The 'before' picture here shows us a man who's lost control of his weight. In his case though, it had happened not only once, but five or six times. For most of his adult life, he'd gained up to 100 pounds at a time, worked hard to get it off, and then put it all on again. Infuriated with his own lack of discipline, things took a dark turn for him one night when he found he'd hit 360 pounds, and his trousers no longer fit. He took an overdose, and tried to end his own life.
He shouldn't have survived, but he did. He took that as a sign that he was still supposed to be here, and that he should take control of his life. Once again, he devoted himself to shedding all the extra weight. This time he not only did better than ever, but he's also managed to keep it all off for good. He's almost 200 pounds lighter than he was on that awful day.