Last year, fans of TLC’s hit reality show My 600-lb Life were introduced to Kirsten Perez, whose 612-pound frame made even getting in and out of a car nearly impossible. “Getting out to the car should be two seconds, but it takes me like, ten minutes,” she said. One day when she tried to get into her mother’s vehicle, she yelled, “I can’t do it! I can’t fit. I can’t do it. It’s not working. I just want to go back inside.”

At the time, Kirsten’s mother, Cris McKee, 60, said, “If Kirstin doesn’t take some dramatic steps to change her eating, she’s going to lose her mobility, and be bed-bound. If I can’t get that door shut then I don’t know what we’re going to do. I’m going to really have a hard time trying to get her out of this house.”

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Luckily, with Dr. Nowzaradan Younan‘s help, the reality star was well on her way to achieving that goal, though she proved to be difficult to work with. The Washington native revealed that she had been gang raped when she was just 17 years old, and he told her that he would discontinue weight loss treatment if she didn’t seek out the help of a therapist first. Eventually, she chose to accept Dr. Now’s proposition.

“Let me be clear — you go to a therapist or there is nothing more I can do for you,” he told the 38-year-old at the time. “Outside of a medical emergency, we are done. Do you understand me?” In a separate interview, he said, “This is not a good situation at all. I’m really disappointed right now in Kirsten… She needs a wake-up call.”

Kirsten agreed to see psychiatrist Lola Clay, who was able to help her open up about her past. “You have written a narrative in your mind where you’re just as culpable as the perpetrators,” Lola told Kirsten during their session. “Let go of [the] responsibility… It’s important that you skew your thinking toward the positive.” Lola linked Kirsten’s binge-eating to self-inflicted punishment stemming from the incident.

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To make matters worse, Kirsten’s father, Kurt, was persistent about his daughter being able to do things for herself, even if it was difficult for her — which triggered more anger. Even after losing more than 100 pounds following gastric bypass surgery, he said, “I really didn’t expect her to do nearly as well as she has done with it.”

Today, however, Kirsten is down 170 pounds and counting. The 38-year-old showed off her slimmer figure in a photo on Facebook, where she gets the support from fans. “You look amazing,” one commenter wrote. Another added, “Wow you look wonderful! Keep up the great job!”