The two-hour follow-up kicked off a little over a year after Alicia’s first meeting with Dr. Younan Nowzaradan (aka Dr. Now) and about seven months after her initial weight loss surgery. She was down to 424 pounds and had committed to working out at the gym three times a week.

By the end of the episode, Alicia had been actively losing weight for two years and had dropped a remarkable 366 pounds. She admitted to Dr. Now that she hadn’t been in the 250s since middle school or possibly grade school. 

"My whole world has completely changed," Alicia told the camera. "I’m feeling more independent than ever, and I’m starting to figure out who I am and all the things I want out of life, so I couldn’t be happier."

If she continues down the path she’s currently on, Dr. Now said Alicia could be ready for skin removal surgery by her next appointment. That’s another 40 pounds she won't have to keep lugging around. 

"I’m really excited because, for so many years, I felt like this hideous creature that everybody was whispering about and secretly laughing at because of how large I was," Alicia confessed. "But now, I feel good about myself for the first time in my whole life."