When Sal Paradiso was a senior in high school, his father died of a heart attack at age 42. The teen, who had always been the heaviest student in his class, comforted himself with food and steadily gained weight.
By the time he was in his early 30s, he weighed about 700 pounds. As he struggled to stand in the shower, get out of bed or cook food without getting winded, he thought life shouldn't be so difficult.
"I wasn't getting any younger and I realized I had to make a drastic change or I would end up like my father," Paradiso, 35, of Land O' Lakes, Florida, told TODAY.
In February 2014, he visited a doctor for a consultation for weight-loss surgery. He was so heavy that the office scale couldn't register his weight. The doctor and nutritionist put him on a strict low-carb, high-protein diet, noting he had to shed weight before surgery.
"As someone who was eating upwards of 10,000 calories a day prior to it, it has been a monumental change and it is what worked for me," he said.
© Sal Paradiso At his heaviest weight, Sal Paradiso estimates he weighed about 700 pounds. He's unsure because he could not find a scale that could register his weight.
While he dropped pounds right away, he wasn't sure how much he lost initially because he didn't know what his starting weight was. Then he started dropping seven or eight pounds a week. Because he weighed so much, exercise was difficult.
"Early on, I really couldn't work out. When you are that big, it is hard to move around. Fortunately for me, my family has a swimming pool," he said.
Paradiso swims laps — he must do low-impact exercise because his years of being extremely obese ruined his knees.
As he slimmed down, he added free weights to his routine and also started riding an exercise bike.
Over two years, he lost 254 pounds and underwent surgery in the summer of 2016, which helped him lose another 120 pounds.
In total, he lost 374 pounds. The tremendous weight loss means he has excess skin hanging from his 6-foot frame — about 65 to 80 pounds worth of it — and Paradiso is trying to raise money
for skin removal procedures.
These surgeries can be expensive, according to Dr. Jeffrey Gusenoff, a plastic surgeon and co-director of the University of Pittsburgh Medical Center's BodyChangers
, a lifestyle and support program for people who are trying to lose weight or have lost weight. On average, each surgery costs between $4,000 to $6,000, plus extra costs for anesthesia and a hospital stay.
"(Insurance companies) often will cover the abdominal skin removal, but insurance companies often require that the patient proves medical necessity by having persistent rashes that require either prescription creams or oral antibiotics to treat rashes under the skin folds," explained Gusenoff. "This extra skin must also hang low enough to block the genital region or thighs. Arms, thighs, breasts, buttocks and other areas are often not covered and are considered cosmetic."
Paradiso's excess skin causes him physical pain — it chafes and he gets sores and infections — and it makes him feel insecure at times.
"You are making all this progress," he said. "But your shell resembles someone you no longer are."
© Sal Paradiso At 32, Sal Paradiso realized if he didn't lose weight, he might end up like his father, who died of a heart attack at age 42.
Yet, Paradiso wants others to feel inspired by his story.
"Change is possible. I speak as someone who was 700 pounds," he said. "I'm a pretty happy guy and I am a lot happier today than I was three years ago."
Here is his advice to others hoping to lose weight.
© Sal Paradiso Since losing 374 pounds, Sal Paradiso has been able to enjoy an active life more.
1. Get by with a little help from your friends.
Friends and family supported Paradiso as he worked to lose weight. Hearing encouraging words motivated him on days when it felt too hard.
"My friends and family continue to push me every day," he said. "If you can surround yourself with a decent enough support system … you can overcome 10 or 15 years of beating yourself to the ground by putting on so much weight."
2. Set reasonable goals.
Paradiso wanted to weigh between 200 to 225 pounds, a loss of 475 to 500 pounds, and more than half his starting weight (though about 65-85 of it is skin, which cannot be lessened no matter how intense the dieting and exercise).
Thinking of losing so
much weight seemed insurmountable.
"Looking at it in smaller pictures … it is possible to conquer the mountain," he said.
3. Know what motivates you.
Looking at pictures of his father encouraged Paradiso when he struggled.
"He is a constant reminder of why I do this," he said.