Dr. Now Tells Seana "There Is Not Much More We Can Do"

Another week has gone by and you know what that means: Another patient making their way down to Texas for a Dr. Now visit. For the uninitiated, Dr. Now is the celebrity bariatric surgeon and star of My 600-lb Life, who, through his signature tough-love program, helps morbidly obese patients turn their lives around.

In Season 8, Episode 9, we get to see a year in the life of Seana Collins, a 23-year-old Kansas City native whose weight is at 660 pounds when we meet her. "Every day of my life feels like it's harder than the last and like things keep getting worse for me because of my size," she says upon introduction, adding that she doesn't "want to look this way" and feels "like [she's] trapped most of the time because of how hard it is to move and get around."

So, how is Seana doing now that the show has stopped filming? Has she managed to lose any weight since being in Dr. Now's care? Keep reading for everything you need to know about her progress on the show. (Fair warning: Some spoilers ahead.)

Seana feels "like a monster just walking around" and hates her body "more than anything in the whole world." She might be one of the youngest cases we've seen on the show this season, and she explains that a lot of her early weight gain came from the fact that she was raised in an abusive home.

"I've had a really hard life," she says, "and I feel like it's just been chaos since I was born." Her dad would abuse Seana mentally and physically, and she came to turn to food for comfort from an early age. "Eating made me feel like I was going to be OK, like nothing got worse," she says.

At 8 years old, she weighed more than 150 pounds, at 10, she had put on another 100 pounds and weighed more than 250 pounds. "Kids started making fun of me for how big I was," she says of not having friends. "My perspective was that I had food as my friend and didn't need anyone else," she shares.

By the time she reached high school, Seana weighed 400 pounds and the teasing got so bad at school that she decided to drop out at the age of 16. But having nothing to do at home led to a depression spiral, and soon she was committed by her mother to a mental hospital. 

For the following year, by her account, all she did was eat food. But she also invited a man she met online to move in with her, and through his dependency, Seana too became addicted to meth. "It was a downward spiral until my mom came and got me," she recalls. She checked herself into a mental hospital once again, and after her release, continued eating to cope.

So, by the time we meet her, Seana's situation is dire. Her mother takes her down to Houston, where Dr. Now is based and Dr. Now essentially predicts upon their first meeting what we see unfold over the next hour and a half on screen. "My concern about Seana right now," he says, "is that she doesn't seem too motivated to start turning her life around."

It's honestly impressive how Dr. Now can identify the patients that will end up losing weight from those who won't in the first few seconds of meeting them, and it's especially wild because everyone enters his office talking the talk and saying all the right things. 

Anyway, back to Seana. As Dr. Now predicts and despite the words that come out of her mouth, Seana is not committed to changing her life around. As seasoned viewers know, Dr. Now requires his patients to prove their commitment to him by losing weight on their own in the first few months of treatment—and only then does he give the green light for gastric bypass surgery. In short: Seana never does.

At the weight check-in required around the two-month mark, Seana just bails. "I was too scared to go," she says. Why? Because she has misplaced Dr. Now's diet printout and "was too scared of what he would say" to ask for another.

Dr. Now, as you can imagine, is not happy when she finally does arrive a few months later and rather than losing 40 pounds per month, has lost only one pound.

Seana misses her six-month appointment as well, and Dr. Now decides that she needs to fly down to Houston because her weight is clearly not losing itself. That's the first and only time we see her lose any weight — she drops 35 pounds. "I've never lost that type of weight before," she confesses with excitement. At this point, viewers are led to think that she might just have the best character arc and plot twist of the season...

But that's sadly not the case. Seana begins therapy, at Dr. Now's suggestion, but that leads to her reverting to old coping mechanisms (i.e. binge eating) to deal with the topics that therapy is bringing up. By month 10, she gains 13 pounds rather than lose weight. "I think the therapy messed me up," she says. "And it's terrifying because Dr. Now said I only have one chance left 'cause without this I'm doomed, I'm going to die soon."

And alas, by the time her last chance does come around, she gains 25 pounds, which puts her at a higher weight than she was when she arrived. Sigh. "You're going down the wrong path even faster now," Dr. Now laments, reminding her that she "just turned 23" and needs to make huge changes if she wants to keep living her life. 

"You don't have any support from your family ... you have depression, anxiety and multiple issues you need to take care of," he attempts in a moment of tough love. "I know it's very hard when you are alone but you need to decide if you want to change your situation and live or if you want to continue on this path you are on." "Until you decide to start making the changes you need," he continues, "we are out of options with nowhere to go."

That said, he does tell her that she can come back into his care if she loses significant weight over the next six months, and now that she's moved down to Texas permanently and started water aerobics, we hope for Seana that that's what she'll do.

New episodes of My 600-lb Life air Wednesdays at 8 p.m. on TLC.