We see the legs of a fat woman wearing sandals. The color tones dark brown (almost sepia) with an emphasis on shadow. The lighting seems to shift as we hear the voice-over of overweight people talking about being fat and wanting to do something about it. Much of what they are saying is shown in captions on the screen. For example, "NORMAL PRETTY TEENAGE GIRL". The shot changes to a side shot of a fat woman wearing black underwear. Rolls of fat and lumpy flesh are shown, though her face is out of the shot or in shadow. Another shot shows a close up of a fat woman's buttocks. Lots of lumpy cellulite is visible at the top of one of her legs. Then, the upper back of a fat man is shown. Another shot of a black woman's lower body. Then a shot of an overweight man's side, showing some rolls of fat. Finally a shot of what looks like an older woman sitting and a image of her standing in the background as well. Fade to black and we see the caption, "DESPERATE TIMES CALL FOR DRASTIC MEASURES". The last shows hows a couple surgeons in scrubs looking at us with confidence. The show's logo and "ALL NEW NEXT MONDAY 9/8c" plus the TLC channel logo appear.

Transcript

I just want to be a normal, pretty, teenage girl. I've never felt full before. I have to do something. This is the ending of being obese. If I die, I'll die trying. This is a start of a new me. The surgery we perform changes their lives forever. Big Medicine is all new. New Monday at 9, only on TLC.