New Zealand ` clean, green... and fat. In the last year, nearly 70,000 extra New Zealanders became obese. Now most of us are fat. You are... morbidly obese. Do you know what the word 'morbid' means? It means 'deathly'. Premature death. 65% of adults are dangerously overweight, and South Auckland is the ground zero of our obesity explosion. The Manukau SuperClinic is on the frontlines of this epidemic, treating over 1200 patients with controversial weight loss surgery. We remove about 80 to 90% of the volume of the stomach. Not much room for food. We've now spent two years with the most at-risk patients, and the specialist doctors and nurses dedicated to helping them through the highs and the lows of their weight loss journey. I'm anxious and scared. That's what I feel. SOBS: I did this because eating was my safe place. It's where I went. Why are you doing it? For myself. I wanna do it for myself. I can't wait to tell people... stick it up your arse, really. (CHUCKLES) (HEART MONITOR BEEPS) It's a brand-new year on The Big Ward. Weight loss surgeon Richard Babor is a man on a mission. In the last couple of years since we did the last series, do you think things have got worse? The state of things in New Zealand is dire, and people are getting fatter and fatter, and sicker, and dying. For Joe Average in Otara, nothing's changed. Things have got worse. Nobody's looking out for him or her or their family. Takeaways; tasty fried chicken; pizza; Chinese takeaway. (LAUGHS) It's remarkable that there are so many shops here and so little of any nutritional value. Richard's first appointment of the day is a young man well-known to the clinic. (SNORES) Jackson is just 20 years old, weighing in at over 200 kilos. He's failed his weight loss surgery target three times. He's one of the largest and youngest patients on the books. And today, he's a little hung-over. Getting a bit sick of waiting? Yeah, man. I wanna go home. Fighting Jackson's laid-back attitude is bariatric nurse specialist Cecilia Westmacott. Jackson? Saving people from themselves is all in the line of duty. (SHOUTING) It's time to go, man. That was more than 10 minutes. Shh! Be quiet. All right, Jackson, we're going to weigh you. You have a late night? You've got the sunglasses on. Yeah. (CHUCKLES) Come on through, and we'll see what your weight is. To qualify for surgery, Jackson needs to get under 200 kilos. It was 216 before. Today, he's put on weight. Despite the setback, mum Mary is by his side. He's been partying. Sunglasses are on, so we don't know what the pupils are looking like. Uh... yeah, yeah. Richard's been trying to get Jackson on to the operating table since he was 14. Deep breath. (BREATHES HEAVILY) Big girl's knickers. We can do it. (LAUGHS) So how's it going? It's going all right. Uh, you've kinda bounced up a little bit since we last saw you. Yep. But we need to get you down to 200 and` 200, don't we? So, why do you reckon you've slid back? Going away from home from my structured... from my structured stuff, I went away, and` Where'd you go? Down the line. What for? To see some friends, stay down there a couple weeks. Juiced it up a bit? (LAUGHS) Yeah. You need to get off the juice. That was like my first ever time doing those kind of things. Just like... I need to get back to my routine. That's why I came here. So you're back home and back in the fold of your loving family. Yep. How's your diet been? Good? Yep. Once I got home, it was good. Can I just have a little look at your tummy and... I'll just kinda see if I can detect any change. Yeah, it's good when you're standing up, eh? Yeah. You're still quite hard to feel in there. But you're getting there. Yeah, hard, bro. I'm gonna get there. Awesome. It'll take me time, eh? OK. All right, so I'll leave it with you. Should I`? What should we do? Should I arrange to see you in three months? Is that gonna be good? Yeah, that's a good time. Is that OK to kind of let you be free for three months? Or do I need to bring you in more regularly for a telling off? (LAUGHS) He's back home now, so we can go three months. OK. All good. All right. You have a really nice weekend. Thank you. Stay out of trouble. All right. (LAUGHTER) Stay home. Yeah, well, you don't have to be home all the time, but... (BOTH LAUGH) ...obviously, going down the line is not... conducive to making your weight track down. Yep. What are the chances that he's going to make it to surgery? Um, I don't know. You know, like I'm not going to... I don't wanna write him off. But, I mean, I can't follow him around Auckland, checking on his progress, snatching donuts out of his hands and tipping his RTD's down the drain. Adolescents are a really hard group of patients to deal with. They're the least compliant, probably have the greatest difficulty with motivation, have the least control over their diet, because they often live in a household where other people do shopping and buying of food. So who knows? Really, we've just given him multiple chances. Chance after chance after chance. And one day, maybe he'll grasp that. (DOG BARKS) It's a few days later, and back home, Jackson has enlisted the help of housemate and amateur dietician Willem. I have to take into consideration, y'know, for his weight and stuff, so I try mostly to use fresh foods, cos... yeah. Fresh food's the way to go. It's better. It's better. Tastes better too. Cos I try to cut back on carbs a lot. Having survived on a diet of junk food, a home cooked meal makes a change. Even butter chicken. Now, that's how you cook butter chicken, mate. What was it that meant that you couldn't stop eating? That you couldn't control yourself? I was in, uh, the YJ. What's YJ? Youth Justice, where, like, little bad criminals go. (CHUCKLES) Jackson served time in juvenile detention, where he wasn't in charge of the meal plan. His weight ballooned. Were you a little bad criminal? Yep. But that's almost cute. - (BOTH LAUGH) - Were you doing cute stuff? Oh, no way, eh. The stuff that I was doing was stupid. What did you do? (SMACKS LIPS) Not nice stuff. Oh, eh, I was all prepared to go to jail and stuff, eh? Like, yeah, but my parents and my grandparents and my family helped me turn my life around, pretty much. Mostly my parents. I either go that way, that way or straight ahead. And now it's all straight ahead. (SIGHS) Fresh from a feed, Jackson's re-launching his exercise plan. He has high hopes. Oh, we should do the old powerwalk from one power pole to the other, then walk from that power pole, and then powerwalk to the other one. You know? (PANTS) They're off to a great start. (BREATHES HEAVILY) But fatigue soon sets in. (COUGHS) (PANTS HEAVILY) (SIGHS) Mate... Jackson's 20 kilo weight loss target... will be no walk around the block. It's all good. 1 40 year-old housewife Mel loves food. She thinks about food all day, every day. Her weight has peaked now at over 100 kilos. The supermarket is her happy place. (PLAYFUL MUSIC) I wanna be strong and have willpower and I wanna say, y'know, I'm gonna eat this tasteless, sugarless stuff. But, no, I won't. I'd rather not eat than eat something that's good for me. I'd rather starve all day than to try and eat something I don't like. From the deep south of the US, Mel is finding it hard to give up the comforts of home. Hot Dog Friday. We have it every Friday. What happens on Hot Dog Friday? Uh, Mummy gets a break. (LAUGHS) It's one of the easiest meals in the world to make. You get hot dogs and chips and that's it. And I don't have to do anything other than boil the hot dogs and put the chips in the oven, so... Is it American style? Yeah, it's American style. I like chilli and slaw and all the good... By the time you get done, you don't have a hot dog; you have a masterpiece. (LAUGHS) Mel's love affair with food doesn't extend to cooking. They've actually stopped carrying my mashed potato. I had gotten so lazy that I was buying frozen mashed potato, and it came in these, like, wonderful little frozen pellets. It was amazing. You just threw it in the pot, heat it up, add some milk and some butter, and you had the most creamiest mashed potatoes in the world. And they've stopped carrying 'em, which means now I have to peel potatoes, which means we haven't had mashed potatoes this week, cos Momma don't like peeling potatoes. So I might have to have a few dumplings today. The chicken and prawn ones, I like the little samosa thingies and the little balls. So, this is it. This is the grocery shop for the week. I say that, but I'll probably come back probably around Friday. Mel lives at home in Karaka with husband Mark, 12-year-old daughter Hayley and 13-year-old son Andrew. The whole family love food, and Mel isn't the only one with the eating problem. Score for Murphy. (LAUGHTER) He says, 'Mmm, that was good! Hot Dog Friday! Whoop, whoop!' (LAUGHS) You're bad, Murphy. It called to him, sweetie. It said, 'Come. Eat me.' He can't help it. It's an urge. I know what that feels like. (LAUGHS) Mel's weight loss journey isn't all fits and giggles. She's already had weight loss surgery 10 years ago, and it failed. She has a gastric band, which is why she hasn't lost weight. It's also causing her pain, and she wants it out. Best description I can give you? If you're using, um... a funnel. All right, this is my oesophagus, this is my band, and my stomach's down here. We've tried to put coleslaw through it. Did anything go through? That's what it feels like. This is gonna hurt me. I'm gonna feel this for an hour afterwards, at least. So what do I do? I go to the toilet and I get rid of it so that I can swallow again and not feel like I'm gonna choke. And this is my life. My life is a funnel. So, when you say you go to the toilet to get rid of it, what does that mean? It's just regurgitation. So I've done it quite a few times, and it's really quite disgusting. I didn't tell Mark right away when we started dating. I think it was actually after I had eaten something that I finally told him. You told him about what? About the band, about the` I think I told him about the lap band, but I didn't tell him about the side-effect of my lap band ` the regurgitation. And, Mark, were you alarmed when Mel first told you? I think the first time, we were actually out in the car, and... and she asked me to stop and had to throw up. Yeah. It's like somebody's really ill ` that's what it sounds like. It's quite dramatic. It's something you'd rather not be` (CHUCKLES) you'd be privy to, I'd say. The only reason I'm having this surgery is because I'm sick. I'm sick of being sick. I'm sick of hurting. I'm sick of carrying all this weight around and feeling awful all the time. It's definitely not an appearance thing for me. Is there something`? I'm just thinking that Mark met you when you were already... Already big, yep. ...a bigger girl. Mm-hm. So obviously, he was attracted to that. Are you worried you'll get skinny, and then, you know...? Oh, and then he won't want me? Yeah. Oh, God no. He wasn't a chubby chaser. He didn't come at me because I was chubby. He come at me because of my personality and who I am, and that` he saw past the outside. She's still a very sensual woman. Very sexual woman, and, um... Edit. (LAUGHS) Yeah. That doesn't matter whether you're` what shape you are, really. Yeah, and because I'm not afraid to go to the beach and go to the pools and I'll walk right out in my bathing suit. I don't give a crap. You know what? If you gon' judge me, have a look in the mirror, because I can guarantee you there is something on you that ain't good, Mr Hairy Back or Miss` you know, I mean everybody's got their own issues. You might not be fat, but you might be furry, you know? So, you need to talk me through your dog. All right, so it's mayonnaise, then your hot dog, then your ketchup, and then your slaw. So we would just call this a 'slaw dog' back home. And it's really good. (LAUGHS) (CHUCKLES) It tastes so good. (GIGGLES) And that's the real problem ` is that it tastes good. It's time to go and get rid of it. (COUGHING, VOMITING NOISES) 1 Father in heaven, we've come before you. You are the healer, you are... Josephine is praying for good news. She's going for her fifth weigh-in at the SuperClinic in the last two years. She's been turned down for surgery every time. Her life depends on you, father. Amen. We first met Josephine two years ago. At 36 years old, she weighed in at 167 kilos. At the moment, I can't even feel your ribs. She was dedicated to a certain sort of diet... I love the taste. Feeling it coming down my throat. ...and didn't know there were alternatives. Have you ever get to see a red cabbage before? But she tried. Nicki Minaj ain't got nothing on us. (UPBEAT MUSIC PLAYS) And she tried. I got that goal. Got that goal. And she tried again. She couldn't lose her target 20 kilos. But she didn't give up. She's been dedicated to one thing ` making the surgery list. Josephine's back for her fifth weigh-in with mum Naomi at her side. Hi, Josephine. Hi! Nice to meet you again. How are you? Nurse specialist Cecilia will decide if Josephine makes the surgery list. Let's see what the scores on the doors is. Josephine can't look, but her target was 147 kilos. Come on in, then, Josephine. So, Josephine... Hi! (GIGGLES) We planned, fifth time, and initially it was 167 and we wanted 20kg off, and today, we're 3 kilograms short. Oh... But... let's start working you towards surgery now, OK? (LAUGHS) (CRIES) Really? (LAUGHS) Yeah. (LAUGHS) Hard work, hard work. Well done. You deserved it. Well done. You're welcome. You're more than welcome. Thank you! As I said, we wanted 20kg off. We got to 17, but you carry on working as well as you've done so far, and then, before you know it, we'll get a date for surgery. (HOPEFUL MUSIC) (SIGHS) We did it, Mum. LAUGHING: We got it! I'm so proud of you. Well done. I knew you could do it, Josephine. Well done. Well done Thank you! My pleasure. OK, I'll go book those appointments. My God, it's happening! It's happening! Josephine, can you believe it? Yes, and... yes. (LAUGHS) And no. How do you feel? I feel... like some sort of weight is lifted from me, and I can let everyone know that if I can do it, even though I struggled a lot, don't give up. Keep on going. You'll eventually get there, like I have. So long as Josephine can lose the 3 kilos, surgeon Richard Babor can finally do her operation. A happy end to two years' hard work. I` I had my doubts at the beginning, but then, you know, as the, sort of, story evolved and she kept coming back and coming back and, kind of, being so tenacious, I kind of had this feeling we'd get to this point. Yeah. So how are you feeling now? Good. I'm kinda pleased. I'm happy for her. She's such a, kind of, bubbly, happy, smiley sort of person. I'm pleased that we didn't, sort of, just turn her away, you know? Captions by Cameron Grigg Edited by Jake Ebdale.