I'M STILL STUCK HERE IN THIS CHAIR AT MY HOUSE RIGHT NOW.

SO IT'S FRUSTRATING.

BECAUSE I JUST WANT TO GET OUT THERE,

AND I DIDN'T EXPECT IT TO BE SO HARD.

AND I STILL FEEL LIKE MY FAMILY

DOESN'T THINK I'M GONNA DO IT.

BUT I KNOW IF I STICK TO IT AND KEEP WORKING HARD,

THEN I'LL GET THERE.

AND ALL OF THIS WILL CHANGE SOON ENOUGH.

[ SIGHS ]

I JUST HOPE I DON'T START TO MESS IT UP LIKE BEFORE,

LIKE I DID WITH THE GASTRIC BALLOON,

AND I ENDED UP GIVING MY FAMILY ONE MORE REASON

NOT TO BELIEVE IN ME.

MY PARENTS AND MY SISTER ARE STILL PUSHING ME TO GET A JOB,

BUT I DON'T KNOW HOW I CAN DO THAT.

I DESPERATELY WANT TO, BUT I STILL CAN'T GET AROUND.

I HAVE A LONG WAYS TO GO STILL.

AND IF THEY KEEP PUSHING ME LIKE THIS,

THEN I KNOW I'M NOT GOING TO MAKE IT.

THE STRESS IS GOING TO BE TOO MUCH FOR ME.

AND I'M GOING TO START GIVING IN.

**

**

**

**

Karina: IT'S BEEN TWO MONTHS SINCE MY SURGERY

AND ONE MONTH SINCE MY LAST APPOINTMENT WITH DR. NOW.

AND I'M NERVOUS THAT THIS CHECKUP WON'T BE AS GOOD

AS THE LAST ONE.

BECAUSE IT'S BEEN MORE OF A STRUGGLE WITH ALL THE STRESS

AND GOING BACK ON SOLID FOODS.

SO I'M JUST ANXIOUS RIGHT NOW.

AND I REALLY HOPE THAT DR. NOW ISN'T UPSET WITH ME.

**

KARINA GARCIA?

I WAS 494 AT MY LAST APPOINTMENT.

DO YOU NEED HELP?

I GOT IT.

AND DR. NOW SAYS I SHOULD BE LOSING

AT LEAST 20 POUNDS A MONTH.

SO HOPEFULLY, I'M ON TRACK.

AND I LOST THE WEIGHT I NEED TO DO THAT.

**

**

**

COME WITH ME.

THAT'S NOT THE NUMBER I WAS HOPING TO SEE.

IT'S A LITTLE SCARY TO SEE MY PROGRESS SLOWING DOWN.

BECAUSE THAT'S WHAT HAPPENED WITH MY LAST PROCEDURE.

AND I CAN'T LET THAT HAPPEN AGAIN.

'CAUSE THIS IS THE LAST CHANCE TO GET ANY SORT OF HELP

TO LOSE WEIGHT.

[ KNOCKS ON DOOR ]

-HELLO. -HELLO.

-HI, DOCTOR. -HOW Y'ALL DOING?

GOOD, YOURSELF?

ALL RIGHT. SO YOU ONLY LOST SEVEN POUNDS THIS PAST MONTH.

AND I SEE STILL YOU ARE IN THE WHEELCHAIR.

SO WHAT'S GOING ON? HOW IS YOUR ACTIVITY?

IT'S INCREASING, LITTLE BY LITTLE.

ARE YOU ABLE TO WALK?

UM, I'M TRYING TO DO EVERYTHING WHAT THEY TELL ME TO DO

AT THE PHYSICAL THERAPY.

I DON'T THINK THAT'S COMPLETELY ACCURATE.

BECAUSE PHYSICAL THERAPY SAYS YOU'RE STILL NOT

WALKING WITH THEM.

AND THERE IS NO REASON FOR THAT OTHER THAN

YOU CHOOSING TO BE LAZY.

I'VE BEEN UNDER THE WEATHER, SO...

I'VE BEEN LIKE, KIND OF, LIKE, MORE WEAK.

SO IT'S TIME TO STOP WITH THE EXCUSES.

YOU'RE STARTING TO RUN TO FOOD AGAIN.

YOU'RE STILL NOT WALKING, AND YOU'RE LYING TO ME.

MM-HMM.

IF WE DON'T GET AHEAD OF THESE ISSUES,

THEN YOU'LL HAVE NO WEIGHT LOSS THE NEXT MONTH.

SO I'M MAKING AN APPOINTMENT FOR YOU

TO START PSYCHOTHERAPY.

OKAY.

SO WE CAN START TO GET AT SOME THESE UNDERLINED ISSUES.

DO YOU UNDERSTAND?

OKAY, AND BY YOUR NEXT APPOINTMENT,

I WANT YOU WALKING AND DOWN 60 POUNDS.

OKAY.

ALL RIGHT, SUPER.

**

KARINA'S PATTERN SEEMS TO BE THAT SHE STAYED DETERMINED

FOR A WHILE AND THEN SHE STARTS GIVING IN TO HER EMOTIONS

AND STARTS MAKING EXCUSES.

HER FAMILY DOESN'T SEEM TO OFFER HER MUCH SUPPORT.

AND THE LACK OF SUPPORT IS A FACTOR

THAT PLAYS INTO HER EMOTIONAL STATE.

AND WE NEED TO CHANGE THAT.

**

Karina: I KNOW DR. NOW WAS DISAPPOINTED IN ME.

AND I KNOW THAT I REALLY NEED TO GET UP AND WALK.

IF DR. NOW THINKS THAT SEEING A THERAPIST

WILL HELP ME TO DO THAT, I'M WILLING TO DO IT.

**

I WANT TO PROVE EVERYONE WRONG.

NOBODY BELIEVES IN ME.

AND I'M GOING TO DO WHATEVER IT TAKES

TO SHOW THEM I CAN DO THIS.

**

**

**

TODAY, I'M HEADED TO SEE A THERAPIST.

DR. NOW THINKS I HAVE ISSUES

THAT ARE HOLDING ME BACK FROM WALKING.

**

I'VE NEVER REALLY DONE ANYTHING LIKE THIS.

**

SO I JUST DON'T KNOW WHAT TO EXPECT.

**

I'M JUST HOPING IT'S NOT GOING TO BE WEIRD OR UNCOMFORTABLE.

**

-GOOD MORNING, KARINA. -GOOD MORNING.

-NICE TO MEET YOU. -NICE TO MEET YOU.

-YOU READY TO COME ON BACK? -MM-HMM.

OKAY.

YOU CAN GO RIGHT OVER HERE.

SO, WELCOME.

I'M GONNA GET STARTED BY

JUST KIND OF ME GETTING TO KNOW YOU A LITTLE BIT BETTER.

-OKAY. -OKAY.

SO TELL ME ABOUT YOUR BACKGROUND WITH YOUR FAMILY.

UM, I WAS MORE CLOSER TO MY GRANDPARENTS

THAN TO MY PARENTS 'CAUSE MY PARENTS WERE ALWAYS WORKING.

AND MY SISTER WAS ALWAYS -- SHE WAS THE POPULAR ONE.

SHE WAS MORE WITH THE FRIENDS THAN WITH ME.

OKAY. I KNOW THAT YOU WERE DEALING WITH SOME ASTHMA.

TELL ME ABOUT THAT WHOLE PROCESS.

WHEN I WAS ALMOST LIKE AN INFANT,

I WAS IN AND OUT OF HOSPITALS.

-OKAY. -I DO REMEMBER THAT.

AND I DO REMEMBER MY MOM ALWAYS BEING THERE.

AND AS I GOT OLDER,

MY ASTHMA JUST KIND OF, LIKE, WENT AWAY OR...

OKAY. THAT OFTEN HAPPENS WITH KIDS.

HOW DID THAT CHANGE IN TERMS OF THE ATTENTION FROM YOUR MOM?

PROBABLY, I MEAN, 'CAUSE SHE WAS ALWAYS MORE WORKING NOW.

OKAY.

SO WHAT I SEE A LOT WITH KIDS AND WITH ADULTS

IS THAT WHEN THEY'VE GONE THROUGH A PROCESS

OF HAVING A CHRONIC MEDICAL CONDITION,

THEY DO GET A LOT OF ATTENTION FROM PARENTS.

BUT THEN AS THEY START TO FEEL BETTER,

THE RELATIONSHIP CHANGES.

AND SOMETIMES, PEOPLE START FINDING OTHER WAYS

SO THAT THEY CAN REGAIN THAT RELATIONSHIP.

HMM, I DIDN'T, WHEN I WAS LITTLE,

I DIDN'T THINK I WASN'T GETTING THE ATTENTION

OR ANYTHING LIKE THAT. OKAY.

IT CAN HAPPEN SOMETIMES IN A VERY DEEPLY UNCONSCIOUS WAY,

SO IT'S SOMETHING TO KIND OF PAY ATTENTION TO.

SO, HOW'S YOUR RELATIONSHIP WITH YOUR SISTER NOW?

SHE HAS MENTIONED THAT SHE FEELS ANGRY SOMETIMES

THAT MY PARENTS CAN'T BE THERE FOR HER

'CAUSE THEIR DEALING WITH ME. HMM.

SO DO YOU FEEL LIKE RECONNECTING WITH YOUR SISTER

IN A POSITIVE WAY IS SOMETHING THAT WOULD BE HELPFUL FOR YOU?

I WISH WE COULD BE CLOSER LIKE WE WERE

WHEN WE WERE YOUNGER. MM-HMM.

BUT I KNOW IT'S NOT GOING TO HAPPEN RIGHT NOW.

SO MAYBE A POSSIBLE GOAL IS TO FIND A POSITIVE WAY

TO RECONNECT WITH YOUR SISTER?

-MM-HMM. -OKAY.

ANY FINAL QUESTIONS OR THOUGHTS?

-NO. -NO, OKAY.

IT WAS A JOY MEETING YOU.

I WISH YOU WELL ON YOUR JOURNEY.

-NICE TO MEET YOU. -NICE TO MEET YOU.

ALL RIGHT, AFTER YOU.

**

Karina: I WAS NERVOUS COMING IN HERE TODAY, BUT I'M GLAD I DID.

I SPENT SO MUCH TIME ISOLATING MYSELF FROM THE WORLD.

SO IT WAS NICE TO HAVE SOMEONE TO TALK TO.

-BYE. -BYE.

-THANKS FOR COMING OUT AGAIN. -THANK YOU.

I DO THINK ABOUT MY PARENTS AND MY SISTER, A LOT.

AND HOW MUCH MY WEIGHT HAS PUT A STRAIN ON OUR RELATIONSHIPS.

I DON'T WANT TO BE A BURDEN.

AND I WANT THEM TO KNOW HOW MUCH I APPRECIATE

WHAT THEY'VE DONE FOR ME.

I JUST HOPE I CAN TAKE WHAT WE'VE TALKED ABOUT TODAY

AND DO SOMETHING WITH IT.

[ PANTING ]

**

**

**

-HI, MIJA. -HEY.

WHAT ARE YOU DOING?

JUST WRITING SOME STUFF DOWN.

SINCE SEEING THE THERAPIST,

I'VE DECIDED THAT I NEED TO START DOING MORE.

SO I'VE STARTED A JOURNAL, AND IT FEELS LIKE IT'S HELPING.

BUT I REALIZED THIS HAS TO JUST TO BE A STARTING POINT.

SO I KNOW I'M GONNA HAVE TO START TALKING ABOUT

SOME OF IT TO MY FAMILY.

**

IT'S BEEN A LONG PATH THIS YEAR.

YOU KNOW I'M VERY GRATEFUL THAT YOU GUYS HAVE BEEN THERE

WITH ME THROUGH THE WHOLE PROCESS OF EVERYTHING

SINCE MY ACCIDENT AND THEN THROUGH THE SURGERY

AND THROUGH EVERYTHING.

HOPEFULLY, I WASN'T MUCH OF...

...HAVING ME AROUND THAT MUCH, RIGHT NOW.

WHAT CAN WE TELL YOU MIJA, I MEAN, YOU'RE OUR DAUGHTER.

YEAH.

BUT I KNOW I TOOK A LOT OF YOUR TIME

THAT YOU COULD BE DOING SOMETHING ELSE.

AND I JUST WANT TO SAY THANK YOU.

YOU'RE QUITE WELCOME.

I FEEL GOOD RIGHT NOW.

I THINK TALKING WITH MY PARENTS WENT WELL,

AND I FEEL LIKE THEY'RE PROUD OF ME.

BUT I STILL NEED TO START TALKING TO MY SISTER

ABOUT SOME OF THE ISSUES WE'VE HAD.

AND THAT'S MAKING ME NERVOUS.

[ KETTLE WHISTLING ]

I SEE DR. NOW AGAIN SOON.

SO I'M TRYING HARD TO DO EVERYTHING I CAN

TO CHANGE THINGS AND DEAL WITH WHAT I NEED

TO STAY ON TRACK.

AND I'M REALLY HOPING THAT I HIT MY WEIGHT LOSS GOAL.

BECAUSE I NEED HIS HELP, AND I DON'T WANT TO LOSE IT.

**

**

**

I'M HEADED TO MY NEXT APPOINTMENT WITH DR. NOW.

AND I'M REALLY NERVOUS.

LAST TIME DIDN'T GO SO WELL.

SO I'M HOPING TODAY GOES BETTER

AND THAT I HIT DR. NOW'S GOAL.

**

BECAUSE I KNOW IF I DIDN'T, IT'S NOT GOING TO BE GOOD.

I'VE STARTED STANDING AND TRYING TO GET UP

A LITTLE BIT AT A TIME.

I JUST HOPE IT'S ENOUGH FOR DR. NOW.

I KNOW THAT EVERYTHING IS DEPENDING

ON THIS WEIGH IN TODAY.

**

**

KARINA GARCIA?

AND IF I'M NOT LOSING LIKE I NEED OR IF I'M GAINING,

THEN I'M LIKELY GOING TO LOSE

ALL OF DR. NOW'S HELP.

**

SO I'M HOPING THAT THE NUMBER IS AT LEAST CLOSE

BECAUSE I DON'T WANT TO GIVE UP.

I WANT MY LIFE BACK, AND THIS IS MY LAST CHANCE TO GET IT.

**

**

Karina: I'M AT DR. NOW'S FOR MY WEIGHT CHECK.

HE TOLD ME I HAD TO LOSE 60 POUNDS BY THIS VISIT

IF I WANTED TO STAY ON TRACK.

SO THAT MEANS I NEED TO AT LEAST BE DOWN TO 427.

427.

-HMM, 427. -[ LAUGHING ]

-WOW. -LOOK AT YOU.

[ PANTING ]

I WAS SURPRISED THAT I LOST THAT MUCH WEIGHT.

I'M LIKE, STILL IN SHOCK.

I KNOW MY PARENTS ARE PROUD THAT I'M STICKING TO THE DIET

AND I'M CONTINUALLY LOSING WEIGHT

BECAUSE THEY WANT TO SEE ME BE A MORE PRODUCTIVE PERSON

AND THEY'RE SEEING THAT. AND I'M HAPPY.

[ KNOCKS ON DOOR ]

-HELLO. -HELLO.

-HELLO, DOCTOR. -HOW Y'ALL DOING?

FINE AND YOU?

ALL RIGHT.

SO YOU'RE DONE TO 427 POUNDS.

YOU TOOK ME VERY LITERALLY AND LOST EXACTLY 60 POUNDS, HUH?

YES, SIR.

WELL, GREAT JOB, YOU'RE BACK ON TRACK.

AND OVERALL, YOU'VE LOST 206 POUNDS

AND PHYSICAL THERAPY SAYS YOU STARTED TO JUST BARELY

WALK AGAIN.

NOT FULLY, BUT YOU STARTED FINE.

SO THAT'S EXCELLENT.

I'VE BEEN FOLLOWING YOUR ORDERS.

HOW DO YOU FEEL NOW?

LIGHTER AND HAPPY THAT I'M DOWN THAT MUCH WEIGHT.

SO NEXT TIME I SEE YOU, I WANT YOU TO WALK IN

AND NOT TO BE IN WHEELCHAIR ANYMORE, OKAY?

ALL RIGHT.

SHE DOING BETTER AT HOME?

YEAH, SHE DOES. VERY HAPPY THAT SHE'S LOSING THE WEIGHT.

THIS IS LIKE A MIRACLE. THANK YOU VERY MUCH, DOCTOR.

YOU'RE MORE THAN WELCOME.

I'M VERY HAPPY TO SEE KARINA IS BACK ON TRACK.

SHE HAD A SETBACK, BUT SHE PUSHED THROUGH,

AND SHE'S SHOWING US ALL SHE CAN DO IS JUST LIKE SHE SAID.

HER FAMILY SEEMS TO BE COMING AROUND.

AND IF THEY CAN START TO BE THAT EMOTIONAL SUPPORT FOR HER,

THAT'S GOING TO HELP EVEN MORE.

SO I'M VERY ENCOURAGED BY HER TODAY.

SO IF YOU STICK WITH IT,

WITH SOME SKIN REMOVAL SURGERIES,

YOU CAN BE AT YOUR TARGET WEIGHT OF 170

WITHIN THE NEXT YEAR.

SO DON'T LOSE FOCUS, OKAY?

OKAY.

I'M PROUD OF YOUR EFFORT.

AND STICK WITH IT. NICE TO SEE YOU ALL AGAIN.

BYE.

**

OKAY, LET'S...

LET'S GET UP AND LET'S GO.

**

I'M SO IN SHOCK THAT ALL THIS WEIGHT I HAVE LOST.

I'M JUST PROUD OF MYSELF THAT I'M SHOWING THE DOCTOR

THAT I WAS GONNA STICK TO THE DIET

AND I WAS GONNA FOLLOW WHAT HE SAID.

AND I DID IT. SO I'M HAPPY THAT HE'S PROUD.

THE DOCTOR SAID MY GOAL WEIGHT'S 170.

AND IT'S STILL HARD FOR ME TO BELIEVE.

I KNOW I'M HEADING THAT WAY,

AND I'M THRILLED WITH EVERYTHING THAT'S HAPPENING.

IT'S BEEN A LONG ROAD AND A SACRIFICE.

BUT IT'S JUST A SACRIFICE THAT I HAVE TO DO

IF I WANT TO HAVE THE LIFE I WANT TO HAVE.

**

**

I'M PROUD OF MYSELF FOR HOW FAR I'M COMING.

AND I'M PUSHING MYSELF TO GO EVEN FURTHER.

I KNOW THAT MEANS I STILL HAVE TO KEEP DEALING

WITH THE EMOTIONAL STUFF IN ME, TOO.

SO TODAY, I'M PLANNING ON TRYING TO TALK TO MY SISTER.

BECAUSE MY SISTER HAS ALWAYS BEEN THE ONE

WHO'S THE HARDEST ON ME.

AND I KNOW IT'S BECAUSE OF ALL THE FRUSTRATION

AND BITTERNESS SHE HAS FROM HOW MUCH THE FAMILY

HAS HAD TO TAKE CARE OF ME AND ALL THE ATTENTION

I TOOK WITH THAT.

-HEY. -HEY.

-WHAT ARE YOU DOING? -LAUNDRY.

OH, WHERE'S MOMMY?

IN HER ROOM WITH PAPI. THEY ARE BOTH UNDER THE WEATHER.

OH, THEY ARE?

YEAH.

LET'S GO TO THE OTHER ROOM.

YOU GOT IT?

YEAH.

AND THERE'S A PART OF ME THAT UNDERSTANDS HER FRUSTRATION

AND CONCERN WITH ME.

BUT THERE'S ALSO A PART OF ME THAT GETS SO HURT BY THAT.

AND IT'S HARD NOT TO BE NERVOUS RIGHT NOW.

**

SO HOW HAVE YOU BEEN? I HAVEN'T REALLY TALKED TO YOU

SINCE THE WHOLE SURGERY THING.

I'M DOING MUCH BETTER.

I MEAN I'M ABLE TO MOVE MORE THAN USUAL.

WELL, THAT'S GOOD.

WHEN ARE YOU GONNA PHYSICALLY BE ABLE

TO START WALKING WITHOUT A WHEELCHAIR?

HOPEFULLY IN A MONTH OR TWO.

IS THAT LIKE YOUR GOAL, OR IS THAT WHAT THEY TOLD YOU?

THAT'S MY GOAL.

ONE THING IS SETTING GOALS, AND ANOTHER THING IS DOING.

AND WE ALL SET GOALS.

BUT WE DON'T ALWAYS ACCOMPLISH EVERY GOAL.

TRUE. BUT I'M GONNA TRY.

AND I HOPE WE CAN GET TO A BETTER PLACE

AS I SHOW YOU THAT I'M CHANGING.

HOPEFULLY, THAT WILL MAKE OUR RELATIONSHIP BETTER BETWEEN US.

YEAH. MAYBE WE CAN HANG OUT AND RECONNECT

AND DO WHATEVER IT IS THAT WE NEED TO DO

TO BETTER THE RELATIONSHIP.

I'M VERY HAPPY THAT YOU'RE DOING SOMETHING FOR YOURSELF.

I'M PROUD.

I FEEL LIKE THE CONVERSATION WENT WELL.

IT WASN'T HOW I PICTURED IT, BUT I THINK IT WAS PROGRESS.

I HAVE TO GO PICK UP THE KIDS.

OKAY.

ALL RIGHT, WELL, IT WAS NICE SEEING YOU.

ALL RIGHT.

-BYE. -BYE.

HOPEFULLY, I'LL PROVE TO HER THAT I'M CHANGING

AND THAT THIS TIME, I'M GOING TO DO IT.

**

**

**

I'M EXCITED BECAUSE I FINALLY MADE IT BELOW 400 POUNDS

AND, SO, TODAY, I'M CELEBRATING

BY MOVING FROM THE LIVING ROOM TO A BEDROOM.

I HAVEN'T BEEN IN A BEDROOM IN YEARS.

AND THAT'S BEEN PART OF THE BURDEN TO MY FAMILY.

SO I'M TAKING THE STEP TO CHANGE THAT TODAY.

AND I'M ABLE TO GET AROUND IN A WALKER NOW.

SO I FINALLY FEEL LIKE I'M NO LONGER STUCK IN THIS HOUSE.

I'M NOT OUT IN THE WORLD YET.

BUT WITH ALL MY PROGRESS, I FINALLY BELIEVE

THAT I'M GOING TO DO THIS AND THAT I'M GETTING BACK OUT THERE.

I MISSED OUT ON TOO MUCH.

AND I FINALLY CHANGED THAT.

I'M EXCITED ABOUT WHAT TOMORROW HOLDS

BECAUSE FOR THE FIRST TIME IN A LONG WHILE,

I ACTUALLY HAVE A FUTURE.

SO I HAVE HOPE, AND THAT'S AN AMAZING FEELING.