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00:01I'm tired of being fat.
00:03I can't control my weight anymore.
00:05I can barely walk, I'm bad red.
00:07I don't want to continue my life like this.
00:09I can't believe I let myself get this way.
00:12I can't even lift my legs up.
00:14I'm really scared.
00:16Dr. Now, you are the change that I need.
00:19I don't want to lose my life.
00:20Dr. Now, I need your help.
00:22Nothing has worked for me.
00:24Please help me.
00:25If you want to live, you need weight loss surgery.
00:28But you're going to have to do your part.
00:30I won't be stopped now.
00:32Back to your next success story.
00:34Ready to go.
00:35Ready to start a new healthy journey.
00:36If we're on to something, we're going to be on it.
00:38So we're going to do this.
00:40I am ready to take on this weight loss journey.
00:43I'll make the changes for my family, for myself.
00:46We want to be able to go out and be free.
00:48For once, I feel like I'm working.
00:52Stand in sunlight, you're motivated to change your life for your family.
00:56If that's a case, I can help you.
00:58This is a life-changing opportunity.
01:00You decided you're going to celebrate your victory lap before you even finish your race?
01:04I'm not going to mess this up.
01:09Dr. Now, my name is Sam Elba.
01:11I'm going to be 42 years old next month.
01:15And I'm well over 600 pounds.
01:17I knew reaching out to you that there was going to be a lot of hard work involved.
01:22Because I know when I see you, you're going to set me up for something.
01:26And I'll make the changes for my family, changes for myself.
01:29I'll become a better family man.
01:31I'll be a better father.
01:33I want to be able to walk.
01:34I want to be able to stand longer.
01:36I want to, you know, look at stairs and like, you know what, I'm going to dominate this.
01:41As a man who wants to run roller coasters, who wants to go to a store and buy regular clothes,
01:48who wants to work on this lymphedema on my leg, I need to make the changes.
01:55So please consider me part of your program.
01:58I was wondering.
01:59Let me see.
02:00Is that the pineapple one?
02:01Here, I got you.
02:04Here she are.
02:07My name is Sam Elba.
02:09I'm married.
02:10I have one son.
02:11I'm a service advisor.
02:12But the one thing I didn't want to be was someone who's well over 600 pounds.
02:16Are you sure you don't want to try a chicken wing?
02:18They're really good.
02:19It's like the rotisserie kind.
02:20My opinion of food addiction is just like any other addiction.
02:23The only difference is that it's legal.
02:25But it's just like alcohol or drugs.
02:28Some people smoke crack.
02:29I smoked ham.
02:30But, you know, how is it you can do a line of coke and not need it again afterwards?
02:35But, you know, I'm going to do a line of burgers and, you know, it's like, let's do this again.
02:41My wife, Nikki, we both have our weight problems.
02:44We're both lovers of very decadent food.
02:48We try to eat healthy, but we can't stick to it.
02:53Sam's like a little kid.
02:55You take away the candy, they're going to fight you tooth and nail for it.
02:57Is Sam's breakfast?
02:59How's breakfast?
03:01Very good.
03:04Sam treats me better than anybody ever has treated me.
03:07He's amazing.
03:08But the mobility thing's hard for me.
03:10I do what I can to help him.
03:12I would never look at him and say, honey, I think you need to change.
03:15Because I love him for the human he is.
03:17But I'd like him to be able to get up and do more.
03:20And not feel his knees hurt and his back hurt and his legs hurt.
03:23Because I don't like him hurting.
03:25When you become this big, you pretty much create your own prison.
03:29Because you are mostly sitting on the couch.
03:31And that's where everyone has to go to spend time with you.
03:34Did you brush your teeth today?
03:36Um, I don't remember.
03:38Do you want to lose all your teeth and be called Dummy Sammy?
03:41Hey, don't talk to me.
03:43Don't talk to me, bitch.
03:45What's your name?
03:46Samuel Outlaw III.
03:48What do you help your dad with?
03:50I help him with helping him up and also a lot of other stuff.
03:53Like helping him feel better and all that stuff.
03:56Why is it important to help him?
03:58It's important to help him just to make sure that he doesn't get hurt.
04:02Because I don't want him to get hurt.
04:04He's my dad.
04:06When you're this big, there's just no easy way to function in life.
04:12You just can't.
04:14I am in a really, really bad situation right now.
04:18I grew up in the San Gabriel Valley area.
04:24A lot of good memories.
04:25I was a bit awkward.
04:27I was always a chubby kid.
04:28Having a Mexican grandmother, you know, she loved feeding me.
04:31I think she was the one that, you know, found out I can crush food and she loved to feed it.
04:36But I got into football.
04:39And at that time in peewee football, you played based on your weight.
04:43And I was too heavy to play with the nine-year-olds.
04:46So I had to play with the 12-year-olds and literally get kicked out of me for nine, ten weeks straight.
04:51And to fully protect myself, I started just adding more weight and just got bigger.
04:56And I think by the time I left junior high, it was a lot over 200 counts.
05:00When I was in high school, I played football for three years.
05:03A senior year didn't work out too well because you had to have a certain weight limit and I got too big.
05:08After high school, I started a band and I just thought I was going to get signed in.
05:14This was going to be my career as being a musician.
05:17Eventually it got to the point that my dad kicked me out.
05:20He had enough of me.
05:21So my only other option was to move to Northern Kentucky.
05:24I have family here.
05:26In my mid-20s, my weight went to like 350.
05:29But that's when I was becoming, you know, the responsible guy.
05:34So once 29, 30 hit, that's when everything started ballooning.
05:38Because I started doing a sedentary job instead of being active and required more labor.
05:44But that's when Nicky and I met on the chat rooms.
05:47It was love at first type, I guess.
05:51I've been waiting for that boy my whole life.
05:54He lived in Dry Ridge, Kentucky and I lived in Oregon, Ohio.
05:58And he rode a Greyhound because his car wouldn't make it to see me for Valentine's Day for our first ever meeting.
06:05And after 11 months, I moved in and been with him since.
06:10Before I got this size, Nicky would go to the zoos, museums, movie theaters.
06:15Now all that would be nearly impossible.
06:18I really want to take Nicky out on a nice proper date.
06:22Just like we did before, you know, get all dolled up and really have a good time.
06:26It took him five years to propose and we got married and ate.
06:32But he's worth the wait.
06:34I was about 31 when we had my son Sammy.
06:37And so I got a big boy job to just provide for my family.
06:41My first professional job was working as a family service worker or caseworker
06:46with an organization that helped families with lower income.
06:49There were situations where I had to do with suspect of any type of abuse.
06:54And if any of the children passed away, that was really tough.
06:58You would carry those things with you.
07:00And food could be my tranquilizer, could be my booze, could be that drug I need.
07:05That's how I got through the day.
07:07Where other people went to the bars, I went to the buffet.
07:10That's kind of how I settled the tab every day.
07:12So even when I found a better position, there was still a lot of the stress of the job afterwards
07:18because he dealt with families who were in really tough situations.
07:21And I was like in my mid-30s and I was already pushing 400 pounds.
07:25But still, I just kept getting bigger and bigger.
07:28And when I first saw that 600 on the scale, I was like,
07:31I became the one thing.
07:33I didn't want to be somebody who could potentially meet doctor now.
07:36So I was like, well, here I am.
07:38I've hit rock bottom.
07:40So that's when I got to the point where I was like,
07:42am I going to provide for my family?
07:44Either I can't provide for my family no more
07:47or I got to make a change.
07:49And it got to that point.
08:01665.
08:02665.
08:05I am deep in the lair.
08:06I am in the cave.
08:08The doctor now is going to walk through that door any minute.
08:11I know he was going to rip me a new one.
08:14But you know what?
08:15I did it myself.
08:17Hello.
08:18Hello.
08:19Hello.
08:20Hello.
08:21How are you all doing?
08:22Good. How are you?
08:23I'm doing good.
08:24All right.
08:25So you're Sam, huh?
08:28Yes.
08:29And you got your wife, Nikki, with you and your son.
08:34How are you doing?
08:35Good.
08:36Good.
08:37All right.
08:38So Sam, you are 42 years old, huh?
08:41Yes, sir.
08:42And 665.
08:44Yeah.
08:45So what do you have done with your eating habit that has not worked?
08:50And what has worked?
08:51Uh, definitely, well, I've tried every diet known, but it's just my discipline was lacking.
08:58So obviously I need to make changes.
09:01How long have you all been married?
09:03Married for 13 years this year and together 21.
09:08Okay.
09:09How much you weighed when you were married?
09:11I was probably over four.
09:13Okay.
09:14And how much did you weigh?
09:15Probably 250.
09:17I've always been bigger myself as well.
09:19250?
09:20So you both gained all that weight after you got married, huh?
09:24We got comfortable.
09:25So what do you do in a typical day from the time you wake up to and you go to bed?
09:32You know what?
09:33I describe it like being a, I guess, equivalent like being a drunk because when you have all that
09:38food and you go to sleep, you know, you wake up with that hangover.
09:41So it could be anything from, uh, stopping from fast food like Chinese and, uh, you know,
09:47chicken places, fried chicken places.
09:49And then, uh, dinner could be whatever we get delivered or something we just put in the
09:54oven or air fryer.
09:55And, oh yeah, I could easily put 6,000, 8,000 calories a day.
09:59Easy.
10:00Especially with the sodas.
10:01So, uh, what do you think is behind his unhealthy eating habits?
10:04I think it's a lot to do with his anxiety.
10:07It was a very hard time for a while with a job that he was in.
10:11That caused a lot of the eating habits.
10:13Everything you all do together is focused around the food, right?
10:17Of course.
10:18Yeah.
10:19So who is the driving force, uh, making, uh, to overeat?
10:24I guess it's...
10:25Both of us.
10:26It couldn't be only you?
10:28Well, yeah, I put it in my mouth, so it's my fault.
10:31So I'm taking responsibility for it.
10:33I'm pretty sure you both affect each other's eating habits.
10:37Mm-hmm.
10:38But if I guess you are probably the driving force to make everybody overeat.
10:43But, um, I'm glad to see that it hasn't translated to your son at this point.
10:49Mm-hmm.
10:50Mm-hmm.
10:51But if that keeps up, um, it won't be too long before he will join the same unhealthy eating
10:57habit.
10:58So that is going to be something that is going to affect, um, the whole family.
11:03So what are you willing to do at this point?
11:06Right now, I'm willing to do exactly what your plan is.
11:10No excuses.
11:11Okay.
11:12This is going to be something that both of you are going to have to be on the same page
11:19and do the same thing and not encourage each other to eat more.
11:24Um, Nikki, is there any way that we can get you to check your weight?
11:28Because I want to see that the influence of, um, changing eating habit is going to be affecting
11:35the whole family.
11:36That's great.
11:37So we'll check your weight and progress.
11:39Yeah, so that's fine.
11:40So I'm going to give you a goal of, um, losing 70 pounds in two months.
11:46And...
11:4770 pounds?
11:48Yeah.
11:49Wow.
11:50Okay.
11:51Okay.
11:52Wow.
11:53Okay.
11:54Okay.
11:55Okay.
11:56So, Sam, I'm going to get the nutritionist to come and see you so you can understand what
12:11changes to make.
12:12Okay.
12:13And to be successful and to maintain a healthy weight.
12:16Yes, sir.
12:17If today you were 200 pounds.
12:20Mm-hmm.
12:21What will be different in your life?
12:24Well, then I can walk normally, get in a car normally.
12:27Just go somewhere and do something.
12:30How long has it been since you had a date with your wife?
12:34Probably 11 years, 12 years.
12:36Yeah.
12:37So how much you can walk before you get really out of breath?
12:41Right now, it's from the house to the car and he's halfway there.
12:45It's probably, uh...
12:47My back starts hurting.
12:48My knees start hurting.
12:49Yeah.
12:50Stops, takes a breath.
12:51Yeah.
12:52Leans to get something, then finishes walking to the car.
12:54That's...
12:55Okay.
12:56With that, I'm going to give you a goal to accomplish.
12:58Do something, uh, with your wife and go on a date.
13:02Without him?
13:03Um...
13:04Wow.
13:05Do his weight.
13:06And then do something with your son.
13:08Okay.
13:09Um...
13:10Some activity with your son.
13:11Okay.
13:12So those are two goals that I want you to meet over the next two months.
13:16Yes, sir.
13:17And when you set you up to, um, see a therapist, they will give you some goals for you to meet
13:25as well.
13:26If you do that and lose 70 pounds in two months, then I'm going to approve you for weight loss
13:31surgery.
13:32Yes, sir.
13:33Your healthy eating habit, uh, should be around 1200 calories for you.
13:38Yes, sir.
13:39So this is going to be something that you're going to have to eat only two or three times
13:44a day, not snacking or having unhealthy food.
13:49So you think you can do that?
13:50Yes, sir.
13:51I'm going to give you my book.
13:53First six pages explain what metabolism is.
13:57It's clear that Sam and Nikki enable each other, but he appeared to be the main source
14:02of negative influence in the dynamic of their family.
14:06So he's the one who needs to take the responsibility and start to change things before it has a bigger
14:12and more damaging effect on him and his family.
14:16So do those exercise.
14:18Yes, sir.
14:19OK.
14:20So this is going to be life-changing, uh, with what you're accustomed now.
14:24Yes, sir.
14:25OK.
14:26Nikki, I'll give you a copy of that for you to read.
14:29So I don't want you to fight over it.
14:32So, uh, uh...
14:34Good boy.
14:35Did you as well understand what changes he did make with your eating habit as well?
14:40Yes, sir.
14:41So we're seeing two months when he lose 70 pounds, how that transferred in the family,
14:47uh, affecting you as well.
14:49OK.
14:50Sounds great.
14:52Can we check your weight also?
14:53Yes, sir.
14:54I want to monitor, see what kind of progress you make in two months.
14:57OK.
14:58Sounds great.
14:59Yes, sir.
15:00All right.
15:01That'd be great.
15:02If you all need anything, give me a call.
15:03Thank you, sir.
15:04That appointment was rough.
15:06And let's hope in the next two months, with the support he needs and everything that
15:11he was told, we can get this weight down for Dr. Now.
15:16428.
15:17Wow.
15:18I just got it handed to me.
15:21I mean, these next two months are going to be brutal.
15:26I bought some equipment online and I'm hitting it hard.
15:29Out here I use the resistance bands and have my mace and usually my day starts around 5am.
15:38And I'm pushing myself with my workouts because I have Dr. Now's goal of taking my wife out for a date and take my family out and do something outside the house for once.
15:47But to do that, I need a lot more stamina.
15:50I could barely get up these stairs.
15:52I still got to do a half a mile.
15:54But the next thing I need to also work onto is my food intake.
15:58Because diet's everything.
16:00It's 95% of the battle is your diet.
16:02This is my dinner and only meal of the day.
16:06So yeah, this is low calorie, nutritious, whole foods.
16:10This past week has been a really good eye opener.
16:13I've got a lot of good support.
16:15First with the nutritionist.
16:16As far as your diet, the point is to learn how to eat in a healthy way long term.
16:22We don't want this to be like a dieting mentality.
16:25We want this to be more of a lifestyle change.
16:27I also had my first therapy appointment.
16:29What do you do for work?
16:30I work in social services, community outreach, stuff like that, so.
16:35What was so stressful about that?
16:38I think one of the worst ones is when I had to sit with social services when they would go over a situation where a child can be removed.
16:44Or even worse, if there was like a child who passed away.
16:47That was always really, really hard.
16:50You know, especially when you get attached to them, so.
16:53I could carry that pain with me for whatever reason.
16:57I could feel that.
16:59That's why it breaks you down like that so much.
17:01Because the idea of somebody coming in and saying that I could, that I wasn't a good enough parent.
17:06And then they would take them away from me temporarily.
17:09Freaking killed me.
17:10And I would carry that.
17:12Your therapy goal is to write about the three worst cases that you had in your career.
17:19And really dig about, like, how they made you feel.
17:25Why were they the worst case?
17:27And then we'll go over them the next session, if that's okay.
17:30That sounds like a great plan.
17:31I'm gonna make sure I do the homework and process all the things that she gave me.
17:35But my first priority is to achieve all the goals that I have with Dr. Now.
17:40I want to at least take Nikki out and focus on my other goals.
17:44I can already feel my stamina improving and my clothes are getting looser.
17:49So I'm excited and I'm determined to achieve all my goals, do what I need to do before I see Dr. Now again.
17:56It's been one month since I've started this journey with Dr. Now.
17:59I don't know how much weight I've lost, but I know I've made a lot of progress.
18:02My stamina is night and day compared when I saw Dr. Now the first time.
18:06It's been a while since I've been able to take Nikki out.
18:09So I told Nikki, I think I'm ready to show you a good time like you deserve.
18:12So that's what we're gonna do tonight.
18:14I called and got a babysitter.
18:16They'll be over soon.
18:18I'm extremely excited about this.
18:20It's been a long time since Sam and I went out for a day night.
18:24I want to make this night great for her, but I can't shake the fear of situations like sitting in tight chairs or fitting in tight spaces.
18:32A situation like a broken chair or too many steps or a trip or a fault.
18:37Situations like that could really embarrass her.
18:39Is that good?
18:40Yes, please.
18:41Okay, this one? Okay.
18:43Certain seats for certain people.
18:46I'm worried about that.
18:48Look at my plate compared to yours.
18:51That's actually mine.
18:52I know that's...
18:53Yeah, I know, right?
18:54I'm the eater.
18:55Yeah.
18:56No worries.
18:57Oh, that's pretty.
18:59My pleasure.
19:01My pleasure.
19:02I gave you this.
19:03I know.
19:04Well, yeah.
19:06I'll just drop it here.
19:08There you go.
19:09You want some filetamon?
19:10Oh, I'm good.
19:11I have plenty of food.
19:12It's nice doing this because it's been a while.
19:16Mm-hmm.
19:17I can remember walking into places and wondering if they're going to have seats that you can
19:22fit into.
19:23Mm-hmm.
19:24And finally are now following, being able to sit into a seat and get comfortable.
19:29Oh, my biggest thing is, like, here are the stairs.
19:31I would not have come here.
19:33Mm-hmm.
19:34There'd have been no way I would have, like, nah, I'm good.
19:37We'll try somewhere else.
19:38Yeah.
19:39Or...
19:40Yeah.
19:41I'm very proud with everything you're accomplishing.
19:44I'm doing good.
19:45Putting your mind to.
19:46You're doing good.
19:47You're doing very good.
19:48And it's going to be even better from here on out.
19:52Mm-hmm.
19:56It was nice to have time with Sam.
19:58Just him and I enjoying, not worrying about if we're comfortable, if anybody's watching
20:06us, just him and I out together.
20:11Something that we've been needing to do for a long time.
20:15Now I'm going to go to sleep because margaritas hit me.
20:18I had a great time.
20:20The restaurant had these stairs and I was able to get up and find, but I was able to
20:25find a comfortable spot, was able to keep Dr. Now's food plan.
20:31Another really good part was at the end where we just had a walk.
20:34And, you know, having a good meal and walking at the end, you know, that's something that
20:39just never happened before because after a full meal, I would want to just lay down and
20:44do nothing.
20:45So it's nice to have Dr. Now's plan where you get a good meal and still feel active right
20:50after.
20:51So I'm really appreciative.
20:53The date night with Nikki going as well as it did really motivated me to go out in
20:58public even more.
20:59So I've been trying to get out of the house more, helping out with like grocery shopping
21:03and doing stuff with Sammy.
21:04I've never been able to take him out and do some fun stuff.
21:08So this week we went out bowling.
21:10I do it.
21:17Good job.
21:18Good job.
21:19About the closest I'm going to get.
21:22Bowling might have been a little more active than I was ready for.
21:26I was a little winded.
21:27I got tired at times, but I was so thankful to do it.
21:31And I'm super thankful that I hope I can do it with Sammy again.
21:34It's been a big desire of mine.
21:36Woo!
21:37Good job!
21:38If anybody's never been like we are, overweight, you use food as a companion to help you.
21:51Oh, this chocolate helped me feel better.
21:53Oh, this piece of cake will help me feel better.
21:56And it worked so well, making you think you feel better.
22:00But it really, really didn't make you feel any better.
22:03It makes you feel worse.
22:05Being addicted to food is something that's very hard.
22:09But...
22:10I slipped up.
22:11I hit a little bit of a wall.
22:13I was eating exactly the way you wanted.
22:16I was exercising and then I had a rough day.
22:20I decided to go back to some of my old ways.
22:23I felt that I deserved it.
22:25And I felt what was one little meal would turn into two.
22:28Then one day turned into a week.
22:30And I just fell down and spiraled again.
22:33Sam is one of the strongest people I know.
22:37And Sam and I have a team.
22:39What he tries, I like to try with him.
22:41Because I like to support him in any way I can.
22:44So together, we will be strong and we will handle it.
22:48All right, it's been two months.
22:50Since I last saw Dr. Nell.
22:52I know I've done a lot.
22:53But again, it's all about the scale.
22:55And man, I hate that machine.
22:57Oh my gosh.
22:58I feel more nervous now than I did the first time I met him.
23:05634.
23:10He can look at you as well.
23:20398.
23:21Get in there.
23:22Yeah, he's definitely going to be very disappointed.
23:23And he's going to tell me like it is, so.
23:24All right.
23:25You only lost 31 pounds in two months.
23:26That's not even half of what the goal I gave you.
23:28So what changes you made with your eating habit?
23:30You know, I really thought I was doing good.
23:31I really thought I was.
23:32I do go to the gym about five days a week.
23:33But I know diet is the most important.
23:34So yeah, I cut back.
23:35And I dropped a lot of weight.
23:36But I was, like, more focused on the goal about going out with dinner with my wife and
23:38my wife.
23:39And that's not even half of what the goal I gave you.
23:43I'm not going to be able to do that.
23:44I'm going to be able to do that.
23:45And I'm going to be able to do that.
23:46And of course, I'm going to be able to do that.
23:47All right.
23:48You only lost 31 pounds in two months.
23:50That's not even half of what the goal I gave you.
23:51So what changes you made with your eating habit?
23:53You know, I really thought I was doing good.
23:54I really thought I was.
23:55I do go to the gym about five days a week.
23:56But I know diet is the most important.
23:57So yeah, I cut back.
23:59And I dropped a lot of weight, but I was more focused on the goal about going out
24:05with dinner with my wife.
24:06And I did that.
24:07And I think maybe I felt that I deserved a reward.
24:12I earned the chocolate, or I earned the burger, or I earned the pizza.
24:16So I know I had a bit of a backslide, but I'll get back to the progress that I made.
24:21I'll get back.
24:22I know I will.
24:24Well, my concern is that this is going to be much more significant if you do that after
24:30we've done surgery.
24:31So that is going to be a problem.
24:33It's not going to happen.
24:34I know it's not because I'm not approving you if you're still struggling.
24:39Yes, sir.
24:40You're right.
24:41But I can get back.
24:42I know I can.
24:43Well, what happened is here that you did not follow up with therapists and do the goal
24:49that they give you.
24:50What happened with that?
24:51I was, like, more focused on my family, and I just thought I was doing all right.
24:56And the emotional component that drive you to eat, you have to take it seriously and meet
25:03with the therapy and meet the goal that they give you and try to understand the issues that
25:08drive you to eat.
25:09Yes, sir.
25:10Okay.
25:11So, Sam, I'll give you the same goal of lose 70 pounds in two months and work with the therapy?
25:17Yes, sir.
25:18So you think you can do that?
25:20I really wish the goal was less, but that's what you got set for me, so I know I can do it.
25:26Yeah, I'm going to come back and the scale's going to be different.
25:30Great.
25:31Well, I see Nikki lost 30 pounds, so you've done well with the diet and keep up with that.
25:39But how do you think he's doing with his progress?
25:42I think I need to be a little bit more stern about us stopping at the fast food places.
25:50Instead of just following along, I should probably tell him no more.
25:53Instead of agreeing going with him, I probably would have lost more myself that way.
25:59Or vice versa.
26:01Or, yeah.
26:02Well, those fast food places, they started having a lot of healthy salad, too.
26:08So if you really shift your choices to better choices over there, you can make better progress.
26:15Yeah, but that's like going to a gentleman's club for a hug.
26:17So, I mean, you know, come on.
26:19I mean, okay.
26:21No, you're right, doctor.
26:22Now, there's some better options I could have picked, but I let my taste buds pick for me.
26:27So, Nikki inspired him to stick with the healthy eating habit, too.
26:32Yes, sir.
26:33And be on his side to remind him to eat healthy and do his exercise, okay?
26:39Yes, sir.
26:40All right, I'll see you in two months.
26:42Yes, sir.
26:43It's positive to see some progress with both Sam and Nikki.
26:47And I don't doubt that Sam may have more progress in the first month than he has now.
26:52But backsliding so soon is very concerning for me.
26:56It's not just about the amount of progress he needs to make, but consistently maintaining that progress for just a while.
27:02Well, that is what I need to see before I'm confident that he's ready for weight loss surgery.
27:08That combined with the fact that clearly he's not taking the emotional component of his overeating seriously means he has a lot to do to convince me that he's truly committed to change his life and move ahead.
27:21After going back to Dr. Now and falling short of that weight loss goal, I came back home determined not to make that same mistake twice.
27:29I know I have a problem getting comfortable and slipping back in my old habits.
27:33So I've been 100% consistent with the diet.
27:36I also took to heart the importance of what Dr. Now said, and that's the importance of therapy.
27:42So I did the therapy goal and shared the three hardest cases, and I'm surprised how good it felt.
27:51I honestly don't know what I'll say to Dr. Now if he says no, because he's worked really, really hard, but I'll try to be a good girl.
27:57Go ahead and just step on.
28:06576.
28:12How much did you need to drop?
28:15I don't remember now.
28:16Nikki, can we go ahead and get your weight as well?
28:23379.
28:27Not as much as I thought I would have lost, but I should get up and do the gym in the morning with you guys.
28:34Hey, y'all doing?
28:35Good, how are you?
28:36Hi, how are you?
28:37Good, I'm doing good.
28:38Nikki, it looked like you did better than last time, and you're down to 379.
28:46So you lost 19 pounds, and Sam, you did better than last time too, and you lost 58 pounds instead of 70, of course.
28:57And you're down to 376, huh?
29:01Yeah, sure.
29:02You're down to 576.
29:04Yeah, 366 is great.
29:06I just dropped 200 pounds easily on you.
29:09Well, you are the best in the world, aren't you, Dr. Now?
29:12Yeah, yeah.
29:13You made good progress on paper.
29:15First time I've seen you laugh ever, man.
29:19It's awesome.
29:21Okay.
29:22All right.
29:23In reality, what changes you made with your eating habit?
29:26Honestly, really, I do three meals.
29:29It's just, I just keep it really just protein and vegetables.
29:32All right.
29:33That's positive.
29:34And you meet the goal, and you have a therapy too.
29:37So this is good.
29:38But in the past four months, you have lost a total of 89 pounds.
29:44But if you really stuck with the diet, you should have lost 150 pounds.
29:50So it is positive that you've lost some weight, but that's not as much as you should have.
29:56But since you made some progress, I'm going to approve you for weight loss surgery.
30:02We did it.
30:03You did it.
30:04We did it.
30:05Yep.
30:06Gym bros.
30:07Congratulations, Daddy.
30:09We did it.
30:10The only condition is that you need to continue to lose another 25 pounds.
30:14Okay.
30:15Okay.
30:16So I'm going to schedule you for a month from now.
30:20But before we do the surgery, we're going to run some tests and make sure that everything
30:25is okay for you to have a safe weight loss surgery.
30:29You okay?
30:30I'm in the waiting room.
30:33So far, they poked him with needles a couple times to get blood.
30:38They have him set up for a chest x-ray and EKG, getting ready to do the scope.
30:45It's weird to see him on the table like that.
30:49I just want to stuff him in my pocket and take him home.
30:51So I finished my tests earlier, got poked and prodded and put to sleep, and all
30:59sorts of things.
31:00I hope everything went well.
31:02I'm going to find out.
31:05Hello.
31:06Hey, Dr. No.
31:07How are you all doing?
31:08Good.
31:09How are you?
31:10How are you?
31:11All right.
31:12Sam, I want to go over some issues we had with your evaluation.
31:15What are the issues?
31:17One of the issues is the sleep apnea he had.
31:20Okay.
31:21So the sleep apnea is going to be an issue with the surgery and also after surgery when
31:27he go home and take pain medication.
31:30Because normally when you have a sleep apnea when you sleep, what happens, your oxygen drop
31:37and CO2 goes up.
31:39But that will wake you up and you wake up and cough and change your position and you start
31:45breathing.
31:46But if you're taking pain medication, you may not have those reflexes.
31:49Okay.
31:50So that will cause the issue that we need to be careful.
31:53For that, he needs to lose some weight.
31:56Right now, I'm freaked out right now.
31:58So I can't talk right now.
31:59I'm sorry.
32:00Well, except there is more.
32:01The other issue is he has some infection in line of stomach and some ulcer that we require
32:08to give him some antibiotic and he needs to take 10 days of antibody.
32:12So the infection that he got in his line of stomach can be a risk factor with our surgery
32:19because the staple may get undone and have a hole in the stomach and leak the content
32:26of the stomach, which can cause peritonitis and complication of surgery.
32:30So we need to clear that situation as well.
32:33Okay.
32:34So Sam will not move ahead with the surgery until you resolve all the issue that we got
32:40right now.
32:41Okay.
32:42But there is a silver lining to all this.
32:45You only lost eight pounds in the past month.
32:48If you have shown up for surgery with that progress, I would have cancer.
32:52So that showed that you are having a problem with the sick and with it.
32:57You got overconfident.
32:59And this is very concerning for playing a yo-yo with your weight.
33:06So you both need to stay consistent and continue to lose more weight.
33:12If he clears up these issues, loses more weight for the sleep apnea and takes the medication
33:17to help with his stomach, will he be approved?
33:20So right now we need to try to get his weight down rapidly and see if we can improve his condition
33:28while he's taking some medication to clear up the infection in his stomach.
33:32Okay.
33:33Okay.
33:34Once he does all those things and we get to the point that we feel is safe for him, then
33:39we will move ahead.
33:40So, Sam, I'm going to set you up for surgery in one month again.
33:44And I want you to lose 40 pounds.
33:46So next one, we come back.
33:48We're going to check your weight.
33:49If you have lost that, we go ahead with your surgery.
33:52If you haven't lost, we're going to cancel your surgery.
33:55Okay.
33:56Okay.
33:57Yeah.
33:58And if anything, give me a call.
33:59All right.
34:01I'm glad that there's the testing.
34:04So, yeah.
34:05I mean...
34:06I'm glad that there's the testing so we know how to fix it.
34:07I was a little freaked out at first.
34:08That's why I couldn't say much because it just made it sound like I was going to die for a second.
34:12No.
34:13Like, you know, I just, like, freaked out.
34:14That's why I needed a second.
34:15I mean, obviously, I mean, I've had these stomach issues.
34:17I mean, how many times did I go to the hospital thinking I was having a heart attack?
34:20Well, that explains everything.
34:21I mean, this is the first time I've actually had somebody actually look at my stomach.
34:26And I've asked doctors for how long about my issues.
34:29And somebody, doctor now, actually took the time to actually look at my symptoms.
34:34And, yeah, so I didn't get the surgery.
34:35But you know what?
34:36Certain answers were found because I didn't get the surgery.
34:39Wait, wait, you're not getting the surgery?
34:41No.
34:42He has...
34:43Doctor, I got some things in my stomach I need to...
34:46Well, I got to wait till...
34:47That's fine.
34:48That's good.
34:49Oh, no, no, no, no.
34:50This is a good thing.
34:51This is a good...
34:52Don't look stressed, okay?
34:53It's a good thing.
34:54Sammy, these are problems that I've had that I didn't know the answer to.
34:55Come here.
34:56He's okay.
34:57I promise.
34:58He's okay.
34:59Sammy.
35:00Yeah?
35:01Doctor now just found the answers to all my problems that I've had.
35:02Yeah.
35:03Now, listen.
35:04If he had the surgery now...
35:05I wouldn't make it.
35:06Is he possible that something can happen and he could die?
35:09Doctor now just saved my life.
35:11It's okay.
35:12It's okay.
35:13He's fine.
35:14He's good.
35:19Well, the last two months, we've been on the diet plan that Doctor Now gave us.
35:25And I haven't seen him work this hard in forever.
35:28And today's the day.
35:29Today we go in, we go upstairs and see if he's lost enough weight to get to surgery.
35:34Sam's infection has cleared up with antibiotics and his sleep apnea is still a little bit
35:41of issue, but it seems to be more manageable.
35:44All right.
35:45You can step on it now.
35:47That is a good sign because it means that he lost some weight.
35:51But the question is, how much?
35:53All right, Sam.
35:55536.
35:56So, good progress.
35:57Sam's biggest issue is consistency.
36:02He loses weight.
36:04He gets comfortable.
36:05Then he sits back into his own breathing.
36:09So, that is an issue that we need to continue to work with him.
36:13But he at least showed me that he's back on track and he's making some good progress today.
36:19All right, Nicky.
36:20Will you do my back so I don't blind the doctor?
36:23He's going to see your insides.
36:24I don't think he's worried about your butt.
36:25Oh, I know, but I just want to be...
36:26Go ahead.
36:27I just want to be calm.
36:30Sam has lost around 130 pounds since he started the program.
36:36So, I'm confident he's ready for surgery today.
36:39Love you, Daddy.
36:40Love you, buddy.
36:41See you in a little bit.
36:42We'll perform a gastric Steve on him today.
36:46So, this operation will reduce Sam's stomach about 70% to 80% and give him an opportunity
36:53to be able to lose weight and maintain it.
36:56I know Dr. Now is a renowned surgeon.
37:00About 22 years with someone.
37:02Knowing that they're in surgery, it's terrifying knowing if you're not going to make it or not.
37:08All I can do is pray everything's going to go the way we planned.
37:12He's going to have my heart on the table.
37:15I just pray that he takes care of him.
37:18I'm going to turn the room light on.
37:22Sam's surgery went very well.
37:24We're able to get his steviostectomy.
37:27Now we're going to get him to the recovery room, and he will be waking up in a couple hours.
37:39We'll keep Sam here for a few days to keep an eye on him and make sure he's doing well before we let him go back home.
37:47For the next month, he will be on a liquid diet, and at that time, he should be able to lose 30 to 40 pounds.
37:54And then after that, if he stays on trial, he should be able to lose 15 to 20 pounds each month until he get closer to his target weight.
38:04I am proud of Sam, but we still have a lot of hard work to do with Sam to get him to his target weight here very soon.
38:12No, it was surgery, buddy.
38:14Yeah, you're all done.
38:16Here we are at the Cincinnati Zoo.
38:19This experience has been tough.
38:22Crazy, busy, emotional, but I'm really very proud of where Sam has come.
38:30What he's come from, what he's done.
38:32I'm so happy he's stuck with it and has gotten this far.
38:37With my continued weight loss, I have so many more goals ahead.
38:41First, I want to see the 300s.
38:43And then when I get to the 300s, obviously I want to see the 200s.
38:47But my main goal is to get on a roller coaster with my son.
38:53I haven't been on a roller coaster in over 20 years.
38:56Oh, I see.
38:57Wait, is that a diamondback?
38:59He's inside the...
39:00Oh, that's an eastern diamondback.
39:02I see him.
39:03I like how Daddy's losing weight because he's been running for a long time and he's really excited that now me and him and Mama, we all can be like a family.
39:15We can go to carnivals.
39:17We can do a lot of stuff now.
39:19Thank you very much, very much, Dr. Now, for letting this be able to happen.
39:23I'm just excited to do some fun stuff.
39:26You know, I'm handling this trip really well.
39:29Been probably more walking than I've ever done.
39:33Well, let's just put it this way.
39:35A year ago, there'd be no way I'd come to the zoo and do this.
39:40And, you know, my back feels good, my legs, my knees feel good.
39:44Certain things that I noticed, he doesn't breathe as heavy as he used to.
39:49The other day, someone took a spot in the parking lot and he said I had to park downstairs.
39:54Before, yeah, that was terrible.
39:57Now he's like, it's okay, I just had to walk up a few steps.
40:00That's huge.
40:01Sam is motivating me to become a better me.
40:05Unfortunately, I'm not as lucky as Sam to have a stomach the size of a little hot dog.
40:11Mine's still the size of Lord knows.
40:13Sam can just eat two pieces of deli turkey and a string cheese and he's full for the day.
40:19482.
40:20Look at this.
40:21Look at that.
40:22Sammy and I are both trying to follow better eating habits so that we all can be healthier.
40:34This weight loss has helped me become a better father.
40:37I'm more active when we go out more.
40:40I help around the house more.
40:42It's building confidence.
40:43It's building stamina.
40:45I'm more alert.
40:46There's just so many things I want to do with my son and my family that have prevented me since I was nearly 700 pounds.
40:53But now, my weight is dropping and I can't wait to see what next year is going to bring.
41:01Bye.
41:02Bye.
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