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My 600-lb Life is back on TLC with more candid stories of dramatic weight-loss journeys. The 11th season of the reality series premieres Feb. 1 with an episode that focuses on Geno. The 31-year-old is closing in on 700 pounds and has decided that it’s now or never if he wants to take charge of his health. 

Dr. Now meets with his new patient in the ‘My 600-lb Life’ Season 11 premiere  

In a teaser (via Twitter) for the first episode of the new season, Geno and his family sit down for an appointment with Dr. Younan Nowzaradan. The Houston-based bariatric surgeon wants to know why Geno has decided now is the time to lose weight. 

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