James King’s mother was an alcoholic and absentee parent and died the same day that his family lost everything in a house fire. Feeling he lost everything in a single day, depression set in which caused his weight to balloon and kept him away from school and social activities.

By the time King appeared on the show in Season 5, he weighed in at 791 pounds and was completely bed-bound. He relied on his wife and children to feed and clean him, with his youngest daughter dropping out of school to tend to his multiple health needs.

Frequently prone to cravings, King had trouble sticking to the plan set before him. He continually bucked Dr. Now’s medical advice, opting instead to eat fast food, which lead King to fail to meet the weigh-in requirement for bariatric surgery.

King appeared on "Where Are They Now?" in 2018 and by the end of the episode, he had gained weight despite being on a Dr. Now-approved diet. The doctor accused King’s wife of sneaking him food, and when King refused to ban his wife from the hospital, he was dropped from the program.

King died on April 3, 2020, at the age of 49. While he had lost 340 pounds since his last TV appearance, his heart gave out after he experienced liver and kidney failure. James was survived by his wife Lisa, four daughters, two sons, and 19 grandchildren.