Original subtitles

Woman #1: I KNOW I'M GETTING TO A BREAKING POINT,

AND I'M JUST WAITING TO DIE.

[ SIGHS ]

♪♪

AH, GOD. AH.

Woman #2: MY LIFE IS WASTING AWAY, AND I HATE IT.

Woman #3: I TRY TO CHANGE, BUT SOMETHING ALWAYS KNOCKS ME DOWN.

♪♪

♪♪

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

AH! OH!

OW! [BLEEP]

THIS IS NO LIFE FOR ANYONE.

Woman #4: OH, JUST PRAY FOR ME.

[ CRYING ]

OW, MY LEG!

-SIT DOWN RIGHT THERE. -WAIT.

YOU'RE MAKING ME MAD.

ALL RIGHT. THIS IS COMPLETELY UNACCEPTABLE.

[ DOOR SLAMS ]

Sarah: I'M ABOUT TO FIND OUT

IF I'VE LOST MY WEIGHT-LOSS SURGERY.

DIDN'T I TELL YOU IF YOU GAINED WEIGHT,

YOUR SURGERY WOULD BE OFF?

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

CAPTIONS PAID FOR BY DISCOVERY COMMUNICATIONS

♪♪

EXAMINING YOUR LIFE TO SEE THE WRONG CHOICES

THAT HAVE SLOWLY LED YOU TO THE LIFE YOU NOW HAVE

CAN FEEL LIKE THE HARDEST THING YOU'LL EVER DO,

BUT IT'S EVEN HARDER TO START

MAKING THE CHOICES TO CHANGE THAT.

♪♪

♪♪

♪♪

♪♪

♪♪

THE LIFE THAT I'M LIVING RIGHT NOW IS MISERABLE,

AND JUST WALKING HURTS BECAUSE OF ALL THE STRAIN ON MY BODY.

♪♪

MY KNEES HURT. MY BACK HURTS.

MY ANKLES STING.

[ SIGHS ] EVEN MY SHOULDERS HURT

FROM ALL THE WEIGHT I'M CARRYING,

AND IT'S GOTTEN TO THE POINT

WHERE IT'S GETTING UNBEARABLE TO GO UP THE STAIRS.

LIKE, I HAVE TO LITERALLY CRAWL UP THE STAIRS, LIKE AN ANIMAL.

♪♪

SO I DON'T DO MUCH ANYMORE

EXCEPT TRY TO GET UP TO STAY CLEAN,

WHICH IS THE ONLY REASON I GO UPSTAIRS.

♪♪

BUT THE MOST DIFFICULT PART OF MY MORNING ROUTINE

WOULD BE SHOWERING

BECAUSE MY MOBILITY IS CHANGING FOR THE WORSE,

AND I CAN'T STAND FOR LONG PERIODS OF TIME.

MY MOM HAS TO HELP ME WITH EVERYTHING.

-YOU GOT IT? -YEAH. I GOT IT.

ABOUT A YEAR AGO, IT GOT TO THE POINT

I COULDN'T SHOWER BY MYSELF.

I HAD TO HAVE SOMEBODY THERE DOING IT FOR ME.

AND IT'S EMBARRASSING TO BE A GROWN ADULT WHO STILL NEEDS

TO BE BATHED BY THEIR MOM,

BUT WHAT'S EVEN WORSE IS,

I KNOW SOON, I WON'T EVEN BE ABLE TO MAKE IT UP THE STAIRS,

AND AT THAT POINT, SHE'S GOING TO HAVE TO BATHE ME

ON A TARP IN THE LAWN,

AND I DREAD THAT, BUT I KNOW THAT I'M MONTHS AWAY

OF IT GETTING THAT BAD BECAUSE IT'S JUST TOO DIFFICULT

AT THIS POINT.

I AM VERY TIRED OF LIVING LIKE THIS,

AND I FEEL BAD BECAUSE MY MOM IS DOING EVERYTHING FOR ME,

AND AT THIS POINT, I'M JUST TRYING TO SURVIVE

BECAUSE TO CARRY ALL THIS WEIGHT

IS PHYSICALLY

AND EMOTIONALLY EXHAUSTING.

AND I'M IN SO MUCH PAIN AFTER MY SHOWER,

BUT I'M SCARED THAT AT SOME POINT,

I'M NOT GOING TO BE ABLE TO MAKE IT.

I JUST WANT TO GET BACK TO MY CHAIR AND EAT.

AFTER MY MOM HELPS ME IN THE SHOWER,

I WANT HER TO GO START MAKING ME BREAKFAST

BECAUSE I CAN'T WAIT TO EAT.

IF I GET DRESSED AS FAST AS I CAN,

BUT THEN I HAVE TO TRY AND MAKE IT BACK DOWNSTAIRS,

AND IT'S THE SCARIEST PART OF MY DAY BECAUSE I'M TERRIFIED

I'M GOING TO FALL.

♪♪

SO I'M JUST WAITING FOR THE DAY THE WORST HAPPENS.

IT'S GOING TO BE REALLY BAD AT THAT POINT.

SO I CAREFULLY TRY AND MAKE IT DOWN THE STAIRS

BECAUSE ALL I WANT TO DO IS GET IN MY CHAIR AND EAT.

♪♪

FOOD IS WHAT I'M LIVING FOR,

AND I LITERALLY CAN'T WAIT TO HAVE MY MOM

BRING ME SOMETHING TO EAT.

I STILL MAKE SARAH'S FOOD. I MAKE HER PLATE FOR HER.

I KNOW I PUT TOO MUCH FOOD ON THE PLATE,

BUT IF I DON'T, SHE'LL BADGER ME UNTIL I PUT MORE ON THERE,

AND I'M NOT EVEN SURE WHY I DO IT.

I THINK IT'S BECAUSE I FEEL GUILTY.

FOOD GIVES ME A FEELING THAT I CAN'T EXPLAIN.

FROM THE MOMENT I WAKE UP, THAT'S ALL I'M WAITING FOR,

AND FOR A BRIEF MOMENT, ALL THE PAIN

AND ALL THE MISERY OF MY LIFE IS GONE,

AND IT'S JOY, EXCITEMENT, HAPPINESS ALL WRAPPED UP IN ONE.

AND AS MUCH AS I KNOW THIS IS WHAT'S KILLING ME,

I LITERALLY CAN'T EAT ENOUGH.

Barbara: SO DIFFICULT TO SEE YOUR CHILD GO THROUGH THIS.

IT TEARS YOUR HEART OUT.

♪♪

I HAD A HARD TIME GETTING ALL THAT FOOD ON THAT PLATE.

-REALLY? -YEAH.

WELL, IT WORKED.

Sarah: FOOD IS EVERYTHING FOR ME.

IT'S MY PURPOSE FOR LIVING,

AND I THINK ABOUT IT UNTIL I GO TO SLEEP.

AND THE SECOND I WAKE UP, IT'S ALL I WANT,

AND FOR AS FAR BACK AS I CAN EVEN REMEMBER,

THAT'S HOW IT'S ALWAYS BEEN.

♪♪

♪♪

MY MOM TELLS ME I WOULD OVEREAT FROM MY EARLIEST AGE,

AND I THINK IT STARTED WHEN I WAS AROUND 3.

I HAD THREE SIBLINGS --

AN OLDER BROTHER, AN OLDER SISTER,

THEN ONE YOUNGER SISTER,

AND I'M THE ONLY BIG ONE.

AND I THINK EATING WAS A WAY FOR ME TO COPE WITH MY WORLD

BECAUSE MY DAD HAD A DRINKING PROBLEM

THAT LED TO A LOT OF FIGHTS BETWEEN HIM AND MY MOM,

AND, SO, SHE DIVORCED HIM.

IT WAS A STRESSFUL TIME IN MY FAMILY

BECAUSE MY MOM WAS TRYING TO RAISE FOUR KIDS BEING SINGLE,

AND SHE WAS NOT FINANCIALLY STABLE,

SO IT WAS A HARD TIME.

AND WE COULDN'T AFFORD A LOT,

SO MY MOM HAD A LIMIT TO WHAT I COULD EAT,

AND SHE WOULD NEVER LET ME HAVE MORE THAN A SECOND PLATE,

UNLESS I WAS TO GET UP AND SNEAK IT REAL QUICK

WHILE SHE WAS IN THE LIVING ROOM,

SO THAT'S WHAT I STARTED DOING,

AND I WOULD JUST EAT IT ALL BECAUSE I COULDN'T

GET CAUGHT WITH IT, AND THE MORE I SNUCK FOOD,

THE BETTER I GOT AT IT.

AND I HIT 200 POUNDS BY THE TIME I WAS 8.

AND AROUND THAT TIME, MY MOM STARTED DATING SOMEONE

WHO WOULD BECOME MY FIRST STEPDAD,

AND WHEN THAT WAS GOING ON, SHE WAS MORE DISTRACTED,

SO I COULD JUST EAT WHENEVER I WANTED,

BUT WITH HOW BIG I WAS GETTING, SHE STARTED TO CATCH ON.

Barbara: I WOULD FIND WRAPPERS AND DISHES

THAT SHE LEFT BEHIND,

AND THAT'S WHEN I REALIZED SHE WAS SNEAKING AT NIGHT.

Sarah: BUT AT THAT POINT, MY MOM DIDN'T TRY TO STOP ME

BECAUSE SHE GOT MARRIED,

AND WE JUST DIDN'T SPEND ANY TIME TOGETHER.

I FELT AT THAT TIME THAT I LOST MY MOM,

AND I WANTED HER ALL TO MYSELF,

AND I FELT LIKE

HE CAME IN AND TOOK HER AWAY.

Barbara: SARAH DID NOT GET ALONG WITH HER STEPDAD AT ALL,

AND THEN I THINK SHE STARTED EATING MORE

WHEN HE CAME INTO THE PICTURE.

Sarah: BUT TO MAKE MATTERS WORSE, WHEN HE MOVED IN WITH US,

HE STARTED TO BECOME EMOTIONALLY ABUSIVE.

HE DID WEIRD, BIZARRE THINGS,

AND I FELT LIKE I WAS GOING CRAZY,

TRYING TO TELL PEOPLE,

BUT DIDN'T BELIEVE ME.

LIKE, ONE TIME HIM AND MY MOM GOT INTO AN ARGUMENT,

AND MY MOM LEFT,

AND HE CAME AND SAT DOWN

NEXT TO ME ON THE COUCH

AND PULLED OUT A POCKET KNIFE

AND SLIT FROM HIS ANKLE TO HIS KNEE

LIKE NOTHING WAS WRONG WITH THAT.

SO I TOOK ALL THAT LONELINESS AND PAIN, AND I JUST ATE,

AND I REMEMBER WHEN I WAS 11, I GOT ON A SCALE,

AND IT SAID THAT I WEIGHED 345 POUNDS,

AND I COULDN'T BELIEVE IT.

IT WAS UNREAL.

I WASN'T EVEN A TEENAGER, AND I WAS ALMOST 400 POUNDS,

AND THAT SCARED ME, BUT NOT ENOUGH TO STOP EATING.

BUT WHEN I WAS 12, I THOUGHT THINGS WERE GOING TO GET

A LITTLE BETTER BECAUSE MY MOM AND MY FIRST STEPDAD SPLIT,

AND WHEN MY MOM AND MY STEPDAD BROKE UP AND HE LEFT,

I FELT REALLY RELIEVED.

BUT THAT RELIEF DIDN'T LAST LONG

BECAUSE MY MOM GOT REMARRIED TO MY OTHER STEPDAD

WITHIN MONTHS OF MY FIRST STEPDAD LEAVING.

I FELT ANGRY BECAUSE

I DIDN'T WANT TO GO THROUGH

WHAT I WENT THROUGH WITH THE FIRST STEPDAD.

IT WAS A FEAR, AND I ALSO

HAD GOTTEN MY MOM BACK FOR A LITTLE WHILE,

AND NOW...

SHE'S GOT ANOTHER HUSBAND.

BUT IT WAS EVEN WORSE WITH MY NEW STEPDAD

BECAUSE MY MOM SEEMED TO FIND GUYS THAT DIDN'T WORK

AND WERE EMOTIONALLY ABUSIVE.

HER NEW HUSBAND WAS WORSE THAN THE LAST ONE.

I WAS SO DEPRESSED AT THAT POINT,

I JUST DIDN'T STOP EATING,

AND I GAINED ANOTHER 100 POUNDS IN 3 MONTHS.

I JUST FELT SO ALONE,

AND FOOD WAS THE ONLY THING THAT MADE ME FEEL BETTER.

I TRIED TALKING TO MY MOM, AND SHE NEVER REALLY LISTENED,

BUT MY MOM KNEW HOW THE STEPDADS TREATED ME, TO AN EXTENT.

A LOT OF IT WAS MY SAY,

AND I DON'T THINK SHE WANTED TO BELIEVE ME,

BUT SHE COULDN'T IGNORE IT FOREVER

BECAUSE IT ALL EVENTUALLY WOULD GET SO BAD,

IT WOULD JUST BLOW UP,

AND THAT HAPPENED WHEN I WAS 16.

I WAS GETTING READY TO GO TO SCHOOL,

BUT I WASN'T GETTING DRESSED FAST ENOUGH,

SO MY STEPDAD TOLD ME TO JUST WEAR MY NIGHTGOWN,

AND I SAID, "NO."

AND ALL OF A SUDDEN, HE HELD ME DOWN ON THE BED,

AND HE WAS PUSHING ME AND SHAKING ME,

AND HE WAS JUST SO ANGRY,

AND MY BROTHER KEEGAN ENDED UP COMING UPSTAIRS

AND, LIKE, PUSHING HIM OFF OF ME,

AND THE COPS CAME AND EVERYTHING,

AND HE HAD RIPPED MY SHIRT OFF, LIKE, HALFWAY OFF,

AND I WAS CALLING FOR MY MOM, AND SHE WOULDN'T COME.

AND I WAS SO SCARED, BUT SHE DID NOTHING,

AND THAT'S WHAT HURT THE MOST, THAT I WASN'T IMPORTANT ENOUGH,

OR MY MOM DIDN'T CARE ENOUGH TO EVEN TRY AND PROTECT ME.

♪♪

SO I WANTED TO LEAVE,

AND I DROPPED OUT OF HIGH SCHOOL MY SENIOR YEAR.

I MOVED OUT OF THE HOUSE AND AWAY FROM MY STEPDAD,

BUT AFTER THAT, MY MOM AND MY STEPDAD SPLIT UP.

I GOT A JOB WORKING AT A FAST-FOOD RESTAURANT,

BUT THAT DIDN'T LAST LONG

BECAUSE I WAS 18 AND CLOSE TO 450 POUNDS,

SO I JUST PHYSICALLY COULDN'T DO IT.

I WAS STILL EATING AND GAINING,

SO IT DIDN'T TAKE ME LONG TO REACH 500 POUNDS.

WHEN I HIT THAT WEIGHT,

THAT'S WHEN I STARTED HAVING TROUBLE TAKING CARE OF MYSELF,

AND I HAD TO MOVE BACK IN WITH MY MOM AND MY SISTER.

BUT RIGHT AFTER I MOVED BACK IN,

MY MOTHER CONFESSED TO ME SOMETHING SHE'S BEEN

DEALING WITH SINCE WE WERE CHILDREN.

SHE SAID SHE'S BEEN BATTLING DRUG ADDICTION FOR 16 YEARS.

WHEN WE WERE YOUNGER, IT WAS VICODIN,

AND THEN IT GREW FROM THERE TO WHERE NOW,

SHE WAS STRUGGLING WITH HEROIN,

AND THAT PUT ME...

[ Voice breaking ] IN A STATE OF SHOCK AT FIRST.

BUT THE REASON MY MOM WAS TELLING ME THIS WAS THAT

SHE SAID SHE WAS DONE AND SHE WAS LEAVING IN 2 HOURS

FOR A REHAB FACILITY.

SO, MY MOM WAS AT THE CLINIC FOR SIX MONTHS,

AND THEN SHE CAME BACK CLEAN,

AND SHE'S STAYED THAT WAY FOR ALMOST 2 YEARS NOW.

BUT I KEPT GAINING.

AND WHEN I WAS 23,

MY WEIGHT SKYROCKETED INTO THE 600s.

AND NOW MY MOM HAS TO DO ALMOST EVERYTHING FOR ME,

AND I'M NOT SURE WHAT MY WEIGHT IS NOW.

I JUST KNOW I'M AT A POINT WHERE I CAN'T GO ON LIKE THIS.

♪♪

-ARE YOU HUNGRY? -STARVING.

THERE IS NEVER A MOMENT I DON'T WANT TO EAT.

I SIT HERE UNTIL I GET IT,

AND THAT'S PRETTY MUCH WHAT MY MOM DOES FOR ME ALL DAY.

AND IF MY FAMILY OR ANYONE TRIES TO GET ME TO STOP,

I GET VERY UPSET.

THEN IT MAKES IT WORSE, AND I WANT TO EAT EVEN MORE.

♪♪

I JUST CRAVE EVERYTHING ALL DAY LONG.

♪♪

AND AS SOON AS ONE MEAL IS DONE,

I NEED A SNACK.

THEN IT'S TIME FOR ANOTHER MEAL.

SO MY EATING NEVER STOPS.

IT NEVER EVEN SLOWS DOWN.

SARAH HAS TO HAVE SNACK CAKES, COOKIES, ICE CREAM,

THINGS OF THAT NATURE, ALWAYS SOMETHING WITH SUGAR,

THINGS THAT ARE NOT GOOD FOR HER.

JUST -- IT SEEMS LIKE THE WORSE IT IS FOR HER,

THE MORE SHE LIKES IT.

♪♪

♪♪

Barbara: WANT ANYTHING ELSE?

Sarah: I NEED SOMETHING SALTY.

I DON'T CARE WHAT IT IS.

Sarah: I KNOW I'M GETTING TO A BREAKING POINT.

I CAN FEEL MY BODY GETTING WORSE,

AND TO A POINT WHERE SOON,

I'M NOT GOING TO BE ABLE TO GO ON,

AND I KNOW WHAT'S GOING TO HAPPEN.

I'M GOING TO GO TO SLEEP ONE NIGHT

AND I'M NOT GOING TO WAKE UP,

SO I HAVE TO FIND A WAY TO STOP THAT FROM HAPPENING.

BUT I'M SCARED I CAN'T, AND THAT NO MATTER WHAT,

I'M STILL GOING TO END UP DYING IN THIS CHAIR

BECAUSE I ATE MYSELF TO DEATH.

♪♪

♪♪

♪♪

♪♪

♪♪

I SET AN APPOINTMENT TO SEE DR. NOWZARADAN TOMORROW,

AND I'M PACKING FOR THE TRIP RIGHT NOW,

BUT IT'S A LITTLE DIFFICULT BECAUSE I HAVE TO HAVE MY MOM

BRING ME EVERYTHING TO CHOOSE WHAT I WANT TO TAKE.

DO YOU HAVE EVERYTHING?

[ SIGHS ] YEAH, I THINK. WILL YOU HELP ME CLOSE IT?

Barbara: I'M CONCERNED ABOUT SARAH GOING TO HOUSTON,

BUT SHE NEEDS TO CHANGE HER LIFE COMPLETELY,

SO I'M REALLY HOPING THAT THIS WORKS FOR HER

BECAUSE I DON'T THINK SHE'LL BE ABLE TO LOSE THE WEIGHT

ON HER OWN, SO WE'RE ALL ANXIOUS TO GET THIS GOING.

Barbara: IS THAT EVERYTHING?

ALL RIGHT. I'M PACKED.

ALL RIGHT. WELL, HOW DO YOU FEEL ABOUT THE TRIP?

EXCITED.

ARE YOU? MM-HMM.

I'M EXCITED FOR YOU.

I'M NERVOUS TO GET ON THE PLANE, THOUGH, BUT...

YOU'LL BE FINE. THERE'S NOTHING TO IT.

YEAH.

I HAVEN'T GONE ON A TRIP IN I DON'T KNOW HOW MANY YEARS,

AND I HAVE NEVER BEEN ON AN AIRPLANE BEFORE.

I'M JUST NERVOUS ABOUT HOW MY BODY IS GOING TO HANDLE IT,

AND SO I'M JUST REALLY HOPING IT ALL GOES WELL,

AND THAT IT'S WORTH GOING THROUGH ALL THIS.

-HEY. -HEY.

-HEY. -BIG DAY?

YEAH.

BUT THANKFULLY, I DON'T HAVE TO GO BY MYSELF

BECAUSE MY OLDER SISTER HEATHER IS FLYING DOWN TO HOUSTON

WITH ME TO HELP ME GET THERE,

AND I KNOW I WOULDN'T BE ABLE TO MAKE THIS TRIP ON MY OWN.

I'D PROBABLY JUST INSTANTLY HAVE A PANIC ATTACK

BEING IN PUBLIC ALONE,

SO I'M THANKFUL SHE'LL DO THIS FOR ME.

WE'RE BOTH GOING TO BE GOING DOWN THERE TOGETHER,

BUT IT IS TEMPORARILY PUTTING MY LIFE ON HOLD,

BUT IT'S NECESSARY BECAUSE IF SARAH DOESN'T DO THIS,

THIS MIGHT BE HER LAST CHANCE,

AND SHE'S NOT GOING TO HAVE A REAL LIFE

IF SHE DOESN'T LOSE WEIGHT,

SO IT'S SOMETHING I'M WILLING TO DO.

♪♪

Sarah: I KNOW THIS IS A BIG SACRIFICE FOR HER,

TAKING TIME AWAY FROM HER LIFE TO DO THIS FOR ME,

BUT WHAT'S EVEN BIGGER IS,

THAT I TOLD HER IF DR. NOW ACCEPTS ME INTO HIS PROGRAM,

AND I GET SURGERY,

HE NEEDS YOU TO STAY IN HOUSTON FOR A YEAR AFTER THE OPERATION

BECAUSE HE SAYS THE FOLLOW-UP

IS MORE IMPORTANT THAN THE ACTUAL SURGERY,

AND YOU HAVE TO HAVE SOME SUPPORT WITH YOU.

SO IF HE APPROVES ME FOR SURGERY,

THEN MY SISTER HAS AGREED TO MOVE DOWN TO HOUSTON WITH ME,

AND THAT'S HUGE.

♪♪

♪♪

Barbara: I'M WORRIED ABOUT HOW SARAH IS GOING TO DO AT THE AIRPORT.

SHE'S NEVER EXPERIENCED ANYTHING LIKE THIS BEFORE,

BUT I'M PROUD OF SARAH FOR TAKING THIS STEP.

FOR A LONG TIME, SHE WOULDN'T DO ANYTHING TO HELP HERSELF,

SO I HOPE THIS TRIP TO TEXAS GOES WELL.

WE'RE HERE.

♪♪

SO MUCH IS RIDING ON THIS,

AND MY WHOLE FAMILY IS SACRIFICING SO MUCH

TO HELP ME DO THIS.

-ALL RIGHT. -HEATHER, CAN YOU GET THAT?

LOVE YOU.

Sarah: SO I DON'T WANT TO LET EVERYONE DOWN.

AND I'M SO SCARED RIGHT NOW.

I DON'T LIKE TO GO OUT IN PUBLIC BECAUSE EVERYBODY STARES AT ME,

AND I FEEL LIKE THEY'RE ALL JUDGING ME CONSTANTLY,

SO I JUST NEED TO GET THROUGH ALL THIS AS FAST AS POSSIBLE.

DO YOU HAVE YOUR I.D.? HAVE IT HANDY.

♪♪

HI.

Heather: SARAH HAS NEVER FLOWN BEFORE.

THIS IS SOMETHING THAT'S GOING TO BE

A TOTALLY NEW EXPERIENCE FOR HER,

AND I KNOW THAT SHE HAS A LOT OF ANXIETY

ABOUT ACTUALLY GETTING ON THE PLANE,

FITTING THROUGH THE AISLE,

SO WE BOTH HAVE SOME ANXIETY ABOUT THAT,

BUT SHE'S GOING TO DO IT ANYWAY

BECAUSE GETTING TO HOUSTON

IS VERY, VERY IMPORTANT FOR HER HEALTH,

SO WE'RE GOING TO MAKE IT HAPPEN.

THAT MIGHT BE WHY THERE'S AN EXTRA SEAT BOOKED.

-YES. -OKAY.

WE'LL BE SITTING DOWN SOON ENOUGH.

ARE YOU STARTING TO BE, LIKE, IN PAIN, LIKE, FOR REAL,

OR JUST DISCOMFORT?

OKAY, GOOD.

I DON'T KNOW. SARAH?

I'M NOT SURE IF I CAN PUSH YOU.

Woman: WHEN YOU GET UP TO THE GATE,

I'LL HAVE THEM REPRINTED FOR YOU.

HERE'S YOUR I.D., SWEETHEART.

-YES. -OKAY.

YOU'RE DEFINITELY GOING TO BE ABLE TO PREBOARD.

THANK YOU.

Sarah: THIS IS HUMILIATING.

WE'LL BE UP THERE.

AND I DON'T KNOW HOW MUCH FURTHER I CAN MAKE IT.

WHEN I'VE PUSHED MY BODY TOO HARD IN THE PAST,

AND I HIT MY LIMIT,

IT'S NOT LIKE I CAN REST A BIT AND RECOVER.

I'M DONE FOR THE DAY.

USE THIS.

SO I'M SCARED RIGHT NOW THAT I'M NOT GOING TO MAKE IT.

ALL RIGHT.

[ SIGHS ]

OH.

OKAY. GET A LITTLE BREAK.

GO UP ONE. I NEED TO LEAN.

GO UP. DON'T KNOCK ME DOWN.

DON'T KNOCK ME DOWN.

[BLEEP]

ARE YOU OKAY?

I DON'T LIKE HEIGHTS.

[ SIGHS ] OKAY.

WHERE IS IT?

Heather: IT'S THAT WAY.

I'M NOT DOING WELL.

I'M TRYING NOT TO GET OVERWHELMED

AND MAKE IT THERE WITHOUT PASSING OUT.

-HI. -HELLO.

HI. DO YOU NEED OUR BOARDING PASSES?

AND WE'RE SUPPOSED TO BE PREBOARDING.

OKAY.

-OKAY. -OKAY.

PERFECT. OKAY. THANK YOU SO MUCH.

WHERE IS IT?

♪♪

THANK GOODNESS THEY'RE BOARDING.

RIGHT NOW, MY BIGGEST WORRY IS GETTING ON THE PLANE

BECAUSE I'M AFRAID THAT MAYBE I WON'T BE ABLE

TO FIT THROUGH THE AISLES AND THE SEATS WELL,

AND PEOPLE IS GOING TO BE STARING AT ME.

♪♪

♪♪

THANK GOODNESS.

♪♪

I'M MISERABLE, AND I JUST WANT TO GET TO HOUSTON,

BUT I JUST HAVE TO MAKE IT FOR THE NEXT 5 HOURS

AND THEN GET TO THE HOTEL AND TRY AND REST.

♪♪

♪♪

♪♪

WE MADE IT, AND I'M IN SO MUCH PAIN,

AND IT FEELS LIKE I HAVEN'T EATEN IN FOREVER.

THIS TRIP HAS JUST ABOUT PUSHED ME TO MY LIMIT,

BUT I'M NOT REGRETTING IT.

I JUST NEED SOMETHING TO CALM ME DOWN

AND HELP ME DEAL WITH THIS WHOLE DAY

BECAUSE MY NERVES ARE FRAZZLED.

♪♪

Heather: SARAH, YOU JUST YELL ACROSS WHAT YOU WANT TO ORDER.

-OKAY. -I DON'T WANT TO TALK.

CAN I GET A NUMBER ONE WITH A MEDIUM FRY?

-AN ADDITIONAL? -YEAH.

-AND THAT'S IT? -YES, PLEASE.

-$8.75, FIRST WINDOW. -OKAY. THANK YOU.

HE WAS VERY SHOCKED THAT YOU WANTED A SECOND FRY.

ALL RIGHT. THANK YOU VERY MUCH.

I KNOW JUNK FOOD ISN'T THE BEST OPTION.

♪♪

♪♪

IT'S GOING TO BE A LONG NIGHT,

SO I JUST WANT THIS STAY AND THIS TRIP TO BE OVER WITH.

ALL RIGHT.

BUT I'M HOPING TOMORROW, THIS ALL TURNS OUT TO BE WORTH IT.

AND I CAN'T SLEEP IN THE BED

BECAUSE MY WEIGHT WILL STOP ME FROM BREATHING IF I LAY DOWN.

WE'RE HERE.

I JUST HOPE I'M ABLE TO DO WHAT I NEED TO GET HELP,

AND THAT I DON'T DO SOMETHING TO MESS THIS ALL UP

AND LOSE THE ONLY CHANCE I HAVE TO SAVE MY LIFE.

♪♪

♪♪

♪♪

Sarah: WE'RE HEADED TO MY FIRST APPOINTMENT WITH DR. NOW,

AND MY EMOTIONS ARE ALL OVER THE PLACE

BECAUSE WHAT HAPPENS TODAY

IS GOING TO DETERMINE MY WHOLE LIFE,

AND IT'S SCARY NOT KNOWING WHAT TO EXPECT.

♪♪

AND I DON'T WANT TO KNOW WHERE MY WEIGHT IS AT NOW,

BUT I'M HERE TO TRY AND CHANGE MY LIFE.

SARAH NEELEY?

Sarah: I KNOW IT'S THE ONLY OPTION I HAVE LEFT,

SO WHATEVER IT TAKES TODAY, I HAVE TO DO IT.

♪♪

♪♪

♪♪

SEEING THAT NUMBER IS HUMILIATING,

ESPECIALLY WITH MY SISTER HERE.

I HAVE TO DO SOMETHING ABOUT MY WEIGHT,

AND I NEED TO DO IT, LIKE, NOW.

SO I JUST HOPE I'M ABOUT TO GET THE HELP I NEED.

[ KNOCKS ON DOOR ]

-HELLO. -HI.

HOW ARE Y'ALL DOING?

GOOD.

I'M DR. NOWZARADAN.

I'M SARAH.

NICE TO MEET YOU, SARAH. AND YOU ARE?

I'M SARAH'S SISTER.

SISTER? YEAH.

FOR A SISTER, YOU TWO LOOK QUITE DIFFERENT.

-YEAH. -ALL RIGHT.

SARAH, YOU ARE 642 POUNDS,

AND YOU'RE ONLY 25 YEARS OLD.YES.

AT THIS RATE, YOU'LL BE 800 POUNDS

BY THE TIME YOU ARE 30,

AND I SEE, ACCORDING TO YOUR CHART,

YOU ARE ON A BLOOD-PRESSURE MEDICATION

AND SOME INHALER AND SOME ANTI-INFLAMMATORIES.

YES.WELL, THESE ARE MEDICINE

WE USUALLY ONLY SEE PEOPLE IN 40s AND 50s, NOT 20s.

YEAH.

SO IF YOU HAVE A BODY OF SOMEONE TWICE YOUR AGE,

NOW IN YOUR 20s, YOU KNOW WHAT THAT MEANS.

YOU'RE NOT GOING TO BE ABLE TO SURVIVE MUCH INTO YOUR 30s,

AND IT SAYS IN YOUR CHART, YOU'RE ALSO HAVING TROUBLE

GETTING AROUND AND STAYING MOBILE,

SO NOW IT'S A TIME TO TURN THINGS AROUND,

NOT WHEN IT'S TOO LATE.

OKAY.

SO YOU NEED TO MAKE COMPLETE CHANGE OF LIFESTYLE,

STARTING WITH YOUR EATING HABITS.

OKAY.

TELL ME, HOW DO YOU THINK YOU GOT TO THIS POINT?

MY MEALS.

LIKE, I'LL, LIKE, COOK A CASSEROLE,

AND I'LL EAT, LIKE, A LOT OF THAT CASSEROLE,

LIKE, THROUGHOUT THE DAY.

BUT NO SNACKING?

LIKE, I DO SNACK, I GUESS, BUT I EAT A LOT OF FOOD,

AND I CAN'T STOP.

WELL, WHO BRINGS YOU ALL THIS FOOD?

MY MOM.

SO WHY ISN'T SHE HERE?

SHE COULDN'T MAKE THE TRIP.

I SEE. WELL, YOUR DYNAMIC WITH YOUR MOM

IS GOING TO BE PART OF THIS CHANGE, TOO,

AND THAT HAS TO START NOW.

-OKAY? -OKAY.

WHAT ABOUT YOUR ACTIVITY?

WELL, I WAS GOING FOR WALKS,

AND THEN I STARTED GETTING SICK WITH MY C.O.P.D.,

AND THAT KIND OF PUT A STALL ON THINGS,

BUT I WALK.

OKAY. WITH C.O.P.D., YOU HAVE INFLAMED LUNGS,

AND THAT'S GOING TO BE AN ISSUE THAT CAN PREVENT YOU

FROM HAVING SURGERY IF WE DON'T GET THEM TO A HEALTHIER PLACE.

SO WE NEED TO START WITH GETTING YOUR WEIGHT DOWN.

SO WE'LL GIVE YOU SOME EXERCISES,

AND THAT'S GOING TO BE A BIG FACTOR

TO GET YOU TO A HEALTHIER PLACE TO HAVE SURGERY,

AND THEN I WANT YOU TO LOSE

AT LEAST 30 POUNDS IN ONE MONTH, OKAY?

SO YOU'RE GOING TO NEED TO FOLLOW A 1,200-CALORIE-A-DAY,

HIGH-PROTEIN, LOW-CARB DIET, THAT I WILL GIVE YOU TODAY.

-OKAY. -OKAY?

AND YOU'RE GOING TO NEED TO FOLLOW IT, AND NO MORE SNACKING.

-GOT IT? -YES.

GREAT, AND IF YOU DO THAT AND YOUR LUNGS ARE OKAY,

THEN I'LL APPROVE YOU FOR WEIGHT-LOSS SURGERY,

BUT THEN YOU'RE GOING TO NEED TO MOVE TO HOUSTON

IF YOU WANT TO BE PART OF THIS PROGRAM,

AND YOU WILL NEED SOMEONE WITH YOU TO SUPPORT YOU,

AND THAT'S GOING TO BE YOUR SISTER?

YEP.

WE'RE WORKING ON IT.

OKAY. WE'LL SEE YOU IN A MONTH

AND HOPEFULLY 30 POUNDS LIGHTER.

OKAY.

-ALL RIGHT. -OKAY.

NICE TO MEET YOU, SARAH.

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

-AND NICE TO MEET YOU, TOO. -THANK YOU.

ALL RIGHT. WE'LL SEE Y'ALL LATER.

-OKAY. -OKAY.

SARAH IS AT A CROSSROADS RIGHT NOW.

SHE CAN EITHER DO WHAT SHE NEEDS NOW

OR THINGS ARE ABOUT TO GET MUCH WORSE FOR HER VERY FAST.

BUT SHE'S GOING TO HAVE TO CHANGE

THE WHOLE DYNAMIC OF HER LIFE TO DO THIS,

SO THIS WON'T BE EASY,

BUT SHE HAS TO DO IT

IF SHE WANTS TO TURN HER LIFE AROUND.

♪♪

Sarah: IT'S A HUGE RELIEF TO KNOW DR. NOW IS GOING TO HELP ME,

BUT I FEEL OVERWHELMED...

I'M NOT GOING TO BE ABLE TO GET IN THAT CAR.

WE'LL MOVE IT.

...BECAUSE NOT ONLY TO I NEED TO LOSE 30 POUNDS IN A MONTH,

I HAVE TO START DOING THESE EXERCISES

TO GET MY LUNGS IN BETTER SHAPE

BECAUSE I CAN'T BLOW THIS CHANCE AND MESS THIS UP.

♪♪

♪♪

♪♪

IT'S BEEN A BIT OF A HARD MONTH.

WHEN I GOT BACK HOME AFTER SEEING DR. NOW,

I HAD A FALLING OUT WITH MY SISTER.

I HAD JUST STARTED TO DIET,

BUT SHE FELT I WASN'T TRYING HARD ENOUGH,

SO SHE SAID SHE WASN'T GOING TO MOVE TO HOUSTON WITH ME,

AND THAT WAS DEVASTATING.

THINGS GOT PRETTY HEATED BETWEEN ALL OF US,

AND MY MOM SIDED WITH ME

AND TOLD HEATHER IT WASN'T RIGHT TO DO THIS

AND MESS UP MY CHANCES TO GET SURGERY.

SO WE ALL DECIDED WE NEEDED SOME TIME APART,

AND MY MOM AND ME CAME TO STAY AT MY GRANDMOTHER'S,

WHO LIVES A COUPLE HOURS AWAY FROM US

SO I CAN FOCUS AND DO WHAT I NEED TO MAKE PROGRESS

WITHOUT GETTING DISTRACTED BY ALL THE DRAMA.

♪♪

Maryann: I FIXED YOU SOME JELL-O.

YOU KNOW, THAT DOESN'T HAVE ANY CALORIES.

IT'S THE SUGAR-FREE,

SO THAT'LL GIVE YOU A LITTLE BIT OF SOMETHING SWEET TO EAT.

LIVING WITH MY GRANDMA IS CHALLENGING,

AS SHE'S CONSTANTLY WATCHING WHAT I PUT ON MY FOOD

AND WHAT KIND OF FOOD I'M EATING.

I AM EATING MOSTLY LEAN MEATS AND VEGETABLES,

BUT MY GRANDMA KNOWS A LOT ABOUT WEIGHT LOSS.

SHE'S EVEN BEEN HELPING ME WITH MY EXERCISES.

HOW DO YOU THINK THE DIET HAS BEEN GOING?

I THINK IT'S GOING GOOD, BUT IT'S TOUGH.

SO YOU FEEL PRETTY SATISFIED?

YEAH. I FEEL LIKE I'M DOING A GOOD JOB.

YEAH. I THINK YOU ARE.

I THINK MY GRANDMA THINKS I CAN LOSE THE WEIGHT,

BUT SHE'S WORRIED THAT MAYBE I'M NOT GOING TO

TRY AS HARD AS I SHOULD

BECAUSE THERE'S A FEAR IN THE BACK OF HER MIND.

ARE YOU READY?

YEAH.

LET'S DO IT.

I'M STILL NERVOUS ABOUT SEEING THE DOCTOR AGAIN.

I WASN'T ABLE TO MAKE IT TO MY LAST APPOINTMENT,

SO I CALLED AND ASKED IF I COULD HAVE A LITTLE MORE TIME.

HE ASKED ME WHAT WAS GOING ON, AND I TOLD HIM,

AND HE'S CONCERNED ABOUT MY LACK OF SUPPORT

IF I MOVE TO HOUSTON,

AND HE TOLD ME I COULD WAIT ANOTHER MONTH,

BUT THAT I NEED TO LOSE ANOTHER 30 POUNDS

TO SHOW HIM I AM STAYING ON TRACK.

SO I SHOULD BE DOWN 60 POUNDS WHEN I COME BACK,

AND I'M NOT SURE WHAT TO DO RIGHT NOW

BECAUSE IF MY SISTER WON'T MOVE WITH ME,

THEN THE ONLY OTHER OPTION IS MY MOM,

AND I DON'T KNOW IF SHE CAN.

SEE? YOU'RE GETTING BETTER, THERE.

♪♪

THESE PAST FEW WEEKS HAVE BEEN MORE OF A STRUGGLE FOR ME.

I JUST FEEL LIKE I'M UNDER A LOT OF PRESSURE RIGHT NOW

TO FIGURE SO MUCH OUT, AND WHAT CALMS ME DOWN IS FOOD.

SO I KNOW I'VE GIVEN IN A FEW TIMES, BUT I TALKED TO MY MOM,

AND SHE WASN'T TOO HAPPY AT THE IDEA

OF MOVING DOWN THERE WITH ME FOR A YEAR,

BUT SHE AGREED.

-GOT YOUR STUFF? -YEAH. I THINK SO.

I MIGHT HAVE A FEW THINGS LEFT.

I GUESS I SHOULD GO AHEAD AND START PUTTING EVERYTHING

IN THE CAR.

I FEEL LIKE A BURDEN BECAUSE I KNOW THAT MY MOM

REALLY DOESN'T WANT TO GO,

BUT SHE'S GOING BECAUSE SHE KNOWS

THIS IS GOING TO SAVE MY LIFE.

I HAVE MY NEXT APPOINTMENT WITH DR. NOW IN A WEEK,

BUT I'M NOT GOING BY PLANE AGAIN.

THE LAST TIME WAS TOO UNPLEASANT,

SO ME AND MY MOM ARE DRIVING,

AND I'M NERVOUS BECAUSE IT'S GOING TO BE A LONG DRIVE.

Barbara: HEATHER PUT ME IN A PRETTY AWKWARD SITUATION

BECAUSE I REALLY DID NOT WANT TO GO.

I'VE NEVER BEEN IN A CAR WITH SARAH FOR MORE THAN 3 HOURS,

AND THIS IS ABOUT A 16-HOUR DRIVE.

I DON'T KNOW HOW WELL ME AND SARAH

ARE GOING TO GET ALONG COOPED UP IN A CAR FOR 2 DAYS,

BUT IF I SAID NO, I WOULD BE A SELFISH MOM,

AND I THINK IF SOMETHING'S NOT DONE TO CHANGE HER LIFESTYLE,

THAT SHE WON'T LIVE ANOTHER FIVE YEARS.

♪♪

Sarah: I'M JUST NOT LOOKING FORWARD TO THIS.

I JUST HOPE I CAN MAKE IT.

Barbara: MY CAR IS ABOUT 20 YEARS OLD,

AND THE PASSENGER-SIDE DOOR WILL NOT OPEN,

SO SARAH HAS TO GET IN THROUGH THE DRIVER'S SIDE

AND SLIDE ALL THE WAY OVER,

WHICH IS REALLY DIFFICULT FOR HER.

Sarah: THESE SEAT BELT THINGS ARE IN THE WAY.

I KNOW.

YOU'RE GOING TO HAVE TO CLIMB OVER THEM.

OKAY. I'M TRYING.

[ GRUNTING ]

[ CHUCKLES ] MOM!

GOD!

Maryann: YOU COULD BREAK THAT STEERING WHEEL!

OKAY.

THIS IS HUMILIATING.

LOVE YOU.

Barbara: WILL YOU GET MY CANDY OFF THE DASHBOARD?

-CAN'T REALLY REACH IT. -THEY'RE A DISTRACTION.

♪♪

Sarah: WITH HOW HARD THIS IS ON ME GOING BACK AND FORTH

ON ALL THESE TRIPS,

MY MOM AND ME PLAN TO STAY DOWN THERE THIS TIME,

AND WE FOUND A PLACE TO STAY, BUT WE BOTH HAVEN'T SEEN IT,

SO WE DON'T KNOW WHAT TO EXPECT,

AND RIGHT NOW,

I'M JUST NOT LOOKING FORWARD TO THIS WHOLE TRIP.

♪♪

DON'T START BITCHING ABOUT MY DRIVING ALREADY.

WHAT ARE YOU DOING?

YOU'RE MAKING ME NERVOUS. CAN I DRIVE?

NO.

I'M DRIVING.

WELL, YOU'RE NOT DOING A REALLY GOOD JOB AT IT.

WELL, THE SUN IS RIGHT IN MY EYES.

LOOK AT THE ROAD!

I CAN'T SEE ANYTHING.

THAT'S IT. LET ME DRIVE.

SARAH, STOP. YOU'RE MAKING ME NERVOUS.

-JUST STOP. -HOW AM I MAKING YOU NERVOUS?

A LOT OF THE TENSION IN MY RELATIONSHIP WITH MY MOM

HAS LED TO A LOT OF ME EATING IN THE PAST,

SO BEING WITH HER MAKES MY STRUGGLES WITH CRAVING

AND EATING MUCH, MUCH WORSE.

♪♪

♪♪

♪♪

Sarah: IT'S BEEN TWO LONG DAYS ON THE ROAD,

AND I THINK ME AND MY MOM ARE BOTH READY TO BE THERE

AND GET OUT OF THIS CAR AND AWAY FROM EACH OTHER

FOR A LITTLE BIT.

Barbara: IT'S RIGHT OVER THERE.

SARAH, STOP.

-WHERE? -OVER THERE.

Sarah: OKAY, WHERE IS, "OVER THERE," MOTHER?

I'M GOING TO IT, AND YOU KEEP TELLING --

LOOK TO YOUR RIGHT.

[ SIGHS ] [BLEEP]

-IT'S RIGHT DOWN THERE. -YOU MEAN MY LEFT?

GOD, I SAW IT.

I DIDN'T KNOW YOU SAW IT. YOU DIDN'T SAY ANYTHING.

Barbara: I DON'T THINK I WAS THE BEST CHOICE

TO COME DOWN HERE AND LIVE WITH SARAH FOR A YEAR.

WE'RE TRYING TO GET ALONG SINCE WE'RE IN SUCH CLOSE QUARTERS,

AND WE'RE GOING TO BE TOGETHER FOR THE NEXT YEAR, AT LEAST,

BUT WE HAVE OUR MOMENTS,

AND SHE TAKES ALL OF HER ANGER AND FRUSTRATION OUT ON ME.

SHE ALWAYS HAS.

♪♪

Sarah: THANK GOD WE'RE HERE.

I JUST WANT TO GET TO OUR APARTMENT AND REST.

DO THEY FEEL STURDY ENOUGH?

YEAH.

WHY ARE THEY SHAKING? [BLEEP]

THEY'RE FINE.

[ PANTING ]

I AM EXHAUSTED.

I'M ALREADY COMPLETELY OUT OF BREATH.

MY KNEES HURT. MY BACK HURTS.

MY ANKLES, EVERYTHING KIND OF ACHES.

BUT AT THIS POINT, I JUST NEED TO GET IN A COMFY CHAIR

LIKE THE ONE I HAD AT HOME AND REST.

ME AND MY MOM WENT ONLINE LAST WEEK

AND BOUGHT SOME FROM A FURNITURE STORE HERE IN HOUSTON,

TO HAVE THEM DELIVERED WHEN WE ARRIVED,

BUT THEY'RE STILL NOT HERE YET.

OKAY, SO, I GUESS I CALL THEM.

[ Ringing ]

This is Robert.

HEY, THIS IS SARAH.

WE ARE READY FOR THE FURNITURE.

162.

160-- okay.

162, YEAH.

♪♪

THANK GOD THEY'RE HERE

BECAUSE I JUST NEED TO SIT DOWN.

WHERE ARE WE GOING TO PUT IT?

WE'LL HAVE TO PUT THEM OVER THERE.

Sarah: I JUST NEED TO REST AND GET MY STRENGTH BACK,

AND I'M HOPING THIS ALL ISN'T FOR NOTHING,

BECAUSE IF I CAN'T GET WEIGHT-LOSS SURGERY SOON,

THEN MY MOM SAYS WE'RE GOING BACK.

-THANK YOU. -NO PROBLEM.

♪♪

I HAVE THREE DAYS UNTIL I SEE DR. NOW FOR MY NEXT APPOINTMENT,

AND I HAVE TO TRY AND STICK WITH MY DIET UNTIL THEN,

BUT THE TRIP DOWN MADE IT HARD NOT TO EAT FAST FOOD,

SO I KNOW I NEED TO WORK HARD TO UNDO THE LAST COUPLE OF DAYS.

WHERE DO YOU WANT TO PUT EVERYTHING?

I DON'T KNOW.

WE'LL FIGURE IT OUT.

I'M GOING TO GO AHEAD AND START BRINGING EVERYTHING UP.

OKAY.

HONESTLY, I DON'T THINK IT BOTHERS SARAH

THAT I HAVE TO DO EVERYTHING.

I DON'T THINK IT BOTHERS HER AT ALL.

SARAH HAS BEEN DEPENDENT ON ME HER WHOLE LIFE.

I'M KIND OF USED TO IT,

BUT IT'S STILL A LITTLE ANNOYING SOMETIMES

BECAUSE SHE CAN'T HELP ME DO ANYTHING.

I HAVE TO DO EVERYTHING.

BUT SARAH'S THE ONLY ONE THAT CAN LOSE THE WEIGHT.

NOBODY CAN DO IT FOR HER.

SHE HAS TO CHANGE HER LIFESTYLE, AND SHE HAS TO WORK REALLY HARD,

AND SHE HAS TO BE THE ONE TO DO IT, YOU KNOW?

IF I COULD DO IT FOR HER, I WOULD HAVE DONE IT ALREADY.

♪♪

Sarah: I'M SCARED ABOUT WHAT'S GOING TO HAPPEN

AND THAT EITHER DR. NOW WILL GIVE UP ON ME

OR MY MOM WILL BECAUSE I KNOW SHE'S ALREADY READY TO GO BACK.

ALL WE'VE DONE IS FIGHT THE WHOLE WAY HERE,

AND NEITHER OF US ARE LOOKING FORWARD

TO BEING HERE TOGETHER FOR A YEAR,

BUT THIS IS WHAT I NEED,

AND I KNOW IT'S ALL RIDING ON MY WEIGH-IN IN A FEW DAYS.

♪♪

[ SIGHS ] WOW.

Barbara: IT'S NOT A GOOD SIGN THAT WE JUST GOT TO HOUSTON,

I'M ALREADY FINDING BAGS OF CANDY AND COOKIES.

EVERYBODY IS BENDING OVER BACKWARDS TO HELP HER OUT.

SHE NEEDS TO DO HER PART.

LOOK WHAT I JUST FOUND.

YES. I GOT THAT LAST NIGHT AT THE HOTEL

BECAUSE I DIDN'T KNOW --

LIKE, FOUR, FIVE BAGS OF CANDY AND TWO BAGS OF COOKIES.

BECAUSE I DIDN'T KNOW HOW LONG WE WOULDN'T HAVE FOOD HERE.

YOU KNEW WE WERE GOING TO THE STORE TODAY.

AND YOU KNOW YOU'RE GOING TO EAT MOST OF THAT ANYWAYS.

YOU DIDN'T TELL ME YOU HAD ALL THIS.

I TOLD YOU I GOT SNACKS LAST NIGHT.

NO. YOU DIDN'T.

YES, I DID.

WELL, I'M JUST GOING TO THROW IT AWAY.

NO YOU WON'T. YOU'LL KEEP IT IN YOUR DRAWER.

NO. I WILL. I AM.

OKAY. THAT'S A LIE.

SARAH COMPLETELY IGNORES EVERYTHING I SAY TO HER,

OR SHE ARGUES,

OR SHE'LL SAY SOME NASTY COMMENT AND THEN DO WHAT SHE WANTS.

I GUESS, TO HELP SARAH,

I'M GOING TO HAVE TO PROBABLY CHANGE EVERYTHING

ABOUT THE WAY I EAT, ALSO, BECAUSE I DON'T THINK

I CAN EAT THE WAY I DO AND SARAH NOT BE TEMPTED,

BUT I THINK SHE NEEDS TO TAKE IT WAY MORE SERIOUSLY THAN SHE DOES

BECAUSE IF SHE DOESN'T, SHE'S GOING TO FAIL.

♪♪

♪♪

Sarah: I'M HEADED TO SEE DR. NOW FOR MY FOLLOW-UP APPOINTMENT,

AND I'M EXTREMELY NERVOUS.

SO MUCH IS RIDING ON THIS,

AND I JUST KNOW WITH ALL THE TENSION BETWEEN ME AND MY MOM

AND HOW HARD IT IS FOR HER TO BE DOWN HERE

THAT SHE'S NOT GOING TO STAY IF I'M NOT DOING THIS.

SO I'M REALLY HOPING THIS WEIGH-IN ISN'T BAD

AND THAT I CAN GET WEIGHT-LOSS SURGERY TODAY.

SARAH NEELEY?

BUT I NEED TO BE AT OR BELOW 582,

AND I REALLY HOPE I'M AT LEAST CLOSE TO THAT.

♪♪

♪♪

THAT'S DISAPPOINTING,

AND I'M GUESSING THIS APPOINTMENT IS PROBABLY

NOT GOING TO GO WELL.

I JUST HOPE I DIDN'T MESS THIS ALL UP.

-HELLO. -HI.

HOW ARE YOU DOING?

-GOOD. -AND WHO IS THIS?

-THIS IS MY MOM. -NICE TO MEET YOU. I'M BARB.

NICE TO MEET YOU.

SO YOU TOOK TWO MONTHS TO GET BACK HERE...

YES.

...AND NOT ONLY DID YOU MISS YOUR 60-POUND WEIGHT-LOSS GOAL,

BUT YOU GAINED 11 POUNDS, AND THAT'S...

-NO. I KNOW. I MESSED UP. -...SIGNIFICANT.

SO WHAT HAPPENED?

WE'VE BEEN EATING OUT A LOT.

YOU KNOW, BECAUSE WE'VE, YOU KNOW,

BEEN TRAVELING THESE LAST FEW DAYS, BUT...

YOU KNOW THAT'S NO EXCUSE,

AND THAT HASN'T BEEN THE CASE IN PAST TWO MONTHS.

YOU JUST MOVED DOWN HERE.

I KNOW.

BUT I'M ALSO CONCERNED ABOUT THAT

BECAUSE INSTEAD OF BRINGING YOUR SISTER,

YOU BROUGHT YOUR ENABLER.

WHAT HAPPENED TO YOUR SISTER?

SHE DIDN'T THINK I WAS TRYING HARD ENOUGH.

SHE FREAKED OUT AND DIDN'T WANT TO COME ANYMORE,

SO NOW MY MOM IS WITH ME.

SO NOW MOM IS GOING TO KEEP YOU ON TRACK?

YES.

BECAUSE, ACCORDING TO SARAH,

THAT HAS NOT BEEN THE CASE IN THE PAST.

YOU'RE THE ONE WHO BRINGS HER THE FOOD,

SO YOU'RE GOING TO HELP HER TO LOSE WEIGHT NOW?

I'M GOING TO TRY TO HELP HER.

Y'ALL GOING TO COOK AT HOME, OR ARE YOU GOING TO EAT OUT?

WE'RE GOING TO COOK AT HOME.

OKAY, I'M GONNA GIVE YOU A COPY OF THE DIET, TOO,

AND I WANT YOU TO LEARN IT,

AND I WANT TO ENCOURAGE BOTH OF YOU TO GO ON IT,

BUT AT A MINIMUM, YOU NEED TO HELP SARAH

STICK WITH IT WITH WHAT YOU PREPARE.

IF YOU DON'T, YOU'RE GOING TO BE

BURYING YOUR DAUGHTER IN NEAR FUTURE.

DO YOU UNDERSTAND THAT?

YEAH, DEFINITELY.

YOU TWO NEED TO CHANGE YOUR DYNAMIC NOW.

SO TO MAKE SURE THAT'S HAPPENING,

I'M SENDING YOU BOTH TO START PSYCHOTHERAPY

TOGETHER IMMEDIATELY...

-OKAY. -...SO WE CAN ADDRESS THIS

BEFORE YOUR SITUATION GETS WORSE.

SARAH, DO YOU REMEMBER HOW SERIOUS YOUR SITUATION IS?

YOU'RE 25, BUT YOU GOT THE DISEASES OF PEOPLE

IN 40s AND 50s.

MM-HMM.

SO YOUR LIFE SPAN IS NOT VERY LONG RIGHT NOW.

YEAH.

SO YOU NEED TO GET CONTROL OF YOUR LIFE,

AND YOU NEED TO MOTIVATE YOURSELF.

YOU'RE GOING TO HAVE TO MAKE SOME DECISIONS,

AND YOU'VE GOT TO BE RESPONSIBLE FOR ALL THE CHOICES

YOU'RE MAKING. YOU UNDERSTAND ME?

-OKAY. -SO I'M GOING TO GIVE YOU

TWO MONTHS AGAIN, AND I WANT YOU TO LOSE 60 POUNDS.

IF YOU STICK WITH THE 1,200-CALORIE,

YOU CAN EASILY DO THAT, OKAY?

AND YOU NEED TO DO YOUR EXERCISES,

SOME AEROBIC, UPPER-BODY, AND THEN WALKING

AT LEAST 20, 30 MINUTES TWICE A DAY.

YOU THINK YOU CAN MAKE ALL THOSE CHANGES?

YES. I CAN.

THAT'S GOOD, BECAUSE YOU HAVE TO DO THIS.

I'M GOING TO LOSE THE WEIGHT.

ALL RIGHT. I'LL SEE YOU BOTH IN A COUPLE OF MONTHS.

SOUNDS GOOD.

IF YOU HAVE ANY QUESTIONS, CALL ME.

-I'LL SEE YOU LATER. -THANK YOU.

-NICE TO MEET YOU. -THANK YOU, YOU TOO.

ALL RIGHT.

SARAH IS NOT TAKING HER SITUATION SERIOUSLY,

AND A LOT NEEDS TO HAPPEN FOR HER TO GET ON TRACK,

BUT THE FACT THAT SHE'S MAKING EXCUSES

MAKES ME CONCERNED THAT SHE'S EXPECTING

AN EASY FIX TO HER SITUATION.

SO IF SHE DOESN'T START TAKING THE RESPONSIBILITY

FOR HER OWN CHOICES AND HER ACTIONS,

THEN SHE'S PLAYING WITH AN OUTCOME SHE MAY NOT SURVIVE.

♪♪

♪♪

Sarah: RIGHT NOW, MY MOM AND ME ARE GOING TO SEE A THERAPIST

TOGETHER BECAUSE DR. NOW WANTS US TO START TO TALK ABOUT THINGS

AND WORK TO HAVE A HEALTHIER DYNAMIC,

BUT ME AND MY MOM HAVE NEVER REALLY TALKED ABOUT

ANY OF THE ISSUES OR PAST BETWEEN US.

AND THERE'S SO MUCH FROM MY CHILDHOOD

THAT I DON'T KNOW WHERE TO EVEN START,

BUT I'M WILLING TO GIVE THIS ALL A TRY AND SEE HOW IT GOES.

-HEY, THERE. -HI.

HI. WHY DON'T YOU COME ON BACK?

OKAY.

[ SIGHS ]

I THOUGHT MAYBE WE COULD START WITH YOU

JUST SHARING WITH ME A LITTLE BIT ABOUT

YOUR EARLY EXPERIENCES AND THE ROLE OF FOOD

AND HOW THAT PLAYED INTO YOUR LIFE

WHEN YOU WERE YOUNGER.

FOOD WAS A BIG, BIG THING FOR ME IN MY LIFE RIGHT THEN.

MM-HMM.

BECAUSE MY MOM HAD JUST GOTTEN MARRIED TO THIS GUY,

AND HE WAS WEIRD,

AND I DIDN'T LIKE HOW MY MOM WAS,

LIKE, GIVING HIM ATTENTION...

-OH, OKAY. -...AND, LIKE, NOT ME.

I DIDN'T WANT TO SHARE HER.

SO YOU FOUND YOURSELF FINDING A LOT OF COMFORT IN FOOD?

YEAH. YEAH.

YEAH.

WELL, A LOT OF TIMES FOOD CAN BECOME A WAY

THAT WE JUST DEAL WITH OUR ENVIRONMENT,

AND ESPECIALLY AS A CHILD,

IT'S A LEARNED WAY OF COPING OR RESPONDING

TO WHAT WAS GOING ON AT THAT TIME FOR YOU

THAT WAS STRESSFUL.

SO THINGS CHANGED?

HE WAS THERE UNTIL I WAS ABOUT 12.

-WOW, OKAY. -YEAH.

LITERALLY RIGHT AFTER HE LEFT, HER THIRD HUSBAND MOVES IN.

-OH. -YEAH, SO IT WAS FREAKY.

NO TIME WITH MOM?

NO, CRAZY. MM-HMM.

SO TELL ME ABOUT YOUR EXPERIENCES WITH HIM.

HE WAS JUST AS BAD AS MY FIRST STEPDAD.

THE WORST INCIDENT WAS ONE TIME HE SAID

THAT I'D HAVE TO WEAR MY NIGHTGOWN TO SCHOOL,

AND IT ENDED UP WITH HIM ON TOP OF ME, HOLDING ME DOWN.

HE, LIKE, RIPPED MY SHIRT,

AND I WAS SCREAMING FOR MY MOM.

MY MOM WAS LITERALLY, LIKE, IN THE NEXT ROOM...

WOW.

...JUST SCREAMING FOR MY MOM.

SHE DIDN'T COME.

[ SNIFFLING ]

I JUST CAN'T BELIEVE SHE DIDN'T COME FOR ME

WHEN I WAS SCREAMING HER NAME.

YEAH.

THAT'S ALWAYS BUGGED ME.

I DON'T THINK I'LL EVER FORGIVE MY MOM FOR WHAT...

-YEAH. -...SHE PUT US ALL THROUGH.

I DON'T THINK I CAN FORGIVE HER.

SO HOW HAVE YOU RECONCILED THAT?

I MEAN, YOU'RE LIVING WITH MOM NOW.

YEAH. I MEAN, LIKE, WE'VE GOTTEN INTO ARGUMENTS,

AND I'VE THROWN IT UP IN HER FACE,

AND THEN AFTER I DO IT, I FEEL SO BAD ABOUT IT.

SO YOU DON'T REALLY GET WHAT YOU'RE LOOKING FOR, THEN?

BUT IT'S GOING TO CONTINUE TO COME OUT,

AND MAYBE IT DOESN'T COME OUT.

MAYBE YOU KEEP IT INSIDE, AND IT'S ALL PART OF THAT.

"THIS IS WHY I GO TO FOOD."

AND THE REALITY IS,

THERE'S A LOT OF THINGS THAT ARE COMING UP IN THE PRESENT,

AND IT'S TRIGGERING THE PAST.

-YEAH. -MOM IS HERE TODAY.

-MM-HMM. -SO LET'S BRING HER IN.

OKAY.

HEY. LOOK. WOULD YOU BE WILLING TO JOIN US IN YOUR SESSION?

-OH, SURE. -OKAY.

-HI. -HEY. HOW'S IT GOING?

WELL, THANK YOU, MOM, FOR JOINING US.

WE WERE JUST TALKING ABOUT LIFE AND FAMILY EXPERIENCES,

AND THERE WERE SEVERAL EXPERIENCES THAT SHE HAD

THAT IT MAY BENEFIT HER TO HAVE VALIDATION FROM YOU.

SO, SARAH, WE HAD TALKED ABOUT JUST YOUR EXPERIENCE

OF HAVING DIFFERENT MEN IN AND OUT OF YOUR LIFE

AND WANTING MOM TO BETTER UNDERSTAND ASPECTS OF THAT.

I GUESS THAT I FELT LIKE YOU THINK

THAT I DESTROYED BOTH RELATIONSHIPS.

NO. I'VE NEVER THOUGHT THAT.

THAT NEVER EVEN CROSSED MY MIND.

DO YOU ADMIT TO SEEING THINGS THAT THEY DID

AND NOT SAYING ANYTHING ABOUT THEM?

YES, BUT I'VE NEVER CONSIDERED EVEN FOR A SECOND

THAT YOU HAD ANYTHING TO DO WITH IT.

BUT I'VE ALWAYS WONDERED WHY YOU NEVER DID ANYTHING?

ABOUT WHAT?

LIKE THE TIME HE ATTACKED ME AND I WAS SCREAMING FOR YOU,

AND YOU NEVER CAME.

YOU WERE LITERALLY, LIKE, RIGHT NEXT DOOR.

I DON'T REMEMBER THAT.

IT HAPPENED.

I DON'T HAVE ANY MEMORY OF THAT WHATSOEVER.

MM-HMM.

LET'S ASSUME THAT IT DID HAPPEN

AND THAT WAS HER PERSPECTIVE.

WHAT DO YOU WANT HER TO KNOW ABOUT HOW YOU FEEL,

AND WHAT DO YOU THINK SHE WAS GOING THROUGH

AS SHE WAS EXPERIENCING ALL THAT?

I'M SURE SHE WAS PROBABLY UPSET AND SCARED, AND I'M SORRY.

YOU LOOK LIKE YOU'RE A LITTLE UPSET THAT MOM DOESN'T REMEMBER.

YEAH. I'M NOT EXAGGERATING.

I'M NOT SAYING IT DIDN'T. I'M NOT CALLING YOU A LIAR.

I'M JUST SAYING, I DON'T REMEMBER,

AND IF I WAS THERE AND DIDN'T DO ANYTHING,

I'M SORRY, BUT I DON'T REMEMBER.

SO YOU WOULD HAVE LIKED TO THINK THAT YOU

WOULD HAVE RESPONDED IF YOU...

WELL, I'D LIKE TO THINK SO, YEAH.

-YEAH. -YEAH.

I'VE ALWAYS LOVED YOU. I THOUGHT YOU KNEW THAT.

YEAH, AND WE'VE ALWAYS HAD A ROCKY RELATIONSHIP,

BUT I'VE ALWAYS BEEN OBSESSED WITH HER, TOO.

OBSESSED IN TERMS OF JUST WANTING HER

TO BE CLOSE TO YOU... -YEAH.

...AND HAVE A CLOSE RELATIONSHIP?

YEAH, I GUESS. YEAH.

-LIKE... -YEAH, WHICH IS REALLY NORMAL,

ESPECIALLY IF YOU FELT LIKE YOU DIDN'T HAVE THAT AS A CHILD.

WHAT'S PROBABLY HAPPENED,

WHICH IS REALLY NORMAL IN SITUATIONS

WHERE THERE'S BEEN JUST A LOT OF TRAUMA

AND ATTACHMENT ISSUES IS THAT, YEAH,

WE WENT FROM YOU NOT FEELING ATTACHED AT ALL TO MOM

TO NOW IT'S ALL MOM, ABOUT MOM.

"I HAVE MOM IN MY LIFE, AND, MOM, WHERE YOU GOING?

WHO YOU WITH? WHAT TIME YOU GOING TO BE HOME?"

-MM-HMM. -"I NEED THIS FROM YOU.

I NEED THAT FROM YOU." AND SO, YOU KNOW, TO BE HONEST,

WHERE WE WOULD WANT TO MOVE TO A HEALTHY PLACE

IS FOR YOU TO BE ABLE, MOM, TO BE OF SUPPORT

AND TO STILL BE MOM AND TO STILL BE PRESENT,

BUT TO MOVE AWAY, A LITTLE BIT, FROM THAT PLACE

OF RESPONDING ALL THE TIME TO THAT,

ESPECIALLY IF IT'S NOT IN HEALTHY WAYS,

AND ESPECIALLY IN THIS WEIGHT-LOSS JOURNEY.

IT'S, "HOW CAN I BE OF SUPPORT?

BUT I DON'T WANT TO ENABLE YOU IN THINGS THAT AREN'T HEALTHY."

YEAH. I WOULD LIKE TO BECOME LESS...

DEPENDENT.

OKAY, BECAUSE WHAT I'M LOOKING FOR

IS FOR YOU ALL TO FEEL LOVE AND SUPPORTED BY ONE ANOTHER

IN HEALTHIER WAYS SO THAT YOU CAN STILL

STAY ATTACHED AND CONNECTED,

BUT YET, BOTH HAVE YOUR INDEPENDENT LIVES,

AND YOU TOUCH IN A WAY

THAT YOU BOTH AGREE UPON THAT'S HEALTHY.

-OKAY. -OKAY.

WELL, I LOOK FORWARD TO SEEING YOU GUYS AGAIN.

-YES, DEFINITELY. -YEAH.

Sarah: I'M A LITTLE SHOCKED THAT MY MOM DOESN'T EVEN REMEMBER

THE MOST PAINFUL MEMORY I HAVE,

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

THERE IS JUST A LOT OF DAMAGE FROM THE PAST

THAT'S BEEN EATING AWAY AT ME FOR SO LONG,

AND IF FIXING ALL THAT IS EVEN POSSIBLE AT THIS POINT,

IT'S NOT GOING TO BE EASY AT ALL,

BUT FOR RIGHT NOW, I KNOW I HAVE TO LEARN

TO START BEING MORE INDEPENDENT

AND DOING THINGS ON MY OWN.

♪♪

♪♪

♪♪

THIS PAST MONTH, I'VE BEEN TRYING TO DO

WHAT THE THERAPIST TOLD ME TO DO

AND START DOING THINGS ON MY OWN,

AND THE BIGGEST THING I'VE STARTED DOING IS COOKING.

I'VE BEEN COOKING HIGH-PROTEIN FOODS AND STICKING TO MY DIET,

AND I FEEL LIKE I'M LOSING WEIGHT AND I'M ABLE TO DO MORE.

♪♪

ARE YOU HUNGRY?

NO, NOT REALLY, BUT I'LL SIT WITH YOU.

Barbara: SARAH HAS MADE A HUGE CHANGE, AND I THINK IT'S GREAT.

I'M GLAD TO SEE HER FINALLY STICKING TO SOMETHING.

SARAH DOESN'T NEED NEARLY AS MUCH HELP AS SHE USED TO.

SHE DOES HER OWN COOKING.

SHE WASHES HER OWN DISHES,

AND I DON'T REALLY HAVE TO DO MUCH OF ANYTHING

LIKE THAT FOR HER RIGHT NOW.

I HAVE A COUPLE THINGS I NEED TO WASH.

DO YOU WANT ME TO WASH ANYTHING OF YOURS?

YOU CAN WASH MY WORK UNIFORMS.

Sarah: THINGS HAVE BEEN A LITTLE BETTER BETWEEN ME AND MY MOM.

IT'S BEEN A LITTLE AWKWARD AT TIMES,

BUT WE'RE GETTING PAST IT, AND MY TAKING CARE OF MYSELF,

IT'S A COMPLETE CHANGE IN OUR WHOLE RELATIONSHIP,

SO WE BOTH KNOW IT'S GOING TO BE A PROCESS

AS WE CONTINUE TO WORK THROUGH THINGS...

ALL RIGHT. SO YOUR WORK UNIFORM?

...BECAUSE WE BOTH WANT THINGS TO BE BETTER BETWEEN US,

BUT WE KNOW WE STILL HAVE A LOT OF WORK TO DO.

♪♪

IT HASN'T BEEN EASY, BUT I'M WORKING REALLY HARD NOW.

I'M GETTING UP AND WALKING AROUND MORE THAN THE 30 MINUTES

A DAY THE DOCTOR WANTED.

♪♪

I AM JUST GOING AROUND OUR APARTMENT COMPLEX,

AND THE LAUNDRY IS DOWNSTAIRS,

SO IT FORCES ME TO GET SOME EXERCISE,

BUT I'M AMAZED AT HOW MUCH EASIER

IT'S BEEN TO GO UP AND DOWN THE STAIRS,

AND AS OUT OF BREATH AS I AM SOMETIMES...

♪♪

I FEEL REALLY GOOD RIGHT NOW.

I SEE DR. NOW IN A COUPLE OF WEEKS,

AND I'M WORKING REALLY HARD TO MAKE SURE

I HIT MY GOAL THIS TIME.

I KNOW I'M PROBABLY NOT GETTING ANOTHER CHANCE AFTER THIS,

SO I'M TAKING IT SERIOUSLY AND DOING ALL THAT I CAN TO MAKE IT.

♪♪

♪♪

ME AND MY MOM ARE GOING TO SEE DR. NOW

FOR MY THIRD APPOINTMENT,

AND I'M MORE NERVOUS THAN EVER.

I KNOW I'M DOING BETTER

THAN ALL THE PREVIOUS TIMES I'VE COME IN,

BUT TO LOSE 60 POUNDS IS A LOT,

SO MY ONLY FEAR IS THAT IT'S NOT GOING TO BE ENOUGH,

AND I'VE WORKED AS HARD AS I CAN.

SO I'M SCARED IF I DON'T MAKE IT THIS TIME,

THEN IT MAY MEAN THE HELP I NEED

IS ALREADY OUT OF MY REACH

BECAUSE I'M JUST TOO FAR GONE AND I JUST DON'T KNOW IT YET.

♪♪

♪♪

Sarah: I'M AT DR. NOW'S FOR MY THIRD APPOINTMENT,

AND HE SAID I NEEDED TO LOSE 60 POUNDS TO BE BELOW 593 TODAY,

AND I KNOW THAT THIS MAY BE MY LAST CHANCE.

♪♪

AHH, YES.

-YAY. -YAY.

-THAT'S GREAT. -YEAH.

I'M SO EXCITED AND PROUD OF MYSELF.

PART OF ME WASN'T SURE THAT IT WAS EVEN POSSIBLE FOR ME

TO LOSE THAT AMOUNT OF WEIGHT,

SO TO SEE ALL MY HARD WORK PAY OFF IS A REALLY GOOD FEELING,

AND I REALLY HOPE I'M ABOUT TO GET MY APPROVAL.

[ KNOCKS ON DOOR ]

-HELLO. -HI.

-HI. -HOW ARE Y'ALL DOING?

-GOOD. -GOOD.

ALL RIGHT. SO YOU'RE DOWN TO 589, HUH?

-YES. -YOU LOST 64 POUNDS.

-THAT'S GREAT. -THANK YOU.

YOU'RE IN 500s RIGHT NOW. SO DO YOU FEEL A LOT BETTER?

I DO.

HAVE YOU BEEN DOING YOUR BREATHING EXERCISES?

-YES. -AND YOU TWO MUST BE

WORKING ON FIXING YOUR DYSFUNCTIONAL DYNAMIC.

OKAY. SO WE'LL RUN SOME TESTS

AND MAKE SURE EVERYTHING LOOKS GOOD,

AND IF IT IS, I'M APPROVING YOU FOR WEIGHT-LOSS SURGERY.

-OKAY. -OKAY?

OKAY.

SO WE'LL GET YOU SCHEDULED FOR NEXT WEEK.

-OKAY. -BUT IN THE MEANTIME,

DON'T LET YOUR GUARD DOWN AND START EATING AGAIN

BECAUSE IF YOU SHOW UP FOR SURGERY

AND YOUR WEIGHT LOSS HAS SLOWED DOWN OR YOU GAIN,

THEN I'LL CANCEL IT. OKAY?

-OKAY. -OKAY.

SO STICK TO YOUR DIET AND DO YOUR EXERCISE,

AS WELL AS YOUR BREATHING EXERCISES,

AND I'LL SEE YOU BOTH IN A WEEK.

-OKAY. THANK YOU. -ALL RIGHT.

NICE TO SEE YOU AGAIN.

-NICE TO SEE YOU. -ALL RIGHT.

ALL RIGHT. WE'LL SEE YOU THEN.

I AM VERY HAPPY TO SEE THE PROGRESS SARAH HAS MADE.

SHE HAS SHOWN ME THAT SHE'S WILLING TO STOP MAKING EXCUSES

AND THAT SHE CAN WORK HARD,

BUT WE STILL HAVE A LONG WAY TO GO WITH HER,

AND THERE IS LIKELY A LOT MORE ISSUES

BETWEEN HER AND HER MOM THAT WE NEED TO ADDRESS,

BUT FOR NOW WITH HER WEIGHT GOING IN THE RIGHT DIRECTION,

I THINK SHE'S READY TO TAKE THIS NEXT STEP.

I'M SO EXCITED RIGHT NOW, BUT I'M ALSO FEELING ANXIOUS

KNOWING I HAVE A BIG OPERATION COMING,

SO I'M JUST GOING TO BE A BUNDLE OF NERVES UNTIL I GET IT DONE,

BUT I KNOW I NEED TO STAY FOCUSED LIKE DR. NOW SAID.

I'VE WORKED SO HARD TO GET HERE,

AND I DON'T WANT TO MESS IT UP NOW.

♪♪

♪♪

AT MY LAST APPOINTMENT,

DR. NOW APPROVED ME FOR WEIGHT-LOSS SURGERY

IF I PASSED MY MEDICAL TEST,

AND I WENT FOR THOSE, AND I JUST FOUND OUT I'M ALL CLEARED.

AND I'M SO EXCITED, BUT I'M STILL NERVOUS, TOO,

BECAUSE I HAVE MY SURGERY COMING UP IN 5 DAYS,

BUT I KNOW THAT AFTER WEIGHT-LOSS SURGERY,

I'M NOT GOING TO BE ABLE TO PHYSICALLY HANDLE SOME FOODS,

AND I'M WORRIED I'M NOT GOING TO BE ABLE TO EAT

MY FAVORITE MEAL AFTER THE SURGERY,

WHICH IS TATER-TOT CASSEROLE,

AND I'VE BEEN THINKING THAT I'VE EARNED THE RIGHT

TO CELEBRATE JUST A LITTLE.

TATER-TOT CASSEROLE IS TATER TOTS, CHEESE,

CREAM OF CHICKEN SOUP

AND A BUNCH OF OTHER STUFF THROWN TOGETHER,

AND IT'S JUST REALLY GOOD.

I THINK THAT I WILL BE ABLE TO MAKE THIS TATER-TOT CASSEROLE

AND BE ABLE TO ENJOY A LITTLE BIT OF IT

AND HAVE IT ONE LAST TIME BEFORE SURGERY

BECAUSE THIS IS A FOOD THAT I KNOW

I WILL NOT BE ABLE TO EAT PROBABLY EVER AGAIN.

♪♪

I THINK THAT SINCE I'VE BEEN APPROVED FOR SURGERY

AND I'VE LEARNED HOW TO CONTROL MY EATING

THAT I DON'T THINK A LITTLE BIT OF IT WILL HURT ME.

♪♪

♪♪

BUT I'M GOING TO REALLY ENJOY THIS.

♪♪

♪♪

I DON'T REALLY KNOW WHY I'M SO OBSESSED WITH THIS DISH.

I'VE BEEN OBSESSED WITH IT SINCE I WAS 12 YEARS OLD.

LIKE, I ALWAYS WANTED MY MOM TO MAKE IT.

LIKE, EVERY DAY, I WOULD ASK FOR IT,

BUT WHEN SHE WOULD MAKE IT, I WOULD GET SO HAPPY.

TO ME, IT'S AMAZING --

THE TEXTURE, THE TASTE, THE SMELL.

♪♪

I GET REALLY EXCITED, AND I JUST...

I'M EATING IT, AND I'M JUST HAPPY WHEN I'M EATING IT.

♪♪

♪♪

IT REALLY COMFORTS ME, FOR SOME REASON.

SO I KNOW THIS IS THE MEAL I'M GOING TO MISS THE MOST.

♪♪

♪♪

AFTER EATING THE CASSEROLE, I'VE JUST FELT SO SICK.

I WAS SO FULL.

I JUST STARTED EATING, AND I THOUGHT I COULD HANDLE IT,

BUT I KNOW I OVERATE,

AND I KEPT DOING IT FOR THE PAST COUPLE OF DAYS,

BUT I DON'T REALLY KNOW WHAT CAME OVER ME.

IT'S LIKE I WAS TEMPORARILY INSANE OR SOMETHING,

AND I FINALLY REALIZED HOW MUCH I WAS OVEREATING.

I STARTED FREAKING OUT AND DIDN'T KNOW WHAT TO DO,

SO I CALLED DR. NOW AND TOLD HIM I MESSED UP,

SO HE SAID HE WANTED ME TO COME TO HIS OFFICE

TO SEE IF I'VE GAINED WEIGHT.

SO I'M SCARED OUT OF MY MIND RIGHT NOW

BECAUSE I'M TERRIFIED I'VE LOST MY SURGERY

AND THAT I LITERALLY JUST MADE THE BIGGEST MISTAKE OF MY LIFE.

♪♪

♪♪

♪♪

I'M ABSOLUTELY TERRIFIED RIGHT NOW

BECAUSE I'M ABOUT TO FIND OUT IF I LOST MY WEIGHT-LOSS SURGERY.

♪♪

Barbara: SARAH IS FEELING VERY NERVOUS

BECAUSE SHE CHEATED ON HER DIET A COUPLE OF TIMES,

AND EVEN IF SHE DIDN'T GAIN ANY WEIGHT,

I'M SURE SHE DIDN'T LOSE ANY EITHER,

SO I REALLY DON'T THINK THIS APPOINTMENT

IS GOING TO GO VERY WELL AT ALL.

SARAH NEELEY?

Sarah: I JUST WANT TO GET THIS OVER WITH.

♪♪

♪♪

♪♪

I'M SO SCARED RIGHT NOW

DR. NOW IS GOING TO TELL ME THIS IS ALL OVER.

♪♪

[ KNOCKS ON DOOR ]

ALL RIGHT, SARAH.

SO YOU GAINED 14 POUNDS IN JUST A FEW DAYS,

AND YOU'RE BACK UP OVER 600 POUNDS AGAIN.

SO TELL ME WHAT HAPPENED.

I ATE SOME THINGS THIS WEEK I SHOULDN'T HAVE EATEN.

AND WHY IS THAT?

I JUST LOST CONTROL.

DIDN'T I TELL YOU IF YOU DIDN'T LOSE OR YOU GAINED WEIGHT,

YOUR SURGERY WOULD BE OFF?

YEAH.

WELL, AT LEAST YOU DIDN'T TRY TO HIDE IT FROM ME.

YOU WERE HONEST WITH ME,

WHICH SHOWS PROGRESS WITH YOUR PATHOLOGY.

SO THIS IS WHAT I WILL DO.

YOUR SURGERY WAS SCHEDULED FOR A FEW DAYS FROM NOW.

I'M NOT GOING TO CANCEL IT,

BUT I'M GOING TO RESCHEDULE IT FOR A MONTH FROM NOW.

OKAY.

AND WHEN YOU SHOW UP FOR YOUR SURGERY,

I WANT YOU TO HAVE LOST ANOTHER 40 POUNDS.

OKAY.

WE WILL WEIGH YOU WHEN YOU GET TO THE HOSPITAL,

AND IF YOU HIT THIS GOAL,

WE WILL MOVE AHEAD WITH THE SURGERY.

IF YOU DON'T, WE WILL SEND YOU BACK HOME.

SOUND FAIR?

-YEAH. -OKAY.

THIS IS YOUR SECOND CHANCE.

YOU CAN EITHER PICK YOURSELF UP AND DO THIS,

OR LOSE THIS CHANCE.

-OKAY. -OKAY.

YOU CAN DO THIS, SARAH.

I'LL SEE YOU LATER.

IT'S DISAPPOINTING TO SEE SARAH MAKE THE CHOICES SHE HAS MADE,

ESPECIALLY RIGHT AFTER APPROVAL,

BUT MOST PEOPLE WOULD TRY TO HIDE IT

UNTIL THE DAY OF THE SURGERY.

SHE WAS AT LEAST HONEST WITH ME,

AND I CAN WORK WITH THAT,

BUT THIS IS HER FINAL CHANCE.

♪♪

Sarah: I'M DISAPPOINTED, BUT MOSTLY IN MYSELF,

BUT I'M ALSO RELIEVED DR. NOW IS GIVING ME A SECOND CHANCE,

BUT LOST 40 POUNDS IN ONE MONTH SEEMS DAUNTING.

I THOUGHT I WORKED MY HARDEST WHEN I MET THE LAST GOAL,

BUT IF THIS IS THE CHALLENGE DR. NOW IS GIVING ME,

THEN IT MEANS I CAN DO IT.

SO NO MATTER HOW IMPOSSIBLE IT FEELS, I HAVE TO DO BETTER,

BECAUSE I CAN'T ALLOW MYSELF TO FAIL AT THIS.

♪♪

♪♪

SINCE SEEING THE DOCTOR A COUPLE WEEKS AGO,

I'VE GOTTEN RID OF ANY BAD FOOD IN THE HOUSE,

SO THE ONLY OPTIONS ARE HEALTHY FOOD

BECAUSE I DON'T WANT TO TAKE ANY RISKS,

BUT I CAN'T DELUDE MYSELF INTO THINKING

I'M AS STRONG AS I THINK I AM RIGHT NOW.

SO I CAN'T BE AROUND ANY BAD FOOD,

AND I'M MAKING SURE I KNOW HOW MUCH IS IN EVERY BITE

I TAKE RIGHT NOW.

TONIGHT, I'M HAVING CARROTS, WHICH HAS 90 CALORIES IN IT,

WITH SOME HUMMUS, AND THAT HAS 60 CALORIES,

AND THEN I'M HAVING ALMOND BUTTER, AND THAT HAS 95.

AND I'M NOT LETTING MYSELF GO OVER 1 SINGLE CALORIE

OF 1,200 IN A DAY.

I FEEL GOOD THAT I MADE THAT GOOD, HEALTHY DECISION,

BUT IT STILL SUCKS THAT I CAN'T EAT LIKE A NORMAL PERSON

AND MAINTAIN A HEALTHY WEIGHT.

I KNOW I'M LUCKY TO HAVE THIS CHANCE,

SO I'M 100 PERCENT COMMITTED

AND DETERMINED TO DOING THIS NO MATTER WHAT IT TAKES.

I NEVER WOULD HAVE THOUGHT I WAS CAPABLE

OF STICKING TO A DIET LIKE THIS,

SO I'M REALLY PROUD OF MYSELF,

AND NEXT WEEK, I'M TAKING IT TO A WHOLE NEW LEVEL

BECAUSE I'M GETTING A TRAINER AND GOING TO A GYM,

AND I'VE NEVER DONE THAT,

BUT IF THAT'S WHAT IT'S GOING TO TAKE TO DO THIS,

THEN THAT'S WHAT I'LL DO.

I KNOW I MESSED UP, AND NOW I HAVE TO FIX IT,

AND I'M MAKING SURE I DO THAT NO MATTER WHAT IT TAKES.

♪♪

♪♪

I'M STARTING SOMETHING NEW TODAY THAT'S COMPLETELY FOREIGN

TO MY WAY OF LIFE RIGHT NOW.

I'M GOING TO WORK OUT AT THE GYM,

AND I KNOW THIS IS GOING TO BE PAINFUL

AND REALLY HARD,

BUT THIS IS SOMETHING I NEED TO DO

AND SOMETHING I'M PROBABLY GOING TO HAVE TO GET

MORE COMFORTABLE WITH,

AND I KNOW THAT ALL THE THINGS I'M DOING

AND HOW HARD I'M WORKING ARE NOT JUST TEMPORARY.

I HAVE TO START DOING THINGS LIKE THIS

CONSISTENTLY FOR THE REST OF MY LIFE.

SO I'M GOING TO DO EVERY EXERCISE THE TRAINER TELLS ME,

AND I'M GOING TO DO IT AS HARD AS I POSSIBLY CAN.

-HOW YOU DOING? -HI.

GOOD. I'M SARAH.

-DERRICK. -NICE TO MEET YOU.

NICE TO MEET YOU. SO YOU READY TO GET TO WORK?

-YEAH. -OKAY.

SO WE'RE GOING TO START ON THESE ROPES OVER HERE.

HAVE YOU EVER SEEN THESE?

-YEAH. -ALL RIGHT. COME ON.

YOU GOT IT? ALL RIGHT.

SQUAT DOWN JUST A LITTLE BIT, AND JUST COUNT.

THERE YOU GO. THERE YOU GO.

EIGHTEEN, 19, 20, GOOD. PUT IT DOWN.

NOW WE'RE GOING TO COME OVER HERE TO THE BAR.

THERE YOU GO. COME ON.

SO THERE YOU GO. YOU DOING GOOD.

THERE YOU GO. THREE, GOOD.

9, 10, AND RELAX.

THERE YOU GO.

ALL RIGHT. SO NOW WE'RE GOING TO COME OVER HERE TO THE BOXING.

WE'RE GOING TO DO A LITTLE PUNCHING.

THERE YOU GO. OKAY?

GET YOUR RIGHT HAND ON THERE, OKAY?

COME ON.

ONE, THERE YOU GO, TWO, THREE.

DOING THESE EXERCISES MAKES ME FEEL STRONGER MENTALLY

AND PHYSICALLY BECAUSE I AM DOING AND ACCOMPLISHING THINGS

THAT I NEVER THOUGHT I WOULD BE ABLE TO DO.

NOW WE'RE GOING TO PUSH THE SLED.

THERE YOU GO.

I WAS EXPECTING TO COME IN HERE AND BE LIKE,

"NO. I CAN'T DO THIS," BUT I DID IT.

I DID SOMETHING I THOUGHT I WASN'T GOING TO BE ABLE TO DO.

KEEP GOING. KEEP GOING.

AND I FEEL REALLY INSPIRED BECAUSE I KNOW

THAT I CAN DO ANYTHING I PUT MY MIND TO.

MY SURGERY IS SCHEDULED IN TWO WEEKS,

AND WHEN I SHOW UP AND STAND ON THAT SCALE,

I WANT TO KNOW THAT I DID EVERYTHING POSSIBLE

TO GET THAT NUMBER AS LOW AS I COULD.

I JUST REALLY HOPE IT'S GOING TO BE ENOUGH

TO KEEP ME FROM LOSING MY SURGERY.

♪♪

♪♪

♪♪

♪♪

I'M A NERVOUS WRECK RIGHT NOW.

I'M JUST WAITING FOR DR. NOW TO COME AND GET MY WEIGHT CHECK

AND FIND OUT IF WE'RE MOVING AHEAD TODAY OR NOT,

BUT I KNOW THIS IS A BIG GOAL TO HIT,

SO I REALLY HOPE I GET TO MOVE AHEAD WITH SURGERY,

BUT I'M STILL REALLY SCARED THAT MY WEIGHT-LOSS SURGERY

WILL BE CANCELED,

AND IF THAT HAPPENS, I'M GOING TO BE DEVASTATED.

♪♪

♪♪

♪♪

Sarah: I'M A WRECK RIGHT NOW.

I JUST WANT TO FIND OUT MY WEIGHT

AND THAT I'M STILL GETTING SURGERY TODAY.

-GOOD MORNING. -GOOD MORNING.

-GOOD MORNING. -HOW Y'ALL DOING?

-GOOD. -SO YOU REMEMBER WE HAD A DEAL.

YOU LOSE 40 POUNDS, WE'LL DO YOUR SURGERY.

IF NOT, WE'RE GOING TO SEND YOU HOME.

OKAY.

DON'T THINK JUST BECAUSE YOU HAVE BEEN PREPPED

THAT WE WON'T CANCEL YOUR SURGERY, OKAY?

OKAY.

SO LET'S GET YOU DOWN TO THE SCALE.

♪♪

THIS IS A WEIRD SCALE.

YOU WERE BACK UP TO 603.

SO YOUR GOAL TODAY IS TO BE AT OR BELOW 563.

♪♪

SO YOU DID IT. GOOD JOB.

WE WILL MOVE AHEAD WITH YOUR SURGERY TODAY.

-GREAT. -OKAY.

[ SIGHS ]

I'M SO RELIEVED I DID THIS

AND THAT I'M ABOUT TO GET THE SURGERY I NEED.

ALL RIGHT. SARAH, LET'S GET YOU STARTED AND GET YOU TO SURGERY.

YOU THINK I'M GOING TO BE OKAY?

YEAH. YOU'LL BE JUST FINE.

-OKAY. -ALL RIGHT?

-THANK YOU. -ALL RIGHT.

-OOH, YOU LOOK GOOD! -DO I?

YES, YOU DO!

I HOPE I MAKE IT THROUGH THIS.

OH. YOU'LL MAKE IT THROUGH THIS.

Heather: THERE'S NO REASON FOR YOU NOT TO.

YES.

Heather: I'M JUST EXCITED THAT THIS IS FINALLY HAPPENING.

WE'RE ALL TRYING TO TELL HER THAT SHE'S GOING TO BE FINE,

BUT THERE'S NO WAY TO REALLY GET RID OF THAT FEAR

UNTIL SHE COMES OUT OF THE SURGERY,

BUT SHE KNOWS THAT SHE NEEDS THIS, TOO,

JUST AS MUCH AS EVERYONE ELSE.

YOU'LL BE ALL RIGHT.

NO. YOU'RE FINE. YOU'RE FINE.

CALM DOWN.

HONEY, YOU'RE GOING TO BE ALL RIGHT.

Barbara: SARAH IS ABSOLUTELY TERRIFIED.

HER ANXIETY LEVEL IS THROUGH THE ROOF

BECAUSE SHE'S AFRAID THAT SHE'S GOING TO DIE ON THE TABLE.

WE'LL BE PRAYING FOR YOU.

SO I'VE BEEN TRYING TO REASSURE HER ABOUT THAT AND TELL HER

THAT WE'RE PRAYING FOR HER.

Sarah: I'M AFRAID THAT MY HEART IS GOING TO STOP BEATING

OR I'M JUST NOT GOING TO WAKE UP.

BUT NOTHING IS GOING TO STOP ME

FROM MOVING AHEAD AND DOING THIS.

I KNOW THAT I DON'T HAVE A LIFE WITHOUT THIS,

SO NO MATTER WHAT, I'M GOING UNDER.

♪♪

Dr. Nowzaradan: TODAY, WE ARE DOING A GASTRIC-SLEEVE PROCEDURE

ON SARAH.

THIS WILL HELP HER TO CONTROL HER EATING

AND STAY ON TRACK EVEN MORE.

BUT DOING SURGERY ON ANYONE THAT'S SUPER MORBIDLY OBESE

IS VERY HIGH-RISK.

ALL RIGHT. BRING THE LIGHT DOWN.

THE STRAIN OF OPERATION OR EVEN ANESTHESIA

CAN PUSH HER BODY OVER THE LIMIT,

AND ANY NUMBER OF THINGS CAN CREATE AN ISSUE

THAT WILL PREVENT US FROM FINISHING THE OPERATION.

SO WE HAVE TO BE VERY CAREFUL

NOT TO PUSH HER BODY TOO HARD.

BECAUSE IF ANY PART OF HER BODY STARTS TO GIVE OUT,

LIKE HER HEART OR LUNGS,

THEN WE MIGHT NOT BE ABLE TO SAVE HER.

BUT IF WE ARE ABLE TO COMPLETE THE OPERATION

SUCCESSFULLY TODAY,

THIS SURGERY IS GOING TO BE A BIG HELP TO SARAH

BECAUSE THE SLEEVE GASTRECTOMY IS AN OPERATION

THAT WE REMOVE 80 TO 90 PERCENT OF THE STOMACH

AND LEAVE A LONG, SKINNY TUBE THAT IS SHAPED LIKE A SLEEVE.

THE SURGERY WILL ALSO ALTER THE DIGESTIVE SYSTEM

AND METABOLISM OF A PERSON

SO THAT THE PATIENT IS LESS HUNGRY

AND CAN GET FULL REALLY QUICK.

♪♪

Barbara: WAITING IS HARD. I'M KIND OF ANXIOUS.

ALL KINDS OF THINGS GO THROUGH MY MIND.

YOU KNOW, IS SHE OKAY?

I'M TRYING TO STAY POSITIVE,

AND I JUST WANT IT TO BE OVER FOR HER.

[ MACHINE BEEPS ]

KEEP PULLING. GOOD.

OKAY. CAN YOU TURN THE ROOM LIGHT ON?

OKAY. ALL FINISHED.

Dr. Nowzaradan: SARAH'S SURGERY WENT VERY WELL.

SO WE WILL GET HER TO RECOVERY.

FOR THE FIRST MONTH AFTER SURGERY,

SHE WILL BE ON A LIQUID DIET,

AND SHE SHOULD BE ABLE TO LOSE

ABOUT 25 POUNDS IN THIS NEXT MONTH,

AND AFTER THAT, 15 TO 20 POUNDS A MONTH

UNTIL SHE GETS CLOSER TO HER TARGET WEIGHT.

BUT WE NEED TO MAKE SURE THAT SHE WILL STICK

TO HER THERAPY APPOINTMENTS WITH HER MOM

BECAUSE SARAH WILL NEED TO CONTINUE

WORKING ON HER CORE ISSUES

THAT HAVE BEEN DRIVING HER TO EAT

THAT MOSTLY REVOLVE AROUND HER MOM,

AND THE CONSEQUENCES IF SHE DOESN'T

IS THAT SHE WILL EVENTUALLY START TO GAIN AGAIN,

AND WE CAN'T LET THAT HAPPEN.

♪♪

♪♪

♪♪

READY?

Sarah: IT'S BEEN A COUPLE MONTHS SINCE MY SURGERY,

AND THE FIRST WEEK WAS REALLY ROUGH,

BUT AFTER THAT, THINGS GOT BETTER.

SO I'M FEELING GREAT, AND I'M STARTING TO BE ABLE

TO DO NEW THINGS THAT I'VE NEVER DONE BEFORE.

OH, MY GOD. LOOK AT IT.

WOW. I LOVE IT.

I KNEW YOU WOULD.

RIGHT NOW, I AM AT THE BEACH SEEING THE OCEAN

FOR THE FIRST TIME, AND IT FEELS ABSOLUTELY AMAZING.

I HONESTLY THOUGHT THAT I WOULD NEVER MAKE IT TO THE BEACH,

SO TO BE HERE RIGHT NOW STEPPING IN THE OCEAN,

IT'S A DREAM COME TRUE.

AND I THINK THERE WAS A PART OF ME THAT JUST GAVE UP ON LIFE,

SO I DIDN'T EVEN TRY TO DO ANYTHING,

BUT NOW THAT I CAN, IT'S JUST A WHOLE NEW WORLD TO ME.

I WANT TO GO FURTHER.

SO I'M REALLY HAPPY RIGHT NOW, AND I THINK THE BIGGEST,

MOST IMPORTANT CHANGE IN MY LIFE

IS HOW MY RELATIONSHIP WITH MY MOTHER IS IMPROVING.

IT'S NICE BEING OUT HERE WITH MY MOM

BECAUSE WE'VE NEVER DONE ANYTHING LIKE THIS TOGETHER

THE WHOLE TIME I'VE BEEN ALIVE.

WE'RE STILL GOING TO THERAPY TOGETHER,

AND WE BOTH KNOW WE STILL HAVE A LONG WAYS TO GO,

BUT I FEEL LIKE OUR RELATIONSHIP

IS GETTING TO A REALLY GOOD PLACE,

AND THAT'S WHAT I'M MOST EXCITED ABOUT BECAUSE I LOVE MY MOM,

AND I'VE WANTED US TO BE IN A BETTER PLACE FOR SO LONG.

IT'S VERY IMPORTANT TO ME THAT MY RELATIONSHIP WITH SARAH

IS BETTER THAN IT USED TO BE.

AS A MOTHER, IT BREAKS YOUR HEART

TO NOT BE ABLE TO COMMUNICATE WITH YOUR KIDS

AND GET ACROSS WHAT YOU'RE TRYING TO SAY,

BUT SHE LISTENS MORE TO ME NOW, AND IT JUST MEANS EVERYTHING.

I AM PROUD OF YOU, AND I LOVE YOU.

THANKS. I LOVE YOU.

GIVE ME A HUG.

Sarah: I'M JUST SO THANKFUL FOR EVERYTHING

AND HOW MUCH PROGRESS I'VE MADE.

♪♪

♪♪

I'M FEELING REALLY GOOD,

AND I'M MOVING BETTER THAN I HAVE IN YEARS.

I'M BREATHING BETTER THAN I HAVE IN YEARS.

I'M JUST DOING GOOD OVERALL, MENTALLY AND PHYSICALLY.

OH, MY GOD. THAT'S GREAT. YAY!

I SEE THE PROGRESS I'M MAKING EACH MONTH,

AND IT MAKES ME MORE CONFIDENT EVERY TIME I SEE THAT.

-HELLO. -HI.

-HI. -HOW Y'ALL DOING?

-GOOD. -DOING GOOD.

ALL RIGHT. YOU ARE AT 458 TODAY.

YES.

SARAH, YOU'RE DOING GREAT.

HOW DO YOU FEEL?

GOOD.

YOU'RE FEELING YOU CAN GET AROUND BETTER?

I CAN LIFT MY LEG AND HOLD IT.

SHE'S NEVER BEEN ABLE TO DO THAT BEFORE.

THOSE LITTLE THINGS, ONE BY ONE, WILL SURPRISE YOU EVERY DAY,

AND EVERY DAY, YOU'RE GOING TO BE ABLE TO DO SOMETHING NEW.

-OKAY. -ALL RIGHT.

SO IF YOU STICK WITH IT,

THE GOAL WILL BE FOR YOU TO BE 190 POUNDS WITHIN A YEAR.

-OKAY. THAT'S CRAZY. -WOW.

-THAT IS. -YEAH.

AND ONCE YOU GET IN THE 300s,

I THINK YOU'LL BE READY FOR SKIN REMOVAL.

SO KEEP IT UP, AND I'M PROUD OF YOU.

-OKAY. -OKAY?

THANK YOU.

ALL RIGHT. I'LL SEE YOU NEXT MONTH.

-OKAY. -BYE.

-BYE. -BYE-BYE.

Barbara: 190, THAT'S GOING TO BE GREAT.

-SKIN SURGERY. -WOW.

WHAT AM I GOING TO DO WITH MYSELF?

ANYTHING YOU WANT.

ANYTHING YOU WANT.

THIS IS EXCITING.

AFTER A ROCKY START, SARAH IS DOING VERY WELL

AND STAYING ON TRACK, SO I'M REALLY PROUD OF HER.

THE KEY HAS BEEN ADDRESSING THE RELATIONSHIP AND DYNAMIC

BETWEEN HER AND HER MOM,

SO AS LONG AS THEY KEEP GOING TO THERAPY TOGETHER

AND WORKING ON THINGS,

THEN I'M CONFIDENT THAT WE CAN GET HER TO HER GOAL WEIGHT.

♪♪

♪♪

♪♪

I FINALLY MADE IT UNDER 400,

SO ONE OF MY BEST FRIENDS FROM EVER SINCE

I WAS REALLY YOUNG CAME TO SEE ME AND CELEBRATE WITH ME,

AND WE WENT AND GOT OUR HAIR AND MAKEUP DONE.

OH, MY GOD. I LOVE IT!

♪♪

READY?

I SEE MY FUTURE NOW AS SOMETHING WITH ALL THIS POSSIBILITY

BECAUSE I'M STARTING TO DISCOVER THE HOPES

AND DREAMS I NEVER LET MYSELF HAVE,

AND I'VE NEVER BEEN ON A DATE EVER.

I HAD NO SELF-ESTEEM, AND I FIGURED

NO ONE WOULD DATE THE BIG GIRL,

BUT NOW, I'M FEELING GOOD ABOUT MYSELF,

AND I'M FEELING A LOT MORE CONFIDENT,

SO CHINA TALKED ME INTO SIGNING UP TO A DATING WEBSITE.

-I'LL BE RIGHT OUT. -OKAY.

IT HAS BEEN SO LONG SINCE I HAVE FELT

REMOTELY THIS GOOD ABOUT MYSELF.

AND I'M DISCOVERING MYSELF THROUGH THIS PROCESS,

AND NOT ONLY AM I LIKING THE PERSON I'M FINDING,

I THINK SHE HAS A LOT MORE POTENTIAL

THAN I EVER GAVE HER CREDIT FOR.

WHICH BEST DESCRIBES YOUR BODY TYPE, SLENDER, AVERAGE,

ATHLETIC, TONED, HEAVYSET?

JUST PUT SLENDER.

[ LAUGHS ]

THIS ONE?

OH, THAT ONE IS CUTE.

I WANT TO DO THINGS AND GO PLACES AND MEET SOMEONE

AND HAVE A FAMILY ONE DAY.

A YEAR AGO, I WASN'T GOING TO LIVE MUCH LONGER,

AND NOW I HAVE A WHOLE LIFE AND A FUTURE AHEAD OF ME

THAT I CAN'T WAIT FOR BECAUSE I'M IN CONTROL

OF MY LIFE AND FULFILLING THE DREAMS I HAVE NOW

AND ENJOYING EVERY SECOND OF IT.