On 1st February 2012, TLC aired the premiere episode of “My 600-Lb Life,” a reality television series that follows morbidly obese people in their attempts to lose weight, possibly have surgery, and lead healthier lives. The somewhat controversial show has aired one season every year since. In 11 years, the show has attracted 10 lawsuits, for allegedly neglecting the mental health of participants, failing to honor its promise to cover their medical costs, and the deaths of several participants who died by suicide after appearing on the show.

The lawsuits are often accompanied by criticism from viewers and critics, who accuse the show’s resident doctor, Dr. Nowzarada – known as Dr. Now – and the producers of robbing participants of their humanity by influencing viewers to perceive them as disgusting, barely covering their naked bodies on camera, ignoring their mental health, and berating them when they fail to follow strict diet and exercise guidelines. Despite the lawsuits and criticism that have been leveled against the show, its impact on most of its participants’ weight and overall quality of life is proven. Here are some of the biggest participants/patients in the series and how much weight they lost after working with Dr. Now.

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10. Joe Wexler

The sixth episode of the third season of “My 600-Lb Life” focused on Joe Wexler. At the time, he was the heaviest participant to be featured in the show since it premiered, with a starting weight of 777lbs, about 350kgs, which rose to 792.6 when he started his journey with Dr. Now. Joe was 31 years old when he sought Dr. Now’s help. He’d struggled with his weight since he was a child, and traced his weight problem to his relationship with his father, who deprived the young Joe of love and affection and bought him presents to fill the void, but Joe filled that void with food. Unfortunately, his parents had given him the freedom to do as he wished, and paid no attention to his food consumption. Therefore, he ate whenever and whatever he wished, driving him further up the weight gain ladder. More misfortune fell upon him when his parents’ marriage started to fall apart, and his weight spiraled beyond control when their parents divorced.

Before he sought Dr. Now’s help, Joe’s quality of life had deteriorated almost beyond repair. He could barely move, and relied on his mother and sister for help. He isolated himself and rarely went out in public, and the lonelier and more reclusive he became, the more he ate and the more weight he gained, leading him down a vicious cycle. Joe suffered indignity due to his weight – for instance, he would need an ambulance to get him back on his feet when he fell. In his desperation, he considered suicide as his only escape from the cycle, and had contemplated taking his life three years before he appeared on the show.

Joe’s resolve to transform his life was evident to every person who watched his episode. Dr. Now required Joe to lose 150 pounds about 70kgs before qualifying for safe weight loss surgery.  Unfortunately, he had a setback after his first session with the doctor, and gained 15 pounds, bringing his weight to the brink of 800 pounds. With therapy, his mother’s support, and Dr. Now’s firm hand, Joe brought his weight down to 652.2 pounds and was operated on. 12 months later, Joe weighed 592.6 pounds, having lost 184.4 pounds to become one of the show’s success stories. He lost more weight after the show, had surgery to remove the resulting sagging skin, and has reduced to maintaining a healthy weight of 200lbs, quite an achievement.

9. Marla McCants

Looking at side-by-side pictures of Marla before and after weight loss, one would be forgiven to think that pre-weight loss Marla is post-weight loss Marla’s mother or distant older relative. Marla continued Joe’s streak in Season 3, being the first contestant on the show to have a starting weight of 800lbs. Like most patients in the show, Marla traced the genesis of her relationship with food and weight gain to her childhood. In a confessional for the show, Marla revealed that her father molested her. She turned to relationships outside her family with her friends and boyfriends for solace but that only led to a second traumatic incident when her high school boyfriend kidnapped her. Unable to process the trauma from the abuse and kidnapping, Marla turned to food for comfort, driving her up the weight gain spiral that led her to the show.

When Marla first appeared in “My 600-Lb Life,” she struggled with the simplest motions such as standing and cleaning herself up. She relied on her daughter, Sierra, who moved with her mother to Houston and supported her for a year as she worked to lose weight. Marla was a model patient in the show, following the doctor’s advice diligently. She had Dr. Now’s specialty weight loss surgery early on in the episode and continued to exercise and diet under his keen eye. At her last appointment with the doctor, Marla had lost 266 pounds and weighed 534 pounds.

Marla has turned her commitment to a healthy lifestyle into her life’s work. She is a health advocate and motivational speaker who focuses on personal accountability, the weight loss journey, healing from childhood trauma, and relying on family for support in difficult moments. While she appreciates Dr. Now and the show for helping her turn her life around, she is one of the former participants who have boldly called the producers out for putting entertainment above the well-being of patients. She revealed that the show exaggerated serious activities such as the timeline of her surgery, which spread misinformation on the length of the recovery period after gastric bypass surgery.

8. Teretha Hollis-Neely

Usually, fans and viewers made up their minds to either love, or brand a participant difficult, within the first few minutes of an episode, but Teretha had viewers loving and labeling her obtuse and difficult in equal measure. She weighed 800lbs or over 360kgs at the beginning of her consultation and journey with Dr. Now in the show’s fourth season. Before she contacted the doctor, she’d been bedridden for two years and relied on her son and his girlfriend for help getting meals, and doing basic hygiene activities such as taking a bath and getting dressed. She felt incredibly uncomfortable having her son touching and seeing her private parts but had no choice since her husband was unwell. Teretha was determined to escape the life of helplessness and indignity to which her weight had condemned her, move around without pain, and spend time with her grandchildren.

Teretha blamed her weight on a traumatic childhood. Her uncle molested her when she was 11, and she fell pregnant at 15. Both incidents drove her to seek comfort in food, a behavior she carried with her to the moment she started Dr. Now’s diet and exercise regimen. Since she was heavier than the doctor’s average patient, she had to lose 200lbs to qualify for surgery. She worked diligently, met the goal, and had successful surgery, after which Teretha had lost a combined weight of 440lbs. Unfortunately, the demands of Dr. Now’s program became too much for her and she left the program prematurely, much to the disappointment of viewers who were rooting for her to reach her goal. When Teretha was featured on the show’s “Where are They” segment over a year later, she had gained back some of the weight, and regressed to her earlier immobile and bedridden state.

7. Roshanda Perrio

Season 6 featured an interesting trio dubbed “The One Ton Family.” The trio comprised siblings Roshanda, Brandi and Clarence Perrio whose combined weight was close to a ton. Of the three siblings, Roshanda was the heaviest, with a starting weight of 803.7lbs, over 360kgs – she and her siblings traced their weight problems to their parent’s divorce; their father threw their mother out of their house and the siblings decided to go with her. Without his help, their mother couldn’t watch them all the time, and allowed them the free will to do as they wished, including using food as their escape route. Years later, Roshanda led her siblings to Houston to seek Dr. Now’s intervention.

Participating in the program as a trio worked out for Roshanda, who lost more than 200lbs to qualify for gastric bypass surgery alongside her siblings, and kept going when Clarence and Brandi left the program. By the end of the year, Roshanda’s weight had stagnated at 600lbs, but she vowed to continue exercising and watching her diet. When the siblings came in for their follow-up episode, they were no longer “The One Ton Family.” Roshanda had lost an additional 100lbs and weighed half of her starting weight. Roshanda is a social media hermit, but from the occasional picture, she seems to be making good progress and has escaped the dark hole of regression that swallows some participants.

6. Steven Assanti

The last two episodes of Season 5 focused on two brothers, Steven and Justin Assanti. While Justin, the younger of the brothers, was motivated and followed Dr. Now’s advice, Steven disproved the common belief that firstborns are responsible, diligent and perfectionists, by being obtuse, rude to the hospital staff, and using substances that had him kicked out of the hospital.

Steven’s starting weight in the show was 730lbs. According to Dr. Now, he was morbidly obese, and would later reveal that his weight had caused him deep psychological problems. Typically, such revelations have viewers in tears of sympathy towards the participants, but Steven attracted no such sentiments, but rather reproach from viewers, who were appalled by his behavior, which led to him being kicked out of the program. No one was surprised when Steven, who defied Dr. Now at every turn, gained over 70lbs, bringing his weight up to 808lbs, a new record high for him. Surpassing 800 pounds must have rattled him because he claimed to have lost 300 pounds when the producers spoke to him for his follow-up episode. However, Dr. Now was skeptical, and accused Steven of lying.

In February this year, Steven shared some sad news with his followers through a post on Instagram. He revealed that he lived in fear of dropping dead at any time after doctors found some fluid around his heart. He implored his fans to pray for him, adding that he felt as if his journey was headed to an abrupt end. A few days after the announcement, another post on his official Instagram account announced that Steven had succumbed to a heart complication. As fans and followers rushed to post comforting messages to his family, his brother Justin rubbished claims of Steven’s death, saying that his elder brother was alive and had been in contact with their father. Stand by for any update!

5. Julian Valentine

Most participants had siblings, parents, and career caregivers join them in Houston, but rarely did a spouse or girlfriend take on the role of caregiver. Julian’s caregiver made his case a memorable and inspiring one, that gave viewers a glimpse of a spouse who looked beyond appearance and weight, saw and treated a morbidly obese person with dignity, and refused to give up on a loved one. Julian’s story was highlighted in the second episode of the show’s 10th season. Fans share an unspoken consensus that he‘s one of the least problematic and dramatic participants in the show.

Julian grew up in abject poverty. Throughout his childhood, his next meal was never guaranteed, and sometimes his family would go to bed hungry. Therefore, he learned to eat as much as he could, whenever he was lucky to get food. The behavior became ingrained in him, and he lost his ability to control himself around food even when he grew up, secured a well-paying job as an electrician, and was assured of his next meal.

Julian sought Dr. Now’s help when his weight stood in the way of him starting a family with his wife and caregiver, Irma. He lost an impressive 136lbs, about 60kgs by following a diet plan and hoped to lose more in time for his surgery. Unfortunately, he gained back most of it, but Dr. Now proceeded to operate on him anyway. By the end of the year, Julian had only lost 190lbs. He and Irma left the show disappointed, but grateful for Dr. Now’s help, and didn’t relent in their combined effort to bring his BMI down. According to recent pictures of the couple, Julian weighs significantly less now, and leads a healthier lifestyle.

4. Robert Buchel

Had Robert Buchel had the gift of foresight when he left his home in Forked River, New Jersey, and embarked on a journey to Houston, he may have chosen to back out and find another way of bringing his weight down. Robert was 41 years old when he joined Dr. Now’s program, determined to transform his life. He weighed 842lbs at the beginning of his episode, about 380kgs, and his first few months in the program were going so well that he had lost 340lbs. Dr. Now, who was pleased with Robert’s progress, operated on him to remove a lymphedema mass. The surgery went well and Robert’s recovery was on track until he developed an addiction to pain medication – five months into the program, Robert had a heart attack and died.  

3. Julius Clark (JT)

Over the years, the show has faced criticism for degrading and dehumanizing participants by zooming in on them devouring unhealthy food in large quantities; the producers cannot shed these accusations in the case of JT. When he first appeared in the show, JT weighed 892lbs, the third-heaviest participant in the history of the show, and the cameras conveniently zoomed in on him putting away three pizzas and burgers, two servings of fries, five sausages, peanut butter, and ice cream in one sitting. A close-up of his body showed a large lymphedema mass on his leg, which weighed 100lbs. JT hoped to bring his weight down and have the mass removed, which would enable him to at least walk again.

Naturally, his case was relatively difficult and he required round-the-clock medical staff to monitor his progress. Fortunately, his girlfriend Jessica was there to hold his hand and cheer him on, until she ended the relationship when taking care of him took a toll on her. Left alone at the hospital, JT had no choice but to become his own cheerleader, with a little tough love from the doctor. He managed to lose 126lbs before gastric bypass surgery and over 400 after the procedure. When he left the program after 12 months, JT had lost close to half of his initial weight. According to his posts on Facebook, JT has maintained the momentum, transformed his physique, and had the lymphedema mass on his leg removed.

2. Samantha Mason

Season nine featured the show’s biggest woman, whose starting weight surpassed the 900lbs mark by 40, and grew to 974lbs later in the episode, over 440kgs.  Unlike most participants who traced their weight problems to traumatic incidents in their childhoods, Samantha’s weight was a result of a bizarre career choice – she worked as a fetish model who ate on camera, but eventually her weight spiraled out of control, and she feared for her life, which drove her to sign up for the show. Samantha lost an initial 230lbs before Dr. Now scheduled her for gastric bypass surgery, after which she lost an additional 114lbs, and by the end of 12 months, Samantha had recorded the largest weight loss in the history of the show- 478lbs, or over 215kgs.

Samantha was grateful for losing more than half her body weight, but still became a vocal critic of Dr. Now and the show’s producers. She started by blowing the whistle on her conversations with Dr. Now, claiming that they were scripted. After questioning the labeling and promotion of the show as a “reality” show when it is, in fact, scripted, Samantha accused the producers of exploiting morbidly obese people and presenting them as a laughing stock to fans and viewers. She went on to accuse the show of embarrassing her and exposing her to hateful comments online, before claiming that the show’s producers had reached out to her and her family members after she turned down their request for additional filming. Although she quickly switched from patient to critic, Samantha remains one of the show’s most successful participants.

1. Sean Milliken

Sean Milliken has been the biggest participant in “My 600-Lb Life,” at his heaviest weighing 1003lbs, or 455kgs. Sean was 26 years old when he and his mother went to Houston for a consultation with Dr. Now. The doctor put him on a low-calorie diet that had him lose 100lbs within two months, but when he failed to lose enough weight to qualify for surgery, Dr. Now had him confined to hospital, a decision that paid off when Sean lost 260lbs. Seven months later, Dr. Now operated on Sean, bringing his total weight loss to 455lbs.

However, when Sean returned to the show for his follow-up episode, he had regressed in his weight loss journey and Dr. Now was concerned that his mother was enabling him. An irate Dr. Now accused Sean’s mother of trying to kill her son and denying him basic care. The doctor took the drastic measure of re-admitting Sean to the hospital, and restricting his mother’s visits. Sean lost some weight but gained it back when he was discharged, confirming Dr. Now’s observation that his mother was responsible for his weight gain.  Sadly, Sean’s mother died shortly after her altercation with Dr. Now, and a dejected Sean turned to food for comfort, and regained 278lbs. Dr. Now intervened and had Sean back in hospital again, but it was too late to reverse the strain his body was under, too weak from the stress of the cycle of weight gain and weight loss. Already broken from losing his mother, Sean’s heart gave out and stopped beating. He is one of fourteen patients who died during filming, or after their episodes aired.

Many supporters of the series point out that the program devised by Dr. Now is very often a last resort, and that no patients are forced into it. Also there are no figures available of those who have never sort help for their weight problem, and have died by simply being so heavy that their organs have given up the unequal battle against huge amounts of food intake.

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