Checking in on the cast of My 600-lb Life Where Are They Now Season 10 feels a bit like catching up with old friends who have been through the absolute ringer. It’s heavy stuff. We watch these people at their absolute lowest points, usually trapped in a bed or a single room, and then we see them fight like hell to get a second chance at a normal life. But the show ends. The credits roll. We’re left wondering if the progress actually stuck or if the crushing weight of reality—and old habits—took back over once the TLC production trucks packed up and left town. Honestly, the success rate for Dr. Nowzaradan’s patients isn't always a sunshine-and-rainbows story, and Season 10's follow-ups proved that the "after" is often harder than the "during."
Success isn't just about a number on a scale at the Houston clinic. It's about not dying.
The Reality of Lucas Higdon’s Transformation
Lucas Higdon was a standout in the early episodes of this follow-up season. When we first met him, he was stuck in a cycle of depression and severe limited mobility, living in a small space on his family's property. He was essentially a prisoner of his own body. By the time his update in My 600-lb Life Where Are They Now Season 10 aired, he had become one of the most legitimate success stories in the show’s history. It’s rare to see someone take to Dr. Now’s strict "1,200 calorie, high protein, low carb" diet with that much discipline.
He didn't just lose the weight; he found a career. He started working in IT, which is a massive leap for someone who previously couldn't stand for more than a few minutes without agonizing pain. His story matters because it debunks the idea that surgery is a "magic pill." Lucas had to rewire his brain. He started going to the gym, and not just for the cameras—he actually seemed to enjoy the movement. His social media updates since the episode aired show a man who is unrecognizable from the guy crying in the shower in his debut. He’s thinner, sure, but he looks alive.
Where Things Got Complicated for Dolly Martinez
Then you have someone like Dolly Martinez. If Lucas is the gold standard for success, Dolly’s journey represents the chaotic, messy reality that many patients face. Her follow-up episode was, frankly, hard to watch. It wasn't just about the food. It was about the lack of a stable support system and the mental health hurdles that often go unaddressed when people focus solely on the physical weight.
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In her update, we saw her bouncing between living situations, struggling with her relationship with her mother, and failing to maintain the discipline required for long-term weight loss. It’s a stark reminder that obesity is frequently a symptom of deep-seated trauma or neurological diversity that a gastric sleeve can't fix. Dr. Nowzaradan often emphasizes therapy, and Dolly’s segment in My 600-lb Life Where Are They Now Season 10 highlighted why that’s the most critical part of the program. Without a stable mind, the body stays stuck. Since the cameras stopped rolling, Dolly has stayed relatively quiet, but her journey remains a cautionary tale about the importance of environment. You can't heal in the same place that made you sick.
The Tragedy and Triumph of the Assanti Brothers
You can't talk about this show without mentioning Steven and Justin Assanti. They are easily the most divisive figures in the franchise's history. By the time we got to the Season 10 updates, the dynamic hadn't changed much, but the stakes felt higher.
Steven, who has faced accusations of faking pain to get medication and being generally abusive to staff, claimed to have changed. But viewers were skeptical. Justin, on the other hand, has consistently tried to distance himself from his brother’s shadow. He’s been focusing on his hobby shop and trying to live a life that isn't defined by his brother's antics. The "Where Are They Now" segments for the Assantis usually involve a lot of shouting and very little actual weight loss from Steven, while Justin tries to maintain his peace. It’s a bizarre sub-plot in the TLC universe that feels more like a psychological thriller than a weight-loss documentary.
Why Some Patients Disappear After the Show
Have you noticed how some people just... vanish?
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It’s actually a common trend. After My 600-lb Life Where Are They Now Season 10, several cast members went dark on social media. There are a few reasons for this.
- Contractual Obligations: TLC has notoriously strict NDAs. If a cast member is filming for a future season, they can't post photos of their current body because it ruins the "reveal."
- The "Failure" Stigma: If someone gains the weight back, the last thing they want to do is face the vitriol of the internet. People can be incredibly cruel to these individuals, forgetting they are dealing with a clinical addiction.
- Legal Battles: Some former cast members have actually sued the production company, Megalomedia, alleging that the show didn't provide adequate mental health care or pressured them into situations for drama. While many of these suits have been dismissed, they often result in the cast member cutting ties with the public.
The Longevity of Dr. Now’s Program
People ask if the diet is sustainable. It's basically a modified ketogenic approach but much stricter on calories. Dr. Nowzaradan isn't trying to be a gourmet chef; he’s trying to keep people from a heart attack. The patients in Season 10 who succeeded were the ones who stopped viewing the diet as a temporary "fix" and started seeing it as their new biology.
Take a look at the data. Long-term success for bariatric surgery is actually quite low if the patient doesn't commit to permanent lifestyle changes. We're talking about a 5% to 10% success rate for maintaining significant weight loss over five years. That’s why the "Where Are They Now" episodes are actually more important than the original ones. Anyone can lose weight for a few months when they're scared of dying. Keeping it off for two years while dealing with a breakup, a job loss, or a pandemic? That's the real fight.
What You Can Learn from Season 10
If you're watching these updates because you're on your own health journey, there are a few "unspoken" takeaways that the show doesn't always spell out.
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First, the scale is a liar. We saw patients lose 100 pounds but still be unable to walk because their lymphedema was so bad. You have to focus on mobility first. Second, the "enablers" are usually the biggest hurdle. In almost every episode of Season 10, the person bringing the fast food to the bed is the one who needs the most therapy. If you're trying to change your life, you have to change your circle.
Third, skin removal surgery is the "hidden" goal. Many of the people in this season were desperate for it. When you lose 300 pounds, you’re left with literal sheets of skin that can weigh 20 to 50 pounds on their own. It’s painful, it causes infections, and insurance often refuses to cover it because they deem it "cosmetic." For the cast of Season 10, getting that surgery was the final hurdle to feeling human again.
Moving Forward: The Next Steps
If you are following the lives of these individuals or trying to apply their lessons to your own life, keep these points in mind:
- Audit your environment. Like we saw with Dolly, if your living situation is chaotic, your health will be too. Focus on stability before you focus on a calorie count.
- Mental health is the foundation. Don't ignore the "why" behind the eating. Most of the Season 10 cast had significant childhood trauma that they were "eating away."
- Celebrate the non-scale victories. Lucas getting a job was a bigger win than him losing another 20 pounds.
- Stay skeptical of social media. Just because someone isn't posting doesn't mean they've failed, and just because they post a "thin" photo doesn't mean they aren't struggling.
The journey doesn't end when the season does. For the cast of Season 10, every single morning is a choice between the old life and the new one. Some are winning that battle today, and some might be losing it, but the courage to do it in front of millions of people is something most of us will never have to experience.