Johnson Coitino’s scale first hit 300 pounds when he was in his 20s. He had always loved sports as a spectator, but wasn’t physically active himself. In his mid-30s, Johnson’s sedentary lifestyle continued because his job as a construction manager didn’t require regular heavy-lifting. And the meals Johnson craved most were heavy and fatty, a combination that led to additional weight gain.

For 15 years, he’d buy gym memberships, but he never worked out for more than a month. Johnson felt self-conscious in large, crowded gyms, and he didn’t have a workout plan or any knowledge about fitness or nutrition. Eventually, he’d always return to his old habits, and his weight continued to creep up. When he reached 380 pounds, Johnson’s doctor warned him he had early signs of fatty liver disease. Johnson was also experiencing excruciating lower back pain, and an MRI showed a herniated disk. His doctor recommended weight loss.

A rare trip to enjoy an out-of-town wedding was a turning point for Johnson. His airplane seatbelt didn’t fit properly, and he felt humiliated when he had to ask for help from a flight attendant. Then, in one of the few vacation photos he’d taken, he reflected on his true size and realized he needed professional help to lose weight and get into shape.