Season after season, TLC’s My 600-lb Life has documented the unscripted lives of countless morbidly obese moms, dads, sons, and daughters on the road to a healthier, more independent life. Fans watched as they went from ordering half the menu at a fast food joint to following a strict weight-loss plan guided by Houston-based surgeon Dr.Younan Nowzaradan, better known on the show as Dr. Now. Under his watch, these very patients have undergone risky weight loss surgeries. 

Although some stories did not end well, many patients have gone on to lose the weight post-surgery and live a healthier life. But some go on to gain back the weight they’d lost. “It’s a daily challenge to work with some patients that can be self-destructive,” Dr. Now told People. “My job is not to get aggravated, but to find a way to motivate them to work hard to get to their goals.”

While My 600-lb Life shows just how debilitating obesity can be — some patients are unable to get out of bed at the beginning of their weight-loss journey — you don’t necessarily see everything that transpires behind the scenes of this larger-than-life reality show. Here’s a look at what you didn’t get to see on TLC’s My 600-lb Life.

My 600-lb Life didn't show you full transformations

My 600-lb Life may show you just how difficult it is for its TV subjects to lose half their body weight, but the road to recovery and transformation is far from over after the cameras stop rolling. Some stars thrive while others find it hard to keep the weight off and live a normal life — one that doesn’t involve eating junk food and remaining housebound.

My 600-lb Life does occasionally follow-up with some of its former cast members months or even years after their TV debut, though. The spinoff series My 600-lb Life: Where Are they Now? follows former stars as they continue with their weight loss journeys and do things they’ve never done before, like try on outfits at a clothing store or invest in their love lives.

In 2015, TLC caught up with Zsalynn Whitworth from Season 2, who lost 400 pounds on the popular series and additional weight after the cameras turned off, which has given her the confidence to start dating for the first time since her divorce.

My 600-lb Life didn't show you how much stars get paid

Just because you appear on a popular TV show doesn’t necessarily mean you’ve hit the jackpot. According to Starcasm, each My 600-lb Life cast member receives $1,500, what is considered to be a “talent fee” for the initial episode, which typically takes a year to shoot. But what about royalties? Stars reportedly don’t receive royalties no matter how often their episode airs on TLC. However, if they decide to appear on the show’s spin-off series – My 600-lb Life: Where Are They Now? – they do receive an extra check. 

Stars also receive a relocation stipend of $2,500 prior to making the move to Houston, Texas, where Dr. Now is based, as reported by Starcasm. It’s necessary to relocate in order for the patient to meet with Dr. Now and qualify for weight-loss surgery. But sometimes that relocation money doesn’t go very far. Following star Robert Buchel’s death, a GoFundMe fundraiser was needed for Kathryn Lemanski, Buchel’s fiancé, to help cover costs of the relocation, plus hospital and medical bills. 

My 600-lb Life didn't show you the truth behind those shower scenes

My 600-lb Life is infamous for its controversial shower scenes that often puts the TV star in a vulnerable position for stronger ratings. If one of the stars needs to take a shower during filming, you can bet the camera crew will be there to capture the moment, later blurring their private areas in editing. As a result, the bathroom can get a little crowded, especially if the bather needs assistance, like Kirsten Perez, whose mom assisted in washing her back. 

Shower scenes may seem unnecessary and embarrassing, but, according to former star Bettie Jo Elmore in a since-deleted Facebook Q&A (via In Touch Weekly), My 600-lb Life patients may earn extra money if they agree to let the cameras roll while showering. However, former star Nicole Lewis said she wasn’t really given a choice. She told Rover Radio she felt “embarrassed” when cameras filmed her while she was hosed down by her significant other in their private backyard because she was unable to fit in a conventional shower at the time. Lewis further divulged that the scene was required in order for her “to be a part of [the] process.”

My 600-Ib Life didn't show you which medical treatments were covered

My 600-lb Life stars are rewarded for their TV appearances with financial help for one year, which covers Dr. Now’s expensive medical fees, according to Starcasm. That’s assuming they qualify for weight-loss surgery during the year-long filming process. If they do qualify that year and undergo weight loss surgery, they may lose the weight, but then comes another obstacle: excess skin. Skin removal surgery is an option, but it’s not covered by the show because it is “classified as a cosmetic surgery,” according to Starcasm, and qualifying for this procedure could take more than a year — longer than it takes to shoot an episode.

Given that, the stars of My 600-lb Life often turn to crowd-fundraising in order to raise the funds necessary for other procedures. Chad Dean of Season 4, for example, raised nearly $6,000 on GoFundMe for skin removal surgery following his massive weight loss on the show. 

My 600-Ib Life didn't show you how many stars ended up divorcing

Although many of My 600-lb Life stars are married when the cameras start rolling, their relationships have a habit of collapsing in post-production or later. According to In Touch Weekly, “most [stars] end up getting a divorce.” This includes Season 2’s Christina Phillips, who weighed 700 pounds at the start of her My 600-lb Life journey and some 400 pounds less by the end. Her husband Zach, who was featured on the show, didn’t support his wife’s decision to lose weight, according to Phillips, and is no longer in the picture. “It became clear that me becoming independent [from Zach] was not going to work for him,” Phillips revealed on My 600-lb Life (via In Touch Weekly).

Like Phillips, Zsalynn Whitworth lost more than weight on Season 2 after also dealing with an unsupportive husband. She announced her divorce in 2015 during her My 600-lb Life: Where Are They Now? special. “He didn’t want me to lose the weight and I didn’t deserve to feel bad about choosing my health,” she said in the episode. Though being single came with its own challenges, she said she was doing better than ever.

My 600-lb Life didn't show you just how dirty some homes were

My 600-lb Life typically focuses on the subject’s overeating habits and mobility issues at the beginning of each episode, but what cameras may not necessarily show you is just how dirty some of their homes might be as a result. A man claiming to be a camera operator for the hit TLC show alleged on Reddit that My 600-lb Life took him to some of the filthiest homes he’s ever seen. 

“One family was moving out of their apartment, and we were shooting the move. They were very very unsanitary,” he revealed. He continued to explain that the family covered up their dog’s excrements with plants, and when they went to remove a bed from one of the bedrooms, they discovered “thousands of bugs” living under it for who knows how long. “It was the most disgusting thing I’ve ever seen,” he recounted. 

My 600-lb Life didn't show you what happened to the stars who died

Since My 600-lb Life premiered in 2012, seven stars have died, as reported by People in April 2020One of the first My 600-lb Life stars, Henry Foots, died in 2013, more than a year after his episode aired, according to Heavy. He visited Dr. Now’s office in hopes of losing much of his 750 pounds. While it’s not clear what might have caused his death, Click 2 Houston reported just months prior to his death that he may have had suffered some sort of “medical episode” while driving a shuttle bus, thus causing an accident.

Former star Sean Milliken died at just 29 years of age, a couple of years after starring on the reality TV show in 2016, when he originally weighed more than 900 pounds. Complications from an infection lead to his death, according to a post on his father’s Facebook page (via TMZ).

Some My 600-lb Life stars have even died during filming. Kelly Mason appeared on the show in 2019, weighing more than 700 pounds, Distractify recapped. She was able to lose some of the weight but around the ninth month of filming she sadly passed away from a heart attack.

My 600-lb Life didn't show you how stars landed the gig

Each episode of TLC’s popular reality show My 600-lb Life details a patient’s year-long weight-loss journey. But where do these people come from and how do they land the coveted role? According to Distractify, it may be as easy as calling Dr. Now’s office, visiting the doctor’s website, or responding to the show’s casting call. While any of those avenues may get someone through the door, it doesn’t necessarily mean they’ll appear on the TV show. 

First, the applicant needs to meet the initial weight requirement of at least 600 pounds, according to a 2018 casting call. If cast, the potential star will also have to abide by Dr. Now’s rules — which doesn’t always happen. “There have been a few patients I felt I could no longer help,” the doctor told People. “I will always be available if they need me. If they won’t stick to the program, at some point, I can longer help them and they are taking resources from someone else who needs it.” 

My 600-lb Life didn't show you how some stars earned an income

Although some stars of My 600-lb Life are unable to work and thus receive disability benefits or financial support from family members, some stars are able to make a living, even at the outset of their weight-loss journeys. How? Well, some turn their obesity into cash by modeling on BBW (big beautiful women) websites, where men pay for suggestive pictures of, well, big beautiful women. 

Season 2 star Zsalynn Whitworth earned money that way, posing in underwear on a fat-fetish website when she weighed around 600 pounds, as reported by San Antonio Express-News. She modeled mainly to raise money for weight-loss surgery — that is, until she landed a role on My 600-lb Life. Whitworth wasn’t the only show alum to earn cash by modeling. Fellow star Pauline Potter, whose online alter ego was “Paulee Bombshell,” also posed on BBW sites, Starcasm reported. 

My 600-lb Life didn't show you what happened when a surgery went awry

Dr. Now is an integral part of My 600-lb Life, but that doesn’t make him immune to controversy. In addition to starring on the series, Dr. Now works with patients unaffiliated with the TLC show — and one such patient even sued the doc.

According to Radar Online, a woman named Michelle Park filed a lawsuit against Dr. Now and his anesthesiologist for malpractice after claiming the pair left a “6.69 inch piece of tubing” in her body post-gastric sleeve surgery in 2012. “The tube punctured Mrs. Park’s colon,” according to the lawsuit, and necessitated “the surgical removal of a part of her colon.” As a result, Park allegedly suffered physical pain and impairment, including medical expenses, Radar reported.

In the end, the suit was dismissed, although Radar suspected a secret mediation and settlement could have been reached. Dr. Now did not deny that a tube was left inside the patient, but he did deny culpability. He told Radar, “The lawsuit against me was dismissed because I was not the one who left the tube.” 

My 600-lb Life didn't show you the lawsuits filed by former stars and their families

Emotional distress, gross negligence and unpaid medical bills are just some of the claims made by former My 600-lb Life cast members against the show over the years (via Starcasm). Transgender star Destinee Lashaee filed a $1 million lawsuit against the show’s production company, Megalomedia, claiming she was taken advantage of during filming. In the lawsuit, she alleged that producers pressured her to shave her beard and only paid for one therapy session even after she told them she suffered from gender dysphoria and needed professional help, The Sun reported. 

The suicide death of LB Bonner, a Season 6 fan favorite, also resulted in a lawsuit filed by the family against the production company, according to Starcasm. The lawsuit claimed the company failed to provide him with mental health services and forced him to film when he wasn’t ready. According to a text chain included in the lawsuit between Bonner and one of the show’s production assistants (via Starcasm), Bonner expressed concerns about his mental health, to which the assistant allegedly responded, “Fake it till you make it.”

If you or anyone you know is having suicidal thoughts, please call the National Suicide Prevention Lifeline​ at​ 1-800-273-TALK (8255)

One My 600-lb Life star alleged the TV show didn't show you her real life

Sometimes reality TV isn’t very real, at least according to My 600-lb Life and My 600-lb LifeWhere Are They Now? star Dottie Perkins, who claimed in a lawsuit against Megalomedia (the production company behind the show) that her TV story was fabricated, Starcasm reported. Perkins, who appeared in the fourth season of My 600-lb Life, claimed some of the scenes were staged and edited in a way to make it look as though she was gaining weight when, in actuality, she was dropping pounds after seeing Dr. Now.

The following is a statement from the lawsuit (via Starcasm): “[To] support Defendants’ narrative, they created a dynamic where Plaintiff would not follow the diet. To do this, Defendants [Megalomedia] forced Plaintiff to [eat] excessive amounts of unhealthy and fattening food. This would lead to confrontations with Dr. Nowzaradan in which he would criticize her for not being able to follow the diet.” The lawsuit also stated that Perkins ended up being hospitalized on the show to have her diet monitored, despite the fact that she was losing — not gaining — weight.

My 600-lb Life didn't show you Dr. Now's detailed diet plan for his patients

So what exactly replaces the burgers, fries, and shakes that My 600-lb Life stars have come to rely on prior to appearing on TLC’s ever-popular reality TV show? A high-protein, low-fat diet, according to Distractify. Upon visiting Dr. Now, patients receive a customized diet plan — one that is meant to dramatically reduce their caloric intake to 1,000 to 1,200 calories daily.

According to Dr. Now’s website, whatever your goal weight is, “nutrition is instrumental in achieving or maintaining it.” For women, he recommends they eat the following on a daily basis: Five to six one-ounce servings of grains like brown rice and quinoa, healthy fats like fish, nuts, and olive oil as well as fruits and veggies, among other healthy foods.

It’s necessary for Dr. Now’s patients to get used to the restrictive diet as they will be unable to eat as much following gastric bypass surgery. “Weight loss surgery may address the mechanics of how much food you will need in order to feel full, or how much of the nutrients and calories are absorbed into your system,” Dr. Now’s site explains, “but the surgery does not control your own post-surgical behavior.”

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