Original subtitles

[David] My back hurts.

My knees hurt, my feet hurt.

The only thing that keeps me going is all the food we just bought.

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

I just wanna be a normal person.

[exhales]

[breathes heavily]

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 gonna be too late.

[groaning] No, it hurts!

[woman] I refuse to stop fightin'.

I have to do this for my children.

I'm stuck.

I can't breathe.

[David exhales] This is crazy.

[David] It's so hard to force myself

to get up in the mornings.

Because my back is messed up from my weight.

[oxygen whooshing out]

My back started gettin' so bad,

I'm in agonizing pain.

[David exhales]

That's when my weight really is...

Really been takin' it's toll.

[grunting in pain]

[deep sigh]

I take muscle relaxers for my back,

and then heavy prescription pain pills.

Probably eight different pills.

[grunts]

Everything is such a struggle.

It's just painful to move around right now.

Getting in my shower is a tough thing for me.

I put a chair in the shower right next to me,

so I can have something to lean on to,

just in case I slip.

With a messed up back already, it...

It makes it impossible to move, being this big.

[breathes heavily]

After I've been standing on my feet

for more than two minutes,

I get scared that I'm gonna fall and hit the ground.

I'm scared every day when I take a shower,

'cause if I fall, it's gonna...

Probably break something and it's gonna hurt.

[sighs]

I've fallen before, and I couldn't get up.

[exhales]

Gettin' clean is a tough thing, for me.

I do my best.

But the pain takes my breath away.

[breathes heavily]

[exhales]

[grunts]

Getting dressed is the hardest thing I do all day.

But I have my foster mom, Robin,

to help me when I need help.

[breathing heavily]

If it wasn't for her,

I would have given up on myself by now.

[coughs]

Hey, Robin? Can you help me put on my socks?

Okay. Where's your socks?

[Robin] David is a part of my family,

and I claim him as a son.

- You about ready for breakfast? - [David] Yeah.

I'll get that started.

[Robin] He's only here in my house because

he really didn't have anywhere else to go,

and, in my mind,

helping a child become healthy is loving them.

[David exhales deeply]

[Robin] And so, I think the reason David put on so much weight

is he didn't have anyone in his life love him

enough to be able to help him,

in a sustained manner.

And, um...

He's a good kid. He deserves...

to find love,

from other people and within himself.

[pants and grunts]

[David] Life has been kinda tough.

[groans in pain]

And the best way to distract myself is to eat.

[David speaking]

- All right, I'll carry it down for you. - [David] Okay, thank you.

[David] Because there's no better feeling than eating.

[exhales loudly and sighs]

My birth mom was 13 years old when she had me,

and she was using cocaine.

And my birth dad wasn't around.

And so I went right into foster care.

I bounced around to different foster care

houses while I was young.

Sometimes I was put in houses that weren't very good,

with foster parents that didn't really care about kids.

Some people are just in it for the money

that the state gives them, for taking in kids.

We'd eat really poorly.

So from an early age,

I learned to eat as much as I could

when a meal was given to me, because

sometimes you wouldn't know you were gonna get fed again,

for days.

Around the time I was three,

I got placed with a permanent foster family, the Nelsons.

So the Nelsons wanted to adopt me.

So I got adopted at six,

but my dad was kind of a scary figure.

When I would get disciplined,

he would hit me so hard with a belt,

it would leave marks.

My foster mom would hit me too.

I remember she took me into the garage,

as a punishment,

and slapped me in the face a bunch,

and I broke my nose.

I would eat to make myself feel better,

because food calmed my nerves.

It was comfort.

All through my childhood years,

I was taking comfort in food, any chance I could get.

And by the time I was in middle school,

I was 250 pounds.

But I was playing football and wrestling, I could run a mile,

but it never bothered me.

In my sophomore year of high school,

our grandma was dying of cancer.

Our parents went to California,

to, uh, bury the grandma.

They up and left my siblings and I.

Three teenagers left alone,

what are teenagers gonna do? They're gonna throw a party.

Kids being crazy.

Drinkin' and smokin' weed.

That party lasted ten days.

Our next door neighbor was an ex-cop,

so he was takin' pictures of the whole thing.

When they got home, just like that,

they kicked us out.

So this was supposed to be my mom and dad,

who had raised me for ten years.

Then they, you know, threw me out, so,

it killed me.

It made me angry

that I was back

in foster care.

That's when I gained, uh, 100 pounds,

in, like, a year.

I was pretty shut down then.

I didn't really talk to anybody

or want to get to know anybody.

I started doing terribly in school.

I probably would have dropped out of high school altogether,

except for that youth program, Foster Appreciation Picnic,

where I met Robin.

Everything after meeting her was different.

[Robin] David came into my world

when he was 17 years old.

He was so personable,

and there's something good about him,

and I was attracted to his goodness,

despite the fact that the world had been unkind to him,

and that people had let him down.

And I met him at a foster youth of Idaho picnic,

and I fell in love with him the instant I met him.

And I called Health and Welfare, and said,

"Hey, I really want David to come live with me."

And they warned me off, they said,

"Nope, he's already blown a few placements,

he's very angry..."

And I said, "No, I really want David to come live with me."

[David] Living with Robin is the best environment

in foster care I've ever dealt with.

She took me in as one of her own.

When she introduced me,

she said "This is my son, David."

She was always there,

to help me with my homework,

and I went down from about 350,

down to 280.

Because she was making me go to the gym twice a day,

and, you know, walk home from school, stuff like that.

And she helped me get into the University of Idaho.

I was excited to go to the university,

and, I went up there with the idea that I was going to study,

but instead, what I wound up doing,

was just, you know, partying.

0.00 GPA.

Didn't go to class.

Smoked weed, drank, partied.

I realized that I had to leave,

'cause I had let myself down.

And, um, should have balanced it a little bit better.

I moved back down to Idaho Falls,

because I found a job working with developmentally delayed people.

You know, I like doing that kind of work.

Pay's not very good, but, you know, it's fulfilling.

And this was the first time in my life

that I had my own money.

I started eating every chance I had.

Fast food, pizza, burgers,

and deep fried things,

and all the goodies.

[David speaking]

So, from the age of 20 to 22,

I worked at Walmart as a cashier,

then I moved back into the cash office,

counting all the money in the store.

[David speaking]

Dated this chick, broke up with her,

dated another chick, broke up with her.

That broke up was really hard,

so I clinged to the only thing that made me feel good, food.

And from the ages of, uh, 23 to 25,

I gained about 100 pounds.

I was eating, drinking and partying,

and not being a good employee and my job at Walmart.

So they had to let me go.

After Walmart,

just started working, driving a forklift,

and in trucks for farmers.

And then that got me into long-distance driving.

I wanted to see the United States.

And I could afford to, because,

when I was sleeping in my semi-truck,

I didn't have to pay rent.

So I got to see all the states.

I didn't leave the road for a year,

which was pretty cool.

But at the same time, on an emotional level,

I noticed that I was depressed.

And I kept eating fast food

because that is what's available on the road.

And it just brought a little bit of relief, I guess.

But there's not a lot of things

that brought me that much happiness.

My weight built up to 800 pounds.

And one day I woke up,

I started thinking about suicide.

It got to the point where I was

thinking about it all the time.

I'd drive over a bridge and I'd flinch,

'cause I thought I'd pull the steering wheel

and dive off of it, with the truck.

It scared me.

So I would just eat to distract myself enough,

to try to want to stay alive.

All right.

About ready to go?

[David] Yeah.

[David] Then I started having trouble

getting in and out of the truck cabin.

And that's when I started to notice

these red patches on the right side of my stomach.

One of them just grew and grew and grew.

I stopped being able to move all that well.

And I was getting weaker, but...

I'm one of those people that don't wanna go to the doctor

unless it's severe.

And by the time I made it,

my back was super weak,

my legs were super weak,

and I could barely walk.

And they sent me to the emergency room.

I had a severe cellulitis infection.

And after... [deep sigh]

some physical therapy,

and a bunch of antibiotics,

and tests and stuff, they got rid of the cellulitis infection.

But I was a mess,

and that's when I reached out to Robin.

That's when I decided to try to lose weight,

and start taking my mental health

and physical health more serious.

I moved in with Robin

after I left the hospital,

'cause they were gonna find me

a physical therapy unit to move into,

but they couldn't find one that would take my size.

So she thought she could help me out.

[exhaling] And she did.

[David coughs]

One of the ways Robin gets me to be more active

is to take me out grocery shopping.

[exhales deeply]

That's the only time I'm willing to leave the house,

because I've lost most of my mobility,

and walking just a few feet,

it's pretty painful.

All right, let's stay out of the candy aisle.

[chuckles]

[Robin] Don't be looking at the pizzas.

[David] Get some eggnog.

[Robin] That's not low-cal.

- [David] No, but it's delicious. - [Robin scoffs]

[Robin] I was nervous about going with David to the grocery store.

It was good to get him out and moving,

and I was really proud that he made it through a number of the aisles,

but his food choices are terrible.

- I want some cookies. - Nuts.

- [David exhales] - Nuts is high protein.

- There you go. - [David breathes heavily]

[Robin] And he knows that I...

don't want to boss him around.

He is a grown person, he is his own person,

but I worry about his food choices.

[David continues to breathe heavily]

[panting] Okay...

- You okay? - No.

- No? - [David exhales]

[Robin] He doesn't have any stamina,

and that's embarrassing for him.

It's embarrassing to go out with people

and have to stop every five seconds to catch your breath.

He gets winded so easily.

And he has to stand and rest his back,

and he just gets worn out.

[breathing heavily] Hi, there.

[breathing deeply]

[grunts]

[continues breathing heavily]

[David] My back hurts,

my knees hurt, my feet hurt.

The only thing that keeps me going is all the food we just bought.

[David] After being pushed to my limits, I usually need something immediate.

[Robin] All right.

[server on speaker] Hey, what can I get started for you today?

[David] Hi, can I get two number fours?

Ah, lemme get one more double bacon western cheeseburger.

And a cheesecake.

Thank you.

[brakes car]

[panting]

[breathing heavily]

Ow.

[exhales loudly]

[grunts]

[panting]

[grunts]

[Robin] I'm scared that David doesn't have an internal motivation.

To feel like I'm the external motivator,

that's a lot.

That puts a lot of pressure on me and it, and it scares me

that he won't be able to find it within himself

to be able to be a healthier person.

[David] I don't consider myself a food addict.

I feel like my life started off on the wrong foot.

And it's been that way ever since.

I'm gonna go to bed, I'm tired.

- I'll clean the rest of this up. - Okay. Thank you.

- [sighs] You all right? - Yeah.

- Just tired. - All right.

- Okay. See you in the morning. - I love you.

[grunts]

[exhales in pain]

My worst fear is that I'm gonna die and...

Robin's gonna find me, and it's gonna mess her up.

[grunting]

[breathing heavily]

At this weight nothing's easy.

[breathing heavily]

Besides laying down.

[breathing heavily]

Even sitting sometimes gets painful.

[exhaling sharply]

My food problem is, is killing me by, you know, weighing down my heart.

And, um, my back's already messed up.

[grunts]

I live every day in despair.

I know it's time for me to...

make that decision if I want to live or... die soon.

Because if I don't lose the weight, I'm gonna die.

[grunts]

[exhales in effort]

[grunts]

- All right, all done. - How can you be "all done"?

- I'm the fastest folder ever. - All right, well, get moving.

Olympic folder.

Today's a big day, 'cause I'm leaving Idaho and driving to Texas

for the purpose of meeting Dr. Now and kickstarting my weight loss journey.

[breathing heavily]

And I'm worried because I don't know what this drive's gonna be like.

There's a good possibility it's gonna be pretty painful for me.

And it might be kind of miserable.

I've got a lot of weight to lose, but I gotta get some help. Obviously.

[grunts]

[car squeaking]

[exhales]

[grunts]

[breathes loudly]

[grunts]

[grunts]

[car squeaks]

[keys rattle]

- All right. - [engine starts]

- [Robin] Are you starving? - Yeah.

[David] I know Dr. Now's gonna make me change my eating habits.

And that's gonna happen pretty much as soon as I get there.

But before then, I'm not gonna change it up yet.

Can I get a number 24 with a diet coke?

[server on speaker] Anything else needed?

Yeah, let me get three... jalapeño poppers, three orders of them, the nine piece.

So nine in total?

No, no, I want...

What's three times nine?

[Robin and David] 27.

- 27 jalapeño poppers? - Yeah.

- Okay, anything else for you? - Uh, supreme croissant.

- Okay, anything else for you? - That'll be it.

-Okay, that'll be $36.90. I'll get that for you. -Thank you so much.

[Robin] Did you ask for vegetables?

Yeah, jalapenos.

Did you get all those poppers?

[server] 27 poppers.

[Robin] Oh, those smell hideous.

[David] They smell delicious.

- Are you eating my hash brown? - [Robin] I ate a bite, yeah.

[David] If you wanted a hash brown, get a hash brown.

[Robin] What are you gonna do about it?

[David] Oh my gosh.

[Robin] It's like stealing candy from a child, huh?

A very large angry child.

[Robin] Let's go!

[David] It looks like it's gonna be about a 25 hour drive.

So, if we do eight hours a day, it should take me about three days.

But if do more than that, and we do 10 or 12 hours,

we could shave a day off of that.

Because I know I'm gonna be hurting after being in the car that long.

So it might just be better to hurry up and get it over with.

Heading to the mountains.

But I don't know. We'll have to see what I can handle.

[Robin] Are we there yet?

[burps]

Um. Yeah, almost.

Just 24 more hours.

So far, I'm doing okay.

My body hurts, but that's why I have this big van.

Because it fits me in it okay.

[David] Cowboy country.

My back hurts just a little.

- Hey. - But once we get out, I'm gonna be crippled.

I can feel my body starting to hurt more.

[grunts]

I don't think we're gonna make it more than 5 hours today.

Ow. [clicks tongue]

My back is killing me.

[Robin whispers] Let's just stay here.

Okay.

[groans]

[long exhale]

[car squeaks]

[breathes out in exertion]

Ow!

[grunts]

[out of breath] Is this...

[grunts] Okay.

[exhales in effort]

[exhaling sharply]

[breathes heavily]

[exhales in exertion]

[exhaling sharply]

[sighs]

[out of breath] I'm stuck.

[huffing]

[grunting]

[exhaling sharply]

[breath escaping lips]

[sigh of relief]

Ow.

[huffing]

Oh.

[huffing]

[loud huff]

[huffing]

I can't breathe.

My heart's beating so fast.

[muttering]

My health's so bad.

It's gotten so bad.

[panting]

Robin doesn't even know how bad it is.

[grunts]

I hate this.

This is crazy.

[grunts]

I can't go on like this.

[Robin] How'd you sleep?

I slept okay.

- Yeah? - [out of breath] Yeah.

You know what? Why don't I take your stuff down and then I'll take my stuff down 'cause

- who knows how many trips I'm gonna have to make-- - I can carry something.

Carry the heavy one... [laughs]

- [David] Okay. - You're strong.

I got that one.

All right.

- I'll see you at the front desk. - Okay.

[David] We've been driving for four days.

And my back is killing me.

And I can hardly sleep at night from the pain.

So, I'm exhausted.

Have a good day.

And I wish I could just stay here and sleep.

But I can't do that because I'd miss my appointment with Dr. Now.

I gotta run.

I'm coming.

And then all this would be for nothing.

So I'm pushing myself to keep going.

Man, my back.

[Robin] Yeah?

-Put your stuff there. I'll get the rest. -[out of breath] Okay.

- Here's the keys. - [huffing]

[groans]

- You don't sound so good. - No, my back hurts so bad.

[grunts]

[groans]

Oof.

[huffing]

- Tada! - [grunts]

[GPS navigator] At the lights, turn left onto...

[David] Gotta remember it's a van, not a sports car, Robin.

You scary driver.

Hush up.

[David] My foster mom has to drive because I'm in too much pain.

And on top of that, I was feeling sleepy behind the wheel.

So it was just too dangerous.

Well, the only good news is that we're in Houston, Texas today.

And now that we're close to my appointment with Dr. Now,

I'm starting to get nervous.

Because I'm gonna have to get on that scale.

And that's when I'm gonna find out the truth

about how bad my situation has gotten.

[grunts]

- Try that. That's got to help. - [groans]

[nurse] David?

[David] It's been a little while since I weighed myself

and I know I've gotten worse since then.

I just hope that I'm in the 600s.

I'm ready to go.

[nurse] You can step up on the scale.

Your weight is 763.

Okay.

Okay, thank you.

[David] Wow. That's a lot worse than I thought.

Well... I guess this is what I'm here for.

And I know Dr. Now, he's seen it all, pretty much.

So I know I'm in the right place.

That's a pretty crazy number.

[sighs in relief]

And I guess I got a lot of work to do.

[knocking at door]

Hello, how you all doing?

Good, thank you. Yourself?

I'm doing good, thank you.

- So... You must be David. - Yep.

Well, David, nice to meet you. And who's this young lady with you?

- That's my mom, Robin. - Well, nice to meet you too.

- So, where you coming from? - Idaho.

All right, that's a bit of a drive for someone in upper 700s.

So I take it, you came all the way here to get some help with your weight?

Yes, sir.

All right, so, you are, uh...

- 763 pounds. - Yes, sir.

And you have a BMI of almost 100.

So what seems to be the issue with your eating habit?

Um, it's probably not the best.

Well, yeah, that goes without saying.

But what's driving you to eat,

and why are you continuing to eat like you have been,

when your weight is so out of control?

Um...

Um, I'm probably, like, an emotional eater

and I have a lot of baggage from my past.

Uh, grew up in foster care and what not, and so...

Some psychotherapy is going to be something that is going to help you

to cope with things in the past in healthy ways

and take care of yourself.

Okay?

Who else live with you?

Uh, I live with my mom right now.

So what do you do all day?

Uh, right now not very much.

Um...

I, uh...

I wake up, try to stretch out my back so I can move.

My back is pretty tight in the morning.

And, um, then, uh,

basically watch TV or eat and...

then, uh, go to sleep.

So, you mostly you sit around all day, eating, doing nothing.

Yes, sir.

All right, David, if you right now close your eyes

and imagine that you are 210 pounds, okay?

Do you work?

Um, right now I do not.

I was driving a truck, cross country.

And then I got a cellulitis infection

and that put me in the hospital for about two months.

And the while I was in there just my back got real bad and my legs...

just, um...

Well, when you're 700 pounds,

you're gonna have a lot of risk factor,

you're gonna have a lot of health issue

that is going to prevent you from being active

and doing what you need to do.

And so you need to go ahead and focus on improving your health

and take care of yourself.

- Right. - Okay?

That is the only thing that is going to improve your situation

and your health, to avoid these issues.

Mom, you got anything to add to what he says?

I think David is doing, uh, a great job of downplaying everything.

There is a lot of food that comes to the door

that when I'm gone, ends up getting eaten.

And David has a--

Well, he doesn't work, how does he afford all this,

uh, a lot of food deliver?

That's what all his money goes for.

That's why he's had to, that's one of the reasons he had to come back.

I don't usually allow my foster kids to come back

and live with me.

And, but David doesn't have anywhere else right now.

All right, well, that needs to change, right?

Yes, sir.

So, are you willing to make those changes?

Yes, sir.

So I'm gonna bring some stuff for you.

It is a diet and exercise plan

that I want you to start immediately.

The diet is going to limit you to 1200 calories a day.

And if you follow it, it's going to eliminate

all the carb out of your diet.

And focus you on eating protein

with a lot of vegetable and salad.

And if you do that, at your weight,

when you're 700 pounds,

you can easily lose 100 pounds over the next month.

But the goal I'm gonna give you is to lose 80 pounds

over the next two months.

- Okay. - Okay.

- Do you think you can do that? - Yes, sir.

Okay, so you've got a lot of work ahead of you.

But if you do what you need and hit your goal,

then we'll consider weight loss surgery for you.

But if you're not able to make those changes,

then the surgery is not gonna be help for you.

- Okay? - Okay.

All right, I'll go get the information

and we'll go over it, okay?

- Okay. - All right.

- I'll be back. - Okay, thanks, Doc.

What do you think?

He said 80 pounds.

It's a lot.

[Dr. Younan Nowzaradan] I am surprised David

is as mobile as he is

at 762 pounds.

But he is at a cross-roads right now.

Because he could easily

be over 800 pounds in a matter of months,

if he doesn't change things right now.

And if he lets things get to that point at his weight,

it's going to be finally too much

for his legs and his knees to handle.

And he will start to become immobile.

And once that happens, his health is only gonna continue

to go downhill

from there, just much more rapidly.

What's up, Doc?

All right, the first thing we're gonna go over is the diet.

So, if David doesn't make the changes he needs now,

his situation

is going to get much worse very quickly.

And then he's likely not going to be alive in a couple of years.

So it's very important he takes this seriously.

To do what he needs done before too late.

Is pizza on that list?

Pizza is a high calorie food that you need to really avoid, okay?

Oh, come on, Doc.

It's pizza or your life, it is your choice.

That's true, all right.

Now the other thing I'm gonna give you is a copy of my book.

- Okay. - And I put the bookmark in here.

In a chapter for exercise.

So I want you to do these exercises,

one hour in the morning, one hour in the afternoon.

Hopefully, David gets the gravity of his situation.

And how close he is to things getting much worse for him.

And I'm hoping his mom is ready to support him like she says.

But the only way for us to be able to help David at all,

is for him to take the first step

by making the changes he needs

to take responsibility for his life.

If you do all this, you can easily lose 80 pounds in two months.

And if you do that, we'll consider weight loss surgery for you.

Then eventually you'll have to move down here

with someone that can help you while you're here.

[David] Okay.

How long will it take you to get down here?

It took, uh, it took me four days this time.

- Four days? - Yeah.

So, you know, that's, uh, a big trip.

And it's gonna take a toll on your body

going back and forth.

Right.

And so, it's gonna be important you move down here, okay?

[David] Yeah, that's the plan.

Okay.

All right, David, I'll see you in two months, okay?

Okay.

But in the meantime if you need anything,

you have any question, give me a call.

Okay, I appreciate it, thank you, Doc.

All right, nice to meet you, guys.

[Robin] Thank you, it's nice to meet you.

- Are you ready to go? - Yeah, I'm ready.

- Okay, let's do it. - Let's go.

[David] Well, it feels good to know that Dr. Now's gonna help me.

Said that he wants me to lose 80 pounds.

Wants me to figure out why I eat.

And, um, stick to his diet.

It's a process and it needs to be done, so, gonna do it.

I'm glad I'm getting that help.

And I know one thing for sure, is that I desperately need it.

And I need it more than ever

because my situation's getting worse by the day.

Oh, maybe not.

[grunting]

[David] It took four days to make it back from Texas.

And it didn't feel any better on the way back.

Next time I'm gonna have to fly because I can't keep doing that.

It's too rough on my body

and I was really sore when I got back.

So I had to take some time to rest.

And since then, I've been struggling

with what feels like an impossible task of losing 80 pounds.

[groaning]

[exhaling deeply]

But it's time for me to kick it up another notch.

I've been pretty discouraged ever since I started.

But I decided now is the time to start doing the best I can.

And work hard and not worry about it as much.

As long as I do my best from here on out, I'm not gonna have any regrets.

[sighing]

[exhaling]

You ready for some breakfast?

- Yes. - All right.

[Robin] I'm gonna make some, um...

Sausage.

- No. - Just four pounds of sausage.

I'm thinking some eggs and some low cal cottage cheese

and maybe some low cal yogurt?

Sounds good.

[Robin] Yum, all right.

Could you bring me that Dr. Now book?

Oh, sure.

You have it memorized yet?

- Yeah. - Good.

I'll test you later.

Mmm.

Did you take the breakfast straight out of the book?

[Robin] Pretty much.

[both laughing]

Oh, my goodness.

[David] My focus is on doing what I need.

And I'm not gonna waste any more time.

If I have to lose 80 pounds,

and there's only a month and a half to do it,

then there's no time like the present.

I hope I make it.

And if I don't, it's not gonna be from a lack of trying.

Did you know cashews are high in calories?

Bummer. But they're. still good for ya and they're high in protein.

What else does it say?

Avoid meal supplements.

Or shakes that have excess carbohydrates and sugar in them.

Thank you, kitty, for this food.

Okay.

Are you doing a food diary yet?

We've talked about it.

No, I'm just doing it in my head.

How's that working for ya?

Super good.

[laughing]

I guess we will see, the scale will tell the truth.

Mmm-hmm.

How's your eggs?

It's good, thank you.

So does the book encourage you to eat three meals a day

or just two?

It says 400 calories, per meal if you eat three meals a day.

Or 600 calories if you eat two meals a day.

Plain yogurt?

Get strawberry yogurt, Robin.

No, you can't have fruit in your yogurt, read the book.

- Is it just plain yogurt? - [Robin] Yeah.

- Yeah. - [Robin] It's low fat.

So what's your plan for the day?

We're gonna go for a walk, me and you.

[Robin] Oh, that sounds like a great idea.

I know.

[Robin laughing]

- [Robin] 'Cause you thought of it? - Uh-huh.

So have you been to this before?

I don't think so, actually yeah.

[David] There's only one way to fail and that's by going half-assed.

And that's what I've decided I'm not going to do.

I don't trust you, I'll get on this side of you.

[David puffing]

You might push me over the edge

if I don't give you dessert.

[Robin laughing]

[David] Because the life I want to live, is gonna be worth it.

I think I'm just gonna keep trying to work out,

keep trying to eat healthy,

and I'm not gonna look at the scale until...

the time gets way closer.

'Cause I think it's just gonna discourage me, honestly.

[David puffing]

- [Robin] Ah. - [David] Argh.

- Good walk. - Yeah.

How about that?

Yay.

[David] Getting pretty good at that.

[David] I made it back to Houston, this time I took a plane.

And it was a lot better.

Thank you, sir.

[driver] You have a good day.

[David grunting]

Plus, I'm starting to be able to move a little better.

So it feels like progress.

Robin couldn't get out of work,

so I was gonna try to reschedule,

but I decided to just do it on my own.

And here I am.

David.

[groaning]

- Hi, there. - Hi.

[David] I've been working as hard as I can,

to hit the goal that Dr. Now gave me.

When I first started, losing 80 pounds felt impossible.

[nurse] And whenever you're ready, go ahead and step on the scale.

[David] But by the end, I feel like I might be getting pretty close.

So I'm just gonna have to wait and see

what the scale has to tell me.

[David] I'm back at Dr. Now's for my first follow-up

to find out how much weight I lost.

And to talk to the doctor about it.

At my first appointment, I was 763 pounds.

And the doctor told me to lose 80 pounds in two months.

And if I did that, I'd be down to 683 today.

That's pretty good.

- Room five. - Okay.

[David] It's not 80 but it's not bad.

And I know I messed up the first week or two, after I got back.

So really that's only after six weeks of trying my hardest.

So I'm pretty proud of that number.

But I don't know if Dr. Now's gonna like it.

I guess I'm about to find out.

[knocking on door]

Hello, how you doing, David?

Hey, Doc.

Doing all right?

Yeah, I'm doing well, how are you?

I am doing good.

You came on your own this time?

Yes, sir.

Well how was your trip down here?

It was good, I flew this time so it was much faster.

All right, well, I'm glad to hear that.

I'm also glad to see your progress over the last two months.

You lost 67 pounds and you're under 700 pounds.

- Yeah. - So that is positive.

So what changes have you made with your eating habit?

Um, it took me a while to get...

on track.

What do you call a while?

Several hours or a couple of days?

Oh, no, it took me probably a couple of weeks, um.

I think I've been on your program now for about five weeks.

So imagine what you could've lost

if you did it for all eight weeks.

Right.

So, what took you a few weeks to get on the program?

It had a lot to do with just mental blockage I think.

Um, I think, um, the shock to my system

from losing 80 pounds wasn't something I was ready for.

I think it just took me...

some time to just put myself in the right state of mind

to start making the right decisions for my health.

Okay.

Well I'm glad you got to where you needed to be mentally

to start making the changes you need.

So that's good.

And I'm glad you lost 67 pounds.

- Thanks, man. - That's a starting point.

But with your progress, this is what I will do.

I will approve you for weight loss surgery

and schedule it for two months from now.

And if you lose another 30 pounds by then,

and move down here to Houston in that time,

we will move ahead with you, okay?

- Okay. - You think you can do all that?

Yeah, I'm totally willing to move to Houston, um...

Are you gonna move by yourself or somebody gonna be with you?

I'm hoping my foster mom will be, she's working on that.

Okay.

So this is a conditional approval for you.

Lose another 30 more pounds and move down here.

And if you do that,

we're gonna go ahead and schedule your weight loss surgery

for two months from now.

Okay, thanks Doc.

But if you get here and you haven't lost 30 pounds,

then I'm gonna cancel the surgery

and we're not gonna move ahead with you.

You got that?

- Yes, I do. - Great.

Then I'll see you in two months.

And if you need anything in the meantime, let me know.

All right, have a nice trip back home,

and I'll see you soon.

Okay, thanks Doc.

All right, see you.

All right, see ya.

I'm happy to see some good progress from David.

It is encouraging but he still fell short of his goal.

And if he was fully doing the diet,

he would've lost triple of what he lost over the past two months.

So I still need to see

a little bit more progress from him.

But if he at least sticks with what he's doing,

he should easily lose another 30 pounds in two months.

So now it is not time for him to get comfortable and slip up.

Because if he doesn't stay on track,

and doesn't meet his goals by the day of surgery,

then we won't be moving ahead with him.

And we will have to start this process all over again.

[David] Well I'm feeling pretty good right now.

But mostly I'm just worried about moving to Houston now,

because I'm not sure if Robin's going to be able to move with me.

But it feels like a huge deal to get approved for my first follow-up

and I feel confident we'll be able to figure out the details of me moving.

I know Robin wants to be here for me

and I know I'm excited for this new life.

Can I just get my towel? Thank you.

Thank you so much.

Ever since I saw Dr. Now and got approved for weight loss surgery,

I've been focused on keeping my weight going in the right direction.

And also I've been focused on moving myself down there,

the way Dr. Now's program requires you to do.

- Okay, I'm gonna go work out. - Okay.

I will see you when you're done. Do good.

- Okay, I will. - Good work, okay.

But today I'm focused on getting a good work out

and I'm excited because I found a way to do that

without hurting my back so much. Water aerobics.

- Hi. - [Shawna] Hey, how are you?

- I'm okay. - Good.

- Let's go work out. - Okay.

-Okay? Meet you in the pool. Ready? -Okay.

Moving to Houston is stressful, though.

The big problem is that Robin doesn't know

if she'll be able to do it right away

and I know she wants to be there for me

but she has a good life here and a job and people that rely on her

and it's a pretty big deal to pick up and move

so I'm stressed about what could happen if she can't go,

and what I'm gonna do about that.

And all that stress, it's making it harder to lose weight

so I'm still working on what I have to do

but it's just been more of a struggle.

[Shawna] Okay, just start with the high knees

and we'll just go... We'll walk a little bit.

[David] I know I have to figure this out

so I can get down there and do Dr. Now's program.

[Shawna] Okay, stand there. I want you just to swish.

Just march and swish. Kick, kick.

I know I need to be in Houston to be accountable for the next year

and I know I need to have someone with me, because that's a requirement

and there's times I won't be able to help myself.

Kick. Good, now lift, just one leg. Up, up.

[David] But Robin is the only one even close to being able to do that

so I'm tryna figure something out.

We're all done. You did great today.

- Let's get you out of the pool. - Okay.

But it feels like an impossible situation, some days.

Hey! I watched you for a while, you look great.

- Yeah. Thank you. - All right. Ready to go?

- Yeah, let me just get changed. - Okay.

- Go get dried off. - Okay.

- Hey. Good morning. - Good morning.

- Are you pumped? - Oh, yeah.

- Yeah? - Oh, yeah.

All right, well, I gotten the laundry mostly done.

- Sweet, thank you. - We'll get you packed.

Well I have it all worked out, so that this move to Houston is actually happening.

All right. I'll get the stuff.

[David] The only thing is Robin isn't able

to go with me right now so I'm going by myself.

All right.

[David] But she's going to come down after me

when she can figure out her schedule.

[Robin] There's one.

[David] It's been a little stressful and I'll admit there's been

a few times that I've slipped up

and caught myself eating food for comfort.

But overall, I haven't been giving in.

[Robin whispering] Oh, gosh. That's huge. Okay.

What do you mean, "huge"?

- It's huge. - That's normal size.

And yes, I believe Robin will make it down.

But not having her there gets me a little worried

so I'm trying not to think about it.

I just keep tryna think about the bright side.

[Robin] We're off!

[David] To see the wizard...

[David] I made it down to Houston,

which is gonna be my new home for a while

so I can get the weight loss surgery I've been working towards.

Which is gonna be the key for me to getting a better life.

I found a place online that I can rent

and my surgery is in a couple weeks.

My foster mom, Robin, she's supposed to be here, too,

but she wasn't able to come just yet

because she still had some stuff

that's she's tryna work out back home.

So until that happens I'm gonna be here by myself which should be fine.

[groaning]

- Thanks, man. - My pleasure.

- Welcome to Houston. - Yeah.

[grunting]

[struggling for breath]

[panting]

Oh!

[sighing in exhaustion]

Okay.

Oh, this is nice. All right.

All right, this place isn't that bad. I can make this work.

And I'll keep working hard to make sure that my surgery happens the way it should.

[grunting]

[sighing in exhaustion]

[Robin] We're keeping this up.

[David] You and your feeling of optimism.

[David] So today is a big day.

My foster mom, Robin, made it down

and she's here in time for my surgery like she said she would be.

I just really hope that this goes according to plan.

Doctor told me to lose 30 lbs. and if I did I'll be down to 665 today.

[nurse] All right, your weight is 733.

Okay.

[groaning]

So what was your weight?

It looked like I gained some weight... since the last time.

Hopefully I can still get the surgery.

- Well I hope so. - [David] Yeah.

I hope so. What if they postpone it?

Then I guess I'll just have to get back on track and lose the weight.

- [Robin] Yeah? - Yep.

You feeling pretty good about it?

Yeah, I mean, I've done it before, I can do it again, so...

- I'll do it. - Okay, well,

I'm sure the doctor will be coming in soon and we'll...

- We'll know shortly. - Yeah.

- Hello, how're y'all doing? - [Robin] Hello.

- What's up, Doc? - David, how are you doing?

I've had better days, Doc.

It seems so, because you're up to 733.

So instead of losing 30 lbs. You gained 38 lbs.

So you're just about 70 lbs. away from where you should be today.

So we're not gonna be able to do our surgery,

so I'm cancelling it because of your weight gain, okay?

- Okay. - So what happened?

You know, it was just stressful with the move and everything, and...

I think, um, got off track a little bit, so...

I know it's been a struggle for you

but we cannot go ahead with you for weight loss surgery

- if you gain like this. - Okay.

It's not safe so I'm gonna send you home

and I want you to lose 70 lbs. In next two months

to make up for the weight you gained

and what you were supposed to lose by today

and if you do that we're gonna put you back on

the schedule again for weight loss surgery

but you have to prove to me you're gonna get back on track

- and stick to doing what you need first, okay? - Okay.

- You think we can do that? - Yes, I'll do that.

Okay, so we're gonna send you home now

and I want you to start working hard and get back on track, okay?

- Okay. - Okay, David, I'll see you in two months

- and hopefully 70 lbs. lighter, okay? - Yes, sir.

- All right, I'll see y'all later. - All right, see you man.

Sorry I made you come all the way down here for nothing.

Well, I'm glad to be here to support you.

Thank you.

It's unfortunate that David gained all that weight after doing well.

With his weight going in the wrong direction

it won't be safe to move ahead and do weight loss surgery today.

So I'm cancelling it until he shows me that he

can get back on track and stick with it.

If he does that, I'll approve him again

and we will move ahead with him.

But until he does that, weight-loss surgery is not an option.

[David] I can't believe this.

I feel like such an idiot.

I let everybody down, especially Robin,

who had to move mountains to come down here for me.

I didn't realize that small cheat days would make me gain.

Not that fast, anyway.

So now I guess there's only one thing to do about it.

And that's to make it right.

[engine starts]

I have to show Dr. Now that this is just a mess up

and that I can do this.

So I'm not going to give up.

I'm just going to try harder because my life is on the line.

And failure could mean a much shorter life span.

[David] Ever since I got my surgery cancelled for gaining weight,

I've been working hard to stay on the diet that Dr. Now gave me.

Robin has been a big help, encouraging me to do better and to stay on track.

All right. What are we going to do for exercise?

- Um, probably Dr. Now's exercises. - Great!

Let's start with ankle rolls.

- Yeah, let's do it. - Go!

One...

[David] And I've been busting my ass to make up for

that weight gain that I posted on my last weigh in.

[continues counting]

[David] But I can't help feeling guilty

that Robin is down here helping me to work out.

- [coughs in pain] - How'd that feel?

It hurt.

- [laughs] Okay, what's next? - Leg lifts.

Standing or sitting?

How would you do leg lifts standing?

You would go like this.

- Yeah, I can do that. - [laughs]

- Up... - No, I can't do that!

- Okay, I guess sitting. - You think I'm some karate expert?

Okay, leg lifts. Ten on each side.

[begins counting]

[David] We try to make it fun, but I am disappointed.

And sometimes it feels like everything I do is all about

making up for my fail at the scale.

Eight... Higher! Nine... Ten!

Hey, that's pretty good except for the face look.

- It hurts! - [giggles]

[David] She's been down a little this month.

Ten on this side. Go! Ten, one... Two...

[David] I know she wants to see me do better.

Live out my dreams, start a life of my own.

I feel bad about that, but I'm trying to make up for it

and get back to where I need to be.

I refuse to mess this up, so I'm putting everything into it.

What's next?

I have to stand up, but I don't want to.

Let's start with arm rolls.

[David] I kind of have a mental block, I think.

Because I can get kind of tripped out about the fail

or the amount that I have to lose

and I get this anxiety about it,

like failure is my only path.

[groans]

And I have no clue why I feel like I need her around to be accountable.

Maybe it's because it's the only time I've ever had tough love.

But also unconditional love.

- [sighing in exhaustion] - Poot.

How about...

[David] These thoughts hit me while I'm getting out of bed some days

and it feels just as hard as ever,

not easier like it's supposed to be getting.

But I can't let myself dwell there,

so I push myself hard in those moments.

For the past month, I've been doing a lot better.

I've been pushing through the mental block.

I'm not sure why, but it's been a lot better since Robin came down.

Nine...

Ten! Next leg.

[David] Anyway, all this hard work, it doesn't matter

if I get to my appointment with Dr. Now next month

and he doesn't approve me for weight-loss surgery.

Then all of this effort will have been for nothing.

[groans in pain]

But I can't afford to have back-to-back failures like that.

So I'm trying to use my fear and anxiety to help motivate myself to work harder.

All right, we're done.

I'm not sure if it's working or not, but I'm sure we'll find out soon enough.

But before that, it's going to be a big test for me.

Because Robin's going to have to go back home...

and I'm going to be on my own again.

That's going to be the real test, if I got myself under control or not.

But I wish I could say with more confidence

that I knew which way it was going to go.

[Robin] You think it's going to be good news today at Dr. Now?

I think I could've done better.

I just had a little, slow start, I...

A lot of stuff going on and...

But I think it'll be okay!

I think I lost some weight.

But, you know, if I lost...

a little bit of weight...

and he was proud of that

or happy about that, that would make me feel good.

Scales don't lie, people do.

[David] Today, I'm on my way to Dr. Now

and I'm not letting on to Robin how nervous I am.

Maybe she can tell, I don't know.

But just the thought of failing...

makes me wish I could escape the whole thing

and just not have to show up for it.

I know that's crazy, though.

So here we are.

And I'm bracing myself for the info we're about to hear.

- My door, Robin. - Okay.

[David] She has to go back for a few weeks next month,

but I'm thankful that she's been able to stay with me and help me.

But I still feel guilty that I'm taking her away from so much.

I just need the effort to do this

and get back on track to be worth it.

[exhales in discomfort]

- All righty... - Got a wedgie.

I don't want to hear about it.

[David] But today's the day that we find out how well I bounced back

after getting off to a rocky start.

The only way for me to do that is...

to meet my weight loss goal

and show Dr. Now that I can do this.

It's just more stressful now 'cause I feel like I'm letting everyone down.

And that feeling leads me straight to wanting to eat.

But I realize that I have to keep going

and do this because if I don't, it's only going to get worse.

David?

- Hi there! - Hello, how are you?

Oh, you know, pretty good.

Pretty good? Good.

[David] I know I haven't done as well as I did in the beginning.

But I've been trying my hardest now for a while...

with Robin's help and I just really hope that it's enough

Okay. Step up on the scale, please.

[David] My last weigh-in was a disaster.

I was 733 when I should've been 665.

So Dr. Now told me to lose 68 pounds

and get down to 665 today.

Your weight is 719.

[David] Oh, man.

Well!

- That's good! - [nurse] Couple pounds down.

- We can go to room five, okay? - All right, thank you.

You're welcome.

[David] To be honest, I'm relieved because I was so scared of gaining again

that I've been having nightmares about it.

So any kind of loss is welcome.

We all know it's not good enough.

So I'm relieved and dismayed at the same time

because I'm just more of a burden to Robin.

[panting]

And I don't want to hear what Dr. Now has to say about it.

[knocking at door]

Hello. How are you all doing?

Hi, Dr Now. Good thanks. And yourself?

Good.

All right. David is down to 719

and you only lost 14 pounds in two months.

You did so well the first two months and then you gained weight.

And now you're not losing that much. So what happened?

I really don't know because I'm trying.

It's just getting harder and the cravings are...

getting bigger than they were at first.

But I don't really feel like I'm giving in to them.

So I feel like I'm trying.

You think you're going to food for comfort because of stress and anxiety?

I really don't know because I thought I was working just as hard...

as I was before.

If you think there is no difference in what you're doing now

from what you did at the start,

then I think it is a good idea to get psychotherapy involved

to try and help you figure it out.

So, David, we're gonna set that up and we go from there.

But if you're not losing at least 35 pounds a month,

we're not going to be able to go ahead with the weight-loss surgery.

So I'm going to give you two more months to lose 70 pounds

if you want to move ahead with weight-loss surgery again, okay?

Okay. I'll figure it out.

All right, we'll get you some help with that.

David, how we doing with your exercises?

I know you've been going to water aerobics

because there is a bunch of girls over there.

[both laughing]

But are you doing exercise here in Houston?

Yeah, I've been trying to work out every day but...

Yeah, I'll...

make sure I'm doing those more often.

All right. Is he doing better at home?

I think he's still struggling at home.

But I think he truly, truly wants to...

keep trying.

All right, this is a long haul.

And you're going to have to stay with the program

before and after surgery.

So this is something that is very important for you to do.

- Okay? - [David] Okay.

All right. We'll get you an appointment time for therapy

and I'll see you in two months.

If you need anything, give me a call.

- Okay, thanks Doc. - [Robin] Thank you.

- All right, we'll see you. - [David] See you.

I'm happy to see that David is losing weight again.

But, it is concerning it is not as much as it should be.

Especially after he did so well with his weight loss in the first couple of months.

To go from losing like he had to gaining, and now, struggling,

is unusual pattern.

So, there is some issues that coming to the surface,

and causing him to struggle like this,

and go back to his unhealthy ways.

Hopefully, psychotherapy will help him to get to the core of what's going on

and what is behind that. To help him start to get back on track.

Because if he doesn't figure out what's going on,

and what's driving him to struggle like this,

then he's not gonna be able to make much progress.

And eventually, here soon, he will start gaining again.

And once that happens, it's gonna be harder for us to turn that around.

So, it's important that he figure this out now

before things get a lot harder for him.

[David] After today, I'm determined to do better.

I have to.

It's super disappointing what the scale said.

And then what Dr. Now just said.

I hope he's right that therapy can help.

'Cause I agree that there has to be something holding me back.

[David panting]

That could be the key.

And I hope that gets me back on track like I need.

Because no matter what, I have to figure this out

and do this, or nothing's gonna change in my life.

I don't wanna look like this anymore.

Whatever it takes, I need to figure it out.

And I need to do it now. I feel like I'm running out of time.

[David grunting and panting]

[David] Today, my foster Mom, Robin, is taking me to see the therapist.

I've never done any kind of therapy, so I don't know what to expect.

But I can use the help.

[pants] Yeah.

Because recently, it feels like I'm just going backwards.

Are you David?

-Yeah. All right. -Hi, David. I'm Dr. Paradise. Come on in.

[exclaims]

[pants]

- How you doing? All right. - Come in, have a seat right over there.

[David panting] Okay.

Oh, man! What? [grunts]

Welcome.

- What's up, Doc? - [chuckles] I'm glad you made it.

Tell me a little bit about yourself.

Um...

Well, I was raised in foster care.

Um, my mom was 13 years old.

- Your mother was 13 when she had you? - 13 years old.

Cokehead.

I popped positive for cocaine when I was born.

So they took me away.

- So, you were born on coke? - Yeah.

- Wow. Okay. - Yeah...

That's a... interesting way to start.

- Yeah. - What happened to you then?

Um...

I was put into foster care, I got adopted at six.

They adopted, the Nelsons adopted an older boy,

and then, they adopted two girls who,

they were actually like, biological sisters.

[Dr. Paradise] Okay.

Uh, one was a year older than me, one was, uh, like, a month younger than me.

-Four kids in the house? All adopted? -Four kids. All adopted.

How long were you with the Nelsons?

Nine years.

- You'd have been a sophomore in high school. - Yeah.

End of sophomore year, I left.

- Kicked out. - Okay.

[Dr. Paradise] What led you to get kicked out?

Um, so, our grandma was dying of cancer.

- Um... - Did you think of her as a grandma?

- Yeah. I mean, I spent every summer with her. - Okay. Okay.

- Yeah. - Okay.

You know, I remember, uh, watching baseball with my grandma.

- Okay. - I still like the smell of cigarettes.

- Because-- - You have that association between...

Yeah, 'cause I can, I just, I get that nostalgia of my grandma's house.

- Sure. So, she got sick... - Yeah.

And my parents went to California to, uh,

bury my grandma. Couple of friends...

did what teenagers do. We threw a party.

So, you threw a party in that house while your parents were gone?

- Yeah. - Okay.

That party lasted ten days.

The whole time they were gone... Kids in and out of the house?

- Alcohol? - Yeah, man. 50 kids, there was cocaine,

there was weed, alcohol,

next-door neighbor was a cop, he was writing everything down. [chuckles]

He called my parents the first day. They were like,

"Don't do anything.

Just record and tell us about it."

- So they were gathering evidence? - Yeah.

They come back, and you guys have thrown this extended party at the house.

Yeah. They're done, they had it. Kick us all out,

give up their parental rights...

-We all go into foster care. Yeah. -Turn you back to the state?

- Um, we went back-- - How did you understand that at the time?

Well, I didn't. I was mad.

Mad, confused.

Angry.

So, tell me about the woman outside.

- She's uh, that's my foster Mom, Robin. - Okay.

She found me when I was 17 years old. I was in a group home.

How'd she find you?

Well, I was the president of Foster Youth of Idaho.

Oh, there was like, an organization?

Yeah, so we-- I helped start this program called "Foster Youth of Idaho."

- Okay. - And, um...

We were reaching out to foster kids, 'cause, you know I was...

So, David... Sounds like you're a leader.

-[scoffing] I don't know. [chuckles] So, I was angry, -Okay.

And I felt like, these foster kids,

they're going through the same things as I am.

And they don't have people to talk to.

And they don't have people to fall back on.

They don't have, uh-- Sorry, dude.

[exhales]

[scoffs]

- David, I'm glad to see you getting emotional. - Just sad...

You know what's interesting is you have access to those

emotions, when you're talking about other kids like you.

But you didn't access the sadness when you're talking about you're own story.

[David breathing heavily]

[choking up]

So, uh...

You know, we started this program, so these, uh,

you know, these kids had somebody to talk to.

'Cause they were going through the same stuff.

- Peers. - And uh, yeah.

And then, so, once a week, we'd do that. Fun activities, you know?

Bowling, um, whatever, Then we...

throw this foster parent appreciation picnic.

I met her at this picnic.

And um, that was Saturday.

Monday, I was in her house.

Yeah...

So, you're pretty good at winning people over.

You know, um...

I'm a good guy. I'd like to think I'm a good guy. And, and--

So, fill in the blanks for me.

There're these contrasts in your history.

- Yeah. - You start this wonderful organization

for other foster kids, you're charming enough to work your way

into probably the best foster home in the Northwest.

But you're all the way to 600 lbs. at this point.

-Dude, I got up to 820 lbs. And then-- -How long ago is this?

This summer.

David presents well, but I saw him crack a little bit

and break down at points, and I think that he was so unemotional

when he was talking about the early part of his childhood.

'Cause his life is characterized by such unsupportive adults,

and I think it's important for him to realize that his success

is not necessarily dependent on somebody else.

So, I really wanna see how he does on his own.

He's a very bright, articulate, capable guy,

and I want him to realize that that's inside of him.

He doesn't need someone else to bring that out.

David, you've had a lot of successes.

I kinda want you to prove to yourself that you can be your own support system.

'Cause the most emotional you got when we were talking,

was when you talked about helping those other foster kids.

And I want you to turn that on for yourself.

So, David, I'm gonna assign you the task

of being in the world by yourself.

So, I'm gonna collaborate with Dr. Now and I think we're gonna send Robin home.

We're gonna put you by yourself

and we're gonna get you independent, and then I want you to spend some time

just with you. And to thrive during that time.

- Right. - And I know you can do it.

-It's really good meeting you. Thanks for coming. -You too, Doc.

- Take care, man. - Hey, you too. Take it easy.

[David groans and pants]

[grunting]

- You know what? - Dr. Paradise knows what's up.

[David] It was awesome, it was really good, super in-depth.

I want to have another session with him.

And uh, yeah. I'm gonna do what he,

what he wants me to do.

He wants me to go out in public, eat in public. Um...

Little worried about it. But I'm gonna do it.

Makes me a little nervous

that Robin's gonna go home.

But yeah, I'm just gonna try to stay focused this time.

Gonna try not to fall apart and...

keep going down this healthy path.

Today, Robin went back to Idaho for a few weeks.

From here on out,

she said she'll come visit me.

And she'd come to any of my appointments with Dr. Now.

But she's not gonna stay with me for a long time.

Because I'm transitioning to living on my own.

That's what I've been focused on since my therapy appointment.

I lived on my own before for a long time.

So I know I can take care of myself.

And I'm not sure why this time it's so different.

I never thought I'd be homesick without Robin here.

[panting]

Sometimes, I get this pit in my stomach.

Like, what it feels like to foster somewhere you don't like.

And I think I'm ashamed of it, too.

Those are feelings that can really throw me off, if I'm not careful.

Sometimes I can't get that feeling to stop.

And that's what I'm doing right now.

[driver] You have a good dinner, sir.

[David] If I'm on my own, I'm fine for like, a week.

And then, I get scared.

Right now, I'm nervous. But I'm choosing not to give into it.

- Hello. How you doing today? - Pretty good. How are you?

- I'll be waiting for you. - [David grunts]

[David] I know I have some work to do in therapy.

And all I can do right now

is just feel the feeling and keep going.

I'm ready to take the steps I need

but it's not gonna be easy.

But I have to do what the therapist said.

And take charge of my life like I need to.

- That smoothie's awesome, by the way. - [waiter] Awesome?

- Yeah. - Thumbs up. That's what we like to hear.

[David] It's time to change for good this time.

I just hope I'm doing everything I need to get approved

when I go back in a month and a half.

- Good night. - [waitress] Bye-bye, take care.

[David] Because surgery is something that I need to do for the long term.

So, whatever it takes...

I need to get where I need to, to take that step and change my life.

[David] This week, Robin is back in town.

And we're headed to my next appointment with Dr. Now.

I'm feeling better going in.

This past month has been hard, but...

I've made it a focus not to give into my fear of being alone.

David?

- Hi there. - Hello!

- How are you today? - I'm doing fine, how about you?

[David] Oh, you know. I think I'll make it.

Hopefully.

[nurse] You wanna step up on the scale?

[David] I didn't tell Robin to come back,

but she said she wants to be with me for the major milestones.

I feel like I've made progress, though.

I think the scale is going to reflect that.

Your weight is 671.

All right.

I'm really happy that I've made some progress.

- [David panting] - [nurse] Good.

[David] I feel good about that.

We're gonna be going to room five.

[David] But I know it's not as much as the goal that I had hoped for.

I'm very happy, but I don't know if it's gonna be enough

to move ahead with surgery.

[indistinct conversation]

I hope that will be enough.

[knocking at door]

- Hello. How are y'all doing? - [Robin] Hello.

Good. How are you, Dr. Now?

I'm doing well.

And seems like you're too, David, because you are down to 671.

- Yeah! - And you lost 48 lbs.

[Dr. Now] So, I'm happy to see that you're losing more weight

and improving. But it's still not as much as you should have done

to show me you're making enough change with your eating habits.

But, any progress is good.

At least you made more progress this time than the last time.

So, I'm happy about that.

Do you feel like psychotherapy is helping you some with that?

Uh, yeah. I think therapy's helped me a lot.

Dr. Paradise has helped me with ways I can be more independent.

And take care of myself, basically.

And it was good to talk about things. And I think it helped me in a lot of ways.

[Dr. Now] Okay, good. Dr. Paradise called me

about your mom going back home for a month at a time, here and there.

And I think, in your situation that would be good for you to be on your own some,

to become more independent.

Just let us know when that is, so we can check in on you.

But I'm glad that you feel like therapy is helping.

So we'll set another appointment with psychotherapy.

Keep going to that.

And working on what you need with Dr. Paradise.

And because of your progress,

I'm gonna give you an easy goal this time.

This time, I want you to lose 45 lbs. in two months.

And if you do that,

I'm gonna approve you for weight loss surgery.

- You think you can do that? - Yeah.

Yeah, I can do that.

[Dr. Now] All right, that's great. So, keep up with psychotherapy,

keep up your good weight loss and let's see how we do in two months.

And then, we'll go from there, okay?

- Okay. - All right, if you need anything,

- you give me a call. - Okay.

- That sounds good. - [Robin] Thank you.

[Dr. Now] It seems like therapy is helping David

to understand some issues driving him to eat.

And to take more responsibility for his life.

But I'm proud of him for working hard and maintaining positive attitude.

When he started to struggle, he didn't make excuses.

He just worked harder.

Right now, I feel confident I'm gonna see the progress I need from him soon

to show me he's ready for weight loss surgery.

And that he's gonna be able to stick to what he needs for the long term.

To get to his target weight and start living healthier, and better lifestyle.

[David] I wish I'd gotten approved, but I know I can meet this next goal.

So I feel very confident that this next appointment,

I am getting approved.

I'm gonna make sure of it.

[David] All right. Thanks, man.

This time, I went back to Dr. Now.

And I've lost another 46 lbs.

So the doctor approved me for surgery.

I'm getting it next month.

I'm so excited for this.

And I'm making sure that I stay on track no matter what.

I'm not messing this up again.

Hey, guys.

- Hey, man. I'm Dr. Clay. - Hey. I'm David.

-David, nice to meet you. You ready? -Yeah.

-All right. Let's get it going. -All right.

[Dr. Clay] We're gonna head back here.

[David] I've already lost another 18 lbs. since my appointment.

I'm looking forward to finally getting surgery and starting my new healthy life.

I know I have a long road ahead this next year,

and a lot of work to do.

Especially with therapy and working with Dr. Paradise

to figure out more of my emotions.

But I'm ready to do whatever it takes to get my future back.

And I wanna make Robin proud.

We're actually just gonna start with a little sit-to-stand, like a squat.

- Okay? - Okay.

Good.

[David] I wanted to do this for a while and find my way,

and everything that is meant for me.

[grunts]

[Dr. Clay] Good. Last one here, David.

Good. All right.

Take a little rest. Come on down.

- [exhaling] - Yeah.

[Dr. Clay] You all right?

- Yeah. - All right, good job.

[David] I'm really excited about the surgery.

And I know Robin will be, too.

We're just gonna work on, kinda bending down, picking this up.

And then, we're gonna come up overhead and do this, okay?

[David] And I know I'm gonna have to work really, really hard

this next year to lose all the weight.

Attaboy. Good.

[David] But I'm determined to get my life figured out.

And finally take responsibility.

[Dr. Clay] Down. Here we go. You got it.

- [grunts] - Atta boy. Good job.

- Okay, all right. Have a rest, have a rest. - [panting]

[David] I'm gonna change my life and I'm never going back.

It's all about consistency at the end of the day.

Honestly, man. You're doing great, I'm real proud of you.

This is some journey that you're on and you're on the right path.

[David] Thanks, man.

-I'll see you next time. Okay, buddy? -Okay. Thanks, man.