All language subtitles for My 600-lb Life S09E05

Of course you're not
supposed to be this way.

And you're supposed to be able
to function as a normal person.

[music playing]

(CRYING) Somewhere in me is
this little glimmer of hope.

I just want to be
a normal person.

[panting]

You can't do it.

And then I just get mad.

If I don't make
a change now, I'm

scared it's gonna be too late.

[groaning] This is hard.

I refuse to stop fighting.

I have to do this
for my children.

I'm happy you asked me out.

Really?

Yeah.

Well, I'm happy you accepted.

[pensive music]

MELISSA: I have a hard time
facing the reality of my life

because at my
size, at my weight,

you purposely avoid
everything that

brings your awareness to how
you appear to other people.

And that's how I've
tried to live for years.

But no matter how hard I
try, I can't ignore it now.

Because when you
get to my size, it's

like the world is on my
shoulders and all over my body.

And it's just globs of fat
just, like, flopping around.

Of course you're not
supposed to be this way.

And you're supposed to be able
to function as a normal person.

And I'm unable to function
as a normal person because

of all this excess weight.

I need to plan every
step and move I make,

or I might end up in a situation
I can't get out of because I

just can't do too much at once.

And it makes me feel
depressed, unwanted.

It makes me feel embarrassed.

It makes me anxiety ridden.

It makes me feel
lesser than a person.

It's like I'm humanizing
myself every day.

(CRYING) And it's miserable
to live like this.

My life is miserable because
of how big I've let myself

get because of my love of food.

My whole life
revolves around food.

And I'm constantly
thinking about it,

craving it, wanting it.

There's not a moment
where I'm not hungry.

And I can't wait to eat because
of the joy that it brings me.

Food makes me feel like
I don't have to feel.

Food feels for me.

It fills you up from what
you feel empty inside.

Food gives you that
wholesome moment

that you're looking for in the
day to feel like you matter.

It doesn't judge you.

It just helps you cope.

And you feel good.

It fulfills that high.

The only problem with
food is the after effects.

As soon as I'm done
eating, then it

goes back to
scheduled programming

of feeling depressed
and feeling unwanted--

everything you
don't want to feel.

So I just keep
eating and destroying

my life to where I'm
not even living anymore

because I'm just too big.

When I was younger, I
struggled with my weight.

But I just never imagined
it would get this bad.

I was always a chunky child.

And I think that issue
started with my mother.

My mother-- I would not say
that she is the sole person

why I gained weight.

But I could say that she is
the person who started it.

My mother fed me these
large meals to make

up for the verbal abuse.

My mother was very verbally
abusive in the things

that she would say.

You're stupid.

I wish I never had you.

I wish you were better.

I wish you were smaller.

And then in turn, dinner would,
like, be a few hours later.

And she would make
you this mass plate

because she's felt guilty for
calling you stupid all day.

So you know, I took
food as love from her.

And I wanted that.

I wanted to know she
felt bad for the things

that she would say to me.

But my mother made me finish
every morsel on that plate.

It could be the morsel of,
like, in between my finger.

You better finish it.

Sometimes after I
would eat the food,

you know, she would be, like,
happy about it because it

brought her some sort of joy.

But if you're a
child, you should not

be eating an adult sized meal.

But I learned eating is good.

And you know, it
doesn't matter if you're

full if you have more food.

You just eat what's
made for you.

It wasn't the same
with my father

because there was no
judgment of being overweight.

You know, I was his little girl.

And he just wanted
me to be happy.

That was my go to person.

He was my best friend.

But when I turned
eight years old,

my parents' relationship really
took a turn for the worst,

became toxic.

And then my father
decided to leave.

But losing my father like
that devastated me because he

was out of my life so fast.

So it was hard for me.

And I know it was hard
for my mother too.

That's when I started
putting on a lot more weight.

I became extremely
depressed for a while

and used food as a pick
me up to make me happy.

And over that summer alone,
my size more than doubled.

I started off at,
like, 60 to 70 pounds.

And then by the end of that
summer, I was 150 pounds.

All the weight gain slowed down
when I went back to school.

And I wasn't eating
as much, but I

was still finding
ways to sneak food

and eat the way that I wanted.

And so I put on another 100
pounds in the next five years.

And I was around
250 when I was 13.

And when it got like that
was when my mom started

to really point out my size.

My mother would constantly
comment on my weight.

Like, she would say, you're fat.

You're a girl.

You're supposed
to be attractive.

So that upset me more.

But I also tried to
stop eating as much just

because I wanted all
the things my mom was

saying to me to stop.

And so I lost some
weight between the ages

of 13 to 15 years old.

And then something
drastic happened.

When I got into high school,
I started dating someone.

And when I was 15,
I got pregnant.

I got pregnant and
got an abortion.

My mother was the one who
took me to have the abortion

because only my mother knew.

And she wasn't happy when I
got myself into that situation.

But after my abortion
and depression,

I felt a lot of regret.

And I felt guilt. So I went back
to food to cope with the pain.

And I started getting bigger.

The food didn't make the
depression I had go away.

And it got too
overwhelming for me that I

didn't want to do anything.

And when I turned 16, I
dropped out of high school.

And for the next
couple of years my life

was just eating and sleeping.

And I hid.

I only had one person
I really got close to

and who I considered
a true friend.

And her name is Shay.

She would come over
and check on me.

And she still does
it to this day.

But she was the only
one who did that then.

Other than seeing
her and my mom,

I was alone, eating
all the time.

Between 16 and 18 I
gained another 100.

So I was close to
being over 400.

But I didn't let my
weight gain hold me back.

About four months
into turning 18,

I ended up going back to school.

And over the summer, I
finished barely and graduated.

And then I got a job and
started to get back on track.

And when I was 22, I
tried to go to college.

I did that, and I got a job
to pay for all my bills.

And it went well
at first, you know?

The first year was OK.

And then I lost my job.

I just fell deeper
into depression

and started eating more.

And I decided to drop out.

So I was a college dropout
at 23 and around 450 pounds.

So I got a job as a receptionist
and got a place of my own.

And so for many years, all I
did was go to work and eat.

I didn't do much
because of my depression

that I was still dealing with.

And then it got worse because
my dad died when I was 27.

Went through a very
big depression.

And then I got sick from
all the stress at the time.

I was over 500 pounds then.

And the weight was
starting to get to me.

I ended up being
very weak and tired.

And I was too tired
to just keep going.

But one day, I
passed out at work.

And that's when I
knew my health was

getting to a really bad point.

But I still couldn't help
myself when it came to food

because food filled that void.

So I needed it even though
it was taking over my life

because I couldn't
work anymore, and I

was getting worse every day.

That was amplified even more
because at 35, I lost my mom.

And that sent me into
another spiral (CRYING)

because she suddenly
passed from kidney failure.

Because I was too big to go
to her wake or her funeral,

so I had to miss that.

And it made me feel so
ashamed that my weight kept me

from that.

But after losing my mom,
I felt like I was alone.

The only person I have
now is my friend Shay.

But I only see her when
she's able to check in on me.

Other than that, I'm trapped
in this apartment every day.

Hey, Melissa.

[inaudible].

Get everything?

Yeah, I got you some food.

MELISSA: When I have
food, I have happiness.

So how do you give up
happiness even though you

know it's killing you?

I know how I eat is killing me.

And if I don't change,
I'm going to die.

And what scares me most
about my life right now

is not waking up, not
being able to live it,

not being able to
accomplish goals

that I set forth for myself.

SHAY: I've known Melissa
for over 20 something years.

Melissa is very bubbly,
very intelligent person.

But she does have some struggles
when it comes to self-esteem

issues and things of that such.

She used to go out.

She used to travel.

Now it's much different.

Even though she gained excessive
weight now, she doesn't go out.

I don't want to
share any of these,

but I'm going to be nice.

That's fine.
You can have them.

You sure?

I'm positive.

MELISSA: I want to
roller blade again.

I want to be able
to have fun and make

jokes and not feel embarrassed
to be around people.

When you're
overweight, you don't

want to be around
people because you

feel like they're judging you.

You just avoid everything.

I want to travel
with my best friend.

I want to be able to go out
and dance and have a good time

and make jokes and feel
secure within myself.

I want to regain my
confidence that I once had.

But I can't do any of that if I
don't give up food because it's

keeping me from all of that.

My food addiction is killing me.

And if I don't make
a change, the people

who do love me and appreciate
me that are still here,

who count on me, won't have me.

And that's not fair.

(CRYING) It's not fair.

And I know life is not
supposed to be fair.

But there are some
things that are.

So I know I have to
do something drastic

because I can't sit
and continue to ignore

what I've done to myself.

It's either face
the music or just

start planning your funeral.

And I don't want to die.

I'm going to be
traveling to Houston

today to try to see Dr. Now.

I have an appointment with
him tomorrow because I

want weight loss surgery.

But I'm willing to do this
and go all that way if there's

any chance I could
turn my life around

because I know I have to.

I'm gonna fly because I know
I can't last in a car for days

to get there from Florida.

[doorbell rings]

Come in!

And my best friend Shay is
coming with me to Houston

to meet Dr. Now as
support and to help me

because I also know I want to be
able to do this trip on my own.

Hi.
- Hey.

Good morning.

Good morning.

I don't know why I booked
this flight so early.

[laughs] Me either.

MELISSA: [laughs]

SHAY: How are you doing?

I'm just nervous.

Well, it's now or never, right?

Yep.

OK.

It's been a while
since I've flown,

so I don't know what the
travel is gonna be like.

I think that's what I'm really
fearful of because when you're

this size, you just avoid
everything because it's

just easier to do that.

All right.

There we go.

But this is a journey that
I've been wanting to start

for a really long time.

I've been waiting for
so long for a miracle.

And I just want change.

I just want to change.

And he could help me.

So I'm ready for the challenge.

But I'm thankful for
the support that I

do have with Shay to do this.

And my friend Wendy is also
driving us to the airport.

So I know I have people
that are there for me.

And that helps me
stepping out like I

am because I do not like going
out in public ever really.

I know I have to do this because
the way I've lived my life

has to change.

Or I know I won't
be here much longer.

And I'm not ready to give
up and wait for that.

So I'm gonna fight to
try to change that.

I just hope my worst fears
of how bad this could go

are wrong.

And I'm not trying
to push myself

to a place I'm not ready.

I'm gonna pray for you.

Thank you.

Let me know how it goes.

[interposing voices]

Love you too.

If I don't make the whole trip,
the worst part would be me not

getting the help that I need.

And if that happens, my
life is basically over.

So I desperately need
to do this because I'm

running out of time.

So no matter what it takes,
I have to make it there.

Me and Shay made it
to Houston last night.

The trip wasn't as bad as
I was worried it would be.

But it was still a lot of
activity for me, a lot more

than I've had in a
really long time.

So I'm sore.

And it's a little harder for me
to move today because of that.

But overall, I feel good.

And I'm ready to meet
Doctor Now and get his help.

I'm just nervous
because there's always

a chance he could say he can't
help me for whatever reason.

And if that happens,
it will be tragic.

So I'm just praying
it all goes well.

Melissa?

MELISSA: This is the first step
for me getting my life back.

It's been years since
I've been on a scale.

So I'm worried about where
my weight is at today.

Seeing that number come
up is not very easy.

And it only gets harder
the bigger it gets.

That's not as bad as I
was afraid it could be.

But it's still way too high.

And I need to get it to drop.

And I'm hoping
Doctor Now will be

able to help me do that because
I'm tired of being this size

and having this life.

I'm ready for it to change.

And I need it to change now.

Hello.

How are y'all doing?

MELISSA: Good.

How are you?

DR. NOWZARADAN: I'm good.

Thank you.

All right.

I'm Dr. Nowzaradan.

You must be Melissa.

Yes.

And this young lady--

This is my best friend Shay.

Nice to meet you both.

You as well.

So Melissa, your
weight is at 592 pounds.

So you're here to
get help with that?

Yes.

DR. NOWZARADAN: That's
good because looking

at your weight and height, your
BMI is 115, which is very high.

It's one of the
highest we have seen.

So the weight you have on you
being under five feet tall,

if you have average height,
you'll be at 200 pounds.

So this is a lot of
weight on your system--

your heart, your lung,
and nervous system.

And on top of that, most of
your weight is in mid portion.

It's going to compromise
your breathing

and compromise your circulation.

And anything can happen to you.

Even something like a
cold, there's a good chance

you won't make it.

You know what?

Your life expectancy for
people in your category

is not even 50 years old.

So that's very dangerous
situation you have.

You know what a normal
weight for you is?

90 pounds.

Not even 100 pounds.

And you're almost
six times that.

So how long will it be
before your heart and lungs

and your joints and every organ
in your body gonna give away?

Won't be too long.

So you need to lose
weight now to stop that.

This is why I'm here.

You're here because you
need some help, right?

Yes.

So what are you willing to do?

Change for the better, eat
healthier, to cut out the soda.

Just to live better.

Well, you haven't
done that for 36 years.

And you knew there
was doing something

wrong eating those things.

But you didn't change.

What is different now?

(CRYING) I don't
have my parents to--

I don't have my parents
to have that cushion.

And I want to
proceed with my life.

And I just want to
be able to accomplish

goals that I didn't get to.

And I'm still young
enough to do it.

I want to do it.

OK.

If you're ready to make a
change, we can help you.

But we're gonna give you
some roadmap that you're

gonna have to follow.

But there's not
gonna be anything I

can do to make you lose weight.

It's gonna be you that you're
gonna have to make the changes.

You think you're ready
to make the changes?

MELISSA: If I have
your help, yes.

OK you will have
my help, but I

can't make the choices for you.

So at the end of the day,
you need to understand

this is mostly up to you.

We just give you
guidance and some tools.

I'm gonna give you
dietary education for you

that I want you to read
every night to understand

what's going on with it.

Follow that.

And it will break down.

It's 1,200 calories a day.

That's going to be
focused on protein.

Zero carb.

Zero carbs.
OK.

DR. NOWZARADAN: Zero carbs.

OK?

You're gonna eat with the
protein and vegetable.

OK?

Yes.

DR. NOWZARADAN: And
if you follow that,

then you're gonna be
easily able to lose

60 pounds in two months.

And if you do that,
then we'll consider

you for weight loss surgery.

OK.

DR. NOWZARADAN: OK?

But right now, it's not gonna be
safe for you to have a surgery

this way that you are.

So you're gonna have
to lose some weight

to change that before surgery
is even an option for you

and understand that your
health and your life

is more important than food.

MELISSA: OK.

OK?

I also want you to
improve your stamina.

So I'm gonna give you
exercise to do too.

I want you to do those exercises
an hour in the morning,

an hour in the afternoon.

OK.

And if you do all
that in two months,

you should be in a lot better
place with your health.

OK?

OK.

But you're eating
because of food comfort.

Oh, yeah.

That need to be addressed.

So psychotherapy is going to
be another step we need to take

for you to be successful
in the long term

to work on those issues, see
what is driving you to eat,

and what is it driving
you to have food comfort.

OK?

One bad day is gonna look much
better if you eat too much.

And so you feel better
after you eat too much.

But then after that, you feel
bad because you ate too much.

Exactly.

OK.

So this vicious circle
is gonna have to break.

So we'll get you
some psychotherapy

to help you with that.

Then if you do the
surgery, you will

need to move to Houston to
do the program since Florida

is far to travel from.

OK.

But the first
step is you showing

me you're ready to do this by
losing 60 pounds in two months.

So everything is gonna be up
to you from this point on.

OK?

OK.

All right.

Well, nice to meet you.

SHAY: You as well.

DR. NOWZARADAN: And
we'll see you again.

OK?

OK.

Thank you.

Have a good day.

You too.
Bye.

BOTH: Bye.

MELISSA: [sighs]

DR. NOWZARADAN:
Hopefully Melissa

means it when she
says she realizes

the danger of her situation and
that's ready to change because

for her height, she has
an exceptional amount

of weight on her that's
putting a great deal of strain

on her whole body.

So she has to lose a
lot of weight fast.

And if she doesn't start that
over the next two months,

we may need to consider more
extreme options to intervene

before something happens
to start the domino effect

of her body shutting down.

Because once she gets to that
point, there won't be very much

we can do to bring her back.

So it's very important
that she starts

to make the changes
she needs right now

before it's too late for her.

MELISSA: I feel good about
my appointment in a weird way

because even though Dr. Now said
some really hard things for me

to hear, I know it's
the truth and what

I need someone to tell me.

Because I know he's right.

And I'm not gonna make it much
longer if I don't do something.

So I'm not gonna let
anything be an excuse

for me not to do this.

I'm gonna give this all
that I got because this

is do or die for me.

Either I follow his plan,
or my heart or something

will give out soon.

And that will be it for me.

So I have to make sure
that doesn't happen.

It's been about a month
since I've seen Dr. Now

for my first appointment
where he gave

me his diet and exercise plan.

And I've been doing it
religiously like he told me.

I'm just doing everything
that I'm supposed to be doing.

I'm not cheating on any of it.

And I'm doing all these
exercises and everything

in the diet plan.

So my days look a
lot different now

than they did just a month ago.

You know, I'm much
more active because Dr.

Now advised that I should
exercise at least twice a day.

And those exercises involve
my upper and lower body.

So I do these band stretch
exercises for my upper body

in the morning.

And that alone took a
lot out of me at first.

I got really sore
after the first day.

But I can do them better now.

And I can do about
double the reps now.

So it's getting better
slowly but surely.

And I've been expanding those
exercises by looking online.

And I just picked
out some videos

that I could just do on
the fly, like, hey, let me,

you know, do this 10
minute interval of exercise

to add to what I do for
my upper body stuff.

So I've made progress there.

And I've also made progress
with my overall stamina

and how I could get
around because I'm walking

the amount that I
need in the morning

and then again in the evening.

And I try to incorporate
that exercising in my day

or getting up to clean
or going to get the mail.

And usually I would wait
for Shay to do that.

And in general, I
would go to my mailbox

once a month because it's
not only hard for me to do,

but I don't like
going outside at all.

But I've been trying
to venture out

more just to get used to
walking out more, you know,

trying to explore more.

And I know just going to the
mailbox doesn't seem a lot,

but it's a lot for me.

But now I make it my
business to at least go

every day or every other day.

So I'm a lot more active now.

And I'm doing more than
I would normally do.

And after a month of it,
I do feel a lot better.

I still have to stop
and take my breaks.

I have to be careful and
not push myself too hard.

But the breaks that I
have to take are shorter.

So I see progress with that too.

And before I started
this journey,

I did not like working out.

But now when I'm done, I'm happy
I did it because I feel good.

And the more that I
do it is something

that I'm becoming more OK with.

So overall, I know I'm
doing a lot better.

And I'm excited about that.

But cutting back on
food has probably

been the hardest part, a lot
harder than the exercises.

You know?

But Dr. Now called me
out on eating bad foods,

eating carbohydrates
that are not,

you know, appropriate
for your body, you know,

and taking more protein.

You know, don't snack.

Eat small.

You know, if you're
not hungry, don't eat.

The biggest thing.

And I'm so used to
ordering something

whenever I get hungry.

And I'll eat it really quickly.

And I get full, but
I still want more.

So I'll get more just
whenever I want it.

But now I have to actually
eat at the appropriate times.

And no more big meals.

You know, I gave
up my big breakfast

and my late night eating.

But my biggest issue
is giving up soda

because soda's like my coffee.

It's like, it keeps you up.

It's sugary, so you're like--

and then all of a sudden,
it's just like you're down.

So that's been the
hardest for me to give up.

But I've done it.

And I'm only sticking
to water now.

So this has been a really
big adjustment for me.

And I'm working really hard.

I have tripped up
a couple of times.

The best advice that
Dr. Now did advise

is that you're
gonna have bad days.

You're gonna have good days.

But it's all about how
you start off tomorrow.

So the times I've slipped,
I've just corrected the course

and got back to
doing what I need.

And my mindset right
now is to do the best

that I can do every day.

And you know, my hope
is that it's all enough,

and I make it to the goal
that I need by next month

when I go back to Dr. Now
because I'm committed to this,

and I'm trying to do it
to the best of my ability.

And I know this is my
last chance to get help.

I have to save my life.

So I'm pushing myself
hard to get it.

And I just need it to be enough.

I'm back in Houston
to see Dr. Now again.

And I'm really nervous
to get back on the scale

because it's gonna be an
important weight check for me

since I need to hit a
weight loss goal today

if I'm going to move ahead.

So all the hard work that
I've put in the past couple

of months comes down to right
now to see what progress I've

made and to see if it's enough.

And I'm really hoping that it
is because I know the chance I

need to get to a better place
and to have a better life all

depends on what Dr. Now tells
me and whether he approves

me for weight loss surgery.

Melissa?

MELISSA: And I'm gonna know what
that answer is when that number

comes up on the scale because
either it will be enough

for me to get it, or it won't.

So I just need it to be
enough because everything

depends on this.

I'm at Dr. Now's for
my second appointment

to see if I made it to my goal
to get weight loss surgery.

I've worked really hard.

So I'm expecting to
see good results.

But I'm still nervous to
find out what I've lost.

Dr. Now told me
to lose 60 pounds

over the last two months.

So that means I need to have
at least gone from 592 to 532

by today.

NURSE: 548.

Really?

NURSE: Yes, ma'am.

[laughs] That's a lot,
but it's still not enough.

I know I worked hard.

So it's disappointing not to
see more of a result right now.

And I don't know
what Dr. Now is gonna

say about where I'm at today.

Hello.

How are you doing?

Good.

How are you?

I'm doing good.

OK, Melissa.

In two months, you
managed to lose 44 pounds.

Yes.

So that's almost 20 pounds
short of what the goal was.

I know.

So what happened?

I'm not sure.

I worked really hard.

Well, not exactly.

You worked hard
to lose 40 pounds,

but not as hard as
you should have.

Because if you did the
diet, you would have easily

lost close to 100 pounds.

So did you do the diet?

Not every day.

There were times
where I tripped up

and ate stuff I shouldn't have.

So why are you
lying to yourself

about how hard you worked and
trying to lie to me about it?

I don't know.

I thought I worked
really hard, but I guess

I should have worked harder.

I'm glad to see that you're
being honest with yourself

about that.

So that's positive.

And losing 44 pounds is
also a positive achievement.

So you're showing me you're
willing to take the first step.

But I still need to see a
little bit more from you

if you want to show me you're
ready for weight loss surgery.

MELISSA: I'll try harder.

I'm willing to make the change.

OK.

I give you two more months
to lose another 40 pounds.

OK.

You think you can do that?

Yes, definitely.

DR. NOWZARADAN: OK.

Good.

But the other thing
I want you to do

is go to psychotherapy
and start that.

I think you're ready to
start working on some

of what's driving you to eat.

So we'll start with that.

You think this is something
you're willing to do?

100%.

I could definitely do that.

OK.

Great.

And then we'll set
that up for you.

Then I'll see you in two months.

OK?

If you need anything
before then, let me know.

Thank you.

You're welcome.

I'll see you soon.

Even though should have lost
some weight over the last two

months, I am at least happy to
seeing her progress from that

to show me she's trying to
make the positive changes she

needs to get healthy
and improve her health.

So if she at least maintains
that over the next two months,

that will show me she's
starting to take a bigger step

and get weight loss surgery.

And since she taken
the decent first step

to show me some commitment,
we will go ahead and start her

going to psychotherapy to see
if she can work on some of what

drives her to use food to cope.

And hopefully that
helps her continue

in the direction she's going.

Because if she doesn't
maintain the level of progress

she just made, she will
show me that her commitment

was only short term.

And that's something that
she was serious about.

And we won't be moving ahead and
doing her weight loss surgery.

But hopefully she stays on
track and does what she needs.

MELISSA: That could
have gone a lot worse.

So I'm relieved it didn't.

And I think Dr. Now's
next goal is fair.

You know?

I could have done
better this time.

Even though I
worked hard, I know

there's room for improvement.

So he's right about that.

And I'll go and try
harder and do what I need.

Whatever it takes.

I'm back in Florida.

And I'm about to do a video
session with Dr. Paradise

to do my first
therapy appointment.

And I feel like
I'm ready for it.

But my hope is that
the session helps

me move in the right
direction and hopefully get

closer to where I need to be.

[video call music]

Hi, Melissa.

Hi, Dr. Paradise.

I'm glad we're
able to connect.

Tell me how you're doing today?

I'm doing OK.

Doing OK.

Going through the
motions of everything.

DR. PARADISE: So how long did
it take you to get this big?

I would approximately say--

I went into a really
deep depression

about three years ago.

I lost my mother in
September of 2019.

And that corresponded
exactly with your weight gain.

Oh, extremely.

Like, you know, binge
eating and definitely

not acknowledging other
circumstances of how to cope.

Wow.

How did that affect you?

It kind of seems surreal,
like, she hasn't left.

And I know (CRYING)
you're supposed

to let go at some point.

But it's like, I know
they wouldn't let go of me

if it was me on the other end.

What are the parts you're
hanging on to that you

need to let go of?

Not feeling good enough.

Your mom's unmet expectations.

You haven't let go of those.

No, nor my father's.

DR. PARADISE: Your
mom's disappointment.

You haven't let go of that.

No.

DR. PARADISE: That's
something to work on, right?

I think you can let go of
their unmet expectations.

You can let go of
their disappointment.

Yeah.

Yeah.

And prior before that,
me losing my job and me

going through a breakup
with my ex definitely

took a bigger toll
than I expected

because I thought I would just
bounce right back into life.

And that didn't happen.

And I started
isolating myself more,

and I started
being less sociable

and not willing to participate
actively in my own life.

There's good news
in what you just said.

OK.

[laughs]

The good news is you
know that when you socially

isolate and keep to yourself and
act depressed, you gain weight.

Exactly.

Of course.

And so what that means is
if you don't socially isolate,

you're likely to lose weight.

Melissa, if you
lost weight, would

your relationships improve?

Yeah, because a
lot of my friends

were just upset that
the fact that I decided

to retract myself and isolate
myself because they found

it to be really unhealthy.

And they thought it was
like, oh, this will--

it's like a phase.

It'll pass.

But it hasn't passed yet.

No.

[laughs]

I want you to make
friends with how you look.

You're so engaging and
articulate and smart.

It's a shame that you're
not around other people.

You know?

I mean, you have
so much to offer.

Friends, maybe
future boyfriends.

You're wasting yourself.

I kind of want you
to get dressed up

and go out and do something.

[laughs] [sniffs] Oh.

Melissa, it's been
so good to talk to you.

I'm really glad
we got to connect.

Yes.

I'm really proud of you
for letting all this out.

You're a great talker.

And have a good night, OK?

Take care.

Bye.

Oh, wow.

That's a lot.

I feel emotionally tired
and drained but good because

of what I was able to get out.

But I know doing what Dr.
Paradise wants me to do

is gonna be tough.

It's not gonna be
easy for me to put

myself out there and go out more
because that makes me nervous.

But I'm gonna try because
I'll do whatever it

takes to keep moving forward.

Everything depends on that.

You know, if I fail, then
I lose everything that I'm

desperately fighting to have.

So no matter what I have
to face, I'm gonna do it.

For the past week, I've been
working on getting to where

I feel like I am mentally and
emotionally ready to try to go

out and be in public more.

It's a big step for me.

I don't like putting
myself out there.

But I'm working on it.

And I started going to the
pool in my apartment complex

to do my exercises
to kind of try

and start the process
of being around people.

I'm going in the morning, so not
a lot of people go to the pool

then.

But some do.

So this is a start with me
being OK around people more.

You know, it gets
me out a little bit,

but it's still close to my home.

And in a smaller
area, I don't have

to worry about being
around a whole bunch

of people all of a sudden.

So it may be a
baby step, but it's

still a step and a forward
motion in the right direction.

And that's what counts.

But doing this and
being in the pool

has helped me with my exercises.

So that's a bit of a bonus too.

It's a lot easier to move
around and do more in a pool.

So I've really enjoyed
that part of how

it helps me because
I'm pushing myself

to be more and more active.

And it puts a lot of strain
on places like my back,

my knees, and all that.

So having that alleviated a
little has felt really good.

So I've really been enjoying it.

And overall, it hasn't been
too overwhelming for me.

I still struggle with not
wanting anyone to see me.

But I do feel like I'm getting
a little better with it.

And maybe soon, I'll feel like
I'm ready to do something more.

But I'm not there yet.

I've been able to
do all the stuff

that Dr. Paradise said about
getting ready for the day

and looking at
myself in the mirror

instead of avoiding that.

And while I do it, I'm
working on realizing

my worth and my value because
I'm not any less of a person

because of the size that I am.

I'm back in Houston on my
own this time to see Dr.

Now for my third appointment.

Shay couldn't make it.

But with all the progress
that I feel like I'm making,

I told her that I was ready
to do this trip on my own.

So I did.

And I'm here now.

And I'm just as nervous this
time as I was the last time

because of how
important this weigh in

is gonna be since I need
to have hit another goal.

But this time, I didn't have to
lose as much as my first goal.

Melissa?

MELISSA: Dr. Now wanted me
to lose at least 40 pounds

over the past two months.

I was at 548 last time.

So that means I need to
be at or under 508 today.

507.

[laughs] OK.

I did it.

Barely, I guess.

But I did it.

So I'm feeling excited
because this should mean

I'm getting approved and
getting closer to everything

that I want and that I'm
working hard to get to.

So I'm just really happy
and looking forward

to how this appointment is
going to go because I think

it's gonna go well for me.

Hello.

How you doing?

MELISSA: Good.

How are you?

DR. NOWZARADAN: All right.

That's good to hear.

So did you have a
good trip this time?

Yes, I did.

It feels like it's
getting easier.

Well, probably it is because
of the weight you lost.

You lost 85 pounds as of today.

So that's very positive.

And I'm proud of you for that.

Thank you.

So I'm gonna go
ahead and approve

you for weight loss surgery.

MELISSA: Really?

Are you serious?

[laughs] Thank you so much.

Very excited.

Good.

So I'm gonna schedule
you for a month

so you can move down
here to Houston.

And then just stay on track,
because when you show up

for surgery and your
practice has slowed down

a lot or worse, than
I'll cancel the surgery

and we won't move ahead.

You understand that?

Yes.

But I need to talk
to you about moving.

My support system, my
family, and my friends

are back in Florida.

So I don't know how I'd
be able to leave and come

here for a long period of time.

DR. NOWZARADAN: The problem is
the same environment that got

you to be 600 pounds is there.

So I'm not sure
what kind of support

you're looking for in Florida.

But it doesn't seem
like you have it.

And the other issue is if
you start to gain again,

it's more difficult for us to
intervene when you're not here.

I guess.

I told you, to do my program,
it means you need to be

in Texas because Florida is too
far to travel back and forth

every time with
all the [inaudible]

you have in your body still.

So we can provide you with
functional support that

will monitor your
progress and help

you to do this for the
long term if you're here.

MELISSA: Is there any other way?

The only other way
is for you to get down

to a healthier weight to
continue to travel and show me

you're gonna stick
with it no matter what.

And you need to lose another
100 pounds to do that.

You think you can do that?

I'm willing to try.

So if I give you three
months to lose 100 pounds,

and you do that, and we do
weight loss surgery on you,

would you agree to
move here if you start

to slip afterward at any point?

Yes, I could do that.

OK.

Then lose 100 pounds more
over the next three months,

which basically
is the same amount

per month as previous goals.

And if you do that, then
we'll see what we can do.

OK.

I'll do that.

All right.

Then I'll see you
in three months.

Have a safe trip back.

And if you need
anything, give me a call.

Thank you so much.

DR. NOWZARADAN: Take care.
- Take care.

Have a great day.

You too.

I'm happy to see that
Melissa has stayed

on track with her weight loss.

And so far, she is as
committed as she says she is.

The question now
is if she can keep

going over the next few
months to show me that it's

a possibility she can do
this from her old environment

and away from the support
system we have here.

I have concerns
about her doing that.

But if she's able
to hit the goal

I gave her to lose another
100 pounds on her own,

then I will consider it.

So see what progress she
makes at the next appointment

and how she's doing.

Then go from there.

But if she doesn't do that
and still refuses to move,

then we won't be
moving ahead with her.

MELISSA: I'm excited
because I got approved.

And Dr. Now is giving me the
chance to get the surgery

and not move.

But the goal that he gave me to
do it is a little overwhelming.

And the more that it
sinks in, the more I think

I was crazy to agree.

But it's what I want.

So I'm gonna go back and work
just as hard as I have been so

that when I come back, I'll
be down another 100 pounds

so I could get the
surgery and stay where I'm

around family and
friends and the support

that I have with them.

Because I know I can do this.

I just have to
prove it to Dr. Now.

So that's what I'm gonna do.

I've been working hard
for the past month

to keep moving forward
until I lose what I need.

So I'm sticking to my diet
and exercising more than ever.

And I'm also working on my
emotional and mental stuff

I need.

I had another session
with Dr. Paradise.

And he wanted me
to make sure that I

start going out in
public more like we

discussed the first time.

I told him I've been
going to the pool

and taking some baby
steps towards that.

But he says it's time
that I start doing more.

So I figured I'd try to do my
own grocery shopping today.

That's gonna involve a
lot of things outside

of my comfort zone like
being around a lot of people

and getting in a car, which
is hard for me at my size.

Shay would usually
help with that,

or I would just
have it delivered.

But I'm gonna try
to do it myself

today to get what I need to
keep making healthy meals.

But this is a big step for me.

I really don't like being out
and doing stuff that involves

being around food and
in public because I

feel like that's where
I'm being judged the most.

But I know I need to
take a step like this

to keep moving forward.

So I am.

It's just probably the
hardest thing I've done

yet, as weird as it sounds.

I feel like I'm on display,
and I hate that feeling.

Shay told me she would be with
me if it got too overwhelming,

and I could just call
her if I needed her.

But it's important for me to
be able to do this on my own.

But it helps knowing
that I have somebody

like her who's there for me.

She's been pushing me
to do this for years

and even tries to get
me to meet people,

people she thinks that would
be good to have in my life.

But I've always made
excuses to avoid it just

to stay home because
I just didn't

want to have to deal with it.

But I'm not doing that anymore.

Trying to eat healthy isn't
the easiest thing either.

Like, everything has a lot
of sugars or carbs or salts.

It's just a lot of stuff that
I'm not supposed to have.

So it's a learning process.

But I hopefully will
get the hang of it

and know what's what the more
that I do it because like Dr.

Now says, this has to
be a lifestyle change.

And eating like this
needs to be my new normal.

And I'm trying to
make that adjustment.

It's just not that easy.

I think I'm ready
to go back home.

I got a lot of what
I need, you know?

I've been out in
public around people

for a good amount of time.

So that's enough for today.

But I feel really good
about it and how I did.

Thank you.

Have a great day.

It's not like I was
worried about freaking out,

but my anxiety gets really
high when I do stuff like this.

And I've gotten used to
hiding from the world.

And I know it's gonna be
a process to change that.

But as long as I'm moving
forward and making progress,

I'm good.

And I feel like I'm doing that.

But I know I have a
long way to go to get

to my next goal for Dr. Now.

So I'm keeping at it because
I'm determined to do this.

And I'll keep doing my best
to make all the steps that I

need to get to where I want.

Today I'm going to try to
take another big step for me.

I'm focusing on dealing with
the stuff behind my eating.

And after another appointment
with Dr. Paradise,

we talked about how I
need to deal with some

of the things that have
happened to me from my past,

particularly how I
keep that stuff inside

and don't talk about it.

So today, I asked Shay
to come over for lunch.

And I'm gonna to tell
her about a boyfriend who

crossed some major boundaries
when I was younger.

[doorbell rings]

Come in.

Hey, Melissa.

MELISSA: Hey.

- How you doing?
- Good.

I have my hands full.

I'm sorry.

That's OK.

OK.

Smells good.

It's smells good?

[laughs]

MELISSA: After I was violated,
I didn't tell anyone.

Things I kept to myself and
never even told the people

who were close to me.

So what Dr. Paradise
thinks what I need to do

is start the process of
letting things like that out

so I can have a chance
to deal with them

instead of suppressing them
and using things like food

to try to forget them.

So I'm gonna try to do
that today with Shay.

But it's not easy.

All right.

Let's do a taste
test before we eat.

[laughs] It's good?

Are we sitting at the table?

Yeah.

Want to stand and eat?

How rude of me.

We gonna go sit at the table.

MELISSA: I'm not
gonna worry about what

she's gonna think or say.

That's not the issue for me.

It's just I don't
want to feel what

I do when I think about that
stuff and talk about it.

I've avoided it for so long.

But I know that's part
of why I've had issues.

And that's what I'm
trying to change.

And that's why I'm doing this.

It's not bad.

You like it?

It's edible for me.

The blackened
seasoning is really--

Mm-hmm.

So you're doing
pretty good, huh?

I'm trying.

You could do it.

It'll get easier.

Just don't give up, you know?

MELISSA: Yeah.

Dr. Paradise wanted me to do
some homework about opening

up and being more open to
trusting again, which is really

difficult [laughs] because
when you're hurt, you know,

you don't want to
be hurt anymore.

In-- [sighs] when I was
younger, I dated a guy.

And [sighs] you know, he--

you know, he crossed
a boundary that

made me feel uncomfortable.

And I just don't ever want to
be in a situation like that

ever again.

[sighs]

Doing everything that
Dr. Paradise says to do,

I need to, you know,
go back into the world.

I need to you know, have
those important relationships.

But I do need to set those
boundaries not only with just

that ex, because of that ex,
but because of friendship

and all those other things.

Like, I need to be
more back in the world.

I need to interact with people.

I need to [sighs] make sure
that I'm making better choices

but in being selective
of who I'm friends with

and not let them cross
those boundaries.

I have to set them
for that purpose,

to be able to process things
and to not only cope with food.

Just simple fact that
you are acknowledging

what it is that you need
to change in your life

is a big step.

If you remember what
you coming from,

you will enter into
where you're going.

It's going to be hard.

But you have to push yourself
because you know what

it is that you're trying to do.

And you can do it.

Thank you.

You're welcome.

MELISSA: I'm not sure
if I feel better or not.

Appreciate it.

I'm just not sure how I feel or
if that made anything better.

Opening up to Shay felt really
emotional, but in a good way,

like, a release.

But I'm glad I did it because
I know it shows progress.

Whether it helps
me a lot or not,

I'm willing to face
whatever I need

just to give me a chance
to change for the better

and get healthy.

I'm back in Houston again.

And I think I'm more nervous
than I've been this whole time.

I'm not sure why I'm more
nervous than last time

because I got approved.

Melissa?

MELISSA: I guess I just
know a lot still depends

on my weigh in this
time and whether I'm

going to be able to get the
surgery and stay in Florida

or not.

And as I thought
about it, I know

there's a risk that Dr.
Now may even take away

the option of getting
surgery altogether

if he's not happy
with my progress

this time depending on
where my weight's at.

So I know I took a
gamble doing this--

a big gamble.

And I'm just really
hoping it pays off

and doesn't blow up in my face.

I'm back at Dr.
Now's to try to prove

to him that I could
still do what I need

and stay on track in Florida.

But to do that, Dr. Now said
I needed to lose 100 pounds

over the last three months.

So that means I need to be under
407 today, which is a big drop.

But I've worked really
hard to get there.

And so I'm hoping to
see the progress I need.

That's kind of disappointing.

I thought I did a
lot better than that.

But I'm at least losing
a good amount of weight

like the last times.

I just don't think it's gonna be
good enough for Dr. Now to let

me move ahead without moving.

So I'm just worried about
what my options are gonna

be because I need the surgery.

But my life and all my
support is in Florida.

So how do I choose between that?

It just feels like
an impossible choice.

[knocking]

Hi, Melissa.

How you doing?

Well, that depends on what
you think about my progress.

Well, OK.

I'm glad to see that
you're still losing.

But it's only a
fraction now of what

you were supposed
to show me that you

can do this in Florida.

So what happened?

MELISSA: I don't know.

I thought I was more
on track because I've

been working really hard.

OK.

You want me to tell
you what happened?

OK.

When you make a drastic
change in your eating habits

and go from something like
10,000 to 15,000 calories a day

to under 2,000, you're going
to drop a lot of weight

very quickly even if you should
take in some extra calories

here and there because you
still have a large reduction

in what you're eating.

So the easiest point with
weight loss like this

is at the beginning.

But after that, it not only is
harder to maintain the changes

in your eating habit, but
every calorie start to count

more the more weight you lose.

Because the difference
between the amount of calories

that push you to where your body
is storing fat versus burning

fat lessens as you lose.

You understand?

Yes.

OK.

So to be able to stand
back for the long term,

you need the proper tools
and support to do that.

And that's why you have
to be here in Houston

because we can't
provide that and monitor

you if you're not here.

You understand that?

Yes, I do.

But I still believe I could
do this back home because I'm

still losing a good amount.

DR. NOWZARADAN:
Melissa, you lost less

in the last three months than
you did in the two months

before it.

So you're losing around
20 pounds a month before,

and now you're losing around
12 to 13 pounds a month.

So your weight loss is slowing
like I told you it would.

So you may think you can
do this how you want,

but that's not reality.

And unless you show me you can
lose a lot more on your own,

then your choice is
to move here to do

the program if you want to move
ahead with weight loss surgery.

MELISSA: I could do better.

Could I have one
more chance to hit

your goal to prove it to you?

Please, Dr. Now.

DR. NOWZARADAN:
It's your choice.

If you want to try to lose
the other 62 pounds you should

have by today, then go ahead.

But if you're stuck in it, then
you will no longer be approved

for weight loss surgery.

So you can try it your way if
you want and see what happens.

But other thing
is it a good idea?

MELISSA: I understand
what you're saying,

but it's really important to
me that I stay in Florida.

So I want to try again.

DR. NOWZARADAN: All right.

Then I'll give you two months
to lose another 60 pounds

if you want to consider that.

But I think the likelihood
is that your weight loss will

have slowed even more by then.

MELISSA: I won't let
that happen, Dr. Now.

DR. NOWZARADAN: I hope so.

Make sure to keep working
on your emotional issues

because that's gonna
be an important factor

for maintaining things
if you're gonna do this.

OK?

Yes, sir.

DR. NOWZARADAN:
All right, Melissa.

Have a safe trip back.

And you take care and stick
with the healthy eating habit

and try to lose more weight.

And if you need
anything, you may call.

Otherwise, I'll see
you in two months.

OK.

I will.

Thank you.

You're welcome.

Bye.

Bye-bye.

I'm glad Melissa has
continued to lose weight

over the last few months.

But I'm concerned
about where she's

headed right now because she
doesn't really understand

the challenges she's facing
with how she wants to do

things to stay in Florida.

She's done very well
up to this point.

But her weight loss slowing
should be enough to show her

that it's not as
easy as she thinks

to stay on track
without the tools

and support to do that
over the long term.

But she seems determined
to try to show

me she can do it her way.

But it's easy to have discipline
for a short period of time.

Maintaining it is the hard part.

But we'll see how she does
over the next couple of months.

If she's able to
hit the goal, I will

consider weight loss surgery
for her without moving here.

But I don't think that's likely.

I think what likely
is that her weight

loss will slow even more.

And if that happens,
then her only option

will be to move here or not
take weight loss surgery

because there will be no
point doing it if she's

going to fail in the long run.

MELISSA: I'm really
disappointed.

I was so far off from the goal
and where I thought I was.

I really thought
I was doing even

better this time than before.

So it was a surprise to me
to see how little I lost

compared to the other times.

But I don't know why that
is because I think I worked

hard in every way that I could.

So I'm just gonna have to
go back and push myself

even harder because
I know I can make

the progress I need back home.

I'm lucky that Dr. Now is
giving me another chance.

And no matter what it takes for
me, I'm gonna do it this time.

It's been about a month since my
last appointment with Dr. Now.

And I've been working as
hard as I can since then

to make my best progress
yet to make sure I hit

my goal by my next appointment.

You know, I'm doing
good with my diet.

I'm not snacking and only eating
three healthy meals a day.

I have my ups and downs with it.

But I hardly let that
get the best of me.

So I feel good about my
food choices and my eating

and all that.

And I'm exercising every day.

I'm walking.

I'm swimming.

I'm doing all the
upper body stuff.

And then I'm also
working on the stuff

that Dr. Paradise
has been telling me

to do for my emotional issues.

And I think I'm doing good with
all of that too because not

only am I going out
in public [inaudible],,

but today, I'm going
out with someone.

Shay's been trying to
introduce me to more people

to help me get more social.

And I've been texting
and talking to one guy,

Elijah, who she
gave my number to.

And today, we're going out.

So this is another
big step for me.

But I'm actually excited
about being out today

because I'm feeling really good.

So that makes me think
I'm making some progress

because I don't think
that would have been

the case for me a year ago.

I would have just avoided
this whole scenario.

But that's not me anymore.

As Elijah and me got to know
each other better talking

and texting, I was very
upfront about my situation

and my weight--

What's up?

Hi.

Nice to meet you--

and what I'm trying
to do to get healthy

and to get my life together.

And I told him how I'm trying
to find ways to push myself

to do more with my exercises.

And I also mentioned I don't
know if I could afford a gym.

And he told me about
the workout machines

that they have at the
park and that he would

be happy to show me that
area so I could start

working out there for free.

And then we could
walk around the park

and get to know each
other a little more.

And I told him I loved that.

Stand up for,
like, two seconds.

I'll count to five.

OK.

So this is kind of a date.

Maybe?

I'm not sure.

But it doesn't matter to me.

I'm just glad to be
where I'm at and to start

expanding my world
some by getting

out and meeting new people.

Elijah definitely took me
out of my comfort zone.

I don't normally
walk around the park

or ever would
consider those stairs

or even swinging my feet
because my feet are large

and so are my legs.

And that's kind of, like,
embarrassing to show.

[squeals] Woo, we
got a bad slip.

[laughs]

MELISSA: You know, all this
is light years beyond where

I just was in my life.

So I'm feeling really good.

And I'm getting excited about
my future and the possibilities

that I'm starting to see for me.

But I know it all still depends
on me getting to the goal I

need by next month
so I can stay here

and move forward like I want.

So I'm fighting my hardest
to make sure I do that.

Getting out and seeing how I'm
growing and expanding my life

is helping motivate
me to work my hardest

to get the life I want.

I just really hope when
I go back to see Dr. Now

and I get on the scale that
I'm where I'm supposed to be.

Because if I have to
choose between moving

away and getting surgery, I'm
not sure what I'm gonna do.

I'm back in Houston again
for my next appointment.

And I'm more nervous than ever.

It just feels like so much is
riding on what happens today.

But I went back home
after the last time

and did the best that I could.

You know?

I feel like I worked even harder
this time than all the times

before.

Melissa?

MELISSA: So I'm just hoping
when the number comes up today

that it's what I need to give
Dr. Now the evidence he wants

to be convinced and to
believe that I mean it

when I say I know I could do
what I need and stay on course

without being here.

I mean it with every
fiber of my being.

But I guess it's all
just gonna come down

to what comes up on the scale.

So I just really
hope it's enough.

I'm at Dr. Now's to see
if I made it to the goal

that he gave me to get
weight loss surgery

and to stay in Florida.

And to do that, he wanted me
to lose 60 pounds from my last

weigh in where I was for 469.

So if I made it, I'll
be down to at least 409.

That's really upsetting.

I don't know what to think
because I don't understand why

my weight loss is less now
when I'm working so hard

and doing so much to make
all the progress that I can.

I want this so bad, and
I'm putting in so much.

And it just doesn't
make sense to me.

So I'm upset because I
don't know what happened.

Hi, Melissa.

How are you?

MELISSA: It depends on
what you're gonna tell me.

DR. NOWZARADAN: OK.

Well, I'm glad to see you're
still losing some weight.

But your progress has slowed
down even more this time, which

is what I was worried about.

So that's not good.

MELISSA: But I'm working as
hard as I can, way more than you

know.

I explained it to
you the last time.

But you seem to think you're
the exception to the rule.

MELISSA: I don't think that.

I just know how hard I'm trying.

So I don't get why
I'm doing worse.

You need to have the proper
tools and support, like I have

been telling you, if you
want to be able to do

this for the long term.

And the only way
for you to get that

is if you are down
here until you get

to a healthy enough
place physically

and emotionally to
do this on your own.

So you can either do that and
stay in Houston for as long

as you need, or surgery
won't be an option for you.

OK.

I definitely want to
keep trying to get

down to the goal you
gave me to show you

I could do this, Dr. Now.

Please.

What makes you think this
pattern with your weight

loss slowing won't continue?

MELISSA: Because I
know I can do it.

You know, Melissa, your
current weight loss per month

isn't actually that bad.

You lost about 14 to 15
pounds a month this time.

So it's right around
what I expect to be

if you had weight loss surgery.

But my concern is this
trend is gonna continue.

And the next step is that
your weight loss is gonna turn

into half of what you just did.

Then after that, it will stop.

And then in four
months or so, you

will start the process of
gaining all your weight back.

So at this point, your
option is to either move here

to Houston so we can move ahead
with you before you let all

that happen.

Or there's nothing
more we can do for you

if you want to continue on
this path to try and show me

you're an exception
to how this works.

Do you understand that?

Yes.

OK.

So what do you want to do?

I don't know.

May I have some time to
figure out what I'm gonna do?

I would really appreciate
it because this is

a really big question for me.

I thought I was gonna
make more progress.

OK.

Take some time.

But don't take too long and
fall back into old habits

because if you
start to gain again,

surgery won't be an option
for you at that point.

OK.

So stick with it.

And let me know
what you want to do.

OK.

I definitely will.

DR. NOWZARADAN: But
you need to decide

what your life is
worth to you if you

can't do this like you want.

Because if you
start gaining again,

you're gonna be back to
where you were very quickly.

And that is a very
dangerous place to be.

MELISSA: I know.

I won't let that happen.

OK.

Melissa, good to see you.

Thank you so much.

DR. NOWZARADAN: You're welcome.

It's unfortunate that Melissa
isn't seeing her situation

objectively and waking up to
what the scale is telling her

because right now, she's not
headed in a good direction

if she continues to try to
do things how she wants.

I've been happy to
see how she's been

willing to make the changes she
needs to get her life on track

and be healthy.

But she still has
a long way to go

to get to where she needs
to be to be able to maintain

this for the long term.

And there's no point
to do a major surgery

on her if it's not going to
make a difference long term.

But right now, she
is at a point where

it's going to get
much harder for her

to keep going if she doesn't
make the choice she needs.

So hopefully she realizes the
reality of her situation soon

and the steps she needs to take
to get the support she needs

before she starts heading
back in the wrong direction

again because she still has
a lot of strain on her body.

And to try to put more back
on won't be good for her.

But we have done all we
can to offer her a path

to get to where she needs.

The only step left for her is
to make a decision for what she

wants to do and whether her life
is worth giving up the comfort

of her home for a little while.

MELISSA: After my last
appointment with Dr. Now,

I thought about the
choices he was giving me.

And I've decided that for right
now, the best thing for me

is to be in Florida for
a number of reasons.

You know, overall,
I have no doubt

that I'm gonna be
able to stay on track

and keep losing the weight
here even if it's not as much

as Dr. Now thinks I should.

So today, I am going to lunch
with a guy that I just met,

I've been speaking
to for some time.

I'm really nervous.

But the biggest thing
for me is that I'm

finally starting to get the life
I'm working hard to have here.

And it doesn't make sense for me
to just give all that up right

now when I don't think I should
because it's what's motivating

me to keep pushing
myself to work

as hard as I can to lose more.

What's up?

Hello!

How you been?

I'm good.

How you been?

Good.

Thank you.

You're welcome.

It's really hot.

MELISSA: It is.

I'm happy you asked me out.

ELIJAH: Really?

Yeah.

I'm happy you accepted.

OK.

Oh, wow.
That's a lot of food.

WAITRESS: OK.

Here we go.

Yeah, they don't mess around.

MELISSA: I need the
inspiration of being

able to be with the
people who support me

and who are there for me.

So I know it's
the right decision

and what's best for me.

But it doesn't mean I'm giving
up on weight loss surgery.

I still know I need that tool
to help me for the long term

like Dr. Now says.

But once I get down
to the 300s, my

hope I could get
back and show Dr. Now

that I'm doing it
to help him see

how determined I am to
succeed no matter where I am.

But I'm sticking
to a healthy diet.

And I'm still losing weight.

But you know, feel like
doing this to get your life,

you know, in order.

And it's something
that you really want.

And it takes a lot of courage.

Aw!

I really hope after this
that you're truly happy.

Really?

Everyone deserves
to be truly happy.

MELISSA: I've lost
almost 10 pounds

over the last two months.

So I'm still making progress
even though it's slower.

And as long as I'm moving
forward, I know I'm doing this.

I'm gonna cook you dinner.

How about that?

OK.

You better put
your foot in that.

[laughs]

I'm talking that
better be delicious.

You know?

MELISSA: [laughs] It's gonna to
be the best macaroni and cheese

you had in your life.

OK.

OK.

MELISSA: I'm also keeping
up with all my exercises.

And Elijah's been a big
help with me to do that.

How you been?

Tired.
[laughs]

I feel you.

MELISSA: He's pushing
me to be active

and working out
with me at times.

So I've appreciated all
his support because he's

helping keeping me motivated.

And I've appreciated that.

So I feel really good right now.

And I'm still very
excited about my future

even more now than ever because
I know I'm gonna make it.

And I'm doing this, you
know, even if it doesn't look

like how I thought it would
to where it's taken me longer

to get weight loss surgery.

The water is pretty.

It is.

This is the most
beautiful place to get

to know someone and walk.

To get to know me better?

Yeah.

But the fact that you took
your time to come and see me?

This just puts a
smile on my face.

Aw!

You're making me blush.

But I know without a doubt
that this route I'm taking

is what's right for
me and how I need

to do it because I'm starting
to live how I want now.

I'm not having to wait for it.

My hard work is paying off.

And I'm doing things that
I wasn't doing a year ago.

So that's keeping me motivated.

And I'm gonna keep pushing
myself forward no matter what.

And hopefully when I go back
to Dr. Now in a few months

and show him, that he sees
that and I'm able to get

weight loss surgery.

I really hope you feel better.

And--

I feel better that
I'm here with you.

Really?

Mm-hmm.

Man, now you making me blush.

[laughs] Because I'm not
gonna stop fighting for my life

until I make it where
I need no matter

what anybody thinks or says.

Just because I'm doing
it my way and how I need,

it doesn't mean I'm gonna
fail because no one knows

how bad I want this but me.

And I want this
more than anything.

So I'm gonna keep going.

And I'm gonna succeed
because I'm not

gonna stop or give up until
I'm living my best life yet

and I get to where I need.

And I know I'm gonna do it.

I'm gonna show
everyone I can make it.

And I have everything I
need to do that in Florida.

No matter what, I'm
gonna keep moving forward

and working on whatever I need.

And I have no doubt my best life
and days are ahead of me now.

And I can't wait
for all that's gonna

be there for me so I can finally
have the life that I want.

And I can't wait for that.