The Weight of the Nation: Part 2 - Choices (HBO Docs)

miss julia is heavy as I was it's called a can ptosis 18 plus percent of our children right now are obese a lottery map today if you'd go with the flow in America today you will end up overweight or obese as 2/3 of Americans do I don't want to be fat for the rest of my life I've got diabetes sleep apnea high blood pressure I get dizzy when I get up everything's hurting now you don't crave broccoli and our generation has grown up craving a Big Mac we have built a cheap food model and that's the one we're dealing with right now it's so hard to combat against what the TV's telling you to buy your kids the kind of food that we eat is the kind that's most profitable local and regional foods taste better the weight of the nation is out of control but we can fix that hey Mike the Market Market mean everything for this neighborhood we have got to come together as a country and really make this a priority so as we stick together that's what it's about it's not only health it's about survival and well-being of the United States as a nation the reason we have government in the first place is to solve problems collectively we can't solve individually if we don't now take this as a really serious urgent national priority we are all of us individually and as a nation gonna pay a really serious price hi how are you good how are you good I'm sit I always say this is the biggest I'm ever gonna be and I said that like 20 pounds ago this is crazy I'm sick and tired sometimes when I walk upstairs I feel like a bucket of bolts how did I become what I am now I can't seem to lose weight no matter how hard I try where do I start what could I do to change what can I do what can I do I want to think that there's something better for me you start by giving us you hide away I'm 5 foot 10 and 242 pounds why are you fat I just love good food what I consider to be good food I love burgers I'm a big burger fan I got a cheeseburger tattooed on my knee can I say it absolutely you got the ketchup you got the mustard yeah I love cheeseburgers mom see that's the thing as I know what to do um I just I just can't do it sometimes with the RDX full stomach reducing plan you fill your stomach yet fat just seems to melt away and safe pleasant-tasting RDX tablets contain no dangerous drugs no hormones will there ever be a magic bullet that just instantly helps us lose weight please please we can do something about this we are not doomed to this situation but it's gonna take a combination of rigorous research to understand the causes and also to identify interventions that work and that we can demonstrate work in the real world not in some artificial ivory tower way people up you can do it try to push try to push that's it right keep it at 60 okay what we're doing now is to get a metabolic signature it rests and a peak exercise this blood actually it contains a different metabolic profile than this blood it goes the science of obesity has exploded in the last 15 to 20 years savings I race normally as we learn more and more about the basic science of what drives obesity we can develop better therapies to treat and prevent obesity pardon I just give me a thumbs up before you're welcome in there there's a projector and what's being projected to him are these images here we're looking at changes in blood flow to brain regions has that become active was my brain more responsive to something that was more pleasurable or something that was neutral or natus pleasurable that's absolutely the case in fact that's what this image shows we now understand many of the factors that regulate food intake that we never understood before that we never knew existed before it's still not enough you can talk about obesity prevention here if you can sustain somebody at a lower weight early that you'll prevent but once you get here so it's over with there's some pretty clear advice that follows from this research that's gone on fad diets diets they haven't been scientifically tested things that promise miracles because there really isn't such a thing as a miracle here so if you promised it it's a pretty good idea to run in the other direction but people want to hear that quick fix people don't want to hear eat more fruits and vegetables lean food and less fried food nobody wants to hear it's like a boring story no action is not a thriller the weight that I am now I haven't been in over 20 years anybody that sees me hey how do you look so good what are you doing what are you doing and as soon as I tell them they tuned me out my doctor's office that I went to she didn't have a scale that weighed me so for quite some time I really never knew how much I weighed my mother would make comments I look a little tight on you I finally bought a scale that went up to 450 pounds and I got on it and I was 430 pounds I didn't say nothing to anyone cuz I'm like wow he's 70 pounds from 500 hi Yolanda hi dr. Klein now you've been with us for a year and a half uh-huh and you have lost about 20% of your body weight going from 409 to 328 pounds over the last year and a half which is quite remarkable and today was 324 324 Sivan more today so you broke the 20% mark how have you been able to do it the biggest part of it has been the lifestyle change on eating learning how to create new habits and better I'll turn to you achieve that very very successfully Yolanda achieved successful weight loss because she was able to incorporate the principles she learned in her weight management program into her daily life but it requires a considerable amount of work and attention to detail you got to start somewhere so what I did was I committed to looking at how many calories I drink and I just did that and when I was up to 15 2000 calories and just drinking because you get back down everybody okay no soda but you get to sweet tea and before you knew it you haven't eaten any food but you've had your caloric intake for the day we don't realize consciously or what we're drinking and eating my skinny would be about 225 I think was my height um I think that would be great for me I think I probably be maybe a 16 or 18 pie 18 would be great 16 and I'll watch out I might be on somebody's beach in a bikini Yolanda how are things going how is your this week this month it's been kind of hard for me cuz I was back nibbling so what I had to do was the celery sticks again yeah absolutely on the counter we support each other if you have a great week we're cheering for you if you have a bad week we're cheering for you I didn't get any clues I was gonna have some but like she can read my money and get any cookies and get it did you get a ticket No then get hit cat I have this thing with KitKat's four bars it's 210 calories I break and a half and I throw a half out the window so now I'm just eating a hundred and five calories snack I got my chocolate fix on I said but why are you throwing away why you don't save it later I said because I probably have an accident trying to reach for it to pick it back up and eat the other half in my purse I carry the calorie cake I look at what I'm eating before I eat it I cannot count for those calories lot of times I skipped breakfast as soon as the bacon came I grabbed a piece of bacon and the sausage came out grabbed piece of sausage then made it egg oops I made too much for them so I ate that egg so ended up I said I wasn't eating breakfast but I didn't know what I was eating and how much I was eating because it was a constant nibbling here and there so I had to become more structure I had to plan for my day I had to come in and say this is breakfast time eat your oatmeal and two pieces of turkey sausage I'm very proud of myself I'm very proud that I've decided to become a healthier person I've always been overweight I mean I can't say I've tried every diet but I tried most the popular diets at one time or another I have tried all sorts of diets can I him South Bazaar yeah it's probably my most successful one Oh cabbage soup diet it's a seven day diet where you're pretty much just drinking cabbage soup that can start Atkins diet Atkins Atkins stacking heads the healthy fats the low-fat nonfat the low carb all I ate were chicken tenders and chicken wings the Masters Cleanse lemonade and cayenne pepper and maple syrup mixture that me as I did so I get skinny heart Beyonce and that didn't work for me Weight Watchers everything except for the on practical ones I don't like the cookie diet that's just stupid and you're paying out thousands of dollars and nothing ever works you might lose a few pounds but nothing sticks nothing's right the diet industry has no reason to solve the problem solving the problem puts them out of business almost all diets are just low-calorie plans masquerading as some secret in order to lose weight and keep it off people have to do an awful lot of hard work they have to eat less and exercise more they need to eat a balanced diet and they need to be vigilant over a long period of time no publishing company is going to publish a book that says just eat a little bit less and move a little more you gotta have a hook or a gimmick one of the myths that's out there is that if you eat a calorie of fat it's different than a calorie of lettuce or a calorie of candy or a calorie of pumpkin pie for all intents and purposes a calorie is a calorie there are only three macronutrients and that's fats carbohydrates and protein diets are generally based on eliminating one of those three food groups but we just cut back on all of them and just ate less that would work the laws of physics as we say relate to the regulation of body weight energy in energy out if you are taking even slight excess of energy in versus what you're expending you will gradually put on weight one thing that the diet industry knows that we don't know that it's a lot easier to lose weight than it is to keep weight off that's why even if you look at a lot of the diet plans are out there they're all focused on losing weight not on maintaining what you've lost how many pounds have you lost in a lifetime I'll mercy goodness crisis do you have a calculator upwards of 200 pounds three times in my life forty forty five pounds fifty three pounds for some aback lightin sinner so after about a year I was ballooning back up but now and I'm getting that back I've gained all that 45 back I would lose 20 pounds gain back 40 I'm definitely a yo-yo dieter that's like probably close to 300 pounds I can regain it literally almost within weekend sometimes you know 10 pounds where another person could you have the same food and wouldn't have an issue at all it definitely feels like my body has a set point that it's fighting me to keep individuals losing weight are not metabolically the same as they were before they lost weight consider two individuals same gender same age exactly the same body weight one of whom is at that body weight as a result of let's say a ten or fifteen percent weight reduction the other who's been at that weight for their entire adult life the weight reduced individual will be requiring about 20% less calories per day relative to what somebody of that way who's never lost weight would eat or eat ten percent less and increase their physical activity by ten percent in order to keep it that body weight if that reduced individual goes out to lunch with her friend and they both order the same meal that will represent a 20 percent overeating for the weight reduced individual quite normal for the individual who's not in that state 20 percent may sound like a little but 20 percent excess caloric intake a year will account for the inexorable weight regain as far as we know this phenomenon does not go away so being successful for a year or two doesn't mean that you're going to be able to go back to eating at the rate that would be appropriate for a person who never lost weight does the struggle ever seem sort of unfair sure it does seem unfair it's unfair that you know I can't just lose the weight and go back to the way a normal thin person lives their life but that's part of the price you pay for allowing yourself to get overweight in the first place I'm pre-diabetic I'm borderline on the verge of having to do something serious about it I was diagnosed a type-2 diabetic he's borderline diabetes I'm borderline diabetic I've been told I'm a borderline diabetic or possibly hyperglycemic I've got diabetes I've got high blood pressure I'm on cholesterol medicine I'm on medications for all those because of my diabetes I may be pre-diabetic and what do I need to do to prevent it we now know very well from a number of very well conducted research studies that they can reduce their risks dramatically we had a study that was sponsored by the National Institutes of Health called the diabetes prevention program and it was a research study to determine whether we could decrease the development of diabetes in people who are identified as being at very high risk we identified what we thought were the leading risk factors for example sedentary lifestyle not enough physical activity increased body mass and we thought if we could reverse these environmental factors that led to the development of diabetes and to correct them with a lifestyle intervention could we decrease the development of diabetes in this population ready together oh that's good one two three no crash on that one two got a ball we have this remarkable set of identical twins the daily brothers twelve years ago one of the brothers Tim came to us and joined the diabetes prevention program as a research volunteer he still doesn't have diabetes while his brother Paul recently started on insulin I mean he's gone through the usual steps I'll get worsening diabetes over time big kiss a big wet kiss well well it wasn't the shoes must be the weight gotta get this weight off 8174 10 Timothy Patrick wall said daily and I'm 5 feet 10 inches and 192 pounds right now at the moment Paul Francis Jerrod daily five foot eight three-quarters you shrink and about two out to 40 chest pop yeah it's been twelve years I remember we were working at the video store together and Paul is heavier than I was then I was probably 25 pounds heavier than he was he was more active he played basketball once a week I ran I was more sedentary than him I probably didn't tell him at the time that the doctor said come to find out I was the auto line diabetic I ignored it all of a sudden I I have this thirst that I cannot quench drinking drinking sad go see the doctor and then it was yes you're a diabetic I'm gonna put you on medication and that's when it kind of hit you in the gut because then you realize how your life is gonna change the risk that one twin will get diabetes if the other twin has it is actually 95% I was at my sister-in-law's house and a friend of hers had a brochure about this diabetes prevention study they do all the tests of blood work and everything you blood Sugar's high you're at risk and thank God I gonna tell no I didn't shoot man another so you were in risk at that time yes I had let your the was not because of the family history and also because the blood sugar was was elevated the goal was to try to get people to lose some weight and 7% of their initial body weight when I went into the study I was a little over 200 pounds losing 7% which for me was 14 pounds you know no no disrespect but whoop-dee-doo and it was work I'll be honest it was work I can't say what to do but it was work in addition we wanted them to increase their activity levels and what we wanted them to do was increase it to at least a hundred and fifty minutes more per week than they were doing currently which if you think about that's not much at all so within six months I dropped the 7% there's my numbers my name is were ideal in and they were fine what we found in the first phase of the study which went on for about an average of three years was that we could decrease the development of diabetes with this lifestyle intervention by 58% with identical twins you can separate out environmental factors from genetic factors what Tim Daly has done is he's taken the weight and the activity level out of the equation I mean how much more proof can you have if someone has the same genes as you that has diabetes and really the only difference is is the the weight there's dr. Daly's how are you yeah so nice to see you both the heck is want to thank ya see you yeah yeah yeah I'm not sure about that I'm a working frog was still thought but look at the two of you it's like looking in a mirror look at this and he's got an extra and look where the weight is yeah that's actually it's all right there and we know in putting that weight around the middle which seems to lead to the biochemical mischief that leads to diabetes and blood pressure and is associated with heart disease and all that stuff the mall walking that he does you start doing that and it doesn't take a huge loss of weight you know there's some idea that oh I've got to get down to the weight I was in high school or something really 10 20 pounds is enough to improve diabetes once you have it after talking to dr. Nathan so Paul you don't have to be on insulin for SDIO you just have to work harder the old muscles that what they used to be too hard to get home yeah I'll let you finish up I see myself as a cautionary tale especially with Tim right here doesn't have it because he worked harder at it when he found out I got it that kind of gave into it and I was probably the worst decision I've ever made in my life we are fighting this together Tim's my inspiration I really want you to commit to yourself if you feel yourself and then to me to visit you know we're so close that that you can do it I know I know you can do it you if you commit every day I get up every morning say I'm gonna do it I will lose the seven percent hey Deb yes hello how are you I'm good how are you good my name is Vivian I am 27 years old I am five five in height and I weigh 341 pounds in the fifth grade which was the same time that my father had passed away at the age of 53 and I was 10 years old I used to get poked in the back with pencils because they wanted to see if I was gonna pop whenever there was a big boy in school they would try to match me with him you know you like big Reggie yeah Vivian big Reggie they go together it's like why I gotta like big Reggie because he's being I do not have a sexually active life I've been told you know numerous times there's guys are like big girls I don't want a guy that likes a big girl I was when a guy that likes me I don't want a chubby chaser my relationship with food has very different dimensions food can be my best friend food can be my boyfriend at the moment food can be a vacation two feet and I can't afford to go if I were not obese I would have no hesitation in doing the things I want to do going the places I want to go trying for things that I want to accomplish I could go on a roller coaster I was skydive if I wasn't obese I would be able to roller skate I would probably pursue dating if I were not obese and I would have a little Vidya I want her to be Vivian a second I shouldn't deprive the world of that they need another me when it comes to fighting obesity what's the best single thing that I can do for me and my family soda and other sugary drinks are the number one source of calories in our diet and the only individual food that's actually directly linked to obesity these drinks are making us fat there is nothing in a soft drink that is good for you a Twinkie or a potato chip or a candy bar has at least a little nutrition with it these sugared beverages have none at all sugar teas energy drinks sports drinks flavored waters even they're completely empty calories everyone seems to think a day without orange juice is like a day without sunshine juice is just like so and I'm saying it right here on camera there is no difference when you take fruit and you squeeze it you throw the fiber in the garbage that was the good part of the fruit the juice is Nature's Way of getting you to eat your fiber the body doesn't seem to recognize calories very well when they get delivered in liquids our thirst mechanism is independent of our hunger mechanism when we drink these calories it doesn't fill us we don't compensate by cutting our food intake in the war on obesity they're not the only problem but it's a darn good place to start Priscilla what's the craziest way you ever tried to lose weight oh I think everybody knows this it's the three-day diet toast with one tablespoon of peanut butter eight ounces of grapefruit juice I have a can of tuna five saltine crackers a half a cup of green beans three ounces of meat any style it doesn't say a small apple and a one cup of ice cream okay and if you do this three days you will lose five pounds okay I think any time that you go on a restricted diet or you do anything that's extreme it's going to come back and bite you there's a lot of very very low-calorie diets that are out there on the market we often see this men will say they've gone on a diet and they you were able to you know cinch their belt in a little bit quicker men deposit their fat in this visceral Depot the BeerBelly location that's the easiest place for you to break those calories down for energy when you go on these really low calorie diets your metabolism actually slows down significantly what happens specifically in women we fight against losing weight in our hips and thighs girls let's call a spade a spade now if you have a figure problem if you want to improve the bustline or the waist or the hips or the thighs or the calves of the legs or or if you're getting a double chin the secret is what correct deep systemic exercise physical fitness has to be a state of mind the important thing is to stick with your exercise make it a daily routine by E it's a good idea to warm up all of your objections will be easier to reach if you are physically fit I don't know if there any myths about exercise and weight loss there but there's certain realities that are unavoidable people seem to have this tremendous misconception but how much they have to exercise to lose weight to burn a hundred calories one has to run about a mile so think about that one donut if you're out there running three miles for thirty minutes you could come back and you could undo all that goodness in about 45 seconds by picking up a candy bar and wolfing it down 20 minutes of jogging is one chocolate-chip cookie nobody believes you burn as few calories as you do any exercise to really lose weight you have to do a whole lot of exercise you don't walk in here unless you're ready to work no Rudy it's never going to stop until you die oh geez I cringe when I see the Biggest Loser it can actually do a disservice seeing this rapid weight loss that they achieve on television that is just not doable under normal circumstances in the real world they focus on physical activity exercise as a major therapeutic approach for treating obese patients and we know that that's just not correct when you're overweight it's a lot easier to lose weight by reducing what you're eating than it is by increasing physical activity substantially it's a heck of a lot more simple to modify portion size to modify our intake if you will I believe that in terms of obesity prevention that both strategies are important a combination of aerobic and resistance training is the most effective both in terms of sustaining weight loss and also in terms of reducing other risk factors physical activity really is the wonder drug if you have regular physical activity you're less likely to have high blood pressure less likely to have cancer less likely to become depressed less likely to be injured less likely to have arthritis such likely to have osteoporosis more likely to feel better about yourself and be more productive at work Tony let's have some fun let's pretend that you and I were marching down the road to health and happiness to you so really do some good marching everybody together come on one two three four on the soldier march this end shoulders back head up thinks my upon this morning pull the waist and add one bill tell me right now why are you obese a lot has to do with of the some of the job situations that I'm and I have very long work days out of the house by about 5:00 5:30 in the morning don't get home till about 6:00 and so I've had a struggle motivating myself to get up early and exercise I'm out with clients for lunch and don't typically make the better choices that I should be making we have a lot of mandatory overtime you do get you know your two 15-minute breaks a day and you get a half an hour for lunch you still have to get to the restroom you still have to get your water filled up all those things and so many of us have our desk drawers just filled with snack food when I'm sitting at my desk and I'm either frustrated you know with what I'm working on or I want to get up and do something else but I have to sit there that my emotions can lead me to to eat to snack you know something else to do with your hands like boredom right maybe that - mm-hmm what can I do about it americanus Sandri thank you for coming about you place Memphis on a mission that's usually Sunday through Thursday so you're saying Friday and Saturday as well I think I gained maybe 10 pounds in the first few months here and then it's just I weighed 126 and then um now that's like 170 I think cuz you get bored and you just want me some of us are here eight hours some of us are here 12 hours a day good afternoon Beverly this is Gigi within link reservation services how are you I work 60 hours a week my biggest weight loss challenge has been being able to find the time to concentrate on myself I am a single mom and I always felt like it was selfish to concentrate on me and to make myself healthy but when you go to the doctor and then you find out you have high blood pressure or you're borderline Nisour you know and I think that's really a huge wake-up call so we've all kind of collectively come together because we finally realize that living a healthy lifestyle is very very important it's a necessity if I want to be here for my daughter so we need to get things finalized for the health fair um you guys all know who you need to contact to get people there I know Pam you're taking care of the nurse to come for the blood pressure I'll be weighing people - yeah yeah just make sure that you just let people know not to feel uncomfortable so we formed a Wellness Committee here about three months ago to promote health and wellness in every aspect mental physical emotional but really the physical challenges that we face here it is an employee run willness committee we have a month so this crunch time yeah and for the record blue team's gonna kick y'all's butt I'm sorry the black our lunch we would typically get fast food especially delivered pizza Chinese we had a healthy lunch challenge which Gigi's really helped promote so making healthy lunch options they can work that off on their list that they chose subway or home-cooked meal instead of McDonald's or any other fast-food restaurants I bring little snacks in little Ziploc snack bags and I just go around and ask anybody want a snack normally they do not turn it down bring in up grates and carrots most of the time the grapes go quicker than the carrots but they love it I'm in charge of the bulletin board so I'm the keeper of the stars when everybody tries their fruits and vegetables of the month and we just encourage each other currently we're doing a walking challenge at lunch we go out and we walk about two miles people now instead of going and grabbing this soda for their 15 minute break they're walking around the building weighing in at 400 pounds at 40 40 years old was just I didn't know how I got there I don't want to live like this anymore I started off at 400 pounds three months ago and I'm almost at a 50 pound loss I've had the support of the whole company but these ones right here are very special and dear to my heart they've cheered me on they write me messages they call me email me I really couldn't have done it without their support and I love every every one of you guys we something to work will happen I'll trigger screw this from going on getting a piece of beer I have a lot of work Mike's wife recently been through a divorce uh fights with my ex-wife mailer these days I have two small children we all kind of know what's happened in the last few years with building industry and everything you never know until the very last minute if you're gonna get paid and you'll be able to make your mortgage payment the next month that kind of thing I've gained probably thirty pounds since that divorce probably about 50 pounds in the last four years just seems like when I'm stressed out it just comes on like this so you're a stress eater stress eater definitely it's really not just about what we're eating but it's about what is eating you they have an epidemic of obesity we also have an epidemic of stress and the two are feeding each other during times of stress when we need to be really efficient and replenish our calories a natural hardwired reaction is to reach for the highly palatable food the doughnuts the chocolate food with a lot of fat sugar salt the body wants dense calories now why is that when we were hunters and gatherers it made all the sense in the world that when were under stress during times of famine periods of hunting and escaping predators we're going to need to replenish our energy stores when we're stressed we're changing the biochemistry of our blood starts with a perception of threat in the brain something's wrong the chemical signal triggers the adrenal glands to release adrenaline and cortisol and this combination of which I call stress soup turn on enzymes that then turn the fat cell into a fat storing machine our body pours thus cortisol to the blood and alerts the brain to look out for those sweet high-fat foods so it's not just how much we eat but it's how much stress soup is there at this moment in our blood and that's going to determine if we're in fat storing mode or fat burning when cortisol has stimulated our appetite it's one of the strongest drives we have like the drive to seek a drug we're chronically stressed so when we're surrounded by palatable abundant food we are destined to eat it what we need to do is take some control back today we're going to work with chocolate it's not okay okay laughter okay we've got brownies here we go so everyone has their plates and as we usually do we're going to start by moving into a place of mindfulness letting go of any place in your body that feels a little tense at the moment one of the strategies that we teach is to do a mini meditation throughout the day and check in with their bodies and we especially want people to do that right before a meal take one of the pieces bringing this up to your nose noticing any feelings or thoughts you're having from the smell of they become in tune with her body and their body's needs and then they can eat based on caloric need not emotional need how is that what did you notice I was thinking I want ice cream so that helps cuz it was an ice cream like this is not ice cream I want ice cream so I don't need to eat so I stopped after you said it's up to you to choose to eat or not the smell is so good you know when I first smelled like thought I have to have a bite and then I had a bite and then smelling it again I was like oh that's what I really like now do I really need another bite and that satisfied it for me doesn't always do that sometimes like I eat too fast and I'm I look and I'm like who ate my food but you don't even realize that you ate your food you just did you weren't mindful about it and this totally helps with that exercise is probably one of the most powerful stress buffering activities we can do it affects how we think and feel and the level of opioids in the brain for the comfort food eaters and the emotional eaters you can't just take away the comfort food people are gonna feel bad it's not going to work for very long exercise can actually keep our brain at that same level of opioids that we need so we don't need to turn to food how good something is pretty interesting here it's a reminder to me of how much way to actually have lost it may be heavier and it looks it weighs 48 pounds and now I'm actually down 60 pounds I keep it where I can see it almost every day when I drop it it's heavy this is probably the lightest I've been in my adult life as a police officer I worked irregular hours I ate too regularly a lot of fast food my mother actually died of heart disease at age 57 and I'm 56 and I got to a place where I almost thought well she lived a good life I was pretty resigned and being the way I was mindless eating would describe me very well I would eat a sandwich at 5 bites and now I'll lead a piece of toast in 12 bites mindfulness is about being aware the best thing I do at a meal is to stop initially and observe the food take in just the sight the sense of the food and where it came from its origin and what it does for you yes God doesn't it ever you actually examine your food and you like smell it and you look at it it's a way to eat with all your senses as of today I've lost 12 pounds diet equals restriction whereas mindfulness equals paying attention and so that's kind of my motto going forward is like okay pay attention to your life and pay attention to what you're eating and like how you're feeling and not diet don't restrict its flip the switch for me and now I'm looking forward to don't play out a nice old age you I'm five five and I weigh 415 pounds approximately like 500 pounds I'm six feet and our way approximately 627 I've been having pain on my knees my elbows my hands everything is hurting now I hope one day I could change everything and I could live a 27-year old life how am I gonna be thinking about marriage how am I gonna be thinking about how many kids I have a family of five and you know that we do not have a family photo we just don't my kid should be able to see that on the wall it's like I'm in some kind of prison I get so angry I can't do stuff as simple as putting on a son what was the low point for you I sat down on a toilet seat and it broke I just can't believe I gotten to the point where I was so obese that I broke a toilet seat I need to find something that works for me because this is you know I might see somebody that that lose weight and and I try what they tried and it just doesn't work for me there's a great question that we have yet to answer about who are the people that are the optimal group to have bariatric surgery as a surgeon who deals with folks who are struggling with obesity I personally believe that we should be targeting people who are on the heavier and sicker side of the spectrum you know some people to make judgments about people who decide they're going to have obesity surgery they think that there may be weak or don't have strong character that they cop out that they need they need to do an operation instead of doing the hard work of diet and exercise and I think when you see the people who've gone through the struggle you realize it's exactly the opposite these dry squares in session thank you ladies and gentlemen please be seated just press Q I'm bringing your witness back to the stand please just walking upstairs to get to my job is a very painful experience my knees are stressed to the max I first met Darrell almost eight months ago he was really struggling with effects of obesity horrible diabetes that needed more and more medication to control high blood pressure he thought the way it was gonna kill him if I set my mind to it I can do almost anything why can't I solve this problem it's not a question willpower it's not a question brain power I didn't get through law school because I couldn't study any of the things that I've done as a judge I've been very successful and enjoyed my career but I can't solve this problem cannot so this is a tool I'm gonna get to help me do that when he has to get really early give up her beauty sleep cuz we have to be there 5:30 the doctor has said that they want last will and testament and I know that you're concerned about whether you're in it or not you're not I'm 63 he's life expectancy at this weight is less than 10 years I don't want that to be the case yeah you're back to the big guy you're back to the big guy I've got a young wife young kids I got lots of things to do in life just a little bit nervous about this I'll be here for my husband no matter what and you know this actor forfeit my country burger card delay farther to go the celebrity have to go yes I like still handle it okay so I don't sure how quite the lock what we're doing in a roux and why gastric bypass it's taking the stomach and cutting off a small part of it by applying a stapler here and here creating an egg size new stomach we map out about two feet of the small intestine and that stomach is reconnected to the intestinal tract and then reconnected to the intestinal tract down here the normal digestive pathway is no longer through this part of the intestines and down it's at this point right here where digestion starts to occur for about two or three feet food that passes from that new stomach pouch in through that tunnel of small intestine is not being digested the operation works three ways one by restricting the amount of food you can eat to because while food is traveling in here it's probably not being well absorbed and three because the food is skipping this whole segment of stomach and this part of the stomach is really important in stimulating your brain to be hungry and hold for a sec right there make sure the arms aren't going anywhere legs are good I looked others that I want to have a balance at night the risk of death is about one in 300 that risk of 0.3% is something we talk with our patients about and we try to get them to understand that 0.3% means that somebody is having a really bad outcome after surgery and it might be you okay we're now moving through the different layers of the abdominal cavity the pink stuff is muscle would be another layer behind it now there you go and then you see they were in the abdominal cavity beautiful Oh what you got right there for a second this operation is easy if you're not heavy Orson I'm gonna do other people aren't heavy when I asked for blue load stapler next so this is a staplers we're laying on we're creating the bottom part of a gastric pouch I would certainly give you an egg size pouch what do you think about that yeah looks good I'm gonna take it then all right stapler that's his new stomach for light crazy right this was his old stomach all right that's the size of a large melon and and this is now the size of an egg okay close her down in that old stomach out of the way beautiful this is where it's connected from stomach it's a small bowel that's his new channel for food right there at the inside of the small bowel the food will never go down this path again all right fantastic the fascinating part about this operation from my perspective is just by having the food skip the main part of the stomach and the first part of the intestines the duodenum it seems that it turns on the machinery of the pancreas so that people who have diabetes their pancreas functions of much much better so much to the point that they may come off their diabetes medications altogether within a week or so of the operation can we do okay can I sit yeah oh yeah thank you I love you yeah I asked the doctor if I was gonna be a hundred fifty pounds liar when I woke up and he said no and so that's a disappointment I'll have to work it out and I can handle a kiss on the cheek if your documentary showed me coming out and talking to everybody for hours after the operation everything was cool and copacetic know the rest we got mentioned me like quite a lot happen the better I think I was prepared for the possibility of complications now I didn't know all the bad things that could happen would happen something ruptured in the intestine or the stomach or something and there was leakage into the body cavity and then I had some really adverse reactions to the morphine I developed something they call a fistula with a leakage from the old stomach the bypass stomach into the wound to kidney stones a blockage serious kidney infection that became a blood infection a surgery to remove the kidney stones six or seven surgical procedures of varying seriousness spent a lot of time in the hospital a total of probably close to 30 days he's changed a lot too we've changed together he said you've gotten bigger and I've gotten smaller when they were here before I didn't have a lap for you to sit on it was all full of me now I got a lamp when I entered surgery I weighed 425 pounds today I weigh 316 pounds so the total loss in five and a half months is 109 pounds hey nice huh I don't get up there I wasn't very far for me that was a good shot if I hadn't been diabetic for so long I probably would be totally off of diabetes medicine now I take a little bit a very small amount of insulin so we're out there's no I don't take blood pressure medications at all instead of the three I was taking before I've never felt that the complications were a mistake that somebody made this was not an error in judgment this is not at Aaron procedures it was a good decision for me six months of discomfort is a small price to pay to have years of life and enjoyment the surgery is not a magic wand what you really need to be successful after this operation is radical behavioral change exercising daily a sensible diet the right amount of multivitamins you have the ingredients for success I talked about this operation as being a radical step and I think they're far less radical steps that everybody who's considering this operation should entertain lots of people are able to keep off the weight with behavioral changes it's hard for them but it's doable there are some people who are successful losing in some cases even very large amounts a hundred pounds or more and then are able to keep that off for the long term when you get in and look at those individuals you get a sense of the extreme vigilance that's necessary in order to accomplish and maintain that goal it takes work it takes work to do all of this it's a mindset it's what it's all worth it it's it's all worth if the payoff is you today girl I know that but we gotta warm up for okay for my warmup is moving fast yeah I know that but no come on okay I did some warmups over four five two one two this is very strenuous exercise ready - ready yeah 908 and go okay so what do we do at nine miles - that's what the schedule says do you know what today is today - 20th this is exactly one year from when we did our very first six mile walk I never in our lives I swear oh my god it's scary to think of it that I was at a certain weight I never pictured myself looking like like this it's scary from where I started to where I am because my whole life has changed my daughter she's gonna kill me for this okay sorry honey my daughter weighs 106 pounds I've literally lost my daughter I've literally lost a person do you think you and I could both fit guys what did this it is amazing really yeah it is it's it's totally amazing you were how tall and how much did you weigh at that time I was six feet four no oh I know you're still missing hi this is the hard stuff saying the number this is very difficult I'm 410 and when I weighed in at the doctor I was 215 pounds and that is a scary number I never thought I was that weight I'm 5 foot 3 and I was morbidly obese oh my god well I don't even know what I was saying there but it was just all a cover like here I am having a good time whoo-hoo you know and um fat people don't have their videos taken this is very painful for me it's also inspirational because I've transformed my life and I'm gonna do what it takes not to go back there this represents about 106 pounds of weight loss it just gives me a very objective non-judgmental literally screenshot of where I've been and it's also keeps me focused yes I'd like to make an order for delivery the chicken shish kebab how was that made it's just grilled no sauce right instead of the rice can you just um put extra salad grilled steamed baked those are key words my calories are so little I try to maximize as much as I can and a way to maximize it for me is with vegetables and salad sauce on the side always on the side it's a budget you know it's like what am I gonna spend my budget on so you want to have a guessing game don't peek how much do you think this weighs I'm gonna say six and a half six and a half you rock you rock so six point five at 52 calories an ounce fruit Sam is 52 is 3 38 chicken kabab all right chicken is 47 calories an ounce times six point five so that chicken is three or five this I'm gonna count maybe 25 calories do you think this lunch non cluding dressing is 356 Bon Appetit what now Rondo yes what is that our dietitian had told us to keep a food journal so I kept the food journal for the first week then I said okay let's do another week and another week this is my fourth year without even looking at it I could just tell you yesterday when I act for breakfast I have my chil bong a nonfat yogurt 1/2 a cup of berries which were 45 calories 1/4 of a cup of pure pumpkin and I added cinnamon and vanilla to that and then I had it with coffee my whole breakfast was 205 calories 19 grams of protein and 3.5 grams of fiber which will take you a long ways do you want to do a hell you wanna get hurry up Oh yep tomorrow I've called it off my heart rate is going to years ago I couldn't walk a block without huffing and puffing I mean I'm not exaggerating I really couldn't that's 110 steps and now I do 15 to 20,000 steps every day now I look for hills yeah you're gonna lose weight by eating less but once your weight is off exercise is the number one predictor of keeping weight off oh look at the Sun it's like the Bahamas on a bad day at night I will stand in front of my TV and God's honest truth I walk in place and it could be up to four or five thousand steps and how do I know that I wear a pedometer every single day it's good to have a partner you know routine where tell yes we are I don't like the word willpower I don't use that word what I use is um something that's achievable I will pick one small thing and it could be as little as just drinking eight glasses of water each day you have to master that and then once I master that I then go on to the next little thing and that could be something as little as eating breakfast every day I make my goals very very small yes small enough so they can be a hundred percent achievable correct I'm just an ordinary person who does a whole bunch of very very tiny ordinary things that together are extraordinary everyone has the power to lose weight and become healthier yeah never give up it's a lifelong process you never know which attempt will allow you to achieve long-term success we're in the midst of an epidemic of childhood obesity with childhood obesity rates tripling in just a generation the evidence is incontrovertible that children who are obese are at greater risk for a variety of health problems estimates are that one in three children born in the year 2000 will develop diabetes sometime in their lifetime and this is a direct consequence of the obesity epidemic when I walk into a room people don't look at me they look at my size and they don't want to get to know me I've struggled my weight all my life it's important for the parents or understand that there are all these forces working against them food marketing direct eighty kids it's powerful it's precious and it's predatory all across the country only one out of six schools require PE at least three days a week a lot of school cafeterias will have stations set up where children can buy chicken nuggets french fries hot dog it's a fast food and unhealthy food the obesity crisis is a moral challenge for us as a society what kind of society do we owe all of our children you

Channel: HBODocs

Views: 1,022,196

Rating: 4.7221465 out of 5

Keywords: hbo documentary films, docu, docs, weight of the nation, may 14, may 15, weight, fat, troubles, heart disease, type 2 diabetes, diabetes, high blood pressure, blood pressure, liver disease, infertility, cancer, stroke, overweight

Id: hLv0Vsegmoo

Length: 72min 54sec (4374 seconds)

Published: Mon May 14 2012

Reddit Comments

[u/Hamnesia]

Great video. I liked the advice of the two ladies towards the end. Change one thing at a time and make the goals small enough that they're 100% achievable. Over time the small changes add up to extraordinary changes.

[u/crashdummie]

I'm 18 minutes in, and they're talking about the set-point theory, which sounds fatlogicky to me.

[u/Deacon_Steel]

Is this available on any legal streaming sites besides HBO Go? I am assuming not.

[u/CellularPeptideCake]

Wow, very hard to imagine that something like this would be put out today. Just this morning there was yet another anti-diet, anti-lifestyle change, pro-surgery article in the NYTimes.

And even in this video, I have a hard time listening to the constant ragging on the 'diet industry' and the accusations that 'they' are intentionally not helping because they have no reason to. The problem is not fad diets. A lot of fad diets actually provide an organized way to jump-start weight loss. If you put no effort at all into learning how to make the impact of a diet last, that's on you.