Obesity: The Post Mortem

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[Vinette] Obesity is an epidemic

happening right here

in the UK right now.

Honestly, the first thing

I'd say is that Im a big girl.

How my friends would describe me

would be large, fat probably.

I dont like to use the word fat.

But at the end of the day,

that is what I have inside me.

I have a large amount of extra fat.

[Vinette] We all know what fat

looks like on the outside.

[Chanel] I think of cellulite,

rolls, big thighs,

big arms.

If youre Kim Kardashian,

you can have a really fat arse.

Ive got a fat stomach,

shes got a fat arse.

[Vinette] But what if we could see

what fat looks like from the inside?

Do we have any idea of the damage

obesity is doing under our skin?

When you say to somebody,

well, it is affecting your health,

you know, show me, I cant see inside,

I cant see what is happening inside me.

[Vinette] BBC3 has secured the first

televised access to a full post-mortem

on an obese person whose body

was donated to medical science.

This summer, our pathology team assembled

to reveal, from the inside,

the dangers of us all getting too fat.

Post-mortems are tightly controlled

and access to them is strictly limited

to protect the privacy and dignity

of the deceased.

Filming is not usually allowed.

But for this post-mortem

we have been allowed in

to help understand a problem

that costs the nation billions and

ruins so many lives. Obesity.

Carla Valentine and Dr Mike Osborn

are the specialist team responsible

for carrying out the post-mortem.

Carla is an Anatomical

Pathology Technologist

and Technical Curator

of the Pathology Museum

at Londons Queen Mary University.

For this post-mortem,

I will be carrying out the evisceration,

which means removing all of the organs.

Being part of a filmed post-mortem

is a very unique opportunity.

Death terrifies some people,

but what it also does is it

eventually gives you a real sense

of the fragility of life.

The topic of obesity is a huge problem,

and its something that I get

to see quite a lot,

but its not something

I get to study in depth.

[Vinette] Mike is

a Consultant Pathologist

and Fellow of the

Royal College of Pathologists.

Hes been working with death and disease

for over 20 years.

Obesity is very much there,

it's seen, but I think its

very, very poorly understood.

It seemed that making this film

would be a way of exploring that

and allowing a broader public

to learn about the problems

that are associated with obesity.

[Vinette] Carla and Mike have performed

thousands of post-mortems,

but always behind closed doors.

Today, well witness what

really happens in an autopsy

and discover what the body of our donor

can tell us about the creeping effects

of obesity over time.

We dont know this woman's name,

but we do know a few details about her.

She was in her early 60s.

5'5". Almost 17 stone.

And, just like a quarter of people

in the UK, clinically obese.

But where did she come from?

And how did she end up here

on a post-mortem table in London?

Long Beach, on the West Coast

of the United States.

Glamorous, sunny, carefree California.

But away from the beach,

on an anonymous industrial estate

on the outskirts of the city,

is where our donor began her journey

to the post-mortem table.

This is a place where people

who donate their body

to essential medical science

are brought when they die.

Up to 20 donated bodies, or cadavers,

a day come through these doors

destined for thousands of medical research

projects all over the world.

[Randall] My name is Randall Delgado.

Im 29. My main role now

would be in charge of distribution.

Some days, you know, we have an order

for cadavers going to Lebanon

and so then we have to start checking

on them... How are they looking?

Are they firm?

Is there mould growing on them?

You gotta be a certain breed of person

to be able to do this.

At first, Id be like, "Ooh,"

but eventually you get used to it.

Im Kelsy, Im 32

and I live in Costa Mesa, California.

We perform a procurement

on each donor that comes in,

which entails us dissecting

different specimens from each donor.

We get to dissect the brain,

take certain parts of the brain,

internal organs, or taking

veins and arteries,

different parts of the eye...

The job itself can still be pretty taboo.

I mean, even when I first came here,

I wasnt exactly sure what they did.

I knew they recovered tissue,

but I didnt know like

to the extreme of like

really recovering almost everything.

[Vinette] Our donor was processed here,

in preparation for her final trip.

Her left arm was removed for cremation,

and its ashes returned to her

family in California.

The rest of her body was frozen,

placed in a body bag,

boxed and labelled for

transportation to London.

From here, she made her last car journey

through the streets of California.

She was loaded into the hold of a plane

and carried 5,000 miles from her home.

And finally she arrived in London.

Her body remained in a cool chamber

for ten days

to allow it to thaw completely

before it

was brought to the post-mortem table.

The first stage of every post-mortem,

before any cut is made to the flesh,

is an external examination of the body.

The donors ID number is confirmed

against her medical record,

which details the cause of her death,

heart disease,

and that shed only had minor surgery

and drank minimal alcohol.

But what will her body go on to reveal

about the way that she died?

[Michael] This lady has died

of heart disease,

which is one of the things that is

associated with obesity.

And interestingly already in this lady,

weve got signs of heart failure,

because if I press here,

particularly on this side,

you can see this dimpling there

and thats because theres youve

got too much fluid,

and thats the side effect

of heart failure.

[Vinette] The other obvious external

damage to our donor

are the blisters on her skin.

They are one of the earliest signs of her

body decomposing after death

and they're particularly noticeable

on larger bodies.

But they're not what Mike and Carla

are focusing on.

The most important thing about this lady

is that the obesity

that shes got is centred on her abdomen.

So this lady is carrying a lot of weight

around her tummy,

that's associated with more

of the complications

than if somebody weighs the same,

but they carry their weight

around the bottom and around the thighs.

So thats less associated

with complications,

thats more associated with complications.

So we can see the distribution of the fats

from the external exam,

but once we actually get inside,

well see more of how that has affected

the inside of her body,

and her internal organs as well.

[Michael] When we open this lady,

there may be other findings

that are less easy to diagnose

before somebody has died,

that wont have killed her,

but are examples of problems

that can get worse and lead to illness

and death in other people.

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