Ordinary People and Extraordinary Struggles: My 600-lb Life

Since 2012, TLC’s My 600-lb Life has given viewers an inside look at the lives of people dealing with extraordinary obesity. Cast members have peeled back the curtain, allowing the world to see their daily struggles before, during, and after weight loss surgery as their last resort to save themselves.

Dr. Younan Nowzaradan and patients / Dr. Younan Nowzaradan / Two overweight women / Dr. Younan Nowzaradan and his patient
Source: TLC

Many of the individuals are so large that other physicians cannot treat them. However, Dr. Younan Nowzardan, a Texas surgeon, gives them another chance to make their hopes and dreams come true. While the show shares intimate details, there are still many surprising aspects viewers don’t get to see.

Older Than You Think

Dr. Younan Nowzaradan, known as Dr. Now on the show, is the tough love surgeon in Houston, Texas, who performs the weight loss surgeries. Dr. Now is loved by fans because of his compassionate yet straightforward approach to dealing with the show’s participants. He has performed over 2,000 surgeries on extremely challenging patients.

A woman poses with Dr. Now.
Source: Instagram/@paulaspurpose

While he is quite experienced, most viewers don’t realize Dr. Now is in his 70s. He looks much younger than his age, but he graduated from medical school in 1970. Dr. Now moved to the US to continue his training. His skills are the reason people fly from all over to see him.

“Untreatable” Patients

Dr. Now is a specialist in laparoscopic surgery, specifically as part of bariatric weight loss surgery. Patients come from all over the country to stay in Houston as part of his year-long program because he specializes in helping those who are morbidly obese. Typically, patients have a BMI of 50 or higher.

Three obese people sit in a waiting room.
Source: TLC

However, participants on the show weigh at least 600 pounds, meaning Dr. Now’s patients from the series have a BMI of 100 or higher. Some doctors have a limit on a client’s starting weight. The UCSF Medical Center has a weight limit of 450 pounds, the maximum weight for its x-ray machine.

He Makes It Work

While some doctors have to turn down patients, Dr. Now takes on the most challenging cases. Those unable to get bariatric surgery elsewhere come to his office as their last resort. However, his program is quite similar to other programs around the country regarding general surgery requirements.

Dr. Now is talking to patients.
Source: TLC

Candidates for bariatric surgery are required to lose weight on their own before the surgery. Dr. Now’s program follows this protocol because it helps determine if patients are serious about changing their lives. The surgery is not a quick fix to make people skinny; it requires hard work before and after the procedure.

Inspiration for the Show

The idea for My 600-lb Life didn’t come about from the brains of TLC executives; it was the brainchild of Jonathan Nowzaradan, a TV producer for Megalomedia and the son of Dr. Now. In 2007, his company filmed a documentary about Rence Williams, a woman who weighed 841 pounds.

An over-weight woman is lying in bed.
Source: YouTube

Dr. Now performed the weight loss surgery for Williams after other doctors refused to treat her because she was too much of a risk. Sadly, she died two weeks after the surgery due to cardiac arrest. The footage was adopted into spin-off shows like Half Ton Mum in the UK.

Making a Full Season

The documentaries aired on TLC and Megalomedia also filmed several bariatric surgery patients over a period of seven years. The footage was edited into the first season of My 600-lb Life. The first season was successful, so TLC picked it up for a full-time series.

An obese woman is sitting on the couch.
Source: TLC

Since the show aired a second season, the participants are only followed for a year. TLC also has update episodes to show how past participants are doing on their weight loss journey after their year of treatment in front of the cameras.

It’s Not a Quick Fix

While some people think bariatric surgery is a quick fix to lose weight, it’s not really the case. Even some people who go on My 600-lb Life think the surgery will allow them to lose weight but keep their lifestyle.

A large woman sits in a hospital bed.
Source: TLC

It’s a shock when they find out they must put in the hard work. Some patients on the show didn’t change their lifestyles, so the surgery didn’t help them. One participant, Penny Seager, complained about not losing as much weight but refused to get out of bed.

Diet and Exercise Required

On the show, Seager famously asked, “Where’s my yellow brick road?” She didn’t want to put in the hard work, so she didn’t lose as much weight. Dr. Now explained that bariatric surgery shrinks the size of the stomach significantly, but that alone will not spur weight loss.

An obese woman is practicing boxing in the gym.
Source: TLC

The patients who undergo weight loss surgery on the show have to adhere to a diet and add regular exercise to their lifestyles. Dr. Now said the surgery would not work if a patient didn’t want to make these changes.

A Niche Market

Everyone has a different definition of what they find attractive, and many feel the body types on My 600-lb Life are unattractive. However, there are people out there who admire very large body types and seek out websites that feature these types of people.

An overweight woman is crying on the couch.
Source: TLC

Before coming on the show, Zsalynn Whitworth posted her lingerie photos on sites for bigger women to raise money for her weight loss surgery. She met her notorious ex-husband Gareth through the site, who was “shopping for a fat girl” to marry.

A Messy Divorce

While Dr. Now shares his expertise on the series, his personal life is not in the spotlight. He seems like a low-drama man, but there was a rocky period in his life. In 1975, he married Delores, who became a stay-at-home mom to their three children.

A screen grab of Dr. Now.
Source: YouTube

After 30 years of marriage, Dr. Now’s wife filed for divorce, which dragged on and was only finalized in 2004 after a long trial. He was accused of hiding assets, claiming to be retired, and reportedly obstructing the discovery process in the divorce. His wife won 70 percent of their assets.

In It for the Spotlight

When people sign up for a reality TV show, they usually expect some fame to come with it. Some participants on My 600-lb Life have been more prone to seeking the spotlight. Steve Assanti, who appeared on the show in 2017, was on TV before.

The heaviest woman alive is on a news show.
Source: YouTube

He appeared on the Dr. Phil show in 2007. Pauline Potter was also on the Dr. Phil show claiming to hold the world record for the heaviest living woman at 643 lbs. However, the actual record holder weighed 1,000 lbs. Her media presence wasn’t featured on the TLC show.

Unhealthier Than You Think

Most viewers understand that obese people are at risk of medical problems, including diabetes, cardiovascular problems, stroke, and high blood pressure. However, the participants on My 600-lb Life have even more severe conditions due to their weight, such as lymphedema.

A subject from My 600 lb Life.
Source: YouTube

Other health conditions include skin infections, sleep apnea, anxiety, and depression. These are much more prevalent in people who weigh over 600 lbs. Patients on the show also suffer from social stigmatization and discrimination, which hurts their mental well-being and will to change.

The Most Severe Case

Season 5 saw one of the most severe cases of lymphedema and cellulitis when Tracey Matthews shared her story. She weighed 605 lbs, and 400 of those pounds were her legs. It was the most dramatic case in the show’s history and required a special plan.

Tracey Matthews is sitting in a hospital bed.
Source: TLC

Dr. Now couldn’t safely perform the weight loss surgery until Matthews lost 100 lbs. Fortunately, she worked hard to shed the weight before her surgery. Dr. Now removed the excess skin from her legs to help with the lymphedema instead of performing the typical weight loss surgery.

Extreme Physical Pain

As seen on the show, weighing over 600 lbs can be severely limiting. While it’s sometimes hard to understand through our screens, many participants are in constant pain due to their weight. Some people are so heavy that they can’t walk or even get out of bed.

A woman is working out.
Source: YouTube

None of the participants are elderly or terminally ill, yet they feel pain from the moment they wake up until they go to sleep. Lupe Donovan from Season 4 hadn’t walked in ten years when she shared her story. Other participants couldn’t walk across a room without being in pain.

Childhood Trauma

People who have never watched the show often wonder how participants could let themselves get to such an unhealthy point. But many factors played into the lives of those on the show struggling with food addiction. In many cases, their addiction started because of childhood trauma.

Dr. Now is talking to a patient.
Source: TLC

Some participants were sexually assaulted as children and started putting on weight as a protective mechanism. Others turned to food for comfort to deal with their trauma. Ashley Reyes from Season 5 used food to cope after her uncle assaulted her when she was 12.

An Emotional Journey

Because many participants faced childhood trauma that led to food addictions, the weight loss journey often opens old emotional wounds. When they start losing weight, their coping mechanism is removed, forcing them to deal with their trauma differently. Therapy is often necessary in those cases.

An obese woman is in a hospital bed.
Source: TLC

When Reyes shared her story, she said, “I didn’t know how to feel safe, so I would eat to gain back whatever little happiness I could.” During her weight loss journey, she only lost a significant amount of weight after going to therapy to deal with the abuse.

There Are Enablers

Viewers often say the participants are looking for someone to blame for their weight, but they often have enablers in their lives. While participants need to take responsibility for their unhealthy habits, they must also face their enablers who brought them whatever food they wanted.

An obese woman talks about her life.
Source: TLC

In most cases, there is usually at least one or more enablers. Many wonder why these people don’t stop bringing th person unhealthy food or control the grocery cart, but it’s not that simple. Sometimes, the participant throws a fit until they get what they want.

They Don’t Help

When an enabler is involved, it is even harder for the participant to change their lifestyle. In some cases, the enabler is also heavy, and they don’t want to change their own diets. In other cases, the enabler wants to be a caretaker and fears they won’t be needed if the person loses weight.

Two overweight women are sitting in the bedroom eating.
Source: TLC

The enabler has to be supportive of the participant’s journey; otherwise, they are only getting in the way of positive change. Some episodes featured relationships ending because of the lack of support or participants having trouble succeeding.

They Don’t Know Their Weight

When patients see Dr. Now, they often don’t know exactly how much they weigh. Most of the time, even they are shocked by the number on the scale because they don’t expect it to be so high. They likely couldn’t stand on a regular home scale for many years or chose not to.

An obese woman is being weighed.
Source: YouTube

Typical bathroom scales generally don’t measure over 300 lbs; average scales at doctors’ offices aren’t built to measure high body weight. However, Dr. Now’s scale measures up to 900 lbs. It’s stressful because many don’t realize how bad their situation is.

Not Always Inspiring

Some stories on My 600-lb Life have been heartwarming and inspirational, but there are those whose stories leave viewers annoyed. For example, James King from Season 5 left viewers angry with his unwillingness to change his lifestyle. He would order his family around from his bed.

An obese man is telling his story to the camera.
Source: TLC

King’s sister had to quit school to care for him, and his father refinanced his home to pay for transportation to Dr. Now’s office. He was awful to his girlfriend and manipulated her into bringing him food. He gained 150 lbs on the show when he was supposed to lose weight.

Fired By the Doctor

Dr. Now was so disappointed in King’s behavior and saw that he had no desire to change his life. Therefore, Dr. Now made the difficult decision to “fire” King as a patient and never performed the surgery. He didn’t want to work with a patient who wouldn’t take the program seriously.

A selfie of James King.
Source: Twitter

Unfortunately, if someone doesn’t want to change and put in the necessary work, there is nothing Dr. Now can do to help them. He couldn’t perform the surgery because of King’s increased weight. Sadly, King passed away at age 49 in April 2020.

They Are in Relationships

It might come as a surprise, but many of the show’s participants have spouses or live-in partners. Tanisha Cleveland from Season 5 had a husband, but he left during the show because he didn’t want to help her lose weight. She found a new boyfriend while still bedridden.

A couple from the show listen to the doctor.
Source: TLC

Most of the relationships on the show change after the weight loss surgery. Some change for the worse because the patients’ new lease on life threatens their partners, who are often overweight themselves. They don’t want their partners to change, even in life-threatening cases.

Humiliating Scenes

Some scenes on My 600-lb Life are almost too uncomfortable to watch. Because showering and using the toilet can be challenging at 600 lbs, participants are shown having trouble squeezing into the bathroom and shower. Many rely on sponge baths as their primary shower method.

Dr. Now is talking to patients in his office.
Source: TLC

While it’s awkward to film, each person has to be filmed showering at least once for the show. The scenes are censored to hide genital areas, but their bodies are on full display. It is humiliating for the participants who have been shamed for their bodies.

The Show Changed

In earlier seasons, the show didn’t provide much therapy for patients. However, later seasons emphasized the importance of mental health during their weight loss journey. Mental health plays are large part in the success of their journey to improve their lives.

An obese woman is at home.
Source: YouTube

Season 5’s Kristen Perez was sexually assaulted by several people as a teen and blamed herself for several years. She struggled to lose weight after the surgery until Dr. Now ordered her to therapy. He refused to treat her if she didn’t go, and it ultimately helped her lose over 170 pounds.

More Than Weight Loss Surgery

The primary procedure on My 600-lb Life is bariatric surgery, but that isn’t the only surgery Dr. Now’s patients receive. The patients often have other health issues and sometimes get surgery to fix the problem. Season 4’s Ashley Bratcher had to have her gallbladder removed.

A patient from the show tells her story.
Source: TLC

Brittani Fulfer from Season 4 went under the knife to have excess skin removed from her abdomen, arms, and legs because it was preventing her from being active. There have also been cases where transgender participants hope to qualify for gender reassignment surgery.

Filming During the Pandemic

When the pandemic began, everyone was advised to social distance, and those with compromised immune systems were advised to stay home. However, My 600-lb Life continued filming until March 26, 2020. It was an issue because the participants were more vulnerable to the virus.

An overweight woman is sitting at home.
Source: TLC

Many crew members worried they would infect the cast members but kept working because they didn’t want to lose their jobs. The show’s production company, Megalomedia, only stopped filming because of strict government guidelines. They said the health of everyone was their top priority.

Negative Effects

Although many participants work hard to turn their lives around, but that hasn’t stopped people from criticizing My 600-lb Life. Some feel the show perpetuates fatphobia and profits off the exploitation of vulnerable people with trauma. Many critics have voiced their concerns.

Dr. Now is talking to his patients.
Source: TLC

Derrick Clifton wrote an opinion piece for NBC News criticizing TLC. He wrote, “The network’s approach to entertainment often seems to embrace the presumption that fat is inherently precarious and undesirable and yet also worthy of constant surveillance.” It’s more compassionate than other shows but not much better.

Suing the Company

Participants like Justin McSwain and Amber Radchi have praised My 600-lb Life and Dr. Now’s life-saving procedure. However, others haven’t been as happy with their experience and treatment from Megalomedia. Radchi actually criticized the production company for bullying her and disrespecting her boundaries.

Two overweight woman are out for a walk.
Source: TLC

By April 2020, at least ten former cast members filed lawsuits again Megalomedia for several reasons. Season 6’s Alica Kirgan sued the production company, stating they didn’t provide adequate mental health counseling. Many lawsuits stated that the promise to pay for surgeries was not fulfilled.

Not Always 600 Pounds

The show might be called My 600-lb Life, but some participants weigh under 600 lbs. Some casting guides for the show state the individual must be over 18 and weigh between 500 and 800 pounds. People can qualify for the show depending on the casting guide they follow.

An obese woman is eating in the back of a car.
Source: YouTube

A different casting guide stated, “The producers of My 600-lb Life are searching for individuals weighing 600 lbs or more who are ready to make a life change.” Therefore, some participants might be slightly under the 600 lbs presumption.

He Died While Filming

Unfortunately, the participants come on the show with life-threatening health issues because of their weight. Season 6’s Robert Buchel had a starting weight of 840 lbs but lost 124 lbs in the first month of filming. He had surgery to remove a lymphedema mass and lost another 502 lbs.

A photo of Robert Buchel.
Source: YouTube

Five months after his surgery, Buchel lost another 340 lbs. However, following another successful surgery, he became addicted to pain pills. Dr. Now tried to wean him off the pain medication, but it hurt Buchel’s progress. He sadly died of a heart attack in November 2017.

The Show Made It Worse

Season 7’s Annjeanette Whaley shared her story about food addiction, which began after her mother’s tragic death. Her starting weight was 679 lbs, but Whaley was prepared to take on the challenge. She lost 274 lbs, receiving approval to have surgery.

A photo of Annjeanette Whaley.
Source: YouTube

Although Whaley lost a significant amount of weight post-surgery, she faced other issues. Whaley became depressed due to the hate she received online because of the show. She ultimately sued Megalomedia for manipulating her and her family for dramatic purposes. They also never paid for her medical expenses as promised.

He Went into a Coma

During Season 1, viewers were introduced to Donald Shelton, who weighed 675 lbs. He admitted to struggling with food and drug addictions, severely affecting his health and confidence. But Shelton was serious about losing weight, so he traveled to see Dr. Now.

A photo of Donald Shelton.
Source: Reddit

He did well on the show, losing 300 pounds following his gastric bypass surgery. However, he started having trouble walking and slipped into a coma. The doctors diagnosed him with Guillain-Barre syndrome, which left him in a wheelchair. Shelton remained determined and is doing well today.

She Had to Gain Weight

Season 2’s Christina Phillips was incredibly successful during her weight loss journey. She went from 700 to 523 points, which left her with a lot of excess skin. When she wanted to have surgery to remove the excess skin, Phillips was told she had to gain a little weight to do the procedure.

Christina Phillips sits in the doctor’s office.
Source: YouTube

Phillips decided to go through with the surgery, but it didn’t help her confidence. Although she shed another 300 pounds, her mental health suffered because she was always anxious about gaining the weight back. She sought therapy and turned her life around.

Kicked Out of the Hospital

Season 5’s Steven Assanti only got cast on the show after he was kicked out of a Rhode Island hospital. He ordered pizza to his hospital room, and the hospital kicked him out. His story was all over the news, leading producers to contact him for My 600-lb Life.

Steven Assanti is talking on his phone.
Source: TLC

Since appearing on the show, Assanti lost 300 lbs and weighed 500 lbs. Dr. Now believed he weighed more than he claimed. Sadly, Assanti is still not speaking to his brother Justin, who also appeared on the show to lose weight.

She Lost Feeling in Her Legs

When Susan Farmer was introduced to viewers during Season 3, she weighed 607 pounds. She suffered from lymphedema, which caused her severe pain. But Farmer was determined to change her life and lost over 400 pounds by dieting, exercising, and removing excess skin.

A photo of Susan Farmer watching tv at home.
Source: Facebook

After her gastric bypass surgery, Farmer lost feeling in her legs. She saw a specialist who diagnosed her with neuropathy. The doctor said the nerve damage resulted from being overweight for so long. Farmer is doing well despite the challenge and has stuck with her weight loss journey.

She Didn’t Lose Much

Participants on My 600-lb life typically have hundreds of pounds to lose until they reach a healthy weight. When Penny Saeger went on the show, she weighed 530 lbs, so Dr. Now put her on a strict diet. However, she refused to comply with his rules.

Penny Saeger is seen in bed.
Source: YouTube

Despite her stubborn ways, Saeger lost the 40 pounds required for gastric bypass. Following the surgery, she refused to diet, asking her recovery nurses to sneak her extra food. Saeger turned away from the spotlight after the experience, but her niece revealed she only lost 35 lbs.

Uncomfortable Filming Conditions

The show is not only hard on the cast members, but it is also sometimes hard for the crew members. Sometimes, the participant doesn’t live in the best conditions, making it difficult for the crew to film in their homes. One instance stuck with a camera operator.

Dr. Now is in his office.
Source: TLC

A camera operator from the show revealed that they filmed a participant moving out of their two-bedroom apartment. The crew had trouble filming because the apartment was filthy with dog poop all over the floor. They had to use menthol oil to “withstand the smell.”

She Is Still Suffering

When Tracey Matthews appeared on the show, she had the most severe case of lymphedema in the show’s history. With the help of Dr. Now, Matthews shed 167 lbs. Dr. Now decided to remove her excess skin from her legs instead of performing gastric bypass.

Tracey Matthews looks unhappy.
Source: TLC

His decision didn’t help Matthews because she was still suffering from lymphedema. In recent years, Matthews ended up in the hospital for four days because of lymphedema. She shared on her Facebook page that she had “no veins left in her arms.”

It Changed Her Life

As we previously mentioned, Season 4’s Lupe Donovan hadn’t walked in ten years when she appeared on the show. She weighed in at 642 lbs but wanted to change her lifestyle. The weight loss journey was challenging, and Donovan received shocking news while filming.

Lupe Donovan takes a selfie with her partner.
Source: Twitter

While filming the show, Donovan discovered her husband had been cheating on her for years. The stress and heartbreak through a curveball in her journey, but she pushed through. Donovan got down to 220 lbs and has kept the weight off since Season 4.

His Mother Enabled Him

When Sean Milliken appeared on Season 4, he was just 26 and weighed 919 lbs. He was the heaviest patient in the show’s history. Milliken’s weight kept him bedridden, causing him to rely on his mom for help. The journey was tough, but Dr. Now helped him lose 455 lbs.

Sean Milliken is playing video games in bed.
Source: TLC

Milliken stuck with the program well beyond the show, dropping down to 493 pounds. However, his mother was his enabler, and he regained weight under her care. Dr. Now told her she was killing her son and hospitalized Milliken. He also limited Millikin’s mother’s visits.

He Was Too Young

Milliken stuck with Dr. Now’s program well past filming for the show. His weight continued to fluctuate, but things took a turn when his mother tragically passed away. Milliken regained most of his weight, but Dr. Now continued to help him.

Sean Milliken is in a hospital bed.
Source: YouTube

Although Dr. Now kept trying to help Milliken, he regained 278 lbs following his final hospital discharge. He weighed 766 pounds in early 2019. Milliken had trouble breathing and sadly passed away in February 2019 at age 29. His father shared the unfortunate news on Facebook.