0:00:02 > 0:00:05Last year, we followed three people battling obesity
0:00:05 > 0:00:08at Wales' only weight management clinic.
0:00:08 > 0:00:10- You feel like killing me now, don't you?- No.
0:00:10 > 0:00:12Are you sure?
0:00:12 > 0:00:15Led by Dr Nadim Haboubi, the clinic is now facing
0:00:15 > 0:00:17an ever growing challenge,
0:00:17 > 0:00:19as worrying numbers of morbidly obese young people
0:00:19 > 0:00:22are coming through the doors.
0:00:22 > 0:00:24- Easter eggs, is it?- Yeah.
0:00:24 > 0:00:27Who buy them?
0:00:27 > 0:00:31Over one in three Welsh youngsters are now officially overweight
0:00:31 > 0:00:37or obese, and Wales' weight problem costs £73 million a year.
0:00:37 > 0:00:39It's a problem that needs tackling early on.
0:00:39 > 0:00:44I don't want to see him upstairs in bed for the rest of his life.
0:00:44 > 0:00:45Something will have to give.
0:00:45 > 0:00:48So we've been filming with three of the youngest patients,
0:00:48 > 0:00:52all with complex reasons for being obese
0:00:52 > 0:00:55but with one urgent aim - to lose weight.
0:00:55 > 0:00:57They know that's going to be tough.
0:00:57 > 0:00:59No, because I'll start crying.
0:00:59 > 0:01:02- I can't. I'm sorry.- Don't worry.
0:01:02 > 0:01:06It's hard. It's really, really hard.
0:01:06 > 0:01:11Can this next generation in Wales win their fight for life?
0:01:18 > 0:01:21It's early morning on the outskirts of Aberdare
0:01:21 > 0:01:25and James is indulging in the typical passions of someone in their early 20s.
0:01:25 > 0:01:29A fledgling DJ, he's also obsessed with computer games
0:01:29 > 0:01:32and fantasy characters.
0:01:32 > 0:01:37What catches me the most is if I'm depressed, if I'm stressed,
0:01:37 > 0:01:41I go straight for food. Food is my number one comfort.
0:01:41 > 0:01:43It's like food's my drug.
0:01:43 > 0:01:47You've got people who are alcoholics,
0:01:47 > 0:01:50people who are drug abusers.
0:01:50 > 0:01:56Me, food is my substance of comfort, then.
0:01:56 > 0:01:58See, I can have a bacon sandwich.
0:01:58 > 0:02:01Where normal people would have two slices, I'll had five.
0:02:01 > 0:02:04Sometimes I fight myself.
0:02:04 > 0:02:06I'm always in a constant battle with myself.
0:02:06 > 0:02:08Which...
0:02:08 > 0:02:10Which is hard.
0:02:10 > 0:02:13James' weight problem goes back to the first difficult
0:02:13 > 0:02:17years of his life, before he met his new family.
0:02:17 > 0:02:20We adopted James when he was three-and-a-half.
0:02:20 > 0:02:25We think that this problem he has with food
0:02:25 > 0:02:28is connected to that.
0:02:28 > 0:02:31Emotionally he is quite fragile
0:02:31 > 0:02:35and does depend on food a lot to make him feel better.
0:02:37 > 0:02:40James weighs over 34 stone,
0:02:40 > 0:02:42his health is at serious risk.
0:02:42 > 0:02:46Morbid obesity increases his chances of getting heart disease,
0:02:46 > 0:02:50diabetes and other dangerous medical conditions.
0:02:50 > 0:02:53But losing weight is a battle that James is not winning
0:02:53 > 0:02:56and there are other issues he's having to deal with.
0:02:56 > 0:03:00Knowing that I've got Asperger's, which I only got diagnosed last year,
0:03:00 > 0:03:02plus like the learning difficulties,
0:03:02 > 0:03:04the dyspraxia...
0:03:04 > 0:03:08It's like loads of stuff that, really,
0:03:08 > 0:03:11are like layered on each other,
0:03:11 > 0:03:14which makes everything harder to get through.
0:03:14 > 0:03:19So say something, as simple as, routine going off plan,
0:03:19 > 0:03:22some people know how to get back on plan.
0:03:22 > 0:03:26Someone like me has to stick to a set routine.
0:03:26 > 0:03:29If anyone breaks that, I just lose the plot.
0:03:33 > 0:03:35Going through school, I got bullied so much.
0:03:35 > 0:03:37My parents were so scared of what might happen
0:03:37 > 0:03:40because I came so close to thinking, "Why should I bother?"
0:03:40 > 0:03:44Why should I bother just living like this getting bullied constantly,
0:03:44 > 0:03:47maybe just kill myself, really.
0:03:47 > 0:03:52Once you get into that mind status, it's really hard to get out of.
0:03:52 > 0:03:55You know, my parents have done a hell of a lot to help me
0:03:55 > 0:03:58and, you know, I'm still here.
0:04:00 > 0:04:03James lives at home with his parents.
0:04:03 > 0:04:07Due to his learning disability, he's visited by support worker,
0:04:07 > 0:04:10Nicola, several times a week.
0:04:10 > 0:04:13She's trying to make sure he develops the skills to live
0:04:13 > 0:04:18independently and is encouraging James to exercise and eat healthily.
0:04:18 > 0:04:24James doesn't buy typical junk food, crisps, chocolate, biscuits.
0:04:24 > 0:04:27There would be the rare occasion.
0:04:27 > 0:04:29But what he does buy, he buys large.
0:04:29 > 0:04:33Probably if I wasn't here today, he would have cooked
0:04:33 > 0:04:36- the whole joint of it. A lot of it is about portion control.- Yeah.
0:04:36 > 0:04:39Typically it's not what I eat, it's how much I eat.
0:04:39 > 0:04:42Like now I'm just peeling potatoes, I'm feeling out of breath,
0:04:42 > 0:04:44I'm sweating.
0:04:44 > 0:04:46Only I can change myself, but I find it really hard to do that.
0:04:46 > 0:04:50I know I can do it, but trying to put it into practice...
0:04:50 > 0:04:52It's not so easy.
0:04:54 > 0:04:57James is due for a regular appointment at Wales'
0:04:57 > 0:04:59only weight management clinic.
0:04:59 > 0:05:03Since starting there last September he's lost two stone,
0:05:03 > 0:05:05then put it back on again.
0:05:05 > 0:05:07Now radical surgery is on the agenda.
0:05:07 > 0:05:11Dr Haboubi has given me the option of having a gastric bypass,
0:05:11 > 0:05:13which has been playing on my mind a lot
0:05:13 > 0:05:17because, you know, it's going to be a massive life-changer, really.
0:05:19 > 0:05:23The Clinic at Ebbw Vale has a team to support patients lose weight
0:05:23 > 0:05:25slowly and then keep it off.
0:05:25 > 0:05:29It's about motivation, praise and getting under people's skin.
0:05:29 > 0:05:34But Dr Nadim Haboubi knows that young patients are desperate
0:05:34 > 0:05:36when they're referred to see him.
0:05:36 > 0:05:39A lot of these patients will give an arm,
0:05:39 > 0:05:41would prefer being blind,
0:05:41 > 0:05:43than being obese.
0:05:43 > 0:05:46James and his family have come to the clinic to discuss
0:05:46 > 0:05:49whether he should be put forward for weight loss surgery.
0:05:49 > 0:05:53Bad news on the scales, a further half stone weight gain,
0:05:53 > 0:05:56puts pressure on them to make a decision.
0:05:56 > 0:05:59With James in his early 20s, he could be one of the youngest
0:05:59 > 0:06:02people in Wales ever to have the operation.
0:06:02 > 0:06:05Just tell how much you've been trying?
0:06:05 > 0:06:07And, how hard?
0:06:08 > 0:06:10Obviously, not a lot.
0:06:10 > 0:06:12I just feel like I've gone downhill.
0:06:12 > 0:06:15Completely lost the plot as far as food is concerned.
0:06:16 > 0:06:18It's been Easter time.
0:06:18 > 0:06:20- Chocolate...- OK.
0:06:27 > 0:06:30- Easter eggs, is it?- Yeah.
0:06:30 > 0:06:32Who buy them?
0:06:32 > 0:06:35- I buy them all a small one.- Why?
0:06:35 > 0:06:36Why, why, why?
0:06:36 > 0:06:41With James struggling with conventional weight loss programmes,
0:06:41 > 0:06:44Dr Haboubi asks for a final answer about putting him
0:06:44 > 0:06:46forward for surgery.
0:06:46 > 0:06:48Obviously, surgery means risk.
0:06:48 > 0:06:51I, personally, think that'll probably have to be taken here.
0:06:51 > 0:06:55There are things which are against him, that he's not diabetic
0:06:55 > 0:06:58and he's not hypertensive and he hasn't got sleep apnoea
0:06:58 > 0:07:02They might say, "Well, he's not ill enough."
0:07:02 > 0:07:05- Yet...- Exactly. Exactly, yet.
0:07:05 > 0:07:09I keep on coming up with the same answer, not yet.
0:07:09 > 0:07:11Now I have an answer from you,
0:07:11 > 0:07:13I think...
0:07:13 > 0:07:17- I think it's probably I have to refer you. OK?- OK.
0:07:18 > 0:07:21Even with a referral from Dr Haboubi,
0:07:21 > 0:07:25James has to prove he can stick to a diet and lose weight,
0:07:25 > 0:07:29so there's no risk of him stretching his stomach after an op.
0:07:29 > 0:07:34I don't want to see him upstairs in bed for the rest of his life,
0:07:34 > 0:07:38getting bigger. I mean, a district nurse coming back and forth
0:07:38 > 0:07:42to look after him. I mean, he's 22 years of age.
0:07:42 > 0:07:44That's...
0:07:45 > 0:07:47That's not what I want.
0:07:47 > 0:07:49Come on, then...
0:07:49 > 0:07:53In Blaenafon, Stacey is one of Dr Haboubi's younger patients.
0:07:53 > 0:07:56She's been overweight for most of her life
0:07:56 > 0:07:59and admits that, as a child, she was spoilt.
0:07:59 > 0:08:01I was allowed anything I wanted.
0:08:01 > 0:08:05Which sometimes can be a good thing, other times a really bad thing,
0:08:05 > 0:08:08as in this case, really.
0:08:08 > 0:08:09CHUCKLES
0:08:09 > 0:08:10I've always been overweight.
0:08:10 > 0:08:12My weight always fluctuates.
0:08:12 > 0:08:15Like most teenagers, goes up and down.
0:08:15 > 0:08:18In school, I always had the odd person who'd have a go at you
0:08:18 > 0:08:21for your weight, calling you fatty and all this lot.
0:08:21 > 0:08:23When I was in school, I just didn't care.
0:08:23 > 0:08:26Call me whatever you want, it doesn't hurt.
0:08:26 > 0:08:28Deep down inside it did, when I left.
0:08:28 > 0:08:30Got home from school and I'd sit there and cry.
0:08:30 > 0:08:33The only people who know how much I weigh, really,
0:08:33 > 0:08:37are the nurses and doctors in the clinic
0:08:37 > 0:08:43and my partner because I hate saying how heavy I weigh.
0:08:43 > 0:08:47I just tell him how much I lose and leave it at that.
0:08:47 > 0:08:51Excess weight has always been an issue for Stacey,
0:08:51 > 0:08:54but in recent years she's had to deal with another
0:08:54 > 0:08:56debilitating condition.
0:08:56 > 0:09:00I've had depression for just over three years now.
0:09:00 > 0:09:04My job was as a carer. I was working long hours to start with.
0:09:04 > 0:09:08I slowed down and then something just hit me for six.
0:09:08 > 0:09:11I've been on the sick now for just under a year.
0:09:12 > 0:09:15Stacey's depression isn't unique.
0:09:15 > 0:09:17Obesity can often trigger the condition
0:09:17 > 0:09:21and many of the clinic's patients are on anti-depressants.
0:09:21 > 0:09:24But will it knock Stacey's motivation?
0:09:24 > 0:09:26Today's appointment with Dr Haboubi
0:09:26 > 0:09:29is to see if she's on the right path.
0:09:29 > 0:09:33Can you tell me what changes have you made since we've met?
0:09:33 > 0:09:36Erm, eating a bit more healthier.
0:09:36 > 0:09:40Drinking less pops and squashes, it's mainly water.
0:09:40 > 0:09:42- Less or no?- Less.
0:09:42 > 0:09:44A lot less.
0:09:44 > 0:09:47- Do you know the healthiest drink in the world?- Water.
0:09:47 > 0:09:49Do you know which one?
0:09:49 > 0:09:51Tap water.
0:09:51 > 0:09:52Do you know which tap water?
0:09:52 > 0:09:55Welsh water. You are not as depressed as you were before
0:09:55 > 0:09:57- when you came last time.- I know.
0:09:57 > 0:09:58Do you know why?
0:09:58 > 0:10:00- Because you lost the weight.- Yeah.
0:10:00 > 0:10:03- I'm very proud of you.- Thank you.
0:10:03 > 0:10:04Thank you for coming.
0:10:04 > 0:10:08Stacey's lost almost five pounds, and has taken the first steps to
0:10:08 > 0:10:13hitting the clinic's target of a 10% loss in body weight over a year.
0:10:13 > 0:10:17Gradual weight loss can avoid the danger of yo-yo dieting,
0:10:17 > 0:10:20ensuring the patient keeps it off long term.
0:10:22 > 0:10:25Her main snack weakness are crisps.
0:10:25 > 0:10:28Their availability in every supermarket is a problem.
0:10:28 > 0:10:31The clinic's psychotherapist, Janet, wants Stacey to try
0:10:31 > 0:10:34and resist the bad snacks at source...
0:10:34 > 0:10:36Don't buy them in the first place.
0:10:36 > 0:10:39Sometimes when we go round the shop and that,
0:10:39 > 0:10:41I'll say, "Oh, no, we don't want crisps, we don't need 'em."
0:10:41 > 0:10:44- So you don't go down that aisle. - We don't go down that aisle.
0:10:44 > 0:10:47It's a shame we can't have like a sticker on them, or something,
0:10:47 > 0:10:50that says, "Stop, do you really need these?"
0:10:50 > 0:10:52Then that's like the red button thing.
0:10:52 > 0:10:56- "Do not press a red button," you just want to press it.- Ah, OK.
0:10:57 > 0:11:00So if it was on, "These are bad for you..."
0:11:00 > 0:11:03A shame we can't put a picture of Dr Haboubi's face on the crisps.
0:11:03 > 0:11:06I know, that would scare anyone! THEY CHUCKLE
0:11:07 > 0:11:10Over the next two weeks, Stacey will have to knuckle down
0:11:10 > 0:11:13and stick to her lifestyle changes.
0:11:13 > 0:11:15But will the clouds of depression
0:11:15 > 0:11:18allow her to improve on her early success?
0:11:23 > 0:11:28In Cwmbran, another of Dr Haboubi's young patients, Haike,
0:11:28 > 0:11:30is fighting morbid obesity.
0:11:30 > 0:11:34Her teenage weight gain was made worse by a medical condition.
0:11:34 > 0:11:35The weight started when I hit puberty
0:11:35 > 0:11:38because I suffered from polycystic ovaries.
0:11:38 > 0:11:40Before that I was quite average.
0:11:40 > 0:11:44As soon as I hit puberty, the weight started piling on.
0:11:44 > 0:11:48Like all the patients at Ebbw Vale, the solution to Haike's problems
0:11:48 > 0:11:52is changing her lifestyle, but this isn't the first time
0:11:52 > 0:11:55she's tried to get to grips with her weight.
0:11:55 > 0:11:58I've been on and off diets since 15/16
0:11:58 > 0:12:02and going to Slimming World and Weight Watchers, I've tried them all.
0:12:02 > 0:12:07It's nice to finally go to someone who has to the whole team
0:12:07 > 0:12:11to try to get to the bottom of why you are like this, really.
0:12:11 > 0:12:14Haike's main motivation at the moment is her wedding
0:12:14 > 0:12:16in a year's time.
0:12:16 > 0:12:19To raise the funds for this, and a new house, she's moved back home
0:12:19 > 0:12:22and is holding down two jobs.
0:12:22 > 0:12:26But can she find the time to prepare food and take proper exercise?
0:12:26 > 0:12:29Yeah, working two jobs is hard because sometimes
0:12:29 > 0:12:30I don't finish till 9pm at night.
0:12:30 > 0:12:34By the time you get home and you're trying to think of something to eat,
0:12:34 > 0:12:37sometimes you just think, "Oh, sod it, I'll have something naughty."
0:12:37 > 0:12:39Now I'm living back at home for a bit,
0:12:39 > 0:12:42it's going to be easier because Mum can make me something
0:12:42 > 0:12:43to get home to.
0:12:45 > 0:12:48Dr Haboubi has put Heike on a prescription for tablets
0:12:48 > 0:12:51that prevent fat being absorbed from her food.
0:12:51 > 0:12:55The results can be dramatic and potentially embarrassing.
0:12:55 > 0:12:57On these tablets I can't eat any fat.
0:12:57 > 0:12:59Because of the side effects of the tablets
0:12:59 > 0:13:01you are scared to eat any fat.
0:13:01 > 0:13:03Basically...
0:13:03 > 0:13:07If you eat any fat, you're going to pass fat
0:13:07 > 0:13:11and it's a bit of short notice to get to the toilet.
0:13:11 > 0:13:13So...
0:13:15 > 0:13:18Haike's fiance, also started to hit the gym
0:13:18 > 0:13:20with her in the past few months.
0:13:20 > 0:13:24With his moral support she's been working out three times a week,
0:13:24 > 0:13:28a major commitment with such limited time.
0:13:28 > 0:13:31Trying to fit it in around two jobs is hard,
0:13:31 > 0:13:34but I do have some time off so I just make sure that I go
0:13:34 > 0:13:37when I can and just do as much as I can.
0:13:40 > 0:13:42I find it really helpful that I've got someone to go with me.
0:13:42 > 0:13:47I find that he pushes me more when he's with me. If I go on my own,
0:13:47 > 0:13:49it's just a case of, "Oh, that'll do,"
0:13:49 > 0:13:51whereas I work as hard as he does.
0:13:53 > 0:13:56After a session like that, I feel good. I feel like I've done
0:13:56 > 0:13:58what I need to do to lose weight.
0:13:59 > 0:14:03But will even three workouts a week and all the changes to her diet
0:14:03 > 0:14:06be enough when Haike has her next appointment
0:14:06 > 0:14:08with Dr Haboubi's scales?
0:14:12 > 0:14:17In Blaenafon, Stacey isn't the only one counting the calories.
0:14:17 > 0:14:20Partner Phil has lost more than half his body weight in the past
0:14:20 > 0:14:24five years, and it's been a key motivating factor for Stacey.
0:14:26 > 0:14:29That's me. I was 33 stone, 4.
0:14:29 > 0:14:30I'm now 16 stone, 5.
0:14:30 > 0:14:33You can't make someone do it, they've got to want to do it.
0:14:33 > 0:14:37It's all well and good going through the motions but unless you want to lose the weight,
0:14:37 > 0:14:39you are not going to lose it.
0:14:39 > 0:14:42Seeing the scale of her partner's achievement has been
0:14:42 > 0:14:45just the inspiration that Stacey needed.
0:14:45 > 0:14:49It started off when we were at my parents' house with my old clothes.
0:14:49 > 0:14:52I had a pair of 66 inch trousers.
0:14:52 > 0:14:54That's a big, old pair of trousers.
0:14:54 > 0:14:58Stacey was looking at them and said she wouldn't mind losing a bit of weight.
0:14:58 > 0:15:00We discussed if I can do it, Stacey can do it
0:15:00 > 0:15:02and I'll offer as much as I can.
0:15:02 > 0:15:05But despite this, Stacey's depression still has a major
0:15:05 > 0:15:08effect on her ability to lose weight.
0:15:10 > 0:15:13She's back for her regular appointment with Dr Haboubi.
0:15:13 > 0:15:14Stacey.
0:15:14 > 0:15:18And in the two weeks since her last visit, a lot has changed.
0:15:19 > 0:15:23You're not going to be my friend. I've put on weight.
0:15:23 > 0:15:27- Just tell me first. - BAD couple of days.- Tell me more.
0:15:28 > 0:15:30No, cos I'll start crying.
0:15:33 > 0:15:36You mind if they're filming us while you're like that, or not?
0:15:36 > 0:15:39- TEARFUL: No, I can't, I'm sorry. - Don't worry, don't worry.
0:15:41 > 0:15:44At times like these, Dr Haboubi feels there's
0:15:44 > 0:15:48an even greater need for support and encouragement.
0:15:48 > 0:15:50He wants to make sure that small setbacks
0:15:50 > 0:15:53don't stop future weight loss.
0:15:53 > 0:15:56The weight is something like just a pound more.
0:15:57 > 0:16:00I don't call this a failure at all.
0:16:00 > 0:16:03I know you're upset about it, but I'm not.
0:16:03 > 0:16:07You came and you cried, and that was it. That's a bonus, that's a plus.
0:16:08 > 0:16:11And I'm grateful to you, and I thank you.
0:16:12 > 0:16:15'I feel better now we've had a chat and he's not too worried about me'
0:16:15 > 0:16:20putting on a pound in a couple of weeks, so...
0:16:20 > 0:16:22I feel a bit better about that.
0:16:24 > 0:16:27Stacey will be back to see Dr Haboubi in two weeks.
0:16:27 > 0:16:30Will she be able to overcome the effects of her depression
0:16:30 > 0:16:33and get back on her weight loss path?
0:16:36 > 0:16:40James in Aberdare is having a similar battle with depression.
0:16:40 > 0:16:42His motivation has taken a nosedive,
0:16:42 > 0:16:45and he's struggling to hide his emotions.
0:16:45 > 0:16:49I try and make myself look, "Oh, yeah, I'm all happy",
0:16:49 > 0:16:53but really, in reality, I'm just... I'm not.
0:16:53 > 0:16:57I just sometimes feel really, really bad about why I'm doing what I am.
0:16:59 > 0:17:03I'm sorry, but this thing is hard, it's really, really hard.
0:17:07 > 0:17:12It's only now I've started to think why it's so hard. Don't know why.
0:17:17 > 0:17:22Despite his struggles, James knows he needs to keep trying.
0:17:22 > 0:17:26His visits to the gym have become rare, but today,
0:17:26 > 0:17:29personal trainer Andrew hopes to lift his mood
0:17:29 > 0:17:30as well as burn calories.
0:17:30 > 0:17:32Hard as you can, ten punches.
0:17:32 > 0:17:35One, two, three, four, five, six, seven, eight, nine, ten.
0:17:35 > 0:17:40Go on, then, push me. Go on. Ohhh, come on.
0:17:42 > 0:17:46Good, there you are. Well done, good.
0:17:46 > 0:17:50I'm just really tired now, feel like I've been punching brick walls.
0:17:50 > 0:17:55All that pent-up anger and frustration I had building up,
0:17:55 > 0:17:58feels good after doing it.
0:17:58 > 0:18:01Next time we should really go, "This...is...Sparta!"
0:18:01 > 0:18:06- And just punch into it.- That's the way. Show them who's boss.
0:18:06 > 0:18:09- Not sure about "This is Aberdare" instead!- Nah, look at it.
0:18:12 > 0:18:16James and his parents have hear about a local weight loss coach
0:18:16 > 0:18:20who successfully conquered his own teenage obesity problems.
0:18:20 > 0:18:23He's even been offered work as a David Beckham lookalike.
0:18:23 > 0:18:26But at 14, Merthyr-born Nathan Hewitt
0:18:26 > 0:18:28weighed a staggering 23 stone.
0:18:30 > 0:18:33One event motivated him to make a change.
0:18:33 > 0:18:34I was around 15 years of age
0:18:34 > 0:18:37and I couldn't get on a theme park ride at Alton Towers.
0:18:37 > 0:18:40When I sat down, the seat clamp would not secure me in fully.
0:18:40 > 0:18:45I felt very disgusted with myself, I thought, "How did I allow myself to
0:18:45 > 0:18:50"become this person?" I felt very sad in that moment,
0:18:50 > 0:18:51but at the same time
0:18:51 > 0:18:55it was a moment of clarity where I realised I had to make a change.
0:18:55 > 0:18:57It was something I needed to do
0:18:57 > 0:19:00so I would never have this situation occur again.
0:19:00 > 0:19:05Can Nathan offer help to motivate James to make a similar life change?
0:19:05 > 0:19:07One of my expertise is obviously
0:19:07 > 0:19:10motivational things. The problem is,
0:19:10 > 0:19:12if you don't have a big enough reason to lose weight, you'll
0:19:12 > 0:19:16never find anything to motivate you long enough to follow through.
0:19:16 > 0:19:22- James, why lose weight? - To be better, to be more confident.
0:19:22 > 0:19:24You want to be able to walk out the door
0:19:24 > 0:19:26and feel happy about the person that you are.
0:19:26 > 0:19:29Using Nathan as a coach is one of the things that James
0:19:29 > 0:19:33is now considering as an alternative to weight loss surgery.
0:19:33 > 0:19:37He still isn't 100% sure if he wants to go under the knife,
0:19:37 > 0:19:39or even if he'll be accepted for an op.
0:19:46 > 0:19:50Back at the clinic, bride-to-be Haike knows what she needs to do.
0:19:50 > 0:19:53Lifestyle changes are in place, and she wants to know
0:19:53 > 0:19:54if they're working.
0:19:54 > 0:19:57Today, there's consultations with the full team -
0:19:57 > 0:20:02dietician Sian, psychotherapist Janet and Dr Haboubi.
0:20:02 > 0:20:06For Janet, the truth is in the tape measure.
0:20:06 > 0:20:09What we got Tina, the nurse, to do was measure you, your waist,
0:20:09 > 0:20:11how many inches is it you've lost?
0:20:13 > 0:20:16- About 18cm since first starting.- Wow.
0:20:16 > 0:20:23What do you know about you that might sabotage, that might go wrong?
0:20:23 > 0:20:25Not seeing the numbers on the scale change!
0:20:25 > 0:20:28Especially if you're exercising, they might not
0:20:28 > 0:20:32go down quite as quickly, but the inches might be coming off.
0:20:32 > 0:20:34I only lost half a pound this week,
0:20:34 > 0:20:38- but then I lost six centimetres, so...- Absolutely.- That's really good.
0:20:38 > 0:20:41You look so different, you look an absolute babe.
0:20:41 > 0:20:42HAIKE LAUGHS
0:20:43 > 0:20:48Janet's thrilled, and Haike's lost two-and-a-half stone so far,
0:20:48 > 0:20:51but what will Dr Haboubi make of her progress?
0:20:54 > 0:20:56Wow. This is lovely.
0:20:57 > 0:21:02- How did you do it? I'm jealous. - With a lot of hard work.
0:21:03 > 0:21:07- Tell me more.- Just eating healthy and going to the gym.
0:21:09 > 0:21:11It's worked, hasn't it?
0:21:11 > 0:21:15You're not hungry, you're losing weight, you're much happier.
0:21:16 > 0:21:18- Because you're lighter.- Mm-hmm.
0:21:18 > 0:21:20I'm confident that weight will come down,
0:21:20 > 0:21:24but if I want you to increase your focus and your activity.
0:21:24 > 0:21:27When you want to lose weight, I think you could afford
0:21:27 > 0:21:30being more active, especially with your age now.
0:21:30 > 0:21:34- Well done, thank you very much. - Thank you.- See you again. Cheers.
0:21:34 > 0:21:37'Compared to a year ago, I'm a lot happier.'
0:21:37 > 0:21:40I feel like I've got more energy and I'm a lot fitter.
0:21:40 > 0:21:43I'm just happy with the fact my body's getting smaller.
0:21:43 > 0:21:47Haike's been given the good news that instead of attending the clinic
0:21:47 > 0:21:51every two weeks, she doesn't have to come back for a couple of months.
0:21:51 > 0:21:54From now on, it's a case of staying on the right path.
0:21:58 > 0:22:01In Aberdare, James continues to struggle.
0:22:01 > 0:22:04Over the past few months he and his family have been waiting
0:22:04 > 0:22:06to hear whether he's been accepted
0:22:06 > 0:22:08for a weight loss operation, and they're not sure
0:22:08 > 0:22:10that it's the best option.
0:22:10 > 0:22:14They've arranged to meet one of Dr Haboubi's former patients
0:22:14 > 0:22:17- Mark Weller - who's gone under the knife.
0:22:17 > 0:22:22When we filmed with Mark a year ago, he weighed almost 30 stone.
0:22:22 > 0:22:24He underwent an operation in the autumn.
0:22:24 > 0:22:27Despite some complications, he's eight stone lighter
0:22:27 > 0:22:32and counting, and has no regrets about taking such a drastic measure.
0:22:32 > 0:22:36If and when you're accepted for the operation.
0:22:36 > 0:22:40Once you go through that process, it's like somebody's waved a wand.
0:22:40 > 0:22:41It's just amazing.
0:22:41 > 0:22:44Are you disciplined in what you eat?
0:22:44 > 0:22:50I think what is significant now is the quantities I'm able to eat.
0:22:50 > 0:22:54For example, I had the first opportunity to have a bacon sandwich
0:22:54 > 0:22:59last week, but I only had one slice of bread with a few
0:22:59 > 0:23:03bits and pieces of bacon in it, and I struggled to eat that.
0:23:03 > 0:23:07Previously, I'd have had no problem demolishing probably
0:23:07 > 0:23:12four slices of bread with at least four, maybe six pieces of bacon.
0:23:12 > 0:23:15Now, there is no way on Earth I could eat that,
0:23:15 > 0:23:19I just haven't got the capacity to swallow that much food.
0:23:19 > 0:23:22Not only am I not able to, I don't want to do it,
0:23:22 > 0:23:24cos it makes you feel uncomfortable.
0:23:26 > 0:23:28With Mark's words ringing in their ears,
0:23:28 > 0:23:31James and the family go to a crunch appointment.
0:23:31 > 0:23:34They're meeting top obesity surgeon Jonathan Barry.
0:23:34 > 0:23:38With operations rationed in Wales to less than 70 a year,
0:23:38 > 0:23:40the barrier for entry is high.
0:23:40 > 0:23:43Mr Barry has concerns about James.
0:23:43 > 0:23:46Post-op, he'd have to stick to a diet of smaller portions
0:23:46 > 0:23:49or he could reverse the op's effects.
0:23:49 > 0:23:50Does he have the self-control?
0:23:50 > 0:23:56People who can't stick to quite strict diets after surgery
0:23:56 > 0:23:59can actually dilate up that stomach.
0:23:59 > 0:24:01So really, they can put a significant amount
0:24:01 > 0:24:02of weight back on.
0:24:02 > 0:24:05We need to be sensible that putting James through
0:24:05 > 0:24:10quite a big operation without a great improvement in his weight
0:24:10 > 0:24:13post-operatively probably wouldn't be in his best interests.
0:24:13 > 0:24:14No, I agree.
0:24:14 > 0:24:19- Do you understand what we mean by that, James?- Yeah.
0:24:19 > 0:24:23As James hasn't shown he'll be able to control his diet after an op,
0:24:23 > 0:24:27Jonathan Barry doesn't think that surgery is in his best interest.
0:24:27 > 0:24:30It stands to reason that you wouldn't put somebody through quite
0:24:30 > 0:24:34a major operation in order for them not to achieve a good result.
0:24:37 > 0:24:39Surgery is no longer an option,
0:24:39 > 0:24:42so James concentrates on getting motivated.
0:24:42 > 0:24:46Over the past few weeks, he's been meeting weight loss coach
0:24:46 > 0:24:50Nathan Hewitt, who has conquered his own weight problems.
0:24:50 > 0:24:53Although James is yet to start on major changes to diet
0:24:53 > 0:24:57and exercise, the pair have been working on setting key goals
0:24:57 > 0:25:00that will see James through his weight-loss journey.
0:25:01 > 0:25:04- So what's the main goal here? - Number one goal is lose weight.
0:25:04 > 0:25:06Yeah, and if you lose weight, these are all the things
0:25:06 > 0:25:09you'll get in life, and I can see you've written here,
0:25:09 > 0:25:10"I can buy new clothes."
0:25:10 > 0:25:12I can buy new clothes, I can feel good,
0:25:12 > 0:25:15I can prove to others I can do it.
0:25:15 > 0:25:17"I'll be a different person and others will be amazed."
0:25:17 > 0:25:20There's no greater feeling than having someone look at you
0:25:20 > 0:25:22and go, "My God, James, you look amazing."
0:25:22 > 0:25:25- That's a good feeling. - Oh, that's what I want.
0:25:25 > 0:25:28Yeah, it might take you two years to be where you want to be in life,
0:25:28 > 0:25:32but you can absolutely achieve all of those in the next year.
0:25:32 > 0:25:35Soon James will be going back to Dr Haboubi,
0:25:35 > 0:25:38and although it's too early to know if his work with Nathan
0:25:38 > 0:25:42will help him lose weight, first signs are promising.
0:25:43 > 0:25:46He told me that every time we have a session, he says,
0:25:46 > 0:25:49"I feel better about things, I feel excited about the future."
0:25:49 > 0:25:51And that's key, because it's important
0:25:51 > 0:25:53he believes what's possible.
0:25:53 > 0:25:56I think I've made up my own little saying.
0:25:56 > 0:26:00Life's a puzzle, it's up to you how you put it together.
0:26:00 > 0:26:02It sounded better in my head.
0:26:07 > 0:26:11Back in Ebbw Vale, Stacey has her latest appointment.
0:26:11 > 0:26:14Her last visit two weeks ago saw her gaining a pound
0:26:14 > 0:26:18after suffering from a serious bought of depression.
0:26:18 > 0:26:21Will the scales have a happier tale to tell today?
0:26:21 > 0:26:25- Yes! Woo-hoo, I've lost weight. - You have.
0:26:25 > 0:26:29Lovely! I'm happy now.
0:26:29 > 0:26:32Stacey's lost over three pounds in two weeks.
0:26:33 > 0:26:36But following her recent ups and downs,
0:26:36 > 0:26:40is it enough to persuade Dr Haboubi she's on the right path?
0:26:40 > 0:26:43SING-SONG: I've been good.
0:26:43 > 0:26:44SHE LAUGHS
0:26:47 > 0:26:50Yeah, you've been very good actually. Hmm.
0:26:53 > 0:26:58- So what's the magic?- Eating brown bread like you told me to.
0:26:58 > 0:27:01- Tell me about your activities. - We'll take the puppy with us
0:27:01 > 0:27:05and we'll go for a walk round a lake or the pond.
0:27:06 > 0:27:10- You need to think of yourself.- Yeah. - You've got to believe in yourself.
0:27:10 > 0:27:14"Because I want to be healthy. Because I want to live longer.
0:27:14 > 0:27:16"I'll do it. Of course I can do it."
0:27:19 > 0:27:21- Yeah.- Of course, yes.
0:27:22 > 0:27:26- Let me see you in two months. But don't let me down.- Not a problem.
0:27:26 > 0:27:28- Thank you for coming.- Thank you.
0:27:28 > 0:27:32Stacey's regular two-weekly visits to the clinic are at an end.
0:27:32 > 0:27:35She's proved she's committed to lifestyle change
0:27:35 > 0:27:38and won't be back for several months.
0:27:38 > 0:27:42If all goes to plan, she'll have lost 10% of her body weight within
0:27:42 > 0:27:45a year, like the majority of Dr Haboubi's patients.
0:27:45 > 0:27:47Just take your weight card, Stacey.
0:27:47 > 0:27:50A victory for Dr Haboubi in the ongoing war,
0:27:50 > 0:27:54but as more and more young people struggling with obesity
0:27:54 > 0:27:57come to the clinic, the staff have a warning to us all.
0:27:57 > 0:28:02The sooner you start treating these patients, the better.
0:28:02 > 0:28:07And the less heavy they are, the success is higher as well.
0:28:07 > 0:28:11If you catch somebody at an early age then you've set
0:28:11 > 0:28:16a new pattern and a much more helpful pattern.
0:28:16 > 0:28:20And the more they do it the more that becomes their norm.
0:28:20 > 0:28:24This is currently the only NHS weight management clinic
0:28:24 > 0:28:28in Wales, and it continues its battle against the odds.
0:28:28 > 0:28:31But young people like Stacey - who's keeping up her diet
0:28:31 > 0:28:35and exercise changes - Haike - who's on track to fit into
0:28:35 > 0:28:38next year's wedding dress - and James - who's been meeting
0:28:38 > 0:28:41his weight loss coach regularly -
0:28:41 > 0:28:46have to win this war if Wales is to have a lighter and healthier future.