All language subtitles for My 600-lb Life S10E01

Every day I question
whether or not

I should keep going like this.

-What's the matter?
-[crying] I'm hurting!

Something in my head is telling
me I have to eat the food.

I just can't stop.

My whole life
revolves around food.

Make sure you put butter
in the bacon.

[man] When I eat,
I never wanna stop.

[woman] He eats in his sleep.

I think other people take for
granted the ability to just move

and not be in pain
all the time.

I have severe anxiety.

I have stabbing pain
in my feet.

The lymphedema growth, it's got
open sores that leak body fluid.

-I have depression issues.
-Diabetes. High cholesterol.

-High blood pressure.
-Ouch! [Bleep].

My body is crushing itself.

-[woman distantly] Are you okay?
-No.

That's what living like this
has done for me.

If you keep this up,
I guarantee you neither of you

will be here
five years from now.

My food addiction
is killing me,

and I know
it's now or never.

Can you imagine being a...
Arabian horse --

strong,
ready to run --

but you stuck in the body
of a elephant.

You are not ready
to lose weight!

Prove them wrong.

I'm so close to quitting,
it's ridiculous.

Ooh.

-I tell my dad, "We got this...
-Eight. Nine.

...I'm behind you
no matter what."

Honestly, our intimacy
has changed.

If something doesn't change,
I will either be a widow

or I'll be divorced.

Oh, [bleep].

-[sobbing]
-Well, I'm sorry.

I'm scared it's already
too late for me.

The situation could still become
critical at any moment.

Every time I go to bed,
I wonder if this is the time

I don't wake up.

[sobbing]

I'm trying to tell y'all
I need help. I want it.

If I don't change,
I'm gonna die.

[Nathan] I'm at a point now
where it's painful
to do anything

and it gets worse everyday

because now I have
this large sore
on the back of my leg.

[woman 1] Somewhere in me
is this little
glimmer of hope.

I just want to be
a normal person.

You can't do it
and then I just get mad.

[woman 2] If I don't make
a change now, I'm scared
it's going to be too late.

-[groaning] It hurts.
-Stand up, you're all right.

[woman 3] I refuse
to stop fighting.

I have to do this
for my children.

Does she respect you?

[Amber] No. Probably not.

I just want her
to be proud of me.

[sighs]

[Nathan] The mornings are
the worst part of my day.

And I hate waking up

because of how hard
and painful it is
being in this body now.

I can't really lay down
anymore, you know.

I can't breathe if I do
because my weight pushes
the air out of my body.

So, I started sleeping
in my chair, but I hate that

because it means
that I can't sleep
by my wife Amber anymore.

She's usually gone
by the time I get up.

She's a school teacher
and so am I.

I teach theater, but I've been
on medical leave
for a while now,

because of how hard it is
for me to get around
at the size I'm at.

I'm at a point now
where it's painful
to do anything

I think other people
take for granted the ability
to just move, you know.

And not be in pain
all the time.

Like, I'm constantly
in pain even sitting.

Go use the restroom.

But the dogs,
if I don't let them out,

then they'll have accidents
around the house.

I won't be able
to clean it up.

So I push myself to let them
do what they need.

Come on, house. Let's go.

But after that, I have to get
to where I can rest
as soon as possible.

And I already want
to go back to bed.

But in the morning,
I have to get clean.

[shower running]

Because the growth
that's in between my legs,

the lymphedema growth,

it's got open sores
that actually leak body fluid.

And not taking care of that
could lead to infections,

and infection means
I could wind up
in the hospital.

So as much as I hate it
because of how hard it is,

I make myself shower everyday.

It's just hard to do
because of my size.

And sometimes I don't get
as clean as I want to.

Sometimes my wife
has to help me,

but when she's gone,
I try to do it on my own.

Some of the things that I do
Nathan specifically asked

that it not be mentioned

because I do things

that not even a wife
should have to do.

[Nathan] It just shows
how bad off my body is.

That's not something
that a healthy person
should experience.

Knee pains and back pains
and open sores.

I shouldn't have all that.

And it gets worse every day,

mainly because of the sore
on my leg.

It's itchy
and it's filled with puss.

So I have to keep
the wound dry

so it doesn't get infected
and get even worse.

Dad's going to go fix him
some food. He's hungry.

And finally, now that
I'm clean and dressed and dry,

it's time for breakfast.

There isn't a moment
when I'm not craving
something to eat.

No matter what I'm facing,
food will make it better.

Food is my relief
and my comfort,

and it's what
I constantly want.

Food is the only thing
in the world
that doesn't talk back

unless it gives you
acid reflux.

It's just going to
make you feel better.

And when I'm eating,
it's euphoric.

It's like this feeling
of relief from whatever
negative emotion

I have going on at that time.

And so, even though
a meal like this
will make me really full,

I'll keep eating and eating.

Because that craving
never goes away,

and it's always
been there for me.

Eating has always been
a big part of my life,

starting when I was
really young.

I think part of that
is because my dad worked
for a food company.

So we constantly
had junk food around us.

You know, I'm the youngest
of three siblings.

I have an older sister
and an older brother,

and all of us,
including our parents,
just ate all day long.

Food, it was almost like
a headache pill
would be for a headache

because it made me happy.

But the downside of that

obviously that led to me
putting on weight.

I didn't realize it at first,

but in junior high,
when I was 13,

that's when the bullying
really started
because of my weight.

Because I got up to
over 250 pounds by then.

I was probably already
in like a 1X, 2X.

And I can remember
I tried out for basketball

because I liked
watching basketball.

And I thought,
maybe I would be good at it.

They made us try out
in front of the whole school
in the morning

because what they did
was they had the students

assemble in the gym

before they went
to their first period.

And people were laughing
and pointing,

and the coach
had to stop tryouts.

And he yelled at them,
saying, "At least he's down
here trying." You know.

Being 15 and around 350,

I didn't really
try to make friends.

I kept to myself
and after school,
I'd just go home and eat.

When you get upset,
you reach for that ice cream,
you know.

And I can finish ice cream
like nobody's business.

But things did get
a little better

toward the end of high school.

That's when I fell in love
with theater.

It was theater
that made me feel like

I could be who I wanted to be.

I still to this day think

that my theater teacher
in the high school level

was probably one of the ones
that helped get me through.

It was around the same time
that I found out my mom
was diagnosed with cancer.

And ironically at that time,
I was playing a cancer patient

while my mom was going through
the cancer treatment.

So, it allowed me to really
deal with it in a safe place.

I chose a college
based on theater.

But I was still eating a lot
and gaining.

And by the time I graduated,
I was around 450 pounds.

But immediately
after I graduated,

I got a job at a high school
in Longview,

and that's where
I met my wife, Amber.

Come on, guys. Get back.
Get back, get back.

-Hey.
-Hey.

-Thank you
for picking up the food.
-Welcome.

[Nathan] So how was your day?

[Amber] It was crazy.

-[Nathan] Oh, really?
-Yeah.

[Amber] From the first time
I saw Nathan,

I could see
what made him special.

He's a great person.

He is an amazing
theater director,

he is an amazing teacher.

And having similar
backgrounds with food

was something I saw
as a positive back then.

And that was one of the things
that I was attracted to

was the idea that

he would be a partner for me

to keep focusing
on my journey with.

-You want a cheese stick?
-No, thank you.

[Amber] But shortly after
we got married,

Nathan went to a doctor

to try and get
weight loss surgery.

So, I actually
got approval for surgery

because I had lost
enough weight.

And I didn't have the copay

and so, they cancelled
my surgery.

And I guess at that point,
I was like, "Forget it.

I'm... I'm done. I'll just
eat however I want to."

-You want a bite?
Last bite of sweets?
-Sure.

That's when
all of his motivation

went by the wayside
really quickly.

[Nathan] I guess I felt like
I wasn't good enough.

When we'd go to eat,

I physically was getting ill
from watching him eat.

He would eat his food.

He would eat an appetizer.
We would have a dessert.

He would eat my leftovers
and it would make me

just absolutely
just disgusted.

When Nathan decided
he didn't want to try

and lose weight anymore,

I told him I was disgusted
with what he was doing.

And I basically told him
he was an embarrassment.

[Nathan] You remember
we have to get
to the grocery store, right?

Mmmhmm.

[dog barking]

All right,
I know you're tired,

but [sighs] can you really
help me to wrap my leg?

Yeah, I guess I'll do it
before I go take a shower.

[dog barks]

[Nathan]
So now I'm at the point

where I'm 600 pounds,

and I have a huge
lymphedema mass on my legs

that pretty much keeps me
stuck in my chair
all day everyday.

I wanted to be
a good father to our kids

just as much as I wanted to be
a good husband to Amber.

Because when we got married,
she had a son, Mark,

and a daughter, Hannah,
who were ten and six.

And now they are my kids too.

But my weight has become
a really big problem

in my relationship with Amber,

and with our whole family.

[Hannah] I do worry
about my dad's health.

I would like him to feel
more confident in his body

and lose some of the weight
so we can do
more activities together.

I always tell him that, like,
"Don't give up.

We got this. I'm behind you
no matter what."

Sometimes I feel like
he's not going to be okay,

but I really do
believe in him.

[music playing on radio]

[Amber] I'm driving
to the grocery store

because that's what
me and Dad needed to do.

[Nathan] I want to be
off experiencing things
with my family,

but I can't
because of my size.

And now I feel like
grocery shopping
is the only thing

that me and Amber
really have left together

and it's the only thing
we do together
aside from eating.

And if you took
eating and food
out of our relationship,

we wouldn't have anything
left now really.

[Nathan] They have carts.
Thank God.

-[Amber] Yeah.
Yeah, yeah, yeah.
-Ow, ow.

For three years,
Nathan's health
has not allowed us

to completely do those things
that we enjoy.

And our relationship
is very strained

because of the amount of care
that I have to give him.

And I miss
being able to have,

I guess,
an intimate relationship.

Not like
a sexual relationship,

because Nathan and I
have never.

-Hey, look.
They have croissants too.
-[Amber] Huh?

-[Nathan] You like croissants,
don't you?
-Uh-huh.

[Amber]
That's not what it's about.

But just like,
being able to spend

quality time with each other

where it doesn't involve care.

That's what I want
that we don't have anymore.

And I'm very scared
I'm going to be
just like Nathan.

I would say within
the next four to five years.

Because it's getting to
where I'm having trouble

doing what I need for myself.

I'm over 400 pounds now.

That's what living like this
has done for me.

-You want some bologna?
-[Amber] No.

I have severe anxiety.

I have depression issues.

And I am always
extremely exhausted.

-[cashier] You all doing
all right this evening?
-[Nathan] Yeah.

[Amber sighs] Yeah, yeah.

We're super tired.

-I'm going to place this
right here for you.
-Awesome. Thank you.

[cashier] You're very welcome.
You be careful out there.
Be safe.

-Can you... You need to open
that since we're slow.
-[cashier] Yeah, okay.

[Amber] And I just feel like
Nathan's just let me down

as a husband altogether.

He has tried his best.

I don't want it
to seem like he hasn't.

But it's getting to be
too much.

And I'm at a point now

where everyday I question
whether or not I should stay.

And I stay because I have
love for Nathan.

But I just can't keep going
like this.

Neither of us can.

[Nathan] I can't do much
of anything on my own anymore.

And I know
that frustrates Amber

and it's a lot for her.

So much so that we had
to move our whole life here

to Palestine, Texas.

Because she needed help

and the only family
that she could go to
were her parents.

So they help out
when it's too much for Amber.

And I hate it because
I feel like I'm a burden

to my whole family
at this point

and I'm ashamed of that.

And if it gets to be
too much for Amber,

I'm scared
she's going to leave me.

[Nathan] My appointment
with Dr. Now is tomorrow.

So today,
I'm headed to Houston.

[Jack] We're here. Hey.

[Nathan]
Amber is working today,

so my in-laws
came over to get me

and help me get there.

[Tracie] Are you ready?

Ready as I'm going to be.

It's only three hours there
and three hours back.

But I told Amber
I wanted to go down

the day before the appointment

so I can rest
before we see Dr. Now.

All right, what's...
What's going?

This is a bag of snacks.

Where's mine?

-It's in there, Jack.
I promise you.
-Okay, okay. I'm just...

Because you know
I don't do jalapeno stuff.

I'm making sure
you got my chips.

-I did.
-You stay right there.

[Jack] Because over the years,

I've seen him get
bigger and bigger.

Before he was able to
move around a lot more.

And do a lot more things.

But now that he's so big,
he's limited.

He can't do a lot on his own.

So we help him out
when he needs us,

when Amber
can't be there for him.

But we're all scared for him
because of how bad it is now.

-You have your charger?
-Yes, everything's in there.

-You sure?
-Yes.

-Okay.
-You can't use mine.

I know.

If he goes on this,

it would be benefit
for both of them.

Because if he can
lose the weight,

it'd make
both their lives better.

-Are you excited?
-Yeah, I am.

Nathan has struggled
with his weight
since I've known him.

Even early on,
I saw how he ate

and I remember
they had just moved down here.

And he got up and made
breakfast one morning
for himself.

He made macaroni and cheese
and a can of peas
for breakfast.

And I'm like going,

"Oh, that's disgusting."
[laughs]

But over time, I've seen him
gain more weight.

And it's getting to
a breaking point for him

and I think Nathan
does understand.

He is a young man
with a short lifespan
right now.

[Tracie]
We are on the road. Yay.

On the road again.

[Nathan] I'm a little
bit overwhelmed

and I'm embarrassed

because I'm starting to feel
a little bit of shame.

I know I have to do this,

but it shouldn't have
gotten to this point.

Isn't this
where I'm at right now.

I guess I'm a little shaky

because this may be
the last chance to save

what I can see as my family
at this moment.

So I'm ready to make a change
to my life, no matter what.

[Jack] How much is that
going to be?

-[cashier] Thank you.
-[Jack] Thank you.

Ooh.

[Nathan]
Best chicken fingers ever.

Because I know what's at stake

to save my life
and save my family.

And I'm not going to fail
and let them down.

[exhales]

[Nathan] I'm tired
and a little sore.

But I'm in good spirits

because I get to see
Dr. Now today

and hopefully get his help.

I think, overall,
I'm mostly just nervous

about hearing what he says.

So, I'm glad Tracie's
going to go with me

and I have her support
so I'm not doing this alone.

Because what happens today
at this appointment

determines everything for me.

Mr. Prater?

[Nathan] And whatever
Dr. Now has for me to do,

I'm ready to do it if it means
I can get a better life
for me and my family.

[Nathan grunts]

It's never fun seeing
my weight on the scale,

especially knowing
other people
are seeing it too.

It's embarrassing.

But I know
my starting point now.

So from here,
my goal is to get
that number going down.

[knock on door]

-Hello, how are you all doing?
-I'm good. How are you?

Good.

All right, Nathan,
good to meet you.
Glad you're here.

-Yes, sir.
-Now who's this
young lady with you?

[chuckles] This is my
mother-in-law, Tracie.

-Your mother-in-law?
-[Tracie] Yes.

[Dr. Now] All right,
good to meet you both.

-So, you come here
from Palestine, Texas, huh?
-[Nathan] Yes.

And you're here to see me
to lose weight

because you're just
over 600 pounds?

-[Nathan] Yes.
-Is that the highest weight
you have been?

That I know of, yes, sir.

Okay. Well, that amount
of weight puts a lot of strain

on your body,
especially at your height.

And it doesn't take long
for your health

to start deteriorating rapidly

especially
if you're not very mobile.

And how much you
can walk or be active?

It hurts to...
Like, when I'm at home

and if I go from the bathroom
back to my living room,

I get winded.

So I can't walk very far
without help.

And what makes it worse
is that I have lymphedema.

-[Dr. Now] Mmmhmm.
-And so there's issues

with open sores on my legs.
My right leg.

And I also have a growth
in the groin area.

And it just... It feels like
it's getting bigger,

so it pulls at the lower back

and that's what's adding more
to the out of breath right now

I think, I don't know.

Okay. So you have
developed a lot of issues
from your weight.

So you are at
a critical point now

where you have to change
your eating habit

before things
get worse for you.

So how committed are you
to make the changes?

I... I'm gonna have to be
100% committed.

That's... That's it.

-It's either that or--
-"I'm gonna have to be"

is a figure of speech.

[stammering] I will tell you
that I am going to be
100% committed.

-So you are ready
to make the changes?
-[Nathan] Yes, sir.

Okay. That's what
we wanna hear from you.

So the changes
that we're gonna do,

I don't want any excuses that,

you know,
"The weather was not good,

I was depressed,

-and food was there,
I had to eat it."
-[inaudible]

Those excuses, I don't wanna
hear them when you come back.

-Right.
-[Dr. Now] Okay.

And your wife, does she
struggle with her weight too?

Yes. Um, she is
overweight as well.

So why isn't she here
with you today?

She had to work.

Okay. So I'll give you
an extra copy
of the instructions

for you to take to her
so she can understand

what needs to be done
to support you.

And the next time
you come back,

see if she will come with you.

Okay, Doctor.

Okay. I'm gonna give you
some written instruction

that I want you
to read every day

and I'm gonna give you
some exercises.

I want you to start
doing those exercises
twice a day. Okay?

-Okay.
-Well, any questions?

No, sir.

All right. So let me get all
the stuff that you need to do

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

-All right. I'll be back.
-[Tracie] Okay. Thank you.

[Dr. Now]
Nathan seems motivated.

Hopefully, we see that
translate into action with him

to where he makes the changes
he needs when he goes home.

But ultimately,
no matter the situation,

this is all gonna be
up to Nathan

to make the changes he needs
to get healthy.

All right, Nathan.
Here's your homework.

If Nathan wants to move ahead,

he's gonna have to prove
to me that he's committed.

So he either does this
and hits his goal

to show me what I need
to see from him

or weight loss surgery
won't be an option.

Because it will
ultimately fail

if he isn't willing to do
at least his part.

All right, Nathan. This is
something you have to do

if you want to get
your life back

before you run out of time.

So you have a lot
of changes to make.

-Yes, sir.
-All right.

You think you can do that?

Yes, I... I do.

[Dr. Now] All right. Super.
So I see you in two months.

Lose 60 pounds by then

and work to get
your stamina up.

In the meantime, if you have
any issues, give me a call.

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

Before you go,
we're gonna run some tests

to check on some things.

And if everything looks good,
you can go home. Okay?

-Yes, sir.
-All right.

Nice to meet you guys.

[both] Nice meeting you.

[Nathan] That was intense
but it was good.

And I'm excited

because I have a plan
to fix what I messed up

and finally make things
right like I should.

So I'm happy about that,

and that I have this chance.

But I know it's not
going to be easy.

It's gonna be a hard road
ahead to do this.

But I'm ready for it.

[Dr. Now]
Nathan is already developing

severe medical issues
with his body

that is a direct result
of his weight.

So he doesn't have
any more time to waste.

He either make the significant
changes he needs now

or things are gonna continue
to get worse for him

until he pushes his body
to a breaking point.

And my concern right now

is that he may a lot closer to
that point than he realizes.

So it's very important
he does this now

before he gets
to that breaking point

and something happens
where he doesn't make it.

[Nathan] Ready?

Oh, you better get up.
Go to the door.

[grunts]

[Nathan] It's been three weeks

since my appointment
with Dr. Now.

Whoa.

And since then, Amber and I
have been focusing

on making
all the changes I need

with the diet and exercises.

[Amber] Come here, Peanut Ann.

[Nathan] I feel like
my journey is in
a really good spot

because I can finally see
something positive

moving forward in my life.

The most significant
is the energy.

There's just some things
that I'm able to do physically

that I couldn't do
20 days ago.

So I actually look forward
to exercise now.

[Amber] Come on, this way.
Come on, mama.

[Nathan] Walking with Amber,

she always
has a good attitude.

[Amber exhales]

[Nathan] I think
our relationship has changed

for the positive.

I feel like we're headed
towards a better situation.

[Amber] Nathan's actually been
better than I expected.

As soon as
we got back to town,

with counting calories
and his exercise...

[Nathan] No,
stop eating everything.

[Amber] ...he jumped right in,
so I was really impressed

and I would say overall
he's doing great.

So I really expected him to
struggle more than he has.

[Nathan] I don't even know
how far we walked.

[Amber]
About an eighth of a mile.

-Oh. Well, we can turn
around if you need to.
-No, till the stop sign.

[Amber] I'm good.
I just... It hurts.

[panting]

[Nathan] I try to walk
every day for, like,
20 to 30 minutes.

The changes have been
pretty easy for me

because I just got to a point
where I chose life.

-You made it to the store.
-Yeah?

-How you feel?
-I'm good.

You're not too out of breath.
That's good.

Are you ready?

[exhales] Yeah.

I think so.

-All right.
You first this time.
-All right.

-Let's go, Big T.
-Let him take the charge

and the lead.

-Me and Peanut
will go towards the end.
-You know he will.

-This way. Go home.
-We're going home.

Let's go home.

[Nathan] The transition
to eating healthier

has been a lot easier
than I thought.

I try to stick to
the 1,200 calories or less...

[clicking]

...not allowing myself
to just eat what I want to
when I want to.

Going into it, I was like,

"I'm gonna have to eat all
this stuff that I don't like."

Well, when I figured out that
I could stay under the 1,200

and work hard
and still lose the weight,

I was like,
"I'm gonna do this."

And so if I feel the urge
to have ice cream,

I always make sure
that it still falls

under that 1,200 calories
or less.

I'm still getting
my little fix

but I'm staying
under the calorie count.

Remember how
I would get, like,

a chicken and a burrito
and two Big Reds?

[Amber] Yeah.

That has changed a lot.

Why would I do that?

-[Amber] Well...
-And why would you let me?

It's not about
what I would let you do.

What would you do
if I went back to that?

[Amber] Well, I don't know...

to be perfectly honest

because I've already told you
how I feel about things
as they were.

How much bacon do you want?

Just a couple of slices.

[Nathan] How do you feel?

[Amber] I mean,
I already told you, like,
it's too much for me. I'm...

I'm your caregiver.
I'm not your wife, so...

[bacon sizzling]

[Nathan] All right.
In 2.5 miles, you're gonna
exit 125A.

[Amber] Hello! I know
where I'm going kind of.

[Nathan] Amber and I
are in Houston

for my second appointment
with Dr. Now.

I told her how important
it was to me

for her to be the one
that brought here.

[Nathan] It's on the corner
right there.

See where that red car is?

[Amber] Voila.

[Nathan] 'Cause I want her
to see the progress
that I'm going to have.

So she made the time to do
this with me today

and that means a lot.

And I'm feeling better
than I have in years.

I made all the changes
and followed all of
Dr. Now's instructions.

-Nathan.
-[Nathan whispers] You ready?

So whatever the scale says,
I think it's going to be

something I'm at least
proud of.

But my ultimate goal is to get
weight loss surgery.

And that's not gonna happen
if I didn't lose

all that I was supposed
to lose by today.

[nurse]
We're gonna weigh you.

-Just hold on one second.
-Yes, ma'am.

[nurse]
Let me just level it out.

Okay.

-Go ahead and step up
on the scale, please.
-Yes, ma'am.

[Nathan] And if I don't get
weight loss surgery,

all I've lost today
won't mean anything.

[Nathan] I'm back at Dr. Now's
for my second appointment

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

And I think I have
a good chance at it today.

At my last appointment,
I was 607 pounds.

And Dr. Now told me to lose at
least 60 pounds in two months.

So that means I need to be
under 547 pounds today.

Wow. [chuckles] I'm excited.

Good for you.

I'm good. I'm good.

[knock on door]

-Hello, how are y'all doing?
-[Nathan] Good. How are you?

[Dr. Now] I'm doing good.

This must be your wife, Amber.

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

[Amber] Good to meet you.

-So, Nathan,
you're down 72 pounds, huh?
-Yes, sir.

So tell me
what changes you made.

The biggest change
that I've made

is I've really stuck
to the 1,200 calories or less.

That's the ultimate
bottom line for me.

Plus, I will not eat anything
past six o'clock.

I just... I've made it a point
to make sure that

I have dinner
before 5:00, 5:30, so.

[Dr. Now] All right.
That's great.

Well, I'm proud of you.

But my concern right now,
seeing both of you,

is your wife
has a weight problem, too.

So it's very hard
for one person in a family

to eat healthy while
the other person is not.

So, Amber, have you talked
about getting healthy

and doing this with Nathan?

Um, I actually already
had weight loss surgery
when I was 16.

And so I'm really familiar
with the weight loss process.

And I already kind of had

somewhat better eating habits
than he did.

I've been preparing food
for the last ten years

to his accommodations really.

So you're saying it's his
fault he gained weight?

[Amber] Not necessarily.

Okay. Then would you
consider yourself

failure of the weight loss
surgery or success?

-Me?
-[Dr. Now] Yeah.

I would say I was success...

I was a success
until I had my children.

Because I was very successful,

I lost over 360 pounds
on my first...

With my first surgery.

Well, you're like a gambler
sitting at the table
and saying--

[both laughing]

..."An hour ago,
I had a million dollars

but then right now,
I'm out of everything.

So I was a
successful gambler."

That's not the reality.

Where are you at this point
and what you need to do

is the issue.

Now, you may consider
that a lot surgeons,

they don't do revision
because that's complicated

and it's not something that
your surgeon are acquainted

or willing to do,

but that's something
we may be able to perform.

People in the high BMI,
90 to 95%,

have failure of their weight
loss surgery in ten years.

And the reason for that being
that the underlying issues

driving you to eat
were never fully addressed.

And in your case, your success
was only short term.

And that's a factor now,

not just in your health,
but Nathan's health

Because you both influence
each other negatively.

I'm frustrated and angry

because this journey
was supposed to truly be
about Nathan

and Nathan's health
and his well-being.

And I don't want
to take away from that

and I feel like
that's going to happen.

And I don't want
that to happen.

I was 16 when I had
a procedure done

and now I'm 60 pounds
heavier than I was
when I started that.

There's just not words
for that emotion right now.

So I think the dynamic
of household will be better

if you both are working
to get healthy together

so that both of you
are in the same situation

with the eating habit

and able to
manage it together.

So is that something
you're interested in?

Yes. I think
I'd like to do that.

Okay. Nathan,
because you hit your goal,

since you have made
good progress,

I'm gonna go ahead
and approve you

-for weight loss surgery.
-Yes.

-[Amber] Yay!
-Oh, thank God.

[Dr. Now] Okay. All right.

So we'll schedule that
for next month.

In the meantime,
don't let your guard down.

Just stay on track
and keep losing weight.

-Okay.
-[Dr. Now] Okay?

But we need to do
some more testing on you

to make sure that
the surgery is gonna be

a safe option for you

and if everything looks good
and you still are trying,

then we will proceed
with weight loss surgery
here very soon.

-Okay?
-Okay.

All right. So let's set you
for some testing

and go from there.

But right now, let's get
your weight, Amber,

to see where you're at

and I'll get some instruction
to go over with you.

Yes, sir.

Nathan is doing very well

and I'm proud
of the progress he's made

over the last two months.

So I'm confident he's ready
for weight loss surgery.

But my concern right now
is Amber and her health

and how that's gonna affect
both of them going forward.

Are you gonna look
into the revisions?

I mean,
I'll look into it again.

But I have before,
I'll do it again.

Is that something you want?

I hadn't really
thought about it much.

Okay, Amber. I'm gonna
start a chart on you, okay?

And we check your weight
and all that.

-That's if you want to.
-Yeah.

[Dr. Now] Okay.

That's what you want, right?

-[Amber] Yes, sir.
-Okay.

So let's do that now.

Amber seems to blame Nathan

for most of their poor
eating habits

and has excuses
for why she got them

to the weight she is.

Okay, you can step up
on the scale.

Do I need to turn
around backwards?

Your weight is 502.

But the reality is that
at her size,

she's eating
because she wants to eat

and so she shares
some of the blame

for their dynamic as well.

And if she doesn't take
responsibility for her part

in their unhealthy dynamic

and how her behavior
influenced Nathan negatively

just as much as
his does to her.

Then it will be unlikely
either of them

will be successful
making any progress

that will last the long term.

Hopefully,
she considers the option

to change her unhealthy habits

and ultimately, get a revision

to her previous weight loss
surgery that she has failed.

All right.

Well, Amber, you are just
over 500 pounds. 502.

-Yes, sir.
-All right.

So your weight
is less than Nathan

but at your height,

your BMI is 20 points
higher than Nathan.

So your weight is putting
more strain on your body

than his weight is on him.

So what we need to do
is also work with you

to get you to lose weight.

So I want you
to read these every night.

-Yes, sir.
-And start working on that.

So both of you
have the same instruction.

And, Nathan, I want you to
stick with what you are doing.

And Amber, I want you
to lose 50 pounds

over the next two months.

-Yes, sir.
-Okay?

But first step is to change
your eating habit.

So make sure you only eat
two or three times a day,

no snacking,

and your daily limit
is 1,200 calories. No more.

-Okay?
-Yes, sir.

All right, Nathan,
I'll see you in the hospital

-and we go from there, okay?
-Yes, sir.

And if either of you
need anything, give me a call.

-Yes, sir.
-All right.

-I'll see you later.
-All right. See you later.

Thank you, Dr. Now.

[Nathan] I'm extremely excited
that I got approved

for weight loss surgery

because that's something
I've wanted

for a really long time.

The fact that
she responded to Dr. Now

and told him she'd consider
doing his program

has me excited.

Because one of my big fears

is how our relationship
became about food

and what losing the only
thing we have to bond over

could mean for us.

So if we have doing this
to bond over now,

that'd be incredible.

And if she could get another
weight loss surgery,

I think it'd be amazing

because there's so much
we want to do

that we haven't been able
to do because of our weight.

Then we can build a new life
we've dreamed of together.

[Nathan] After the last
appointment with Dr. Now,

Amber and I came
back home to Palestine.

And after a day or two,
Amber was able

to think through
Dr. Now's offer

to do his program
and try to get a revision
to her weight loss surgery.

[Amber] You know,
when Dr. Now approached me

when Nathan was there
to be seen,

I was angry.
I was really angry,

And I was hurt,
because I felt blindsided.

But once I had time
to process,

I was overjoyed.

Because just knowing that
Dr. Now is willing to help me

just makes me blessed
and makes me excited now.

[Nathan] And so,
I'm happy about that.

And I'm just really happy that
we're doing this together now.

[Amber] What are you
gonna get, dude?

-I'm thinking the lunch
Swiss chicken, maybe?
-Okay.

Um, but what do I want today?

Oh, I love their potato soup.

Would you like
any appetizers today?

Montreal steak? Fries?

-No.
-[chuckles]

[Amber] It's also been
a big motivation for me

to see how
Nathan's been doing.

But I still do worry

because Nathan
has the tendencies

to go back to his old habits.

Broccoli and mac and cheese,
and a broccoli... [inaudible]

[Amber] So there's still
the possibility of failure.

But I'm trying to keep...

-as optimistic as possible.
-Thank you.

So what do you think?

'Cause this is our first time
eating out

since you've had your...
Been on your little journey.

-Like, out in public.
-Mmmhmm.

How do you think
you're gonna do?

'Cause you got
a smaller meal,

you think
you're gonna be hungry...

afterwards? You think...

-Probably shouldn't think
about it. [chuckles] I mean...
-I guess so.

It's one of those things
that you just can't plan.

I was nervous
going to the restaurant

because that restaurant
in particular,

I normally would get
all this stuff

that is insanely unhealthy.

But I went in there
with the idea of

" have got to make sure that
I start making good choices."

Otherwise, what was
the point of me

going through the whole
journey in the first place?

I am definitely ready
for surgery.

I pray that
it happens next week.

[woman speaking indistinctly
over PA system]

Will you help me put these on?
I never get these on right.

I can do that.

They're gray this time.

We're here at the hospital
for my weight loss surgery.

[Amber] They were bigger.

[Nathan] I'm excited
to finally get something
I've needed for years.

[Amber speaking indistinctly]

[knock on door]

-Good morning.
-[both] Good morning.

-How are y'all doing?
-[both] Good.

All right. Nathan, you're
ready for your big day today?

-I am.
-All right.

So far, you have done good job
on losing weight.

And that make, uh, surgery
and risks much less.

So you're doing good.

-And you're ready for this.
-Thank you.

All right. We're gonna
get you started, okay?

-Yes, sir.
-All right.

We'll see you
in a few minutes.

[nurse] We'll lift your head
and arms, is that... Good.

[Nathan] I don't take
for granted what today means.

And how important
this is for me.

-[nurse speaking indistinctly]
-[air kisses] Love you.

Because I'm starting
a new life today,

so this is kind of like
a birth in a weird way.

Because it's the official
start of the new me.

So I'm excited about that
and the fresh start
that it's gonna give me.

Because I'm leaving
the old me behind.

And when I wake up,
I'm going to be a new person
ready for a new life.

And I can't wait for that.

[Dr. Now] Today,
we're gonna attempt to do
a gastric sleeve on Nathan.

So far, he's done a great job,

and he's continued
to lose weight

and lost another 14 pounds
this past month.

He's down to 521,

so he's moderated
and he's working hard,

then started doing
what he needs.

So I think he's ready
for his weight loss surgery,

All right. Give me a knife.

[surgeon]
Room lights off, please.

[Dr. Now] But he's still
around 500 pounds,

and he's not very tall,

So this still is gonna be
high-risk surgery.

Okay. Let's transition now.
Bring the robot.

Because all that weight

is putting a significant
amount of strain on his body,

to where any number
of small things

can push his body
to the limit.

So we have to be careful today

to make sure
that doesn't happen.

The greatest factor with that
is how long he has to be
under anesthesia.

Because the longer
he is under,

the more strain
there will be on his body.

But I'm hoping
that using a robot

will help us safely go faster,

so the surgery would not be
a long operation.

Then, hopefully, we'll be able
to complete it without issue.

And give Nathan
an important tool

that will help him
lose more weight

because what this surgery does
is reduce the stomach by 90%,

leaving a small narrow tube
that looks similar
to a sleeve.

So the patient's food
intake is physically limited

and the patient
is less hungry,

So this operation
will give them an opportunity

to lose even more weight.

[Amber]
I am waiting to hear that

Nathan is recovering
so I can see him.

I'm not worried,

because this surgery
is something
that is done so often.

But sometimes things,
you know, happen

when you're in surgery
and under anesthesia.

So I'm looking forward to...

Just knowing that
he's come through
everything successfully.

So I'm just trying
not to get too overanxious.

[Dr. Now speaking]

Okay. All finished.

Nathan's surgery
went very well.

We were able to complete
his sleeve gastrectomy,

and, uh, he's doing very well.

Nathan had a very long stomach
and big stomach.

We were able to remove
80-85% of his stomach.

And this is Nathan's stomach
we took out. It's a...

very long stomach.

And it can hold a lot of food.

So he's gonna be able
to lose weight much easier
after surgery,

because he's gonna be able
to eat small amount,

get full real quick
and not be as hungry.

And operation's
gonna give Nathan

a better chance
to control his eating habit

and lose more weight

and get closer
to his ideal body weight.

So having the stomach
reduce capacity by this amount

will help him
to get full faster.

For the next month,
Nathan will need to stay

on liquid diet
until he fully heals.

But, during that first month,

he's gonna be able to lose
at least 40 pounds.

Then, once he goes back
on solids,

he should be able to lose
at least 20 pounds each month

until he gets close
to his target weight.

So this surgery will help
keep Nathan on track

while we work to address
the underlying issues

and the dynamic behind
all this unhealthy eating.

But I think
he's gonna do very well.

I'm a little bit more
concerned about Amber,

because she already had
the weight loss surgery.

So she already has had
a tool to help her,

and it failed
because she ultimately

didn't stick to doing
what she needed.

But hopefully,
at next month's appointment,

we will see
enough progress from her

to show me she's trying
to turn things around

so we can move ahead
with her weight loss surgery

and start working
on addressing the issues

driving both of them to eat,

so that they both
can have a chance

to be successful
in the long term.

But we have a long way to go,
and a lot of work to do

with both of them
to get them to that point.

[Amber] Okay, so...

Breakfast...

An egg, please.
You're gonna scramble?

No, I thought
I'd just, you know,

bounce it off the floor
and see if it works.

You could... [stutters]

-Like, do it--
-Don't... Don't ask me

to try fry it. Don't.

I've been home from surgery
for a little over two weeks,

and I've been doing okay.

It's just been a bit
of an adjustment

with how little I can eat.

But overall,
I feel a lot better.

I was put on a liquid diet
after surgery for a week.

And that was tough.

And then he put me on
what is called the Stage 2,

which is mainly liquids,

but I could add stuff
like vegetables juice,

or skimmed milk,
and maybe some yogurt.

And I'm supposed to stay
on that for another week.

But after two weeks
of not having anything solid,

I couldn't take it.

And I'm eating a lot
of mashed potatoes lately,

and I know there's not
protein in mashed potatoes,

but it's one of the things
that I could tolerate.

[Amber] Nathan is progressing,

but he is definitely
not eating the right things.

And when I saw him starting
to make the wrong choices,

my whole body was like,
"I hope he throws his guts up

and I hope
it comes out his nose."

Only because he needs
to know what that feels like.

I'm not on liquids.

So I just eat what I eat.
And if it tempts him?

You know, hey, if he's gonna
do it, he's gonna do it,

and he's gonna
have to see for himself.

Amber's told me
I'm making her worried

because of some
of my recent food choices.

I know I'm still losing weight
because my clothes are bigger.

So I'm not concerned
about my progress.

I'm concerned a little
about hers, to be honest.

I've seen her struggle
this past month.

She's made some choices
that aren't a part
of the diet plan.

By next month,
if she doesn't make it
to her weight loss goal,

I'm scared
she won't get the surgery.

And it's important to me
that she does that,

so we're able
to keep doing this together.

-You done?
-I don't know, I think so.

When you had your surgery,
how did you feel like?

What did your body do
when you were like,
"Oh, I'm done"?

For me,
if I even smelt the food,

another bite, like,
I would be sick.

I need to learn
to listen to my body.

I think that's part
of the problem.

Could be.

Amber and I
are back in Houston

to go to our next appointment
with Dr. Now.

And I'm nervous.

Because I don't know
what the scale's gonna show
for either of us.

I know I've been losing

because of
the weight loss surgery

and how little it lets me eat.

And I know
Amber's been working hard.

So I'm just hoping
that we both have
some good progress today.

Nathan and Amber.

[Nathan] At the time
of my surgery, I was at 521,

and Dr. Now told me
I should lose 40 pounds

the first month
after my surgery.

-Me first?
-You first.

[Nathan] So to be on track,
I should be down to 481 today.

I'm a bit speechless,
because I don't see
how I lost so little.

I had known that I've made
some poor choices

before I came in here,

but I didn't realize
it was as bad as it had been.

[Amber] I had a feeling
this was gonna happen.

I tried to tell him,
but all I could do
is control me.

At my last appointment,
I was at 502.

And Dr. Now
told me to lose 50 pounds

in order to get approved
for my revision.

So that means
I have to be at 452 today.

That's disappointing,
to say the least.

I am not happy about that.

[Nathan] I don't think
today's gonna go like I hoped.

So that's disappointing,
but we both have no one
to blame but ourselves.

So we just need
to take responsibility.

And work to fix it
because that's all
we can do right now.

-Hello, how are you
all doing?
-[both] Good.

All right, let's see
what we got
with your own progress.

With Nathan,
starting with you.

This is about a month
after surgery.

And you have lost...

the whole six pounds
instead of 40.

So what's going on that
you only lost six pounds

in one month
after weight loss surgery?

I... Honestly, the only thing
I can think of is that

I've... probably eaten stuff
that I shouldn't have.

-Like what?
-Um... [clicks tongue]

[chuckles] I had
mashed potatoes.

I've had
macaroni and cheese.

And so you're in
the Stage 2 of diet,

which is an only-liquid diet.

But you're eating
mashed potato,
and macaroni and cheese.

-Mmmhmm.
-So which part of that

is making sense to you?

-None of it.
-Were you hungry?

Yeah, I was.

I guarantee that's not
the physical hunger.

That's a psychological hunger.

So in one month after surgery,
losing six pounds.

That mean next month,
you're gonna start
gaining weight.

That's not gonna
happen, but--

Let me put something to you.

You just had an operation
that take away
your physical hunger

and prevents you
from overeating.

And you hardly lost anything,

so that is exactly
what's gonna happen.

And you're not seeing
the reality of that.

Right.

You're going through
all these things,
and you work hard

and got a second chance
to get your life back,

but now you throw it away

and going back to killing
yourself with food.

What are we gonna do
to change that?

Uh, not make those choices
anymore? Work harder?

Why should I believe
you're gonna follow through
this time?

I feel like I let
a lot of people down, and...

I don't like feeling that way.

So... in order for me
not to feel that way anymore,

I'm gonna have to do exactly
what I'm supposed to do

and continue
to get better at it.

Okay. But this isn't
all dependent on you, though.

Because you both
have to do this

and support each other.
Okay?

Then let's change the gear.

-Amber.
-I did horrible, sir.
Horrible.

Wait a minute. You,

instead of losing weight...
We give you all the tools.

You already had
one weight loss surgery.

-And you gained three pounds.
-Yes.

So what is going on
in this household?

So, [sighs] for me, I...

panicked. And I literally...

did not get out of bed.
I didn't...

count my calories
or anything for two weeks,

which is...
The proof is right there.

I just gave up,

and I should not have
done that at all.

None of this stuff
you saying make any sense.

And, ultimately,
there is no excuse

that justifies being unhealthy

to the point you're killing
yourself like this.

So nothing
and no event in your life

justify overeating.

But you're justifying
to yourself.

So you're convincing yourself,

"It's okay to overeat
because of this issue."

But this issue is not reality.

The bigger issue
I'm concerned about is that

it's clear that there's
something going on
in the household

that both of you encouraging
each other to overeat.

I don't see how you all
gonna change that environment

that you have built over years
for pathological eating.

Well, I know I can do it.

I haven't, but I know I can.

Well, you know, I know
I can go to moon, too.

[chuckles]

But what is the practical
reality of that?

That's gonna happen?

-Yeah, I can go.
-[Nathan] Right.

If you give me a rocket,
I will go.

But that's gonna be reality?
No, it's not.

And a figure of speech
isn't gonna change anything.

I know. Talk is cheap.

You know, I can tell you
whatever I wanna tell you
here, but until I do it,

you're... Nobody's gonna
believe it.

Okay. Amber,
what's the solution for you?

I just have to get back at it
and prove to you that...

That I was on the right track
to begin with

and that I'm not gonna
fail you again.

Well, I can't believe
any word you're saying

-or Nathan's saying...
-[Amber] Mmmhmm.

...until I see some action.

Right.

-Understood.
-Okay?

And, Nathan, you went off
the rail quicker after surgery

than anybody I have ever seen.

So, at this point,

I'm disappointed
for both of you,

so I'm gonna give you both
two months

to get back on track, okay?

Which means that
from here on out, Nathan,

you lose at least
20 pounds a month.

And for you, Amber,
you should be able to lose

the 50-pound goal I gave you.

If I don't see that progress,

I know nothing else
is gonna work.

-Yes, sir.
-All right? So...

Uh, you know,
this is your life,

and the only wealth
in this world you got
is your health.

And you're throwing it away
by overeating

and killing yourself
on the food

and making excuses
that are acceptable
to yourself,

not to anybody else.

So it's totally up to you both
to make the changes

and change your life around
before it's too late.

If you keep this up,
I guarantee you

neither of you will be
here five years from now.

And this is the easy choice,

in that you have to see
the reality of it.

-Okay? I'm gonna set you up
both to see a therapist.
-Yes, sir.

-Okay?
-[Nathan] Yes, sir.

Because maybe they'll
be able to help you all

on your negative dynamic.
Okay?

-Are we clear
about what's going on?
-[both] Yes, sir.

Okay, we'll set that up.

And both of you need to do
everything you can

to get on track now.

Yes, sir.

In the meantime, if you need
anything, give me a call.

-[both] Yes, sir.
-All right.

-[Amber] Thank you.
-[Dr. Now] Mmmhmm.

We have a very
unfortunate situation
with Nathan and Amber.

For Nathan,
I've never seen someone

work against weight loss
surgery like he has,

especially in such
a dangerous way

so soon after the operation.

Because at this point,

there is not only no
physical drive to eat for him,

but it is actually
a painful process

to try to eat solid food

that soon after surgery.

So there are deeper issues
at play here.

And I think Amber's influence

on both her and Nathan's
eating habits

is much greater than they both
realize and she admits.

Because I'm starting to think

she may primarily be
a negative influence

on their unhealthy habits.

But she seems to blame
Nathan for all that.

And Nathan seems
to accept that.

So the dynamic
between them

is looking like
it is a more intricate issue

that is going to be
more difficult to address.

Hopefully, therapy
will help with that

because they both
are in a very dangerous place,

where they are about
to self-destruct

unless they turn things
around now.

And if they don't do
that immediately,

then I don't think there'll
be anything we can do

to stop them both
from going right back

to the same situation

and an unhealthy dynamic
they have had for years.

So this is a very dark
situation with them

that we will, hopefully, help
to turn around right now

before it's too late.

[Nathan]
Amber and I are headed
to the couples therapy

that Dr. Now wanted us
to go to.

[door squeaking]

Hi, folks. I'm Dr. Paradise.
Come on in.

[Amber] Hi, nice to meet you.

[Nathan] And if there's
something that will help us,
I'm ready to do it.

Thank you.

But it's definitely
a little scary.

-Okay.
-Welcome.

Glad to see you guys.
How'd you guys meet?

Her cousin was in my drama
program, introduced us.

Our first date
was at her house.

She cooked me
one of my favorite meals.

And rest is history.

So food... Food was
from the very beginning.

You guys are both already big.

You... You won him over
with dinner.

I guess so. [laughs]

What made you attracted
to each other?

I... I think she's strong.

The strength that I wish
I had, I... I see in her.

What did you see in him?

He's very levelheaded,
very grounded,

um, and very spirit oriented,

which was something that
I felt like I had to have

'cause I was in a very,
very toxic relationship

for a very long time.

-So you were counting
on him to be a good guy.
-Yeah.

Um, tell me about
your physical relationship.

Uh, right now,
it's nonexistent.

How was it at the beginning?

Well, I've always been big.

-And, like, right now,
I have a lymphedema growth...
-[Dr. Paradise] Okay.

...that sits
right on my abdomen

-right above that area.
-Okay.

So there's no way
it's possible.

-Blocked off.
-Yep.

You know, when we married,

everything that we attempted
just didn't physically work.

Okay. So you seem
resigned to it.

It's just not at the top
of our priority list.

It never really has been.

-Is that okay with...
With you?
-Not really.

Okay. I'm worried, Amber,
that you seem pretty shut off

from that part
of a relationship

Yeah, I... I am.

And, you know... [stammers]
It certainly my intent

when you guys came in
was not to do,

like, Dr. Ruth with you guys.

But in most relationships,

it's often the elephant
in the room.

Somebody's not getting
what they want in the bedroom.

And that will cause
ripples of conflict.

Uh, I think neither
one of us are getting
what we want there.

What happened?

Where... Where did it go
off the rail?

I think I know
one of the... The things.

Uh, before this whole
experience with Dr. Now,

I was supposed
to have the surgery.

-I was losing the weight.
I was doing great.
-Yep.

And then the doctor
cancelled the surgery

because I didn't have
the $2,000 payment.

-His... His copay, yeah.
-Ya didn't have the money.
Okay. Mmmhmm.

I... I basically
just got depressed,

and it got hard to do things.

-And I didn't wanna do a lot.
-And your self-esteem...

Weight goes up,
self-esteem goes down.

Mmmhmm.

And that's not attractive
to you, is it?

No.

She called me disgusting,
a bad husband, all that stuff

because I gave up
and went back to food.

Does she respect you?

[Amber] No. Probably not.

Wow!

I... I didn't want
to answer that

'cause I didn't want
to upset her.

No, probably not.
Not, not... No. No.

I just want her
to be proud of me.

Why should
she be proud of you?

So, Nathan,
you're a great guy!

But I haven't seen you
stick up for yourself.

If you don't stick up
for yourself,

it's hard for people,
even your wife,

to respect you.

And so we gotta get
you stickin' up for yourself.

And that may involve
sticking up to her.

Is she helping you
lose weight?

I would say she is.

'Cause sometimes
a partner will undermine
somebody's weight loss.

No, I need her
to be more forceful
when it comes to that.

-But I'm not gonna do that.
-You don't...

You don't need her
to do anything.

You gotta leave her out of it.

Start advocating for yourself.

It's gonna make her
respect you more.

And the number one thing
you can do for yourself now
is what?

-Lose the weight!
-Oh, okay.

So in service of this idea
of... Of being independent,

I wonder if you guys could
actually plan separate meals.

Plan separate shopping trips.

How does that sound to you?

It worries me

because that's
one of the only things

that we do together.

Your most unhealthy habit

is the thing that links
you guys together.

[Nathan] Mmmhmm.

So I need you to...
To break it apart.

I need you to eat by yourself.

And you're gonna have to find
something else to bond with.

Work for you?

Okay, thank you for comin'.

Thank you. Got it?

Nathan's a really
articulate guy,

and I'm impressed
with what he has to say.

I'm worried that the more
he tries to get Amber
to like him,

the less she really likes him.

There's something
in their relationship

that's incapacitating him

in terms of sticking up
for himself

and even just feeling good
about himself,

feeling like he's worth
sticking up for.

[Nathan] There were
a couple of things
in the appointment

that were new to me.

The main thing that was new
to me was the idea

that Amber didn't respect me.

I... I mean, I've always,
to some degree, felt it,

but that's the first time
it was said out loud
and put into words.

I guess I'm a traditionalist
in some sort of the sense

when it comes to marriage.

I feel like we should want
to do everything together.

It just makes me feel like

I'm drifting further away
from Amber.

How fast do you want me to go?

Just go whatever's com...
1 mile per hour, 1.5.

Whatever you feel.

Just two or three minutes,
get ya movin'.

[Nathan] It's been a few weeks

since we've had
our appointment
with Dr. Paradise.

And since then Amber and I
have been focusing

on the things
that he told us to do.

Here's your
stretching pull, man.

[Nathan] It's been
an adjustment,

and I'm still working on it.

But I will say
I've been proud of myself

for how much I've been
doing on my own

and how well I'm doing at it.

-Feeling pretty good?
-Yeah.

All right.

[Nathan] But I joined a gym,
and I got a trainer

so I can push myself
to do even more
with my exercises.

But at the same time,
when I'm here
and I hit a new goal,

what I wanna do
is turn and tell Amber.

And then I wish she was here.

Two more time.

[Nathan] And I'm working
to see myself as someone

who isn't dependent
on anyone else

because I know Amber
isn't going to respect me

until I can respect myself.

I'm trying to change my life,
and I'm trying to get better.

And I'm trusting that
it's gonna be for the best.

But it's scary...

One more time. Come on!

-[effort grunts]
-That's it!

...because it feels like
I'm losing Amber right now.

Good job, man.

-Thank you.
-Proud of you.

[Nathan] I'm in Houston
for the appointment
with Dr. Now.

Amber couldn't make it today
because she had to work.

She got a new job
this past month.

And she wasn't expecting
to have to work today.

So she thought
she was gonna be free today.

But I know
that he's gonna think

that she's trying to avoid him
or avoid the scale.

But that's not what's going on

because this is
important to her.

Nathan.

[grunts]

-[Nathan] Hello.
-Hello.

-[Nathan] How are you?
-I'm okay.

[Nathan]
At the last appointment,
two months ago, I was at 515,

and Dr. Now says
I should be losing

at least 20 pounds a month.

We're gonna weigh you, okay?
Let me just zero it out.

Okay, step up on the scale.

[Nathan] That means I need to
have lost 40 pounds by today

to be under 475.

So I'm hoping that's
the number I made it down to.

-We're gonna
be going to Room 5 please.
-Yes, ma'am.

[Nathan]
Well, it's a lot better
than just six pounds the last,

so I'm happy about that.

But I'm not sure how Dr. Now
will feel about it.

Hopefully, he sees
the positive.

But we'll see.

Hi, Nathan,
how you doing today?

I'm good. How are you doin'?

Good. So where is Amber today?

She couldn't make it
because of work.

But this appointment
has been scheduled
for a while now.

And she knew that
if she needed to be free.

She could easily have been
available to be here

if she wanted to.

Or she could have called
to reschedule.

So I think the issue is
she didn't wanna come today.

So why that?

I... I think she might
have been a little nervous
about her weight

and seeing how she was doing.

Is she making the changes
that she needs?

Some. She's struggling, uh,
but we both are.

Well, you came here today,

and you're making
some progress.

You lost, uh, 28 pounds.

So it looks like you're losing
about 14 pounds a month,

which is closer
to what you should be losing

two, three months
after weight loss surgery.

But you still have
a little ways to go

to be losing 20 pounds a month
like you should be.

Nathan, do you think
that therapy's helping?

Uh, it was hard, um,
but it was really good.

It made us really look
at how we are as a couple

and work on that.

So you're gonna continue that?

Uh, yes, I'm gonna have
an appointment pretty soon

to continue working on that.

Good.

But Amber shouldn't skip
that appointment either.

You know, Amber is gonna
be here next time.

All right, no more excuses
that she couldn't make it.

I know that
she wants to do this.

She'll be here next time.

We're...
We're both in this 100%.

Okay, keep up the good work,

and I will see you
in two months.

And if you need anything
before that, give me a call.

Yes, sir, will do.

-All right, I'll see you then.
-Yes, sir.

[Dr. Now] I'm happy
to see that Nathan
has improved his progress

and that he's moving
in a positive direction.

That shows he's taking
some responsibility
for himself

to seek to the changes
he needs.

But I'm obviously concerned
about Amber right now

because there was
no good reason

for her to have missed
the appointment today.

Because if they both
don't do what they need

to change their life,

then it won't be likely
that either of them

will be able to do this

for the long term.

So the next appointment
will be important,

because that will be
a crossroad for Amber

that will determine
things for her,

as well as Nathan.

[Nathan] Thankfully, Dr. Now
is happy with my progress.

But I know I have some
more ground to make up,

so my focus is going to be

on getting up to the 20 pounds
a month weight loss goal.

He was suspicious about Amber

not being here
like I thought he'd be.

But I know that
we are both committed

to doing what we need to do
in order to get healthy.

And thankfully, Dr. Now just
kept the same goal for her.

And I know she'll be happy
about that.

And I'm confident
that by next time,

we are both going to be
where we need to be.

Because I know we're giving
everything we can

to make sure we can both
keep moving forward.

[Nathan] Amber and I
are back at Dr. Now's

for our next appointment.

And we're both
a little nervous,

but we're both expecting
to see progress today.

I've been trusting that
all we are doing

is going to move us
in the right direction.

Even when I feel like
it's not.

So I'm hoping that
trust and faith
pays off for us today.

[Amber] I know I have a lot
to prove to Dr. Now today,

and that's helped motivate me
to stay on track.

Amber and Nathan.

[Amber] And so, I'm hoping
it's all been enough

to get me to my goal today.

So I can show him
I'm ready to do

what I need to get healthy.

And, hopefully,
get my revision surgery soon.

Okay, Amber, you wanna
step up on the scale.

We're gonna weigh you first.

Hold on, one sec.

Okay.

[Amber]
The last time my weight

was at 505.

And my goal has been
to lose 50 pounds.

So that would put me at

455 today.

If I hit that goal.

That's close,

and it's a lot of weight loss.

So I'm hoping
Dr. Now is happy with that.

I know I worked hard for it.

[Nathan] I don't think
Amber's happy with that,

but I think it's great.

She made great progress.

Step up on the scale, please.

[Nathan] So, hopefully,
I did it too,

and I lost as much as her.

At my last appointment,
two months ago,

I was at 487.

And I'm supposed to be losing
20 pounds a month.

To be on track,
I should have lost 40 pounds

to be under 447 today.

What?

-Literally, ten pounds
between us, that's crazy.
-[Nathan] Yeah.

[Nathan] I'm proud of us.

I think we both did great.
So I'm really happy right now.

Amber seems
a little disappointed,

and a little down on herself.

But I think Dr. Now is going
to be happy with us today.

[knock on door]

Hello. How are y'all doing?

-We're good.
-Good. How are you?

All right. Well,

Amber I'm glad that
you could make it this time.

Sorry, I've missed
the last appointment.

It won't happen again.

[Dr. Now] All right.
I'm glad to hear that.

And I'm glad to see that
you're making some progress.

Thank you.

You both have been
making progress.

So that's good.

So what is it helping you

to get back on track?

Uh, seeing Dr. Paradise,

and doing the therapy
helped a lot.

He helped us realize that,

um, there were things that
we needed to work on.

[Amber] The dynamic
for us is different

than a lot of people.

[Nathan] So it was hard,
but it was really good.

It made us really look at
how we are as a couple,

and work on that.

We started putting those
in place.

All right. So,

the key issue will be to
continue that for a long term.

Yes.

All right.
I'm glad to hear that.

All right. So Amber,

you're down to 461.
So, essentially,

so far you've lost 40 pounds.

So that's a good progress,

and you need to keep it up.

Yes, sir. I will.

[Dr. Now] Here is what
I'm willing to do.

We'll do an endoscopy on you
to see how things are

with your first weight loss
surgery you had
when you were younger,

to see if a revision
is possible.

There could be scar tissue
or other reasons

preventing the revision

or another weigh loss surgery.

If everything looks good,
I'll schedule you

for a weight loss surgery
revision in two months.

-Okay.
-And if you lost

another 25 pounds by then,

then we will move ahead
with you.

But if not, we'll cancel it

and we will be back
at square one with you.

-So, does that sound fair?
-Yes, sir.

You think you can do that?

-Definitely, I can do that.
-Okay. Great.

We will set that up
and we'll go from there.

But I'm proud
of both of your progress.

So keep up the good work.

-Yes, sir.
-Okay?

-[Amber] Thank you.
-All right.

Do you all have
any questions?

-No, sir.
-No.

Okay, Amber,

we will schedule
your endoscopy,

and I will see you both soon.

In the meantime,

if you have any question,
give me a call.

[both] Yes, sir.

-Thank you.
-All right.

-I'll see you all later.
-[both] All right.

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

[both] Yes, sir.

I'm very happy to see
the improved progress

with both Nathan and Amber.

I was initially concerned
about Amber,

because of the fact
she has already failed
one weight loss surgery,

and because of the pattern
I've seen from her,

where she seems to avoid
responsibility for her part,

with the negative dynamic
between her and Nathan.

But I'm glad to see
that's not the case.

And that she is starting
to make the changes
she needs

to move in a positive
direction with Nathan.

So we'll see
how her endoscopy looks,

and how she does
in the next couple of months,

and go from there.

But they are both doing well,

and I'm confident,
Nathan is committed

to do this for the long run.

And if Amber can get
to where she's ready

to take the next big step,

and get her revision,

then they will both have
a fighting chance

to not only make the progress
they need now,

but stick to it
to be healthy for a lifetime.

[Amber]
I'm here at the hospital
for my endoscopy.

But I'm getting
my weight checked on first

to see how I've been doing
the past month.

[nurse] 454.2.

-Yeah, it works.
-[nurse] 454.2.

[Amber] I'm still moving along
and I'm getting there.

So, hopefully,
that leads to me
getting the revision.

Because I've been working
really hard for it

and I know that's a tool
I'm gonna need
for the long term.

But it's all gonna come down

to how things are
in my abdomen

from my last weight loss
surgery, I guess.

I'm a little nervous
because I really want
to have the surgery.

But at the same time,
you know,

this part is out of my hands.

So it will just be what it is.

But I'm confident

that if there's a way
to do it,

Dr. Now will figure it out.

[Dr. Now] Today, we are doing
endoscopy on Amber

to see if it's possible to do
any sort of revision

or weight loss surgery on her

since she already had one
when she was younger.

The issue that
this can create is,

the first surgery
can result in scar tissue.

That limits what we can do
for a second surgery

especially, when it involves

stomach stapling
like Amber describes.

So we are looking
inside of her stomach,

and if the previous operation
created any issues

that will prevent
another weight loss surgery.

[Dr. Now speaking]

Let's begin.

Hold there.

Okay.

Move to the left some.

All right. Hold it there.

Her staple line
is really narrow and long.

And so, it's gonna be
an issue.

It isn't looking good.

Okay. We are done.

Amber has very
difficult situation.

She has a previous
gastroplasty,

which is a staple line,

which is very narrow
staple line,

and leaving a very small
stomach on one side.

That make it very difficult
to work with that.

There is practically
no way to do

a sleeve gastrectomy here

because staple line will
make it so narrow that

she won't be able to swallow.

So, the only potential
for revision

will be gastric bypass,

which is a more
complex operation

than sleeve gastrectomy.

But it's the only option
she has in her situation

because, essentially, she has
very narrow staple line.

So the sleeve will result
in a stomach

that is too narrow
and too small

with the staple line
that she got.

So the only option will be

that we do
gastric bypass on her.

But that option
is still gonna be difficult

because of those
scar tissues she has.

But we can work with it
to do a bypass

if Amber is gonna stay
committed to doing
what she needs

to make the second
weight loss surgery

successful this time.

-Hi, Amber.
-Hey, Dr. Now.

-You awake?
-I'm awake.

All right. Well,
we did the endoscopy.

You do have
a very difficult situation

-because you got
a narrow staple line...
-Mmmhmm.

...which is about
seven inches long.

And that is making it
very, very difficult

to be able to correct that
to sleeve

because we need more room
for that.

Because it's so narrow,
you can have reflux

and issue.

The only possible way

-is to convert that
to a gastric bypass.
-Okay.

So we'll schedule that
for two months from now.

-All right. Sounds great.
-I'll see you later.

-See you later.
-Okay.

[Dr. Now] Right now,
I'm encouraged
by Amber's progress,

and I'm happy to see

Amber lost seven pounds
over the last month.

So hopefully, she sticks to it

and we are able to move ahead
with her weight loss
surgery soon.

So that both she and Nathan

can take advantage
of having the same tools

to continue to work together,

to be able to make the changes
that will last a lifetime.

And from what I'm seeing now,

I'm optimistic that
they'll be able to do that.

[Nathan] Amber and I
had another appointment
with Dr. Now today,

and it went well.

He says we are on track.

And the really good news
is that

he scheduled Amber's surgery
for next month.

So, we're both excited
about that.

I told Amber that
I wanted to stay the night
in Houston.

So we could go out
and have a date night
in the city.

And a theater in the park
sounded perfect.

[Amber] When Nathan told me
his idea to stay in Houston
and go out,

I wasn't sure
if it was a good idea.

Because I didn't know
if this was gonna lead
to any sort of temptation.

Because that's what we have
always done together.

But I decided I was gonna
keep an open mind.

[Nathan] We're not
eating together.

But there are things
that we can try to do

to bring some romance
back into our relationship.

But I know
that's gonna take time.

[Amber] I do think
Nathan is on the right track

to him kind of
going back to being

my husband,
back like it was originally.

But it's a work in progress.

And maybe we'll get there.

Who knows?

It just depends on
how things go.

I'm not gonna rush in,
and I don't think
he should either.

How you have been doing?

As far as what?

Just the whole process.

A lot better.

About a month ago,
I wouldn't have been
able to do this.

[Nathan] I know Amber and I
have a lot to work on

to get back to a good place.

But with all my weight loss,

my relationship
with my daughter, Hannah,
has improved.

Because I'm actually
able to go out

and spend time with her.

So we've been hiking together,

and going on nature walks
at least twice a week.

And she keeps telling me
she's proud of me.

When before, I think,
she was a little
embarrassed by me.

And I just hope that
I can also become the husband
that Amber deserves too.

One big step I'm taking

is I have decided
to go back to work.

I still have my lymphedema

and it still hurts
when I walk,

but it's gotten
a little better.

I feel ready for it.

So I'm no longer
taking a leave.

So I'm really excited
about that,

and know
as I make more progress,

I'm going to be able
to do more and more

and I'm looking forward
to all that.

So what are you gonna think
about when I'm all skinny?

You're gonna look
like a cartoon character.

With a big head,
and a really skinny body.

[laughs]

[Nathan] How rude?

This is a journey.

One that involves much more
than I could have realized,

as harder than I ever thought
it would be.

But it's good
and I'm happy to be on it,

and headed to where
we're going.

Because I know
it's a much better place.